Why does HCA provide Interpreter Services?

Title VI of the Civil Rights Act of 1964 prohibits recipients of federal funding from discrimination on the basis of race, color, or national origin.

DSHS Administrative Policy 7.21 requires DSHS employees, organizational units, programs and services to ensure that Limited English Proficient (LEP) clients are given equal access to DSHS services and programs. [Note: HCA is currently developing the same policy]

Washington State is one of about a dozen states that has a program to assist health care providers in ensuring equal access to services for patients of Limited English Proficiency by reimbursing some of the cost of language access services.

Overview of the Former Broker Overview of the Former Broker System for Interpreter ServicesSystem for Interpreter Services

Brokers scheduled and coordinated interpreter appointmentsThere were 6 brokers in 13 regionsBrokers contracted with interpreter language agenciesLanguage agencies then contracted with individual interpreters Interpreters are DSHS certified or authorized

At the direction of the Washington State Legislature, the Health Care Authority (HCA) was directed to establish a new coordinating entity for receiving and scheduling statewide Interpreter Service requests for medical appointments and DSHS social services.

CTS Language Link out of Vancouver was selected, and began accepting interpreter service requests on September 10, 2012 for appointments scheduled September 24 or later.  

First of its kind in the nation CTS provides three modalities of interpreting at the request

of the medical provider through an on-line scheduling system: Telephonic, Video Remote Interpretation (VRI), and In-person.

CTS contracts directly with interpreters

When a medical provider calls CTS LanguageLink (CTS) to schedule an interpreter appointment…

CTS will need: 48-hour advance notice of requested appointment 4-hours advance notice for an urgent appointment

Who decides if a face-to-face interpreter, telephonic or video connection is needed?Providers are in the driver’s seat for those decisions, which may be influenced by the type of appointment, an individual’s health status, or even past experience of the doctor with the patient. The option to use telephonic and video remote interpreting is new, and will facilitate increased client access to needed services at reduced costs.

What if it’s an emergency and an interpreter is needed right now?Medical providers, including hospitals, have backup systems they use in such cases. The state’s interpreter system is supplemented by other resources and is intended to support providers and their communication with Medicaid clients.

HCA will pay for interpreter services if: The client is Medicaid eligible; The Interpreter is authorized to provide services under the HCA contract with

CTS; The interpreter is DSHS certified or qualified; and The medical service is covered by the client's Medicaid medical benefits.

HCA will NOT pay for interpreter services if:

The interpreter is requested by someone other than the doctor or the doctor's staff;

The interpreter is a member of the client’s family; The interpreter is not contracted with or approved by CTS; or The medical service is not covered by the client’s Medicaid medical benefits

package.

Inpatient hospital services (e.g. labor and delivery);Nursing facility services (covered by Aging and Adult

Services);Community mental health centers, mental health clinics or

mental health institution services (covered by Regional Support Networks or by DSHS programs);

Alcohol or other drug-related treatment centers/programs;Emergency medical appointments (one hour notice or

less);Services provided by any other facility, agency, or provider

that is required by federal or state law, regulation, or rules to provide those services (e.g. public health agencies, public hospitals and local health jurisdictions);

YTDEncounters that have billed YTD

Total hours of Interpretation for

YTD Total

HCA

43328 51,735.93 $ 1,778,233.71

DSHS

4,276 12,919.97 $ 422,140.76

Total

47,604 64,655.90 $ 2,200,374.47

YTDService Area

1 Service Area 2

Client

18,581

3,533

Med Providers 888 357

DSHS Providers 183 76

Interpreter Services Provided September - December 2012

Figures Provided by Contractor as of 1/23/2013

Appointments by Language for December 2012

Language count only

Service Area 1

Row LabelsCount of Language

Amharic 72Bosnian (Serbo Croatian) 38

Bulgarian 1

Burmese 37

Cambodian (Khmer) 97

Cantonese 555

Chinese 8

Croatian 1

Farsi 149

French 20

Hindi 2

Korean 358

Kurdish 2

Laotian 31

Mandarin 245

Oromo 11

Portuguese 5

Punjabi 81

Romanian 20

Russian 2617

Somali 485

Spanish 6919

Swahili 5

Thai 8

Tigrinya 40

Toisanese 5

Turkish 3

Ukrainian 132

Urdu 1

Vietnamese 990

Grand Total 13373

Appointments by Language for December 2012

Service Area 2

Row LabelsCount of Language

Amharic 19Bosnian (Serbo Croatian) 12

Bulgarian 1

Burmese 19

Cambodian (Khmer) 54

Cantonese 179

Chinese 4

Farsi 68

French 20

Hindi 1

Korean 150

Laotian 23

Mandarin 125

Oromo 6

Portuguese 2

Punjabi 37

Romanian 5

Russian 801

Somali 165

Spanish 2421

Swahili 4

Thai 5

Tigrinya 19

Turkish 3

Ukrainian 43

Urdu 1

Vietnamese 423

Grand Total 4785

The Medicaid Administrative Match (MAM) program reimburses governmental agencies a portion of the expenses incurred for performing administrative activities that support the goals of the Medicaid State Plan.

All LHJ’s participate in the MAM program and can be reimbursed for providing interpreter services for LEP Medicaid Clients

Reimbursable Medicaid Administrative Match activities include:Medicaid outreach and educationIdentifying children and families who may be eligibleHelping people with the application processProviding Interpreter Services

For further information regarding the MAM program, please contact Alan Himsl at

Alan. Himsl@hca.wa.gov