2. Building Health Care Interpreter Capacity In The Community: A National Strategy Health Care & Community College Partnership Gayle Tang, Director National Linguistic & Cultural Programs National Diversity Department http://kpnet.kp.org/national/diversity

3. A partnership in improving the health status of our diverse communities

4. Objectives èTo introduction the KP/Community College Health Care Interpreter Certificate Program - A proven approach to increasing linguistic & cultural capacity

5. Building Capacity Outline: ßWhat are the core competencies? ßFeatures, advantages, and benefits of the Program ßCurrent Partnerships & successes ßWhat does it take to create a Partnership? ßInstructor / Coach requirements ßHighlights of Instructor Training Intensive ßWhat are the next steps?

6. Definition of Terms Interpreter Translator BilingualismBiculturalism

7. Goal To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings

8. Cultural Competence Action Beyond sensitivity & awareness Skills knowledge A specific set of skills and a particular knowledge base to operate in a multicultural setting Cultural Competence the Nexus to Eliminating Health Disparities

9. Core Competencies To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings  Conversational proficiency (pre-requisite)  Slang / idiomatic expressions  Health care terms and concepts  Basic medical knowledge  Listening and memory

10. Core Competencies To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings  Self-awareness (Learning model)  Diversity and cultural awareness  US biomedical system & other’s  Characteristics of specific cultures  Health beliefs, values and traditions  Effective communication: cross- cultural, intercultural, and intra-cultural

11. Core Competencies To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings  Roles & responsibilities  Interpreting skills  Types of interpreting  Code of ethics  Standard of Practice

12. Core Competencies To develop linguistically and culturally competent interpreters who can function effectively and efficiently in health care settings  Problem solving / conflict management  Teamwork / Group dynamics  Time management  Giving & receiving of feedback  Legal & regulatory requirements  Systems & resources

13. Interpretation Errors of Untrained Interpreters Translated the target word as “Womb”“Stool” “Bowel Movement” Not interpreted “Liver”“Vagina” Not interpreted “Neck”“Hip” “Cervical Vertebrate” Not interpreted Target Word BowelBladderCervix From assessments of candidates for interpreter training and candidates for interpreter positions Margarita Battle, Massachusetts General Hospital, 1990 - 1996

14. Interpretation Errors of Untrained Interpreters Translated the target word as “Beard/chin”“Push” “Bend down/sit down” “Carry a weight” “Get undressed from the waist down” Not interpreted “Cramp”“Pull” “Radiate”“Pierce” Not interpreted Target Word Bear Down Tingling From assessments of candidates for interpreter training and candidates for interpreter positions Margarita Battle, Massachusetts General Hospital, 1990 - 1996

15. No community standards for health care interpreters No accountability No training available in the service area Curriculum development originated from SFO Why? Profile of a Model Program C. Vargas, D. Kwan, S. Do, A. Yee - Language Coaches Center: R. Lee, MD - Presenter and medical expert consultant G. Tang - Instructor

16. Proposed partnership with community college to institutionalize the curriculum Solidified curriculum National search for programs to benchmark Received training from Cross-Cultural Health Care Program Support and sponsorship from Tony Gately, NCAL RMGA, and Ronald Knox, VP, National Diversity How? Profile of a Model Program

17. City College of San Francisco formally institutionalized the Health Care Interpreter Certificate Program in 1997 When? Profile of a Model Program

18. The curriculum for the Health Care Interpreter Certificate Program is designed to train bilingual and bicultural students to develop the awareness, knowledge and skills necessary for effective linguistic & cultural interpretation in health care settings What? Profile of a Model Program Graduation 1999

19. 3 Courses: – Health 80 Health 81 Health 82 378+ Hours Lecture Language Lab Internship Field work What? Features Profile of a Model Program Integrative Approach...

20. Health 80 - 6 units Develop awareness, knowledge, and skills necessary for effective interpretation in health care settings Roles and responsibilities Basic knowledge of common medical conditions, treatments and procedures Insight on language and cultural nuances of specific communities What? Features Profile of a Model Program

21. Health 81 - 6 units Further skills building in being an integral member of the health care team in bridging linguistic and cultural gaps Specialized health care service areas such as genetics, mental health, death and dying, etc. Development of cultural competency in the community and workplace What? Features Profile of a Model Program LGBT Community Panel

22. Health 82 - 3 units Field work experience Application of knowledge and skills learned in Health 80 and 81 What? Features Profile of a Model Program

23. What? Advantages Profile of a Model Program ¦Convenience - Times & Location ¦Featured Speakers ¦Expert Coaches ¦Diversity in Class ¦Quality Program ¦College Credit - 15 Units ¦Low Cost ¦Sustainability Spanish Lab Cantonese Lab Mandarin Lab Russian Lab Japanese Lab Korean Lab

