making the business case for culturally and linguistically appropriate ...

APPENDIX JTeleSaludMolina Healthcare Inc.CLAS Standards Met: 4,5 and 7See page 12 for list of CLAS StandardsISSUE. In 2002, a review of utilization statistics from Molina Healthcare’s outsourced nurseadvice line was significantly underutilized by Spanish-speaking members (Latinos). Thereport showed that although 45% of Molina’s membership is Latino (primarily of Mexicanorigin), with a declared Spanish language preference, requests for a Spanish interpreterconstituted less than two percent of calls. Molina concluded that this low utilizationsuggested a barrier to members in accessing nurse advice services. Previous internal researchsupported the finding that while English speaking populations would use automated phoneservices, Spanish speaking populations were more likely to hang up when reachingautomated services. The practice of waiting in line for service was not congruent with theLatino culture, which could adversely affect their access to healthcare.DISCUSSION. Molina Healthcare, Inc., headquartered in Long Beach, California, is amulti-state managed care organization that arranges for the delivery of healthcare services tolow-income families and individuals eligible for Medicaid and other government-sponsoredprograms. In an effort to decrease the number of Spanish speaking patients hanging up whenreaching automated services the TeleSalud demonstration project was formed in 2004 as aseparate department within Molina Healthcare of California to offer direct accessibility formedical interpreting services to address the health and language needs of the underservedLimited English Proficient Latino population living in the Inland Empire of SouthernCalifornia.TeleSalud was started as a program component under the Hablamos Juntos demonstrationproject grant, funded by the Robert Wood Johnson Foundation to expand the language accessservices capacity in the Inland Empire region of Southern California. The TeleSaluddemonstration project began as a 24-hour contact center to enable direct access to a SpanishspeakingRegistered Nurse to help address a Spanish-speaking members’ health andinterpreter needs at all times. TeleSalud initially offered three primary services exclusivelyin Spanish: nurse advice, medical interpretation, and member services. The TeleSaludSpanish nurse advice program was implemented in several phases. The launch date wasearlier than originally planned due to operational considerations, and so was initially staffedby nurse practitioners and physicians. No advertising was done during this phase, as part ofwhat was being monitored was member awareness of information printed on their cards.Phase 2 began in October 2004, with launch of computerized protocols and a fully trainednursing staff. Because the program was so well received, in November 2004, the decisionwas made to open the TeleSalud project beyond the Inland Empire area, to all Californiamembers on January 1, 2005; the original pilot group only included 80,000 members in theSouthern California counties of Riverside and San Bernardino.BENEFITS/RESULTS.There are many indirect cost benefits that have been identified with TeleSalud. The project’sgains are multi-faceted, and the bilingual capacity of the TeleSalud staff has been valuable to52