Colorado Conversations

1. Colorado Conversations AHEC, Advocacy, Policy, and Polling

2. AHEC and Advocacy

3. Participants will be able to: • Describe how AHEC can engage the community on healthcare policy • Begin to utilize real-time polling in their healthcare policy presentations • Define the parameters for AHEC-Community collaboration around healthcare policy and advocacy.

4. Colorado Conversations Grant • Build Colorado AHEC Capacity for healthcare policy and advocacy leadership • Develop the Colorado AHEC Advanced Advocacy Leadership Fellowship. We all helped develop this and took it. Several took a formal Policy Fellowship as well • Build rural and community capacity for improved healthcare advocacy leadership • Partner with additional organizations to fund Fellowship and provide participants • Recruit 10-12 community leaders for Fellowship • Facilitate a local-statewide conversation about healthcare policy and advocacy • Facilitate local discussions (5-6 per year in each AHEC)

5. This workshop will focus on our Colorado Conversations • Colorado Conversations • Develop and deploy a centralized clearinghouse of healthcare information and conduct a series of local community events relating to 3 major areas: the health of rural and disadvantaged communities, access to health insurance, healthcare providers and medical facilities, and developing a stronger healthcare workforce.

6. Workshop Roadmap • Introductions • Do part of a Colorado Conversation • Discuss how to implement Conversations • Learn about real-time polling • Discuss how you might use this approach and this technology in your AHEC • Complete your evaluation form • Go home happy

7. Here’s how we start a Conversation Provocative Title • Tell a short story or vignette • Introduce ourselves • Move to the next slide

8. Agenda - • Welcome • Introduction to keypads • Demographic questions – Who is in the room? • Overview of Language Access to health care services – What is it and what are its effects? • Questions on Language Access – How do you view the issue, its barriers, and effects? • Next steps • Adjournment

9. We will go through part of our conversation on Limited English Proficiency and access to healthcare Colorado Conversations Language Access to Health Care Services in Colorado

10. Demographic Questions Who’s in the room?

11. Demographic Questions Who’s in the room?

12. What is Language Access? • Ensuring access to health care not just a matter of having coverage and having enough providers • Being able to communicate effectively and navigate the system equally important to having adequate access • Studies show that effective communication between providers and patients is essential to: • access • quality • likelihood that patients will adhere to treatment plans • All important to successful outcomes

13. What is Language Access? • Ensuring access to health care not just a matter of having coverage and having enough providers • Being able to communicate effectively and navigate the system equally important to having adequate access • Studies show that effective communication between providers and patients is essential to: • access • quality • likelihood that patients will adhere to treatment plans • All important to successful outcomes

14. Why is Language Access important? Language barriers can have many effects: • Patient safety • understanding of prescription medications and other diagnostic explanations and directions • Access to primary and preventive care services • English speakers much more likely to have a usual source of care • Treatment effectiveness • understanding directions and securing follow-up care • Quality of care • interpreted patients more likely to receive right care at right time • Increased costs • excessive diagnostics, longer ED stays, more admissions • Impacts on providers

15. What are the current requirements around Language Access? Federal Requirements • Protection against discrimination on the basis of national origin • Title VI of the Civil Rights Act of 1964 • All entities receiving federal assistance mandated to comply with standards for language access • Health care agencies include those administering or accepting Medicaid, Medicare or other govt programs • Standards: • Patients have right to receive interpretation at no cost • Facilities must inform patients of this right in preferred language • Facilities must ensure competency of interpreters and only utilize family and friends at request of patient • Signage and written materials must be available in common languages for that community

16. What are the current requirements around Language Access? State Requirements • More limited in scope than federal requirements • specific to industries and particular situations • managed care, services for developmentally disabled, administration of state health coverage programs, mental health and long term care facilities, senior care services Credentialing Organizations • Many credentialing organizations have requirements that go beyond federal and state mandates • e.g.: Joint Commission on Accreditation of Healthcare Organizations has strict requirements before granting accreditation

17. What can communities and facilities do to support Language Access? Individual providers, health care facilities, and other local health agencies can take immediate action to support access for residents with LEP in their communities • Simple changes to organizational policies • Bilingual (or multilingual) signage • Translated medical and administrative forms • Partner with local groups to provide trained volunteer interpretation • Basic changes to organizational climate • Spanish language magazines / TV in waiting rooms • Training staff to be culturally competent • Overall culture of inclusiveness and respect

18. Where can I go for more information? • U.S. Department of Health and Human Services, Office of Minority Health:http://www.omhrc.gov/ • Colorado Department of Public Health and Environment, Office of Health Disparities: http://www.cdphe.state.co.us/ohd/ • Colorado Progressive Coalition:http://www.progressivecoalition.org/ • HablamosJuntos, Language Policy and Practice in Health Care:http://hablamosjuntos.org/

19. Let’s shift a bit • That was an abbreviated Conversation • Break • 5 minutes stretch • Next Up: how to do this in your AHEC

