BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1263
AUTHOR: John A. Pérez
AMENDED: June 25, 2013
HEARING DATE: July 3, 2013
CONSULTANT: Valderrama
SUBJECT : Medi-Cal: CommuniCal.
SUMMARY : Requires the State Department of Health Care Services
to establish the Medi-Cal Patient-Centered Communication
Program, called CommuniCal, to provide and reimburse for medical
interpretation services to Medi-Cal beneficiaries who are
limited English proficient, establishes a certification process
and registry of CommuniCal interpreters at the Department of
Health Care Services and grants CommuniCal interpreters
collective bargaining rights with the state.
Existing state law:
1.Establishes the Medi-Cal program, which is administered by the
Department of Health Care Services (DHCS), under which
qualified low-income individuals receive health care services.
2.Requires commercial health plans to assess their members
language preference and provide interpretation and translation
services in threshold languages.
3.Requires hospitals to provide language services, interpreters,
or bilingual staff, under specified circumstances, and to
identify and record patients' primary languages in hospital
records.
4.Requires state and local agencies providing services to a
substantial number of non-English speaking people to provide
bilingual services.
Continued---
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Existing federal law:
1.Provides increased federal matching funding for translation
and interpretation services provided in connection with the
enrollment, retention, and use of services under Medicaid
(Medi-Cal in California) and the Children's Health Insurance
Program (CHIP is known as the Healthy Families Program in
California).
2.Prohibits, under Title VI of the Civil Rights Act of 1964, a
person in the United States, on the grounds of race, color, or
national origin, from being excluded from participation in,
denied the benefits of, or subjected to discrimination under
any program or activity receiving federal financial
assistance.
This bill:
Creation and Administration of CommuniCal
1.Requires DHCS to establish the CommuniCal program to provide
and reimburse for certified medical interpretation services to
limited English proficient (LEP) Medi-Cal enrollees.
2.Requires CommuniCal to offer medical interpretation services
to Medi-Cal providers who are providing services on either a
fee-for-service (FFS) or managed care basis.
3.Requires DHCS to adopt policies, in consultation with the
Community Advisory Committee (CAC), to prohibit duplicate
payments to CommuniCal interpreters and Medi-Cal managed care
plans (MCP) for services provided to Medi-Cal MCP enrollees.
4.Permits a health care provider and other entities entering
into a Medi-Cal managed care contract with the state to
utilize CommuniCal to provide medical interpreter services to
Medi-Cal beneficiaries.
5.Requires all contracts between Medi-Cal managed care
organizations (MMCOs) and their subcontractors to include
provisions describing access to CommuniCal medical interpreter
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services.
6.Requires DHCS, in consultation with CAC, to pursue all
available sources of federal funding to establish and operate
CommuniCal and to seek any federal approvals necessary to
implement this article.
7.Requires CommuniCal to include in-person, telephonic, and
video medical interpretation services by a CommuniCal
interpreter.
8.Provides that, whenever possible, in-person interpreter
services shall be the preferred mode of interpretation in the
following instances:
a. Family meeting regarding medical care;
b. Medical encounters involving difficult or
agitated patients;
c. Medical encounters to make treatment
decisions;
d. Obtaining informed consent involving review of
documents;
e. Any medical encounter that, in the physician's
judgment requires in-person interpretation for the
health, safety or well-being of the patient;
f. Psychiatric encounters;
g. End-of-life discussions; and,
h. Other circumstances identified by the CAC.
9.Requires CommuniCal to be administered by a patient-centered
communication broker.
