1. Kaiser Permanente NORTHERN CALIFORNIA REGION Labor Management Partnership Bilingual Employee Program HCIN Conference July 16, 2009

2. Fast Facts About Kaiser Permanente Founded in 1945 Headquartered in Oakland, California ~ 8.7 million members (6.6 million in CA) ~160,000 employees ~14,000 physicians 32 hospitals 421 medical office buildings

3. Members Who Require An Interpreter Our members speak over 60 different languages Most common languages requiring an interpreter include:  Spanish, Cantonese, Mandarin and Vietnamese Source: Regional Language Preference Summary Report (PRF02), May 2009

4. Language Assistance Resources: Do they have the skills you need? Assessed FluencyInterpretation Skills Knowledge of Medical Terms Friends / Family Untrained Bilingual Staff Trained Bilingual Staff (QBS 1) Trained Bilingual Staff (QBS 2) CNA Bilingual RNs Professional Phone Interpreters Professional Health Interpreters

5. The determination of which kind of language interpreter services to use for a particular encounter is based on: The type of encounter (acuity, urgency, whether medical terminology is needed) The language needed The availability of Professional Health Interpreters (on staff or contracted) Choosing Language Resources

6. Program Overview - Qualified Bilingual Status (QBS) The Labor Management Partnership (LMP) Bilingual Employee Program, established Summer 2003, recognizes and rewards members of participating Partner unions for their bilingual ability on a pay-for- skills basis Program Eligibility  Be a member of a partner union (SEIU-UHW, L20, L29)  Speak one of the designated Qualified Bilingual Status (QBS) languages or a Facility Designated Language  Work in a position that includes patient / member contact and will use the skill on a frequent and recurrent basis

7. Program Overview - Qualified Bilingual Status Five Qualified Bilingual Status (QBS) languages*:  Spanish, Cantonese, Mandarin, Vietnamese, American Sign Language** Local facilities can add their own Facility Designated Language based on their local language needs  South SF = Tagalog  Sacramento = Russian  Fresno = Punjabi & Hmong * Based on 2009 Northern California Regional Language Preference Report, Interpreter Required Field ** To comply with the Americans with Disabilities Act

8. Program Overview - Q ualified Bilingual Status Qualified Bilingual Status (QBS) is a designation  Given to current and new partner union employees if the meet the appropriate program criteria and take the appropriate steps to attain QBS Employees can attain either QBS Level 1 or Level 2  QBS Level 1 skills include conversational ability (able to give directions, etc.)  QBS Level 2 skills include a greater level of fluency plus medical terminology

9. Steps to Attain Qualified Bilingual Status QBS Level 1QBS Level 2 Self Identification Complete the self-selection form Eligibility Be a QBS Level 1 employee Assessment  Successfully complete a 20 - 25 minute telephone assessment on language proficiency in the employee’s qualifying language  Standardized questions and phrases in English and the qualifying language will be used.  An outside vendor administers the assessment  Successfully complete a more difficult 30 - 35 minute telephone assessment on language proficiency in the employee’s qualifying language  Standardized questions and phrases in English and the qualifying language will be used.  An outside vendor administers the assessment Training Complete a one hour training programComplete a 24 hour (3 day) training program

10. QBS Level 1 Training The Role of the QBS Level 1 Employee Standards of Practice and Ethical Principles Instructional Video Legal and Regulatory Requirements General Resources FAQs One hour, in person facilitated training session covering:

11. QBS Level 2 Training The Role of the QBS Level 2 Employee Legal and Regulatory Requirements Standards of Practice and Ethical Principles Serving in an Interpreting Role Medical Terminology Language Labs (specific to clinical area) Three day, in person facilitated training session covering:

12. Program Overview - Qualified Bilingual Status Levels

13. Program Overview - Bilingual Job Postings In addition to attaining QBS, a “bilingual required” posting process that requires appropriate management justification and joint sign off by union and management prior to posting a position  All “Bilingual Required” positions will be posted at Level 1 except for regionally identified and agreed upon professional classifications  Persons who successfully bid on a Level 1 position and qualify as Level 2 shall be recognized as Level 2  “Bilingual Required” postings will be filled by the most senior eligible “qualified bilingual” employee Training is required to qualify for differential

14. Form to be completed by Labor & Management jointly when both parties want to post a position as “Bilingual Required” Bilingual Required Job Posting

15. Program Overview - Infrastructure Local Implementation Team (LIT)  In each facility, Medical Center Leadership works in partnership with local LMP councils to identify a team of at least 2 reps, one from labor and management, to be accountable for the local implementation effort Regional Program Staff  Available to answer questions relating to the assessment and training processes, receive feedback on the program, and serve as regional resource for additional Information  Maya Garcia LMP Bilingual Employee Program Coordinator 510-625-5531  Sebastian Romeo LMP Bilingual Employee Program Learning Consultant 510-625-5525

16. Benefits of the Program For Members  Helps make KP the provider of choice by providing culturally and linguistically appropriate services  Personalizes the care experience by providing services in a member’s preferred language  Facilitates compliance with State and Federal regulations related to culturally and linguistically appropriate services For Employees & Physicians  Demonstrates KP’s commitment to diversity and to being the employer of choice  Helps KP build capacity and improve quality of existing and future workforce to best meet the language needs of our limited English proficient members  Fulfills Labor Management Partnership objective to recognize and reward bilingual ability on a pay-for-skills basis  Demonstrates KP’s ability to work in partnership and KP’s commitment to agreements made with LMP unions

17. The LMP Bilingual Program recognizes and rewards members of participating partner unions for their bilingual ability on a pay-for-skills basis. To obtain Qualified Bilingual Status (QBS), an employee must meet the eligibility requirements, pass an assessment and obtain additional training on how to provide appropriate bilingual services and use their bilingual skills on a frequent and recurrent basis. LMP Bilingual Employee Program Day, n = 3024 Evening, n = 446 Level 1 & Level 2 Staff n = 3551 Level 1 & Level 2 Staff, n = 3551 QBS Assessment, Pass/Non Pass Rates Non passing score Passing score Passing scores are 5, 4, 3+ or 3. Scores of 3-, 2 or 1 are non passing scores Participants can attempt the assessment up to 3 times Level 1 Assessments n = 140 Level 2 Assessments n = 100 KFH, n = 791 TPMG, n = 2579 KFHP, n = 181 QBS Staff by Language as of 07- 01- 09 QBS Staff by Shift as of 07- 01- 09 QBS Staff by Entity as of 07- 01- 09 QBS by Union as of 07-01-09 Night, n = 81 Total QBS = 3551 Q2 2009