For immediate release: April 6th, 2012

Contact:
Kayse Jama, Executive Director
kayse@interculturalorganizing.org
(503) 913-5154

Anya Valsamakis
(503) 415-1383

Coalition of Immigrant & Refugee Community Organizations and Allies Opposes Elimination of Portland Public Schools Family Engagement Staff

PORTLAND – A coalition of advocates and community-based organizations will host a press conference at Cleveland High School on April 9th at 4:30pm to discuss the impact of Portland Public Schools’ proposed budget on immigrant, refugees, and communities of color.

As laid out by Superintendent Carole Smith, the proposed budget eliminates 4 bilingual-bicultural family engagement staff which operate as liaisons to Spanish-speaking, Russian-speaking, Somali, and Vietnamese communities, a 100% reduction in the district’s family engagement staff for immigrants and refugees. These staff members have strong connections within communities of color and immigrant & refugee communities, and are integral to the district’s efforts to build a culturally competent and diverse workforce.

As a community, we need PPS to be focused on closing the achievement gap for our students; cutting its bilingual, bicultural staff is exactly the wrong way to do that. As Portland’s student body becomes more diverse, it’s crucial that the district ensure that immigrants, refugees, and people of color have real access to education. The district should commit to furthering its institutional connections to these communities. The first step is maintaining these family engagement staff positions.

We support the proposed increase in culturally-specific parent engagement contracting. These two proposal are not either/or; the district is well-served by building its bilingual and bicultural staff, while simultaneously contracting with community-based organizations to build an effective, two-pronged family engagement strategy, which retains the strong institutional connections that internal staff provide.

We strongly oppose these cuts to family engagement bilingual staff and demand that Portland Public Schools reinstate these positions.

Coalition members include the Center for Intercultural Organizing, Bhutanese Community of Oregon, Better Life USA, Iraqi Society of Oregon, Causa Immigrant Rights Coalition, Student Alliance Project, Latino Network, Cesar E Chavez Leadership Conference (CECLC), the Oregon Somali Family Education Center, East European Coalition, Portland Russian Media Center, Russian Oregon Social Services (ROSS), NW Russian American Community Center, the Annual Russian Speaking Youth Leadership Conference, AM-RU International Association, the Russian Sports-Cultural Center “ATL-ANTI”, the Salem-Keizer Coalition for Equality, and the Somali Youth of Oregon.

Sign our petition on change.org!

Portland’s immigrant & refugee communities are ever-growing, and our city is becoming more diverse every year. With the changing face of our community, it’s more important than ever that our elected officials consider basic questions of equity and human rights at every stage of our political process.

The Center for Intercultural Organizing is pleased to announce our 2012 mayoral forum, giving our immigrant & refugee communities a chance to engage candidates for Portland Mayor. Please join us in a frank and honest dialogue about the issues that matter to you!

Date: Friday, April 6th, 2012
Time: 6:00pm – 8:00pm
Location: 700 N Killingsworth St, Portland, OR

Joining us will be Charlie Hales, Jefferson Smith, and Eileen Brady.

We look forward to seeing you there! Please RSVP by emailing alton@interculturalorganizing.org or by calling (503) 287-4117, ext. 106.

CIO and its partner organizations are working on health equity policy in the Oregon State Legislature. Watch this video produced by Northwest Health Foundation and find out how … and why!

A lot of our recent work in health care has been fast-paced and behind-the-scenes. I wanted to take a moment to share what it is we’ve been working on.

The main topic of discussion in health care is new organizations called “Coordinated Care Organizations,” also known as CCOs. These CCOs are community-based organizations (sort of like CIO) that provide medical care to patients. This medical care is supposed to integrate or unite physical health (treating people when they’re sick or working with people to prevent illness), behavioral health (mental health services), and dental care. The problem right now is that our health care system is fragmented, and there’s not a lot of dialogue between different kinds of doctors. These new CCOs will change that by facilitating communication between providers, to better help patients.

At first, these CCOs will serve people on the Oregon Health Plan, Oregon’s health care system for low-income folks. The vision of the state, though, is that these CCOs will be a model for transforming ALL of Oregon’s health care system.

