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Study Of California’s Medical Interpretation Services Still Mired In Process

Eric Le talks to reporters at San Diego City Hall about the need for more med...

Photo by Susan Murphy

Above: Eric Le talks to reporters at San Diego City Hall about the need for more medical translators in San Diego County, June 9, 2014.

Gov. Jerry Brown in September signed AB 635. It directed the state to examine whether California is doing enough to provide interpretation to patients who speak a foreign language.

Nearly a year after the governor approved studying California’s medical interpretation services, state health workers are still hiring staff to carry out the task. Gov. Jerry Brown in September signed AB 635, which directed the Department of Health Care Services to examine California’s requirements for providing interpretation to patients who speak a foreign language.

From The Text: What Does AB 635 Do?

"This bill would require the department to work with stakeholders to conduct a study to identify current requirements for medical interpretation services as well as education, training, and licensure requirements, analyze other state Medicaid programs, make recommendations on strategies that may be employed regarding the provision of medical interpretation services for Medi-Cal beneficiaries who are limited English proficient, and establish a pilot project in up to 4 separate sites to evaluate a mechanism to provide and improve medical interpretation services for those individuals."

Department spokesman Tony Cava said he expects to hire a lead employee by the end of August.

“Once the lead staff person is onboard, he/she will work closely with the AB 635 sponsors to schedule regular meetings, develop detailed implementation strategies, establish a timeline, and further refine the proposed budget and work plan,” Cava said in an email.

Cava said a second employee would be brought on to manage the process for selecting a vendor to conduct the sudy, but he did not know when that would occur. He expected to provide another update in December.

Sen. Toni Atkins, D-San Diego, sponsored the legislation when she was an Assemblywoman. She said she had hoped to be a bit farther along in the process, but said the department has been consumed with other important priorities.

“There are critical things that tend to bump things down a bit,” said Atkins, a former San Diego City Councilwoman. “Is it ideal? No. Would I like to see us further along? Absolutely. But I also think we have to do it right.”

Atkins and other Democratic state lawmakers have pushed for years to improve interpretation services, which are required by law but advocates have claimed are lacking. She said she has heard from stakeholders about the consequences of inadequate language services, including the story of a Russian-speaking patient who had to rely on a sibling to interpret during an emergency situation.

"Imagine that; you're in a highly emotional state, and you're having to translate," Atkins said, noting information could get lost during such a stressful time.

She pointed to her own experience when her spouse underwent a minor procedure. Days later, she and her spouse disagreed over the post-care instructions they had received from the doctor.

"And we both speak English and the doctor spoke English, so I think there is such a need for this," she said.

Atkins said she hopes the study and possible pilot program will highlight the need for better services — which she said grew after the passing of the Affordable Care Act — and help identify solutions. The first-term state senator said some clinics and organizations that serve non-English speaking populations may already be addressing the problem on their own.

She mentioned programs that train community members in health education in hopes of spreading that knowledge to their neighbors. One such program exists in San Diego's City Heights neighborhood, where more than two-thirds of residents speak a language other than English at home. Project Concern International has trained Hispanic women as community health workers and recently expanded that program to other ethnic communities.

"There is lots of possibilities and ideas and I think that's the exciting piece of doing the study and the pilots, in particular the pilots," Atkins said.

Editor's note: An earlier version of this story listed Atkins' bill as AB 653. The bill number has been corrected.

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