Planning and Implementing Language Assistance Services in a County Health Department: Challenges and Lessons Learned from San Mateo County, CA

Federal and state guidelines require healthcare providers to ensure limited English proficient (LEP) clients are provided language assistance when accessing services. In San Mateo County, CA, approximately 41% of County residents speak a language other than English at home. Based largely on community input, the San Mateo County Health System (SMCHS) developed a comprehensive Language Assistance Services program that all SMCHS staff can access. The program, through its contracted agencies, provides in-person oral and American Sign Language interpretation, document translation, and telephone interpretation services. These services are centrally managed within SMCHS and accessible through a phone number that any SMCHS staff can use. Additionally, two policies to address the growing needs of its LEP clients were developed and implemented. The policies focus on: 1) the right of clients to request free interpreter services, and 2) the prohibited use of minors as interpreters for family members, and discouraged use of any family members as interpreters. Planning and implementation for such a program at a county health department posed a number of challenges. Funding, health administration support and management of the program were all issues that needed to be addressed prior to program launch. After the program's inception, additional issues emerged. Ongoing staff education and training were necessary to ensure the program was used appropriately and correctly. The presence of a comprehensive Language Assistance Services program at SMCHS ensures equitable access to quality services for LEP San Mateo County residents.