Policies Improving Non-English Speakers' Access & Care

描述（由申请人提供）：克服与英语水平有限相关的准入障碍-“语言障碍”-有望大大有助于消除获得专业精神卫生保健的差距。自1997年以来，加州心理健康部门（DMH）要求，当该县的受益人人数达到“3,000名受益人或占Medi-Cal人口的5%，以较低者为准，主要语言不是英语”的“门槛”水平时，该州的57个县经营的心理健康机构必须以其主要语言向医疗补助（Medi-Cal）受益人提供信息和服务。本研究将评估加州的门槛语言政策要求（tlpr）对19-64岁的加州医疗保险受益人获得和持续护理的影响，为期72个月，从1997年7月到2003年6月。具体的研究问题是：1)在非英语母语者中，tlpr对获得专业精神卫生保健和护理连续性的影响是什么？2)如何通过雇用双语提供者和提供特定语言课程来为非英语人口提供更广泛的服务来取代或补充tlpr的影响？使用面板数据回归方法，以县和月为单位和观察期，我们将评估特定语言在获得和连续性护理方面的差异，因为它们与四种tlpr的实施差异以及双语提供者的雇用和特定语言项目的提供有关。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，以及英语人士获得和连续性的变化。分析将使用从加州DMH获得的Medi-Cal专业精神健康索赔数据和Medi-Cal资格数据进行。其他州数据来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，这些报告记录了每个县实施tlpr的情况，以及双语提供者和特定语言项目的可用性。将由训练有素的双语采访者与英语有限的消费者进行个人深入访谈，以了解他们对家庭护理方案和其他县精神卫生活动是如何帮助或阻碍获得精神卫生保健和其连续性的看法。

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.