In 2024, Washington State launched a new state program called Apple Health Expansion. This program provides Medicaid-like health insurance coverage to low-income adults who are ineligible for other Apple Health programs due to immigration status. Washingtonians with undocumented status also became eligible for the first time to buy private health plans through Washington Healthplanfinder, the state’s health insurance marketplace. CHPW was among the managed care organizations (MCOs) approved by the Washington State Health Care Authority (HCA) to offer Apple Health Expansion to enrollees.

Recognizing that health care providers directly shape health outcomes and are a critical ally in CHPW’s mission to improve health outcomes, CHPW is equipping them with vital resources, training, and support so they can deliver personalized care to diverse communities more effectively.

CHPW brought in several trusted experts to lead educational training sessions for providers and staff ahead of the Apple Health Expansion launch.

Taking an informed approach

CHPW collaborated with the International Rescue Committee (IRC) to host two webinars on “Understanding Forced Displacement and Trauma-Informed Approaches.” IRC is a humanitarian organization that provides aid to refugees and those who have been forced to leave their homes due to conflict, violence, or other causes. These individuals and families come to the U.S. with a variety of unique needs due to past traumatic experiences, pressured adaptation, complex systems, and, for some, lack of permanency due to immigration status, said IRC’s Beth Farmer, the main presenter.

“Immigration status type and migration history introduce many, many risk factors that we as service providers may not normally consider,” said Farmer, who is a Licensed Clinical Social Worker with more than three decades of experience in providing services to people who have experienced trauma.

The importance of culturally responsive care

CHPW also engaged Gino Aisenberg, Ph.D., M.S.W., an associate professor at the University of Washington School of Social Work and a bilingual/bicultural Latino mental health researcher, to talk to providers and CHPW staff about the importance of understanding different cultures, backgrounds, and traditions when delivering care to immigrant and refugee populations.

Aisenberg, who is also the founding co-director of the Latino Center for Health at UW, conducted his webinars in English and Spanish.

Understanding ‘cultural context’

The U.S. health care system is complex for most of us but can be especially daunting for someone who hasn't grown up in this country, Aisenberg told providers.

He stressed that health care workers must strive to understand both the culture of the individual's country of origin and the immigrant or refugee experience.

In medicine, “evidence-based practices historically have been standardized and normed with white, non-Latino adult populations, void of cultural context and realities,” Aisenberg said.

“We have this model that we sweepingly apply to all people, regardless of their history, their race, ethnicity, their environmental contexts. That doesn't appear to me to be good practice.”