Author(s): Christine Wilson Owens; J. Carey Jackson

Date Authored: February 7, 2003

Photo of the exterior of hospital and park
Photo by UW Medicine

On February 6-7, 2003, Harborview Medical Center convened a meeting of key stakeholders involved in providing language access services in health care in the City of Seattle and in King County, Washington. The objective was to identify collaborative approaches to the dilemmas facing the “safety net” providers for non-English speaking patients. These are the proceedings and discussions of that meeting.

Introductory remarks are below. Please see the full proceedings in sidebar.

Introductory Remarks: The Current Challenge: Why Us? Why Now?

These are turbulent times for “safety net” providers in King County, especially those caring for the non-English speaking poor. The downturn in the economy has diminished the tax base and thereby state and county budgets. Cost cutting directly affects services at the Health Department, the Community Clinics and Harborview creating an atmosphere of anxiety and mistrust. Immigrant communities are suffering. The lowest skilled and the last to be hired are often the first to be laid off. Many recent immigrants find themselves unemployed without hope of new employment.

As they lose benefits they fall into the “safety net” infrastructure, as it is unraveling. This is the same scenario for many native Washingtonians, as a result low-income or unemployed natives and immigrants compete for the same jobs and for the same limited pool of social services. The war on terrorism has made many fear and resent immigrants, especially those from Moslem countries. Tolerance and compassion for immigrants is disappearing, and public opinion is beginning to shift.

These streams run together contributing to the turbulence experienced daily in local clinics and hospitals that serve non-English speaking patients. There is a general sense that programs and resources burnished with the effort of 25 years of work are now corroding. We called this meeting intending to build new initiatives, to build new creative collaborations, to rediscover our origins and build on our shared history. On the one hand it could not have come at a worse time, as resources dwindle, morale declines, the temptation is to retreat to a bunker mentality.

On the other hand, this is exactly the time that those committed to what has been developed thus far in our parallel institutions must step forward to protect those resources through information exchange and innovative design. The effort should be toward shared efficiencies in order to contain, if not reduce costs, while creating a more seamless service for immigrant communities. From this view there is no choice but to be proactive or to retreat.

We have specifically invited administrators, program managers, health care providers, interpreters and policy makers from key safety net institutions in King County. In this room Community Based Organizations, Community Clinics, Harborview Medical Center, the Health Department, Hopelink, Pacific Medical Center and the University of Washington Medical Center are represented. Through the next day and a half we ask you to use your combined talents to envision a way forward. Let us use our knowledge and creativity to reduce redundancy, share information, and build networks that will extend the resources of each “safety net” institution working with immigrant communities. As we move forward we must insist on a hardheaded look at the cost of these possibilities.

If there is common ground, if there are shared priorities, and if the possibility of collaboration exists, however small or experimental, those of us working in the “safety net” who serve these communities, and the communities themselves have the most to gain.