Providing Care Across Cultural Barriers
About 40% of California residents speak a language other than English and patients who are not English-proficient may not be able to clearly describe their symptoms to a provider or understand, much less follow doctor’s orders. Effective treatment depends on good communication between doctor and patient.
There are several laws and regulations in place to ensure language access for patients, but these laws need to be fully enforced or extended. It is inappropriate and dangerous to use untrained personnel or patients’ children for interpreting. No parent should have to describe sensitive issues to a doctor in front of their children and children do not have the medical vocabulary to serve as interpreters for their parents.
Health Access has supported language access, including SB 853, “Health Care Language Assistance Act” (2003). Today, limited-English proficient (LEP) and non-English speaking consumers have a right to trained medical interpreters, though how many consumers understand their rights and take advantage of them is not known. Since 1991 the Department of Health Care Services, which oversees Medi-Cal, has required Medi-Cal managed care plans to provide access in the thirteen “threshold languages.” Medi-Cal has recently updated the standards that all Medi-Cal managed care plans must follow to determine which languages they must provide translated materials to enrollees.
Even with these laws on the books, Health Access continues to work with government agencies, insurers, providers, and others in the medical and advocacy community to fully enforce these regulations and translate them into everyday practice.
For over a decade, Health Access also pioneered the concept of Video Medical Interpretation (VMI), hosting a project to implement the technology in public hospital systems throughout California. This project spun off several initiatives, including a partnership with San Francisco General Hospital and Alameda County Medical Center. VMI was shown to be a practical, cost-effective approach to offering the services of trained medical interpreters, both to resolve scheduling issues and wait times for Spanish speakers, but also to dramatically expand the number of languages offered, even in off-site clinics and locations.