Local, regional and national journeys to cultural and linguistic competence

Formed by the Healthy Oregon Act of 2007, the Oregon Health Fund Board (OHFB) is tasked with designing a comprehensive health reform strategy for the 2009 Oregon Legislative session. The Health Equities Committee of the OHFB is chartered with developing multicultural strategies for program eligibility and enrollment procedures as well as with making policy recommendations to reduce health disparities through delivery system reform and benefit design of the proposed Oregon Health Fund Program.  This multicultural, multiracial, multiethnic committee has been meeting twice a month since November 2007 and will finalize recommendations to the Board by May 2008. The committee has wrestled with issues related to immigration eligibility in the context of widespread anti-immigration sentiment in Oregon, as well as topics such as recruiting and retaining a diverse workforce, creating sustainability for interpreter services in the context of a patient-centered medical home model, and funding for community-based approaches to healthcare delivery such as Community Health Worker models. Challenges facing the committee include engaging the public in constructive dialogue and constructing policy recommendations that have broad impact and garner support from the Board. By September 2008, the Board will have created a health reform ‘package’ to take to the Oregon people in a series of public meetings designed to foster engagement, stimulate discussion, and provide feedback to the Board. The ultimate success of the Health Equities Committee will be judged by the successful adoption of strategies to reduce health disparities in the health reform package, and the resonance of these policy elements with the Oregon public. Lessons learned throughout the process include the importance of engaging key stakeholders, the difficulties of balancing good health policy with political realities and knowing when to strive for one over the other.