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 to Achieve 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 Requires provider continuing education requirements to include a component of cultural competency. AB 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

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