Fourth National Conference on
Quality Health Care for Culturally Diverse Populations:
Integrating Community Needs into the National Health Agenda

September 28-October 1, 2004, Washington, DC
Hilton Washington, Washington DC

Workshop D-1: Advocating for policy changes at the state and local level

Advancing Cultural and Linguistic Services through Public Policy

In 2003, the California Pan-Ethnic Health Network (CPEHN) successfully co-sponsored a bill on the provision of cultural and linguistic services by health plans. SB 853 (Escutia) requires the Department of Managed Health Care (DMHC), the state agency that regulates health plans in California, to develop regulations for health plans to provide cultural and linguistic services to their enrollees. The regulations must be established by 2006 and include:

• Needs assessment of health plan enrollees,
• Provision of qualified health interpreters for enrollees who are limited English proficient,
• Translation of vital documents, and
• Reporting of health plans’ cultural competency activities.

The public programs in California, Medi-Cal managed care and Healthy Families, currently have extensive cultural and linguistic requirements, but the same health plans are not required to provide these services to their commercial population. This results in managed care members receiving very disparate cultural and linguistic services, which has caused confusion and unequal treatment. While many health plans understand the importance of providing cultural and linguistic services and are offering such services voluntarily, in order to ensure that all health plan enrollees receive quality services, CPEHN used the legislative process to regulate the cultural and linguistic services provided by health plans.

In the workshop we will discuss using the legislative process to promote cultural and linguistic competency and the issues that arose in negotiating the details of the legislation with legislators, state agencies, and health plans.

Ellen Wu, MPH, is the Executive Director of the California Pan-Ethnic Health Network (CPEHN). She is a graduate of the School of Public Health at the University of California, Los Angeles and has worked with a culturally diverse low-income and uninsured population for the past 10 years. While at CPEHN she has hosted community convenings on critical health policy issues impacting communities of color such as multi-race categories, obesity, and the state budget. In the past year the organization played an important role in mobilizing the health community to defeat Proposition 54 and getting SB 853 chartered. Ellen serves on numerous advisory committees such as the Medi-Cal Managed Care Advisory Group, California Health Interview Survey Advisory Board, and the Healthy Families Quality Work Group. Previous to CPEHN, she was the Director of Health Education and Cultural/Linguistic Services at the Alameda Alliance for Health and served as the co-chair of the California Department of Health Services’ Cultural and Linguistic Services Standards Task Force.

Ellen Wu, MPH
Executive Director
California Pan-Ethnic Health Network
654 13th Street
Oakland CA 94612
(510) 832-1160
(510) 832-1175
ewu@cpehn.org
www.cpehn.org

Advocating for Policy Changes at the State Level: Maryland

Across the United States, a number of states have enacted language access laws to protect persons who are limited English proficient (LEP) or English language learners (ELL). Some laws have focused on a particular branch of service delivery, i.e., health care. Some laws offer guidance to providers on improving access of LEP or ELL clients to various health or social welfare services. Recently, Maryland enacted its own language access laws. In 2001 and 2002, the Maryland General Assembly passed into law Senate Bills 542 and 265. Taken together, the legislation shows that the General Assembly considers it the policy of the State of Maryland to provide equal access to public services provided by all State departments, agencies, vendors, contractors and programs in Maryland to persons who are LEP or ELL.

In this workshop we will describe our experience in developing and implementing a language program in Maryland. Maryland was one of the first States to survey and assess the current access of LEP and ELL clients in Maryland to State programs and services. The survey was conducted by the National Foreign Language Center at the University of Maryland College Park and issued in 2001. Based on the survey results, the General Assembly in 2002 enacted comprehensive language access legislation which requires Maryland agencies to take reasonable steps to provide equal access to public services for all individuals regardless of their ability to communicate in English. The legislation establishes a five year program for bringing Maryland’s various service providers into compliance with State and Federal law. Our goals for this workshop are to share Maryland’s experience with others and to help them strategize as to how they can develop and implement a language program for their State, municipality or county.

We will describe the challenges that face the State in providing large scale training programs, tailoring policy to the needs of each individual agency and its clientele, translation of vital documents, furnishing interpretation services at a state-wide level and monitoring the results.

Lessons learned include the importance of having trained and skilled interpreters; back-translating vital documents; and a systemic approach to training and coordination of language services in the State. Lessons learned also include how to make the most of limited financial resources, including sharing among agencies of information so as not to duplicate efforts, searching out the most economical means of delivering language services and translating documents, and finding economically reasonable means of assisting clients with multiple needs (i.e., LEP, illiteracy in primary language, hearing and sight impairments, intellectual limitations).

