BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2325
AUTHOR: John A. Pérez
AMENDED: June 12, 2014
HEARING DATE: June 18, 2014
CONSULTANT: Bain
SUBJECT : Medi-Cal: CommuniCal.
SUMMARY : Requires the Department of Health Care Services (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
limited English proficient, establishes a certification process
and registry of CommuniCal interpreters at DHCS, and grants
CommuniCal interpreters collective bargaining rights with the
state.
Existing state law:
1.Establishes the Medi-Cal program, which is administered by
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.
Existing federal law:
Continued---
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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 was previously known as the Healthy Families
Program in California; these children are now enrolled in
Medi-Cal).
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, commencing July
1, 2015. Defines an "interpreter" as an oral interpreter who
is fluent in English and in a necessary second language, who
can accurately speak, read, and readily interpret the
necessary second language, but does not include a sign
language interpreter or transliterator.
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, an entity entering into a
Medi-Cal provider agreement, or a Medi-Cal managed care
contract with the state to utilize CommuniCal to provide
medical interpreter services to Medi-Cal beneficiaries.
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5.Requires all contracts between Medi-Cal managed care
organizations (MMCOs) and their subcontractors to include
provisions describing access to CommuniCal medical interpreter
services.
6.Requires DHCS to pursue all available sources of federal
funding to establish and operate CommuniCal and to seek any
federal approvals necessary to implement specified provisions
of this bill, in consultation with CAC.
7.Requires CommuniCal to include in-person, telephonic, and
video medical interpretation services by a CommuniCal
interpreter.
8.Requires that in-person interpreter services be the preferred
mode of interpretation in the following instances whenever
possible:
a. Family meetings 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.
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9.Requires CommuniCal to be administered by a patient-centered
communication broker.
10.Requires DHCS to create and administer a competitive Request
for Proposals (RFP) for the communication broker, and requires
the broker to be responsible for the following duties:
a. Registering CommuniCal interpreters with
Medi-Cal;
b. Verifying the eligibility of an interpreter to
provide 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 appropriate by the
CAC.
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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.
12.Requires that only interpreters certified or authorized by
DHCS under this bill as CommuniCal interpreters are allowed to
participate in CommuniCal.
13.Requires CommuniCal interpreters to be responsible for all of
the following:
a. Performing interpreter services independent of
other policies, rules, or procedures;
b. Performing interpreter services independent of
direction;
c. Preparing and submitting documentation to the
broker in support of time worked 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;
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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
applicable to the activities of CommuniCal
interpreters and their exclusive representatives.
16.Requires the base reimbursement rate for CommuniCal
interpreters to be subject to collective bargaining. Permits
reimbursement to be adjusted for factors, including but not
limited to, geography, language spoken, availability of
interpreters, level of certification, travel time, or other
factors, in consultation with the CAC.
17.Requires DHCS to issue guidance on the administration of the
CommuniCal program to ensure compliance with specified
provisions of this bill and all applicable state and federal
laws by all contractors and subcontractors of the program, in
consultation with the CAC.
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. Requires
that moneys in the Fund are to be used solely to fund the
CommuniCal program.
Certification and Registration of CommuniCal Medical
Interpreters
19. Requires that DHCS 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; and,
b. Approve an examination and certification
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process, in consultation with CAC, to test and certify
the competency of medical interpreters by September 1,
2015.
1.Requires that, as a condition of certification, an interpreter
to complete at least one of the following and specifies that
upon completing one of the following, the interpreter to 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, or hold a
current interpreter's certification under specified
provisions of existing law.
21. Requires DHCS to establish an alternate certification
process, beginning July 1, 2015, that authorizes CommuniCal
services to be provided by an interpreter of languages of
lesser diffusion or language for which a CCMI examination has
not been created. Requires DHCS, in consultation with CAC, to
authorize an interpreter to provide CommuniCal services if the
interpreter passes a screening test that includes both of the
following:
a. A written component testing for specified
knowledge, skills and abilities, including managing an
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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.
1.Requires, by July 1, 2015, 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, 2015, 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 December 31, 2017, is no
longer be authorized to provide CommuniCal services.
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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. Requires the purpose of the fee to
cover the annual projected cost of carrying out the
DHCS-related CommuniCal provisions.
6.Requires CommuniCal interpreters to pay a registry and
certification or authorization fee not to exceed the
reasonable costs, by July 1 of each year, in order to remain
on the registry.
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
unavailable 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, and create a list of those
languages where standards permit registration of the
interepreter.
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,
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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.
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. Defines a labor organization as
defined in a specified provision of the Internal Revenue Code
which has as its primary purpose the representation of public
service providers in their relations with state and other
public entities.
36. Requires CommuniCal interpreters to have 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
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11
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.
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 five 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
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applications submitted pursuant to the above requirements.
Provides that if a PERB regulation or rule conflicts with 41)
and 42) above, 41) and 42) to 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
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 wins 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.
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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
before any regulation is proposed, promulgated, set or
otherwise presented concerning any of the purposes for
collective bargaining.
53. Requires any agreement resulting from collective bargaining
to be legally binding, committed to writing, and presented to
the appropriate administrative, legislative or other 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, services fees or fair share service fees,
and transmittal to the treasurer of the labor organization,
and requires that such fees and dues to 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.
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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.
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 FFS 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 MCP that contract with 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; and,
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.
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15
PRIOR VOTES :
Assembly Health: 13- 6
Assembly Public Employees, Retirement, and Social Security:5- 1
Assembly Appropriations: 12- 5
Assembly Floor: 53- 25
COMMENTS :
1.Author's statement. According to the author, more than 40
percent of Californians speak a language other than English at
home. Almost seven 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).
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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
increased match is 75 percent of allowable expenditures. For
CHIP, the increased match is 75 percent, or the state's
enhanced FMAP plus five 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
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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:
a. The number or proportion of LEP persons eligible to
be served or likely to be encountered by the program or
grantee;
b. The frequency with which LEP individuals come into
contact with the program;
c. The nature and importance of the program, activity
or service provided by the grantee/recipient to its
beneficiaries; and,
d. 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 1263 (Pérez) was similar to this bill.
AB 1263 was vetoed by Governor Brown. In his veto message,
Governor Brown stated California has embarked on an
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unprecedented expansion to add more than a million people to
our Medi-Cal program. Given the challenges and the many
unknowns the state faces in this endeavor, I don't believe it
would be wise to introduce yet another complex element.
AB 2392 (Pérez) 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. SB 442 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 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.
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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.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.
8.Opposition. The National Right to Work Committee (NRWC) argues
this bill will grant union bosses monopoly bargaining powers
over virtually all interpreters operating under the program,
stripping every one of these individuals of the fundamental
right to negotiate for themselves. NRWC argues these
individuals would be subject to a so-called "card check"
recognition and could be forced under union control by the
authorization of merely 30 percent of CCMIs in the state. If
this bill passes, NRWC argues independent contractors would be
forced to accept 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.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees, AFL-CIO
California Communities United Institute
California Immigrant Policy Center
California Medical Association
California Pan-Ethnic Health Network
City and County of San Francisco
Congress of California Seniors
Health Access California
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National Association of Social Workers, California
Chapter
Planned Parenthood Affiliates of California
United Domestic Workers of America, AFSCME Local 3930
Western Center on Law and Poverty
Oppose: National Right to Work Committee
-- END --