National Center onImmigrant Integration Policy

Preparing a Diverse CommunityEmergency Response Plans for Limited

English Proficient (LEP) Communities

Language Access Webinar V:

September 9, 2009

About MPIIndependent, nonpartisan, nonprofit, think

tank dedicated to the study of the

movement of people worldwide

MPI Program Areas:• U.S. Immigration Policy

• National Center on Immigrant Integration Policy

• Borders, Security and Migration

• Labor Markets Initiative

• Migration & Development

• Transatlantic Task Force on Immigration and

Integration

About Our SpeakersMarsha Tamura is the Citizen Corps Volunteer Coordinator and part of

the Homeland Security branch of the State of Hawaii Civil Defense

Agency. She recently received her Graduate Certificate from the

University of Hawaii –Manoa Disaster Management and Humanitarian

Assistance program. [Email: MTamura@scd.hawaii.gov]

Gerald Ohta covers nondiscrimination in services and employment,

ADA, language access, refugee health, and distance learning for the

Hawaii State Department of Health. He is Vice-Chair and state agency

representative on the State Language Access Advisory Council. He is

also active in the community in public health at the national and state

association levels and has worked in preparedness as coordinator for

the CDC Public Health Training Network and Health Alert Network. [Email: Gerald.Ohta@doh.hawaii.gov]

Barbara Yamashita, Chief of the Community Health Division, Hawaii

State Department of Health, has had a diverse career in both

government and the private not for profit sector, spanning over a

period of 25 years. Yamashita holds a Masters degree in Social Work

from the University of Hawaii and has completed several certificated

courses on leadership and management. [Email: Barbara.Yamashita@doh.hawaii.gov]

Emergency Preparedness

Planning for Limited English

Proficient (LEP) Populations

in Hawaii

The 2006 American Community

Survey (ACS) estimates that

about 24% of Hawaii’s population

of 1.2 million speak a language

other than English at home.

Yes = 30%

No = 70%

INCIDENCE OF OTHER LANGUAGE SPEAKERS

IN HAWAII'S MASS MARKET AUDIENCE

What language is that?

Ilocano 36%

Japanese 19%

Hawaiian 14%

Tagalog 11%

Spanish 11%

Korean 3%

Samoan 3%

Chinese 2%

(n=389)

During the wake of 9/11 it became

clear that one of the major

problems that LEP Communities

face during a disaster or

emergency situation is the

communication barrier between

LEP groups and first responders

and care providers.

Project ImplementationProject Title: Development of Language Identification and

Emergency Cards (LIEC)

Time Frame: August 2007 – June 2008

• Partnerships established between the Hawaii

State Civil Defense Citizen Corps, Department of

Health, and the Interagency Council on Immigrant

Services.

• Developed emergency preparedness messages

and included identification of the user’s primary

language spoken.

Traditionally, professionals in Public

Health have developed personal

emergency health cards that contain

personal health information that

emergency medical service

responders need to know about the

individual if they find them

unconscious or incoherent.

The traditional public health

emergency health cards usually

contained information listing

medications being taken, allergies

and sensitivities, medical conditions,

and important contact people that the

emergency responder may call in the

event of an emergency.

The opportunity for us is to work with

agencies who serve LEP populations to

assure inclusion of emergency

preparedness messages and the

importance of being prepared as part of

any intervention. The partnership between

those who work on preparedness issues

and those who work with LEP populations

becomes critical.

Language Identification and Emergency Cards

(LIEC)

Project Implementation

• Formatted and designed the English version of

the LIEC cards.

• Determined the languages that the LIEC cards

would be translated into by using State LEP

population data.

Language Identification and Emergency Cards

(LIEC)

Translation Languages

• Cantonese

• Cebuano

• Chu'ukese

• Ilokano

• Japanese

• Korean

• Kosraean

• Mandarin

• Marshallese

• Pohnpean

• Samoan

• Spanish

• Tagalog

• Tongan

• Vietnamese

• Yapese

Lessons Learned

• Clear purpose and utility of the product

– The goal of the LIEC is to reduce barriers for LEP

populations to access, utilize and understand

preparedness, disaster and recovery messages,

services and resources.

