Dreamer Dreaming Up Change for the Healthcare System (OR UCEDD)

August 6, 2018

This summer I had the opportunity to be an intern for the University Center for Excellence in Developmental Disabilities (UCEDD) within the Institute on Development and Disability (IDD) at Oregon Health and Sciences University (OHSU). My role was with IDD's Diversity Task Force (IDTF) that is made up of providers, clinicians, faculty members, staff, and family members. The mission of the IDTF is as follows: As compassionate leaders in healthcare, we strive to provide innovative and comprehensive services in a welcoming environment. The diversity of life is valued here, and we are committed to making inclusion a priority so everyone at IDD feels comfortable, valued, and respected.

Throughout my internship, I observed and participated in different outpatient clinics at the IDD's Child Development & Rehabilitation Center. This was not only an amazing opportunity for me to gain exposure to different specialties, but I also got to see the patients' and families' experience firsthand. Through my observation and interacting with clinicians and staff, I identified areas where a patient's experience could be improved. I then composed projects that addressed specific topics that I felt passionate about. The projects covered three main areas, making the CDRC a more welcoming environment, creating opportunities for diverse students with an interest in healthcare, and finding ways to better support undocumented families. All while learning how to be an advocate for children who experience disabilities and their families, which remained at the core of all my projects.

In working in such a large hospital, it is easy to get lost, but for a patient, it could be that much more stressful and overwhelming. The stress only amplifies if the patient does not speak English. Prior to this internship it had been identified by CDRC staff that families were having a hard time finding their way to the clinic. Thus, we came up with the idea of creating a welcome packet that can cater to families during their initial visit to clinic or non-English speaking families. During my internship I composed a draft (written in lay language, including pictures, and to be translated to other languages) of what this could look like. The welcome packet would contain information about transportation to OHSU, directions to the CDRC clinic, and after visit advice. We hope that this would help make the CDRC a more welcoming space for all families, while also being interactive and fun for children.

I have enjoyed the experience of working in a healthcare organization that serves such a diverse population of families. Throughout OHSU there is a clear message that family centered care is the priority without regard to race, religion, national origin, disability, age, marital status, sex, sexual orientation, gender identity or expression, military service, or any other status protected by law. In this political climate and knowing that OHSU is an organization that has made statements on being a safe space for undocumented families, I wanted to focus on the undocumented population of families that visit the CDRC clinic. Right now, there is a lot of fear about what could happen if a family member were to be detained. Even more so for families with children with special health care needs who rely heavily on a parent/caregiver and special treatment. At this time, these families are being asked to collect letters from different sources, one of those being providers. These letters can be used as proof of time of residence in the United States, can be used for citizenship processes, and can also be used if detained to be given time to make specific arrangements or to be released. The issue that I found was that when families asked for these letters many clinicians didn't know if they could or how to write such a letter. Many clinicians would then advise the family to go to a primary care doctor, however, a letter a from a specialist carries much more weight in these types of issues. The letter format I created has been verified by both clinicians and an immigration lawyer to make sure it contains necessary information while also respecting HIPPA and regulations of electronic medical records. I was overwhelmed by the amount of support and assistance I received from OHSU staff. Many clinicians felt this project made them feel helpful and like they could contribute, even if they can't control what is happening in other parts of the country. This project is not only to prevent separation but also for the patient to feel safe. As a future healthcare provider, I would want to do whatever I could in order to ensure that my patients felt safe and known.

As a part of being known by the health care system, it is also important that the institution reflects the population it serves. Thus, my final project is to be able to connect students from diverse backgrounds with opportunities at OHSU. Being a woman of color pursuing a career in healthcare I am aware of the stigmas and challenges that a person would face in trying to reach their goal. I would have never thought that I would be an Intern in such a great institution like OHSU. I found myself constantly amazed by each experience and person I met throughout my internship. I reached out to different programs already in place to then share the resources with diverse communities. In creating a bridge between OHSU and the community I hope that there would be a growth in diverse candidates who apply to opportunities, such as the UCEDD Summer Internship Program. This would in turn lead to more diverse healthcare providers that reflect their community.

I am a Latina woman, a DACA Dreamer, from a low-income community, who has a disability. I have many statistics stacked against me. Thus, I have been truly honored to be given this opportunity and I hope that I was able to create some meaningful change through my internship experience. This internship has given me many insights into healthcare of those living with a disability and advocacy skills that I will take with me in my future career. In sharing my experience, I hope I influence others to conduct similar projects within their healthcare system.