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The Robert
Wood Johnson Foundation established the National
Program Office (NPO) for Hablamos Juntos, in late 2001. The
goal of the program is to develop affordable models for health
care providers to overcome language barriers and to develop the
business case for language services. Using demonstration sites
and a two-phase grant process (a planning phase and an implementation
phase) 10 grantee organizations, in communities or catchment
areas with new and fast-growing Latino populations, will develop
and test systems of medical interpretation, signage, and print
materials across multiple delivery points within the local healthcare
systems.
During a press conference at the Washington Press
Club, December 12, 2001, RWJF announced the formation of Hablamos
Juntos along with survey results concluding that language barriers
hinder access and delivery of quality health care to Latinos with
limited English. Hablamos Juntos was created to invest ten million
dollars in ten demonstration sites and to produce interventions
that can be replicated by health organizations across the country.
The NPO sent out a call for Letters of Intent
(LOI) in December 2001 for Hablamos Juntos, resulting in 178 responses
by the February 1, 2002 deadline. Letters of Intent came from 40
states, the District of Columbia and the U.S. Virgin Islands. California
providers responded enthusiastically to the program, with 24 providers
submitting LOI’s, followed by New York (17), Texas (13),
and Illinois (12). These LOI’s were carefully reviewed and
evaluated by a panel of experts, the Hablamos Juntos National Advisory
Committee (NAC).
On February 22, 2002, after much deliberation,
23 applicants were selected by the NAC and invited to submit full
proposals for further consideration. Proposals were submitted by
the April 26, 2002 deadline. NPO staff developed review criteria
and a review tool and assigned the proposals to review committees
comprised of National Advisory Committee (NAC) members, members
of the Robert Wood Johnson Foundation, and NPO staff. Each proposal
was assigned a primary and secondary NAC reader. Scores for the
proposals were tallied and presented at the May meeting in Crystal
City, VA. The goal of this meeting was to discuss the 23 proposal
finalists and applicants for site visits. After two days of reviewing
and discussing the proposals, NAC members were successful in recommending
15 applicants for site visits.
Site visits took place in the summer of 2002,
with 8 site visits conducted in June and 7 conducted in July. Site
visit review teams consisted of NPO and RWJF staff, and two NAC
members. A member of the evaluation team from the RAND Corporation
participated in 5 of the site visits. Applicants were oriented
to the review process and prepared with review criteria prior to
the visits to help them structure the site visit. A Site Visit
Rating Sheet was developed to help the site review team evaluate
the applicant during the site visit.
In August 2002, NAC members met in San Diego,
CA to make recommendations on which applicants to fund as demonstration
sites. Fifteen applicants were reviewed and discussed, with ten
being recommended as Hablamos Juntos demonstration sites.
The planning year included several grantees
meetings and three deliverables.
Grantee Meetings
Getting Acquainted October
10-11, 2002
Grantees meet with NPO staff in Las Vegas, Nevada. This marks the
first time that grantees meet each other, and the first time the
NPO can officially congratulate grantees on their accomplishment.
Exploring the State of the Field January
8- 10, 2003
Meeting in Phoenix, AZ, grantees and the NPO explored the state of
the field. The meeting focused on how health organizations are building
language capacity (Testing & Training of interpreters) and developing
written materials (Translation).
Developing Program Requirements March
5-7, 2003
In Miami, FL grantee explored a range of strategies and interventions
to increase interpreter services and create replicable models that
are affordable. Using small groups to share ideas and opportunities
and brainstorming local implementation challenges, the meeting contributed
to a set of program requirements that all demonstration sites would
work to achieve. Special opportunities in the sites were also identified.
Draft Design Presentations April
24-24, 2003
Grantees and their executives, met in Chicago, IL to present draft
proposals to a distinguished panel of experts to obtain feedback
on their plans. A white paper on the potential of symbol usage in
health care signage was also presented.
