Health Access: Overcoming Barriers

Mireya MunozProgram Manager, ALAS para tu

SaludHealth Justice Network

11/09/2010

This presentation is possible thanks to funding from The California Endowment, Office of Aides Programs and Policy (OAPP),

Susan G. Komen-LA Affiliate

Interpretation, Translation, Testing and Training“We Speak Your Language for a Healthier Community”

Language DivisionTranslationInterpretation Interpreter trainingTranslator trainingContinuing EducationProgram evaluation

Advocacy DivisionConsumer educationProvider educationLEP advocacy

6 FTEs, 2 NAPCA Volunteers, and 90+ interpreters -Arabic, Armenian, Cambodian (Khmer), Chinese (Cantonese, Mandarin, Teo-Chew, and Taiwanese), Farsi, Indonesian, Japanese, Korean, Russian, Spanish, Tagalog,Thai, and VietnameseService area: Los Angeles County with limited services in Orange, San Bernardino and Riverside Counties

Barriers to Culturally and Linguistically Appropriate

Health Care

Togafitiga o le kanesa i vaila’au

(Samoan)

Nababasa mo ba ito?(Tagalog)

(Korean) (Khmer)

(Chinese)

(Vietnamese)

Who is currently interpreting in health care settings?

Unqualified Interpreters

Research shows that 23% to 53% of the words are interpreted incorrectly by unqualified interpreters

They omit, add, or change the information, and render errors that can distort or affect a patients’ care (e.g.. Diabetes vs. Hepatitis)

Misunderstandings related to medication, diagnosis or other instructions

Patients and providers do not have the ability to judge the clarity or accuracy of the interpretation

© Connecting Worlds, PALS for Health 2002

How the Language Barrier Affects the Patient

Delay in receiving medical care

Denial of benefits or services needed

Receive inappropriate benefits or services

Have to use family members or strangers in order to communicate with their doctor.

Ira Pollack, Regional Manager, Region IX Title VI and the Provision of Services

to Persons With Limited English Proficiency

Why Family Members And Friends May Not Be The Best Interpreters

Their knowledge of English may not be good enough

Many individuals, especially children, lack fluidity in their native language

If they don’t work in the medical field, they may not be familiar with medical terminology or important concepts

…Appendix, Arthritis, Chemotherapy, Hemroid, Thyroid, Ultrasound, Virus…

Why Family Members And Friends May Not Be The Best Interpreters

They are not trained and often omit or misinterpret important information.

They are not obligated to keep your information confidential.

There are sensitive information that you do not want your friends and family to know.

There are time when they may have their own opinions or goals, which can confuse the doctor.

Challenges Patients Face

Lack of knowledge about their linguistic rights

Lack of knowledge about the health care system

Difference between emergency and preventative care

Cultural factors: questioning of authority figures (health

providers) is inappropriate

Fear of receiving poor quality care or reprisals

Lack of access to qualified interpreters

Challenges Patients Face

Lack of reimbursement

Lack of resources to quality interpreting services

Lack of knowledge in the area of health care interpreting resources

Lack of tools to evaluate the linguistic proficiency of bilingual staff

Lack of resources for training interpreters

Health Access:

Trained Health Care Interpreters

Improves communication between patient and provider

Empowers patients to care for themselves

Increase adherence to medication and treatment instructions

Reduces the use of expensive and

unnecessary exams

Reduces the number of cancelled

appointments

Having a Trained Health Care Interpreter

Trained Health Care InterpretersProficiency/fluency in English and

source language is verified

Are familiar with medical

terminologies in both languages

Have been train to retain and

interpret what the patient and doctor say with accuracy and in totality

Must adhere to ethical rules, including confidentiality

Using Trained Interpreters

Remember to speak directly to the doctor or patient, not the interpreter

Speak in short sentences and pause so that the interpreter can completely and accurately

Try not to interrupt or speak over the interpreter

Do ask interpreter for cultural clarification

Do not ask interpreter for medical advice

Patient’s Rights

Federal Language Access Law Title VI of the Civils Rights Act of 1964:

Prohibits discrimination based on race, color or national origin (which includes language)

Who should abide by these laws? - Any agency or program that receives federal funding

- State, county, and local health agencies

- Hospitals and health clinics

- Health plans

- Mental health centers

State Laws

Kopp Act Ensures the availability of interpreting services at acute care facilities Hospitals have to post interpreter service signs in different language Notify all employees about the requirement to provide interpreters to all

patients that need them

Dymally-Alatorre Applies to all state-funded agency or program Employment of enough bilingual employees Translation of written materials

Senate Bill 853-(Escutia) – Effective January of 2009 All managed health plans must have language access Health care plans will take necessary measures to ensure that all members

have access to interpretation services and translation of vital documents

What This Means For All Patients… All Patients with Limited English Proficiency :

Have a right to a qualified interpreter

Have the right to receive vital documents in their preferred language

Should never be asked to bring their own interpreter

Should never be charged for interpreting services

Should not suffer unreasonable delay in receiving care due to limited English proficiency

Should always be treated with respect

Health Access:

How To Get An Interpreter When you call to make a medical

appointment, ask for your preferred language to be noted in your chart and ask for an interpreter

Contact your insurance company’s Patient Relations Department, or health care agency’s Language, Interpreter or Diversity Department

If you don’t get an interpreter, file a complaint (Patient Relations, Ombudsman, Office for Civil Rights)

If you still don’t get an interpreter, call PALS or ALAS

I Speak Card (Front)

I Speak SpanishI need a Spanish speaking interpreter for my

medical appointment.

Please, make a note on my medical file

of my language and need for an interpreter.

Thanks!

I Speak Card (Back)

Important things to remember before and after your appointment:

R When scheduling your appointment, ask for an interpreter.

R Ask your doctor to note your language on your medical file.

R Write down any questions for your doctor before your appointment.R Ask your questions at the

beginning of your appointment .R Ask for an interpreter when making your next appointment.

SSG/PALS for Health (213)553-1818. OMH Bilingual Bicultural Service Demonstration Grant

How to Contact Us:

PALS for Health/ALAS para tu Salud

(213)-627-4850 or (213) 553-1818

www.palsforhealth.org

Thank You!