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Preconference Workshops
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Register
Online Now
for
The Fifth National Conference on
Quality
Health Care for Culturally Diverse Populations
October
17 - 20, 2006
Renaissance Seattle Hotel, Seattle, WA
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Preconference A Workshops
Workshop
A-1: Facilitating
use of interpreters as cultural mediators and cultural trainers for health
care providers
This workshop will draw on lessons learned from development and now twelve
years of operation of the award winning Community House Calls Program
at Harborview Medical Center which changed the roles of interpreters in
seven language groups to include advocacy and cultural mediation both
within the hospital, at home visits, and in the community. The workshop
will include:
Workshop
A-2: Growing Our Own: Reducing disparities in quality care through
culturally and linguistically competent workforce training
The President’s New Freedom Commission on Mental Health, the Surgeon
General’s Report on Culture Race and Ethnicity as well as the Institute
of Medicine’s Report Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care all highlight the disparities in quality care
for diverse populations, including Asian Americans, Native Hawaiians and
other Pacific Islanders. Developing a culturally and linguistically competent
workforce is one of the key strategies to improve the quality of care
for diverse populations and fills a major gap in the current service delivery
system.
The need for culturally competent services is frequently cited yet few
have actually defined what those competencies are or should be. In 2002,
NAAPIMHA developed the first national training curriculum to cut across
the disciplines of psychiatry, psychology, social work and counselling
to work with Asian Americans, Native Hawaiians and other Pacific Islanders
with funding from the US Dept of Health and Human Services, Center for
Mental Health Services. The training was developed by experts in the field
of AAPI mental health and was implemented and evaluated at sites in Seattle,
San Francisco, Denver, New York and Wai’anai. The Growing Our Own
training program was recently selected by the Annapolis Coalition for
Workforce Development in their national blueprint for workforce development
as an innovative and best practices model.
The training is a 40 hour curriculum that is divided into five modules
- Self Assessment;
- Connecting with the Client;
- Culturally responsive assessment and diagnosis;
- Culturally responsive interventions; and
- Culturally responsive systems.
The curriculum was developed with direct input from consumers as well
as other experts in the field and is based on the DSM IV Outline for a
Cultural Formulation that provides a rich theoretical framework that infuses
culture throughout each phase of assessment, diagnosis and development
of interventions. Its design makes it conducive to be modified for working
with other communities of color.
In addition to the curriculum, NAAPIMHA developed Standardized Patient
protocols that can be used to assess both the clinical skills of the interns
as well as the efficacy of the curriculum itself. Borrowed from medical
school training, this method has been shown to be an effective tool to
help medical students gain competencies in working with patients but had
not been developed for mental health training.
The presenters will offer an overview of the development of the curriculum,
an overview of the five modules and discussion of the outcomes. Participants
will learn how to incorporate culture into all levels of their assessment,
diagnosis and development of a treatment plan through the use of the Outline
for a Cultural Formulation found in DSM IV and learn the core competencies
that follow the five modules of the Growing Our Own training. They will
watch samples of training videotapes on the Standardized Patient to gain
an understanding of how it can be used as an effective training tool as
well as evaluation instrument. In addition, participants will be presented
with an overview of the National CLAS Standards (Cultural and Linguistically
Appropriate Services) and the Cultural Competence Standards in Managed
Mental Health Care Services. Depending on time, there will also be discussion
on the importance of supervision and other key areas that need to be addressed
in improving the current workforce including the integration of mental
health, primary health and substance use.
D.J. Ida, Ph.D. has over thirty years experience working with
the Asian American/Pacific Islander populations. She helped developed
the Asian Pacific Development Center, a specialty mental health agency
in Denver as well as NAAPIMHA, of which she now serves as Executive
Director. Dr. Ida sits on numerous national boards including the US
Dept of Health and Human Services, Center for Mental Health Services:
National Advisory Council, the National Mental Health Association, the
Research and Training Center of the Louis de la Parte, Florida Mental
Health Institute, University of South Florida, the National Multi-ethnic
Behavioural Health Association, and the Annapolis Coalition for Workforce
Development. She served as peer reviewer for the Surgeon General’s
Report on Culture Race and Ethnicity and was a contributing author for
the President’s New Freedom Commission on Mental Health’s
subcommittee report on Reducing Disparities, served as the Principal
Investigator for the federally funded Workforce Training project and
helped develop a training model for interpreters in the mental health
setting. In 2005 she was selected as a Fellow by the Asian American
Psychological Association.
