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Advocating for Cultural and Linguistic Access: Policy Issues. Martin Martinez, MPP Policy Director California Medicare Coalition, February 2008. California Pan-Ethnic Health Network. Mission :
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Advocating for Cultural and Linguistic Access: Policy Issues Martin Martinez, MPP Policy Director California Medicare Coalition, February 2008
California Pan-Ethnic Health Network Mission: To improve access to health care and eliminate health disparities by advocating for public policies and sufficient resources to address the health needs of communities of color in California.
Our Policy Agenda toAchieve Health Equity • Addressing the Social and Environmental Determinants of Health Disparities • Improving Access to Health Care • Promoting Data and Research • Advocating for Cultural and Linguistic Competency
How We Work • Advocate • Legislative • Administrative • Educate • Multicultural Health Web Portal • Community convenings • Policy briefs • Mobilize and Community Outreach • Action alerts • Sign-on letters • Legislative visits • Connect local advocacy to statewide advocacy
Race and Ethnicity in California • Majority is made up of People of Color: • Hispanic/Latino 32.4% • Asian 10.9% • African American 6.7% • American Indian/Alaska Native 1% • Native Hawaiian/Other Pacific Islander .3% • White 46.7% Source: U.S Census 2000, U.S. Census Bureau
Language Needs in California • 40% of Californians speak a language other than English • Spanish 65.4% • Chinese 6.6% • Tagalog 5.1% • Vietnamese 3.3% • Korean 2.4% Source: U.S Census 2000, U.S. Census Bureau
Cultural Competence • Understanding the background, cultural values, and beliefs of patients, and applying that understanding in a health context. • Cultural competency is the genuine sensitivity and respect given to people regardless of their ethnicity, race, language, culture or national origin. • Ability to anticipate and recognize misunderstandings that arise from the differing cultural assumptions and expectations of providers and patients and to respond to such issues appropriately.
Medical Board of California • AB 1195 -Requires provider continuing education requirements to include a component of cultural competency. • AB 801 -Requires Medical Board to establish a voluntary program for providers to improve their linguistic abilities.
Language Access Requirements • Medi-Cal Managed Care policy letters and contract requirements • Healthy Families contract requirements • Lack of specific Medi-Cal fee for service standards for compliance • Lack of specific standards for Medicare
SB 853 – Commercial plans • Plans and Insurers must complete demographic profile • Plans and Insurers must notify their enrollees/members of their right to interpreter services • Plans must report on their activities related to cultural competency—but no actual requirements
Translation of Prescription Labels • Technically a ‘point of contact’ • Hurdle has been no standardization of labels in the first place • SB 472 (Corbett) signed into law this year • Board of Pharmacy will issue regulations (needs of LEPs mandated to be considered) • Next step will be to work on translation
Provider Reimbursement • DHS Task Force • Based on SB 1040 (Soto) of 2006 • Will recommend interpreter reimbursement through Medi-Cal • Will recommend interpreter certification process
Medicare Part D • CMS Guidance January 2, 2008 • Instructions that plans’ call centers should be able to handle calls in multiple languages • Plans should make marketing materials in any language that makes up 10% of the plan’s geographic service area
CMAMP Act • “Children’s Health and Medicare Protection Act (H.R. 3162)” • Passed House of Representatives 8/07 • Reauthorized and expanded SCHIP • Also added provision to evaluate the provision of language services in Medicare, and collect data on race and language needs in Medicare
Best Practices for Language Access • Data collection: access language needs, disparities • Provide interpretation at all points of contact • Provide written materials in multiple languages • Ensure interpreters are trained, high quality translations • Train staff • Address cultural competency
Addressing Prevention • AB 1472 (Leno) addresses building healthy communities. • Find action alert and more information on www.cpehn.org
CPEHN Contact us • (510) 832-1160 • info@cpehn.org • www.cpehn.org