Even though some individuals are lawfully eligible for health care coverage, fear remains a virulent ruler among immigrant communities, and ACSI knows how to address this situation with cultural understanding and respect. ‘“Epidemics don’t discriminate,” Louise McCarthy, president of the Community Clinic Association of Los Angeles, told Vox. “They don’t discriminate based on your documentation status, based on your income, or anything—and health care shouldn’t discriminate, either.”’ The specificity of this March 13, 2020 article titled, Low-income immigrants are afraid to seek health care amid the Covid-19 pandemic, directly pinpoints the disparity between low-income immigrants and the rest of the U.S. population. ACSI recognizes the need for better health care consultation for immigrant communities; they are entitled to in-depth explanations about what is going on amidst this still raging pandemic, and what types protective precautions they should take. Through our multifaceted, language access services, ACSI can help eligible immigrants obtain health care; we dissuade fear and replace it with understanding by breaking down cultural and language barriers.

Despite the Affordable Care Act (ACA), 4 million citizens and legal immigrants remain uninsured who are actually eligible for Medicaid, but they live in one of the 21 states where Medicaid has not been expanded. Taking part in health precautions tend to be luxuries among low-income immigrant communities, making them particularly vulnerable to the disease, and placing those around them in danger. Immigrants remain more likely to seek services at Community Health Centers (CHCs) and Local Health Departments (LHDs) due to overly complex eligibility rules, as well as misinformation.

Immigrants trust CHCs and LHDs relationships, along with locations in the community and services that enable them more understanding, such as language access, which they rely on. Knowledge of the need for preventive care, especially during a pandemic, must be met with increased cultural competence. Perhaps most importantly, the language barrier makes it difficult for immigrants to access information on prevention, testing and even quarantine guidelines. Concern about revealing citizenship status may prevent immigrants from visiting hospitals, which means we don’t have an accurate depiction of the spread of the illness.

Fear presents itself in two major categories ACSI has experience with, and these categories are cultural awareness and language access. Both of these serve as thick barriers when you begin to discuss reasons immigrant communities are underrepresented in the health care industry. Cultural barriers remain when discussing the concept of health insurance and need for preventive care, such as lab work, x-rays, or medications for chronic conditions—these ideas might still be unfamiliar to immigrants. Linguistically, the inability of immigrants who are Limited English Proficient (LEP) to either understand or communicate with their health care provider runs rampant. Written instructions or forms may not always be accessible or provided.

At home, about 9% of the population speak a language other than English. Title VI of the Civil Rights Act of 1965 requires health care entities that receive federal funding to provide language

interpretation and translation of materials for LEP individuals. As well, LHDs and CHCs are required to ensure access to linguistically and culturally competent care, in response to fluxing demographics around the country.

Some of ACSI’s solutions for taming the fear factor for immigrants, run parallel to an article published by the Partnership for Public Health Law in their article, Opportunities for Maximizing Revenue and Access to Care for Immigrant Populations. Firstly, hiring bilingual and bicultural staff is supremely important, in this case, to run a successful clinic. Also, providing volunteer interpreters with initial and ongoing training. Educating the administrative and legal staff about benefits that language access provides concerning risk management, as well as creating and making available online: sample forms, privacy practices, translated materials, are paramount. These online materials should be shared with CHCs, LHDs and hospitals. The article also gives the following information that may prove helpful, as it provides information on how to consult the National Standards of Practice for Interpreters in Health Care, National Council on Interpreting in Health Care, September 2005, for additional best practices on medical interpretation.

Now we’ll discuss ACSI as a direct solution to the fear immigrant communities are experiencing; once we are able to quell these fears by implementing language access, we may begin to see health care applications and acceptances increase in the U.S. ACSI functions as more than a translation company, which strengthens to our abilities when addressing this very real fear factor common among immigrant communities. ACSI’s Language Access Maturity Model ™ (LAMM) consists of nine different response levels that enterprises exhibit concerning language services. The levels, beginning at -3 (Suppress) and rising to +5 (Transformed), identify how an organization may integrate language services into its own functions. This kind of identification can help ACSI set targets for improvement.

For example, if we pair ACSI with a Community Health Center (CHC) who may be at a Level 1 (ADHOC), in which the center only responds to multicultural opportunities on a case-by-case basis with no formal processes, ACSI’s goal is to then propel the CHC to a Level 2 (Recurring). At a Level 2, ACSI focuses on the CHC beginning to formalize processes for core localization tasks (the CHC would adapt to their strategies to fit their specific locale), and they also recognize their need for a leader. ACSI’s objective is to bring the CHC to the final level, 5 (Transformed), in which the center treats localization as just another business process, continuously improving as they integrate their individuals in need and requirements into all strategic and operational planning.

Two helpful and interrelated pieces to the LAMM are Strategy and Management. We would apply Strategy to elevate the CHC from no awareness and no cohesiveness, to true language access awareness, by including language at an institutional level to complement the CHC’s

strategic initiatives. Then, the Management part to the puzzle would come together to transform your staffing model from no dedicated team to a language access team, working along-side ACSI. This combination will surely effect change and provide everything necessary to alter the immigrant community’s interpretation and navigation of the health care system.

“Health care” and “fear” should not be synonymous within immigrant communities, and only through ACSI’s true push for more cultural awareness and more prevalent language access will we be able to pry these words apart. ACSI has four principles to help you as our client accomplish these goals: Collaboration, Discovery, Execution and Creation. We will form our team with you; perform thorough research to establish your needs; oversee the design and management; and ultimately develop the plan that reaches your goal—in this case, to provide eligible individuals who live in immigrant communities the necessary health care they deserve, especially during this destructive pandemic. This type of positive outcome is ACSI’s goal as well; through more available language access, which in turn fosters calm not fear, we will see individuals in our immigrant communities thrive with their new found understanding of our health care system.