High-Tech Solutions for Underserved Populations

1. High-Tech Solutions for Underserved Populations Alabama’s Medicaid Application En Español/Hablamos Juntos Alabama

2. In the Unites States, more than 21 million people cannot speak English effectively.

3. That equates to about one in every thirteen people.

4. Alabama’s LEP Population In Alabama, the number of individuals with limited English proficiency (LEP) is rapidly increasing.

5. Alabama’s LEP Population Year 2000 census figures indicate that: • Hispanics are the fastest growing minority group in Alabama • Their numbers have more than tripled between 1990 and 2000

6. Increasing Use of Technology at LEP Access Points • A self-guided program loaded on a computer kiosk, which helps clients complete the application process. • A desktop phrase communication tool for Medicaid Specialists to assist clients with the application. In order to increase the use of technology at LEP access points, En Español collaborated with a medical informatics specialist to develop two software solutions to facilitate the Medicaid application process.

7. Rationale • The Medicaid, All Kids and Alabama Child Caring Foundation (ACCF) programs all use the same application process and form. • Many LEP Latinos have children who are eligible for state-sponsored services although the parents may not be.

8. Product Description The Self-Guided Kiosk Module • Clients interact with touch screen technology using a self-guided process directed by the computer • Digitally recorded instructions in the client’s selected language of preference are played along with a narrative of the application requirements • Clients interact with the screen and input basic information that pre-determines whether or not they qualify, before being directed to the full application

9. Product Description The Self-Guided Kiosk Module (cont’d) • The software matrix then guides clients through a series of questions to gain more pertinent information (name, address, marital status, income level, etc) • The computer then generates a preliminary application that can later be processed by a Medicaid Specialist who makes the final eligibility determination • The system also produces a list of all documents required to verify the application, in the client’s language of preference

10. Product Description The Desktop Phrase Communicator • This product is used to facilitate dialogue between Medicaid Specialists (MS) and clients • It includes a series of indexed topics and corresponding questions and phrases displayed in English on the Specialist’s computer screen • When the Specialist selects a phrase with the mouse, the computer will play a digital recording of the phrase in the patient’s language of preference

11. Product Benefits The combination of these products would: • Reduce the current work load on Medicaid Specialist • Create a larger number of entry points for LEP individuals into Medicaid services • Make it more convenient for individuals to apply • Help to increase overall comprehension of the process by applicants • The kiosk module also has the potential to benefit English-speaking clients as well.

12. References • U.S. Census Bureau, “Language Use and English-Speaking Ability: 2000.” • Cindy Brach, Irene Fraser, and Kathy PaezCrossing The Language ChasmHealth Affairs, March/April 2005; 24(2): 424-434. • Leighton Ku and Glenn FloresPay Now Or Pay Later: Providing Interpreter Services In Health CareHealth Affairs, March/April 2005; 24(2): 435-444.