Language Services — Medical Model — Example and General Approach

While the legal system seems to be having difficulty moving forward with language access, here is a nice Oakland Tribune article that talks about creative use of video technology to ensure translation in a hospital.

The medical center uses video conference machines, dual handset phones and speaker and conference phones to get vital medical information to patients, hospital officials said. They started basic translation services using telephones about 30 years ago with the first influx of southeast Asians into Alameda County. But five years ago they acquired 41 video monitoring machines and now serve about 88,000 patients annually, said Sambo Ly, the manager of interpreter services. Medical center officials called Ly the “godmother of the service” because of her work with non-English speakers in refugee camps and community health centers.

The video conference machines were paid for with a $900,000 grant from the California Endowment. Before they arrived, the medical center provided translation services for about 35,000 patients annually, medical center officials said.

The article ends:

Under State Department of Public Health mandate, general acute care hospitals must have a policy and procedures for providing round-the-clock assistance to patients with language or communication barriers, limited or non-English speakers and deaf people.

This might also be a good place to draw attention to the huge progress in language access in health care — progress that has been acheived through a consensus approach.  Here is the LANGUAGE ACCESS IN HEALTH CARE STATEMENT OF PRINCIPLES, adopted by a massive list of organizations.

Note particularly how they deal with the compliance issue — they talk of accountability rather than enforcement:

Language services in health care settings must be available as a matter of course, and all stakeholders – including government agencies that fund, administer or oversee health care programs – must be accountable for providing or facilitating the provision of those services.

Maybe food for thought on how to build a consensus approach.

The Statement of Principles has an Explanatory Guide.

It expands on the accountability principle as follows:

All stakeholders in the health care community fulfill important roles in, and share responsibility for, eliminating language access barriers to quality health care, as evidenced by the preceding principles. They reflect a vision of developing and funding shared resources available to public, private, and nonprofit sectors of health care to enhance access to quality services for addressing language barriers. With responsibility and resources, however, comes accountability for providing or facilitating the provision of those services.

This principle originally arose out of concerns about enforcement. In the view of many of the advocacy organizations, LEP individuals often do not receive language services because implementation and enforcement of existing laws have been inadequate. In the context of other principles these groups wanted to ensure that any new funding (see Principles 3 and 4) was coupled with enforcement. They see such a requirement as entirely consistent with the concept of personal responsibility that formed part of the foundation for Principle 7, which recognizes the value of learning English if there are sufficient resources available to do so. Yet for many of the provider associations, a focus on enforcement detracted from the positive steps of many of their members to provide language services. Others were concerned that noncompliance might, in some cases, arise from lack of knowledge rather than lack of concern. They felt that an emphasis on enforcement in those cases could be counter-productive, and that affirmative measures, such as education about the need to provide language services, could achieve the same result in a more positive manner and more quickly. In addition, framing the issue as “enforcement” put the onus primarily on providers without recognizing that other entities, such as government agencies that ought to assist with the provision of financial and technical resources, also had to be part of the solution.

This debate was resolved when one of the provider organizations suggested focusing on accountability rather than enforcement. All quickly agreed that it is results, and accountability for achieving those results, that matter. Enforcement is merely one tool available to ensure that the money being spent accomplishes its intended purpose. Accountability, though, is a broader concept, one that includes among other things an affirmative responsibility to meet the needs of LEP individuals and clinical staff, both of whom often need assistance in determining how best to overcome language barriers.

The group highlighted that language services must be available as a “matter of course” to reemphasize the concept embodied in Principle 1 that accurate communication is a sine qua non of quality health care, and accurate communication is not possible for LEP individuals without competent language assistance. The Principle envisions a health care system in which an LEP patient with a heart murmur would no more be treated without necessary language services than he or she would be without a stethoscope.

Kudos to the National Health Law Program for pulling this Coalition together.


About richardzorza

I am deeply involved in access to justice and the patient voice movement.
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