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SPONSOR |
Sanchez, B |
DATE TYPED |
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HB |
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SHORT
TITLE |
Cultural & Linguistic Health Care Issues |
SB |
SJM 13 |
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY04 |
FY05 |
FY04 |
FY05 |
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NFI |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Relates to SJM23
which proposes the NM Department of Health (DOH) study the disparities in use
of, and access to, reproductive health services, including family planning
services, abortion, and treatment and prevention services for sexually
transmitted diseases, human immunodeficiency virus and acquired immune
deficiency syndrome, as well as an examination of the incidence of infant and
maternal mortality
LFC Files
Responses Received From
Department of Health (DOH)
SUMMARY
Synopsis
of Bill
Senate Joint
Memorial 13 requires the Department of Health (DOH) to study and make recommendations
in the following three major areas related to culturally and linguistically
appropriate health care:
·
Linguistic and cultural barriers to
coverage and access,
·
Appropriate representation of limited
English proficiency patients and minorities in clinical trials and research
projects involving human subjects, and
·
Cultural and linguistic curricula in
health care professional education and training.
SJM13 would require the DOH to work with
several state agencies: Health Policy Commission, Human Services Department,
Regulation and Licensing, the
Significant
Issues
DOH indicates that the national,
regional, and state data demonstrate that people with limited English proficiency
experience health disparities related to access to care, disparate care when
they have access, and thus disparate health outcomes. In many cases, such as in
the area of reproductive health, linguistic barriers are compounded by the lack
of understanding the full range of services available. Linguistic barriers
especially hinder women’s knowledge of family planning, STD, maternal-child
health, domestic violence prevention programs, and programs for people with
disabilities.
DOH
also points out there is a lack of availability of culture-specific health
information and brochures as well as translated materials for service
providers. Currently, there is no existing
course or credentialing for medical interpreters in the state.
The Department of Health and Human
Services defines meaningful access “as language assistance that results in
accurate, effective communications between provider and client, at no cost to
the client. Typically, effective programs are presumed to have four elements-an
evaluation of the language needs of the population being served, a written
policy on language access, staff training and monitoring.”
The
Office of Management and Budget in a cost-benefit analysis of the guidance
effect on the health-care environment “suggested a host of advantages to
providing language assistance, among them better communication between patients
with limited English proficiency and English speaking providers; greater
patient satisfaction; more confidentiality and truer “informed consent” in
medical procedures; fewer misdiagnoses and medical errors; cost savings through
fewer emergency room visits; less staff time in dealing with non-English
speaking patients; and fewer eligibility and payment errors.”
There is a long history of interest in minority
health issues, particularly relating to the degree to which minority
populations in
FISCAL IMPLICATIONS
SJM13
does not contain appropriation to the DOH but would require additional resources
to achieve the studies required in the bill.
ADMINISTRATIVE
IMPLICATIONS
There would be administrative impact on the DOH.
However, the requirements of SJM13 may
be accomplished with current staff if the timeframe is extended.
TECHNICAL ISSUES
DOH suggests extending
the due date for the study from Oct 2004 to Oct 2006.
OTHER SUBSTANTIVE
ISSUES
Research
demonstrates that clients who receive services from providers
who can communicate with them in their language, who understand their culture,
and who respect their beliefs about health and health care, are more compliant
with health education direction. They also report a greater sense of trust of
providers.
DOH
believes it is critical that adequate attention is given to cultural and
linguistic issues, clinical trials, and education as they impact access, health
care, and health outcomes, if
Deaf and hard of hearing people who use American
Sign Language (ASL) may or may not be proficient in English, because ASL has a
grammar structure all its own. According to the New Mexico Commission for Deaf
and Hard of Hearing Persons, national statistics are that 1/2 of 1% of the
population is deaf and 3% of the population has some degree of hearing loss
(hard of hearing). This means that
around 150,000 people in NM have some degree of hearing loss.
AMENDMENTS
Recommended language additions:
Page
1, line 25, change the language to read: “elderly, people who are deaf or who
have limited hearing ability, poor people, youth, people with disabilities, and
people who have below-average health care visits; and“
Page
3, after line 13, insert “BE IT FURTHER RESOLVED that the Department of Health
work with the Commission for Deaf and Hard of Hearing
Persons, the Indian Affairs Department, agencies and community
organizations focusing on Hispanic issues, and the Office of African American
Affairs to study the issues of access, clinical trials, and education and
training as described.”
Page 3, line 17, change
the date to “
BD/prr:lg