Transcript Spoken Language Interpreter Services

Bridging the Language Gap:
Creating a Sustainable Workforce
Workshop Presenters

Mary J Pohl
Health Policy Consultant
Minnesota Department of Human Services
• Sidney E. Van Dyke
Director, Interpreter Services
Health Partners/Regions Hospital
• Veronica Newington
Associate Director of Programs in Interpreting/Translation
University of Minnesota
Veronica
Newington
Sydney
Van Dyke
Mary
Pohl
Workshop Learning Objectives

Describe a public policy resulting in Medicaid
reimbursement for interpreter services

Identify the functional provision of interpreter services
within an integrated healthcare network

Describe the work of the Minnesota Interpreting
Stakeholder Group, a collaborative

Identify ways to improve interpreter training and
services
Spoken Language
Interpreter Services
Minnesota’s Journey
Demographics
0
Southeast Asia
Sub-Saharan Africa
Eastern Europe
FSU
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
Number of arrivals
8000
7000
6000
5000
4000
3000
2000
1000
Other
Minnesota Health Care Programs

Medical Assistance
(MA – Minnesota’s Medicaid program)

General Assistance Medical Care
(GAMC – low-income adults with no dependents)

Minnesota Care
(publicly subsidized coverage assistance)
Minnesota Law

Yang v. O’Keefe:
Language Access Settlement Agreement
11 December 2000 Judge James Rosenbaum federal
district court of Minnesota approved a settlement
agreement between welfare applicants and recipients
who do not speak English and organizations serving
immigrant communities in Minnesota and MnDHS for
practices violating Title VI of the Civil Rights Act of
1964
Minnesota Law

Summary Terms: Yang v. O’Keefe
1.
MnDHS and counties required to provide
applicants with free translation assistance
State health and welfare forms will be made
available in seven languages (Spanish, Somalli,
Russian, Hmong, Laotian, Vietnamese &
Cambodian)
MnDHS Help Desk lines for Minnesota Care will be
available in these seven languages
2.
3.
Minnesota Law

Summary Terms: Yang v. O’Keefe cont.
4.
MnDHS forms will be translated additional
alnguages when new eligible populations reach
750 in Minnesota
MnDHS and counties will mail forms to welfare
recipients in their preferred language
MnDHS will modify its statewide data collection
system to include a mandatory language field to
track the languages spoken by welfare and MA
recipients
5.
6.
Minnesota Law

Summary Terms: Yang v. O’Keefe cont.
7.
Minnesota counties must develop language access
plans under guidance from MnDHS
Court to retain supervisory jurisdiction for 18
months
8.
Minnesota Law

256B.0625 COVERED SERVICES
Subd. 18a. Access to medical
services
(d) Regardless of the number of employees that
an enrolled health care provider may have,
medical assistance covers sign and oral language
interpreter services when provided by an
enrolled health care provider during the course of providing
a direct, person-to-person covered
health care service to an enrolled recipient with limited
English proficiency or who has a hearing
loss and uses interpreting services
MA Fee-for-service Policy





Providers are responsible for arranging and paying
the interpreter
Three people must be present for the service to be
covered
Provider’s office staff members competent in spoken
language interpretation may interpret the medical
service
Providers are encouraged not to use family members
and are not reimbursed
Coverage of service provided to the parent/guardian
when the patient is a minor
MA Fee-for-service Policy





