California 2021-2022 Regular Session

California Assembly Bill AB1169 Latest Draft

Bill / Amended Version Filed 04/29/2021

                            Amended IN  Assembly  April 29, 2021 Amended IN  Assembly  April 15, 2021 Amended IN  Assembly  March 16, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 1169Introduced by Assembly Member Eduardo GarciaFebruary 18, 2021 An act to amend Section 1259 of, and to add and repeal Section 1259.1 of, the Health and Safety Code, relating to health care facilities.LEGISLATIVE COUNSEL'S DIGESTAB 1169, as amended, Eduardo Garcia. Health care facilities: interpreters.Existing law requires a general acute care hospital to take a variety of actions relating to the provision of language assistance services to patients with language or communication barriers, including, among others, preparing and maintaining a list of interpreters who have been identified as proficient in sign language who have the ability to translate the names of body parts, injuries, and symptoms.This bill would prohibit a general acute care hospital from including a sign language interpreter or cued language transliterator on that list unless the interpreter or transliterator meets certain certification or testing requirements.This bill would require the Department of Public Health, on or before January 1, 2024, to conduct a study to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing. The bill would require the department, on or before that same date, January 1, 2025, to approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.Digest Key Vote: MAJORITY  Appropriation: NO  Fiscal Committee: YES  Local Program: NO Bill TextThe 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) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.SEC. 2. Section 1259.1 is added to the Health and Safety Code, to read:1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

 Amended IN  Assembly  April 29, 2021 Amended IN  Assembly  April 15, 2021 Amended IN  Assembly  March 16, 2021 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION Assembly Bill No. 1169Introduced by Assembly Member Eduardo GarciaFebruary 18, 2021 An act to amend Section 1259 of, and to add and repeal Section 1259.1 of, the Health and Safety Code, relating to health care facilities.LEGISLATIVE COUNSEL'S DIGESTAB 1169, as amended, Eduardo Garcia. Health care facilities: interpreters.Existing law requires a general acute care hospital to take a variety of actions relating to the provision of language assistance services to patients with language or communication barriers, including, among others, preparing and maintaining a list of interpreters who have been identified as proficient in sign language who have the ability to translate the names of body parts, injuries, and symptoms.This bill would prohibit a general acute care hospital from including a sign language interpreter or cued language transliterator on that list unless the interpreter or transliterator meets certain certification or testing requirements.This bill would require the Department of Public Health, on or before January 1, 2024, to conduct a study to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing. The bill would require the department, on or before that same date, January 1, 2025, to approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.Digest Key Vote: MAJORITY  Appropriation: NO  Fiscal Committee: YES  Local Program: NO 

 Amended IN  Assembly  April 29, 2021 Amended IN  Assembly  April 15, 2021 Amended IN  Assembly  March 16, 2021

Amended IN  Assembly  April 29, 2021
Amended IN  Assembly  April 15, 2021
Amended IN  Assembly  March 16, 2021

 CALIFORNIA LEGISLATURE 20212022 REGULAR SESSION

 Assembly Bill 

No. 1169

Introduced by Assembly Member Eduardo GarciaFebruary 18, 2021

Introduced by Assembly Member Eduardo Garcia
February 18, 2021

 An act to amend Section 1259 of, and to add and repeal Section 1259.1 of, the Health and Safety Code, relating to health care facilities.

LEGISLATIVE COUNSEL'S DIGEST

## LEGISLATIVE COUNSEL'S DIGEST

AB 1169, as amended, Eduardo Garcia. Health care facilities: interpreters.

Existing law requires a general acute care hospital to take a variety of actions relating to the provision of language assistance services to patients with language or communication barriers, including, among others, preparing and maintaining a list of interpreters who have been identified as proficient in sign language who have the ability to translate the names of body parts, injuries, and symptoms.This bill would prohibit a general acute care hospital from including a sign language interpreter or cued language transliterator on that list unless the interpreter or transliterator meets certain certification or testing requirements.This bill would require the Department of Public Health, on or before January 1, 2024, to conduct a study to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing. The bill would require the department, on or before that same date, January 1, 2025, to approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.

Existing law requires a general acute care hospital to take a variety of actions relating to the provision of language assistance services to patients with language or communication barriers, including, among others, preparing and maintaining a list of interpreters who have been identified as proficient in sign language who have the ability to translate the names of body parts, injuries, and symptoms.

This bill would prohibit a general acute care hospital from including a sign language interpreter or cued language transliterator on that list unless the interpreter or transliterator meets certain certification or testing requirements.

