Cultural Competence Committee Meeting
Friday, December 14th
12pm to 1pm
Present: Robin Lecoanet, UW Population Health, Laura Saunders, Lilly Irvin-Vitela, WIPHL, Harold Gates, WIPHL, Ann Goth, WIPHL, Mia Croyle, WIPHL, Mary Travis- Menominee Tribal Clinic , Wendy Rusch- Aurora St. Luke’s, Esperanza de Hoyos, Diane Carlson- Menominee Tribal Clinic, Christina Lightbourn- UW Northeast, Zella Van Natta- Family Health/ La Clinica, Robert Cherry- Aurora Sinai Milwaukee, Julia Yates- UW Health Wingra, Kerri Weberg- Marshfield Clinic, Shelley Hammes- St. Croix Tribal Clinic, Betzaida Silva- Rydz- Waukesha Family, Dr.Gross, Ted Kay- Family Health/La Clinica
I. Introductions
II. Understanding Poverty
There are different types of coverage that effect what will be covered and what won’t.
Patients who do not have the money to go to the doctor wait until they have to go to the doctor.
Aurora Family Care Center commented on the socio economic class. Often times they have patients coming in from the E.R. that wait until something is really wrong.
Health Educators could catch the patient in the clinic while the patient is already there and optimize the guaranteed amount of time they have. Sometimes the follow up phone calls are almost impossible, and having the patient come back has them making an extra trip.
People who are living in poverty typically cannot afford to pay for a healthy diet.
Hassle Factor: if it is a hassle for the patient then they will opt out on going to get what they need.
Patients may not be able to come in due to not having any gas, also no child care. Patients may wonder how much of their day will be taken up.
In home care is something that is being utilized in the tribal clinics. Due to the amount of elderly and the number of patients that are homebound for whatever reason, home visits may be more effective. In home health WIPHL can do the brief screen so we are able to screen those homebound patients as well.
When someone has no health care or cannot afford to go to the doctor there are a lot of messages sent out that you do not need to go to the doctor unless it is medically necessary. At the same time the health educators are trying to promote preventative care. There are vouchers given out to people who are in need of a surgery but only if it is medically necessary.
Everyone in the Menominee tribal clinic has gone through poverty training.
Laura talked about the notes and findings that she came across when reading the book:
A few things found wrong with the WIPHL protocol was when asking patients about what they could do with the savings they have since they are no longer spending that money on drugs and alcohol. Instead maybe we should be asking what else might the patient buy.
Consider that relationships have a heightened importance and educational goals may be more or less important. Patient may be present oriented.
There was also a handout that Mia and Laura found, this handout is available if anyone needs one. This handout had many of the same protocol and points that the book has made.
Christina shared her experience in working with a male patient from Sudan. At the initial meeting with him the patient was drinking 1 pint of alcohol a day in order to help him sleep. By the second meeting with Christina he told her that he had finished up the alcohol that he had left in the house and has not had a drink since then.
III. Updates
-Pregnant Women
There was a short presentation given by Lilly at the SCAODA meeting. The issue was not voted on, but it was tabled. There were talks about excluding health care professionals from act 292. More has to happen in house in DHFS in order to come up with a solution. Also community needs to come together to build support in policy change. WIPHL is always interested in hearing if there is a strong reaction to the disclaimer.
Beginning February 1st, Badgercare will cover pregnant women in SBIRT services.
-Protocol Updates
The translator has finished translating the protocol into Spanish. Some of the translation came off as confrontational to the patient so the translator changed the wording of the question a bit to make it non confrontational. The entire protocol in Spanish will be sent out in January.
-Governor Policy Sub Committees
The sub committees were approved. The following 4 sub committees were created:
1. Co Occurring disorders
2. Access- this year the committee is focusing on adolescents and best practices to deliver SBIRT services to adolescents.
3. Billing and reimbursement
4. Creating demand for SBIRT services
These sub committees need members. Please let Lilly or Harold know if you would like to serve on any of these subcommittees. They will put you into contact with the appropriate person.
IV. Announcements
-Diane Carlson and Shelley Hammes shared with the group on the Native American Wellness Conference they attended in October. There were talks about the type of relationship that the states have with the tribes and what can be done to strengthen that relationship, as well as a presentation by Sunny Storm on how to incorporate peace keeping amongst the two.
-SAMHSA had an American Indian Health. Dianne went to a substance abuse issues training. With all the calls that were made to social services and child protective services in a Northern Minnesota tribe, 97% of those calls involved alcohol.
-Georgetown Institute- Conference in July, this announcement can be found in the WIPHL Word.
-Kaiser Family Foundation- Conference in Minneapolis Minnesota. Harold will send out more information. This conference will focus on how to work with the elderly. There was mention of WIPHL’s printouts being made so that it is easier for the elderly to read.
- Rich brought back some materials from the AMERSA meeting.
1. Substance Abusing Latinos
2. Ethno Cultural Factors in Substance Abuse Treatment
-Technical Assistance
If you feel something should be on the Cultural Competence Committee agenda, please let us know. Also continue to let us know of any issues that may come up in your clinics that you may need some assistance with.
-Next Meeting
Next meeting is scheduled for Friday, January 18th from Noon to 1pm.