Capitol Hill Briefing To Focus On Eliminating Health Care Disparities Linked To Race, Ethnicity, And Language

At a Capitol Hill briefing today, researchers, members of Congress, and health leaders will discuss strategies to eliminate racial and ethnic disparities in access to health care services. Participants will address the need for federal health program requirements and funding to improve racial, ethnic, and primary language health data collection, reporting, and monitoring. They will also focus on the need to provide education and technical assistance to health care providers to help them carry out their responsibilities to provide health care equitably. Other topics will include helping patients become better informed about their rights, and the need for stronger enforcement of federal policies to ensure equal access to health care services for patients with limited English proficiency. The briefing, to be held at noon on Capitol Hill, is jointly sponsored by the Congressional Black Caucus, The Commonwealth Fund, and Summit Health Institute for Research and Education (SHIRE). The Honorable Donna Christian-Christensen (D-VI), chair of the Congressional Black Caucus Health Braintrust, will moderate the discussion. Findings from a new report released today by The Commonwealth Fund, Providing Language Interpretation Services in Health Care Settings: Examples from the Field, by Mara Youdelman and Jane Perkins of the National Health Law Program, (NHELP) will be presented by Youdelman. The report profiles a variety of programs around the country that provide interpretation services in health care settings, and also identifies federal, state, local, and private funding sources for interpretation services. Recent U. S. census data show that 44 million Americans speak a language other than English at home. Presentations at today's briefing will include:

• Ruth Perot, SHIRE, Racial, Ethnic, and Primary Language Data Collection in the Health Care System: An Assessment of Federal Policies and Practices
• Karen Scott Collins, M.D., CMWF, Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans- Findings from The Commonwealth Fund 2001 Health Care Quality Survey
• Mara Youdelman, NHELP, Providing Services to Limited English Speakers: Examples from the Field
• Carmella Bucchino, American Association of Health Plans, Reuben King-Shaw, Centers for Medicare and Medicaid Services, and Brian Smedley, Institute of Medicine, will present public- and private-sector perspectives and activities.

The report by Youdelman and Perkins examines 14 programs that demonstrate successful models of language interpretation in a variety of settings:

• Statewide Medicaid/SCHIP (State Children's Health Insurance Program) Reimbursement: Five states-Hawaii, Maine, Minnesota, Utah, and Washington-obtain federal matching funds to provide language services to enrollees.
• State and Local Government Initiatives: Massachusetts requires every hospital to provide language interpretation to non-English-speaking emergency room and in-patient psychiatric patients. Minnesota's Hennepin County established the Office of Multi-Cultural Services to facilitate delivery of services to its diverse population.
• Managed Care Organizations: Many states require Medicaid managed care organizations (MCOs) to accommodate enrollees with limited English proficiency. Two California MCOs' programs are highlighted: The Alameda Alliance for Health Cultural and Linguistics Program, and the L.A. Care Health Plan Health Care Interpreter Pilot Program.
• Hospitals: Gouverneur Hospital in New York City has a Remote Simultaneous Medical Interpretation Program, Maine Medical Center has an Office of Interpreter and Cross-Cultural Services, and eight hospitals in Dane County, Wisconsin have established the Health Care Providers' Interpreter Services Group.
• Community-based Organizations: Northern Virginia Area Health Education Center and Multicultural Association of Medical Interpreters in upstate New York provide community-based "language bank" services.
• Educational Models: The report highlights three types of training programs: a nationally recognized model, Cross Cultural Health Care Program, "Bridging the Gap," a home-study model, HealthReach Community Care Clinic, and a college-level program, the Cambridge Health Alliance.

The authors note that while costs are commonly cited as a primary concern of health care organizations in providing language services for their patients, providers may not be aware of-or may not take full advantage of-funding that is available. Federal matching funds are available to states for Medicaid and SCHIP enrollees; the Department of Health and Human Services Office of Minority Health and Health Resources Services Administration also provide funding or technical assistance for language interpretation. State and county Departments of Health and foundations are other sources of funding. Citing examples from the case studies, the authors recommend ways to increase use of language interpreters, such as improving funding mechanisms for interpreters, documenting the need for interpreters through improved data collection on primary language of patients, conducting further research to assess the quality of informal interpretation compared with formal interpretation, and documenting cost savings resulting from use of interpretation services. "Providing interpreters in health care not only increases the quality of health care for those with limited English proficiency but reduces burdens on providers and could ultimately save health care costs. Without using interpreters, doctors cannot effectively communicate with their patients, or accurately diagnose and treat their ailments," said Youdelman. "We welcome the administration's reinforcement of its commitment to ensuring linguistic access. We look forward to working with the Administration and Congress to ensure the availability of the support, education, and technical assistance necessary to implement these policies, and to identify effective programs and put them into practice."