SAN FRANCISCO — About two years ago, the staff of a Los Angeles hospital tied both of a 97-year-old South Korean immigrant’s hands to the frame of his bed after the man raised his voice in frustration when no one could understand what he was trying to say in his native language.
In another instance, Myung Hee Kim, a 71-year-old South Korean immigrant who spoke no English and was admitted to a hospital in Southern California for diabetes-related complications, was administered pain relievers to her right shoulder when she complained of pain in her left shoulder.
Such medical mistakes are now less likely to happen in California, thanks to a new regulation that requires commercial health and dental insurers to provide translators, if not in person, at least by telephone or video conferencing, said Anthony Wright, executive director of Health Access California, one of a number of nonprofits that helped the California Pan-Ethnic Health Network (CPEHN) push the legislation through.
“This can make a big difference in the quality of health care our communities receive,” said Marty Martinez, policy director at CPEHN, which sponsored the legislation.
The regulation, the first of its kind in the nation, ensures that “everybody who has insurance gets an interpreter,” said CPEHN Executive Director Ellen Wu. Doctors’ orders “will now have to be translated into any language that is spoken.”
An estimated 7 million Californians with limited English proficiency, about half of them enrolled in health maintenance organizations (HMOs), are expected to benefit from the law.
A provision in the Civil Rights Act of 1964 requires all hospitals that receive federal funding to provide interpreters, a law that is often breached.
CPEHN sponsored Senate Bill No. 853, the Health Care Language Assistance Act, in 2003, with co-sponsorship from the Mexican American Legal Defense and Education Fund and the Western Center on Law and Poverty. It was signed into law by former California Gov. Gray Davis that same year.
But for years after that, it faced a myriad of hurdles from health plan opponents and administrative turnovers, resulting from the 2003 gubernatorial recall. The implementation finally began Jan. 1, 2009.
The need to have such a law became more pressing as California became more diverse. More than 40 percent of Californians do not speak English at home, and an estimated 7 million have limited English proficiency, according to U.S. Census data.
For some populations, such as Vietnamese and Korean Americans, more than 60 percent don’t speak English well. As a result, they and other individuals with limited English skills face language and cultural barriers when seeking health care.
Immigrant patients have to take an English-speaking family member with them when they go to the hospital, which is not always possible. And when they do, the family interpreter often cannot understand medical jargon, resulting in miscommunication.
Some hospitals, such as Kaiser Permanente, have long hired people with second-language skills.
Under the new regulation, HMOs and medical providers will have to provide interpreters either in person or via telephone or video conferencing.
And just what language the interpreters will have to know will depend on “how much the language penetrates that particular area,” said Wright.
“In Fresno, for instance, HMOs and medical providers will have to provide interpreters who speak Hmong,” he added.
Martinez noted that even though the Health Care Language Access Act is a California law, there could more than likely be a “spillover effect” to other states.
“Hopefully, this can serve as a model,” he said.
Below is a list of resources CPEHN has compiled to help ethnic communities better navigate the health care system:
• “I Speak” Cards. Available in 13 languages, these were developed by PALS for Health to enable a patient to ask for an interpreter and to help health care staff immediately identify the language spoken by the patient.
• HMO Help Center. Patients can call 888-466-2219 if they need help working with their health plan to get the services they need.
• Sample Notice of Language Assistance. Created by the state Department of Managed Health Care (DMHC), this notice outlines patients’ newly implemented rights to language services in 12 languages.
• DMHC’s Language Assistance Web page. The site — www.dmhc.ca.gov/healthplans/gen/gen_langassist.aspx — compiles information on Senate Bill No. 853, frequently asked questions and sample health plan notices.
• Office of the Patient Advocate’s Web page. The site — opa.ca.gov/ — has information to help patients navigate the health care system, including a “How to Use Your Health Plan” guide.
Viji Sundaram is the health editor of New America Media.
(New America Media)
