AARP Public Policy Institute Innovation Roundtable Explores Language Access in Managed Long-Term Services and Supports
June 27, 2014 09:28 AM
On Wednesday, June 25, 2014, NAHC Executive VP Elaine Stephens attended the AARP Public Policy Institute Innovation Roundtable on Language Access in Managed Long-Term Service and Supports. The roundtable brought together representatives from health plans, front-line service providers, policy researchers, and federal and state policymakers. Their shared agenda was to explore how to increase access to care among Medicare beneficiaries with limited proficiency in English, a pressing issue as our nation becomes more diverse. The Centers for Medicare and Medicaid Services, insurance plans, and providers are increasingly concerned about barriers that prevent Medicare beneficiaries from communicating effectively with their providers at all levels.
Poor communication between patients and providers puts patients at risk for medical errors and receipt of substandard care, so providers must take steps in response to America’s demographic change. The number of minority Medicare beneficiaries has increased and is expected to continue growing. According to the American Community Survey of 2006, 13.9 percent of Americans age 65 and older spoke a language other than English, and a sizable share had limited English proficiency. The U.S. Census Bureau projects that from 2005 to 2030 the proportion of the population that is Hispanic will increase from 14 to 20 percent and the Asian proportion will increase from 4.3 to 6.2 percent.
Currently, CMS addresses the needs of this growing sector through Quality Assessment and Performance Improvement projects and through demonstration projects that gauge the effect of new methods and potential program changes. Yet that is not enough, so the roundtable charged attendees to think creatively about the issue and share perspectives on promising practices, useful research, and needed education. There was also discussion of how to recruit multilingual staff and compliance with language access requirements across the continuum of care.
In addition, the session reviewed current definitions of law and regulations on requirements for language access. There are national standards for providing culturally and linguistically appropriate services (CLAS), designed to eliminate racial and ethnic health disparities and ultimately improve the health of all Americans. At the current time, however, CLAS includes regulatory requirements for hospitals, but no other providers. This is expected to change, so participants discussed current and future ways they are preparing to meet the standards in community settings.
As the front line in community care, home care and hospice must work actively to meet the language needs of their increasingly diverse clientele. Home care and hospice agencies should recruit bilingual staff, build cultural awareness among all their staff, and set up mechanisms for medical translation. Agencies also need to be familiar with CLAS standards and how to make them part of service delivery and business development going ahead. By doing so, agencies will not only have a competitive edge that speaks to consumers, they will also promote a caring culture. “Providing access to care that is culturally and linguistically appropriate is the right business approach as our country changes,” Stephens said. “It is also the right thing to do, and it should improve outcomes for patients and their families.”