Los Angeles: Language Barrier at Forefront of Medical Care

Harold F. Schiffman haroldfs at ccat.sas.upenn.edu
Wed May 24 13:50:55 UTC 2006

>>From the UCSDGuardian www.ucsdguardian.org
05 / 22 / 2006

Language Barrier at Forefront of Medical Care

By Natalie Banach
Daily Bruin

(U-WIRE) LOS ANGELES California health care agencies are on the move after
UCLA public health researchers released a study last week revealing that
more than 1 million adults in California face restricted health care
access because they do not speak English proficiently. The study by the
UCLA Center for Health Policy Research disclosed that those with limited
English proficiency are more likely to have problems accessing health care
services, and health care providers whether public or commercial are not
doing enough to ensure quality treatment. For state agencies, the news
underlines the importance of certain changes already being made.

The Department of Managed Health Care is currently putting together a set
of standards for language service access and is also working to get
private health care providers on par with their public school
counterparts. More than 300,000 Californians enrolled in commercial Health
Maintenance Organization plans report having trouble understanding their
physicians, and 5 percent of these individuals say they were not able to
find translators to help them, according to the study. There is not a lot
of information about language services, said Gerald Kominski, associate
director of the UCLA Center for Health Policy Research and the lead author
of the study. We were able to make comparisons across HMOs. Thats what is

Previous studies regarding the language barrier did not ask respondents
about their specific health care providers and the type of service they
received, Kominski added. The UCLA policy brief has provided information
for the California Department of Managed Health Care, the California
Office of the Patient Advocate and state legislators, which reinforces the
need to address issues associated with the language barrier. We know that
language barriers affect quality, said Ed Mendoza, acting director of the
California Office of the Patient Advocate. What we didnt know was exactly
how many enrollees were talking about.

Understanding ones health care plan and the complex issues surrounding
diagnoses and treatment can be difficult even for those proficient in
English, so you can imagine how much more difficult it is for those who
have limited English proficiency, Mendoza added. The different types of
problems limited English-speaking HMO enrollees run into include
miscommunication with their physician and an inability to efficiently deal
with their health care providers. In fact, one study found that more than
25 percent of non-English-speaking patients could not understand their
prescription instructions, according to the policy brief.

The study also found that public Medi-Cal and Healthy Families plans have
for the most part done a better job of allocating language services to
members with limited English proficiency. The immediate goal of state
agencies and legislators is to regulate commercial HMO plans to mimic
their public counterparts in language service access, public health
officials said. State agencies are already on their way to making
improvements to the system, and the study has worked to emphasize the
needs for such changes, Kominski said. The Department of Managed Health
Care, responsible for managing HMOs, is in the process of regulating the
standards concerning language access for commercial plans. In addition,
state legislators are considering setting up a task force to find out how
health care providers can be reimbursed for providing language services to
their subscribers, Mendoza said.

In addition to the need for an increase in the number of translators and
interpretation services, solutions include offering written and verbal
information about various HMO plans and medications. Spanish and Chinese
are the most predominant languages spoken in California other than
English, and Mendoza said he would like to see these and about 12 to 14
other languages covered. Ninety-three percent of health care plans report
having a Spanish-speaking interpreter available during business hours, the
UCLA study found. Now that we have a better idea of how many enrollees
need language services, wed like to see regulations adopted, Mendoza said.


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