– The goal of the LIEC is to reduce barriers for LEP

populations to access, utilize and understand

preparedness, disaster and recovery messages,

services and resources.

– The goal of the LIEC is to reduce barriers for LEP

populations to access, utilize and understand

preparedness, disaster and recovery messages,

services and resources.

Lessons Learned

• Target Audience clearly defined– Level of education

– Age

– Gender

– When did they migrate, where did they

migrate from?

• Must have buy-in from the community

Lessons Learned (cont.)

• Use trusted resources for translators

– Past experience and training in doing

translations.

– Proficiency in both English and the

language being translated.

– Experience with doing back translations.

Punctuation mark placements are different for

Mandarin and Cantonese

Punctuation marks are in the middle of the space.Punctuation marks are at the bottom of the space.

Lessons Learned (cont)

• Field Test, Field Test, and Field Test!

– Community groups, associations, etc

– Universities and colleges

– Individuals

• Translations are not the end

• Use existing resources in the community

Aloha

About Our Speaker

Herman Schaffer is Director of Community Outreach for the

New York City (NYC) Office of Emergency Management

(OEM), where he coordinates OEM’s outreach efforts to

increase awareness around individual and community disaster

preparedness. Schaffer started working for OEM in June of

2005 in the External Affairs Division. He is the Chairman of the

NYC Citizen Corps Council and runs the NYC Community

Emergency Response Team volunteer program.

Prior to joining OEM, he was a he was a Peace Corps

Volunteer in Zambia where he worked to develop rural

communities ability to address issues around Water,

Sanitation, and Hygiene Education (WASHA). Schaffer also

spent several years as a Case Manager with Safe Horizons’

September 11th Recovery Efforts.

Herman Schaffer

Director of

Community

Outreach

New York City

Office of

Emergency

Management

(OEM)

HSchaffer@OEM.NYC.GOV

About Our Speakers

Uma Ahluwalia is currently the Director of the Montgomery County (Maryland)

Department of Health and Human Services. With more than 1300 employees,

the department is one of the largest agencies in Montgomery County and

includes Aging and Disability Services; Behavioral Health and Crisis Services;

Children, Youth and Family Services; and Public Health Services. The current

budget for DHHS is $239.4 million. Ahluwalia came to Montgomery County from

the Child and Family Services Agency in the District of Columbia, where she

served as Principal Deputy Director and most recently as Interim Director. During

the last position, she had oversight of direct services to children including the

District’s 24-hour hotline for reporting child abuse and neglect, investigations, in-

home and foster care cases and adoptions.

Betty Lam joined the Montgomery County Department of Health & Human

Services (DHHS) in the summer of 2004 as the Chief of the Office of Community

Affairs. In that capacity, Lam is responsible for developing and implementing

outreach strategies targeting communities that are underserved, leads the

department-wide effort on language access, Head Start, Community Action

Agency and minority health programs. Prior to the current post, Lam was

appointed as the Community Liaison for the White House Initiative on Asian

Americans and Pacific Islanders in 2002, and was later detailed to the Office of

Civil Rights for the U.S. Department of Health & Human Services on special

assignments around LEP compliance.

