Advocating for Cultural and Linguistic Access: Policy Issues

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Advocating for Cultural and Linguistic Access
Policy Issues

• Martin Martinez, MPP
• Policy Director
• California Medicare Coalition, February 2008

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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.

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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

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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

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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
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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
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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.

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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.

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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

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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 competencybut no actual requirements

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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

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Provider Reimbursement

• DHS Task Force
• Based on SB 1040 (Soto) of 2006
• Will recommend interpreter reimbursement through
  Medi-Cal
• Will recommend interpreter certification process

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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 plans
  geographic service area

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CMAMP Act

• Childrens 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

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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

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Addressing Prevention

• AB 1472 (Leno) addresses building healthy
  communities.
• Find action alert and more information on
  www.cpehn.org

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CPEHN

• Contact us
• [phone]
• info_at_cpehn.org
• www.cpehn.org