Providers are encouraged to use the same principles
when hiring, contracting or arranging for interpreting
services
Bill only for direct face-to-face/video/phone service
time
Use HCPCS code T1013 (1 unit= 15 minutes)
MHCP payment rate is the lower of $12.50, or the
usual and customary charge, for each 15-minute unit
Bill DHS directly for dual eligible recipients
MHCP Language Determination
CY 2006 Fee-For-Service and Managed Care
Enrollees of MA, GAMC and MinnesotaCare by Language
Language Code
Description
# Enrollees
01
Spanish
27,068
02
Hmong
21,129
03
Vietnamese
3,249
04
Khmer
1,111
05
Laosian
1,372
06
Russian
4,749
07
Somalian
20,385
08
ASL
370
09
Amharic
1,015
10
Arabic
1,371
11
Serbo-Croation
446
12
Oromo
2,115
13
Tigrinya
171
14
Burmese
120
15
Cantonese
221
16
French
482
17
Mandarin
140
18
Swahili
71
19
Yoruba
32
20
Korean
170
97
Unknown
51,921
99
English
726,606
864,314
MHCPs do not require a person to identify their language for eligibility purposes.
It is voluntary information.
FFS Interpreter Services
Interpreter Services
700,000.00
600,000.00
500,000.00
Reimbursement
Physician
Dentist
400,000.00
Psychiatrist
Public Health Clinic
Public Health Nurse
300,000.00
Home Health Agency
Outpatient/Rehab Hospital
200,000.00
100,000.00
CY 2002
CY 2003
CY 2004
CY 2005
CY 2006
CY 2007
Interpreter Service Study
Target Population:
97,194 MinnesotaCare Enrollees
FFS and Managed Care
23 of 36 possible months of enrollment
1/1/04 – 12/31/06
Interpreter Service Study: Design
• Eliminated enrollees with ASL or no language code
and without Hispanic ethnicity
• Remainder represents enrollees potentially needing
interpreter services based on the eligibility
information indicating a language other than English
• Identified enrollees within the remainder group having
a claim with an office visit code
Study population: n=5331
Interpreter Service Study
Eligible study population = 5331
• 73.4% had no claim for interpreter services
• 26.6% had a claim for interpreter services
Interpreter Service Study
Eligible study population = 5331
• 29% of study eligible adults had a claim for
interpreter services
• 24% of study eligible children had a claim for
interpreter services
Interpreter Service Study
Eligible study population = 5331
Language code and interpreter service claim
• > 50% Russian, Somali, Oromo, Cantonese and
•
Korean
~ 50% Spanish, Hmong, Vietnamese, Amharic and
Mandarin
• < 50% Khmer, Laotian, Arabic, Serbo-Croatian,
Tigrinya and French
Interpreter Service Study
Metro area counties claimed interpreter services with
greater frequency than rural counties
•
•
Hennepin (Mpls) 49.6% of study population had
claims for interpreter services
Lyon, Clay, and Olmstead < 10% of study population
had claims for interpreter services
Interpreter Service Study
Outstanding rural counties
•
Kanabec (Mora) 44% of study population had claims
for interpreter services
•
Steele (Owatonna) 59% of study population < 18yrs
had claims for interpreter services
Interpreter Service Study
Study population recipients with claims for interpreter
services had an increased frequency of:
Office visits
Emergency room visits
Inpatient hospital stays
Prescriptions claimed
•
•
•
•
When compared to study population recipients with no
claims for interpreter services
Interpreter Service Study:
Results
Using multivariate logistic regression analysis:
• Females were 1.402 more likely to have interpreter
claims than males (95% CI [1.236 – 1.590])
• Adults were 0.621 less likely to have interpreter
claims than females (95% CI [0.496 – 0.777])
• Children 1-5 yrs were 3.847 more likely to have
interpreter claims than older children (95% CI [2.802
– 5.283])
Interpreter Service Study: Limits

Reflects only claimed services

Does not account for language concordant providers

Received services are not associated with any
standard quality metric
Interpreter Service Legislation
2008
Requires the Minnesota Department of Health (MDH)
•
Create a statewide roster of spoken language health
care interpreters by January 2009
•
Develop a plan for a spoken language registry of
health care interpreters by January 2010
•
Work towards National Certification
Presenter contact information
Mary J. Pohl
Health Services & Medical Management Division
Minnesota Department of Human Services
P.O. Box 64984
St. Paul MN 55169-0984
mary.pohl @state.mn.us
651 431 3431
Language data
Language data from Minnesota
Department of Education
http://children.state.mn.us/MDE/Data/Data_Downloads/Stud
ent/Languages/index.html.
Data counts home primary
language for
K-12 students enrolled on
October 1, 2006 in each district.