Diversity is our Strength FACILITATOR NOTES: TALKING POINTS Kaiser Permanente is proud of Diversity being a strength which helps to distinguish us as an organization. As a testament to this, in 2010 we were ranked as the #4 top company for diversity in the United States on the DiversityInc. list. The diverse backgrounds of our workforce helps us to achieve our mission when caring for our diverse members and serving our diverse communities. KP has a long history of supporting diversity, all the way back to our beginning. For more information on this history go to “Our Diversity Story, Visibility & Tradition” on the National Diversity site. Source information for facilitator use: http://diversity.kp.org/2main-functionalAreas/dsi/dsi-diversity- story.html

In 2010 Kaiser Permanente Ranked #4

Diversity & Health Video Series (DHS) …is a collection of award winning mini-documentaries produced by Kaiser Permanente. These videos focus on the diversity and health of the populations we serve. A VIDEO, A DIALOGUE AND TRANSFORMING CULTURE! TALKING POINTS The diversity and Health Video Series is a collection of award- winning , mini-documentaries produced by Kaiser Permanente. These videos focus on the diversity and health of the populations we serve and work with everyday. The Telly Award is an award presented by a New York City based organization. The stated purpose of the award is to "honor the very best local, regional, and cable short film, commercial and internet programs. This award was founded by in 1978 by David E Carter who’s consider to be an expert in corporate branding, graphic and logo designs.

Overview / Objectives Background and Purpose A video, a dialogue and Transforming Culture Training Metrics Resources TALKING POINTS By the end of this session participants will be able to understand: The Purpose and Background for weaving this training tool throughout our program; Why cultural sensitivity is important; How things may play out in a real-life situation. We will practicing asking members the questions and appropriately addressing potential member responses, questions and concerns; We’ll also look at how KP Mid-Atlantic States will measure progress toward this initiative by monitoring and reporting; and We’ll share the resources, tools and people available to help.

The Need & KP’s Call to Action… Mid-Atlantic request for training tools Colorado found limited training tools specific to diversity and health Tina Martelon and Michael Day produced and directed DHS Staff Associations co-sponsored DHS made it possible for us to standardize diversity training program wide through sharing best practices In 2005 when I started in Diverstiy Programs, I conducted what we called a diversity dialogue. I visited all the KP Medical Centers in our region and invited everyone to come and talk about diversity. During that dialogue we asked our employees what they thought they needed to deliver CCC to our members and to each other. One of the many responses that I received was “We need more training tools around diversity & health. At the same time, Tina Martelon, in our Colorado region was looking for diversity & health training tools specifically around Person’s w/disabilities. Unfortunately, there wasn’t too much to choose from. So with Tina diversity background, her passion around diversity, being a person w/disabilities herself + her brother Michael Day, being a film producer start her journey to create our 1st KP Diversity & Health video…today it’s titled The Spirit is Able. Since then, Tina and her brother Michael Day have produce a video a year.

Our Regions Northern California Southern California We are a large system that offers many benefits to our members, especially in terms of convenience and economies of scale. As with any other large organization, in addition to the many benefits come a few challenges:

Diversity & Health TALKING POINTS Our “Thriving in Diversity” video will give you more background information on how the organization supports diversity You will hear from our executive leadership at the national level In addition, you will see how the work diversity connects with the 3 areas of work that we just describes in our diversity strategy.

Purpose Diversity and Health Video Series was created to raise the cultural awareness of health care providers and staff for the purpose of achieving: Enhanced patient interactions and health outcomes Respectful and productive relationships in the workplace; and Collaborative relationships with the communities we serve to find solutions to eliminate and or decrease health disparities. TALKING POINTS The Member Demographic Data Collection Initiative was designed and is led by the National Diversity Council. The purpose and intent of this policy is to ensure that Kaiser Permanente continues to deliver consistent quality care to all its members regardless of ethnic and racial background, or language preference. Systematic collection and analysis of this demographic data will provide opportunities to improve care and demonstrate Kaiser Permanente’s superior care delivery model that eliminates health care disparities and attends to the different needs of our various populations.

