Cultural Competency Cultural Competency 2011

Transcription

1 Cultural Competency 2011 Cultural Competency

2 Course Objectives In completing this course, you will: Define cultural competence as it relates to healthcare Define CLAS objectives and our program components Identify how company materials support cultural competency Identify the tools and resources WellCare uses to deliver on our CLAS objectives Identify your role in delivering culturally competent care and services

3 The Challenge Healthcare disparities may be exacerbated by many things including specific health conditions, differences in access to care, provider biases, poor patient-provider communication, and poor health literacy.

4 What is the Challenge? There is extensive evidence of disparities in the quality of health among racial and ethnic groups in the United States.

5 Offices and Hospital Settings To a non-english speaking patient, waiting rooms and service areas might look a lot like this.

6 Forms Filling out a simple form can be an intimidating experience

7 Patient Rapport Language barriers can put up an emotional shield between you and your patients.

8 Pharmacy Issues Reading prescription directions, dosages, and general conversation with a Pharmacist may seem impossible and incredibly frustrating

9 What is Cultural Competence? Cultural Competence in health care describes the ability to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients social, cultural, and linguistic needs.

10 Background Information Let s look at some background surrounding Cultural Competency

11 Background Information (cont.) Although important exceptions can be found, there is a general pattern of poorer health among members of racial or ethnic minority groups.

12 Fact More African-American and Latino children used hospital-based clinics as a regular source of care than their White counterparts in a nationally representative sample of individuals covered by Medicaid. Source: Lillie-Blanton, M, Martinez, RM, et al. Site of medical care: Do racial and ethnic differences persist? Yale Journal of Health Policy, Law, and Ethics, 2001, 1,

13 Fact Almost three in ten Latinos say they have had a problem communicating with health providers over the past year. 12% say this has been a major problem 17% say this has been a minor problem Source: Pew Hispanic Center, Health Care Experiences Survey Brief, March 2004.

14 Where it all starts CLAS Standards

15 Culturally Linguistically Appropriate Services 15

16 Who Issues CLAS Standards? The U.S. Department of Health and Human Services, Office of Minority Health is the issuer of national CLAS Standards. WellCare is committed to a continuous effort to perform according to these standards. 16

17 What Does It Take? The delivery of culturally competent health care and services requires health care providers and employees to possess a set of attitudes, skills, behaviors, and policies which enable the organization and staff to work effectively in cross-cultural situations. attitudes skills behaviors policies

18 Our Program Let s look at the Purpose, Benefits and Objectives of WellCare s Cultural Competency program.

19 WellCare s Cultural Competency Program Program Purpose WellCare s program purpose is to meet the unique and diverse needs of all members. Our staff values diversity within the company and members which we serve. Member communication needs are met. We are sensitive to cultural and linguistic differences. The needs of our members with disabilities are indentified, clarified, and fully addressed.

20 WellCare s Cultural Competency Program Program Benefits Cultural competency is a key component of our continuous quality improvement. Results Include: - Tangible gains in member satisfaction. & - Healthy outcomes for our members. * This ties directly to the company s fundamental mission.

21 Program Objectives

22 Program Objectives

23 Program Objectives

24 Program Objectives

25 Program Objectives

26 How Do We Achieve WellCare s Cultural Competency Objectives? (one way is through demographic research) 26

27 PROPERTIES Allow user to leave interaction: Show Next Slide Button: Completion Button Label: Anytime Don't show Next Slide

28 Regional Diversity

29 New York

30 Florida

31 Texas

32 Chicago

33 Hawaii

34 Research (cont.) Research also includes reaching out to community based non-profit organizations (such as the Kaiser Family Foundation) that support minorities, including the disabled and developing, and maintaining grass root sponsorships which reach out to low income communities.

35 Accountability and Readiness The Board of Directors is ultimately responsible for the program. The CEO ensures implementation and oversees day-to-day operations. The Director of Quality Improvement is responsible for internal cultural competency. Senior Management ensures training is conducted.

36 Diversity of Health Staff Bilingual staff is hired for functional units. Spanish is the most common translation required. In Georgia, two thirds of the Hispanic population is Mexican. In Florida and New York City, the Puerto Rican population is predominant. Staff is hired for other bilingual requirements as necessary.

37 Suitable Provider Networks WellCare recruits a diverse array of Providers. We strive to match the makeup of the Provider Network with the composition of the member community. Known language needs are used to match new members with Primary Care Providers (PCP s).

38 Educational Materials WellCare utilizes culturally sensitive and appropriate educational materials based on the member s race, ethnicity and primary language spoken. 38

39 Educational Materials (cont.) Materials that are used for member marketing and enrollment are tested and must be scored at the appropriate state required reading level. Materials are routinely prepared in both English and Spanish and available for translation in up to 39 different languages. 39

40 Educational Materials (cont.) WellCare typically prepares both Medicaid and Medicare materials in languages spoken by 5% or more of the member population. Materials are also created for persons with cognitive impairments. On request, WellCare can even convert materials into Braille. 40

41 Member Communications Certified Language Line WellCare ensures that resources are available to overcome the language barriers and communication barriers that exist in the member population. For urgent/emergent encounters, WellCare recommends the Certified Languages International (CLI) line be used. 41

42 Member Communications Vision Impaired Services For the vision impaired, Customer Service asks members if they would like assistance reading or listening to the marketing, enrollment, member-related or other support materials. 42

43 Member Communications Hearing Impaired Services For the hearing impaired, WellCare members have tollfree access to the Teletypewriting Device for Deaf (TTY/ TTD) line. Customer Service is responsible for making all follow-up phone calls that are necessary (Main Line) (IL/MO Medicaid Only) 43

44 Your Responsibilities

45 Your Responsibilities What can YOU do to insure that WellCare meets and exceeds CLAS standards when delivering culturally competent care?

46 Your Responsibilities Cultural and Linguistic Competency Requires You To: Develop skill sets that enable you to work effectively in cross cultural situations. For example: - Acknowledge cultural differences - Understand your own culture - Acquire cultural knowledge and skills - View behavior within a cultural context - Learn about cultural differences through WellCare University classes - Communicate appropriately for your cultural audience

47 Additional Information WellCare s Corporate Cultural Competency Policy WellCarelink > Corporate Compliance > Policies and Procedures > Compliance 360 US Department of Health and Human Services Minority Health Kaiser Family Foundation Minority Health Cultural Competency Steering Committee (CCSC) WellCare has also established a Cultural Competency Steering Committee (CCSC) that will work to insure that all WellCare members regardless of race, ethnicity, and primary language have equal access to quality health care services and health outcomes. Associates will receive more information on the CCSC, the committee structure, goals, and strategies over the next few months. 47

48 Course Summary You should now be able to: Define cultural competence as it relates to healthcare Define CLAS objectives and our program components Identify how company materials support cultural competency Identify the tools and resources WellCare uses to deliver on our CLAS objectives Identify your role in delivering culturally competent care and services

49 Thank You We hope you have enjoyed learning more about Cultural Competency as relates to WellCare, the healthcare industry, and that you will learn more about your own cultural differences and continue practicing self-awareness. See you next time!