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10.Requires DHCS to create and administer a competitive Request
for Proposals (RFP) for the communication broker who shall be
responsible for the following duties:
a. Registering CommuniCal interpreters with
Medi-Cal;
b. Verifying Medi-Cal eligibility of an
interpreter to provider CommuniCal services with DHCS;
c. Verifying Medi-Cal eligibility for interpreter
services utilizing the state's Medi-Cal Eligibility
Data System (MEDS);
d. Submitting billing summaries to Medi-Cal and
aggregating the cost for services provided;
e. Ensuring compliance with Medi-Cal and
applicable CommuniCal reporting requirements;
f. Making payments to CommuniCal interpreters,
including any dues and fee service deductions;
g. Scheduling CommuniCal interpreter appointments
with Medi-Cal providers;
h. Monitoring the quality of CommuniCal
interpreter services and complying with state
oversight requirements of CommuniCal, as specified;
i. Creating CommuniCal promotional materials for
distribution to providers, MMCOs and beneficiaries;
and,
j. Any other duties deemed to be appropriate by
the CAC.
11.Requires DHCS to make all applicable Medi-Cal reporting
requirements known to the broker and be responsible for the
broker's compliance with these requirements.
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12.Requires interpreters to be certified as a CommuniCal
interpreter by DHCS to participate in CommuniCal.
13.Requires CommuniCal interpreters to be responsible for all of
the following:
a. Preforming interpreter services independent of
other policies, rules, or procedures;
b. Preforming interpreter services independent of
direction;
c. Preparing and submitting documentation to the
broker in support of time worker or services rendered;
and,
d. Directing and controlling the manner and means
of interpretation services.
14.Permits, unless otherwise prohibited, CommuniCal interpreters
to advertise, promote, or otherwise communicate availability
for services to the general public and provide office space,
equipment, support services, forms, supplies, and business
cards.
15.Provides that for the purposes of the CommuniCal program:
a. CommuniCal interpreters are independent
contractors of the state;
b. CommuniCal interpreters are not employees of
the broker, health care providers, or consumers; and,
c. The state action antitrust exemption to the
application of federal and state antitrust laws is
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applicable to the activities of CommuniCal
interpreters and their exclusive representatives.
16.Establishes the base reimbursement rate for CommuniCal
interpreters to be no less than sixty dollars ($60) per hour
and authorizes the rate to be adjusted, in consultation with
the CAC, for factors such as geography, language spoken,
availability of interpreters, level of certification, travel
time, or other factors.
17.Requires DHCS to issue guidance, in consultation with the
CAC, on the administration of the CommuniCal program to ensure
compliance with the provisions of this bill and all applicable
state and federal laws by all contractors and subcontractors
of the program.
18.Establishes the CommuniCal Program Fund (Fund) in the state
treasury and requires any interest and dividends earned by the
Fund be retained in the Fund for specified purposes. Provides
that moneys in the Fund are to be used solely to fund the
CommuniCal program.
Certification and Registration of CommuniCal Medical
Interpreters
19. Provides that the DHCS shall serve as the CommuniCal
interpreter certifying body, and requires DHCS, as the
certifying body to:
a. Develop, monitor and evaluate interpreter
competency, qualifications, training, certification,
and continuing education requirements for medical
interpreters.
b. Approve an examination and certification
process, in consultation with CAC, to test and certify
the competency of medical interpreters by September 1,
2014.
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1.Requires that, as a condition of certification, an interpreter
complete at least one of the following and specifies that upon
completing one of the following, the interpreter shall be
certified as a CommuniCal Certified Medical Interpreter (CCMI)
and listed on the CommuniCal Medical Interpreter Registry:
a. Pass an examination administered by a
nonprofit organization selected by DHCS that is
nationally accredited to offer certification exams for
health care interpreters;
b. Pass an examination developed by a
state-established language testing and certification
program that includes oral and written components and
specified competency standards; or,
c. Achieve the designation of Certified
Healthcare Interpreter from the Certification
Commission for Healthcare Interpreters or Certified
Medical Interpreter from the National Board of
Certification for Medical Interpreters.
21. Establishes an alternate certification process, beginning
July 1, 2014, for interpreters of languages for which a CCMI
examination has not been created and requires it to consist of
a screening test established by DHCS, in consultation with CAC
that contains the following:
a. A written component testing for specified
knowledge, skills and abilities including, managing an
interpreter encounter, health care terminology,
interacting with other health care professionals,
preparing for an interpreting encounter, and cultural
responsiveness; and,
b. An oral component utilizing the target
language to test his or her linguistic and
interpreting skills.
