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it may have changed in the intervening years. For additional information about this
site and the decision to leave it on the web, visit the home page: http://web.utk.edu/~tnlatina/
~Health Care~
 THE LAWS DEALING WITH LANGUAGE & ACCESS TO
HEALTH CARE
TENNCARE
INFORMATION
HEALTH CARE PROVIDERS (WITH
DISCRIPTION OF SERVICES PROVIDED)
For web links and
contacts on this issue, also see our general links & contacts pages.
LAWS DEALING WITH LANGUAGE &ACCESS TO HEALTH
CARE
Note: This information is not a substitution for
professionally obtained legal information and is not intended to contain
legal advice. The introduction is a mixuture
of fact and opinion. The references to applicable cases and
statutes are subject to changes in law that may make the information
outdated or invalid. If you have a question about language
and access to health care not covered on this page, you should contact
your local legal aid office or a private attorney.
In the United States,
the number of individuals who speak a language other than English is on the
rise. Those numbers are growing at much more rapid rate in states
such as Tennessee and in
regions such as the south. One aspect of our society that faces
serious repercussions of this language barrier is the health care and
delivery system. Because of the absence of certified interpreters available
in medical facilities throughout our state and nation, individuals who
cannot speak English must often rely on bi-lingual employees (untrained as
interpreters) and relatives (even their own children) to translate
complicated medical information. Often these untrained translators
are acting as interpreters under the most difficult of circumstances.
The translators are asked to accurately convey crucial information in
life or death situations.
Health care should be provided in a manner that allows an individual to
understand the nature and the purpose of the treatement
he or she is agreeing to. Currently, mandatory, regulated translators
in facilities providing health services are not required by law. However,
there are laws in existance that address language
barriers to accessing health care. This web page references some of
these laws dealing with language and access to health care.
Title VI of the Civil Rights Act
Civil Rights Act, Subchapter V, federally assisted programs.
U.S.Code.1992.Vol 42, Sec 2000d
Lau v. Nichols, 414 U.S.
563 (1974)
Tennessee's emergency
patient transfer statute
Tenn
Code Ann
TENNCARE INFORMATION
FREQUENTLY ASKED TENNCARE
QUESTIONS
SAMPLE TENNCARE APPLICATION
(WITH INSTRUCTIONS)
TENNCARE RESOURCES (PHONE
#S & ADDRESSES)
FREQUENTLY ASKED TENNCARE QUESTIONS
Who is eligible for TennCare?
Why does TennCare ask you to tell
them your income?
Can my child get TennCare?
I have health coverage at work, but cannot afford family
coverage. Does this preclude my children from
receiving TennCare?
Where can I get help with TennCare
EN ESPANOL?
Where can I get help if I
have a hearing impairment?
Need help? Have further questions?
Who is considered a TennCare
"family group"?
Who is eligible for TennCare?
This is who can get TennCare after April 1, 1997:
•People who live in Tennessee:
•Who qualify for MediCAID or;
•Who are losing MediCAID and have not been given a chance to buy health
insurance at their workplace or at a family member's workplace or;
•Who are uninsurable because they
have been turned down for health insurance for health reasons or;
•Who are losing COBRA eligibility
or;
•Who are children under age 18 (Click here for more
info about Children & TennCare)
Why does TennCare ask you to tell them your income?
TennCare uses the family's total monthly
income to decide if you must pay for your TennCare.
If your income is above poverty, you pay: (1) monthly TennCare
premiums and (2) part of your medical costs. If your income is below
poverty, you do not pay for your TennCare
services.
Can my
child get TennCare?
If your child does not have health
insurance, you may be able to get TennCare for
your child. TennCare covers the health care
services that children need.
Effective April 1, 1997,
TennCare enrollment is open to children under the
age of 18. TennCare is free to children whose
family income is at or below the federal poverty level.
Children can qualify for TennCare if:
1. They do not currently have health insurance;
AND
2. They cannot be covered through health insurance available at the
parent's jobs. If the employer offers health insurance but, it is not taken
because it costs too much, that child does not qualify for TennCare.
For those whose income is above the poverty level, there will be a
charge on a sliding scale based on family income.
I have health coverage at work, but cannot afford family
coverage. Does this preclude my children from receiving TennCare?
Parents who have insurance at work but cannot
afford family coverage, can now get their kids on TennCare.
