BILL ANALYSIS Ó
SB 442
Page 1
SENATE THIRD READING
SB 442 (Ron Calderon)
As Amended April 26, 2011
Majority vote
SENATE VOTE :21-14
HEALTH 13-6 APPROPRIATIONS 12-5
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|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hernández, Bonnie | |Gatto, Hall, Hill, Lara, |
| |Lowenthal, Mitchell, Pan, | |Mitchell, Solorio |
| |V. Manuel Pérez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Harkey, Donnelly, |
| |Nestande, Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
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SUMMARY : 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. Specifically, this bill :
1)Requires a hospital's policy for providing language assistance
services to patients with language or communication barriers
to ensure meaningful access to translation and interpreter
services by limited- or non-English-speaking individuals and
to include appropriate criteria for demonstrating the
proficiency of the translation and interpreter services.
2)Requires the hospital policy referenced in 1) above to include
procedures for discussing with the patient any cultural,
religious, or spiritual beliefs or practices of the patient
that may influence care. Requires the procedures to be
designed to increase hospital staff's ability to understand
and respond effectively to the cultural needs of patients.
Requires procedures to ensure that interpreters are accessible
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by telephone or video medical interpretation, 24-hours per
day.
3)Requires hospitals to annually transmit to the Department of
Public Health (DPH) a copy of the updated policy in 1) above
which includes a description of its efforts to ensure
effective communication between patients with language or
communication barriers and staff.
4)Requires hospitals to review the standards of the health care
interpreting industry to incorporate 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.
5)Requires hospitals to 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; and,
c) Possession of an understanding of, and ability to
follow, rules of conduct relating to confidentiality,
impartiality, and interpretation ethics.
6)Requires hospitals to 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.
EXISTING LAW :
1)Prohibits, existing federal laws, guidelines, and executive
orders, public and private entities that receive federal funds
from discriminating based on race, color, or national origin,
and requires these entities to provide limited English
proficiency (LEP) individuals with language assistance, to
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ensure they have equal access to programs and services.
2)Requires the Department of Managed Health Care (DMHC) and the
California Department of Insurance (CDI) 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 LEP
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.
3)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- or non-English-speaking who
speak the same primary language and who comprise at least
5% 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 to translate the names of
body parts, injuries, and symptoms.
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FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill will result in a negligible direct state
fiscal impact.
COMMENTS : According to the author, professionally trained
medical interpreters and policies to increase the ability of
hospital staff to respond to unique cultural needs will help to
ensure that patients who require on-site medical interpreters
are provided the appropriate care. The author argues that
hospitals are increasingly turning to the provision of telephone
interpreting services for reasons of convenience and/or cost to
meet the requirements in existing law to provide medical
interpreters to patients. The author also asserts that
professionally trained medical interpreters on-site at the
hospital provide the most protection, for both the patient and
the provider, against compromised services and poor health
outcomes for ethnic and underserved persons in a multi-ethnic
population. The author maintains that this bill will result in
high patient satisfaction rates and may reduce the risk of
medical malpractice suits.
According to United States Census Bureau data, over 40% of
people in California speak a language other than English at
home, and over 20% 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, the hospital
accrediting body, found that communication problems are the
cause of a high number of reported adverse events that occur in
hospitals.
Cultural competence in addition to linguistic competence has
increasingly become recognized as a fundamental aspect of
quality in health care and as an essential strategy for reducing
disparities by improving access, utilization, and quality of
care. According to the California Healthcare Interpreters
Association publication, Guidance on Interpreter Roles and
Interventions (CHIA publication), various barriers to
cross-cultural communication exist including language
differences, language complexity, and differences in cultural
norms, in addition to organizational or broader systemic
barriers. The CHIA publication further reports that culture
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determines how people behave, make decisions, communicate and
interact with each other and that culture and language are
inseparable. Cultural beliefs about health and illness around
the world vary significantly from the biomedical perspective and
that many traditional health beliefs, practices, and healers
lack equivalent terms. According to the CHIA publication
healthcare interpreters have a fundamental role in helping both
parties understand each other's cultural explanation on health
and illness.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097
FN: 0001954