BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 442|
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VETO
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
SENATE FLOOR : 21-14, 6/1/11
AYES: Alquist, Calderon, Corbett, Correa, DeSaulnier,
Hancock, Hernandez, Kehoe, Leno, Lieu, Liu, Lowenthal,
Negrete McLeod, Padilla, Pavley, Price, Rubio, Vargas,
Wolk, Wright, Yee
NOES: Anderson, Berryhill, Blakeslee, Cannella, Dutton,
Emmerson, Fuller, Gaines, Harman, Huff, La Malfa,
Strickland, Walters, Wyland
NO VOTE RECORDED: De León, Evans, Runner, Simitian,
Steinberg
ASSEMBLY FLOOR : 52-27, 8/30/11 - See last page for vote
SUBJECT : Hospitals: interpreters
SOURCE : Author
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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:
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;
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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.
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
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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,
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
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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)
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.
GOVERNOR'S VETO MESSAGE:
"I am returning Senate Bill 442 without my signature.
Inquiring into a patient's cultural, religious, or
spiritual beliefs is good hospital practice, but not
one that needs to be mandated by the state, nor
applied only to non-English or limited
English-speaking patients.
With basic requirements for language assistance
already set in law, I believe specific improvements to
hospital policies should be done at the local level
where people deal with real problems based on direct
experience."
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ASSEMBLY FLOOR : 52-27, 08/30/11
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fong, Fuentes,
Furutani, Galgiani, Gatto, Gordon, Hall, Hayashi, Roger
Hernández, Hill, Huber, Hueso, Huffman, Lara, Bonnie
Lowenthal, Ma, Mendoza, Mitchell, Monning, Pan, Perea, V.
Manuel Pérez, Portantino, Skinner, Solorio, Swanson,
Torres, Wieckowski, Williams, Yamada, John A. Pérez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Fletcher, Beth Gaines, Garrick, Grove, Hagman, Halderman,
Harkey, Jeffries, Jones, Knight, Logue, Mansoor, Miller,
Morrell, Nestande, Nielsen, Norby, Olsen, Silva, Smyth,
Valadao, Wagner
NO VOTE RECORDED: Gorell
CTW:nl 1/4/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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