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1.Requires, by July 1, 2014, an interpreter to be CCMI certified
or authorized to provide CommuniCal services through the
alternate certification process referenced in 21) in order to
provide CommuniCal services.
2.Requires DHCS to maintain a list of authorized CommuniCal
interpreters called the CommuniCal Medical Interpreter
Registry.
3.Permits DHCS, in order to meet anticipated demand, to
authorize an interpreter to provide CommuniCal services prior
to becoming certified if the interpreter meets all of the
following requirements:
a. Is at least 18 years of age and demonstrates
that as of January 1, 2014 he or she has worked
regularly and professionally as an in-person medical
interpreter during the previous two years;
b. Holds a minimum of a Untied States high school
diploma or General Education Development (GED), or its
equivalent from another country; and,
c. Has demonstrated linguistic proficiency in
English and another specified language.
4.Specifies that an individual authorized under the provisional
requirements who does not subsequently become certified or
receive permanent authorization by January 1, 2016, is no
longer be authorized to provide CommuniCal services.
5.Requires the certifying body to establish and charge fees, not
to exceed the reasonable costs, for applicants to take an
applicable exam. Requires a single fee that does not exceed
the reasonable costs for certification, authorization, and
listing on the registry.
6.Requires CommuniCal interpreters to pay a registry and
certification or authorization fee, by July 1 of each year, in
order to remain on the registry.
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7.Requires DHCS to establish, maintain, administer and publish
annually an updated registry of CommuniCal interpreters and
permits DHCS to remove the name of a person from the registry
if the person is deceased, notifies the board that they are
unable to work, does not submit an authorization or renewal
fee, or fails to meet the quality standards and medical
certification requirements.
8.Waives, for the 2013-14 fiscal year only, the fee for
certification and listing on the registry.
9.Requires DHCS to adopt quality standards and medical
interpretation certification requirements through regulations,
to include, but not be limited to, maintaining patient
confidentiality and familiarity or experience working with
medical terminology and determine the testing requirements for
certification in each language.
10. Requires a CAC to be established to make recommendations on
interpreter certification and services and to assist with
developing standards and requirements.
11. Requires the CAC to include stakeholders that reflect the
diversity of the state in terms of race, ethnicity, gender,
sexual orientation, immigration status, and geography,
including representatives from government, health care
providers, LEP consumers, health care or language access
advocates, medical or health care interpreters, and any other
individual DHCS deems appropriate.
12. Requires the exclusive representative of CommuniCal
interpreters, the CAC, and a nonprofit organization to partner
to create and administer a training program for medical
interpreters, in order to prepare interpreters for exams or
other certification standards established for languages of
lesser diffusion and to provide continuing education for those
CommuniCal interpreters placed on the registry.
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13. Specifies that, unless otherwise specified, the
relationship of CommuniCal interpreters to all parties and
recipients of service is one of independent contractor.
Collective Bargaining for CommuniCal Certified Medical
Interpreters
14. Requires only CommuniCal interpreters be represented by a
labor organization for the purposes of collective bargaining
as established by this bill.
36. Grants CommuniCal interpreters the right to form, join, and
participate in the activities of a labor organization of their
own choosing for purpose of representation.
37. Applies the state action antitrust exemption and state and
federal antitrust laws to the activities of CommuniCal
interpreters and their exclusive representatives.
38. Requires CommuniCal interpreters to have the right to be
represented by an exclusive labor organization of their own
choosing for the purpose of collective bargaining with the
state of California on matters of mutual concern, including
but not limited to, a list of 10 specific provisions,
including: development; maintenance and application of the
registry; the setting of reimbursements and rates for
state-funded medical interpreter programs; professional
development and certification; scheduling; dispute resolution
mechanism; mediums and modes of delivery of interpretation
services; and, collection and disbursement of dues.
39. Requires the appropriate bargaining unit for CommuniCal
interpreters to be a statewide unit of eligible CommuniCal
interpreters.