20. San Luis Valley Area Health Education Center PRESENTS “Colorado Conversations for Better Health Care Policy” Do you think Colorado needs to reform its Health Care System? Are you satisfied with your Health Care Costs? Do You have Health Care Insurance? If these and other questions regarding health care services in Colorado concern you, please attend the Student Conversation on Better Health Care Policy Date of presentation: April 23, 2009 Location: Porter Hall - Room 128 Time: 6:00 p.m. Pizza will be served! Conducted the San Luis Valley Area Health Education Center These Conversations are funded in part with a grant from The Colorado Trust through the Colorado AHEC System Office

21. Costilla County Department of Social Services and Costilla County Public Health Agency

22. Schedule of Conversations

23. Where do we do these talks? • Our Boards • Our Students • AHEC Partners • Community Groups • Rotary • Chamber of Commerce • Hospitals and Clinics

24. Alamosa County Public Health Agency

25. What Topics? • Short-term responsive • House Bill 09-1293The Colorado Healthcare Affordability Act (2009 Colorado Legislative Session • Health Care Reform 101 – • Colorado Fiscal Policy – with Bell Policy Center (2010 Ballot Initiatives) • Long-term • Limited English Proficiency • Advocacy and Policy 101

26. Sign-In Roster serves many purposes

27. Real-time key pad polling • Other uses • Evaluation of programs • Get demographics of participants • Start a discussion • Classroom – test class and address problem areas • Other?

28. Why Key pad polling • Collect data • Start a discussion • Anonymous • Can comment on how the group answered • Engaging to audience to get immediate feedback • Ask for audience participation. • Specifically ask for folks to talk. One answer or the other. • Gives them the sense they are not alone

29. Guatemalan Community

30. EVALUATION FORM • Guage for Presentation Effectiveness • Help plan next Conversation • Allows audience to provide feedback • Find out what topics are of interest • to audience • Assists in reporting to funder

31. Colorado Conversations • 50 Conversations • >2000 • Broad and Deep • Start with Broad Conversations • From these develop deeper long-term relationships • Ongoing conversations • Individual policy ideas • Action step

32. Select choices, then push “Enter” on keypad. Based on today’s discussion and my current understanding of this issue I would be willing to:(choose up to 4 responses) Urge my institution to begin to offer (or increase) clinical placements Become a preceptor Post the Workforce Collaborative’s report on my website Contact my state legislator by phone, email, or mail to express support for some or all of these policies. Testifying during a committee hearing at the Capitol Join the Health Care Workforce group at EngagedPublic.com in order to stay informed and get involved Other None of the above

33. Mini-Bighorn and ongoing conversations • Lamar • Sterling • Aurora Chamber • LEADS

36. Polling Logistics

37. Let’s actually build a question and then answer it. • How to engage the group using polling and immediate answers • What question shall we ask. • Healthcare policy • Federal reform • Local issue

40. Turning Point Technology – Real Time Polling. http://www.turningtechnologies.com/ • Colorado Trust Foundation initiative to expand healthcare coverage. http://www.coloradotrust.org/program-areas/expanding-coverage

41. Colorado Conversations

42. End

43. Abstract • Colorado AHEC conducted a statewide effort to improve the knowledge and skills of community members to participate in healthcare policy and advocacy work. This interactive workshop will provide participants with the basics on how to engage community members in healthcare policy and advocacy work using innovative and interactive real-time polling technology.

44. The Colorado AHEC is conducting a statewide effort to improve the knowledge and skills of Colorado community members to participate in healthcare policy and advocacy work. After participating in an online health policy course, the Colorado AHECs actively engaged their local communities in Conversations for Better Healthcare Policy. These Conversations were developed and deployed using a centralized clearinghouse of healthcare information and by conducting a series of local community events relating to 3 major policy areas: access to primary care, institutional policy for Limited English Proficient community members, and healthcare workforce. In the first year over 37 Conversations were conducted reaching over 900 community members. • Colorado Conversations include the innovative use of real-time polling devices to increase the interactive nature of our presentations. The real-time polling is a valuable tool to increase conversation, interaction, and data collection. • The workshop will be divided into 2 general sections. The first will be to describe the Colorado Conversations, our topics, mission, and methods for engaging the community in meetings and events while maintaining a neutral convener role. We will include interactive components as the participants identify ways to engage their communities, and identify possible relevant topics for healthcare policy conversations in their regions and states. • The second portion of the workshop will deal directly with the use of real-time polling in conducting Conversations. Real-time polling is a valuable tool for engaging the audience. We will provide ample opportunity to experience ways to use the polling devices to stimulate conversation, encourage participation from the audience, and collect data. Participants will be provided full access to the Colorado Conversations slide shows that may be customized for their local community. • This interactive workshop will provide participants with the knowledge and skills to begin engaging communities in healthcare policy work using tangible real-time polling technology.