Example: Mrs. M is a single parent with one child. She has income of
$1,035 a month. TennCare for her child would cost
just $14.25 a month
Requirements:
•Your child must be under age 19
•Your family's gross income must
be less than:
$1 ,726 per month for a 2 person family
$2, 164 per month for 3 person family
$ 2,600 per month for 4 person family
If you have more than 4 people in your family
call 1-800-669-1852
•If you would like to apply for TennCare for your child, you must send an application
to TennCare. You may call the Tenncare
Hotline and they will send you an application. The phone number is
1-800-669-1851 or 741-4800 in the local Nashville
area. You may also call your county health department. If you need help
filling out the application, the county health department can help you.
Speak only Spanish?
Para mas informacion Ilame al centro de informacion del Proyecto en espanol de TennCare al Tel: 227-7568 Si su Ilamada es en el condado de Davidson
o condados que lo rodean, Si es de larga distancia llame al Tel:
1-800-254-7568.
Where can I get help if I
have a hearing impairment?
If you have a hearing impairment and use a TTY machine to talk on the
phone, there are operators to help you. Your phone call will be answered by
a TTY machine if you call 1-800-772-7647 or 313-9240 in the Nashville
area. These telephone numbers are to be used only by those with a TTY
machine.
Need help? Have further questions?
You can call the TennCare Hotline at
1-800-669-1851, or 741-4800 if you live in Nashville.
You can also ask your county health department for help.
Who is considered a TennCare "family group"?
•A married couple living together
without children in the home;
•A married couple and their children
or step-children under age 21 who live with them;
•A single parent and children under
age 21 living together;
•A guardian with children under age
21 living together;
•An unmarried adult age 21 or older,
with no children living with them;
••These
persons should list only themselves, not their parents or another adult
they live with.
•An unmarried person under age 21
who has children or is pregnant;
•• She
should list only herself and her children who live with her.
•• She should
NOT list other relatives she lives with.
SAMPLE TENNCARE APPLICATION
(WITH INSTRUCTIONS)
This form is used to apply for TennCare as an
uninsured or uninsurable person. To apply for MediCAID,
contact the Tennessee Department of Human Services. If elderly or disabled
contact a Social Security Office.
How to use this form to apply for TennCare:
•Read the instructions on pages
3 and 4
•Fill in the application form on
page 2
•Sign and date the application
•Make a copy for yourself if you can
You should mail the application to:
TENNCARE BUREAU
P.O. BOX 740
NASHVILLE, TN 37202-0740
If you want to prove you mailed your application:
You can take this application to the Post Office. Ask for a proof of date
of mailing slip. It costs $0.55. Keep the slip. If your application is lost
in the mail, the TennCare Bureau agrees that the
slip proves you sent it.
[Click here for a sample photo of a TENNCARE APPLICATION]
--Sample refered to in the
following instructions for filling out a TennCare application
HOW
TO FILL IN THE TENNCARE APPLICATION
Look at the example already filled in at the top of the chart
(refer to sample) The name "John D. Doe" has been used to
show you how to fill in each block.
Columns 1, 2, & 3: Who to List and Not List
Print first name, middle initial, and last
name.
Do NOT just list all the relatives who live together. Look at the TennCare family groups below. Find the one that
describes you. Put on your application only the people who are in the TennCare family group that applies to you. Some
households will have several family groups sending separate application
forms.
The TennCare family groups are:
•A married couple living together
without children in the home;
•A married couple and their children
or step-children under age 21 who live with them;
•A single parent and children under
age 21 living together;
•A guardian with children under age
21 living together;
•An unmarried adult age 21 or older,
with no children living with them;
••These
persons should list only themselves, not their parents or another adult
they live with.
•An unmarried person under age 21
who has children or is pregnant;
•• She
should list only herself and her children who live with her.
•• She should
NOT list other relatives she lives with.
Don't know who to list on your application?
Call the TennCare Hotline at 1-800-669-1851.
(In Nashville, call 741-4800.)
When the phone is answered, press "0" to talk to a person.
Column 4: Social Security number
Print the Social Security number of each person listed. Double-check to
make sure you got each number right.
Column 5: Sex
Put an M for male or an F for female for each person listed.
Column 6: Race
This block tells TennCare the race of each
person listed. You do not have to tell your race. TennCare
asks about race only to make sure that no one in TennCare
is treated unfairly because of their race.
To tell your race, use one of these letters for each person:
I = American Indian or Alaskan W = White H = Hispanic
A = Asian or Pacific Islander B = Black M = Mixed race
Column 7: Date of Birth
Put each family member's date of birth. Print it like the "John D.
Doe" sample. Put the month first, the day next and the year last
(example: April 9, 1985
= 04-09-85).
Column 8: U.S. Citizen
Put Y or N to tell us if each family member listed is a U.S. Citizen.
Column 9: Have Health Insurance?
