In 2003 - 2004, a number of health care leaders in Alameda County recognized that they were confronting similar challenges of providing quality healthcare for the increasing number of residents with limited English proficiency. This shared concern became the topic of many conversations in settings that brought these leaders together. These leaders soon recognized that there were cross cutting issues and that individual providers could learn from the experiences, successes and initiatives of their peers. Recognizing both that this was a systemic issue and that there was value in sharing information and learnings, this initial group of stakeholders agreed to come together on a more regular basis to discuss this issue and to surface strategies that could be effective in addressing it. This initial group began to identify itself as the Alameda County Coalition on Language Access in Healthcare (ACCLAH). Participating in and working to advance the work of ACCLAH was a voluntary contribution of these early leaders. Recognizing the challenges facing the medical community, and especially individual providers, the initial goal of this emerging Coalition was to convene physicians to increase their awareness of the need for language access services. At the same time, this new Coalition searched for strategies to increase language access services. They were hopeful for county-wide solutions to this critical and cross cutting issue. Recognizing the voluntary nature of their contribution to this essential work and the magnitude and critical nature of the issue, the new Coalition sought and received funding from The California Endowment to advance its vision.
Toward County-wide Solutions
The initial funding from The California Endowment, in 2004, was intended to engage key stakeholders in a process to develop a framework for a pilot program to expand language access services. Key stakeholders, including hospitals, health plans, medical groups, community health centers, interpreters, health departments, the University of California at Berkeley, School of Public Health, and the Alameda County Board of Supervisors, were identified and invited to participate in planning meetings to identify current practices, existing resources, and the key components of a county-wide approach to deliver language interpreter services in healthcare settings. Their initial task was to develop collaboratively a feasibility plan for a pilot county-wide solution to the language access issue. The feasibility plan would include the extent of the problem, the costs of interpreter services, potential sources for payment for these services, and potential barriers to implementation of the pilot project.
As the newly formed coalition, ACCLAH successfully completed a multi-phase needs assessment which included: a written self-reported survey of licensed physicians, focus group discussions with each health care sector, and two cross-sector stakeholders meetings. The feasibility planning also included a literature review, interviews to understand the scope of services available, and a review of data from the US Census, California Health Interview Survey, and OSHPD (Office of Statewide Health Planning and Development). During this planning phase, these stakeholders also revisited the question of the need for and value of forming and sustaining the coalition itself. Essentially they asked: Why form a coalition? These new collaborators concluded that a coalition was needed to emphasize the importance and urgency of the language access issue and to provide structure and coordination for this critically important work. It was also recognized that developing individual solutions to address the need for language access in healthcare was both time consuming and costly and that there is great expertise in language access that does not exist within one's own organizations. A coalition held the best promise of serving as a forum to share learnings, resources and tools across organizations as well as a forum to discover potential county-wide solutions to a shared county-wide problem. A coalition had the potential to leverage expertise, resources and materials and could also serve as a vehicle for attracting funding from foundations and others to support work that goes beyond a single provider.
Based upon its effectiveness in forming an effective coalition and establishing a framework to share promising practices and move toward county-wide solutions, The California Endowment granted ACCLAH additional funds to take the Coalition work to the next level. Within the past two years, ACCLAH has strengthened its infrastructure by hiring executive and administrative staff to support and facilitate the structured and regularly scheduled meetings of the Coalition, its core team, and various committees. During this period, ACCLAH also formed a Senior Leadership Council with the express purpose of assisting in developing strategies to support the on going work of ACCLAH. The Coalition developed a request for proposals to test county-wide solutions and subsequently funded four key demonstration projects to test 1) a web-based portal to provide appropriate interpreter services, 2) procedures for sharing best practices for translation of key medical documents, 3) a methodology and process to test and certify the capacity of interpreters, and 4) assessment of the English skills of interpreters as dual-role staff. It was also during this period that ACCLAH and its related partners developed this strategic plan to focus and assure the effective work of this Coalition. To download a PDF of ACCLAH's Strategic Plan Executive Summary, click here.
Within a short time period, ACCLAH has become the voice for the need for language access services in healthcare as well as the focal point for surfacing and developing county-wide solutions to achieve the goal of language access in healthcare for all of Alameda's residents. The future direction for ACCLAH is detailed in the strategic plan that follows. Conceptually, ACCLAH's activities will be guided by the five goals that are included in this plan:
- To engage, inform and support stakeholders in their work to increase language access services to the residents of Alameda County
- To increase opportunities for collaboration among providers as a means to increase the number of providers and healthcare organizations with formalized language access services
- To facilitate the implementation of county-wide solutions to assure language access services which are affordable, effective and user friendly in all healthcare settings
- To develop and present to key healthcare leaders a case statement that will demonstrate the health outcomes and organizational and financial benefits of funding and using language access services
- Secure adequate funding to support the infrastructure and programs of ACCLAH
THE ALAMEDA COALITION ON LANGUAGE ACCESS IN HEALTHCARE
THE VISION: Everyone in Alameda County has access to quality healthcare and public health services regardless of language.
THE MISSION: To increase the capacity of healthcare professionals and organizations in Alameda County to provide culturally competent and linguistically appropriate services
CORE FUNCTIONS: To achieve its mission of culturally competent and linguistically appropriate language access services, ACCLAH will:
BE A FORUM and CATALYST for the development of county-wide solutions
EDUCATE the medical and public health community about the need for and benefits of language access services
INSPIRE, ENCOURAGE and MOBILIZE stakeholders to assume leadership roles
ADVOCATE for public and private policies and practices
CONVENE stakeholders to discuss shared issues and to work toward collaborative solutions
FACILITATE partnerships among stakeholders
COORDINATE activities among stakeholders, healthcare organizations and professionals
PROMOTE awareness and use of best practice models