Connecticut: Rell's Budget Cuts Funds For Medical Language Services

[Harold Schiffman]

Rell's Budget Cuts Funds For Medical Language Services
Hospitals, Health Centers To Argue For Restoration Of $4.7M Program

By Judy Benson ,     Published on 2/15/2008

Several weeks ago, an immigrant from Bangladesh went to the Community
Health Center for treatment of some gynecological problems.  The woman
spoke little English, and registered nurse Paige Woodruff knows no
Bengali. Woodruff telephoned a translator fluent in both languages and
in medical terminology, and with the help of over-the-phone
communication, was able to examine the patient, learn about her
symptoms and tell her she would need to be tested for a sexually
transmitted disease.

Each of the 14 exam rooms at the health center's New London clinic are
equipped with the special speaker telephones that can access language
translators within seconds for common languages like Spanish, longer
for more uncommon ones like Bengali. The translator will remain on the
line throughout the entire exam, if needed, to give instructions,
answer questions and relay information among patient, doctor and
nurse.

"I waited about 20 minutes for the Bengali translator," Woodruff
recalled after demonstrating the Language Line Services system
Thursday afternoon. "I think the service is excellent, and I've had to
use it in some pretty tricky translation situations that involved not
just language, but cultural issues. "You can't really provide good
care if you can't communicate." Health centers and hospitals around
the state routinely provide over-the-phone or in-person translation
services for non-English speaking patients. Until last week, they had
reason to expect the cost of providing the services would be
compensated from the state when the service went to the state's
low-income residents covered by Medicaid.

A $4.7 million appropriation approved last year for the state budget
for fiscal 2008-09 would have done just that, but Gov. M. Jodi Rell
last week proposed canceling that appropriation. Now hospitals, health
care advocates and legislators are pushing for restoration of the
funds. The Connecticut Coalition for Medical Interpretation will make
its case at a news conference at 1:30 p.m. today at the Capitol that
will coincide with an Appropriations Committee meeting where the
funding for this and other programs administered by the state
Department of Social Services will be considered.

"This is not an illegal-immigrant issue; these are Medicaid patients,"
said Estela Lopez, director of the Hispanic Health Council's Latino
Policy Institute. "We're hopeful it will be restored."  The $4.7
million would have reimbursed hospitals, health clinics and private
doctors for translation services for state Medicaid patients who don't
speak English or have limited English skills. They number about
22,400, according to the Connecticut Health Foundation, a nonprofit
health policy organization.

The state, however, would have been able to recoup $2.35 million of
the expenditure from the federal Medicaid program. Helen Mulligan,
spokeswoman for the Center for Medicare and Medicaid Services' Boston
office, said the matching reimbursement is only available to states
that pay for the other half of the cost. Eleven other states
participate in the program, including Massachusetts, Maine and New
Hampshire.

Rich Harris, spokesman for Gov. Rell, said the governor believed
substantial funding for the state's nonprofit hospitals, several of
which are struggling financially, has been provided in other
appropriations left in the 2008-09 budget plan. In addition, some
issues regarding criteria for the reimbursement had not yet been
worked out, he said. Federal civil rights laws require hospitals and
clinics to provide translation services, so they would continue to be
provided regardless of state reimbursement. "We consider this an
unfunded mandate," said Leslie Gianelli, spokeswoman for the
Connecticut Hospital Association. "This is very disappointing."

Recent research conducted by the Connecticut Health Foundation
concluded that inconsistent translation services were a major cause of
health disparities between minority and non-minority patients, noted
foundation President Patricia Baker. At times, for example, family
members or a hospital staff member not medically trained are used to
translate, and this is a poor substitute for an impartial,
professional translator trained in medical terminology, she said.

The foundation's findings were the basis of the legislation adopted
last year that originally put the $4.7 million in the budget. "This
was one of our primary recommendations for reducing health
disparities," Baker said. "We're now asking health providers to do
this with little or no support. If we institutionalized it, it would
ensure that the services are high quality and effective."  The
Community Health Center, which serves about 70,000 patients at clinics
statewide, including those in Groton and New London, spends about
$100,000 per year on translation services, said Mark Maselli,
executive director. The William W. Backus Hospital in Norwich spends
about $30,000 per year, according to spokesman Shawn Mawhiney, while
Lawrence & Memorial Hospital in New London spends about $40,000
annually. With slim operating margins at both, the reimbursement would
have been welcome.

"We had been hoping there would be some relief," said L&M spokesman
Kelly Anthony.According to research by the health foundation, there
are about 970 Medicaid recipients in the New London area who need
translation services. In the Norwich area, there are about 675.  David
Dearborn, spokesman for the state social services department, said the
department's request for fiscal 2008-09 will be for $1.175 million
appropriated for language services but heretofore not released in this
year's budget be carried forward into next year. The $4.7 million in
the original 2008-2009 budget would be rescinded.  He said the
department is "in discussions" about whether the reimbursements should
be given only for face-to-face translators, phone translators, or
both.

http://www.theday.com/re.aspx?re=cf0cda4a-17b5-4024-9e3f-1e12017b3036

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