Language Assistance (LA)

Language Assistance (LA)
Presented by Education & Consultant Department
Objectives
 At the conclusion of this training, the staff member will be
able to:
– Know the difference between interpretation & translation
– Document and complete the Language Assistance (LA)
Questionnaire at every patient encounter.
– Locate and apply the Interpretation & Translation
policies and procedures for every patient encounter.
2
October 30, 2014
Definitions
 Interpretation is the act of listening to something in one
language and orally saying it in another language.
 Translation is the act of converting written text from one
language to another language (Qualified Bilingual Staff not
allowed to translate).
 Sight Translation is the act of reading out loud from a
document written in one language into another (Qualified
Bilingual Staff can perform sight translation).
3
October 30, 2014
What is law for Language Assistance?
 Department of Managed Health Care Language Assistance
Regulations (formerly know as SB853) effective January 1, 2009.
The Law - SB853
LA 001
Policies and Procedures
1.1: Policies and Procedures in Place
Policies and procedures are in place
that address, at a minimum, the
following four elements: Standards for
enrollee assessment, Standards for
providing language assistance
services, Standards for staff training
and Standards for compliance
monitoring

LA 002
LA 003
Enrollee Assessment
Language Assistance Services
2.1: Language needs assessed and
documented
Enrollee linguistics needs are
assessed; language preference is
captured and tracked at point of
contact.
3.1: Point of Care – Patient Informed

Enrollees are informed of the
availability of free language assistance
services.

2.2: Translation Services Provided
3.2: Point of Care – Qualified
Interpretation and Translation secured
Standard vital documents are
identified and translated into
threshold languages.
Processes and standards are in place
to provide translation and

interpretation services.

3.3: Point of Care – Qualified
Interpretation and Translation services
provided and documented
 = Elements that apply
Processes and standards are in place
for ensuring the quality, accuracy, and
timeliness of translation and
interpretation services.

