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Choice Regional Health Network


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).

Click 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 program.

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.

Website: www.crhn.org



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