Policies Improving Non-English Speakers' Access & Care

改善非英语母语者访问的政策

• 批准号: 7048063
• 负责人: LONNIE Roscoe SNOWDEN
• 金额: $ 27.27万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7048063
• 关键词: Hispanic Americans; Medicare /Medicaid; clinical research; comprehensive care; computer data analysis; health care policy; health care quality; health care service availability; health services research tag; human middle age (35-64); human population dynamics; human subject; interview; language translation; longitudinal human study; mental health services; multilingualism; nonEnglish language; southeast Asia; young adult human (21-34)

DESCRIPTION (provided by applicant): Overcoming access barriers associated with limited proficiency in the English language-the "language barrier" - is expected to contribute greatly toward eliminating disparities in access to specialty mental health care. Since 1997, the California Department of Mental Health (DMH) has required that the state's 57 county-operated mental health agencies provide information and services to Medicaid (Medi-Cal) beneficiaries in their primary language when the number of beneficiaries in the county reaches "threshold" levels defined as "3,000 beneficiaries or 5% of the Medi-Cal population, whichever is lower, whose primary language is other than English." This study will assess the impact of California's threshold language policy requirements (TLPRs) on access and continuity of care for Medi-Cal beneficiaries ages 19-64 over a 72- month period beginning July 1997 and ending June 2003. Specific research questions are: 1) Among non-English speakers, what is the impact of TLPRs on access to specialty mental health care and continuity of care? 2) How is the impact of TLPRs substituted or complemented by broader efforts to serve non-English speaking populations through hiring of bilingual providers and provision of language specific programs? Using panel data regression methods, with the county and month as the unit and period of observation, we will evaluate language-specific differences in access and continuity of care as they relate to differences in implementation of the four TLPRs as well as hiring of bilingual providers and provision of language-specific programs. At the same time, we will control for differences in county sociodemographic environments, mental health systems, as well as changes in access and continuity for English-speaking persons. The analysis will, be carried out using Medi-Cal Specialty Mental Health Claims data and Medi-Cal Eligibility data obtained from the California DMH. Other state data sources will be used to measure county and service system characteristics. Primary data will be collected from county cultural competency plans and state compliance review reports documenting each county's implementation of the TLPRs, and the availability of bilingual providers and language-specific programs. Individual in-depth interviews will be conducted by trained bilingual interviewers with limited-English consumers to obtain their perspectives on how the TLPRs, and other county mental health activities, have helped or hindered access to and continuity of mental health care.

描述（由申请人提供）：克服与英语熟练程度有限的“语言障碍”相关的访问障碍，预计将有助于消除获得专业心理保健的差异。自1997年以来，加利福尼亚州心理健康部（DMH）要求该州的57个县经营的心理健康机构以其主要语言为医疗补助（Medi-Cal）受益人提供信息和服务，而当该县的受益人数量达到“阈值”的“阈值”水平为“ 3,000个受益人”或Medi-CAL的5％，而这些语言的主要是低于Medi-CAL的主要语言，而该语言的主要是其他。”这项研究将评估加利福尼亚的门槛语言政策要求（TLPR）对19-64岁的Medi-Cal受益人的访问和护理连续性的影响，从1997年7月开始，并于2003年6月结束。具体的研究问题是：1）在非英语演讲者中，TLPRS对特殊精神保健和连续保健的影响是什么？ 2）如何通过雇用双语提供者和提供特定语言的计划来替代或补充TLPRS的影响？使用面板数据回归方法，县和月份作为单位和观察期，我们将评估语言特定的访问和护理连续性差异，因为它们与四个TLPR的实施差异以及雇用双语提供者的实施差异以及语言特定计划的提供。同时，我们将控制县社会人口统计学环境，心理卫生系统的差异，以及讲英语的人的访问和连续性的变化。该分析将使用Medi-Cal专业心理健康索赔数据和从加利福尼亚DMH获得的Medi-CAL资格数据进行。其他州数据源将用于衡量县和服务系统特征。主要数据将从县文化能力计划和州合规性审查报告中收集，记录了每个县的实施TLPR，以及双语提供者和特定语言计划的可用性。训练有素的双语访调员将与有限的英语消费者进行深入的访谈，以获取他们对TLPR和其他县心理健康活动如何帮助或阻碍获得精神卫生保健和连续性的观点。