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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

Language Assistance Program and Cultural Competency

Date: 07/20/18

The Health Care Language Assistance Regulations require all California managed care health plans to provide language assistance and culturally responsive services to members with limited English proficiency (LEP), limited reading skills, are deaf or have hearing impairments, or have diverse cultural and ethnic backgrounds. To comply with this requirement, California Health & Wellness Plan (CHWP) created the Language Assistance Program (LAP). CHWP’s LAP offers interpreter services to ensure that CHWP LEP members can obtain language assistance while accessing health care services. CHWP’s LAP is available to physicians and ancillary providers, including nurses and physician assistants, and independent practice associations (IPAs) to support CHWP members’ linguistic and cultural needs.

CHWP does not delegate its LAP obligations to IPAs, physicians or ancillary providers; however, IPAs, physicians and ancillary providers must comply with CHWP’s LAP.

LANGUAGE ASSISTANCE PROGRAM OVERVIEW

CHWP’s LAP includes the following:

  • Interpreter services for CHWP LEP members at all medical points of contact, available 24 hours a day, seven days a week at no cost. All interpreters meet the interpreter quality standards established by the U.S. Department of Health and Human Services 45 CFR 92 and CA Senate Bill 223.
  • Translation of vital documents or member-informing materials produced by an IPA on behalf of CHWP in the threshold languages.
  • Taglines to inform members that they can receive an interpreter in their preferred language and nondiscrimination notices must be included in all member mailings.
  • Standards to monitor the quality and effectiveness of the LAP.

Members have the right to file a grievance with CHWP and the ability to file a discrimination complaint with the Office of Civil Rights if their language needs are not met.

LAP COMPLIANCE REQUIREMENTS

All CHWP participating providers are required to follow CHWP’s LAP by using:

  • Interpreter services – Use qualified interpreters for LEP members. CHWP provides interpreter services at no cost. Telephone interpreters are available in more than 150 languages. Advance notice is not required for telephone interpreters.
  • Translation services – Translations and alternate formats of utilization and case management materials must be made available to members that have a preferred language or format listed on the CHWP eligibility file. All LEP members may request a translation or alternate format of utilization management (UM) or case management (CM) letters. If a CHWP member requests translation or an alternative format of an English document that was produced by a delegated IPA, the provider must refer the member to the CHWP Member Services telephone number on the member’s identification (ID) card. When Member Services receives the request, CHWP will request the document from the IPA. The IPA must submit the document within 48 business hours.
  • Tagline and nondiscrimination notice – Include a CHWP-specific tagline and nondiscrimination notice with member information sent to CHWP members. The CHWP-specific tagline and nondiscrimination notice are available on the CHWP website at cahealthwellness.com/non-discrimination-notice.html.
  • Member complaint/grievance forms – Provide translated member grievance forms to members upon request. Forms are available on the CHWP website at cahealthwellness.com under For Members > Member Resources > Complaints and Appeals.
  • Independent Medical Review (IMR) Application – Locate translated IMR applications on the Department of Managed Health Care (DMHC) website at www.dmhc.ca.gov and make them available to members upon request.
  • Medical record documentation – Document the member’s language preference (including English) and the refusal or use of interpreter services in the member’s medical record.

INTERPRETER SERVICES

To obtain interpreter services, contact Member Services at the telephone number on the member’s ID card or the toll-free numbers listed on the CHWP provider website.

Non-English interpreter services include:

  • Qualified interpreters trained on health care terminology and a wide range of interpreting protocols and ethics.
  • Telephone interpreters available in more than 150 languages on short notice.
  • Support to address common communication challenges across cultures.
  • Oral translations of member materials in more than 150 languages.
  • Sign language interpreter services are available. Please request a sign language interpreter as soon as the appointment is made, but not less than five business days before the appointment.