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40. Provides that CommuniCal interpreters are not public
employees and that this bill does not establish an
employer-employee relationship between CommuniCal interpreters
and the state or patient-centered communication brokers for
any purpose.
41. Requires DHCS to furnish, upon request by a labor
organization that is signed by 20 percent of CommuniCal
interpreters, a list of all CommuniCal interpreters including
full names, telephone numbers, e-mail addresses and mailing or
home address to the labor organization within 5 days of the
request.
42. Requires the Public Employment Relations Board (PERB), upon
application by petition, authorization cards, or union
membership cards of a labor organization adequately showing
that a majority of CommuniCal interpreters in the state desire
to be represented exclusively by that labor organization and
no other, to certify and grant exclusive representation to the
labor organization. Requires, if less than a majority but at
least 30 percent of CommuniCal interpreters desire to be
represented exclusively by that labor organization, the matter
to be set for a mail ballot election.
43. Requires PERB to accept, review, and certify all valid
applications submitted pursuant to the above requirements.
Provides that if a PERB regulation or rule conflicts with this
section, this section shall control.
44. Requires any representation election to be a mail ballot
election.
45. Establishes requirements for a pre-election conference
within 10 days of receipt of an adequate petition or
authorization cards. Requires the labor organization and the
state to engage in a good faith effort to reach a consent
election agreement, as specified.
46. Prohibits other labor organizations from being allowed to
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intervene in an election unless the intervening labor
organization shows at least 30 percent of the CommuniCal
interpreters desire to be represented exclusively by the
intervening labor organization and requires PERB to initiate a
mail ballot election.
47. Requires PERB to determine all issues or matters in
dispute. Requires the determination and a directed election
order or consent election agreement between the labor
organization and the state to be made within seven days of the
conference.
48. Requires PERB to initiate a mail ballot election within 10
days of the execution of a directed election order or consent
election agreement. Provides that the proposition receiving
the votes of a majority of all valid votes cast shall win the
election and if no option receives an absolute majority vote
of all valid votes cast, requires a runoff vote between the
two options receiving the highest number of votes to occur
within seven days.
49. Requires a pre-election meeting between the labor
organization and the state 30 minutes prior to the mailing of
ballots for the purpose of resolving any final issues.
50. Requires PERB to validate the ballots against the list of
CommuniCal interpreters provided by DHCS.
51. Requires discussions and collective bargaining between the
certified labor organization and the state and its designated
agents to commence within 30 days upon certification and at
any time thereafter upon request of the labor organization.
52. Requires the state, through its designated agents to meet
and collectively bargain in good faith with representatives of
a certified labor organization and to fully consider the
proposals made by the labor organization on behalf of
CommuniCal.
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53. Provides that an agreement resulting from collective
bargaining be legally binding, reduced to writing, and
presented to the appropriate governing body in the form of a
binding agreement, resolution, bill, law, or other form
required for adoption.
54. Prohibits anything in this bill from affecting the right of
a CommuniCal interpreter to authorize dues or a service fee
deduction from his or her reimbursement, provides for the
deduction of dues or services fees, fair share services fees,
and transmittal to the treasurer of the labor organization,
and requires that such fees and dues shall continue in effect
as long as the labor organization is the recognized
representative.
55. Requires the state to meet and collectively bargain in good
faith, as defined. Prohibits the state from interfering with,
intimidating, restraining, coercing, or discriminating against
CommuniCal and requires a complaint alleging a violation of
this provision to be processed as an unfair practice charge.
56. Requires that execution of a valid written agreement
between the state and the certified labor organization to bar
the filing of an application or petition for certification of
a majority representative for the length of the agreement
except as otherwise provided in this bill.
57. Prohibits the state from encouraging or discouraging
membership in a labor organization, or discriminating against
any CommuniCal interpreter.
58. Permits the state to adopt reasonable rules and regulations
after consultation in good faith with representatives of a
certified labor organization for administration of CommuniCal
interpreter labor relations under this bill.
59. Provides, in the event of a judicial declaration declaring
any provision invalid, the remaining provisions remain in
force.