Put T (TennCare) for any family member who has
TennCare now.
Put Y (Yes) for any family member who has one of the following kinds of health
insurance:
•Health insurance from his/her
job or a family member's job
•A medical insurance policy bought
on his (her) own
•MediCARE
(red-white-blue insurance card for people on Social
Security)
•CHAMPUS
Put P instead of Y if this insurance does not cover a health problem the
person had before they got insurance.
Also put P instead of Y for anyone whose insurance is only a limited
policy, such as a cancer, accident or hospital-only policy.
Put N (No) for anyone who has no health insurance.
IMPORTANT: If you put P for anyone, send a copy of the policy with the
application.
Column 10: Could Get Health Insurance through Employer?
Put Y or N to tell TennCare if each person
listed could buy health insurance at his/her job or at another family
member's job. You must put Y here even if you do not buy this insurance
because you think it costs too much.
Put N for each person who cannot buy health insurance at his or her job,
or through the job of another family member.
Column 11: Turned Down for Health Insurance?
Put Y if the person has been turned down for health insurance because of
a health problem.
Put N for everyone who has not been turned down for health insurance.
IMPORTANT: If you put Y for anyone, send TennCare
a copy of the insurance company letter turning him/her down.
Column 12: Disabled?
Put Y or N to tell TennCare if a family member
has a physical or mental disability. You do not have to answer this
question if you do not want to.
Column 13: Applying for TennCare?
Tell TennCare if each member listed is
applying for TennCare or is already enrolled in TennCare.
•If the member is now enrolled in
TennCare put a Y in column 13
•If the member wants to enroll in TennCare at this time put Y in column 13
•If the member does not want to
enroll in TennCare at this time put N in column
13
Column 14: Total Monthly Income
Print the total monthly income for each adult. The total is the big
amount (gross) before anything is taken out. Do not use the "take
home" amount. Show only whole dollar amounts. For example put $600,
not $600.28.
Include:
•Money you earn from work
•Social Security checks
•Pensions
•Interest and dividends
•Rental profits
•Alimony
•Unemployment compensation
Do NOT include:
•Child support you get
•Worker's compensation
•Money a dependent child under 21
earns from work
Still not sure what money to count?
Call TennCare at 1-800-669-1851 (In Nashville,
call 741-4800). When the phone is answered, press "0" to speak to
a person.
Number 15: Pick the TennCare Health
Insurance Plan You Want (This is also called a managed care organization or
MCO)
From the list included with this application, pick the TennCare health insurance plan you want to join. Write
the plan name here. If other family members belong to TennCare,
you must choose the same plan they have. If you do not pick a TennCare health insurance plan, we will pick one for
you.
Number 16: Sign and Date
Read the statements printed at the bottom of the application. The head
of the family should sign and date the application. If married, the spouse
should also sign and date the application.
TENNCARE RESOURCES (PHONE #S & ADDRESSES)
Where to write:
TENNCARE BUREAU
P.O. BOX 740
NASHVILLE, TN 37202-0740
Where to Call:
Call TennCare at 1-800-669-1851 (In Nashville,
call 741-4800). When the phone is answered, press "0" to speak to
a person.
Para mas informacion Ilame al centro de informacion del Proyecto en espanol de TennCare al Tel: 227-7568 Si su Ilamada es en el condado de Davidson
o condados que lo rodean, Si es de larga distancia llame al Tel:
1-800-254-7568.
If you have a hearing impairment and use a TTY machine to talk on the
phone, there are operators to help you. Your phone call will be answered by
a TTY machine if you call 1-800-772-7647 or 313-9240 in the Nashville
area. These telephone numbers are to be used only by those with a TTY
machine.
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HEALTH CARE PROVIDERS (WITH
DISCRIPTION OF SERVICES PROVIDED)
[This page consists of a list of East Tennessee Health care providers that provide
services to hispanic and low
income individuals. Also included, is a list of services
each provider offers]
INTERFAITH HEALTH CLINIC
REACHOUT
RURAL MEDICAL SERVICES
KNOXVILLE HEALTH DEPARTMENT
CALL FOR HEALTH
UNIVERSITY OF TENNESSEE MEDICAL
CENTER
GOOD SAMARITAN CLINIC
INTERFAITH HEALTH CLINIC
315 Gill Avenue
Knoxville, Tennessee 37917
Telephone: (423) 546-7330
FAX: (423) 546-6643
Patient Guidelines
Eligible patients meeting the following guidelines are treated without
regard to race, sex, creed, age, sexual orientation, or national origin.
