1. Comunidades Latinas Unidas En Servicio - CLUES Founded in 1981 Largest Latino based Latino led non profit in Minnesota Mission: To advance the capacity of Latino families to be healthy, prosperous, and engaged in their communities. Vision: A thriving multicultural community enriched with confident and strong Latino families who contribute their voice, entrepreneurial spirit and cultural richness.

2. Setting the Landscape Minnesota’s foreign-born population is increasing faster than the national average, tripling since 1990 while the national average has only doubled. Only about one-third of Minnesota’s immigrants were born in Latin America, compared to more than half of immigrants nationally. Similarly, one in five Minnesota immigrants were born in Africa, compared to only 4% nationally. The Twin Cities, in particular, is home to a relatively large American Indian population, including members of the Little Earth of United Tribes and Shakopee Mdewakanton Sioux communities. 2014 Health Equity of Care Report2014 Health Equity of Care Report http://mncm.org/wp-content/uploads/2015/01/2014-MN- Community-Measurement-Health-Equity-of-Care-Report.pdf

3. Continued…. Immigrants are younger than native Minnesotans: They fill jobs vacated by retiring workers, and pay taxes that provide needed state and local revenues. Immigrants comprise 7% of the state’s population but 9% of the workforce. In six industry sectors and 17 occupations, both higher- and lower- skilled, immigrants comprise more than one quarter of the workforce. Immigrants pay an estimated $793 million in state and local taxes annually. Six percent of the state’s business owners are immigrants. 2013 The Economic Contributions of Immigrants2013 The Economic Contributions of Immigrants http://www.csp.edu/wp- content/uploads/2015/07/Economic_Contributions_of_Immigrants_in_Minnesota_2013.pdf

4. SEAMLESS COVERAGE… WHAT’S THAT ALL ABOUT?!

5. Navigator Input: Realities LEP speakers receive follow-up communications in English, despite designation of preferred language. Health Care Notice/Notification forms in English with limited timeline to respond. Clarity needed around Open Enrollment, MA, and MCRE enrollment periods.

6. Realities Continued Increase in case management support to consumers (pre and post enrollment assistance). Consumers selecting individual mandate and forego health insurance as is still unaffordable. Income, language barriers, disabilities, and not understanding the healthcare system deter consumer enrollment.

7. Recommendations to Improving Quality of Care Keep Navigators to support/ assist “hard to reach” consumers in obtaining health care coverage. MCRE should remain as Minnesota’s Basic Health Plan. Consumers with DACA immigration status should be allowed to access affordable health care coverage. Navigators should be integrated in supporting consumers in navigating the health care system. Intentional collaboration and cross polination with local counties and DHS.

8. Juan Perez My wife and I were seeking health insurance coverage as my employer did not offer it. I was able to connect with a Navigator at CLUES who helped me with the enrollment process and I obtained MCRE. We immediately took our three children to the doctor for their physical and preventative care check ups. We had tried in the past to enroll at our local human services office but wasn’t successful. They would provide us with an interpreter and I didn’t feel comfortable or that they were understanding. I was relieved to receive services by a navigator who spoke my language and who I could communicate with easily. My family is now able to access health care that we had not been able to do so in the past.

9. Anita Morales I received a letter in the mail in English. After my neighbor translated it for me, they said that I was loosing my MA coverage. I was worried since I am older and need to take my diabetes medication. I went to visit a Navigator who said that my eligibility had changed to MCRE and that I will need to pay a premium. I live on a tight budget and paying a premium along with co pays for my medicine would be very difficult for me. After explaining my current income, the navigator called the local county and explained that my eligibility determination was miscalculated. They reevaluated my case and I was to continue on MA. I can continue to receive my medications and do not have to worry about an additional expense on my fixed income.

10. Thank you! Carla Kohler Community Health Services Manager ckohler@clues.org 612-746-3507