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FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1. One-time costs likely in the hundreds of thousands of dollars
to develop program guidelines, seek necessary federal
approvals, and contract for CommuniCal administration.
2. Ongoing costs potentially exceeding several million dollars
per year to provide interpreter services in fee-for-service
Medi-Cal. The actual cost of this voluntary program will
depend on the demand level for interpreter services not
already being met.
3. Minor costs in Medi-Cal managed care. Under current law,
health plans are required to provide interpretation services,
including managed care plans that contract with the DHCS. It
is unclear whether the bill's provisions would increase costs
above what is already incurred.
4. Potential one-time costs of $139,000 and ongoing annual costs
of $53,000 per year to PERB.
5. State General Fund (GF) costs would be offset by an enhanced
federal match of 75 percent, pursuant to a 2010 federal
guidance, rather than the 50 percent match generally
attributable for administrative costs.
PRIOR VOTES :
Assembly Health: 13- 5
Assembly Public Employees, Retirement and Social Security:5- 2
Assembly Floor: 55- 23
Senate Public Employment and Retirement 3-2
COMMENTS :
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1.Author's statement. According to the author, more than 40
percent of Californians speak a language other than English at
home. Almost 7 million Californians are estimated to speak
English "less than very well." Research finds that language
barriers can contribute to inadequate patient evaluation and
diagnosis, lack of appropriate and/or timely treatment, or
other medical errors that can jeopardize patient safety and
lead to unnecessary procedures and costs. Today, language
assistance in medical settings is provided by trained or
untrained staff or in an informal manner by family members or
friends. California has an opportunity to develop a more
comprehensive language assistance program by seeking
additional federal funding for medical interpreter services in
the Medi-Cal program.
2. Enhanced federal matching funds for translation and
interpretation services. The Children's Health Insurance
Program Reauthorization Act (CHIPRA), Public Law 111-3,
enacted on February 4, 2009, contains provisions that affect
both CHIP and Medicaid. In July 2010, the Centers for Medicare
and Medicaid Services (CMS) provided guidance on the
implementation of Section 201(b) of CHIPRA, which provides
increased administrative funding for translation or
interpretation services provided under CHIP and Medicaid.
Under Medicaid, increased federal funding for translation and
interpretation services available under CHIPRA is limited to
children and family members of those children. Under CHIP,
increased federal funding for translation and interpretation
services is not just limited to children, and includes
pregnant women receiving CHIP coverage.
Prior to CHIPRA, states could claim federal matching funds for
translation or interpretation costs as either an
administration expense or as a medical assistance-related
expense, and were reimbursed at the standard Federal Medical
Assistance Percentage (regular FMAP) rate (which is typically
50 percent in California for Medi-Cal and 65 percent for the
Healthy Families Program).
CHIPRA provides increased federal matching funding for
translation or interpretation services provided to eligible
individuals for whom English is not their primary language.
The increased federal match for translation or interpretation
services differs for Medicaid and CHIP. For Medicaid, the
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increased match is 75 percent of allowable expenditures. For
CHIP, the increased match is 75 percent, or the state's
enhanced FMAP plus 5 percent, whichever is higher (in
California, it would be 75 percent). However, the increased
federal match is only available for eligible expenditures
claimed for administration of the Medicaid or CHIP plan, and
not expenditures claimed for benefits (which are matched at
the state's usual FMAP rate of 50 percent for Medi-Cal and 65
percent for CHIP). In addition, the expenditures that qualify
for the increased match under CHIP are subject to the 10
percent cap on administrative expenditures.
3. Federal anti-discrimination law. Title VI of the Civil
Rights Act of 1964 and its implementing regulations provide
that no person shall be subject to discrimination on the basis
of race, color, or national origin under any program or
activity that receives federal financial assistance. Each
federal department has a civil rights office that is charged
with ensuring that its programs are free of discrimination.