•Social Security Number requested, but not required
•Bring your own interpreter, there are no Spanish speakers on staff
•No pre-natal care available at this clinic
Mission: To provide healthcare to the medically
uninsured and medically under-served
Insurance Guidelines
Uninsured with the exception of Medicare. (With Medicare coverage, no supplemental
policies covering office visits or medications.) All other exceptions are
made on an individual basis. Example: insurance covers only
hospitalization.
Financial Guidelines
Household income between indigent level and 200% of federal poverty guidelines.
(Indigent care is offered at the Health Department.)
Examples:
1 person $4,320 - $14,940
3 persons $5,040 - $25,180
5 persons $5,940 - $35,420
Payment Requirements
Patient payment is required for services rendered. IHC is not a free clinic.
Patients are charged on a sliding fee scale based on income and number of
people in the household.
Services Offered
•Primary care with available specialty care (includes pediatric care)
•Dental clinic
•Mental health services
•Pharmacy (dispensed for a $3 handling fee)
•Eye clinic
•Hospitalizations on sliding fee
•Minor surgery
Centrally located on Gill
Ave., one block off Broadway.
If you think you might qualify, call with the following
information:
•Number in household
•Household income
•Insurance information
•There are no Spanish speakers on staff, so if you call please have
an interpreter
Appointment is necessary.
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REACHOUT
400 W Main Street Suite 312
PO Box 731
Morristown, TN 37815-0731
Phone: (423) 587-7307
Fax: (423) 587-7307
Rosie M. Freeman (Director)
Who We Are
Mission/Purpose
Established in April, 1996, Reachout, Inc. is a
nonprofit 501(c)3 organization committed to
enhancing the physical and mental well-being of low-income and under-served
communities in East Tennessee. This is accomplished
through collaborative peer education, outreach, and advocacy programs
designed to empower those communities. Our target community includes the
Hispanic migrant, seasonal, and settled farmworkers
of East Tennessee.
Reachout empowers natural helpers who live and
work in communities through training, access to service agencies, and
networking. Our trained Community Outreach Aides (COAs)
unite with local service providers to improve community access to health
care and social services while expanding health education and community
action for health promotion.
Services
•Provide individuals, families, and communities with
information on basic health care, health education/promotion/prevention;
•Assist individuals and families in identifying their needs; provide
periodic community needs assessments;
•Act as a linkage/referral source to needed medical, social, and
community services;
•Provide assistance in obtaining services and function as a liaison/advocate
between families and services;
• Conduct health screenings an follow up;
•Provide social support, counseling, and client translation services
•Provide basic English as a second language and GED facilitation.
Health Education Topics
AIDS/HIV Women's Health
Alcohol/Substance abuse Farm Safety
Dental Care Pesticides
Prenatal Health Ed. Tuberculosis
Postnatal Health Ed. Domestic Violence
Infant Health Child Development
Diabetes Lead
Hygene
Program Delivery
Locations within the community, camps, health centers, schools, churches,
work sites, homes
Geographic Area/Unit
Rural, county, multi-county, individual, family, community
Current Programs/Projects Under our Community Outreach Aide
Umbrella
•COA: Community Comadre Pre-, Postnatal
Home- Visiting Program
•COA AIDS/HIV Education Progam
•Amigos Volunteer Project
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RURAL MEDICAL
SERVICES
PO Box 99
Parrottsville, TN
37843
Phone (423) 625-1170
Fax (423) 625-3618
After Hours (423) 625-0766
Kelly N. Melear (Migrant Program Coordinator)
email: kmelear@planetc.com
MIGRANT HEALTH PROGRAM
Rural Medical Services, Inc., Parrottsville
Center operates a Migrant
Health Program designed to meet the Health needs of migrant farm laborers
in Cocke, Hamblen, Jefferson, Greene and Sevier
counties. We offer the following services to farmworkers:
•Primary health care including: Prenatal care, pediatrics,
family planning, adult sick care, laboratory testing, pharmacy, specialty
referral, immunizations, and patient health education
•Bilingual (Spanish-English) medical providers so that
patients can be treated in their own language (one physician, one nurse
practitioner, 2 migrant program staff)
•Sliding scale fee based on income, patients pay according to
ability
•Limited transportation services (free)- We realize that many farmworkers find transportation to be a problem and we
don't want that to be a barrier for them in getting the health care they
need
•Case management services - Our bilingual staff is trained to
treat the patient in a holistic manner, addressing social as well as health
needs. We make appropriate referrals to the department of human services,
and other charitable agencies, and we provide assistance in accessing
services at other agencies
•Prenatal Outreach - It is vitally important for every
pregnant woman to receive adequate and consistent prenatal care beginning
as early as possible in her pregnancy. We have a bilingual Perinatal Outreach worker on staff
who works primarily with pregnant women to assist them in getting to their
appointments and in understanding how to have a healthy baby.
