History of CLESE

COALITION OF LIMITED ENGLISH SPEAKING ELDERLY

The Coalition of Limited English Speaking Elderly (CLESE) was founded by leaders of ethnic organizations in 1989 as a result of a comprehensive ethnic elderly needs assessment conducted in the city of Chicago that examined the needs of immigrant, refugee and migrant older adults. The purpose of the study was to find out why ethnic elderly were under-represented in the utilization of traditional social services. The needs assessment conducted 1,500 personal interviews in ten languages with older adults from twelve ethnic groups. The results showed that ethnic elderly needed services, were eligible for services, but were not receiving them due to barriers of language and culture.

To guide the needs assessment process, the Chicago Department on Aging and Disability (at that time) formed an advisory committee whose tasks were to identify interviewers, assist in training them, translate the assessment tool and most important, to identify at least 150 older adults in each group who would be able to engage in the one and a half hour interview. In the process of meeting together, the advisory committee members realized that they had much more in common than what might be assumed given that they were from very different countries. All were bi-lingual, bi-cultural and all had experienced difficulties themselves in adjusting to life in a new country. One ethnic agency executive director said that she was afraid to give public testimony on the needs of the elders in her community because she spoke with an accent and worried that people would hear her accent and not her words. Everyone else at the table understood. They came to see that by speaking with one voice, they would be heard.

The results of the ethnic elderly needs assessment spurred them into action and incorporation of the Coalition of Limited English Speaking Elderly with the mission to improve the lives of limited-English-speaking older adults through leadership, education and advocacy.

From the beginning, CLESE membership reflected the ethno-linguistic diversity of Northern Illinois and increasingly the entire state. Members represent countries from all parts of the world. As new groups of refugees and immigrants arrive, they form new organizations and they ask to join CLESE. CLESE presently has 50 members and speaks over 100 languages. Critical to the success of the coalition is that all members are welcome at the table. CLESE members have always appreciated and worked well with representatives from other ethnic groups. The 14-member CLESE Board of Directors is comprised of executive or program directors of agencies serving ethno-linguistic communities.

The ethnic elderly needs assessment was widely distributed among the aging network leadership. In response to the documented gap in services to limited-English speaking elderly, the Illinois Department on Aging changed its rules for the home and community based services program funded by a Medicaid waiver and Illinois General Revenue funds. The first two contracts (in 1991and 1992) targeted specific populations and were awarded to four communities: Chinese, Korean, Polish and South Asian (Indian).

CLESE provided technical assistance to new provider organizations including writing a homecare training manual and helping new providers understand homecare program regulations. Presently over 16,000 limited-English speaking elderly (out of 90,000 statewide) receive adult day and/or in-home services in Illinois from 27 CLESE member organizations.

Other major programs over the years have either addressed a demonstrated need in the limited-English speaking populations or have been an exploration of a particular need. CLESE has received funding for health screening fairs and several health education programs, translation of health and safety information, citizenship preparation, English instruction for older adults, elder abuse and neglect identification and intervention, cultural adjustment and access to benefits services specifically for elderly refugees, Alzheimer’s disease awareness, combating depression, building urban farm for multigenerational refugee families in busy Chicago and a number of capacity-building projects.

CLESE has received grants and contracts from city, state and federal government, from area agencies on aging and from various foundations.

In order to ensure continued program relevance and attention to critical issues, CLESE checks updated Census data, discusses issues of concern at Board meetings, researches issues in specific ethnic populations, conducts surveys of member organizations and has recurring conversations with major funders, officials and other aging, immigrant, and refugee network leaders.

CLESE has advocated on a variety of issues, all addressing the disparity of services and benefits or seeking to inform mainstream officials about particular needs of immigrant, refugee and migrant elderly.

CLESE speaks on behalf of all ethno-linguistic member organizations to the general public and to specific officials, decision-makers and funders. CLESE represents ethnic communities on committees, advisory councils and other vehicles that foster an improved understanding of and access to limited English-speaking elderly. CLESE presents at state and national conferences, in addition to speaking at many meetings, seminars, and workshops, always with the intent to educate the attendees.

Many evidenced-based programs, proven successful with mainstream elderly, cannot be replicated in ethnic communities without significant modification. One example: in the Alzheimer’s disease project, CLESE learned that Alzheimer’s disease could not be translated, there was a tremendous amount of stigma in having a “mental illness,” ethnic families did not designate one primary “caregiver;” there were many obstacles of language and culture in obtaining a comprehensive medical assessment to rule out other causes of dementia. CLESE is engaged with several universities and individual researchers in exploring how to adjust evidence-based practices without losing fidelity to the original program.

Currently, CLESE works through Illinois Department on Aging to counsel and enroll eligible low-income beneficiaries into Medicare and assist with Medicaid and other benefits application processing. CLESE serves close to 10,000 eligible individuals in SHIP (Senior Health Insurance Program). CLESE also works with the Department to support minority caregivers and educate them about healthy ways of coping with stress and to create Dementia Capable State of Illinois.

Transition to managed care created an opportunity for CLESE to provide effective leadership and education to the large network of providers. CLESE created Language Access Center where we work with Managed Care Organizations to assist care coordinators with language access and cultural competency trainings to better serve their members.

Major objectives of the partnerships are:

1) Educate and train CLESE ethnic providers’ network about the transition to managed care and assist them in the process of contracting with managed care organizations so they understand the impact of the changing landscape of the long term service programs on their elderly clients;

2) Educate managed care organizations about the CLESE providers’ network and the LEP elders in order to raise the MCOs awareness about the cultural and language barriers this population faces in accessing services;

3) Foster collaboration and partnership between the managed care organizations and CLESE ethnic providers in order to educate ethnic communities about the transition to managed care, improve care coordination and support ethnic elders so they can make informed decisions when choosing a managed care provider;

4) Provide one-on-one consultations and assistance to CLESE ethnic services providers so they have an opportunity to learn about specific contract provisions required by managed care;

5) Serve as a resource to managed care organizations when it comes to serving the LEP populations and assist MCOs with addressing the specific needs of ethnic elderly clients through the CLESE network.

In partnership with managed care organizations, CLESE serves close to 2,000 individuals every year.

For more information, please call 312-461-0812 or email the Executive Director of CLESE, Marta Pereyra at marta@clese.org