The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65282

Cori D. Reifman, MPH¹, Ed Mendoza, MPH¹, and Cheri Agonia². (1) California Office of the Patient Advocate, 320 W. 4th Street, Suite 880, Los Angeles, CA 90013, 213-576-1320, creifman@dmhc.ca.gov, (2) School of Public Health, Community Health Science, University of California Los Angeles, Box 951772, Los Angeles, CA 90095-1772

The California Office of the Patient Advocate (OPA) was created in 1999 as part of one of the most comprehensive HMO reform initiatives in the country. OPA is required to produce an annual HMO Report Card for California HMO enrollees. The first annual HMO Report Card in 2001 was the first in the nation to also include data on linguistic services. As part of the Year 2 Report Card project, OPA surveyed California’s largest commercial and Medicaid health plans to assess the provision of linguistic services and whether plans provide: telephone interpreters, access to face-to-face interpreters, bilingual provider lists, translated written materials, and language and cultural barrier grievance monitoring. These health plans represent over 90 percent of the 18 million HMO enrollees in the state. California’s delegated model and the different types of coverage (commercial, Medicare, Medicaid and Healthy Families) posed unique challenges in both obtaining the data from health plans and presenting the information to consumers in a useful format on the 2002 HMO Report Card. OPA’s report on the project describes the survey methodology, key findings and analysis, as well as programmatic and policy recommendations. The report also outlines efforts to develop criteria to review linguistic services as a measure of quality in HMOs. The report is targeted toward an audience of advocates, policy makers, and the research community, and may be used as a model for other states as they assess the cultural and linguistic appropriateness of their managed care delivery systems.

Learning Objectives:

• List criteria in the development of quality measures for linguistic services in HMOs.
• Describe the provision of linguistic services in California to create further discussion among stakeholders about ways to better construct health plan services and information for consumers.
• Identify areas in the provision of linguistic services where gaps exist in services or in informing members about how to access services.

Related Web page: www.opa.ca.gov

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.