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Community House Calls Program

Our Mission

To contribute to the health and well-being of refugee and immigrant patients, families and communities through a partnership that promotes cultural humility in the care provided.

Community House Calls (CHC) is a program of Harborview Medical Center’s (HMC) Interpreter Services.  Community House Calls serves limited English proficient patients, families and communities who receive health care at HMC.  Bilingual/bicultural caseworker cultural mediators provide same language services for patients facing complex medical and social circumstances and serve as liaisons to their respective communities.

Community House Calls began in 1994 when doctors Ellie Graham and Carey Jackson were jointly awarded a Robert Wood Johnson grant to help address barriers to health care for refugees and immigrants receiving care at HMC.  Caseworker cultural mediators (CCM) were hired with input from community leaders. In 1996, CHC became a Harborview program in the Interpreter Services department, and more CCMs as well as a nurse manager were added to the staff. Currently, there is a nurse manager working with a team of eight that serve five language groups: Amharic, Cambodian, Somali, Spanish, and Vietnamese. Of this team, two staff focus on diabetes self-management in the Somali and Spanish-speaking communities.

Community House Calls Program Photo
Community House Calls Program staff: (back row l-r) Yodit Wongelemengist, Anab Abduallahi, Leticia Magaña, JT Christianson, Lea Ann Miyagawa, Salma Musa, (front row l-r) Jeniffer Huong, Rose Cano, Kim Lundgreen, José Mayorga

Services Provided

Services available to patients 

  • Navigation: Support and teach patients to navigate health care system by overcoming barriers and identifying gaps. Facilitation of Medicaid-eligible patients to receive coverage. Help with forms and applications. 
  • Case Management: Monitor and coordinate on-going needs. Find resources for social issues that impact the health of patients, such as immigration concerns, job searches and enrolling in English for citizenship classes. Coordination of patient care, including arranging transportation and providing home visiting as necessary. 
  • Mediation & Advocacy: Observe and communicate patient and family beliefs and values as needed when in the healthcare, social service, school and agency setting.
  • Health education: Assist patients in learning about medical and health issues.  
  • Interpretation: Provide spoken language interpretation to patients, medical providers, and staff. 

Services available to providers 

  • Cultural mediation & advocacy: Facilitating clinical encounters that involve cultural differences. Provide cultural consultation about issues affecting patient care. Case management for complex medical and psycho-social needs. 
  • Education: Teach providers about cultural issues surrounding care for their patients e.g., health beliefs, traditional health practices, explaining diagnoses to patients, end-of-life issues and parenting practices. Didactic presentations providing cultural information on a variety of topics. 
  • Interpretation. 

Services available to the community 

  • Education on requests for health topics from a cultural lens. 
  • Consultation on issues impacting ethnic communities. 
  • Bridging the institution and communities viewpoints to provide positive health outcomes and optimal relationships. 



The following videos highlight how Harborview's patient navigator program helps LEP patients from other cultures navigate the health care system.
The following video illustrates a simulated "prehuddle" with a Cambodian interpreter/cultural mediator before a Palliative Care family meeting.


The following video shows the Physicians for a National Health Program Western Washington (PNHPWW) August 15th Monthly Meeting focused on the Community House Calls/Interpreter Services Program at Harborview Medical Center with presentations and discussion led by Lea Ann Miyagawa - Nurse Manager and three Cultural Mediator team members - Salma Musa, Kim Lundgreen and Jose Mayorga, including brief cases illustrating how they facilitate underserved patients to interact with and overcome barriers to health care.


Publications referencing the Community House Calls Program


Contact Information

Community House Calls
Harborview Medical Center
Box 359977 Seattle, WA 98104

Contact: Lea Ann Miyagawa, MN, RN at

  Phone: 206 744-9256
  Fax: 206 744-9981