I. Need for Language Assistance Services in California
California is one of the nation?s most linguistically diverse states, with over 40 percent of its population speaking a language other than English at home, encompassing over 200 languages.1 Despite the rich diversity of its residents, the lack of both available language services and payments for language services in Medi-Cal?s fee-for-service (FFS) program makes it difficult to assess the level or quality of such services.2 Language assistance services often are not provided or compensated appropriately.
Providing adequate language services improves health outcomes and patient satisfaction, comports with existing federal and state requirements, and achieves long-term cost savings.3 Language services facilitate effective communication between health care providers and patients, thereby reducing medical errors, ensuring better health outcomes and lessening health disparities. In contrast, language barriers impede access and quality of care and also result in costly, unnecessary testing due to the lack of a thorough patient interview.4
All federal fund recipients, including all Medi-Cal providers, must comply with Title VI of the Civil Rights Act of 1964. Title VI prohibits discrimination based on national origin, which federal agencies and the Supreme Court have defined to include language.5 The Office for Civil Rights of the U.S. Department of Health and Human Services (DHHS) has issued policy guidance that requires all of its recipients of federal funds to provide meaningful access for limited-English proficient (LEP) persons.6 Since Medi-Cal is federally funded, Medi-Cal providers should assess the needs of its LEP population; provide competent interpreter and translation services (such as translation of readily understandable print materials); provide notice of the availability of free languageassistance services; train staff; and adopt, monitor and update an adequate language services plan.7
Additionally, state contracts and policy letters apply to the Medi-Cal Managed Care (MMC) Program that outline the language access requirements in more detail. The policy letters assist managed care plans provide high-quality, culturally and linguistically appropriate services, including interpreter services and translated materials.8
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