Hospice Agencies Serving the Cultural Needs of the Hispanic Community

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The Medicare Hospice Benefit (MHB) is a national policy that was enacted in 1982 to reduce end-of-life care expenditures and improve quality end of life. Hospice care is of value to all qualifying individuals who have a terminal diagnosis. The focus of hospice is to provide comfort care through pain and symptom management while providing psychosocial and spiritual support. Research reports that the Hispanic population is one of the most underserved populations in healthcare, with hospice care being one of those services. In a study by O’Mara and Zborovskaya (2016), utilization of hospice services was found to amount to 5% among Hispanics. It is projected that by the year 2050, the Hispanic senior population over the age of 65 years of age will increase by 14%. The Hispanic population continues to be one of the fastest-growing populations in the United States. In this study, the researcher explored whether hospice agencies utilize culturally linguistically appropriate services (CLAS) standards while providing hospice services. In addition, she examined whether hospice agencies are promoting social equity, best practices, and cultural competencies and meeting the needs of the underserved communities with specific attention focusing on the Hispanic communities. The theoretical framework used to analyze this study was social equity and its relationship to cultural competence. Much of the hospice expenditure coverage comes from federally-funded Medicare, making the MHB an entitled benefit for many; therefore, it is imperative that the MHB be equitable and accessible to all those who qualify. This study interviewed 2 hospice administrators and 7 hospice social workers. The analyzed data determined that hospice staff personnel felt they were competent in their abilities to serve all populations that are receiving services through their agencies, especially when it comes for servicing the Hispanic populations. However, some agencies recognized the need to implement services for the deaf and blind communities. The researcher has proposed that additional studies guided by the principles of CLAS should be conducted more extensively in order to better meet the needs of the underserved populations, ultimately improving quality end of life.
A dissertation submitted in partial fulfillment of the requirements for the Degree Doctor of Public Administration
Public Administration, Health Care Management