Manos Home Care: Moving Beyond Cultural Boundaries of Care

by HCE Exchange on January 23, 2014

Kevin-Rath-thumbLocated in the East Bay of Northern California, the nonprofit organization, Manos Home Care, has been providing services to people needing care within their homes, both those who can afford this care and those who cannot, since 1989.

Manos Home Care has been operating ahead of the curve in health care since its founding, using technology and cost-effective solutions to serve its customers’ needs, with a special emphasis on providing culturally sensitive care.

Delivering compassionate care to a diverse population

Manos Home Care offers respite care, child care, and home care for children, adults, and seniors in Alameda and Contra Costa counties, one of the most culturally diverse regions in the United States. The organization has 1,300 clients, speaking seven different languages: English, Spanish, Cantonese, Mandarin, Tagalog, Vietnamese, and Farsi.

The diverse cultures represented in Manos’ service area present a unique challenge to those providing health care. But Manos has embraced the diversity and created an environment within the organization that mirrors this diversity from the top down.

“The management team from Manos represents four cultures; our administrative staff speaks seven languages, which are represented by our clients,” said Kevin Rath, founder and executive director. “We have staff, executives, and administrators from the various cultures we serve, not just individuals who have learned the language.”

A primary way in which Manos achieves multicultural service is through cross-cultural training. The goal of this training is to give its team a better understanding of each other and reduce cultural clashes within the administration. It can be challenging, but Rath said it is necessary in order to provide the best care for clients.

“To be multicultural, you have to start with the board of directors and continue with the staff and administration,” he said. “You have to let go of your fear. Most people hire within their culture because it’s comfortable. Sometimes we make mistakes, miss cultural cues, but it is part of our vision and we stick with it.”

Using technology to meet patients’ needs

Manos is in the midst of upgrading its technology to better serve clients’ needs, in part because of the geographically dispersed nature of the service. With 1,300 clients in a home-care environment, this amounts to 1,300 work sites spread over a 1,500 square-mile radius.

Rath understands the importance of using technology to lower costs and has created a web-based software application that will serve as the platform for rolling out Internet-based services designed to enhance the home-care experience while reducing its cost.

Manos’ new software will include a mobile-phone app component, allowing parents, case managers, and workers to log into the website and view its activity.

For many of the parents who access home-care services for children with disabilities, benefits are provided through the government with a limited number of hours available for them to use those services. The new app would allow parents to log in and see how many hours they’ve used and also see the status of their requests from Manos.

Rath said Manos is also working on translating the website into several languages. All patient forms have already been translated into Spanish and many into Chinese.

Seeing into the future

Before founding Manos, Rath was organizing day laborers and house cleaners with limited English skills into collectives. The James Irvine Foundation was offering grants to community-based businesses that could provide jobs to low-income women. Rath received a planning grant and wrote the business plan for Manos Home Care, which was awarded a $400,000 grant.

Rath chose home care because it was a rising need in the area and offered the potential to create many jobs.

Manos eventually added respite care and home care for children with disabilities in 1992. This area has now become a major focus of the organization.

The group has faced challenges with the recession, but has remained open while many stand-alone home-care centers in the area have closed. Seniors have had trouble affording home care, and some have chosen to go into nursing homes, convalescent hospitals, or assisted-living facilities rather than staying at home.

In order to address the rising costs of home care, Manos plans to create a web-based service for home care that would reduce costs by 30 percent, allowing more people to take advantage of its services. This would also allow care to be provided anywhere, as employees can clock in virtually, be paid virtually, with client, family, and worker interaction based on a web portal.

Manos plans to continue pushing technology to improve access to care at a lower cost. Rath will work to expand the organization to other areas in California and seek partners on the web-based home-care service.

“We have an incredible affordability crisis in health care,” he said. “We cannot continue to spend this much of our GDP on health care with the returns we are getting. And we can’t create systems that exclude people from receiving health care. We have to figure out how to use technology to reduce costs.”

As the United States becomes more diverse and health-care reform seeks system integration on a national scale, Rath said he hopes to see more diversity reflected in health-care organizations and more coordination with services such as Manos.

“We are a non-medical social service that is tied into the health-care system,” he said. “Hospitals need to work as closely with attending care agencies and workers as they do with skilled-nursing facilities and post-acute care organizations. Without that coordination, they will see an adverse financial impact. For example, if someone breaks a hip three times because they don’t have home care, the hospital has to pay for that surgery and the client suffers needlessly. We need to figure out how to integrate and work together across all areas of health care.”

-by Patricia Chaney

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