A new bill in California makes additional provisions for health care language assistance services in a move that looks set to increase access to services and improve the quality of interpreting services in the state.

The California Senate Bill No. 223 Chapter 771, which was approved by Governor Jerry Brown on October 13, 2017, aligns with The Health and Safety Code, The Insurance Code, and the Welfare and Institutions Code.

This bill comes soon after another relevant code, The Labor Code, came under fire from the interpreting community, who felt that it has led to the undercutting of professional interpreters’ fees by allowing “provisionally certified” interpreters to be used in certain situations.

Crucially, The Health and Safety Code is referenced by a provision in The Labor Code, which means that the new amendments this bill introduces could help clamp down on undercutting of costs.

Access to Services

Existing laws require health care service plans and health insurers to provide the insured population with language assistance in obtaining health services such as access to interpretation services, assessment of linguistic needs, and translation of vital documents.

The new bill would require the provision of a written notice of the availability of free language assistance services in English and in the top 15 languages spoken by individuals with limited English proficiency (LEP) in California, and a written notice of the availability of interpretation services.

The bill also provides that individuals must be notified at least once annually in notices and other regular communication, and on easily accessible platforms such as the website of the health insurer.

Notifications must include details on how to access the services and must provide information relating to the availability of auxiliary aids and services for individuals with disabilities, guidance on non-discrimination policies, grievance procedure, and instructions on how to file a discrimination complaint.

Quality of Interpreting

Confusingly, the previous bill pointed to a long list of external sources for guidance on interpreting standards, ranging from standards adopted by other states, those established by California or nationally recognized associations, to information gathered from complaints made to the HMO Helpline.

To meet the minimum qualification criteria under the new bill, interpreters must now demonstrate proficiency in English and the target language; have knowledge of terminology and concepts relevant to health care and health care delivery systems in both languages; and adhere to ethical principles and client confidentiality.

Furthermore, the new bill states that individuals will not be required to provide their own interpreter or rely on other people (such as medical staff and accompanying adults or children) for interpreting services unless it is an emergency and a qualified interpreter is not immediately available or it is specifically requested by the individual and deemed appropriate.

Aside from these exemptions, a qualified interpreter must be provided.

Wider Impact

The bill should help improve access to the language assistance services available to LEP individuals in California. Moreover, the local interpreting community will welcome these amendments, and wait with baited breath in the hope that these changes go far enough to stamp out the perceived undercutting of professional interpretation services.

In the California legal sphere, interpreting is starting to fare somewhat better. Thanks to a pioneering project exploring the use of a Virtual Remote Interpreting system (VRI) in its State Courts.

The project, which launched in July 2017, aims to trial the success of VRI and, if successful, could be rolled out to other areas, and perhaps address some of the challenges still facing providers of language assistance within the health care arena.