Angenette Pickett Call was in the waiting room of her local hospital’s emergency department when she saw a language barrier causing a patient to become distressed and the staff to get agitated because they could not communicate.
Born in Argentina and fluent in Spanish, Pickett Call stepped in to help.
“It wasn’t the first time that I pretended to be somebody's cousin in a situation like that,” said Pickett Call, a continuing education program manager at Pacific Lutheran University in Tacoma, Washington.
“But it was the first time that I noticed how much the staff was frustrated,” she said. “So the next day at work, I told my boss: ‘We need to start a medical interpreter program.’”
With more than $42,000 in funding from the Virginia Mason Franciscan Health Community Health Improvement Grant program, an online Spanish-language medical interpreter course was developed and offered for free to a cohort of 15 students. The grant also pays the fee students must pay to take the state exam.
“There's a serious lack of interpreters in this area,” Pickett Call said. “Jobs are lined up for anybody who wants to take them.”
So far, 30 students have taken the course, and the third cohort of students is presently enrolled.
“Most of our students are first-generation immigrants,” Pickett Call said. “A lot of the people that have been through the class are those kids that grew up interpreting for their parents or their grandparents.”
Pacific Lutheran was one of 24 nonprofits that received a share of a $1.7 million pool created by holding back 0.05% of the previous year’s audited expenses at Virginia Mason Franciscan Health’s eight hospitals in the Puget Sound area.
While the grants are a new endeavor for Virginia Mason Franciscan Health, it’s an established program for many health organizations under the umbrella of their parent system, CommonSpirit Health.
The grants range between $20,000 and $100,000. Organizations receiving them must have two or more collaborative partners, and the funded projects must have a focus on reducing health inequities while aligning with priorities identified by the Virginia Mason Franciscan Health community health needs assessments. These include:
- Access to health care.
- Chronic disease prevention.
- Behavioral health.
- Violence prevention.
“We don’t want this funding to be just like a transaction: ‘Here's a check. Never talk to us again until we ask for reports,’” said Doug Baxter-Jenkins, Virginia Mason Franciscan Health region director for community health.
“We're not just giving funding for an organization to do what they've always done,” Baxter-Jenkins explained. “We're requiring collaboration in all of these proposals.”
Collaboration is listed as one of the health system’s five core values, and it includes a pledge to “commit to the power of working together” and to “build and nurture meaningful relationships.”
Virginia Mason Franciscan Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Addressing community needs
Pacific Lutheran University, for example, is collaborating with a Tacoma-based organization called Workforce Central that works to train people in skills needed by area businesses and then seeks to connect job seekers, training programs and employers.
Virginia Mason Franciscan Health doesn’t hire interpreters but, instead, works with “language vendors” who provide interpreters either in person, virtually or over the telephone.
“Our language-access manager is connecting students to our language vendors,” Baxter-Jenkins said. “So when these students graduate from the program and take that test, they now know how to connect to our vendors so that they can be working in our facilities as in-person or telephonic interpreters.”
This collaboration helped the school get its grant.
“Part of what made Pacific Lutheran University’s application stand out was that collaboration piece with Workforce Central—getting access to underemployed or unemployed individuals to feed into that program,” Baxter-Jenkins said. “And then, having that connection to language vendors and having that direct path to employment.”
He noted that grant applicants are not required to have a connection to any of the Virginia Mason Franciscan Health hospitals. While some of the system’s physician leaders participate in scoring grant applications, most of the eventual awardees have been addressing social drivers of health rather than providing a health care service.
One exception is the $80,000 grant awarded to the YMCA of Pierce and Kitsap Counties to support their diabetes prevention programs that encourage long-term lifestyle changes to ward off chronic disease and slow or halt the progression of type 2 diabetes.
For the most part, however, Baxter-Jenkins said the grants seek to solve problems discovered by asking:
- Who doesn't have reliable access to food?
- Who doesn't have access to stable employment?
- Who has transportation challenges?
- How do we increase access to these opportunities before people develop a chronic disease or before some other adverse health effect?