Why is CIO involved in advocacy around these CCOs? Well, we view this new model as an excellent way to promote health equity. In fact, organizations that want to become CCOs will have to have a plan to reduce health disparities and improve health equity. There are a few ways they do this:

• First, the CCOs are required to work with the state health department to develop standards for improving health equity, and to include community representatives as part of their governing boards of directors.
• Second, CCOs will have to collect and track data about patients’ race, ethnicity, and native language, which allows advocacy groups to better understand and eliminate health disparities suffered by our communities.
• Third, and maybe most importantly, CCOs are required to promote culturally and linguistically competent care, including working with community-based health workers to improve the health of all communities.

CCOs by themselves won’t solve all of the disparities our communities experience. That’s a challenge that ALL of us have to undertake: community groups like CIO, health care providers and CCOs, the state health department, and members of the community: you. By working together, sharing stories, understanding the issues, and continue to push our state to promote health equity, we can make sure that all of us have the chance to be happy & healthy.

We’ll keep updating you about the work we’re doing – and I’d like to invite you to get involved. We want our work to be rooted in the community, and for that, we need you. Please call me at 503-287-4117 ext. 106 or email me at andrew@interculturalorganizing.org to talk about engagement opportunities.

As Oregon moves toward an overhaul of its health care delivery system, it’s crucially important that we take into account the growing diversity of our state. One in five Oregonians is a person of color, and one in ten is a first-generation immigrant or refugee. These different communities have distinct health needs rooted in historical disempowerment and structural inequities, and the advent of coordinated care organizations offers an incredible opportunity to achieve health equity for our state.

The Center for Intercultural Organizing, a nonprofit organization dedicated to advancing immigrant & refugee rights, is cautiously optimistic about the proposed Request for Applications and administrative rules and the potential of CCOs to help improve health for our communities. We offer the following constructive critiques of the draft documents for the state’s consideration, in alignment with our communities’ health equity priorities.

Cultural and linguistic competency: The draft documents repeatedly reference the state’s commitment to making sure CCOs provide culturally and linguistically competent services and communication, from the organizations’ governance structures to the actual care itself. The introduction at 1.2.1 (pgs. 5-6) most notably lays out a commitment to eliminating health disparities and a focus on culturally appropriate care, language that is broad enough to include many different communities.

The challenge here relies in the state’s reliance on “evidence-based practices” as the gold standard for care. For many immigrant & refugee communities, the most culturally-competent care would promote the parallel use of traditional models of healing along with conventionally allopathic medicine; these traditional models might include the use, for example, of shamans or other culturally-situated healers, herbs and other medicines, or other treatments that might not have a defined evidence based for success, but are key for a culturally-appropriate engagement of these communities with the health care system.

We propose that the state include language around health equity which includes culturally-situated healing practices not rooted in an evidence base, but which are key to communities’ successful health outcomes.

Workforce development: The state has committed itself to ensuring a diverse workforce in two respects: increasing the utilization of community health workers, and ensuring that the state promotes a medical workforce that represents a variety of cultural, racial, and ethnic backgrounds. The state has thus prioritized two of the most important ways to facilitate dialogue and trust between underserved communities and health systems: ensuring that the workforce reflects the state’s diversity, and that community health workers are readily available to serve as liaisons between patients and health systems. We ask that the state and new CCOs work with advocates to identify national best practices in workforce diversity and community health worker promotion in the implementation of these standards.

Equity and accountability standards: We applaud the OHA for ensuring that CCOs will be required to work with the Office of Equity and Inclusion in the development of community needs assessments. The expertise of the Office will be well-situated to effect concrete changes in community health moving forward.

At the same time, OHA’s language is far from inclusive in this regard; the list of criteria delineated in A.1.8 specifically identifies race, ethnicity, and a host of other factors, but excludes any mention of immigrants and refugees. Although the health challenges experienced by communities of color and immigrant & refugee communities are similar, but distinct, especially when it comes to culturally competent and appropriate health services. We recommend that the state and CCOs specifically include immigrant & refugee communities in these community needs assessments as an explicit focus, with other underserved communities.

