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Communicating with your Clients:
Tools for Health and Social Service Providers
Lois Wessel, FNP-Associate Director for Programs, ACU
Center for Health Literacy
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Goal 1
Explain how language, culture and communication affect access to services and appropriate use of community resources
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Poor use of services
How are you taking it?
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Tip of the Iceberg
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Clients Bring…
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LANGUAGE AND
LITERACY
RELIGION AND SPIRITUALITY
COMMUNITY VALUES
POLITICAL SITUATION
ECONOMIC SITUATION
INSURANCE STATUS
HEALTH CARE SYSTEM
FAMILY BELIEFS AND
HISTORY
Cultural Norms
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Internal Factors
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External Factors
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Health Literacy
53%
12% 14%
22%
National Center for Education Statistics, 2006
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Goal 2
• Describe federal civil rights legislation and how it pertains to consumers with Limited English Proficiency
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Civil Rights Legislation
• Title VI of the Civil Rights Act of 1964
• President Clinton's 2000 LEP Executive Order (Executive Order 13166)
• Mandates compliance for agencies receiving federal funds
Who Is Covered by Title VI?
DHHS Guidance and Requirements
Culturally and Linguistically Appropriate Services
(CLAS) Standards • Directed at Health
Care organizations• Guidelines • Culturally
Competent Care• Language Access• Organizational
Supports
Additional Legislation
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Goal 3
• Assess the barriers your organization has to communication based on language, culture and literacy
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Barriers
FORMSINTERPRE-
TATION
LITERACY LEVEL
DIRECTIONSLOCATION
FRONT DESK
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Walk Through Office
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Welcoming
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Pay Attention to Signs
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Listen to Another Language
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Assessment Tools
• National Center for Cultural Competence• Cross Cultural Healthcare Program• HRSA• American Speech Language and Hearing
Association
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Goal 4
• Demonstrate how health and other social service agencies can create consumer friendly environments that address language, culture and literacy
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The Culture of Your Organization
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Organizational Commitment
Organizational Practice
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Example: LEP
• Purpose: MobileMed serves a diverse population of patients who speak a language other than English. MobileMed is committed to providing culturally-sensitive and language-appropriate care for each patient. High-quality interpretation services enhance the quality of clinical care provided by MobileMed. There are several ways in which interpretation services are provided at MobileMed.
• Guidelines and Procedures….
• Source: Mobile Medical Care, Inc. Bethesda MD
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I Speak Cards
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Appropriate Interpretation Services
http://www.access2interpreters.com/images/Interpreters.jpg
Linguistic Competence
• Language Access Services• Linguistically/culturally
competent Staff• Signs, brochures, posters
culturally and linguistically appropriate
• Health education materials culturally and linguistically appropriate
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Organizational Demands
• Intake Protocols• Dissemination of
Information• Use of community
partners• Office Flow• Office
Communication
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Staff
• Diversity• Staff Training• Performance
Review• Support for
Training• Self Assessment
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Goal 5
• Identify ways to incorporate low-cost consumer friendly tools into your office setting to reduce barriers to communication
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Universal Precautions Approach
Simple Signs
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Arlington Free Clinic
Appropriate Education
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Consumer Friendly Materials
• Simple font (12 pt)• Layout• Writing level• Appearance• Cultural context• Limit message to one or
two key points• Supplement with visuals• Plain Language
http://www.dshs.state.tx.us/diabetes/patient.shtm
Words Count
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Use of Community Workers
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Slide Idea: Tawara Goode, National Center for Cultural Competence, 2009
Pieces All Need to Fit Together
For More Information
Association of Clinicians for the Underserved (ACU)[email protected]
www.facebook.com/CliniciansfortheUnderserved
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@ACUnderserved
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