A non-English language identification poster is available to post in providers’ offices by contacting the Cultural and Linguistic (C&L) Services Department. Providers are not required to post this information; however, using this tool makes it easier to identify the specific language needs of the patient.

Providers are asked to make accommodations to use telephone interpreters as that may be the only service that is available for the appointment time or language. Allow adequate time before the appointment to get the telephone interpreter on the line.

Interpreter services contact information is on the CHWP provider website at cahealthwellness.com/Language-Assistance.html.

PROVIDER RESPONSIBILITIES

Participating providers may use CHWP’s interpreter services to provide interpreters to members who require or request them. Participating providers must ensure that language services meet the established requirements as follows:

  • Ensure that interpreters are available at no cost to members at the time of the appointment.
  • Ensure that LEP members are not subject to unreasonable delays in the delivery of services, including accessing providers after hours.
  • Extend the same program and activity participation opportunities to all members regardless of language preference.
  • Provide services to LEP members that are as effective as those provided to non-LEP members.
  • Record the member’s language needs, request or refusal of interpreter services, in the member’s medical record.
  • Provide translated member grievance forms to members upon request.
  • Provide translations or alternate formats to CHWP members in a timely manner.

Providers are prohibited from:

  • Requesting or requiring an individual with LEP to provide his or her own interpreter.
  • Relying on staff other than qualified bilingual/multilingual staff to communicate directly with LEP individuals.
  • Relying on a minor or accompanying adult to interpret or facilitate communication except:

-   In an emergency where there is no qualified interpreter for the LEP individual immediately available. The emergency must be noted in the member’s medical record. A parent cannot give permission for a minor child to interpret in any other circumstance.

-   When the LEP individual specifically requests that the accompanying adult interpret, that adult agrees to provide such assistance, and reliance on that adult is appropriate. Providers are encouraged to document in the member’s medical record the circumstances that resulted in the use of an accompanying adult as an interpreter.

PROVIDER RACE AND ETHNICITY

Providers should consider providing CHWP with physician race or ethnicity information. The information is voluntary. Providers can update their race or ethnicity information by sending an email to CHWP_Contracting@cahealthwellness.com.

Threshold Languages and Language Assistance

CHWP has established the languages that are used to provide print translations and alternate formats. The threshold languages for CHWP members are determined through analysis of member and Census data.

IPAs have access to members’ preferred spoken and written languages via the CHWP Eligibility Report. Individual and ancillary providers can obtain members’ language preferences by contacting their CHWP Provider Relations representative. UM or CM delegated provider groups may send any member information that requires translation into the member’s threshold language to CHWP for translation. Materials sent for translation must be in a Word or unlocked PDF format.  Scanned or faxed documents will not be accepted. Care plans must be sent with proof that the document is at 6th grade reading level or below. The IPA must send the member’s name, member ID, the document requested, and the member’s address to CHWP. Providers can call 1-877-658-0305 to request translation services. Providers must also use the same process to request an alternate format of any UM or CM materials in English or a threshold language.

CULTURAL COMPETENCY TRAINING

All CHWP participating providers are required to take cultural competency training. Completion of cultural competency training is reflected in CHWP’s provider directory. Cultural competency training may be met through various programs. CHWP recommends the Office of Minority Health (OMH) computer-based training (CBT) for health care providers, A Physician’s Practical Guide to Culturally Competent Care. The no-cost educational training was developed to furnish providers with competencies to better treat an increasingly diverse population and is available on the OMH Think Cultural Health website at https://cccm.thinkculturalhealth.hhs.gov. CHWP does not sponsor or maintain the OMH CBT or website.

Cultural competency resources are available for use in providers’ offices through the provider operations manuals on cahealthwellness.com under For Providers > Provider Resources > Manuals, Forms and Resources. CHWP’s C&L Services Department can create customized cultural competency training upon request.

If you have questions about interpreter services, or would like more information about cross-cultural communication, health literacy or would like to schedule training, contact 1-877-658-0305.