Shelly Eilene Mintz, J.D. - Ms. Mintz is a Senior Assistant Attorney General with the Office of the Attorney General of Maryland. She has been admitted to the practice of law in Maryland since 1977 and in the District of Columbia since 1980. She is also admitted to practice before the United States District Courts for the District of Maryland and for the District of Columbia, the United States Court of Appeals for the Fourth Circuit, the District of Columbia Court of Appeals and the United States Supreme Court. She has been with the Office of the Attorney General of Maryland since 1988 and assigned to represent the Maryland Department of Human Resources, the umbrella agency for the State’s social service agencies, since 1991. In her capacity as one of the attorneys assigned to the Maryland Department of Human Resources (MDHR), Ms. Mintz serves as legal counsel to the State Coordinator for Language Services, Robin Weambe. Together with Ms. Weambe, Ms. Mintz has drafted MDHR’s policy for serving clients who are limited English proficient or English language learners. She has worked with MDHR’s Office of Employment and Program Equity and the U.S. Department of Health and Human Services, Office for Civil Rights, Region III, to design and implement a training program for State employees working with clients who are limited English proficient.

Shelly Eilene Mintz, J.D.
Senior Assistant Attorney General
Office of the Attorney General of Maryland
410-767-7246
SMintz@dhr.state.md.us

Advocating for Policy Changes at the State and Local Level
The D.C. Language Access Act

The District of Columbia is fast becoming one of the most diverse destinations for immigrants in the United States. People from Asia, Africa, Europe and Latin America are making the District their home. Many of these immigrants are attempting to learn English but do not have the proficiency to understand government documents or speak to government employees about eligibility for benefits and participation in programs.

In this workshop, we will describe our experience working to pass a local law to ensure meaningful language access to government benefits and services in the District. We have worked on all phases of a campaign to pass a comprehensive language access law for the district. We began in the winter of 2002 by building a coalition of community-based organizations interested in working on this issue. We then began to document the problems that limited English proficient populations face, and air them at public hearings and to the media. We then worked to draft legislation, which was introduced in February 2003, and to advocate for its adoption. The law passed in April 2004, and we are now working to ensure that it is fully implemented.

We will describe some of the challenges we faced along the way in building our coalition, in trying to pass the law, and in working to implement it.

Lessons learned include the importance of having a very broad coalition that is both ethnically diverse and professionally diverse. Our coalition includes community organizers, researchers, lawyers, and people who have a lot of experience providing translation and interpretation services. Our coalition includes organizations that fully represent the District’s diversity, including the Asian community, the African immigrant community and the Latino community.

Isabel van Isschot started La Clinica del Pueblo (LCDP) language assistance department in 1996. Over 30 trained medical interpreters currently serve thousands of limited English clients of non-profit clinics in the District of Columbia. LCDP is dedicated to providing free, culturally competent health care services to underserved Latinos, and its five departments provide comprehensive medical, mental health and social services, health education, language assistance and advocacy to thousands of clients per year. Prior to working with La Clínica, Isabel taught Central American refugees living in Montreal French as a second language for three years, using innovative techniques for teaching a second language to individuals with low literacy levels.

Sonya Schwartz joined the Health Policy Department of Families USA in September 2003. Families USA is a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health care for all Americans. Sonya’s work focuses on advocating for improved access to health coverage for the uninsured and defending the private health insurance market from attacks that would weaken it. Prior to working at Families USA, Sonya was a National Association of Public Interest Law Fellow at the Food Research & Action Center (FRAC), where she coordinated a legislative campaign that restored food stamp benefits to legal immigrants who lost them under welfare reform and also sought to restore Medicaid. Sonya also organized community based organizations in the District around immigrant’s access to government benefits and services, an effort that led to the passage of the Language Access Act. Sonya attended Middlebury College in Vermont and graduated from the inaugural class of UCLA School of Law Public Interest Law and Policy Program in 2000.

Isabel Van Isschot
Director, Interpreter Services
La Clínica del Pueblo
2831 15th st NW
Washington DC 20010
202 464-0157 Phone
202 332-0085 Fax
iisschot@lcdp.org
www.lcdp.org

Sonya Schwartz, Esq.
Health Policy Analyst
Families USA
1334 G Street, NW
Washington, DC 20008
(202) 628-3030 Phone
(202) 347-2417 Fax
sschwartz@familiesusa.org
www.familiesusa.org

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