24. Why? Benefits Profile of a Model Program ë Setting community standards ë KP practitioners gaining cultural competence through teaching ë Increasing work force diversity in the health sector & improving KP’s image ë Leveraging program to recruit for the very best ë Satisfying KP’s mission & meeting organizational business objectives ë Setting community standards ë KP practitioners gaining cultural competence through teaching ë Increasing work force diversity in the health sector & improving KP’s image ë Leveraging program to recruit for the very best ë Satisfying KP’s mission & meeting organizational business objectives Kaiser Permanente ì Source of revenue ì Key to future partnerships ì Increasing reputation ì Linking with other programs ì Leveraging health care expertise ì Satisfying community colleges mission ì Source of revenue ì Key to future partnerships ì Increasing reputation ì Linking with other programs ì Leveraging health care expertise ì Satisfying community colleges mission Community Colleges

25. Benefits Challenges KP People & Systems ì Coordination for field work can be a challenge if no systems in place Challenges ì Enhance skills ì View training as an incentive ì Tuition reimbursement ì Enhance skills ì View training as an incentive ì Tuition reimbursement Benefits

26. Next? Experience Dissemination & Replication SKILLSSKILLS Disseminated curriculum to 6 community colleges in California Conducted Summer Institute 2001 - Health Care Interpreter Instructor Training Additional KP / community college partnerships identified Developed & disseminated training manuals Balancing demand & supply Replicating Model

27. Language & Culture The work of an interpreter is invaluable and has a direct impact on the patient’s health outcome. They hold a very important key that helps unlock those cultural and linguistic barriers. Quality

28. 27 Access Quality & Outcomes Cost Risk Factors

29. 28 Risk Management Accreditation State & Federal Requirements Implications

30. Partnership Structure Initial Sponsorship of the HCI Certificate Program: q Interest  7 Days of Intensive Instructor Training and curriculum dissemination offered to HC liaison and College Instructors (April / May 2004) Minimal Partnership Requirements for HC Organizations: q Liaison with college q Provide site for field work q Provide expert speakers if college is interested q Use of classroom & equipment, q Use printed material, e.g., health education material, etc.. Initial Sponsorship of the HCI Certificate Program: q Interest  7 Days of Intensive Instructor Training and curriculum dissemination offered to HC liaison and College Instructors (April / May 2004) Minimal Partnership Requirements for HC Organizations: q Liaison with college q Provide site for field work q Provide expert speakers if college is interested q Use of classroom & equipment, q Use printed material, e.g., health education material, etc..

31. 30 Timeline Interest 5/03 - 6/03 Present and identify interested Regions Sponsorship 6/03 - 8/03 Decision & designate Regional Champion & Liaison College 9/03 - 10/03 Present and identify interested Colleges Instructor Training April / May 2004 Disseminate Curriculum 5 - 7 Days Intensive Instructor Training Program Start Fall 2004 or Spring 2005

32. 31 Timeline Interest 5/03 - 6/03 Present and identify interested Regions Sponsorship 6/03 - 8/03 Decision & designate Regional Champion & Liaison College 9/03 - 10/03 Present and identify interested Colleges Instructor Training April / May 2004 Disseminate Curriculum 5 - 7 Days Intensive Instructor Training Program Start Fall 2004 or Spring 2005 Agreement Finalize Coaches & Instructors KP & College ID Coaches & Instructors KP & College

33. Instructor Training Objective highlights: Overview of curriculum Integrating all essential components of health care interpreting with trainer’s tips The role of the instructor and of the language coach Assessment and testing of students Operationalizing from marketing to instructions

34. Instructor Training Logistics:  Travel - arrive at least day before  Networking evening night before  Sessions - consecutive days with 8 - 10 hr days  Partners join on 1st and part of last day

35. Agreement Provisions Institutional specific for contract See specifics for field work experience

36. General Coach & Instructor Requirements Minimum Requirements:  Fluency in pair language: Oral and written communication skills (except instructor if not able to find)  Educational level: BA  Knowledge and experience in the health care system  Organized, professional, flexible, commitment, interpersonal skills & empathy  Team player, ability to give and receive feedback  Ability to work under pressure  Teachable, with learning attitude and works effectively with diversity  Leadership skills and possible Masters required, especially instructor  See college specific requirements for the primary instructor

37. General Coach & Instructor Requirements Required Competencies:  Minimum two (2) years of interpreting experience.  Certified Health care Interpreter or experience in teaching HC interpreters  Good facilitation skills  Cross-cultural / Intercultural communication techniques  Experience in working with diversity and a clear understanding and respect of various cultures  Good knowledge of medical terminology  Teaching experience - Presentation skills  See College requirements for the primary instructor  See Language Coach job description

38. Bridging Languages and Cultures “Access with dignity”