Culturally and Linguistically Appropriate Service Standards U.S. Department of Health & Human Services: Office of Minority Health (OMH). Final Report. Federal Register: December 22, 2000, Volume 65, Number 247, pages 80865-80879, www.omhrc.gov/CLAS Standard # 3 Health care organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery. TALKING POINTS CLAS Standards are a driving force for addressing health disparities As an organization we must comply with these standards NCQA (the National Committee for Quality Assurance) measures KP against other health care organizations. CLAS Standards compliance will be important for receiving accreditation from NCQA. Three themes: Culturally competent care (1-3); Language access (4-7); and Organizational supports cultural competence (8-14) Some are: mandates, guidelines, and recommendations In 2006 the U.S Department of Health and Human Services. Office of Minority Health. Issue guideline. National Standards on Culturally and Linguistic Appropriate Services. CLAS Standards. www.omhrc.gov/CLAS Three themes 1 CCC ( 1-3) 2 Language Access Services (4-7) 3 Organizational Support for Cultural Competence (8-14) Basically the care we provide must bridge the cultural and linguistic differences between you and your patients. Improving the cultural gap, can influence medical outcomes by improving access, quality of care, patient safety by reducing medical errors and increase patient adherence to medical therapy. It will help our communities to thrive in our health care centers. We are Kaiser Permanente have created a strategy plan to move from education and strategy to planning and implementation of sound diversity management practices. We view competent care as an organizational goal.

Background TALKING POINTS Our “Thriving in Diversity” video will give you more background information on how the organization supports diversity You will hear from our executive leadership at the national level In addition, you will see how the work diversity connects with the 3 areas of work that we just describes in our diversity strategy.

Cultural Sensitivity Historical injustices Immigration concerns Reasons Why Patients May Be Distrustful of the Health Care System… Historical injustices Immigration concerns Fear of discrimination TALKING POINTS Listed here are just some of the reasons why members may be reluctant to visit or talk freely with providers. There are documented cases of historical injustices that have taken place regarding health, health care and health research. One example is the Tuskegee Syphilis Study. (ASK: “Does anybody know about this study?”) The Tuskegee Syphilis study (formally known as The Tuskegee Study of Untreated Syphilis in the Negro Male) was a clinical study, conducted between 1932 and 1972 in Tuskegee, Alabama, by the U.S. Public Health Service. 399 poor - and mostly illiterate – African American sharecroppers were studied to observe the natural progression of the disease if left untreated. The study became controversial, and eventually led to major changes in how patients are protected in clinical studies. Individuals enrolled in the Tuskegee Syphilis Study were not required to give informed consent and were not informed of their diagnosis; instead they were told they had "bad blood" and could receive free medical treatment, rides to the clinic, meals and burial insurance in case of death in return for participating. So you can understand why some African Americans who know about this study might be apprehensive in giving out their information, for fear that the information may be used to harm them. This is only one example, but there are many others that have affected other populations, which may elicit similar responses from members. Many of the other reasons listed on this slide based on historical events and personal experiences can lead to members being distrustful of the health care system.

Building Training Capacity

2008 Integration of DHS in Mid-Atlantic States Region... Solicited KPMAS employees who had a passion for diversity Completed Interview Sessions Conducted DHS TTT (25 Employees) Observation Period Eligible to conduct Trainings at Medical Centers

2008 Integration of DHS in Mid-Atlantic States Region... Required to complete all videos at their center during the year Feb Touching the Dream African American May Journey of 10K Miles Asian/Pacific Islander Jun Out LGBTI Sep Viva Bien Latino Oct Spirit is Able Person’s w/Disabilities Nov Hozho’ Native American Indian 2011 Middle Eastern

Challenges and Successes Recruiting and sustaining our volunteers (went from 25 to 15) Time for staff to attend the training Successes 2008 - 2010 Programs wide 15,000 KPMAS Total 2,816 98% of the employees who completed evaluation forms would recommend the video series to a friend or a colleague. 97% of the employees reported they could apply the content learned during the DHS trainings on the job. The R.J. Erickson awards are presented to individuals, groups, and facilities across the Program that champion outstanding diversity initiatives. Named in honor of Robert J. Erickson, former general counsel for Kaiser Permanente and lifelong advocate and champion of diversity in the Program and the community, the awards are recognition of meritorious achievement in the field of cultural competence, work force diversity, and community service.

R.J. Erickson Award Winners

DHS Brochure and Flyer On line tool that we use to evaluate the DHS Program. TALKING POINTS DHS brochure and flyer will help to communicate to region about DHS training Cuts down on amount of paper Standardizes communication

Diversity Site Mid-Atlantic States

Thank you!