Why SafeGuard Provides Interpreter Services

1. Why SafeGuard Provides Interpreter Services

2. Government Programs Mission • To ensure the provision of culturally sensitive and linguistically appropriate health care services to the Healthy Families/Healthy Kids/Medi-Cal Programs by advocating to members and providers. • To ensure contract compliance with Department of Health Services and Managed Risk Medical Insurance Board. • To ensure compliance with Title VI of the Civil Rights Act.

3. Culture Culture has a powerful impact on how we interact with others and how we perceive the actions of others. The same words can have different meanings to people of different backgrounds. To avoid such barriers, professional interpreter services use a method that is called “Cultural Competence”.

4. What Is Cultural Competence? Cultural Competenceis the willingness and ability of an organization to value the importance of culture in the delivery of services to all segments of the population. It is developmental, community focused, and family oriented. In particular, it is the promotion of quality services to underserved, racial/ethnic groups. This is done through the integration of cultural attitudes, beliefs, and practices into diagnostic and treatment methods throughout the healthcare system.

5. What Are Cultural Competence Activities? Cultural Competence activities include: • The development of skills through training; • The use of self-assessment for providers and systems; • And the implementation of objectives to ensure that governance, administrative policies and practices, and clinical skills and practices are responsive to the culture and diversity within the populations served. It is a process of continuous quality improvement.

6. Common Cultural Barriers To Accessing Health Care • Kin-based culture (some require an entire family to make a decision) • Religious background (i.e. Hindus believe pain is tied to Karma and may not exhibit symptoms of pain) • Food preferences or behaviors associated with food (i.e. Kosher laws, fasting) • Concepts of disease, sickness and health • Eye contact (i.e. avoiding eye contact may be considered dishonest, while others believe it’s rude to make eye contact) • Touch (beliefs on greeting properly vs. modesty) • Language • In southern California there are over 100 different languages spoken.

7. Interpreter Services Are Important Research has shown that many Limited English Proficient (LEP) patients hesitate to get treatment because they fear they will be unable to communicate with or understand their doctor/dentist. In many cases, delayed care led to worse symptoms and the patients had to access emergency care for treatment. Quality of Care Cultural misunderstandings or the inability to communicate with one’s doctor can lead to negative health outcomes and seriously compromise the quality of care.

8. Surprising Findings Professional interpreter services are a highly underused service! According to the findings of the Commonwealth Fund’s 2001 Health Care Quality Survey: only 1 percent of those needing an interpreter reported they had a trained interpreter. 43% used a family member or friend, while 53% had a health facility staff person serve as their interpreter.

9. Access to Care: LEP patients can feel comfortable with seeing their selected dentist/doctor. No need to hesitate. Quality of Care: An interpreter can have a direct impact on the quality of care by simply making it easier for LEP patients to understand a doctor’s instructions. State and Federal Requirements: To comply with cultural competency laws, publicly sponsored programs are required to provide access to interpreter services for their participants. These programs encourage the use of interpreters in place of family members or friends. Why SafeGuard Provides Interpreter Services

10. Why All The Regulation? Because of language or cultural barriers, some populations in the United States … • do not receive the same quality of care as others, and/or • have higher risk factors or propensities for medical conditions or diseases. Regulatory agencies have created policies to improve the health of these populations.

11. The Department Of Health Services Requires … • Materials in the patient’s own language: • Health education materials • Plan documents • Availability of an interpreter for provider/patient communication, at no cost. • Sign posted advising member of interpreter availability • Chart notation of member’s need for an interpreter • The right not to use family members as interpreters. • Companies must conduct a group needs assessment and community advisory committees to address health care access and quality of care issues • Grievance and appeals policy

12. Reasons For Using A Professional Interpreter • Interpreters are trained to be culturally sensitive and understand health care terminology. • Using anyone other than a trained interpreter violates confidentiality and may lower the quality of the interaction. • Minors, who are being used as interpreters, may not be able to cope with the severity of a disease and/or treatment.

13. SafeGuard Interpreter Services SafeGuard offers interpreter services for Healthy Families, Healthy Kids and Medi-Cal Programs. SafeGuard contracts with Language Line Services to provide over-the-telephone interpretive services for more than 150 languages. This service is available through our Members Services Department during normal business hours and through our answering service after hours. *** Need to note how*** Interpreters may assist members with questions during an office visit and there is no charge for this service.

14. The Right Not To Use Family LEP patients have the right to not use family members as interpreters! Receiving health care is a sensitive issue. Having a patient's friend or family member as an interpreter violates confidentiality and can create an embarrassing situation for the patient.

15. Leave It Up To The Professionals • Family and friends are not the same as a professional interpreter. Professional interpreter services require a minimum level of proficiency in two languages and the ability to convey a complex set of concepts that are appropriate to both the provider and the patient. • Family members/friends are more likely to modify what the patient has actually said in their effort to be helpful. Relying on these types of interpreters may mean that a health organization or individual provider is violating Title VI of the Civil Rights Act of 1964 and is not guaranteeing the quality of care.

16. Summary To comply with quality care standards for the Healthy Families, Healthy Kids, and Medi-Cal programs, SafeGuard provides interpreter services through Language Line Services. These government programs encourage the use of professional interpreters over family and friends. Professional interpreter services ensure quality of care by overcoming communication barriers and by being culturally competent.

17. SafeGuard Dental & Vision 95 Enterprise, Suite 100 Aliso Viejo, CA 92656-2605 Tel: (949) 425-4300 Government Programs Team Paula Lopez ext. 4177 Stephen Hall ext. 4384 Alan Stobaugh ext. 4132