Data collection: CCOs will be required to compile race, ethnicity, and language data (so-called REAL standards). This presents an opportunity to comprehensively track health outcomes for communities of color, immigrants, refugees, and other underserved communities. Often times, the data collected around immigrants & refugees is incomplete; patients might be incorrectly categorized based on their apparent racial or ethnic identity, data about native language might be collected, and identification categories – e.g. “Asian & Pacific Islander” – might aggregate data about a large number of distinct communities thus reducing the utility of that data.

We ask that the state and CCO candidates partner with community-based organizations and advocates to develop culturally-competent and appropriate standards for this data, and that CCOs disaggregate the data they collect about these communities to the most granular level possible.

Transparency and community engagement: The biggest flaw with these documents and the process as proposed is the utter lack of transparency in CCO certification. As written, the current standards don’t allow the public full access to records about who is seeking certification and their plans to improve community health, until after the state has agreed to contract with them. Before that point, only the names of entities seeking certification will be available. This process, seemingly designed to ensure a smooth, quick certification process, cuts the public out of the discussion entirely. Without access to the full application materials – with trade secrets obviously protected – the public will have no opportunity to raise legitimate concerns about the ability of certifying organizations to provide for population health.

The state’s language around community engagement in the development of CCO applications is similarly problematic. Although appendix A encourages applicants to promote community involvement in the application process, there are no real requirements around stakeholder engagement at all during the application phase.

To correct both of these issues, we first propose that the state require some amount of community engagement during the application process. We also suggest that the state allow the public full access to applications to the fullest extent possible without compromising trade secrets, to allow this process to be truly transparent.

March 9th, 2012

To: Oregon Health Authority staff, Oregon Health Policy Board members and staff
Cc: Oregon Office of Equity and Inclusion, Representative Tina Kotek, Representative Tim Freeman, Senator Alan Bates

Public input process on Coordinated Care Organization certification lacks transparency

As Oregon takes bold steps toward reforming and transforming its health care system, it’s important to ensure that the process is truly patient-centered and public. As the Oregon Health Authority itself notes, “[w]e all have a stake in Oregon’s path to better health, better care and lower costs.” [1] It is with great disappointment, then, that we note the recent lack of transparency in the public comment period for Coordinated Care Organization certification documents; specifically, the draft Request for Applications, draft Oregon Administrative Rules, and draft memo to the Center for Medicare and Medicaid Services on program integration.

The three combined documents [2] total 345 pages of text, and OHA has given community groups and the public at large roughly a week to read and analyze them, and then provide substantive comments. Given that the documents also use complex policy-specific language, the time frame proves simply insurmountable for much of the public. The process is kept inaccessible to most of Oregon’s communities, especially those who have been traditionally underserved by our health care system, such as communities of color, immigrants, refugees, and rural communities.

This process might retain a modicum of transparency if the final date for approval of the RfA and rules weren’t targeted for March 19th, with initial certification Letters of Intent due April 2nd. [3] It’s clear that no substantive changes to any of the documents can be made at this stage, and it seems that this opacity was by design rather than coincidence.

As concerned advocates, we understand that the state feels a sense of urgency in the desire to certify CCOs and see them begin operations. At the same time, the process for that certification is the anything but transparent. We urge the state and the Oregon Health Authority to extend its public comment period on these CCO certification documents to allow 30 days of input, and to meaningfully engage with communities across the state to ensure that this process is open, public, and transparent.

Respectfully submitted,

Center for Intercultural Organizing
Asian Pacific American Network for Oregon
We Can Do Better
Sisters of the Road Café
Ecumenical Ministries of Oregon
Latino Network
Cascade Aids Project
Oregon Action
Urban League of Portland
Upstream Public Health
Coalition of Communities of Color
Oregon Center for Public Policy
Causa Oregon

Notes:
1: http://www.oregon.gov/OHA/OHPB/health-reform/get-involved.shtml
2: http://cco.health.oregon.gov/
3: Draft Request for Applications, p. 1