BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 442|
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                                 THIRD READING


          Bill No:  SB 442
          Author:   Calderon (D)
          Amended:  4/26/11
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-1, 04/13/11
          AYES:  Hernandez, Strickland, Alquist, De León, DeSaulnier, 
            Rubio
          NOES:  Anderson
          NO VOTE RECORDED:  Blakeslee, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


           SUBJECT  :    Hospitals:  interpreters

           SOURCE  :     Author


           DIGEST  :    This bill requires general acute care hospital 
          policies for the provision of language assistance to 
          patients with language or communication barriers to include 
          procedures for discussing with the patient any cultural, 
          religious, or spiritual beliefs or practices that may 
          influence care, and to increase the ability of hospital 
          staff to understand and respond to the cultural needs of 
          patients.  This bill requires hospitals' policies on 
          language assistance services to include criteria on 
          proficiency similar to those that apply to health plans.

           ANALYSIS  :    Existing law:

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          1.Requires the Department of Managed Health Care and 
            Department of Insurance to adopt, not later than January 
            1, 2006, regulations to ensure that health plan enrollees 
            have appropriate access to language assistance services.  
            Pursuant to regulations, health plans must translate 
            written materials into non-English languages based on 
            their number of enrollees and the number and percent of 
            limited English proficiency enrollees.  Plans must also 
            assess and survey the language needs and demographic 
            profile of their enrollee population on a regular basis, 
            provide interpreters at points of contact between 
            enrollees and the plan, and inform enrollees of the 
            availability of language assistance services.

          2.Requires licensed general acute care hospitals to meet 
            several requirements related to language assistance for 
            persons with language or communication barriers, 
            including:

             A.   Adopt and review annually a policy for providing 
               language assistance services to patients with language 
               or communication barriers, defined as barriers faced 
               by individuals who are limited-English-speaking or 
               non-English-speaking who speak the same primary 
               language and who comprise at least five percent of the 
               population served by the hospital or the actual 
               patient population served;

             B.   Develop, and post in conspicuous locations, notices 
               that advise patients and their families of the 
               availability of interpreters;

             C.   Identify and record a patient's primary language 
               and dialect on the patient's medical chart, hospital 
               bracelet, bedside notice, or nursing card;

             D.   Notify employees of the hospital's commitment to 
               provide interpreters to all patients who request them; 
               and

             E.   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 

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               to translate the names of body parts, injuries, and 
               symptoms.

          This bill:

          1.Requires general acute care hospital policies for the 
            provision of language assistance to patients with 
            language or communication barriers to include procedures 
            for discussing with the patient any cultural, religious, 
            or spiritual beliefs or practices that may influence 
            care, and to increase the ability of hospital staff to 
            understand and respond to the cultural needs of patients. 
             

          2.Requires hospitals to ensure that interpreters 
            communicate information about the unique needs of 
            patients to their hospital health care team.

          3.Requires policies on language assistance services to 
            include criteria on proficiency similar to those that 
            apply to health plans.

           Background
           
          Hospitals are subject to both federal and state 
          requirements pertaining to language assistance.  Federal 
          laws, orders, and guidelines require hospitals that receive 
          federal funding, e.g. through the Medicare or Medicaid 
          programs, to provide language assistance to limited English 
          proficient individuals whom they serve.  The Office of 
          Civil Rights within the US Health and Human Services Agency 
          enforces compliance with these requirements.  Hospitals 
          must provide language assistance services at no cost to 
          patients, at all points of contact, and in a timely manner 
          during all hours of operation.  

          SB 1840 (Kopp), Chapter 672, Statutes of 1990, requires 
          general acute care hospitals to adopt and review annually a 
          policy for providing language assistance services to 
          patients with language or communication barriers. With 
          respect to spoken language, state law defines "language or 
          communication barriers" as barriers which are experienced 
          by individuals who are limited-English-speaking or 
          non-English-speaking who speak the same primary language, 

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          and who comprise at least five percent of the population of 
          the geographical area served by the hospital, or of the 
          actual patient population of the hospital.  Hospitals must 
          also notify patients and their families of the availability 
          of interpreters, identify and record each patient's primary 
          language and dialect, and prepare and maintain 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.  


          The Department of Public Health assesses whether hospitals 
          are complying with these requirements in response to 
          complaints and during initial and routine licensing 
          surveys.

          The Joint Commission has issued language assistance 
          standards for hospitals, which will become requirements for 
          accreditation beginning in 2012.  The standards emphasize 
          identifying patients' language needs, informing patients of 
          their right to receive language assistance services, and 
          ensuring the competence of individuals providing language 
          assistance services.

           Comments
           
          According to US Census Bureau data, over 40 percent of 
          people in California speak a language other than English at 
          home, and over 20 percent speak English less than "very 
          well."  Seventy percent of health care providers in a 
          recent survey stated that language barriers compromise 
          patients' understanding of their disease and treatment 
          advice, increase the risk of complications, and make it 
          harder for patients to explain their symptoms.  A recent 
          study by the Joint Commission, hospital accrediting body, 
          found that communication problems are the cause of a high 
          number of reported adverse events that occur in hospitals.  


           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  5/10/11)

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          American Federation of State, County and Municipal 
          Employees
          California Hospital Association
          California Language Teachers Association
          California Medical Association
          Healthy House Within a MATCH Coalition 


           ARGUMENTS IN SUPPORT  :    The American Federation of State, 
          County, and Municipal Employees supports the bill's intent 
          to ensure that limited English proficiency patients are not 
          deprived of their health care rights.  The California 
          Language Teachers' Association states that effective 
          communication is a critical component in the diagnosis of 
          health care needs.  


          CTW:nl  5/10/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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