Subscribe to free AMA email newsletters
Get the latest news from the AMA on the topics that matter to you—delivered to your inbox.
Making community connections
He cited Key Peninsula Healthy Community, which received a $95,000 grant, as a prime example of an organization working to address these issues.
Located southwest of Seattle, the 70-square-mile Key Peninsula boasts some expensive homes along its coastline, but resources are lacking once you go into its rural interior and social isolation among its older population is seen as a major contributor to poor health.
“Our funding is supporting KP Healthy Community as a backbone organization,” Baxter-Jenkins said. “They do a lot of community organizing out there.”
This includes working with organizations such as the Mustard Seed Project of Key Peninsula, which focuses on helping older adults age in place, and with Food Backpacks 4 Kids, which fights food insecurity among the area’s youths.
“We are a community health organization that has four pillars: Hunger, health and wellness, transportation and childcare,” said Ben Paganelli, co-executive director of Key Peninsula Health Community.
“One of the long-term, upstream purposes of this grant is to help us address digital inequity and, in doing so, improve access to digital medicine,” Paganelli said, explaining that residents who lack transportation would then be able to ease their social isolation while enjoying the economic and behavioral health benefits an internet connection can provide.
“We look at digital equity in terms of broadband access, terminal access and digital literacy,” he said. “We've been making strides towards getting broadband access, but that does not necessarily address the other issue of digital literacy. Specifically, we know that many of our seniors, while they may have broadband access, they are not yet capable of navigating the internet to the extent of virtual medicine, for instance.”
A 2023 Pew Research Center survey found that 73% of adults in rural areas subscribed to high-speed internet at home compared with 86% of adults in suburban areas. Among English-speaking Asian adults, 84% subscribed to a home broadband service, compared with 83% of white adults, 75% of Hispanic adults and 68% of Black adults.
Learn about the AMA’s 2024–2025 strategic plan to advance health equity.
The AMA STEPS Forward® Toolkit “Social Determinants of Health: Improve Health Outcomes Beyond the Clinic Walls” provides information on the health impacts of food insecurity and transportation difficulties. The toolkit is available on AMA Ed Hub™. And physicians can receive CME for a maximum of 0.5 AMA PRA Category 1 Credit™ for completing the module.
Helping students when school is out
While Virginia Mason Franciscan Health’s partnership with the Key Peninsula Healthy Community is relatively new, Baxter-Jenkins said the system has been working with the Rainier Foothills Wellness Foundation for more than a decade.
Among other services, the foundation pays for licensed behavioral health counselors in the Enumclaw School District’s middle and high schools. A $60,000 grant from Virginia Mason Franciscan Health has allowed it to extend those services for students during summer and winter breaks.
“There's just an absolute lack of behavioral health providers, so the service they're providing is just so crucial,” Baxter-Jenkins said, adding that a 2021 survey found that 35% of King County middle and high school students showed signs of depression. Across the U.S., 17% of children ages 12-17 reported symptoms of depression in 2021-2022, according to the National Center for Health Statistics.
Our programs serve their patients, and they are extremely supportive of our programming,” said Sara Stratton, the foundation’s executive director. “Our mission has been that we mobilize the community to address hunger the community to address hunger, access to health care, mental health and student support.”
The services have been expanded to include the families of students and, if counselors have the capacity after serving students and families, they are available to other members of the community who don’t have a connection to the schools. All services are free and offered in person or via telehealth.
“I can definitely say—with 100% certainty—that without this program, the huge majority of our clients would not be receiving any mental health support otherwise,” Stratton said.
Along with the school district, the foundation partners with Plateau Outreach Ministries, which offers people emergency assistance for food, utilities, rent and medical prescriptions plus referrals for people with substance-use disorder or are at risk for domestic violence. The organization received a $25,000 grant from Virginia Mason Franciscan Health.
“They need resources and we're trying to help them build that—but again, not just with a transaction,” Baxter-Jenkins said.
“It’s working to build true partnerships and using funding as one way to build that partnership,” he added. “We don't just rely solely on grants to make change in our community. It's one tool in our toolbox.”
