BILL NUMBER: SB 442	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 26, 2011
	AMENDED IN SENATE  APRIL 7, 2011

INTRODUCED BY   Senator Calderon

                        FEBRUARY 16, 2011

   An act to amend Section 1259 of the Health and Safety Code,
relating to health facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 442, as amended, Calderon. Hospitals: interpreters.
   Existing law establishes the State Department of Public Health and
sets forth its powers and duties, including, but not limited to, the
licensing and certification of health facilities, including, but not
limited to, general acute care hospitals.
   Existing law requires general acute care hospitals to, among other
things, adopt and annually review its policy and procedures for
providing assistance to patients with language or communication
barriers to ensure access to health care information and services for
limited-English-speaking or non-English-speaking residents and deaf
residents. Existing law requires that the procedures ensure, to the
extent possible, as determined by the hospital, that interpreters are
available, either on the premises or accessible by telephone, 24
hours per day.
   This bill would, in addition, require the policy to  ensure
meaningful access to translation and interpreter services by
limited-English-speaking or non-English-   speaking
individuals and to include appropriate criteria for demonstrating the
proficiency of the translation and interpreter services   .
The bill would require the policy to  include procedures for
discussing with the patient any cultural, religious, or spiritual
beliefs or practices of the patient that may influence care, and that
the procedures be designed to increase hospital staff ability to
understand and respond effectively to the cultural needs of patients.
 The bill would require the hospital to review the standards of
health care interpreting, as prescribed. 
   Existing law requires hospitals to notify their employees of the
hospital's commitment to provide interpreters to all patients who
request them.
   This bill would, in addition, require the hospital to notify
employees of the hospital's commitment that the interpreter
communicate information about the unique needs of the patient to the
health care team.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1259 of the Health and Safety Code is amended
to read:
   1259.  (a)  The Legislature finds and declares that California is
becoming a land of people whose languages and cultures give the state
a global quality. The Legislature further finds and declares that
access to basic health care services is the right of every resident
of the state, and that access to information regarding basic health
care services is an essential element of that right.
   Therefore, it is the intent of the Legislature that where language
or communication barriers exist between patients and the staff of
any general acute care hospital, arrangements shall be made for
interpreters or bilingual professional staff to ensure adequate and
speedy communication between patients and staff.
   (b)  As used in this section:
   (1)  "Interpreter" means a person fluent in English and in the
necessary second language, who can accurately speak, read, and
readily interpret the necessary second language, or a person who can
accurately sign and read sign language. Interpreters shall have the
ability to translate the names of body parts and to describe
competently symptoms and injuries in both languages. Interpreters may
include members of the medical or professional staff.
   (2)  "Language or communication barriers" means:
   (A)  With respect to spoken language, barriers which are
experienced by individuals who are limited-English-speaking or
non-English-speaking individuals who speak the same primary language
and who comprise at least 5 percent of the population of the
geographical area served by the hospital or of the actual patient
population of the hospital. In cases of dispute, the state department
shall determine, based on objective data, whether the 5 percent
population standard applies to a given hospital.
   (B)  With respect to sign language, barriers which are experienced
by individuals who are deaf and whose primary language is sign
language.
   (c)  To ensure access to health care information and services for
limited-English-speaking or non-English-speaking residents and deaf
residents, licensed general acute care hospitals shall:
   (1)  Review existing policies regarding interpreters for patients
with limited-English proficiency and for patients who are deaf,
including the availability of staff to act as interpreters.
   (2)  Adopt and review annually a policy for providing language
assistance services to patients with language or communication
barriers.  The hospital's policy shall ensure meaningful access
to translation and interpreter services by limited-English-speaking
or non-English-speaking individuals and shall include appropriate
criteria for demonstrating the proficiency of the translation and
interpreter services.  The policy shall include procedures for
providing, to the extent possible, as determined by the hospital, the
use of an interpreter whenever a language or communication barrier
exists, except where the patient, after being informed of the
availability of the interpreter service, chooses to use a family
member or friend who volunteers to interpret. The policy shall also
include procedures for discussing with the patient any cultural,
religious, or spiritual beliefs or practices of the patient that may
influence care. The procedures shall be designed to increase hospital
staff ability to understand and respond effectively to the cultural
needs of patients, maximize efficient use of interpreters, and
minimize delays in providing interpreters to patients. The procedures
shall ensure, to the extent possible, as determined by the hospital,
that interpreters are available, either on the premises or
accessible by telephone  or video medical interpretation (VMI)
 , 24 hours per day. The hospital shall annually transmit to the
state department a copy of the updated policy and shall include a
description of its efforts to ensure effective and speedy
communication between patients with language or communication
barriers and staff. 
   (3) Review the standards of health care interpreting industry to
incorporate industry improvements or standards for health care
interpreter certification, and standards for testing to ensure
quality, accuracy, and consistency in the provision of health care
interpreter services.  
   (4) Take reasonable steps to assess whether interpreters
demonstrate proficiency in the ability to communicate information
accurately in both English and in the other language, including, but
not limited to, all of the following:  
   (A) Knowledge, in both languages, of health care terminology and
specialized terms or concepts unique to the hospital's program or
activity.  
   (B) Ability to use the appropriate mode of interpreting,
including, but not limited to, consecutive, simultaneous,
summarization, or sight translation.  
   (C) Possession of an understanding of, and ability to follow,
rules of conduct relating to confidentiality, impartiality, and
interpretation ethics.  
   (3) 
    (5)  Develop, and post in conspicuous locations, notices
that advise patients and their families of the availability of
interpreters, the procedure for obtaining an interpreter and the
telephone numbers where complaints may be filed concerning
interpreter service problems, including, but not limited to, a T.D.D.
number for the hearing impaired. The notices shall be posted, at a
minimum, in the emergency room, the admitting area, the entrance, and
in outpatient areas. Notices shall inform patients that interpreter
services are available upon request, shall list the languages for
which interpreter services are available, shall instruct patients to
direct complaints regarding interpreter services to the state
department, and shall provide the local address and telephone number
of the state department, including, but not limited to, a T.D.D.
number for the hearing impaired. 
   (5) 
    (6)  Identify and record a patient's primary language
and dialect on one or more of the following: patient medical chart,
hospital bracelet, bedside notice, or nursing card. 
   (5) 
    (7)  Prepare and maintain as needed a list of
interpreters who have been identified as proficient in sign language
and in the languages of the population of the geographical area
serviced who have the ability to translate the names of body parts,
injuries, and symptoms. 
   (6) 
    (   8)  Notify employees of the hospital's
commitment to provide interpreters to all patients who request them
and that the interpreter communicate information about the unique
needs of the patient to the health care team. 
   (7)
    (9)  Review all standardized written forms, waivers,
documents, and informational materials available to patients upon
admission to determine which to translate into languages other than
English. 
   (8) 
    (10)  Consider providing its nonbilingual staff with
standardized picture and phrase sheets for use in routine
communications with patients who have language or communication
barriers. 
   (9) 
    (11)  Consider developing community liaison groups to
enable the hospital and the limited-English-speaking and deaf
communities to ensure the adequacy of the interpreter services.
   (d)  Noncompliance with this section shall be reportable to
licensing authorities.
   (e)  Section 1290 shall not apply to this section.