Nuts and Bolts ofLanguage Access Planning

Rodrigo MonterreyCLAS ManagerMassachusetts DPH-OHE

Sponsored bythe Nebraska Association of Local Health Directors and Health Literacy Nebraska

through the Federal OMH State Partnership GrantJanuary 13, 2015

Agenda:

1. History of Language Access2. Language Access as part of “CLAS”3. Steps: How to develop and implement

your own Language Access Plan

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Key Terms:

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• Translation: written• Interpretation: spoken or American Sign

Language, usually simultaneous• Bilingual Staff: proficient in additional

language, understands content and protocols• Translator/Interpreter: trained or certified,

contracted or volunteer• Vital Documents: critical records, consent

forms, eligibility documents, notifications that require a response or action from a client

History :

Federal:Executive Order #1366 (2000)– "Improving Access to Services for Persons with

Limited English Proficiency" – Federal agencies (and those receiving federal

funding) to ID services and implement system– Use of a specific approach to determining

when/how to provide Language Access– Unfunded mandate

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History (cont):

State and Local Agencies (MA):• Chapter 151B of the General Laws, Executive

Order 478, Administrative Bulletin #16 (2010)– Follows similar suit to the implementation of the

national LA standards– Review of resources, populations, and agency-

specific language access plans

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History (cont):

Emergency Room Interpreters Law (ERIL 2000)

1. Before implementation (“land before time”):– Use of friends, family members– Use of available bilingual persons/staff

2. Post implementation (present):– Competency a key element of interpreters– Hospital-Based Interpreter Services Best Practice Guidance– Training and Interpreter Credentialing– Language access planning

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LAP in CLAS:

• What is “CLAS”?• How does Language Access

Planning fit into CLAS?

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CLAS:

• Culturally and Linguistically Appropriate Services

• 15 standards for service delivery• A framework for continuous quality

improvement

• Goal? To reduce health disparities• How? By creating culturally-competent

systems of care8

The Standards:

Over-arching principle: #1

Governance, Leadership, Workforce: #2-4

Communication and Language Assistance: #5-8

Engagement, Continuous Improvement and Accountability: #9-15

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The Steps:How to Develop and Implement Your

Own Language Access Plan

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Framework:

Plan-Do-Study-Act:Rapid-cycleprocess improvement

(SMART Objectives)

Plan:

• Who: include staff from various levels and clients/community-members/stakeholders

• Why: review your mission/goals/needs. How will language access fit/benefit what you do?

• What: determine where language access is most needed. What are you hoping to address/improve?

• When: give yourself an end-date

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Goal:

1. Organization Priority2. LA Working Group3. Assessment4. Policy, Plan & Procedures5. Interpreters & Translators6. Document Translation7. Training8. Evaluate

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“Ensure that LEP clients receive services in their preferred language”

1. Organization Priority• In order to serve LEP clients• Unfunded mandate:

– Operating cost – like the light bill– Line item for language services in budget

• Include in all grant proposals and apply for grants specifically for language access work– Use data to show why it matters

• Hire qualified bilingual staff14

2. Working Group• Executive Director support• Participation from all levels of organization

– Management/administrators– Front line (clinical and non-clinical) staff– Clients/advocates/stakeholders

• Work plan, with SMART objectives, regular meetings and action steps (accountability)

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3. Assessment• What are we already doing well? • What resources do we already have?• Where are the gaps in service?• Who can we partner with? • Then go after “low-hanging fruit”

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4. Policy, Plan & Procedures

Language Access Plan and Protocol Working document (never done) Working Group reviews/updates

annually Staff routinely trained on it Clients made aware of it

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5. Interpreters & Translators List of interpreters and translators

Easily accessible by all staff Updated annually Volunteer and employee “bank” for needed languages List qualifications & skills (translation vs. interpretation)

Quality Control (including certification boards) Application/Initial Screening Meeting/Interview with Referral Coordinator Interpreter Protocol & Code of Ethics (2006)

Negotiated lower rate for phone interpreter and video remote interpreter services

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6. Document Translation• Write in Plain Language! (Health Literacy)• Translated Document Bank

Easily accessible to staff Informational materials for clients, staff, family Signs, notices, forms, vital information

• Always have multiple people review• Then pay for proofreading – less expensive

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7. Training• Build in-house training capacity (FREE)• Online training resources (FREE)• Partner with agencies, courts or orgs (FREE)• LEP Training for all New Hires in Orientation• Annual Staff Training

– Working with an Interpreter, Language Access Plan & Protocol and Language Access Issues

• Interpreter Skills-Building Training – Bilingual Staff and Privately Contracted Interpreters

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8. Evaluation• Based on intended outcomes established in

the workplan – concrete “measures”• “Benchmark” – set a baseline against which

to measure progress (e.g. % increase)• Set up recurrence – periodic cycle for short,

mid and long-term goals (monthly, quarterly, annual)

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Elements of an LAP (template)1. Purpose of the LAP2. Mission/Vision3. Populations Served/Populations within

your catchment4. Service Provisions of the LAP5. Implementation6. Complaint Procedure7. Signatures: CEO, Dirs. (accountability)

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Resources:

• Agency/Program:http://www.mass.gov/eohhs/docs/dph/health-equity/clas-chapter6.pdf

• State/County (example): www.montgomerycountymd.gov/LEP/

• Federal:http://www.lep.gov/

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Resources (cont):

• How to work with an interpreter (video): http://www.health.medicbd.com/library/video?vq=working+with+interpreter&s=relevance&submit=Search

• Telephonic Interpreters:www.languageline.comwww.ctslanguagelink.comwww.pacificinterpreters.comwww.callopi.com

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Resources (cont):

Checklist:

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Questions?

Rodrigo Monterrey CLAS CoordinatorDPH-Office of Health Equity250 Washington St. Boston, MA 02108rodrigo.monterrey@state.ma.us617-994-9806 (office)617-938-4024 (cell-phone)

Thank you!

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