Primary care training and enhancement - language and disability access - yakima county is one of the largest agricultural areas in the united states

The population of yakima county is now ~52.6% hispanic/latinx, with some regions, such as the lower yakima valley having more than 80% of hispanic/latinx constituents. Yakima and the neighboring kittitas county are designated health professional shortage areas (HPSAS) with nearly half of county constituents living at or below 200% of the federal poverty level; a majority of residents living under the poverty level are hispanic/latinx people. The impact of rurality and poverty on health outcomes is amplified in hispanic/latinx populations with limited english proficiency (LEP). In groups of low socioeconomic status, LEP individuals have a three times reduction in health literacy compared to english-speaking patients. Community health of central washington (CHCW) is a federally qualified healthcare center (FQHC) with a mission to "provide high quality healthcare through service and education in yakima and kittitas counties''. At CHCW's central washington family medicine residency (CWFMR) program, our residents provide medical services to a diverse community of underserved populations, particularly latinx migrant farmworkers (N=3,707) and limited english proficiency (LEP) members spanish-speaking community (~11% of 27K patients, representing over 3,000 patients). While we continue to graduate residents to practice in yakima, kittitas, and other regional rural counties, very few of our current and graduating residents display spanish language proficiency or the cultural competency training to fully engage with latinx patients in their clinical visits. As a response to this concern, CWFMR is drawing upon our current resources and seeking new funding to increase the number of family medicine physicians trained to provide high quality, culturally and linguistically appropriate care to spanish-speaking patients of LEP. CWFMR plans to do this through the development of a residency track called "language instruction and dedicated education of residents for the latinx community" (LIDERES-LC). LIDERES-LC is designed to ultimately recruit and train resident physicians with a desire to improve their cultural and linguistic competency, and thereby better serve latinx populations, specifically those with LEP. LIDERES-LC will provide a specialized curriculum that includes: longitudinal spanish language instruction, clinical rotations with latinx language/cultural immersion, didactics covering cultural and linguistic considerations when working with LEP patients, and community engagement focused on serving latinx populations. The presence of the LIDERES-LC program at CWFMR will promote the cultural and linguistic competency of all residents through the shared didactic trainings, new options for cultural immersion, specialized clinical rotations, and community engagement. IT is our goal that when our enrolled resident trainees graduate from the LIDERES-LC track, they will become healthcare "LIDERES" or leaders, who are dedicated to lifelong advocacy for our latinx community through their delivery of culturally and linguistically appropriate care to meet the healthcare needs of LEP spanish-speaking individuals.