BILL NUMBER: SB 442ENROLLED BILL TEXT PASSED THE SENATE JUNE 1, 2011 PASSED THE ASSEMBLY AUGUST 30, 2011 AMENDED IN SENATE APRIL 26, 2011 AMENDED IN SENATE APRIL 7, 2011 INTRODUCED BY Senator Calderon FEBRUARY 16, 2011 An act to amend Section 1259 of the Health and Safety Code, relating to health facilities. LEGISLATIVE COUNSEL'S DIGEST SB 442, Calderon. Hospitals: interpreters. Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, the licensing and certification of health facilities, including, but not limited to, general acute care hospitals. Existing law requires general acute care hospitals to, among other things, adopt and annually review its policy and procedures for providing assistance to patients with language or communication barriers to ensure access to health care information and services for limited-English-speaking or non-English-speaking residents and deaf residents. Existing law requires that the procedures ensure, to the extent possible, as determined by the hospital, that interpreters are available, either on the premises or accessible by telephone, 24 hours per day. This bill would, in addition, require the policy to ensure meaningful access to translation and interpreter services by limited-English-speaking or non-English-speaking individuals and to include appropriate criteria for demonstrating the proficiency of the translation and interpreter services. The bill would require the policy to include procedures for discussing with the patient any cultural, religious, or spiritual beliefs or practices of the patient that may influence care, and that the procedures be designed to increase hospital staff ability to understand and respond effectively to the cultural needs of patients. The bill would require the hospital to review the standards of health care interpreting, as prescribed. Existing law requires hospitals to notify their employees of the hospital's commitment to provide interpreters to all patients who request them. This bill would, in addition, require the hospital to notify employees of the hospital's commitment that the interpreter communicate information about the unique needs of the patient to the health care team. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1259 of the Health and Safety Code is amended to read: 1259. (a) The Legislature finds and declares that California is becoming a land of people whose languages and cultures give the state a global quality. The Legislature further finds and declares that access to basic health care services is the right of every resident of the state, and that access to information regarding basic health care services is an essential element of that right. Therefore, it is the intent of the Legislature that where language or communication barriers exist between patients and the staff of any general acute care hospital, arrangements shall be made for interpreters or bilingual professional staff to ensure adequate and speedy communication between patients and staff. (b) As used in this section: (1) "Interpreter" means a person fluent in English and in the necessary second language, who can accurately speak, read, and readily interpret the necessary second language, or a person who can accurately sign and read sign language. Interpreters shall have the ability to translate the names of body parts and to describe competently symptoms and injuries in both languages. Interpreters may include members of the medical or professional staff. (2) "Language or communication barriers" means: (A) With respect to spoken language, barriers which are experienced by individuals who are limited-English-speaking or non-English-speaking individuals who speak the same primary language and who comprise at least 5 percent of the population of the geographical area served by the hospital or of the actual patient population of the hospital. In cases of dispute, the state department shall determine, based on objective data, whether the 5 percent population standard applies to a given hospital. (B) With respect to sign language, barriers which are experienced by individuals who are deaf and whose primary language is sign language. (c) To ensure access to health care information and services for limited-English-speaking or non-English-speaking residents and deaf residents, licensed general acute care hospitals shall: (1) Review existing policies regarding interpreters for patients with limited-English proficiency and for patients who are deaf, including the availability of staff to act as interpreters. (2) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The hospital's policy shall ensure meaningful access to translation and interpreter services by limited-English-speaking or non-English-speaking individuals and shall include appropriate criteria for demonstrating the proficiency of the translation and interpreter services. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter whenever a language or communication barrier exists, except where the patient, after being informed of the availability of the interpreter service, chooses to use a family member or friend who volunteers to interpret. The policy shall also include procedures for discussing with the patient any cultural, religious, or spiritual beliefs or practices of the patient that may influence care. The procedures shall be designed to increase hospital staff ability to understand and respond effectively to the cultural needs of patients, maximize efficient use of interpreters, and minimize delays in providing interpreters to patients. The procedures shall ensure, to the extent possible, as determined by the hospital, that interpreters are available, either on the premises or accessible by telephone or video medical interpretation (VMI), 24 hours per day. The hospital shall annually transmit to the state department a copy of the updated policy and shall include a description of its efforts to ensure effective and speedy communication between patients with language or communication barriers and staff. (3) Review the standards of health care interpreting industry to incorporate industry improvements or standards for health care interpreter certification, and standards for testing to ensure quality, accuracy, and consistency in the provision of health care interpreter services. (4) Take reasonable steps to assess whether interpreters demonstrate proficiency in the ability to communicate information accurately in both English and in the other language, including, but not limited to, all of the following: (A) Knowledge, in both languages, of health care terminology and specialized terms or concepts unique to the hospital's program or activity. (B) Ability to use the appropriate mode of interpreting, including, but not limited to, consecutive, simultaneous, summarization, or sight translation. (C) Possession of an understanding of, and ability to follow, rules of conduct relating to confidentiality, impartiality, and interpretation ethics. (5) Develop, and post in conspicuous locations, notices that advise patients and their families of the availability of interpreters, the procedure for obtaining an interpreter and the telephone numbers where complaints may be filed concerning interpreter service problems, including, but not limited to, a T.D.D. number for the hearing impaired. The notices shall be posted, at a minimum, in the emergency room, the admitting area, the entrance, and in outpatient areas. Notices shall inform patients that interpreter services are available upon request, shall list the languages for which interpreter services are available, shall instruct patients to direct complaints regarding interpreter services to the state department, and shall provide the local address and telephone number of the state department, including, but not limited to, a T.D.D. number for the hearing impaired. (6) Identify and record a patient's primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card. (7) Prepare and maintain as needed a list of interpreters who have been identified as proficient in sign language and in the languages of the population of the geographical area serviced who have the ability to translate the names of body parts, injuries, and symptoms. (8) Notify employees of the hospital's commitment to provide interpreters to all patients who request them and that the interpreter communicate information about the unique needs of the patient to the health care team. (9) Review all standardized written forms, waivers, documents, and informational materials available to patients upon admission to determine which to translate into languages other than English. (10) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers. (11) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf communities to ensure the adequacy of the interpreter services. (d) Noncompliance with this section shall be reportable to licensing authorities. (e) Section 1290 shall not apply to this section.