G-2402-20177

The Refugee Community Partnership (RCP) is a grassroots organization composed of migrant and refugee members across central North Carolina who come together to design community-owned solutions to healthcare exclusion, creating relationship-based interventions for better health outcomes for limited-English proficiency (LEP) patients. RCP Members, staff, and interpreters examine the impact of institutional policies on Members’ daily lives, pilot community-designed interventions, and advocate for changes to policies and practices blocking refugee and migrant communities from safe health care. Decision-making comes from Membership through neighborhood level conversations between Members, staff, and interpreters, and through Member Councils, composed entirely of refugee and migrant residents.

RCP is a new grant applicant to CareQuest Institute, but the organization has been focused on health equity and social justice since its inception. With this proposal, RCP plans to leverage its Language Navigators, who are multilingual refugee and migrant adults who provide 1-on-1 language support and accompaniment to LEP patients, to evaluate the quality of language services when they are provided and intervene if needed in oral health care settings. Historically, this community has reported experiencing shame and verbal abuse from telephonic interpreters, uncertainty of their rights to care, and fear of harm/punishment by providers for complaining, which all serve as population-specific barriers to effective oral health care and patient agency. To combat these reported barriers, RCP’s Language Navigators complete a Language Access Assessment after each appointment to develop an access map based on the local healthcare systems and ultimately advocate for more equitable access to critical language resources for LEP patients in oral health. This work aims to hold oral health systems of care accountable to patients with unique/specific health care needs, similarly to the medical healthcare system, while also building evidence for the benefit of language interpretation services to be covered by Medicaid and the viability of this employment pathway for migrant and refugee communities.

The proposed project is an adaptation of a similar pilot RCP launched within the healthcare system and has continued since 2018. The pilot examined data from 135 appointments accessing a hospital system and discovered that LEP patients rarely received interpretation services that could be rated as “adequate”. By expanding Language Navigation to oral healthcare, RCP hopes to better understand where and why exclusion for the LEP population occurs. Using its community-owned Data Vault, which houses data on patient experiences, RCP will tell data-driven stories that shed light on the magnitude and impact of language exclusion for migrant and refugee communities, report Title VI violations, and initiate institutional advocacy efforts that build the case for more equitable language policy and practices. Furthermore, with North Carolina’s expansion of comprehensive medical and dental coverage to include an estimated 600,000 people in 2023, there will be intentional education to and with organization members about their oral health benefits and rights to services.

RCP’s proposal is being recommended for funding in the requested amount of $123,000. The project’s approach reflects an intentional health and racial equity lens that builds community power among historically marginalized individuals and outlines work that will support language access advocates’ push for interpretation to be a 100% reimbursable Medicaid expense. Success of this proposed work will improve language access in oral health care and create a pathway for oral health advocacy based on community-collected data. The proposal budget indicates most grant funds will support staff salaries (across five project roles) and the Language Navigators, with remaining funds applied to mileage and technology fees. Overall, this grant makes up approximately 8% of the organization’s budget and match support for all request items is indicated.