The federal Department of Health and Human Services (HHS)
Office for Civil Rights (OCR) responsibilities include
enforcing the Civil Rights Act, the Americans with
Disabilities Act, and the Age Discrimination Act. Any
organization or individual who receives monies through
HHS-health departments, health plans, social service agencies,
nonprofits, hospitals, clinics, and physicians-is subject to
OCR oversight. The OCR has the authority to investigate
complaints related to linguistic barriers, to initiate its own
reviews, and to withhold federal funds for noncompliance.
4. OCR policy guidance. CMS issued a State Medicaid Director
letter on August 31, 2000, that informed states of the policy
guidance that the OCR had issued on the prohibition against
national origin discrimination as it affects persons with LEP,
pursuant to Title VI of the Civil Rights Act of 1964.
OCR Policy Guidance requires recipients of federal assistance
to take reasonable steps to ensure meaningful access to their
programs and activities by LEP persons. The Guidance explains
that the obligation to provide meaningful access is
fact-dependent and starts with an individualized assessment
that balances four factors: (1) the number or proportion of
LEP persons eligible to be served or likely to be encountered
by the program or grantee; (2) the frequency with which LEP
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individuals come into contact with the program; (3) the nature
and importance of the program, activity or service provided by
the grantee/recipient to its beneficiaries; and (4) the
resources available to the grantee/recipient and the costs of
interpretation/ translation services. CMS states there is no
"one size fits all" solution for Title VI compliance with
respect to LEP persons, and what constitutes "reasonable
steps" for large providers may not be reasonable where small
providers are concerned.
5. Data on language in California. According to the US
Census Bureau 2010 American Community Survey, 43.7 percent of
Californians over the age of 5 speak a language other than
English, and 19.9 percent of Californians over the age of 5
speak English "less than very well." According to the
California Health Interview Survey, of the 3.5 million adults
in the Medi-Cal program, about 281,000 (8.1 percent) had
difficulty understanding their doctor and/or needed another
person to help them understand their doctor. Among the parents
of 1.8 million children under age 12 in the Medi-Cal program,
about 135,000 (7.4 percent) had difficulty understanding the
child's doctor and/or needed another person's help to
understand the doctor.
6. Prior legislation. AB 2392 (Perez) would have required
DHCS to establish the CommuniCal program to provide and
reimburse for certified medical interpretation services
provided to Medi-Cal beneficiaries who are LEP. AB 2392 would
have established the State Personnel Board (SPB) as the
certifying body for the CommuniCal certified medical
interpreter (CCMI), and would have required CommuniCal to be
administered by a patient-centered communication broker that
is a third-party administrator. AB 2392 was moved to the
Assembly inactive file on concurrence.
SB 442 (Calderon) of 2011 would have required 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. Would have required hospitals' policies on language
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assistance services to include criteria on proficiency similar
to those that apply to health plans. SB 442 was vetoed by the
Governor.
SB 1405 (Soto) of 2006 would have required the Department of
Health Services (now DHCS) to create the Task Force on
Reimbursement for Language Services, as specified, to develop
a mechanism for seeking federal matching funds from CMS to pay
for language assistance services, as specified. SB 1405 was
placed on the inactive file.
AB 800 (Yee), Chapter 313, Statutes of 2005, requires all
health facilities (hospitals, skilled nursing facilities,
intermediate care facilities, correctional treatment centers)
and all primary care clinics to include a patient's principal
spoken language on the patient's health records.
SB 853 (Escutia), Chapter 713, Statutes of 2003, requires the
Department of Managed Health Care and the California
Department of Insurance to adopt regulations to ensure
enrollees have access to language assistance in obtaining
health care services.
7. Double referral. This bill was heard in the Senate Public
Employment and Retirement Committee on June 24, 2013 and
passed with a 3 to 2 vote.
8. Support. The California Pan-Ethnic Health Network writes
that California's population is one of the most diverse in the
country with over 100 different languages spoken and an
estimated 6 to 7 million Californians LEP. Barriers to
communication in the health care setting can result in
increased risk of misdiagnoses and misunderstandings,
resulting in lower quality care and reduced adherence to
medication. The American Federation of State, County and
Municipal Employees (AFSCME) argue that communication is
critical to quality of care and cultural competency in our
state's Medicaid program. With the expansion of Medi-Cal and
the exchange market under the ACA, the state has a clear
opportunity to create an interpreters program that will allow
patients and providers to clearly communicate with each other.
