Nuts and Bolts of
Language Access Planning
Rodrigo Monterrey
CLAS Manager
Massachusetts DPH-OHE
Sponsored by
the Nebraska Association of Local Health Directors and Health Literacy Nebraska
through the Federal OMH State Partnership Grant
January 13, 2015
Agenda:
1. History of Language Access
2. Language Access as part of “CLAS”
3. Steps: How to develop and implement
your own Language Access Plan
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Key Terms:
• Translation: written
• Interpretation: spoken or American Sign
Language, usually simultaneous
• Bilingual Staff: proficient in additional
language, understands content and protocols
• Translator/Interpreter: trained or certified,
contracted or volunteer
• Vital Documents: critical records, consent
forms, eligibility documents, notifications that
require a response or action from a client
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History :
Federal:
Executive Order #1366 (2000)
– "Improving Access to Services for Persons with
Limited English Proficiency"
– Federal agencies (and those receiving federal
funding) to ID services and implement system
– Use of a specific approach to determining
when/how to provide Language Access
– Unfunded mandate
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History (cont):
State and Local Agencies (MA):
• Chapter 151B of the General Laws, Executive
Order 478, Administrative Bulletin #16 (2010)
– Follows similar suit to the implementation of the
national LA standards
– Review of resources, populations, and agencyspecific language access plans
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History (cont):
Emergency Room Interpreters Law (ERIL 2000)
1. Before implementation (“land before time”):
– Use of friends, family members
– Use of available bilingual persons/staff
2. Post implementation (present):
–
–
–
–
Competency a key element of interpreters
Hospital-Based Interpreter Services Best Practice Guidance
Training and Interpreter Credentialing
Language access planning
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LAP in CLAS:
•What is “CLAS”?
•How does Language Access
Planning fit into CLAS?
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CLAS:
• Culturally and Linguistically Appropriate
Services
• 15 standards for service delivery
• A framework for continuous quality
improvement
• Goal? To reduce health disparities
• How? By creating culturally-competent
systems of care
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The Standards:
Over-arching principle: #1
Governance, Leadership,
Workforce: #2-4
Communication and
Language Assistance: #5-8
Engagement, Continuous
Improvement and
Accountability: #9-15
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The Steps:
How to Develop and Implement Your
Own Language Access Plan
Framework:
Plan-Do-Study-Act:
Rapid-cycle
process improvement
(SMART Objectives)
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Plan:
• Who: include staff from various levels and
clients/community-members/stakeholders
• Why: review your mission/goals/needs. How
will language access fit/benefit what you do?
• What: determine where language access is
most needed. What are you hoping to
address/improve?
• When: give yourself an end-date
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Goal:
“Ensure that LEP clients receive
services in their preferred language”
1.
2.
3.
4.
5.
6.
7.
8.
Organization Priority
LA Working Group
Assessment
Policy, Plan & Procedures
Interpreters & Translators
Document Translation
Training
Evaluate
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1. Organization Priority
• In order to serve LEP clients
• Unfunded mandate:
– Operating cost – like the light bill
– Line item for language services in budget
• Include in all grant proposals and apply for
grants specifically for language access work
– Use data to show why it matters
• Hire qualified bilingual staff
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2. Working Group
• Executive Director support
• Participation from all levels of organization
– Management/administrators
– Front line (clinical and non-clinical) staff
– Clients/advocates/stakeholders
• Work plan, with SMART objectives, regular
meetings and action steps (accountability)
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3. Assessment
•
•
•
•
•
What are we already doing well?
What resources do we already have?
Where are the gaps in service?
Who can we partner with?
Then go after “low-hanging fruit”
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4. Policy, Plan & Procedures
Language Access Plan and Protocol
 Working document (never done)
 Working Group reviews/updates
annually
 Staff routinely trained on it
 Clients made aware of it
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5. Interpreters & Translators
 List of interpreters and translators
 Easily accessible by all staff
 Updated annually
 Volunteer and employee “bank” for needed languages
 List qualifications & skills (translation vs. interpretation)
 Quality Control (including certification boards)
 Application/Initial Screening
 Meeting/Interview with Referral Coordinator
 Interpreter Protocol & Code of Ethics (2006)
 Negotiated lower rate for phone interpreter and video
remote interpreter services
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6. Document Translation
• Write in Plain Language! (Health Literacy)
• Translated Document Bank
 Easily accessible to staff
 Informational materials for clients, staff, family
 Signs, notices, forms, vital information
• Always have multiple people review
• Then pay for proofreading – less expensive
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7. Training
•
•
•
•
•
Build in-house training capacity (FREE)
Online training resources (FREE)
Partner with agencies, courts or orgs (FREE)
LEP Training for all New Hires in Orientation
Annual Staff Training
– Working with an Interpreter, Language Access Plan &
Protocol and Language Access Issues
• Interpreter Skills-Building Training
– Bilingual Staff and Privately Contracted Interpreters
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8. Evaluation
• Based on intended outcomes established in
the workplan – concrete “measures”
• “Benchmark” – set a baseline against which
to measure progress (e.g. % increase)
• Set up recurrence – periodic cycle for short,
mid and long-term goals (monthly,
quarterly, annual)
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Elements of an LAP (template)
1. Purpose of the LAP
2. Mission/Vision
3. Populations Served/Populations within
your catchment
4. Service Provisions of the LAP
5. Implementation
6. Complaint Procedure
7. Signatures: CEO, Dirs. (accountability)
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Resources:
• Agency/Program:
http://www.mass.gov/eohhs/docs/dph/healthequity/clas-chapter6.pdf
• State/County (example):
www.montgomerycountymd.gov/LEP/
• Federal:
http://www.lep.gov/
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Resources (cont):
• How to work with an interpreter (video):
http://www.health.medicbd.com/library/video?v
q=working+with+interpreter&s=relevance&subm
it=Search
• Telephonic Interpreters:
www.languageline.com
www.ctslanguagelink.com
www.pacificinterpreters.com
www.callopi.com
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Resources (cont):
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Checklist:
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Questions?
Rodrigo Monterrey
CLAS Coordinator
DPH-Office of Health Equity
250 Washington St. Boston, MA 02108
rodrigo.monterrey@state.ma.us
617-994-9806 (office)
617-938-4024 (cell-phone)
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Thank you!
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