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State
Health Commissioner Dr. Antonia C. Novello has proposed patient
interpreter services as part of new regulations that would help ensure
the delivery of quality health care to hospital patients with limited
English proficiency or disabilities.
"It is essential and of the utmost importance for hospitals to
implement measures to communicate effectively with every patient
– including offering free interpreter services”,
Dr. Novello said. “The proposal provides hospitals with a
blueprint that, when fully implemented, will ensure that they are
providing the best and most comprehensive care to patients."
Currently,
federal Title VI of the Civil Rights Act and state regulations require
hospitals to provide interpretation services to patients with
difficulty speaking English or who have disabilities affecting their
communication. State regulations specifically require hospitals to make
resources and interpreters available to such patients within 20 minutes
following admission or during an outpatient visit, and within 10
minutes if the patient is in the emergency department.
Dr.
Novello said the new regulatory proposal, which has the support of key
hospital associations and advocacy groups, would require hospitals
statewide to create and implement formal Language Assistance Programs
(LAPs). The establishment of these programs will assure appropriate
communication with patients on such critical issues as treatment
options, informed consent, discharge plans and health care proxy
decisions.
Under
this expanded process, hospitals will discourage the use of family
members, as well as individuals under 16 years of age as interpreters,
except in emergency situations. This expanded process will help ensure
the quality of interpreter services and protect a patient's right to
confidentiality.
When
interpreting vital medical information, the accuracy of the translation
is crucial to ensuring that patients are fully informed and able to
make decisions about their health care. Family members or minors may be
fluent in conversational language, but may be unprepared to interpret
complex medical information.
Many of New York's hospitals have already implemented policies and
protocols to provide effective communication assistance to patients in
need of such services. Some hospitals have created LAPs, appointed LAP
coordinators, developed brochures or palm cards notifying patients of
the availability of free interpreter services, and even purchased
over-the-phone translation services to assist patients with their
communication needs. The proposed regulations will bring uniformity and
consistency to the process in hospitals statewide.
To
ensure that the 'standard of care' is being met and that patients'
rights are protected, the proposal would essentially require hospitals
in New York State to:
Implement policies that will assure that the patient's communication
needs and language preference, are identified, confirmed and documented
in the front page of his or her medical record during the initial
hospital visit;
Post signage in entrance ways and common areas of the hospital offering
free interpreter services;
Provide
continuing education and training to staff on the importance of
delivering culturally and linguistically competent services, as well as
how to access interpreter services on behalf of patients; and
Conduct
annual assessments of the linguistic needs among the population in the
communities the hospital serves, and evaluate whether those needs are
being met. Dr. Novello said, "In a state as culturally and
linguistically diverse as New York, where one in five New Yorkers is
foreign born and approximately 150 languages are spoken, it is
essential that we continue to work with hospital associations and
advocacy groups to move these proposed regulations forward. Clearly, we
must continue to adapt to the changing demographics here in New York,
and tailor our health care system to meet those demands."
The
Department is in the process of finalizing the regulations. The
proposal will be presented for discussion to the State Hospital Review
and Planning Council's Codes and Regulations Committee on Thursday,
September 22, 2005. The proposal will also be submitted to the
Governor's Office of Regulatory Reform for review and approval and
subsequently will be placed in the State Registry for public comment
for 45 days from the date they are published. Once the public comment
period is completed, the regulations would go to the full State
Hospital Review and Planning Council for approval. The regulations, if
approved, could take effect as early as June 2006.
For more information on patient rights and communication assistance,
visit the State Health Department's web site at: www.nyhealth.gov.
9-17-05
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