California Law Now Requires Health Plans to Provide Language Assistance Program for Patients

Effective January 1, 2009, California health plans are required to implement a language assistance program to comply with Senate Bill 853. The legislation was passed to assist those with limited English language proficiency to better communicate and participate in personal health care matters.

Who must comply with S.B.853 regulations?
All California Department of Managed Health Care (DMHC) licensed health plans and specialized plans (such as vision or dental plans) are required to establish and implement a language assistance program. Health plans must design their programs based upon an assessment of their members’ needs. A list of health plans required to comply with S.B.853 is available on the DMHC Web site at www.dmhc.ca.gov/library/reports/licensing/licensed.pdf.

What does S.B.853 require?
S.B.853 requires California DMHC licensed managed care organizations and insurance providers to translate vital health plan documents for members and to provide interpretation services at no cost to the patient.

The language services selected by the health plan must be provided by an individual with the following demonstrated proficiencies: (1) fundamental knowledge of both languages, (2) knowledge of health terminology and concepts relevant to health care systems, and (3) education and training in interpreter ethics or standards from the California Healthcare Interpreting Association or National Council on Interpreting in Health Care.

S.B.853 requires that vital documents—including applications, consent forms, letters containing eligibility and participation criteria, notices about changes in services and benefits, and explanations of benefits—be translated into threshold languages. The threshold languages include:

• Spanish
• Chinese
• Korean
• Vietnamese
• Tagalog

The health plan is also required to educate participating medical providers regarding its language assistance plan.

What is the physician’s responsibility?
Physicians should be aware of S.B.853 requirements. They may refer a patient back to his or her health plan for translation and interpretive services of health plan documents and to request and arrange for language assistance prior to an office appointment.

If a patient is not covered by health insurance, the physician should be prepared to provide appropriate language assistance services as needed. Your patient safety/risk manager can assist you if you have questions about providing language assistance services.

Who will enforce S.B.853 compliance?
The DMHC is responsible for approving health plan language assistance programs and for enforcing compliance with S.B.853 requirements. The DMHC’s HMO Help Center will assess each health care service plan language assistance program through regular surveys and program assessments. Violations or problems will be referred to the DMHC’s enforcement unit for evaluation.

Who can I call if I have questions?
Our Department of Patient Safety is available to respond to questions related to the S.B.853 language service requirements. Please call (800) 421-2368, extension 1243, for assistance and support.