What are the Language Assistance
Policies?
 KP Policies
– Qualified Interpreter Services for Limited English Proficient
Persons CA.HP.Operations.LA.005002
– Quality Translation Process for Member Informing Materials
CA.HP.Operations.LA.005001
 Where to locate the policies:
– SD Intranet (http://sandiego.ca.kp.org/Home/KPHomepage)  Policies  Administrative Policies
ADA Highlights on Auxiliary Aids
Pocket Talker helps
hard of
hearing/amplifies voice
 Ubi Duo for
Deaf or Hard
of Hearing
7 October 30, 2014
 Pharmacy
Talking Bottles
for Visually
Impaired
 Signs
Auxiliary Aid Pocket Talker
 Pocket Talker – an assistive
listening device that amplifies
sound and enhances the
member’s ability to listen to
health information.
– Auxiliary Aids Utilization
Log (Ask manager about
the log) should be
documented in whenever
we use auxiliary aids.
 Contact Nurse Manager
for pocket talkers
8
October 30, 2014
Auxilliary Aids Documentation
Pocket Talker
Translation
Facts
 Translation is the conversion
of written text of one language
into another language.
 If member requests
documents to be translated,
we must provide them within
21 days.
 Departments to keep a log of
requests.
 QBS employees are not
allowed to translate
documents.
 QBS can only do sight
translations (read in English
but say verbally in Spanish).
 CRITICAL Inform your
manager that a request was
made.
10 October 30, 2014
Information Needed
to order
Translation
When requesting translation
services, provide to the
vendor:
 18 digit cost code (of the
dept who needs form)
 FDA Approver’s NUID
 Requester’s Name
 Language Needed
Approved Translation
Vendors
GLOBAL LANGUAGE
SOLUTIONS
Michael Dwyer
Phone: 949-798-1400 x238
Email:
[email protected]
Silvie Peric
Phone: 949-798-1400x 243
Email:
[email protected]
AVANTPAGE
Elias Lemoine
Phone: 530-750-2040 x5
Email: [email protected]
Luis Miguel
Phone: 530-750-2040 x1
Email: [email protected]
Translations-Proper Documentation &
21 Day Timeline
Interpretation Service Questionnaire
12
October 30, 2014
What is the Qualified Bilingual Staff (QBS)
Program?
 Spanish-speaking Kaiser Permanente staff
who are qualified to provide language
assistance services
– Level 1 (conversational skills)
– Level 2 (medical terminology)
 QBS are acknowledged for their valuable
service
13
October 30, 2014
Non-QBS staff who speak a member’s
language….
 May assist in providing directions
 May engage in social small talk with the
members
 Must transition to QBS interpreter if
conversation goes into level 1 or 2 scope
– If no QBS interpreter available, use Language
Line
14
October 30, 2014
Language Assistance Rules
 Must provide interpretation services free of charge 24
hours/7 days a week.
 Use of a minor is NOT permitted for interpreting.
 Should NOT use family/friend for interpreting unless
member refuses KP’s services; refusal should be
documented in questionnaire with name of interpreter
and relationship to member.
 Use “Point-to-Card” (ask manager for this resource) to
identify which language the member speaks, then call
Language Line for further assistance.
15
October 30, 2014
Can Physicians ask for a QBS or a Vendor?
 Yes, if the physician is uncomfortable with family member or
friend being the interpreter, he or she may request a QBS or
Vendor.
Why complete the Interpreter Service
Questionnaire?
Q2 2012 Medical Center Summary – Interpreter Service Questionnaire KPHC Documentation for Patients with the "Y" Flag
("Y" Flag indicates "yes, I need language assistance / interpreter services")
1) Gap 2) It is the law 3) It is right thing to do
KP Southern California
TOTALS
SAN DIEGO
KPHC Documentation
#
Total Encounters with
"Y" Flag
%
41,845
#
Gap
%
416,164
Language Assistance
Documented
14,461
34.6%
143,164
34.4%
No Services
Documented
27,384
65.4%
273,000
65.6%
17 October 30, 2014
Interpreter Questionnaire has 4 questions
ALL MEMBERS should be
asked:
1.“What is your primary spoken
language?”
2.“What is your primary written
language?”
•If answer to 1 is a language
other than English, then #3
must be “YES”. Please do not
put a “No”on #3. This
disables & prohibits access
to the questionnaire for
future encounters. Q#4, can
be “Yes or No” answer.
18
October 30, 2014
Required Workflow: Language
Assistance
Any time there is contact with the patient who requires language assistance
the Interpreter Needed fields are to be completed in HealthConnect
•
Booking an appointment
•
Check-in Patient
•
Telephone Encounter
•
Rooming Patient
Required Workflow: Language
Assistance Booking an Appointment
Required Workflow: Language
Assistance Booking an Appointment
Required Workflow: Language
Assistance Check In - Appointment
Required Workflow: Language
Assistance Documentation within an
Encounter
Staff to document starting at # 4
Required Workflow: Language
Assistance Interpreter “Questionnaire”
– use to assess needs
