California: Health plans will have to offer translators; New state regulation covers commercial providers

Harold Schiffman hfsclpp at
Wed Jan 7 14:18:41 UTC 2009

Health plans will have to offer translators New state regulation
covers commercial providers

By Bobby Caina Calvan / The Sacramento Bee

Millions of Californians with limited English proficiency now have the
right to an interpreter from their commercial health and dental plans
-- made possible by a first-in-the-nation law aimed at dismantling the
language barriers that get in the way of good medicine. The new
regulation -- implemented New Year's Day after five years of hearings,
delays and wranglings among insurance companies, regulators and
consumer advocates -- is widely touted as a milestone in reducing
mistakes because of miscommunication. "This is really huge, especially
in California where we're getting more and more diverse," said Martin
Martinez, policy director for the California Pan-Ethnic Health
Network. "Even if you speak English well, it's really hard to
understand what your doctor is saying."

As many as 7 million Californians with health-related private
insurance lack English fluency and could benefit from the new language
service. Patients rights advocates applaud the new rules but worry
non-English speakers won't be told about the help now available to
them. To spread the word, the state is launching a publicity drive in
the coming weeks. "This law has been some time coming," said Anthony
Wright, executive director of California Health Access. "Our big
concern now is whether people have adequate notice about their rights,
and can actually use them." Doctors' orders will now have to be
translated, at least verbally, into Spanish, Mandarin, Hmong, Russian
-- any spoken language.

The size and cost of the task -- estimated by insurers to be about $25
million -- make it the biggest regulation effort undertaken by the
California Department of Managed Health Care, which regulates HMOs.
The law, Senate Bill 853, was signed in 2003, but shelved as part of a
moratorium imposed by Gov. Arnold Schwarzenegger when he took office.
It was finally dusted off, but insurers balked at the cost.
"Obviously, we know this is a diverse state and people speak many
different languages," said Nicole Kasabian Evans, spokeswoman for the
California Association of Health Plans.

The insurers' concern, she said, was about balancing access and
affordability. Some insurers plan to contract out the language
services. Some of the infrastructure was already in place because
federal law requires health plans to offer interpreters to those
enrolled in Medi-Cal or Healthy Families. For years, larger hospitals
have had interpreters standing by. Kaiser Permanente, for instance,
has 50 at its Northern California facilities and has 3,400 employees
with second-language skills.

But many patients did not have guaranteed access to interpreters. For
that reason, California's law is broad in its sweep. It requires
health, dental and specialty insurers to provide subscribers with
translators, at least by telephone, while visiting their doctor,
pharmacist or dentist.

"The intent is that better communication leads to better health care.
To the extent we can make that possible, we're going to work to do
that," said Ben Singer, a spokesman for Anthem Blue Cross, which
provides dental and medical insurance to 8 million Californians.

More than 40% of the state's 37 million residents speak a language
other than English, according to U.S. Census estimates. A fifth of the
population say they do not speak English "very well."

The California Healthcare Interpreting Association in Sacramento is
pushing for a certification program to ensure that interpreters used
by health plans are well-versed in medical lingo and the languages
they translate.

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