Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #101803

Sylvia Torres¹, Glenn Flores, MD¹, Linda Holmes², Debbie Salas-Lopez, MD³, Sandra C. Tomany-Korman, MS¹, and Mara K. Youdelman, JD, LLM⁴. (1) Center for the Advancement of Underserved Children, Medical College of Wisconsin/Children's Hospital of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, 414-456-8273, STorres@mail.mcw.edu, (2) Office of Minority and Multicultural Health, State of New Jersey Department of Health and Senior Services, P.O. Box 360, Trenton, NJ 08625, (3) Division of Academic Medicine, Geriatrics, and Community Programs, Department of Medicine, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, MSB, I-594, Newark, NJ 07103, (4) National Health Law Program, 1101 14th St NW, Suite 405, Washington, DC 20005

47 million Americans speak a non-English language at home and 21 million are LEP. With 11% of its population LEP, New Jersey (NJ) is a model state for studying interpreter issues. The study aim was to assess the adequacy of interpreter services (IS) in NJ hospitals in meeting LEP patients' needs, and to make policy recommendations on unmet needs. Methods: Cross-sectional survey in which representatives at all 122 NJ hospitals were contacted to answer 37 questions on hospital/patient features, IS, and resources/policies needed to provide quality IS. Results: 67 hospitals completed surveys (55% response rate). A median of 9% of staff and 33% of MDs are bilingual. A median of 93 patients/hospital need interpreters (range=0-15,000), and the median IS budget is $10,063 (range=$0-458,000). 97% of hospitals use phone IS. 87% of hospitals have no IS department, 19% offer no written translation services, and 31% lack multilingual signs. Only 3% of hospitals have a full-time interpreter, for a ratio of 1 interpreter per 235,769 LEP persons in NJ. 80% of hospitals offer no staff training on working with interpreters. The proportion of non-white patients is associated with providing written translation (P<.01) and with staff training on working with interpreters (P<.02), and the proportion of Medicare patients is associated with having multilingual signs (P<.04). Three hospitals had model programs with more extensive IS. Hospitals stated the following would improve IS at their institutions: more funding; federal/state interpreter certification and guidelines; more staff education on interpreter use; listing locally available interpreters; and identifying bilingual staff. Most said third-party reimbursement for IS would be beneficial, by reducing costs, adding full-time interpreters, freeing staff for other services, meeting future population growth, and improving communication and education. Conclusions: Most NJ hospitals have no formal interpreter services department, 97% have no full-time interpreter, 80% provide no staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals said third-party reimbursement for interpreter services would benefit their hospitals. Implications: Based on these findings, we suggest NJ provide third-party reimbursement of IS. If restrictive budgetary challenges preclude third-party reimbursement, we suggest considering one or more of the following: Medicaid/SCHIP reimbursement for emergency department IS; using federal Medicaid/SCHIP funds to train more interpreters; negotiating bulk discounts with telephone IS; implementing licensure requirements and regulations mandating adequate access to IS for LEP patients; and if other measures fail, legal enforcement of Title VI compliance.

Learning Objectives: At the conclusion of this presentation, attendees will be able to

• List at least four measures for assessing the adequacy of hospital interpreter services for patients with limited English proficiency. And
• Articulate mechanisms for ensuring that hospital interpreter services meet the needs of patients with limited English proficiency.

Keywords: Interpreters, Access and Services

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.