Putting All the Pieces Together: Identifying Languages Spoken and Promising Practices for Overcoming Language Barriers 2007 Federal Interagency Conference on Limited English Proficiency March 15-16, 2007 Presenters •Walter (Curt) Norris, Director of Employment Diversity, Las Vegas Metropolitan Police Department •Susan Shah, Senior Planner, Center on Immigration and Justice, Vera Institute of Justice •David M. Smiddy, ESOL/Volunteer Coordinator, Clark County Literacy Coalition •Mara Youdelman Director, Language Access Advocacy Project, National Health Law Program Conducting a Self Assessment: Understanding Demography •Analyses of census and ACS data –State and city departments of planning –Modern Language Association (www.mla.org) –Migration Policy Institute (www.migrationinformation.org) Conducting a Self Assessment: Understanding Demography •Federal, state, and city departments of education –School accountability reports •Federal, state, and city departments of health –Vital statistics data •Municipal and state courts –Use of interpretersUse of interpreters Conducting a Self Assessment: Understanding Demography •Data from community (pros and cons) •Private research and marketing companies Conducting a Self Assessment: Measuring Nature and Frequency of Contact •Promising Practices Reports by NHeLP from The Commonwealth Fund –RPT. 1RPT. 1 - Small Providers (released 4/05) examined how small providers (<10 clinicians) offered language services: •Solo Practitioners and Small Group Practices •Community Clinics and Health Centers •Family Planning Clinics •Assistance to Small Providers from Other Systems/Institutions Conducting a Self Assessment: Measuring Nature and Frequency of Contact –RPT. 2RPT. 2 -State/Local Benefit Offices (forthcoming): examined how state/local health-related benefit offices offered language services: •State central agency offices •Local agency offices Conducting a Self Assessment: Measuring Nature and Frequency of Contact •Important to identify individuals being served and eligible to be served –Measuring those being served can help to ensure needed language services are available as well as planning future needs •Determining language needs at first points of contact– notations in schedule/patient records; language notification flyers Conducting a Self Assessment: Identifying Language Needs •Identification of language needs –“I Speak”cards/posters –patients can point to their language and office staff can note •Recording language needs –L.A. Care Health PlanL.A. Care Health Plan –color-coded stickers designate language needsdesignate language needs –Women’s Health and Education Centers –notes language needs in schedule and computer data system Conducting a Self Assessment: Identifying Language Needs •WA Department of Social and Health Services –requires noting the client’s primary language in its computer systemin •KY Cabinet for Health and Family Services collects language information and specifics on each encounter using language services Arizona •Department of Economic Security – database does not proceed past certain fields without noting the client’s language needs –clients are asked their primary language at initial and renewal interviews –includes 68 language choices plus an open- ended option Los Angeles County •Department of Public Social Services collects language information at initial eligibility and renewals •County compiles a report to show the number of LEP individuals in the Medicaid caseload, by language spoken, served by each eligibility office during the month Identifying Available Resources •Need to identify both internal and external resources •NHeLP's Language Services Resource Guide for Healthcare Providers helps identify external resources including interpreter/translator associations and providers; training programs; translated materials; symbols; etc. Identifying Available Resources •Community Resources –ID Department of Health and Welfare contracts with local community organizations –NC Division of Public Health is working with the United Hmong Association to translate its fact sheets –IL Department of Human Services funds the IL Coalition on Immigrant and Refugee Rights Community Resources •DC Medical Assistance Administration worked with community advocates to develop its “I Speak”poster and cards and a “Know Your Rights” pamphlet Identifying Available Resources • CASE STUDY: Clark County, October 2006 – The meeting – The ideas – The results Identifying Available Resources •Las Vegas Metropolitan Police Department’s Hispanic Interpreter Services Program (HISP)H Background (HISP) > Hispanic Population – Between 1990 to 2000 the census bureau estimated that the Clark County Hispanic population was approximately 22% – In 2002, the estimation had increased to 24%, and it was