Deliverables
Resource and Needs Assessment
Grantees completed a Resource and Needs Assessment with four components:
1) develop a profile of the limited English proficiency (LEP) Latino
population in the region, their health and language needs and determine
how the demonstration program may best serve this population; 2)
assess the language capacity of local healthcare providers and
identify potential for improving and increasing this capacity;
3) identify synergistic opportunities that may exist with other
community efforts to develop language services; and, 4) determine
the future demand and trends for language services. The assessments
in all demonstration sites informed planning activities and collectively
helped the NPO better understand demonstration environments and
offer grantee technical support.
Design Document
Using a logic model, grantees developed demonstration model designs
to: 1) clarify interventions that will be applied in the demonstrations;
2) ensure a manageable scope of work for implementation; and, 3)
consider the long-term impact of the interventions in demonstration
model catchment areas. The design documents articulated unique
opportunities and challenges embedded in the demonstration environments.
Draft plans were presented to a panel of stakeholders who offered
suggestions and critiques.
Business Plan
Grantee sites were required to develop a Business Plan based on a
5-year planning horizon to demonstrate that interventions proposed
were viable investments that will continue beyond the grant period.
The goal of the Business Plan deliverable was to present an analysis
of expected costs, cost savings and potential funding sources to
sustain interventions selected.
Review of Implementation Proposals
Reverse Site Visit July 31,
2003 – August 1, 2003
The Reverse Site Visit was an opportunity for grantees to describe
their proposed demonstration models and presented their rationale
to the Hablamos Juntos National Advisory Committee. Through this
process, the NAC then offered recommendations to the NPO and the
Foundation. Proposed models were assessed on the potential for replication
and financial sustainability, and whether presenters demonstrated
strong commitment to systems change with implementation funding.
Nine of ten sites were recommended for funding and in December 2003
the tenth site was approved.
The implementation phase has involved the following
grantee meetings:
Grantee Meetings
Language Services and Technology November
12-13, 2003
Grantees were asked to explore various ways of providing interpreter
services and how technology could be applied to bridge the language
gap through the many encounters that comprise a health care visit.
Attendees heard panel presentations on developing local multilingual
language banks and the potential of more cost effective models using
technology such as 1) Telephone; 2) Video-Conferencing and 3) Hand
Held Devices.
Language and Interpreter Skills Assessment, Scoring & Administration
Workshop December 11-12, 2003
Two-day workshop helped to prepare grantees to administer and score
the Language and Interpreting Skills Assessment tools in their demonstration
sites. Participants received hands on practice and guidelines to
score four assessment tools with language specific rating practice
in Spanish from Claudia V. Angelelli, Ph.D., Assistant Professor,
Department of Spanish & Portuguese, San Diego State University, the
assessment tool designer and expert in Translation & Interpreting
and Applied Linguistics. To learn more about the assessment tools
see Language
and Interpreter Skills Assessment.
Developing Useful Spanish Materials January
15, 2004
The meeting focused on the limitations of translations and criteria
health organizations can use to make "make or buy" decisions related
to the production of Spanish materials. Grantees heard presentations
on the challenges presented by different types of text and the approaches
needed to create useful Spanish materials. The results of the Gap
Analysis were presented and ways for grantees to work collaboratively
were discussed.
Health care Interpreter Instructor
Training April 12-16, 2004
Week long training held in Oakland, California offered to faculty
in colleges and universities interested in partnering with Hablamos
Juntos grantees to start college-level health care interpreter training
program. The training exposed participants to the curriculum and
design of the Health Care Interpreter Certificate Program offered
by San Francisco City College. Gayle Tang, Director of Kaiser Permanente's
National Linguistic and Cultural Programs developed the week long
training specifically for Hablamos Juntos sites and Kaiser Permanente
staff with the hope of replicating these program in Hablamos Juntos
partnering educational institutions and Kaiser regions. Participants
received Instructor's tools and templates to provide a solid foundation
for course instruction. To learn more about the training programs
being developed by the site see Educational
Partners.
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