Francis G. Lu, M.D., is considered one of the country’s
leading experts on AAPI mental health as well as cultural competency
in general. He is currently a Professor of Clinical Psychiatry at the
U of C, San Francisco as well as Dir. of the Cultural Competence and
Diversity Program, Department of Psychiatry at San Francisco General
Hospital, where he has worked for over 28 years. In 1991, UCSF awarded
Dr. Lu the Dr. Martin Luther King, Jr. Award for “extraordinary
leadership and inspiration in furthering the goal of achieving ethnic
diversity within the UCSF community”. As a Distinguished Fellow
of the American Psychiatric Association, Dr. Lu has contributed to the
areas of cultural psychiatry, psychiatric education, film and the transpersonal,
and the interface of psychiatry and religion/spirituality through his
presentations and more than 70 publications. In 2002, he received a
Special APA Presidential Commendation for his work in cross-cultural
psychiatry. In 2002, the National Alliance for the Mentally Ill awarded
him an Exemplary Psychiatrist Award for exceptional cultural awareness
and sensitivity. He served as Executive Scientific Advisor for a 58-minute
training videotape/DVD "The Culture of Emotions" about the
DSM-IV Outline for Cultural Formulation.
Janet L. SooHoo, MSW, is the Deputy Director for Asian Counseling
and Referral Service in Seattle, the largest pan-Asian multi-service
center in the Pacific Northwest. She oversees the operations of its
12 programs, including comprehensive outpatient mental health and substance
abuse treatment services. Ms. SooHoo is currently a Governor-appointed
member of the Washington State Mental Health Planning and Advisory Council.
She has also worked as a lobbyist on healthcare reform, children’s
issues, and human rights legislation. On a national level, Ms. SooHoo
has served as a Region X Mental Health Advisor to the Dept of Health
and Human Services; a Federal Block Grant Monitor for Community Mental
Health Services; a Grant Reviewer for the Substance Abuse and Mental
Health Services Administration (SAMHSA); a consultant for the Center
for Substance Abuse Treatment; is an Okura Mental Health Washington,
D.C. Fellow; and a founding board member for both the National Asian
American Pacific Islander Mental Health Association (NAAPIMHA) and the
National Alliance of Multi-Ethnic Behavioral Health Associations (NAMBHA).
Ms. Soohoo served as the primary editor for the Growing Our Own curriculum
and helped develop the training curriculum for interpreters working
in the mental health arena..
Ann Yabusaki, Ph.D. has been involved with AAPI mental health
and substance abuse issues for many years and served as the Principal
Evaluator for the Growing Our Own curriculum. In her capacity as lead
evaluator, she developed the standardized patient protocols used in
the training and evaluation of the project. This innovative approach
holds great promise as both a training and evaluation tool in for assessing
the cultural competence of clinicians at all levels of professional
development. A skilled trainer, Dr. Yabusaki has extensive experience
in teaching and served as Dean of the American School of Professional
Psychology, San Francisco Bay Area Campus, Point Richmond, CA., the
President and Dean of the Rosebridge Graduate School of Integrative
Psychology, Concord, CA, and served as a core and adjunct faculty member,
John F. Kennedy University, Graduate School of Professional Psychology,
Orinda, CA, where she helped to create and implement a Doctor of Psychology
program integrating multicultural competencies. She currently serves
as Director of Substance Abuse for the Coalition for a Drug Free Hawaii
and maintains a private consulting practice
Workshop
A-3: Eliminating health disparities through medical education: a hands-on
workshop for building and enhancing your curriculum
Recent years have shown a growing interest in and emphasis on teaching
health providers to provide culturally and linguistically relevant health
care. The journal, Family Medicine, for example, published family
medicine residency curriculum guidelines for culturally competent and
sensitive medicine in 1996. More recently, the Institute of Medicine published
Unequal Treatment (2002) which argued for increasing awareness about disparities
among health care providers and others. This seminar aims to respond to
the needs of medical education programs that are facing the challenges
of developing and creatively expanding their cultural medicine curricula,
particularly with ACGME criteria in mind.
Effective teaching of culturally and linguistically relevant care must
include an attitudes/awareness component that facilitates self-reflection
on cultural biases that can interfere with the provision of culturally
relevant care in even the best-intentioned of physicians. Furthermore,
health care providers must develop a growing knowledge base from which
to develop hypotheses about cultural dynamics in diagnosis, health disparities,
the doctor-patient relationship and problems in patient adherence to treatment
regimens. Finally, physicians must receive hands-on experience with the
skills involved in the practice of excellent culturally and linguistically
relevant medicine toward the elimination of health disparities.
The session will begin with a review of how and why students and practicing
health care providers must receive training in the awareness, knowledge
and skills aspects of culturally responsive medicine, particularly as
connected to the goal of elimination of health care disparities. Next,
the presenter will describe and demonstrate a number of creative experiential
learning activities in awareness, knowledge and skills development components
of culturally responsive care. Participants will receive ample curricular
materials to empower their own confident and creative teaching in the
area of culturally responsive care.
Jeffrey Ring, Ph.D. is the Director of Behavioral Sciences at
the Family Medicine Residency Program at White Memorial Medical Center
in East Los Angeles. His work with the cultural medicine team at White
Memorial, and funded by the California Endowment, has focused on the
development of a comprehensive curriculum which attends to the awareness,
attitudes, knowledge and skills components of cultural issues in residency
training. Moreover, the curriculum has been developed with attention
to successfully meet ACGME criteria. Over the past fifteen years, Dr.
