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相关的准入障碍（“语言障碍”）预计将大大有助于消除获得专业精神卫生保健的机会差距。自 1997 年以来，加州心理健康部 (DMH) 要求该州 57 个县运营的心理健康机构，当该县的受益人数量达到“阈值”水平定义为“3,000 名受益人或 Medi-Cal 人口的 5%（以较低者为准），其主要语言不是英语。”本研究将评估从 1997 年 7 月开始至 2003 年 6 月结束的 72 个月期间，加州门槛语言政策要求 (TLPR) 对 19-64 岁 Medi-Cal 受益人获得护理和连续性的影响。具体研究问题是：1 ) 在非英语国家中，TLPR 对获得专业心理健康护理和护理连续性有何影响？ 2) TLPR 的影响如何被更广泛的努力所取代或补充，通过雇用双语服务提供者和提供特定于语言的项目来服务非英语人群？使用面板数据回归方法，以县和月为单位和观察期，我们将评估护理获取和连续性方面的语言特定差异，因为它们与四项 TLPR 的实施以及双语提供者的聘用方面的差异有关以及提供特定语言的课程。与此同时，我们将控制县社会人口环境、心理健康系统的差异，以及英语人士的访问和连续性的变化。该分析将使用从加州 DMH 获得的 Medi-Cal 专业心理健康索赔数据和 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的特征。主要数据将从县文化能力计划和州合规审查报告中收集，记录每个县 TLPR 的实施情况，以及双语提供者和特定语言计划的可用性。训练有素的双语访谈员将与英语水平有限的消费者进行个人深度访谈，以了解他们对 TLPR 和其他县心理健康活动如何帮助或阻碍心理卫生保健的获取和连续性的看法。