State agencies address language barrier

State 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. … We were able to make comparisons across HMOs.
That’s what is unique,” said Gerald Kominski, associate
director of the UCLA Center for Health Policy Research and the lead
author of the study.

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. What we
didn’t know was exactly how many enrollees we’re
talking about,” said Ed Mendoza, acting director of the
California Office of the Patient Advocate.

Understanding one’s 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 over 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, we’d like to see regulations
adopted,” Mendoza said.

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