estimated that by the year 2008, Hispanics would account for 30% of the Las Vegas population Background Continued > Acquisition of Funding – In 2002, LVMPD, with the assistance of the Latin Chamber of Commerce and Senator Harry Reid’s office, submitted and obtained a grant for HISP – HISP is now a regular LVMPD budget item Hispanic Interpreters Services Program > Created in 2003 > Currently staffed with 23 part-time civilian employees (3 Leads) > Provides oral and written language services > Primary mode of communication between the LEP community and LVMPD > Language interpretation certification by LVMPD only, no outside certification required at this time > Interpreters are fluent in various dialects of Spanish, to include Cuban, Venezuelan, Nicaraguan, El Salvadorian, and Chilean HISP Continued > Provides 24/7 Response to Patrol requests for Spanish language access services > Assist Communications call-takers with LEP persons during 911 and non-emergency calls > Provides LVMPD Spanish translation, and transcription > Assists with Directed Patrol assignments, which involves LVMPD focusing on a problem or issue specific to the Hispanic community > Dispatched in the same manner as a police officer (Radio) > Responded to 5,000 calls for service in 2006 Ensuring Quality: User Training •Working With Interpreters •Working With Translators Ensuring Quality: Interpreter Training •Neponset Health Center (MA) – employs native Vietnamese speakers trained as medical interpreters through the MMIA or Mass. DPH •L.A. Care Health Plan – –offers medical interpreter training for bilingual staff of participating clinics and medical groups –training for health care providers (for continuing medical education credit) on how to work with interpreters Ensuring Quality: Assessing Bilingual Competency •St. Joseph Health System Community Health Programs (CA) –requires assessment of staff providing services in non-English language or as interpreter •North DeKalb Health Center (GA) –requires all bilingual staff to attend training sessions and pass test Ensuring Quality: Bilingual Staff •KY Cabinet for Health and Family Services – designated Language Access Section with four trained interpreters •LA Cty. DPSS. – human resources division certifies language skills of bilingual staffl •WA DSHS – bilingual employees can provide interpretation only if certified as interpreters and documented in the employee’s classification questionnaires •NE – developing language assessment test for self-declared bilingual staff Ensuring Quality: Testing and Certification •No national standards for healthcare interpreters/translators •National Council on Interpreting in Health Care has National Code of Ethics and Standards of Practice •Few states are exploring the issue –IN, MA,NC, OR Ensuring Quality: Compensating Bilingual Staff •AZ Department of Economic Security offers a stipend of $1,000 a year •NC Department of Health and Human ServicesN –pays bilingual employees at a higher grade level •LA Cty. Department of Public Social Services gives $100 monthly to certified bilingual workers •KY Cabinet for Health and Family Services plans to pay qualified bilingual employees at a higher pay level Ensuring Quality: Use of Contract Interpreters •KY Cabinet for Health and Family Service – qualifies community partners (both individual interpreters and language agencies) to interpret for the agency •WA DSHS – comprehensive process to certify contract employees and only those who pass certification (in the state’s seven most common languages) or assessment (for other languages) may provide services to the agency Ensuring Quality Translations •NE –uses designated translators with a degree from translation program •ID Department of Health and Welfare –works with the Idaho Migrant Council and the Hispanic Commission to review benefits forms for appropriate Spanish translation Ensuring Quality: Developing a LEP Policy •Translating Justice Policy Development Workshop with the LVMPD LVMPD LEP Policy Development Process > Policy development workshop facilitated by the Vera Institute – Vera staff met with LVMPD’s key policy makers to discuss various issues and points to developing a draft language access policy – Goal • Inform and engage LVMPD’s administrators in the language access planning process • Elicit feedback on LVMPD’s draft policy • Discuss and resolve outstanding issues in finalizing policy Policy Development Process Continued > Internal approval process – Distribution to mid-level managers forfeedback – Presentation to LVMPD’s Executive Staff – Submission to Department of Justice (DOJ) Ensuring Quality: Seeking Community Input •Seek community input = seek input into the community – Get involved in collaborations and coalitions – Use the synergy to get the word out Questions?