Federal funds are available for interpreters
While cost is a primary concern of health care organizations in providing language services for patients, providers may not be aware of available funding or do not take full advantage of it, according to a Commonwealth Fund survey conducted by the National Health Law Program (NHeLP).
Federal matching funds are available to states for Medicaid and State Children’s Health Insurance Program (SCHIP) enrollees, and the Department of Health and Human Services also provides funding or technical assistance for language interpretation. State and county health departments are other potential sources.
Report author Mara Youdelman, a staff attorney with NHeLP in the Washington, DC, office, says that providing interpreters "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. . . . 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."
Some points from the survey:
• States using federal matching funds for translation services for Medicaid and SCHIP enrollees are Hawaii, Maine, Minnesota, Utah, and Washington. NHeLP says that more states could develop mechanisms to obtain federal reimbursement for interpreter services and the Centers for Medicare & Medicaid Services could enhance mechanisms for reimbursing interpreters who help Medicare beneficiaries. States can receive a 50% administrative match, and even more if they adopt language assistance as a covered service.
The report profiles Washington state’s system of direct payments to language-service agencies and Minnesota’s system of requiring providers to purchase interpreter services and then be reimbursed by the Medicaid agency, and lays out pros and cons for each model.
• Other funding sources are state and local government initiatives. In Massachusetts, for example, since 1989, most hospitals have submitted plans for providing interpreter services as part of the state’s determination of need process, which requires that providers reassess health care needs in the community and respond accordingly whenever a provider seeks to add or expand services or when ownership is transferred.
Through this process, the report says, more than 50 of the state’s 80 hospitals have addressed providing interpreter services, training staff, and tracking services. Also, in 2000, the Massachusetts legislature passed a law requiring that every acute-care hospital provide competent interpreter services in connection with all emergency department services provided to every non-English speaker who is a patient or who seeks appropriate emergency care.
In Hennepin County, MN, the Office of Multi-Cultural Services was created in 2000 to help deliver services to its diverse refugee and other new American populations in an efficient, effective, and culturally sensitive manner. The county’s 44 staff members speak 28 languages and act as a bridge between county departmental staff, those with limited English skills, and the rest of the community. Community outreach liaisons assist with forms completion; connection to resources, social services, health and child care issues; and home visits. Liaisons can accompany clients to medical appointments and have helped many understand the complexities of health care and managed care, the report says.
• Managed care organizations that enroll Medicaid, SCHIP, or Medicare patients or otherwise receive federal financial assistance have to comply with federal law and regulations that require that patients have access to language services. The report profiles The Alameda Alliance for Health in California and its Cultural and Linguistics Program that oversees policies on translation of materials and interpreter services. If a staff member who speaks a patient’s language is not available, the organization will provide an interpreter at no cost to the patient. The provider directory specifies the languages that providers and their staff speak, and patients can obtain additional information and assistance from member services.
[Contact Youdelman at (202) 289-7661.]
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