making the business case for culturally and linguistically appropriate ...

APPENDIX KTraditional Safety Net TelephonicInterpreting Project—Dual Head SetAnd Hand Set InterpretationL.A. Care Health PlanCLAS Standards Met: 1 and 4-6See page 12 for list of CLAS StandardsISSUE. Language needs of limited English proficiency (LEP) patients enrolled in L.A.Care Health Plan (L.A. Care) exceeded available licensed bilingual providers. As a result,untrained staff members, family members and children were being used for languageinterpretation during medical visits. Research indicates that sometimes family members,children and friends may: 1) not give the patient a provider's complete explanation, 2)potentially be embarrassed to admit they do not understand what is being said, 3) find thenature of the conversation embarrassing, 4) not agree with the provider, and 5)miscommunicate the patient’s message, preferring that the provider hear their version ofthe situation. In addition, family members and child interpreters may lack understanding ofthe medical and non-medical vocabulary, whether in English or their own language.DISCUSSION. L.A. Care Health Plan (L.A. Care) is a public health maintenanceorganization serving more than 750,000 people in Los Angeles County. L.A. Carecontracts with more than 10,000 health care providers annually, health plans, IndependentProvider Associations (IPA’s) and Medical Groups, community clinics and hospitals. Thehealth plan serves large populations with limited English proficiency. More than 55percent of patients prefer a language other than English, including Spanish (45 percent ofenrollees), Cantonese, Korean, Mandarin and 27 others.In 2003, L.A. Care developed and implemented the Traditional Safety Net TelephonicInterpreting Project to eliminate language barriers within the patient-provider relationshipand to reduce errors in medical language interpretation. The project targeted L.A. Care’snetwork of county and community clinics and provider groups within Southern California.The purpose of the project was to assist LEP patients in communicating with theirproviders, while reducing the administrative time involved in obtaining interpretingservices. When using this system, providers and patients need not pass a telephone orheadset back and forth nor use a speaker phone. Providers and patients accessed languageservices using telephonic dual headsets or handsets when a bilingual health care provideror on-site interpreter was not available. The hand/headsets are compatible with mosttelephone systems.L.A. Care made equipment, training, and technical support available to its participatingproviders at no cost. The dual handset equipment itself was priced at approximately $14 perunit, depending on the model and make of phone and type of handset needed. In addition, alimited number of dual headsets assisted by the use of high quality amplifiers wereimplemented in County and community clinics which had a need for hands freecommunication with patients. The price per unit for this model was approximately $178 per54