This bill would require the Department of Public Health, on or before January 1, 2024, to conduct a study to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing. The bill would require the department, on or before that same date, January 1, 2025, to approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.

## Digest Key

## Bill Text

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) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.SEC. 2. Section 1259.1 is added to the Health and Safety Code, to read:1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

The people of the State of California do enact as follows:

## 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) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.

SECTION 1. Section 1259 of the Health and Safety Code is amended to read:

### SECTION 1.

1259. (a) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.

1259. (a) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.

1259. (a) (1) 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.(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:(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 either of the following:(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.(ii) The department shall make the updated policy available to the public on its internet website.(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.(5) (A) 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.(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.(7) 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.(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.(e) Noncompliance with this section shall be reportable to licensing authorities.(f) Section 1290 does not apply to this section.



1259. (a) (1) 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.

(2) Therefore, it is the intent of the Legislature that when 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, the following terms have the following meanings:

(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 either of the following:

(A) With respect to spoken language, barriers that 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 of Public Health shall determine, based on objective data, whether the 5-percent population standard applies to a given hospital.

(B) With respect to sign language, barriers that are experienced by individuals who are deaf or hard of hearing 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 or hard-of-hearing residents, licensed general acute care hospitals shall:

(1) Review existing policies regarding interpreters for patients with limited-English proficiency and sign language interpreters for patients who are deaf or hard of hearing, including the availability of staff to act as interpreters.

(2) (A) (i) Adopt and review annually a policy for providing language assistance services to patients with language or communication barriers. The policy shall include procedures for providing, to the extent possible, as determined by the hospital, the use of an interpreter if a language or communication barrier exists, except if 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 procedures shall be designed to 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, 24 hours a day.

(ii) The hospital shall, on or before January 1 of each year, make the updated policy and a notice of availability of language assistance services available to the public on its internet website. The notice shall be in English and in the other languages most commonly spoken in the hospitals service area. For purposes of this paragraph, the hospital shall make the notice available in the language of individuals who meet the definition of having a language barrier pursuant to subparagraph (A) of paragraph (2) of subdivision (b). However, a hospital is not required to make the notice available in more than five languages other than English.

(B) (i) The hospital shall, on or before January 1 of each year, transmit to the department a copy of the updated policy and shall include a description of its efforts to ensure adequate and speedy communication between patients with language or communication barriers and staff.

(ii) The department shall make the updated policy available to the public on its internet website.

(3) 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 TDD number for the deaf or hard of hearing. 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 department, and shall provide the local address and telephone number of the department, including, but not limited to, a TDD number for the deaf or hard of hearing.

(4) Identify and record a patients primary language and dialect on one or more of the following: patient medical chart, hospital bracelet, bedside notice, or nursing card.

(5) (A) 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.

(B) A sign language interpreter shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the interpreter satisfies one of the following:

(i) Is certified by the national Registry of Interpreters for the Deaf or the equivalent.

(ii) Has achieved a score of 4.0 or above on the National Association of the Deaf/American Consortium of Certified Interpreters assessment.

(C) A cued language transliterator shall not be included on the list prepared and maintained pursuant to subparagraph (A) unless the transliterator possesses a Testing, Evaluation, and Certification Unit certification.

(6) Notify employees of the hospitals commitment to provide interpreters to all patients who request them.

(7) 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.

(8) Consider providing its nonbilingual staff with standardized picture and phrase sheets for use in routine communications with patients who have language or communication barriers.

(9) Consider developing community liaison groups to enable the hospital and the limited-English-speaking and deaf and hard-of-hearing communities to ensure the adequacy of the interpreter services.

(d) On or before January 1, 2024, 2025, the department shall approve one or more entities to administer testing for American Sign Language interpreters for individuals who are deaf or hard of hearing pursuant to guidelines established by the department.

(e) Noncompliance with this section shall be reportable to licensing authorities.

(f) Section 1290 does not apply to this section.

SEC. 2. Section 1259.1 is added to the Health and Safety Code, to read:1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

SEC. 2. Section 1259.1 is added to the Health and Safety Code, to read:

### SEC. 2.

1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.

1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.



1259.1. (a) On or before January 1, 2024, the department shall conduct a study, with the collaboration of professionals in the field of sign language interpretation and members of the deaf or hard of hearing community, to establish the guidelines for selecting testing organizations, agencies, or educational institutions to administer tests for certification of interpreters, including, but not limited to, American Sign Language interpreters, in medical settings for individuals who are deaf or hard of hearing.

(b) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.