Medical Interpretation Resource Guide

Overview

Why is providing Medical Interpretation Important?
New Hampshire is a state experiencing increasing racial, ethnic and linguistic diversity. These differences enrich our society in many ways such as contributing to the arts, food, and economic development. The challenge we face is how a primarily English-speaking state can provide adequate health care access to those with limited or no English speaking ability. The Institute of Medicine Report "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" states that "language barriers may affect the delivery of adequate care through poor exchange of information, loss of important cultural information, misunderstanding of physician instruction, poor shared decision making, or ethical compromises." To address these barriers, health care organizations must develop strategies for providing linguistic access to their patients.

What do the Demographics in NH look like?
New Hampshire's estimated population for 2000 was 1,235,786. According to the Census Bureau's 2000 Census, New Hampshire has doubled the number of residents who are ethnic minorities. Census figures also show that New Hampshire's Hispanic population has nearly doubled since 1990 and its Asian population increased by 70.5%. In Nashua alone the Hispanic population grew 123.8%. In more recent years, New Hampshire has increased the number of refugees residing in the state as a result of refugee resettlement.. As of January 2005, the Manchester Union Leader reported that there are more than 70 languages spoken by students in the Manchester schools. Given the trend over the last decade, it is likely that more ethnic minorities will make New Hampshire their home. Building a system to care for diverse patients is a strategic move for health care organizations in the state.

What is the Law regarding medical interpretation?
Congress passed Title VI of the Civil Rights Act of 1964 to assure that health care providers who receive federal funds do not discriminate. "No person in the United States shall, on ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance." The Office of Civil Rights oversees compliance with Title VI and has issued guidance and regulations for health care organizations to assist them in assuring "meaningful access" to communication. Organizations can meet this requirement by developing a language services plan comprised of four activities:

• Assessment
• Policy Development
• Training
• Monitoring

Organizations may also want to be familiar with the American Disabilities Act and how it relates to providing sign language interpretation for deaf and hard of hearing individuals. Resources:

• USDHHS, Office of Civil Rights (OCR) - contact OCR at www.hhs.gov/ocr/lep or call Region One (617)565-1340 or (617)565-1343 (TDD)
• The National Health Law Program strives to improve access to quality health care for the disadvantaged. They can be reached at 1101 14th St. NW, Suite 405, Washington, DC 20005 or(202) 289-7661 or www.healthlaw.org
• Title VI of the Civil Rights Act of 1964 www.usdoj.gov./crt/cor/coord/titlevi.html
• www.lep.gov This website is created by the Federal Interagency Working Group In Limited English Proficiency. It acts as a clearing house for information and resources regarding language services.
• Language Services Action Kit -This kit is designed to assist advocates in assuring language assistance services are provided to limited English speakers. It was developed by NHeLP & the Access Project, www.accessproject.org
• "Communication through Interpreters in Healthcare: Ethical Dilemmas Arising from Differences in Class, Culture, Language, and Power" Journal of Clinical Ethics, Vol 8, No. 1, Spring 1997.
• "Getting the Most From Language Interpreters" Family Practice Management, Herndon E, Joyce L, June 23, 2004.
• Institute of Medicine Report, "Unequal Treatment: Confronting Racial & Ethnic Disparities in Health Care" Smedley et al, National Academy Press, 2002. www.nap.edu
• National Association of the Deaf, legal rights section, www.nad.org
• Working with Deaf & Hard of Hearing Patients - A Guide for Medical Professionals, Karen Rickow, PhD, www.deafinc.org
• Northeast Deaf & Hard of Hearing, www.ndhhs.org
• Granite State Independent Living, www.gsil.org
• Limited English Proficiency (LEP) Regulations Implications & Guidance for US Hospitals Serving Minority Populations. June 2002, www.drtango.com
• Providers Guide to Quality & Culture, http://erc.msh.org
• The Commonwealth Fund, www.cmwf.org