With a growing population of diverse patients, hospitals and health systems increasingly must address language barriers between non-English-speaking patients and providers, and sometimes must do so on stretched budgets.
Hospitals, clinics and private practitioners typically pay high costs for interpretation services, according to the New Haven Independent. For example, Hartford Hospital paid $85,000 in the 2009-2010 fiscal year, up from $70,000 in 2008-2009. And Yale-New Haven Hospital, which employs 14 full-time interpreters, spends more than $1 million on such services.
Smaller facilities, however, often must settle for lower-cost solutions because of a mandate in Title VI of the Civil Rights Act that requires any medical facility accepting federal funds to provide interpretation services. At such institutions, family and friends of patients often fill in the language gaps, which poses safety risks. For less common languages in the U.S., hospitals often turn to telephone services.
"Whether the government pays for it or not, you have to meet the patient's needs," Hospital of St. Raphael Director of Quality Improvement and Patient Relations Jim Judson told the Independent. "One word wrong could produce a medical error."
In Philadelphia, as part of a Department of Health & Human Services (HHS) initiative that began in May, volunteer "health promoters" carry wellness messages in Spanish and English in the Latino community. However, most of the volunteer "promotoras" do not carry medical degrees and are members of the community, according to the Philadelphia Inquirer.
Regardless, the results of the volunteer program have proven fruitful, according to HHS.
"Now that they have been recognized, we want to develop a national database of networks for training and certification," said Jose Velasco, a public health adviser at HHS's Office of Minority Health.