Ring has written, taught and lectured on culturally responsive care
both nationally and internationally, including a number of past ‘Quality
Health Care for Diverse Populations’ Conferences. He has served
as a consultant for the Tools for Tolerance Program at the Museum of
Tolerance in Los Angeles, and was formally the Co-Chair of the Group
on Minority Health and Multicultural Education for the Society of Teachers
of Family Medicine. Dr. Ring has published several articles on medical
education in Family Medicine, and authored ‘The Long and Winding
Road: Personal Reflections of An Anti-Racism Trainer’ in the American
Journal of Orthopsychiatry in January, 2000.
Workshop
A-4: Using an Organizational Development Model as a roadmap to incorporating
In order to begin to reduce health disparities, the quality of care for
all patients must be equally high. One way of making care equitable for
all is to implement the CLAS (Culturally and Linguistically Appropriate
Services) Standards, which are intended by HHS to “contribute to
the elimination of racial and ethnic health disparities and to improve
the health of all Americans. For an organization to take on the implementation
of the CLAS standards, it is important to have a model or “road map”
that has been previously used in order to achieve its goal effectively.
The Center for Cross Cultural Health (CCCH) has developed an Organizational
Development Model for Cultural Competence implementation in medical and
human service organizations and has even been applied at a community systems
level. This model is a practical innovation, which has been used effectively
with multiple organizations in Minnesota. It is based on an assessment
of the organization and its current status in relation to CLAS mandates,
and cultural competency programs and initiatives. The assessment is followed
by an external assessment of its diverse patients, community organizations
and agencies, and leaders of ethnic and cultural communities in the organization’s
catchment area. The assessments are used to create a report of the organization’s
cultural competence, from which specific recommendations and initiatives
can be drawn. The implementation of these initiatives creates a more culturally
competent organization, which is better able to serve the needs of its
diverse patients, thus improving health care quality, with the goal of
reducing health care disparities.
This intensive training session uses interactive dialogue and techniques
that will give participants a hands on approach to implementing the model
by conducting the internal and external assessment on a sample organization.
Participants will then design create recommendations, develop a timeline
to implement the action plan and create a monitoring system to evaluate
the system changes.
Other methods to use the model in appropriate ways with a range of organizations
and communities will also be discussed.
Take-home resources will include the Organizational Development Model,
information on creating internal and external assessments, and a description
of the CLAS assessment tool developed by CCCH for use in organizational
assessments.
Loudi Rivamonte is the Co-Executive Director of The Center for
Cross-Cultural Health and leads the agency’s program development
and consultation areas. Ms. Rivamonte has over twenty-five years experience
in assessing and developing program for diverse clients and patients
in the areas of health and human service. She has extensive knowledge
in community organizing and establishing and maintaining collaborative
partnerships. Additionally, Ms. Rivamonte has eight years experience
in developing and implementing customized trainings and organizational
assessments in cultural competency for individuals, organizations and
systems. She holds a B.A. in Recreation Administration with an emphasis
in therapy from SanFrancisco State University and has advanced training
in Mind, Body, Medicine Integration. Loudi is also a practicing Spring
Forest Qigong healer and has lived cross-culturally here in the United
States, Asia and Brazil.
Workshop
A-5: Finding Ways to Pay for and Establish Language Assistance Services
This session will provide participants an opportunity to develop a reimbursement
mechanism to seek federal matching fund, which could raise many related
issues, such as how can language services be reimbursed ( i.e., explaining
the four existing models that some states are using), should it be charged
as an administrative expense or service cost, who can seek reimbursement,
fee-for-service providers v. managed care providers, how to ensure the
competency of interpreters ( i.e., assessing proficiency, requiring minimum
training, whether to require certification, etc.), and what advocacy strategies
to use once you have a proposed model ( i.e. how to use local organizing
to garner grass-roots support, how to get interested stakeholders to the
table, etc.).
Doreena Wong is a staff attorney at the National Health Law
Program ("NHeLP"), which is a national public interest law
firm working to increase and improve access to quality health care on
behalf of limited income people by providing legal analysis and representation,
information, education, and policy advocacy. She provides support to
the Health Consumer Alliance, a partnership of consumer assistance programs
operated by community-based legal services organizations whose mission
is to help low-income people obtain essential health care. She also
advocates for culturally and linguistically appropriate health care
services for immigrant and limited English proficient populations. She
has participated on the National Advisory Committee for the Development
of Culturally and Linguistically Appropriate Services in Health Care,
and currently serves on the California Department of Consumer Affairs/Department
of Health Services’ Task Force on Culturally and Linguistically
Competent Physicians and Dentists, as well as the Policy and Research
Committee of the National Council on Interpreting in Health Care. Before
coming to NHeLP, she worked in the area of civil rights for a number
of public interest organizations including the Asian Law Caucus in San
Francisco, CA, the ACLU of Philadelphia and Pennsylvania, the National
Women's Law Center in Washington, D.C., and a Los Angeles civil rights
firm specializing in enforcement of consent decrees in race discrimination
cases. She graduated from New York University School of Law in 1987
as a second career after having worked as a health care professional
for nine years.
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