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York-area residents spoke Tuesday night in a forum at the Crispus Attucks community center dedicated to discussing barriers to health care.

Chief among the issues were the costs of care, difficulty serving Hispanic patients sufficiently and troubles with getting and keeping insurance, the few dozen people in attendance said.

"This is our first feeling into the community," said Dr. Deborah Bernal, who works for WellSpan Heath and served as something of an emcee for the forum.

Language barriers: Bernal spoke at some length about how language barriers cause frustrations for patients and doctors alike.

"Sometimes providers are impatient with the process of translation," she said, as it can add a good deal of time to an appointment. But there need to be ways of getting past that, she said. For example, WellSpan has translators familiar with the medical field who can come to an appointment. That works well, she said, as little gets lost in translation.

Otherwise, it usually ends up being the patient's family members who take on that role, and they aren't medical professionals, so communication can become confused. Dolores Minaya, who is Dominican born, said she always has to come to advocate for any of her family members who are seeking care.

"Where anybody has an appointment, Dolores has to be there," she said.

Jose Santiago, who runs the Centro Hispano in York City, said there aren't enough facilities that cater to Spanish-speaking people.

"I think it's time to bring Latino mental health services into York City," he said, garnering snaps from the audience.

He said counselors need to have the ability to speak Spanish and knowledge of Hispanic culture to get people to open up.

"It's a comfortability thing," he said.

Costs: Other people talked about the difficulty in paying for care, even when they had insurance.

Wickie Woerthwein said that was the case with her — she and her husband, a doctor, have insurance, but their carrier decided it didn't want to keep paying for the type of medication she was getting, she said. She'd need to pay more or change.

"You can't have this good medication," she said they were basically saying to her.

Salome Johnson, a retired hospital administrator, also has insurance, but she has had issues with health care nonetheless. Almost 20 years ago, she donated one of her kidneys to her husband, a procedure that would have cost more than $300,000 if they'd have had to pay for it out of pocket.

"For a person who doesn't have health insurance, I guess you would just have to die," she said.

Resources: Carla Christopher, one of the forum's organizers, said there needs to be better information out there about what options are available. There are some resources, she said, but many people don't know what they are. She said it would be a big help if there were more people who were playing the role of guide or facilitator.

As a care coordinator at Family First Health in York City, it's Shane Moore's job to do more or less that — patients come to the clinic with one issue or another, and he has to figure out how to get them care.

Moore is not dissuaded by the fact that these are some big issues.

"It's about bringing the community partners together," he said.

It has to start somewhere.

"We chip a little at the bottom," Moore said. "We start with the smaller things that we can take care of."

— Sean Cotter covers York City for The York Dispatch. Contact him at scotter@yorkdispatch.com or on Twitter at @SPCotterYD.

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