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Health Access California maintains that building a strong
workforce of certified interpreters is crucial to adequately
serving the hundreds of thousands of LEP Californians who will
be coming into coverage in the new world of health reform.
This is an important measure that will help ensure that newly
insured Californians can truly benefit from their new access
to care.
9. Opposition. The National Right to Work Committee states
that this bill would grant union bosses monopoly bargaining
powers over virtually all CCMIs operating under the program,
stripping every one of these individuals of the fundamental
right to negotiate for themselves. If this bill passes,
independent contractors would be forced to union boss
representation and would then have union dues stripped from
their compensation and transferred straight to the treasury of
the Big Labor representative they didn't want.
10. Policy issues:
a. Base reimbursement rate. This bill establishes a
base reimbursement rate for CommuniCal interpreters of
sixty dollars per hour that can be adjusted upwards for
various factors. This rate covers the individual
interpreter reimbursement and the cost of the third party
broker that would administer CommuniCal. The author's
office indicates that this rate is based on the rate paid
to American Sign Language interpreters reimbursed under
Medi-Cal. Staff was unable to find comprehensive or
validated data on medical interpreter rates but an informal
survey done by staff indicates that rates vary
significantly by language and geography. The rational for
codifying a base rate in the bill remains unclear.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees, AFL-CIO
Health Access California
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Latino Coalition for a Healthy California (LCHC)
Access California Services, Anaheim
Asian Pacific American Librarian Association, San
Diego
Asian Pacific Health Foundation, San Diego
BaySide Community Center, San Diego
American Federation of State, County and Municipal
Employees
Binational Center for the Development of Oaxacan
Indigenous Communities
California Church IMPACT
California Immigrant Policy Center
California Pan-Ethnic Health Network
Cambodian Buddhist Society of San Diego
Campeonas de la Salud, San Jose
Catholic Charities of Santa Clara County
Central American Refugee Committee, Oakland
Chinese Service Center, San Diego
Coalition for the Human Rights of Immigrants, Los
Angeles
Dolores Huerta Foundation
East Bay Refugee Forum
East Bay Sanctuary Covenant, Berkeley
Eastside Neighborhood Center, San Jose
Fresno Interdenominational Refugee Ministries
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Greater Logan Heights Community Partnership, San Diego
Healing Hope, Fresno
Health Access
Hmong Women's Heritage Association, Sacramento
Horn of Africa Community, San Diego
Interpreting for California
Korean American Senior Association of San Diego County
Korean Community Services, Buena Park
Khmer Girls in Action, Long Beach
La Maestra Community Health Centers, San Diego
Lao Community Action Network, Sacramento
Latino Coalition for a Healthy California
Little Saigon Foundation, San Diego
Los Angeles County Federation of Labor
Low-Income Self-Help Center
Mid-City Community Advocacy Network
National Association for the Advancement of Colored
People, San Diego
National Association of Social Workers, California
Chapter
National Hmong American Farmers, Fresno
Operation Samahan, National City
Planned Parenthood Affiliates of CA
Russian Orthodox Church, San Diego
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San Diego and Imperial Counties Labor Council AFL-CIO
San Diego LGBT Pride
San Diego Vietnamese Senior Club, San Diego
Services, Immigrants Rights and Education Network, San
Jose
Solami Family Services, San Diego
Somos Mayfair
Southern Sudanese Community Center, San Diego
St. John's Wellness Center, Los Angeles
Street Level Health Project, Oakland
The Cambodian Family, Santa Ana
Transnational Institute for Grassroots Research and
Action
United Domestic Workers of America/AFSCME Local 3930
Viet-CARE, Westminster
Vietnamese Community of San Diego
Wat Lao Buddhavam of San Diego
Oppose: National Right to Work Committee
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