Language Services FEBRUARY 2010 Resource Guide for pharmacists prepared by The National Health Law Program with American Association of Colleges of Pharmacy National Alliance of State Pharmacy Associations Language Services february 2010 Resource Guide for pharmacists prepared by The National Health Law Program with American Association of Colleges of Pharmacy National Alliance of State Pharmacy Associations Language Services Resource Guide The National Health Law Program Washington, DC • Los Angeles, CA • Chapel Hill, NC Copyright 2010 National Health Law Program 2 National Health Law Program authors The Resource Guide was primarily written by Mara Youdelman and Sarah Lichtman Spector from the National Health Law Program. Sections were also authored by the National Council on Interpreting in Health Care and William Felkey, Professor Emeritus of Healthcare Informatics, Pharmacy Care Systems, Auburn University. acknowledgements from the primary author Special thanks to the following: Rebecca Snead, National Alliance of State Pharmacy Associations Lucinda Maine, American Association of Colleges of Pharmacy National Council on Interpreting in Health Care William Felkey, professor emeritus of healthcare informatics, Harrison School of Pharmacy, Auburn University The Washington, D.C. office of Hogan & Hartson LLP Priti Patel and Emily Ambizas, St. John’s University School of Pharmacy (NY) Participants in the NHeLP/AACP/NASPA Advisory Committee on Pharmacies and Language Access: Wilma Alvarado-Little, National Council on Interpreting in Health Care; Ignatius Bau, The California Endowment; Anne Burns, American Pharmacists Association; William E. Fassett, Ph.D., Washington State University - Spokane; William Felkey, Auburn University; Francesca Gany, M.D., M.S., Center for Immigrant Health at NYU School of Medicine; Leslie C. Higgins, RPh, Walgreen Co.; Michael Kim, Pharm. D., Grubb’s CARE Pharmacy; Carole L. Kimberlin, Ph.D., University of Florida College of Pharmacy; Paul Moore, RPh, Rural Health Association; Priti N. Patel, PharmD, BCPS, St. John’s University College of Pharmacy; Kate Putz, Iowa Pharmacy Association; Leslie Elizabeth Scott Russell, Virginia Board of Pharmacy; Rod Shafer; Dimitra V. Travlos, PharmD, BCPS, Accreditation Council for Pharmaceutical Education. Support This publication was made possible with the generous support of The California Endowment. Language Services resource Guide for Pharmacists 3 Table of Contents Introduction ......................................................................................................................... 6 Contents of this Guide Chapter 1. Background ....................................................................................................... 9 Background: The Research on Language Services By the Numbers: The Growing Need for Language Services Why Using Friends and Family Members is Not Advisable Chapter 2. Assessment of Needs and Developing a Language Services Plan ............... 19 Description of Language Services Assessment and Evaluation Tools Developing a Language Services Plan Suggested Plan for Implementing Language Services Other Resources Chapter 3. Language Services resource Locator .............................................................. 31 Overview: Locating Sources of Interpreting and Translation Services What’s in a Word? An Overview to Understanding Interpreting and Translation in Health Care Chart: State Interpreter and Translator Associations Chart: Language Service Providers Training for Interpreters Chapter 4. Multilingual Tools and resources .................................................................. 65 Overview “I Speak Cards” Multilingual Health Resources and Translated Health Promotion Materials Bilingual Dictionaries and Glossaries, Online, In Print, and Other Formats Chapter 5. Promising Practices and Technology .............................................................. 77 Overview Promising Practices for Providing Language Services in Pharmacies Using Technology to Address LEP Patient Needs 4 National Health Law Program Chapter 6. Health Care Symbols ....................................................................................... 93 Overview Pictograms from USP Symbols for Use in Health Care Frequently Asked Questions on Symbols Chapter 7. Brief Guide to u.S. Department of Health & Human Services Office for Civilr ights resources ................................................................. 109 Selected OCR Publications and Resources Chapter 8. Glossary of Interpreting and Translation Terms ........................................... 115 Chapter Endnotes .................................................................................................................. 131 Appendix A. Statement of Principles ...................................................................................... 137 Appendix B. Federal Laws and Policies to Ensure Access to Health Care Services for People with Limited English Proficiency ........................................... 145 Appendix C. Language Services in Pharmacies: What is Required? .......................................... 153 Appendix D. Analysis of State Pharmacy Laws: Impact of Pharmacy Laws on the Provision of Language Services ............................................................... 165 Appendix E. Language Assessment Tool A: National Council on Interpreting in Health Care, Linguistically Appropriate Access and Services: An Evaluation and Review for Health Care Organizations ................................... 243 Appendix F. Language Assessment Tool B: Department of Justice Interagency Working Group on LEP, Language Assistance Self-Assessment and Planning Tool for Recipients of Federal Financial Assistance ........................ 255 Appendix G. How Can States Get Federal Funds to Help Pay for Language Services for Medicaid and SCHIP Enrollees? ....................................................... 267 Appendix H. Medicaid and SCHIP Reimbursement Models for Language Services .................. 277 Language Services resource Guide for Pharmacists 5 Introduction In 2003, the National Health Law Program convened national organizations interested in working together on language access issues. This coalition is a collaborative effort to envision and foster a health care delivery system that would better respond to the increasing diversity of our nation. The coalition joins health care providers, advocates, language services agencies, accrediting organizations, and other interested stakeholders to identify areas of consensus to improve language access for limited English proficient individuals. The coalition developed a Statement of In 2007, NHeLP began working with the Principles (see Appendix A) to guide its American Association of Colleges of Pharmacy work. The very first Principle embodies the and the National Alliance of State Pharmacy commitment of the coalition – a recognition Associations to identify needed resources that the ultimate goal in the health care to assist pharmacists in identifying and setting is effective communication between providing language services. The Language provider and patient. It states: “Effective Services Resource Guide for Pharmacists is communication between health care based on the earlier guide with additions providers and patients is essential to and updates related to providing language facilitating access to care, reducing health service in pharmacy settings. This guide, disparities and medical errors, and assuring developed with input from AACP, NASPA a patient’s ability to adhere to treatment and an Advisory Committee convened in plans.” Other principles address issues of March, 2009, gathers basic information funding for language services, technical about providing language services in one assistance, workforce diversity, data document. Information includes interpreter collection, and quality improvement. and translator associations and agencies, training programs, assessment tools, and In 2003, NHeLP, in collaboration with other materials. A searchable version is the National Council on Interpreting in available online at www.healthlaw.org. Health Care, released the Language Services Resource Guide for Health Care We hope that this guide will aid Providers. This Guide offered an overview pharmacists and pharmacies in improving of materials related to providing effective language access and improving health language services in health care settings. care for their clients and patients. 6 National Health Law Program Contents of this Guide Chapter 1. Assessment of Needs and pharmacists to identify available language Development of a Language Services Plan services. A directory of language service This chapter provides an overview of the providers follows. This directory is far from issues around language access. First, it comprehensive. Attempts were made to provides information on the demographics of find language services in every state. To the United States and the changing face of the our knowledge, only programs that provide limited English proficient population. It also services to the public are listed, rather than explains concerns with relying on untrained those limited to in-house service. Many interpreters such as family members, friends, unique and innovative in-house language and children in health care encounters. access services also exist within various pharmacy chains, hospitals and social services Chapter 2. Assessment of Needs and settings, but since their services are not Developing