Nearly eight percent of Medicare beneficiaries are persons with limited English proficiency, according to research by the Centers for Medicare & Medicaid Services’ (CMS) Office of Minority Health (OMH). Those with limited English proficiency are less likely to have routine health visits and more likely to defer needed health care or leave the hospital against medical advice — situations that can lead to poorer health outcomes.
“Being able to communicate with a patient and clearly understand his or her concerns and health challenges is really the first step towards providing high quality care,” said Cara James, director of the CMS OMH.
While federal law requires providers receiving federal financial assistance to take steps to improve care access for those with limited English proficiency, creating effective programs and evaluating progress remains a challenge.
To help providers improve access to care, the CMS OMH recently published a Guide to Developing a Language Access Plan.
According to James, the guide can help health care providers evaluate their current programs and identify ways to create — or improve — plans to ensure those with limited English proficiency have meaningful access to their programs. The guide recommends that language access plans include the following five key sections:
1. Needs Assessment
The first step is to gather information about the needs of current and prospective health care customers whose preferred language isn’t English. This can consist of the number of individuals, as well as the places and ways in which they interact with the organization. Internal data sources like call center information and electronic health records can make up the data required for an effective needs assessment.
2. Overview of Necessary Language Services
Providers should develop a list of the types of needed translation or interpretation services. Interpreters can be dedicated staff members, qualified bilingual staff or remote interpreters. For translation services, the plans should outline the written materials that will need to be translated for patients.
3. Plan for Notifying Patients
Plans should evaluate how the organization will inform patients, clients, customers or beneficiaries of the availability of services. The guide recommends clear signage about language services and “I speak” cards, both of which can help ensure that patients with limited English proficiency are aware of the language services available to them.
4. Employee Training Programs
Plans should have protocols in place for training staff — from receptionists and security guards to clinicians — on how to respectfully communicate with individuals with limited English proficiency and how to capture data about their language needs.
5. Evaluation Framework
Plans should establish a framework for continuous improvement by determining when the organization will evaluate and update its plan. Taking steps such as monitoring the organization’s response to complaints by those with limited English proficiency and surveying staff members about their use of language assistance services can determine if organizations are on the right track.
CMS OMH suggests that developing an effective language access plan can help ensure that organizations meet their legal requirements to provide access to high quality care for patients with limited English proficiency, as well as increase customer satisfaction and improve long-term care outcomes.