1. TRI-CITY MEDICAL CENTER INTERPRETATION & TRANSLATION PROGRAM 1 13th Annual Education Conference Francisco Valle, MBA, Ph.D. Candidate Vice President – Marketing, Community Activities & Special Projects

2. 2 Presentation Overview Diversity in Our Service Area Key Items within the National Standards for Culturally and Linguistically Appropriate Services (CLAS) – Standard 4 – Standard 5 – Standard 6 – Standard 7 TCMCs Interpretation Program Results

3. 3 3 Tri-City Healthcare District - Demographics According to a Service Area Market Assessment Study by Medical Development Specialists Consulting - January 28, 2011: Population 500,000 residents in service area that includes 13 zip codes in Carlsbad, Oceanside and Vista Highly variable median household income Lowest is $44,215 in zip code 92054 in Oceanside Highest is $109,688 in zip code 92011 in Carlsbad White54.8% Hispanic32.8% Asian5.3% Black3.0% Other4.1%

4. Key Features of Hispanic Population Growth According to the 2009 American Community Survey issued by the Census Bureau, a linguistically isolated household is a household where all members of the household 14 years and over have at least some difficulty with English Linguistically Isolated Members Aged 14+ Years Old Households Speaking: Linguistically Isolated Households CarlsbadOceansideVista Spanish17.4%33.1%53.1% Other Indo-European languages 4.9%11.0%50.2% Asian and Pacific Island Languages 17.8%14.8%42.0% Other languages0.0%38.6%16.3% 4

5. Educational Level Education level is an important factors to consider when trying to reach multicultural markets Educational Attainment by People 25 Years and Over – Bachelors Degree and Above U.S. Census Bureau – Current Population Survey, 2010 All races30.0% White30.4% Asian52.4% Black19.9% Hispanic13.9% 5

6. 6 Standards 4, 5, 6, and 7 of Title VI of the Civil Rights Act of 1964 (Title VI) deals with services required for limited English proficient (LEP) individuals Title VI requires all entities to ensure that LEP persons have meaningful access to the health services that they provide TCMC complies with these requirements National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care Based on Title VI of the Civil Rights Act of 1964 National Standards for Culturally and Linguistically Appropriate Services

7. 7 National Standards for CLAS in Health Care (Continued) Health care organizations should: Explicitly inquire about the preferred language of each patient/consumer (e.g., the language in which he or she feels most comfortable in a clinical or non-clinical encounter). Record this information in all records. TCMC modified its MRS to enforce this requirement + more Health care organizations must provide to patients/consumers in their preferred language: Both verbal offers and written notices of their right to receive language assistance services Language services must be made available to each LEP individual regardless of the size of the individuals language group: At no cost At all points of contact In a timely manner During all hours of operation TCMC complies with all of this

8. 8 National Standards for CLAS in Health Care (Continued) Family and friends should not be used to provide interpretation services (except on request by the patient / consumer) If requested, a note is added to the patients medical record A TCMCs telephone/face-to-face interpreter must monitor the interpretation

9. 9 Only Staff Personnel Qualified as an Interpreter can provide Medical Interpretation Services Healthcare organizations must: Not rely on staff who are apparently bilingual or lack interpreter training because it frequently leads to: Misunderstanding, Dissatisfaction and Omission of vital information Misdiagnoses and Inappropriate treatment Lack of compliance Assure the competence of language assistance provided by interpreters and bilingual clinical, non-clinical and staff person who are in direct contact with patients Assess and ensure the training and competency of individuals who provide interpretations services TCMCs personnel who have been qualified through an assessment performed by TCMCs outside vendor are the only ones who can provide interpretation services

10. 10 TCMCs Current Enhanced Interpretation Program for All Languages Contracted Services: Telephone & video interpretation services for more than 200 languages American Sign Language Spanish Sign language TTY TCMCs Assessed/qualified bilingual clinical, non- clinical and staff personnel In-house, face-to-face, medical interpretation service for SPANISH LANGUAGE ONLY – This service is available right now by dialing a direct dedicated telephone number

11. 11 Telephone Interpretation Services for more than 200 languages The new LSA phones – Corded Dual Handsets LSA phones can be used to obtain interpretation services for more than 200 languages Just press the INTERPRETALK button on the phone: When greeted by a coordinator, please provide the following information: Department/Unit Callers Last Name and First Name Patients Medical Record Number Language needed Cost Center

12. 12 You can secure the LSA service from any place through any telephone or cell phone by dialing a dedicated telephone number REMOTE ACCESS TO LSAs Telephone Interpretation Services (continued) Cost Center

13. 13 The LSA & Wireless NexTalk Video Remote Interpretation Service Interpretation Services for American Sign Language, Spanish Sign Language, and TTY

14. 14 TCMC has assessed bilingual (English-Spanish, English- Tagalog, English-German, and English-Russian) clinical, non- clinical and staff personnel who have volunteered to serve on a dual-role capacity. NOTE: The individuals assessed are not used to interpreter at other units or departments unless there is an emergency situation TCMCs Assessed/Qualified Bilingual Clinical, Non-Clinical and Staff Personnel

15. 15 The in-house, English-Spanish medical interpreters providing Face-To-Face interpretation services: Were rated superior or above by an outside vendor Hold a medical interpretation certification Have prior experience as medical interpreters In-House, Face-To-Face, Medical Interpretation Service for SPANISH LANGUAGE ONLY

16. 16 Employee Orientation & Training/Certification Requirements Each employee must complete a competency check list Compliance with this requirement is tracked in RESQ This compliance is scanned into each employee file LBI will track compliance and report each employee not in compliance with this requirement

17. 17 TCMCs Interpretation Program Provides language interpretation services when they are needed and where they are needed Ensures equal access to medical services and communication tools to LEP patients and their families, friends, support persons, and surrogate decision makers Decreases missteps, misdiagnosis and miscommunications with LEP patients and their families, friends, support persons, and surrogate decision makers Meets the interpretation services recommended by Title VI, Joint Commission, and others Increases the patient satisfaction scores of TCMC Prevents sentinel events caused by miscommunication

18. You are probably thinking: Does this really work? 18

19. Results 1. Passed with no findings the JC Survey in Fall 2012 19

20. 20 Francisco J. Valle was named by the U-T San Diego The 2013 Health Professional of the Year Results 2. Recognition throughout San Diego County

21. 21 Result 3. Contribution to The Overall Medical Centers Outstanding National Rating

22. 22 Results 4. Hispanic Market Share Growth

23. Questions? 23

24. Thank You! 24