which is doing the training to do the certification. Is that curriculum available? Could we leverage
that into Alaska to develop and AHEC there? Could we build on the community health worker?
[Jan Ritter] Is this working? To answer your question about
the AHEC in Alaska, uh I’m not familiar with that, they had the, let’s see, was
it the National AHEC met – no, that was the National Rural Health Association met
in Alaska I believe last year. I didn’t attend that. that would be something that
you could look into as far as developing an AHEC in your state. That is a state by state
issue. And not every state has an AHEC, but there are 42 states that have them. Is it
48? Thank you. I’m not up on my math on the National AHECs. But, yes, that would be
a possibility. Sure. And as I said, we are updating our curriculum. It is an AHEC curriculum
and if I’m not mistaken, it’s going to be available if that would be something that
your state would approve. It’s an approval process and ours has been by the state of
Texas. [Alana Knudson]
And just as a quick comment, I know that we have linked, I shouldn’t say linked but
we have identified the Alaska resource as one of the resources that we’d like to include
in the toolbox. But if you have a specific person that you think would be a good resource,
I would very much welcome to get that name and contact information to make sure that
we have the most current resource available for the online toolkit.
[Valerie Darden] Okay, I think we have time for one more question.
Oh, we have two more people. Dr. Wade Hannah from the Georgia Health Policy
Center; just one comment and one question for the training of the promotoras because
I was glad to see you had included cultural competency within the training for the promotoras
because not- it isn’t only the matter of sharing a common language and common ethnicity
that makes one an effective promotora because what is necessary because of the diversity
in the Latino population you will find that even in the same country individuals, for
instance, in Mexico from Yucatan will only speak Mayan preferably rather than Spanish.
And so it’s real important to have the promotora from the community level. They understand
the language, they understand the culture and more importantly, for those people who
speak Mayan, Spanish is a second language. The question I wanted to ask is within the
Latino community, do you look for individuals, for instance, from Latin America who perhaps
might have been in their country, health care professionals or even coramderos or pervalistas
- anything like that and then do you train them to become a community health worker?
[Adalinda Gaytan] I personally have not encountered someone
with those characteristics but I’m pretty sure if they’re willing to be trained as
a community health worker that wouldn’t be a problem. So if they have those skills
already from Mexico, it’s a plus for us. So, definitely.
Hi, Oscar Gomez with Health Outreach Partners. I have one question but I just had a comment
about that – I think the cultural competency piece is critical. The one thing I think that
is probably essential in the whole critical in the whole cultural competency piece that
I think we forget to add is the commonality around socio-economics. Because even within
the Latino community, there’s a tendency for us to say “Oh, we’re culturally competent”,
but we’re very disconnected. I’m first generation American here and thankfully my
parents raised us with both cultures, but there is still a conscious disconnect that
I feel. And so, I think, you know, Adalinda, I think what great about what you all do is
that you really look at the work experience in the lifestyles that your families have.
I would say that is one of the top pieces in cultural competency and yet we don’t
talk about that a lot. I think the socio-economic connection, commonality is really key.The
one thing I wanted to say about- you were talking about some of the different models
that are out there. The FQHCs are doing a lot around that right now. A lot of FQHCs
have what they call their outreach programs or community service programs and they have
a variety of models. They’ll do the traditional promotora model, they’ll have clinical outreach
where they’ll have a whole set of clinicians to do that. They tend to do as a team and
so they are really looking at that. And if you’re going to look at a curriculum for
certification, I think the two states to talk to at the primary care level with the FQHCs
are Texas and California because what they’re doing is they’re trying to get a certification
program for reimbursement. And the one thing, if you do that…Well, no, because I think
they just scaled back, but they’re actually having a round table discussion tomorrow with
a couple of us on Thursday. But, yeah, they’re going in that direction, but I think one of
the things that they really it’s a community-wide effort. Well, my, my point being that it’s
to talk to those states for those folks that are interested in that as well. So, anyway
I think there’s several FQHCs out there that are, have a lot of those models and they
sort of - it’s funny, because they don’t operate in a sense where they’re different.
They all kind of just mesh together based on the need. But Texas and California have
some good stuff and also North Carolina actually also.
[Jan Ritter] And that is our long term goal is to have
the services reimbursable and we are working on that. We are fortunate, like I said, to
have a very strong program office at UTMB, the medical school, East Texas AHEC; they’re
very active at the state level and we think that is a possibility. We’re investing time
in that. It may not be an easy thing to do. It may take several years, but that is definitely
a goal and that’s why our data and being able to tell the story and the return on investments
and try to track as much as we can, the type of activities obviously that the community
health worker is doing and we think that, you know, in probably two to four years that’s
a possibility. But a standardized curriculum it looks like is the one thing that we’ve
heard needs to be done. I think Minnesota is one of the first states to be able to be
reimbursed and that’s what they had to do before they furthered their cause at the legislative
level. [Valerie Darden]
OK, well thank you very much. That was excellent. Thank you all.