Language Access and Emergency Preparedness:

The H1N1 Challenge

Montgomery County, Maryland

September 9, 2009

3535

Montgomery County Today—Fast growth of foreign born population

18.6%

26.7%29.3%

Year 1990 Year 2000 Year 2006

Foreign Born Population Growth in Montgomery County Population size nearly

doubled since 1990

1990 140,000

2006 270,000

Source: American Community Survey 2006, U.S. Census

Bureau

3636

Montgomery County Today—LEP Population More than Doubled since 1990

60,000

105,000

135,000

1990 2000 2006

LEP Population Growth in

Montgomery County

Source: American Community Survey 2006, U.S. Census Bureau

3737

Language Diversity in MoCo

Source: American Community Survey, U.S. Census Bureau 2000

County’s top 12 languages• English

• Spanish

• Chinese

• Hindi

• Korean

• French

• Vietnamese

• Amharic

• Farsi

• Russian

• Tagalog

• Portuguese

Montgomery County, MD APC

• The Montgomery County Department of Health and Human Services serves a diverse semi-suburban population adjacent to the nation’s capital and is in close proximity to the NIH and other national health resources.

• Our focus includes public health emergency awareness and education, systems to dispense medicines and supplies, and vulnerable populations such as young children and senior

residents.

Philosophy• Ecological

Behavioral Health Model

Identifying Gatekeepers (i.e., community health nurses, home health aides, Latino,

Asian and African-American Health Promoters, public/private agencies)

Montgomery CountyEmergency Preparednessand Response Vulnerable

Populations Committee

County Offices of:• PH Emergency Preparedness• Homeland Security• Community Affairs• Senior Health Promotion

• Aging and Disability• Police• Volunteer Center• Health Promoter Programs• Community groups, advocacy

groups, hospitals, assisted living facilities, group homes, nursing homes, and faith communities

Who are Our Community Partners?

• Faith Communities• Businesses• Home Health Care• Pharmacists• Child Care• Universities• Outreach workers and

community advocates

• School Systems• Physicians• Nurses • Schools of Public

Health• Hospitals• Ethnically based

community non profits• Volunteers• Many others..

Stay At Home Toolkit• Basic 101 on all different

aspects of influenza including prevention and care giving

• Available at: www.montgomerycountymd.gov/pandemicflu

• Adapted by many localities and in multiple languages

Latino Health Promoter Curriculum• Purpose: To train

promotores de salud in Public Health Emergency Preparedness

• 3-Day training

• Includes Plan to Be Safe tools

Proposed Timeline for School Based Flu Vaccine Administration

• Notification of Seasonal School Based Flu Plan to all schools– Websites-MCPS/County/MCPTA– Parent Letter– Consent form for Seasonal Flu Vaccine 9/01/09

• Each school notifies parent of vaccination date9/09-10/09

– Connect Ed– Principal Newsletter

• Start seasonal flu vaccination Dose #19/23/09

• Start seasonal flu vaccine Dose #2 10/24/09• Notification and vaccination dates for H1N1 TBD

Goals for School Based Flu Vaccine Administration

• Seasonal Vaccine– Vaccinate 32,000 students(50% of enrollment) in 131

elementary schools including Pre K-Head Start– Primary vaccine: Flu Mist– Second dose Flu Mist for 10-30% of students– 10% IM Vaccine– Complete Dose #1Sept-Oct;Dose 2 Oct-Nov

• H1N1 Vaccine– When, what schools and who get it depends upon

availability

Other Activities• Parent letter and Informed Consent form have been

developed in English and six other languages• The Informed consent form can be printed off of the

Montgomery County Government and Montgomery County Public School websites

• Also developed a vaccine dispensing card to keep track of vaccines administered

• The State of Maryland Department of Health and Mental Hygiene, through the Board of Physicians is also developing select messages to healthcare providers who access language specific populations

• Similarly the American Academy of Pediatrics and the MD Board of Physician Licensing is putting out messages to physicians with access to language

specific populations

Communication Activities• Strategic use of Radio and TV – public interest

messages and use of county cable strategically. The superintendent and the health officer have already gone on the airways.

• There is a state and county information line that has been set up.

• The County’s 311 line will be operational to respond to flu related issues and will be staffed by volunteers, public health staff, light duty police and fire personnel and the medical reserve corps with significant language competencies in the 12 major languages prevalent in the County with access to language line capabilities in other less prevalent

languages

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