REACH stands for Racial and Ethnic Approaches to Community Health. REACH grantees from across the country gathered to share their accomplishments in eliminating health disparities in their local communities. Here at HealthVisions, Raquel and her staff are working at decreasing infant mortality among Hispanic women. A key component of the program is providing medical interpretation between provider and client.

In the past year the focus of the grants has moved from purely "hands-on" to "systemic change." HealthVisions Midwest REACH/Alcance program was chosen to give a poster presentation showing change in the grant focus. The poster was entitled "From Grassroots to Grass-is-Greener: Assembling the Mechanisms for Systems Change. The poster emphasized that three intervention levels are necessary for successful, sustainable change:

• Individual Support Services-Community Health Workers (CHW) provide medical interpretation for individuals;
• Improve community practices-Partnerships expand local language access and medical interpretation;
• Advocate for systems change through policies and procedures-Submit state language access policy agenda and Medicaid reimbursement for interpreting services.