Health Access: Overcoming Barriers Mireya Munoz Program Manager, ALAS para tu Salud Health Justice...
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Transcript of Health Access: Overcoming Barriers Mireya Munoz Program Manager, ALAS para tu Salud Health Justice...
Health Access: Overcoming Barriers
Mireya MunozProgram Manager, ALAS para tu
SaludHealth Justice Network
11/09/2010
This presentation is possible thanks to funding from The California Endowment, Office of Aides Programs and Policy (OAPP),
Susan G. Komen-LA Affiliate
Interpretation, Translation, Testing and Training“We Speak Your Language for a Healthier Community”
Language DivisionTranslationInterpretation Interpreter trainingTranslator trainingContinuing EducationProgram evaluation
Advocacy DivisionConsumer educationProvider educationLEP advocacy
6 FTEs, 2 NAPCA Volunteers, and 90+ interpreters -Arabic, Armenian, Cambodian (Khmer), Chinese (Cantonese, Mandarin, Teo-Chew, and Taiwanese), Farsi, Indonesian, Japanese, Korean, Russian, Spanish, Tagalog,Thai, and VietnameseService area: Los Angeles County with limited services in Orange, San Bernardino and Riverside Counties
Barriers to Culturally and Linguistically Appropriate
Health Care
Togafitiga o le kanesa i vaila’au
(Samoan)
Nababasa mo ba ito?(Tagalog)
(Korean) (Khmer)
(Chinese)
(Vietnamese)
Who is currently interpreting in health care settings?
Unqualified Interpreters
Research shows that 23% to 53% of the words are interpreted incorrectly by unqualified interpreters
They omit, add, or change the information, and render errors that can distort or affect a patients’ care (e.g.. Diabetes vs. Hepatitis)
Misunderstandings related to medication, diagnosis or other instructions
Patients and providers do not have the ability to judge the clarity or accuracy of the interpretation
© Connecting Worlds, PALS for Health 2002
How the Language Barrier Affects the Patient
Delay in receiving medical care
Denial of benefits or services needed
Receive inappropriate benefits or services
Have to use family members or strangers in order to communicate with their doctor.
Ira Pollack, Regional Manager, Region IX Title VI and the Provision of Services
to Persons With Limited English Proficiency
Why Family Members And Friends May Not Be The Best Interpreters
Their knowledge of English may not be good enough
Many individuals, especially children, lack fluidity in their native language
If they don’t work in the medical field, they may not be familiar with medical terminology or important concepts
…Appendix, Arthritis, Chemotherapy, Hemroid, Thyroid, Ultrasound, Virus…
Why Family Members And Friends May Not Be The Best Interpreters
They are not trained and often omit or misinterpret important information.
They are not obligated to keep your information confidential.
There are sensitive information that you do not want your friends and family to know.
There are time when they may have their own opinions or goals, which can confuse the doctor.
Challenges Patients Face
Lack of knowledge about their linguistic rights
Lack of knowledge about the health care system
Difference between emergency and preventative care
Cultural factors: questioning of authority figures (health
providers) is inappropriate
Fear of receiving poor quality care or reprisals
Lack of access to qualified interpreters
Challenges Patients Face
Lack of reimbursement
Lack of resources to quality interpreting services
Lack of knowledge in the area of health care interpreting resources
Lack of tools to evaluate the linguistic proficiency of bilingual staff
Lack of resources for training interpreters
Health Access:
Trained Health Care Interpreters
Improves communication between patient and provider
Empowers patients to care for themselves
Increase adherence to medication and treatment instructions
Reduces the use of expensive and
unnecessary exams
Reduces the number of cancelled
appointments
Having a Trained Health Care Interpreter
Trained Health Care InterpretersProficiency/fluency in English and
source language is verified
Are familiar with medical
terminologies in both languages
Have been train to retain and
interpret what the patient and doctor say with accuracy and in totality
Must adhere to ethical rules, including confidentiality
Using Trained Interpreters
Remember to speak directly to the doctor or patient, not the interpreter
Speak in short sentences and pause so that the interpreter can completely and accurately
Try not to interrupt or speak over the interpreter
Do ask interpreter for cultural clarification
Do not ask interpreter for medical advice
Patient’s Rights
Federal Language Access Law Title VI of the Civils Rights Act of 1964:
Prohibits discrimination based on race, color or national origin (which includes language)
Who should abide by these laws? - Any agency or program that receives federal funding
- State, county, and local health agencies
- Hospitals and health clinics
- Health plans
- Mental health centers
State Laws
Kopp Act Ensures the availability of interpreting services at acute care facilities Hospitals have to post interpreter service signs in different language Notify all employees about the requirement to provide interpreters to all
patients that need them
Dymally-Alatorre Applies to all state-funded agency or program Employment of enough bilingual employees Translation of written materials
Senate Bill 853-(Escutia) – Effective January of 2009 All managed health plans must have language access Health care plans will take necessary measures to ensure that all members
have access to interpretation services and translation of vital documents
What This Means For All Patients… All Patients with Limited English Proficiency :
Have a right to a qualified interpreter
Have the right to receive vital documents in their preferred language
Should never be asked to bring their own interpreter
Should never be charged for interpreting services
Should not suffer unreasonable delay in receiving care due to limited English proficiency
Should always be treated with respect
Health Access:
How To Get An Interpreter When you call to make a medical
appointment, ask for your preferred language to be noted in your chart and ask for an interpreter
Contact your insurance company’s Patient Relations Department, or health care agency’s Language, Interpreter or Diversity Department
If you don’t get an interpreter, file a complaint (Patient Relations, Ombudsman, Office for Civil Rights)
If you still don’t get an interpreter, call PALS or ALAS
I Speak Card (Front)
I Speak SpanishI need a Spanish speaking interpreter for my
medical appointment.
Please, make a note on my medical file
of my language and need for an interpreter.
Thanks!
I Speak Card (Back)
Important things to remember before and after your appointment:
R When scheduling your appointment, ask for an interpreter.
R Ask your doctor to note your language on your medical file.
R Write down any questions for your doctor before your appointment.R Ask your questions at the
beginning of your appointment .R Ask for an interpreter when making your next appointment.
SSG/PALS for Health (213)553-1818. OMH Bilingual Bicultural Service Demonstration Grant
How to Contact Us:
PALS for Health/ALAS para tu Salud
(213)-627-4850 or (213) 553-1818
www.palsforhealth.org
Thank You!