1. Limited English Speaking SMP Discussion Groups

2. What is CLESE?
CLESE-Coalition of Limited English Speaking Elderly-is a non for profit membership organization with the mission of providing leadership, education and advocacy to limited English speaking older adults, so they can have access to services and programs they need.
CLESE collaborates with AgeOptions and the aging network in Illinois to educate ethnic communities and ethnic seniors about older adults services and promote healthy aging.
CLESE is a statewide coalition well known in the country for it unique approach to service delivery to the limited English speaking seniors.
Currently, CLESE has 54 member organizations which together serve about 200,000 per year out of whom 75% are people 60 years and older.
GRACE

3. CLESE & AgeOptions: A Long Partnership
The Illinois SMP has partnered with CLESE to provide SMP outreach to limited English speaking (LES) beneficiaries for over a decade
CLESE and their member agencies helped us translate a lot of our materials into 13 non-English languages
CLESE member agencies have also come up with great ideas for new outreach materials
CLESE and AgeOptions have had an SMP partnership for well over a decade
Note: LES stands for Limited English Speaking
CLESE and their agencies have helped us translate most of our materials into 13 non-English languages
They have also helped us come up with great outreach ideas like our In Case of Emergency card that we encourage people to use instead of carrying their Medicare card. That idea came from a CLESE agency

4. Is Our LES Outreach Effective?
Does the message we use for English speaking beneficiaries work in limited English speaking communities?
The question we are left with though is: Is any of this effective? Does the message we give to English speaking beneficiaries resonant with LES consumers?
That’s why we decided to have the discussion groups
GRACE: Need a lot of education. A lot of time.

5. Discussion Group Goal
To gain a better understanding of culturally appropriate ways to talk about health care fraud and encourage limited English speaking consumers to prevent and report fraud
Here is the goal of our discussion groups

6. Five Questions What do you like about your health care benefits?
If you had questions about your health care benefits, who would you ask?
Have you seen [fraud] in your community?
In your own words, why should you care about [health care fraud]?
Anything else you’d like to share?
CLESE and AgeOptions staff came together to think of very simple questions.
The first two questions are meant to ease people into the conversation while the middle questions get at their experience of fraud.

7. Five Local Agencies Host Groups
Agency
Language for Discussion Group
Chinese American Service League (CASL)
Chinese
Metropolitan Asian Family Services (MAFS)
Hindi/Gujarati
Arab American Family Services (AAFS)
Arabic
Hanul Family Alliance
Korean
Korean American Community Services (KACS)
We chose five agencies that were already working with CLESE to do SMP outreach in their communities.
This chart shows the five agencies and language group that they primarily do SMP outreach with
GRACE: They serve a big community. SHIP as well and many other services.

8. Planning for Each Group
Two staff from local agency:
Facilitator
Notetaker
Discussion entirely in the non-English language
1 hour for discussion
30 minute debriefing afterwards with AgeOptions and CLESE staff
We stipulated that each agency needed two staff – one to lead the group while another person helped with notes
AgeOptions and CLESE staff attended each group, but it was important that the group was conducted entirely in the language the beneficiaries spoke
We met to discuss the group and what was said afterwards

9. Lessons Learned Work with local agencies
Use phrases that the community will understand
Fraud impacts communities differently
Listen to professionals working in community and their creative ideas
Here are a few lessons we learned

10. Lessons Learned Work with local agencies
Build relationships and partnerships with local agencies serving LES populations
We would never be able to do this without our partnership with CLESE and the relationship with their member agencies
Many participants were knowledgeable about fraud because of CLESE outreach efforts
AgeOptions has partnered with CLESE for over a decade. Building these relationships takes time, but it is worth it. The feedback from staff after the discussion group was very helpful in understanding what these beneficiaries face.

11. Lessons Learned Use phrases that the community will understand
E.g., “Health care benefits” instead of Medicare, Medicaid, dual-eligible, Marketplace, MMAI, etc.
Ask the community leaders or service professionals
In preparing the five questions, CLESE had a great suggestion to say “health care benefits” instead of Medicare. They knew and understand their member agency’s constituents and knew that many people may not have traditional Medicare and may not know the name of the program they are on. We also encouraged the facilitator to take liberties with phrasing if needed.

12. Lessons Learned Fraud impacts communities differently
Korean community in Chicagoland has rampant fraud (e.g., so much unnecessary DME that buildings have lending closets of unused equipment)
Arabic speaking beneficiaries cannot get basic health care services or appropriate referrals –fraud is not number one priority
Some groups are seeing a lot of fraudulent activities (Korean). Whereas, others are struggling to understand the basics of health care (Arabic). It’s not that fraud is not happening in these communities; it’s just harder to recognize because they are dealing with more basic issues.

13. Lessons Learned
Listen to professionals working in community and their creative ideas
MSN is only available in English and Spanish
Service coordinator serving Chinese speaking older adults tells them to scan their MSN for:
Dates
Doctors
Dollars
This creative idea doesn’t work 100%, but it helps. We have to encourage this type of creativity.
If there’s time, turn to GRACE to talk about how other CLESE partners are helping their clients read their MSNs.

14. What’s Next?
Advocate for MSN in more languages (currently only in English and Spanish)*
Use this feedback for future outreach materials
* CMS recently made MSNs available in Braille, large print, audio and data CD

15. Thank you! Presenters: Jason Echols, AgeOptions
Grace Nawakowski, CLESE
Questions? or call Jason Echols (708)
For more information on CLESE, visit
This project was supported, in part by grant number 90MP0216, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.