208415 Assessing Language Access Disparities in Los Angeles County through Evaluation of a Healthcare Interpreter Training Program

Wednesday, November 11, 2009: 1:15 PM

S. Rae Starr, MPhil, MOB , Healthcare Outcomes & Analysis, L.A. Care Health Plan, Los Angeles, CA
Lenna Monte, MPH, CHES , Cultural and Linguistic Services, L.A. Care Health Plan, Los Angeles, CA
Nai Kasick, MPH, CHES , Cultural and Linguistic Services, L.A. Care Health Plan, Los Angeles, CA
Beverly Treumann , Health Care Interpreter Network, Downey, CA
Stergios Roussos, PhD, MPH , ACRD/CBEACH, Merced, CA
Whitney Schroeder , ACRD/CBEACH, Merced, CA
L.A. Care Health Plan provides health care to nearly 800,000 low-income families and individuals in vulnerable communities in Los Angeles County, California. L.A. Care's membership reflects the county's diverse urban population, with over 50% of members indicating a preference for services in languages other than English. Language access is key to addressing disparities and providing quality health care. For this purpose, L.A. Care sponsors a 40-hour Health Care Interpreter Training program for bilingual medical office staff members who serve as interpreters for patients. As part of program evaluation, trainees in 2007 and 2008 completed pre- and post-course surveys (n=88). This presentation covers lessons learned from analysis of the data on operational questions like the following: Are clinics accurately detecting members' interpretation needs and voluntarily seeking training, or does the training need to be targeted? To analyze this, attendees were grouped by geographical region within the county, and matched against language access findings in the health plan's annual CAHPS member satisfaction survey. 2008 CAHPS results identified two regions where interpreter needs were double the county average. Providers in the two regions with the greatest disparity on interpreter access were underrepresented among clinic staffs seeking interpreter training. This analysis is designed to help target interventions, to educate members to ask for interpreter access; to promote interpreter training among existing providers; to seek contracts with bilingual health care providers; and to familiarize providers with professional interpreter services.

Learning Objectives:
1. Identify language access disparities through CAHPS member satisfaction surveys coupled with geographic data. 2. Assess provider response to geographic disparities through enrollment data in health care interpreter training programs. 3. Describe methods for promoting use of telephonic interpreter services among members and provider staff.

Keywords: Cultural Competency, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Experience: Five years as the Biostatistician, then Senior Biostatistician at L.A. Care Health Plan. I have managed the CAHPS survey for L.A. Care Health Plan from 2006 to 2009, and participated in the design of the Health Care Interpreter Survey and the evaluation from which the comparisons in this paper were derived. Education: Master of Philosophy in Policy Analysis from the RAND Graduate School of Policy Analysis (Santa Monica CA); Master of Organizational Behavior from Brigham Young University (Provo, UT); Bachelor of Political Science with Honors from Brigham Young University (Provo UT). L.A. Care Health Plan is the largest public health insurer in the United States, and its CAHPS survey in a typical year represents roughly 800,000 Medicaid and SCHIP members in an ethnically diverse, urban county in the southwest United States.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
L.A. Care Health Plan Healthcare Outcomes & Analysis -- CAHPS Lead Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.