If the Patient answers Yes to needing an Interpreter for
the encounter
Required Workflow: Language Assistance
Interpreter “Questionnaire” – use to assess
needs
If the Patient answers “No” to needing an Interpreter for
the encounter
Important TIPS for Documentation
Please follow guidelines for Questions 4 A (Yes) and 4 B (No):
 If 4a is “yes” and QBS staff assisted, please document the name
of the QBS and their NUID.
 If 4a is “yes” and vendor assisted (ie. Language Line), please
document the name of the interpreter and interpreter ID number.
 If 4b is “no” and family member was used, please document
name of the family member and relation to the patient.
How is LA going to be monitored and
reported?
 Use specific reports that measure compliance on
department and individual level based on LA requirements
(DA/ADA).
 Internal Audits to monitor performance (Education &
Consulting will assess performance and work with
DA/ADA’s as needed for improvement).
Workflow Efficiency Reports:
Interpreter Needed (Data as of 1/2013)
Specialty
Addiction Medicine
Interpreter
numerator denominator Questionnaire
Specialty
0
32
17
37
9
13
Audiology
34
45
76% Pediatric Endocrinology
Cardiology
35
57
61% Pediatric Gastroenterology
Allergy, Asthma and Immunology
Anesthesiology
Continuing Care
0
2
Dermatology
76
113
Endocrinology, Diabetes/Metabolism
41
Gastroenterology
32
Genetics
0% Otolaryngology
88
110
80%
46% Pain Management
0
2
0%
69% Pediatric Cardiology
0
3
0%
11
18
61%
2
2
100%
0
18
0%
67% Pediatric Infectious Disease
0% Pediatric Hematology/Oncology
1
1
100%
48
85% Pediatric Learning and Development
8
11
73%
56
57% Pediatric Pulmonology
0
1
0%
2
4
83
109
7
7
89
165
Laboratory
0
1
0% Population Care Management
Mohs Surgery Services
0
0
0% Psychiatry
Nephrology
39
44
89% Pulmonary Diseases
Neurology
18
29
62% Radiology
Neurosurgery
4
7
Nuclear Medicine
0
0
Nutritional Services
9
12
Occupational Medicine
8
Hematology/Oncology
Infectious Diseases
Intermediate Care
Occupational Therapy
Interpreter
numerator denominator Questionnaire
50% Physical Medicine
13
27
48%
76% Physical Therapy
108
271
40%
0
15
0%
41
64
64%
39
41
95%
0
269
0%
19
38
50%
0
1
0%
100% Plastic Surgery
54% Podiatry
57% Respiratory Therapy
9
12
75%
47
54
87%
75% Sleep Clinic
5
7
71%
83
10% Social Services
0
4
0%
0% Rheumatology
5
37
14% Speech Therapy
11
14
79%
Ophthalmology
74
333
22% Surgery, General
11
169
7%
Optometry
23
349
7
10
70%
106
241
34
76
45%
4
10
Orthopaedics, Medicine
Orthopaedics, Surgery of the Spine
7% Surgery, Maxillofacial
44% Urology
40%
Ambulatory Report (As of August 2013)
Target is 100%, we are at 62%
Encounter Month/Year
% Completed
Target
NOV2012
51%
100%
DEC2012
51%
100%
JAN2013
51%
100%
FEB2013
53%
100%
MAR2013
55%
100%
APR2013
58%
100%
MAY2013
59%
100%
JUN2013
59%
100%
JUL2013
61%
100%
AUG2013
62%
100%
San Diego Interpreter % Completed
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
00%
51%
51%
51%
53%
55%
58%
59%
59%
Target:
61%
62%
NOV2012 DEC2012 JAN2013 FEB2013 MAR2013 APR2013 MAY2013 JUN2013 JUL2013 AUG2013
Sample Reports
By Specialty & Location (not real data)
2013
Apr
Specialty
Addiction
Medicine
# Of
Completes
# Interpreter
Required
%
Completed
Otay Mesa
0
1
0
Point Loma
1
64
2
Vista
0
2
0
Location
.
Sample Reports
By Specialty, Location, Person (not real
data)
Specialty
Location
Document
By
2013
May
# Of Completes
Addiction
Medicine
Otay
# Interpreter
Required
% Completed
Jane Doe
0
1
0
Total
1
64
4
Verification of Service Form
How to Use Verification of Service
Form? (Complete Part 3 Only)
– Arrival Time for Vendor
– Start & End Time
– Sign and Date
– Keep Copy for Department
– Vendor faxes (not kp staff) form to KP onelink
2013 Q1-Q4 Action Steps and Timeline
March: Preliminary training for departments
April: Training provided to DA/ADAs & Super Users
May: Departmental Training
a. DA/ADAs & Super Users provide education & coaching
within department
b. Educational classes scheduled at all MOB’s for staff
training
June-November: Internal Audits to monitor performance.
(Education & Consulting Services will conduct departmental
audits to assess performance and work with DA/ADA as
needed for improvement)
34 October 30, 2014
Summary
1. Know the difference between Interpretation &
Translation
2. Know which policies we follow for LA and how to find
these
3. Assess LA needs & properly document in KP Health
Connect
4. Implement process in departments to complete &
maintain Auxilliary Devices, Translation Logs, and
Verification of Service Form
5. Educate others in your departments on LA issues
Questions or Concerns?
 Contact Education & Consulting Staff:
– Marlene Ruiz - (619) 641-4138
–
–
–
–
–
–
36
October 30, 2014
Connie Zaragoza - (619) 641-2405
Gail Sentesy - (619) 641-4204
Brenda Matthews - (619) 641-4821
Gabriella Peñaloza - (619) 641-4131
Ruth Ann Obregon - (619) 641-4137
Lucinda Millar – (619) 641-4133

Download Report