CHOICE will focus on improving language services
for the region’s rapidly growing Latino population, half
of whom reside in rural areas. Specifically, CHOICE will pilot,
replicate and sustain an efficient language access system with
multiple and diverse entry points; train linguistically and culturally
competent interpreters and providers who use them; assess, support
and expand the number of dedicated and dual-role interpreters;
expand availability of culturally competent services beyond medical
interpreting; improve distribution of existing Spanish language
materials and develop high priority materials where none exist.
About the Organization
CHOICE Regional Health Network is a nonprofit
organization dedicated to improving the health of people living
in Washington State. CHOICE was established in 1993 as a workgroup
among the nonprofit and public hospitals in the region to ensure
that all residents had access to quality health care. CHOICE has
built a strong provider consortium based on natural collaborative
opportunities among partners, including: seven public and nonprofit
hospitals, five public health jurisdictions and hundreds of practitioners,
who collectively serve 16,000 clients.
SeaMar Community Health Center, Mason General
Hospital, The Clinic at West Olympia, Catholic Community Services
Southwest, St. Peter Family Practice, Oakland Bay Pediatrics, Mt
View Women’s Clinic, North Mason Medical Clinic, Grays Harbor
County Public Health and Social Services Department, Grays Harbor
Community Hospital, Centralia Community College, Providence Health
and Education Center, Providence Centralia Hospital, Centro Integral
Educativo Latino de Olympia (CIELO), Washington State Public Health
Association, and a number of small rural practices.
About the Service Area
Five rural central western Washington counties
(Grays Harbor, Mason, Thurston, Lewis, and Pacific).
here to view their service area map.
Existing Language Services
CHOICE has conducted extensive outreach to the
Latino community under a HRSA grant, helping individuals and families
gain access to care through existing programs. Some facilities
in the region recruit bilingual providers and staff, while others
rely more heavily on family members to serve as interpreters. One
hospital has provided interpreter training for bilingual employees
and community professionals, and a local community college has
identified potential collaborations between their Spanish and nursing
departments and is committed to providing Spanish heritage speakers
with formalized instruction in Spanish.
In developing its approach, CHOICE is responding
to a unique arrangement in the state of Washington on the reimbursement
for interpreter services offered through Medicaid. When interpreters
are needed, provider offices must call a regional broker, who contacts
one of three interpreting agencies to obtain a contract interpreter.
The system has several known inefficiencies and has led to increased
costs for travel in this rural area and a serious reliability problem.
Pressure for change in the system creates opportunities for collaboration
and the pooling of funds to maximize federal Medicaid match dollars,
while increasing the level of support for a viable language services
The Latino Population in the Service Area
Latinos in 1990: 8,748
Latinos in 2000: 19,747
% Increase: 126%
Total Population in 2000: 413,538
Latinos have found work in agriculture, dairies
and in many service industries, particularly around the state capital,
Olympia. While immigration to Central Washington State had been
predominantly male and seasonal, it has taken on an increasingly
communal and permanent nature as immediate and extended families
are reunified. Communities of individuals from Guatemala and the
Mexican state of Oaxaca have formed in several small towns. The
Latino communities are young - 41% under 18, 80% 40 or younger.
The median age of females is 18, resulting in a general demand
for reproductive services. More than half of Latinos say they need
help with speaking, reading, or writing English. Approximately
25% of Latinos in Washington are undocumented. The percentage is
likely much higher for the five-county region. This has key implications
for access to care, particularly as the state of Washington has
ended Medicaid eligibility for undocumented individuals and children.
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