BILL ANALYSIS Ó
AB 389
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Date of Hearing: April 7, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 389
(Chau) - As Introduced February 18, 2015
SUBJECT: Hospitals: language assistance services.
SUMMARY: Requires general acute care hospitals to provide
annually, their language assistance policies to the Department
of Public Health (DPH) and the Office of Statewide Health
Planning and Development (OSHPD) and requires hospitals, DPH,
and OSHPD to post the policies on their internet Websites.
EXISTING LAW:
1)Establishes DPH which licenses and regulates general acute
care hospitals.
2)Establishes OSHPD and designates it as the single state agency
to collect specified health facility or clinic data for use by
all state agencies.
3)Requires hospitals to adopt and annually review a policy for
providing language assistance services to patients with
language or communication barriers and for the policies to
include procedures for providing, to the extent possible, as
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determined by the hospital:
a) The use of an interpreter whenever a language or
communication barrier exists, unless the patient chooses to
use a family member or friend;
b) The efficient use of interpreters including minimizing
delays in providing interpreters to patients; and,
c) That interpreters are available, either on the premises
or accessible by telephone, 24 hours a day.
4)Requires hospitals to 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.
5)Requires hospitals to identify and record a patient's primary
language and dialect on one or more of the following:
a) The patient medical chart;
b) The hospital bracelet;
c) The bedside notice; or,
d) The nursing card.
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6)Requires hospitals to 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 served, and notify employees of the
hospital's commitment to provide interpreters to all patients
who request them.
7)Provides that non-compliance with these provisions is
reportable to licensing authorities, but that violations will
not result in fines.
FISCAL EFFECT: This bill has not yet been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, California has
been a leader in ensuring that the state's healthcare
infrastructure meets the needs of Limited English Proficient
(LEP) patients, however existing practices for ensuring
hospital compliance with language assistance policy submittal
requirements lack central oversight by DPH. The author notes
that by requiring hospitals to submit their language
assistance policies to both DPH and OSHPD, and requiring
hospitals, DPH, and OSHPD to post them on their Websites, this
bill will provide greater oversight and enable policymakers
and consumers to access information the law already
guarantees.
2)BACKGROUND. SB 1840 (McCorquodale), Chapter 672, Statues of
1990, was implemented with the intent of increasing the
quality of care for patients with limited English proficiency,
however, as noted, DPH cannot issue fines and current law does
not require the notices to be posted on either the hospital's
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or DPH's Website. DPH most recently sent an All Facilities
Letter on May 11, 2012, reminding all general acute care
hospitals to submit their language assistance policies on an
annual basis to their local Licensing and Certification
District Office; however, according to a survey conducted on
behalf of the California Pan-Ethnic Health Network (CPHEN),
hospital compliance has waned over the last several years.
3)SUPPORT. CPEHN is the sponsor of this bill and states
language barriers are correlated to higher rates of death and
illness. CPEHN notes that patients who face language barriers
are more likely to have higher rates of hospitalization,
encounter drug complications, and fail to return for
follow-ups after an emergency room visit. CPEHN contends that
by making language assistance policies available online, this
bill will provide consumers access to information already
required by current law.
Health Access California (HAC) also supports this bill and
writes, according to recent estimates, the majority of those
newly eligible for health care coverage under the Patient
Protection and Affordable Care Act will be from communities of
color, and 40% of those newly eligible for subsidies in
Covered California will be LEP. HAC concludes that making
language assistance policies available online will provide
greater transparency and oversight of a key accountability
measure serving the needs of LEP patients.
4)RELATED LEGISLATION. AB 635 (Atkins) would require the
Department of Health Care Services (DHCS) to seek federal
funding to establish a program to provide and reimburse for
certified medical interpretation services, except sign
language interpretation services, to Medi-Cal beneficiaries
who are LEP.
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5)PREVIOUS LEGISLATION.
a) AB 2325 (John A. Pérez) of 2014 would have required DHCS
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 LEP, to establish a certification process and
registry of CommuniCal interpreters at DHCS, and granted
CommuniCal interpreters collective bargaining rights with
the state. AB 2325 was vetoed by the Governor.
b) AB 1263 (John A. Pérez) of 2013 was substantially
similar to AB 2325. AB 1263 was vetoed by Governor Brown
who expressed concern given the substantial growth in
Medi-Cal as a result of health care reform, he did not
believe would be wise to start a new program.
c) AB 2392 (John A. Pérez) of 2012 was substantially
similar to AB 1263 with the exception of naming the State
Personnel Board as the certifying body for the CommuniCal
program. AB 2392 was held on the inactive file when the
bill was in the Assembly for concurrence.
d) SB 442 (Ron 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
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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 assistance
services to include criteria on proficiency similar to
those that apply to health plans. SB 442 was vetoed by
Governor Brown who said these types of policies should be
developed at the local level.
e) SB 1405 (Soto) of 2006 would have required DHCS to
create the Task Force on Reimbursement for Language
Services to develop a mechanism for seeking federal
matching funds from the Centers for Medicare & Medicaid
Services to pay for language assistance services. SB 1405
was placed on the Senate inactive file.
f) AB 800 (Yee), Chapter 313, Statutes of 2005, requires
all health facilities (hospitals, skilled nursing
facilities, intermediate care facilities, and correctional
treatment centers) and all primary care clinics to include
a patient's principal spoken language on the patient's
health records.
g) 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.
6)SUGGESTED AMENDMENTS. In order to insure that LEP patients
truly have access to language assistance policies and
services, the Committee may wish to amend this bill to require
hospitals to post a notice on their Website, in the top
languages other than English most commonly spoken in their
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service area, regarding the availability of language
assistance services at the hospital.
REGISTERED SUPPORT / OPPOSITION:
Support
California Pan-Ethnic Health Network (sponsor)
AARP, Sacramento
Advancement Project
Asian & Pacific Islander American Health Forum
Asian Americans Advancing Justice - Los Angeles
Asian Americans Advancing Justice - Sacramento
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Asian Law Alliance
California Communities United Institute
California Health Nail Salon Collaborative
California Immigrant Policy Center
California Rural Legal Assistance Foundation
Consumers Union
Having Our Say Coalition
Health Access California
Language World Services, Inc.
Multicultural Health Institute
San Francisco General Hospital and Trauma Center
Southeast Asia Resource Action Center
Stanford Healthcare
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Union of Pan Asian Communities - Positive Solutions Program
United Way of Merced County
Western Center on Law and Poverty
Numerous individuals
Opposition
None on file.
Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097