Multilingual Medicaid (Part 3)… not my fault

by Translation Guy on February 5, 2010
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Legislative lip service talks multilingual medical care, for Medicare beneficiaries. But the best intentions of regulators still leaves lots of LEP (Limited English Proficient) patients  in the lurch. According to The California Medicare Part D Language Access Coalition report “Please Hold”, subtitled “Medicare Plans Leave Limited English Proficient Beneficiaries Waiting for Access,” getting help when you don’t speak English is tough. They had a bunch of callers playing LEP Medicade recipients call and try to get some questions answered. Responses, detailed in earlier posts, are anecdotal, and sound very familiar to what we’ve seen.

These guys were pretty hard on the telephone interpreting services that most healthcare providers rely on to improve access for non-English speakers. But as is clear from the report and again my own experience, that LEP problems don’t magically disappear as soon as a telephone interpreter comes on the line.

Its useful to see how our customer’s customers use our service.  We usually don’t get to see it in context. We get feedback on only our contribution to our clients total service package.

Our client’s use telephone interpretation service because they have identified it as the best value around for  fulfilling the requirement to offer multilingual services.  But I think in some cases, purchasers of telephone interpretation services view TI as a cost and admin headache. They are providing multilingual access only as a matter of compliance or law. Years ago, we had to change our offering to eliminate paper users of our system. That is people who signed a contract with us to meet a mandate, with no intention of providing our service to those in need at their own institution.  More often, programs are created with honest intention, but the constant grind of controlling costs inhibits use of telephone interpreters. Multilingual call trees are omitted,  steering limited English speakers to English. Others, less fluent, are left to whither on the grapevine, left in hold limbo without a clue that a translator will soon be available in their language. Staff are not trained on how to work with telephone interpreters, or even how to contact them.

I’m not claiming some vast monoglot conspiracy (although that sounds like it might be a good hobby horse to flog for future blogs.) Multilingual is hard, and it takes more than mandates and regulations for entities to take responsibility for client communication, as obvious as it may sound.

Multilingual tasks and functionality are so easily omitted from job descriptions, and never come under management review. Vendor bills are the only way to measure activity. Customer satisfaction surveys are conducted only in English. Bad feedback in other languages doesn’t count.  It’s not unique to Medicare or medical organization, but is uniquely ‘monoglotish’… all customers are required to speak English.

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