•Pesticide Safety and Occupational Health education - This
summer, the Migrant Program at RMS is offering to provide Pesticide Safety
trainings in Spanish for farmers employing Spanish-speaking workers. The
presentations meet EPA requirements for Worker Protection Standards, and
are conducted by a bilingual, state-certified trainer. We also touch on
occupational health topics such as heat exhaustion and dehydration. These
trainings are free of charge and we will also provide each worker attending
with a pair of unlined nitrile gloves, which
protect hands from pesticides, and the first 10 farmers to participate will
receive a free Mixer/Applicator kit which includes the following: gloves,
coveralls, goggles, a face shield, a respirator, overshoes, an apron, and a
field warning sign. Call Kelly or Laura at 423-625-1377 for more
information.
•Health Screenings: Many times farmworkers
are unable to come to the clinic because of transportation problems, time
constraints or other barriers. Our staff tries to alleviate this problem by
doing periodic health screenings at migrant labor camps or farms. This is a
service we offer to help farmers keep their workforce healthy with minimal
time away from work, and no travel necessary.
For more information or to request any of the above services,
please contact Kelly Melear-Hough or Laura Lyons
at 423-625-1377/625-1170. We are here to help you!
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KNOX COUNTY
HEALTH DEPARTMENT
140 Dameron
Avenue
Knoxville, Tennessee
423-544-4101
The Health Department does not discriminate against undocumented persons.
They will ask for a Social Security number, but you do not have to give
one. Please bring documentation of income and expenses such as pay stubs
and rent receipts.
Services provided to all persons:
1. Family planning (must meet income guidelines or TennCare
guidelines)
2. Immunizations for children and adults (available to all persons
regardless of income – bring any records of prior immunizations)
3. WIC (nutritional program for pregnant women, breastfeeding mothers, and
children to age five – must meet federal income guidelines)
4. Prenatal services (must be a permanent Knox
County resident with low income
and care must be for the entire pregnancy)
5. Communicable diseases (no income guidelines)
6. Sexually transmitted diseases including HIV counseling and testing (no
income guidelines)
7. TennCare enrollment for children (must give
Social Security number; income determines premium and/or co-pay amounts, if
any)
Services provided to documented persons only:
1. Only accept TennCare for children and
pregnant women who are assigned to the Knox County Health Department
2. Indigent medical and limited dental care for adults (must be a Knox
County resident and meet income
guidelines)
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CALL FOR HEALTH
National Center for Farmworker Health
America's Voice
for Farmworkers, a Free Phone Call Away
Una Voz Para la Salud Con Solo Llamar... y es Gratis
1-800-377-9968
The Call for Health Project has been designed to provide nationwide
information and referral on health services for migrant farmworkers
and migrant clinic staff in the United
States. The Call for Health
toll-free line is answered by bilingual Information and Referral
Specialists who find the closest available health care resource for you and
provide you with reliable referral.
We have information about health services for farmworkers
including referrals to migrant health centers that are specifically created
to meet the health care needs of farmworkers. We
can direct you to the closest health department, access point for social
services, volunteer medical provider or private physician who is bilingual.
To find out how your program can work with Call For Health, or to obtain a
health referral, call:
CALL FOR HEALTH- America's
Voice for Farmworkers, a Free Phone Call Away. 1-800-377-9968
Contact us if you are in search of referrals for medical assistance
on issues such as:
•Medical Services for Adults and Children
•Immunizations
•Dental Care
•Health Education and Social Services
•Sexually Transmitted Diseases
•WIC Programs
•Diabetes
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UNIVERSITY OF TENNESSEE MEDICAL CENTER
1924 Alcoa Highway
Knoxville, TN 37920
423-544-9000
Emergency Room: 423-544-9401
• Emergency services provided to all persons (documents not
needed). Pregnant women can sign up for childbirth services beginning in
the 8th month.
•No preventive or on-going care for undocumented persons.
•UT Hospital absorbs the charges for undocumented persons.
•Spanish Speakers available to translate
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GOOD SAMARITAN CLINIC
811 E. Lamar Alexander Parkway
Maryville, TN 37804
423-983-9802
•Family practice, pediatrics, and infant care.
•Prenatal referred out.
•Dental clinic scheduled to open in June, 1999.
•Sliding fee or TennCare.
•Spanish Speakers available to translate
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![TENNCARE APPLICATION]](http://web.utk.edu/~tnlatina/Applicat.bmp){kind=link}