Tuesday, May 21, 2002

Spanish emerges in hospitals

Voice mail messages added to assist Hispanic people

By Cindy Schroeder cschroeder@enquirer.com
The Cincinnati Enquirer

        Cincinnati hospitals that don't have people to answer the phone in Spanish are going to start at least taking a message in Spanish.

        The Health Alliance of Greater Cincinnati is adding Spanish-language voice mail at its six hospitals after a survey found that Spanish-speaking residents often can't get help when they call a hospital.

        The recent survey of four hospitals in Hamilton and Butler counties found Spanish-speaking residents who call face odds of less than one in six that someone will speak their native language.

        “I hear it from my clients every day,” said Carmen Madera-O'Malley, a social worker who works with young parents in Butler County's Hispanic community.

        “They know their children need vaccinations and regular exams. But they don't know where to find the pediatrician or how to make an appointment. Then, once they get there, they're being told to bring their own interpreters. My fear is that if translation services aren't provided, the only time (health care workers) are going to see children is when they're very very sick and they end up in the emergency room.”

        Greater Cincinnati's Hispanic population increased 135 percent dur ing the past decade — from 9,419 to 22,124, with most of that growth in Butler County, Northern Kentucky and on Cincinnati's west side.

        In two of the biggest jumps, Boone County, Ky., saw a 435 percent increase in Hispanic population from 1990 to 2000 and Butler County, Ohio saw a 225 percent increase.

        When doctor and patient don't speak the same language, everything from the diagnosis to treatment and followup care can be compromised, advocates say.

        “We thought the survey would be a good way to document the anecdotes we were hearing through various sources,” said Trey Daly, senior attorney at the Legal Aid Society of Greater Cincinnati.

        “I think there's a recognition among local hospitals that they're obligated to remove language barriers to health care. But even when a policy is developed, it doesn't always trickle down to the front line people who have the responsibility of dealing with those who speak Spanish,” he said.

        The survey was conducted by the Greater Cincinnati Healthcare Access Project, of which Legal Aid is a member.

        In the survey, the Healthcare Access Project had four bilingual callers call the admitting, billing and emergency departments at four hospitals in Hamilton and Butler counties this spring to test language barriers. C

        Of the 36 calls completed, callers encountered someone who spoke Spanish only five times, Mr. Daly said. A frequent response was to suggest that callers call back the next day.

        “I had one hospital person who actually put me on the speaker phone and laughed at me,” said Ms. Madera-O'Malley, a Puerto Rican native and one of the survey's four bilingual callers. “Another time, I called on a weekend and left a detailed message in Spanish asking about my bill. “I left my real name and phone number, but no one ever called me back.”

        Still other times, Ms. Madera-O'Malley said she reached voice mail in English only.

        “At the very least, hospitals need to devise a system where the people who take incoming calls — especially in the emergency room and admitting department — are prepared to talk to a (Spanish-speaking person,) even if it's something as simple as having a script that's written phonetically,” she said. “A Spanish option on the voice mail also would be very helpful.”

        The coalition of groups ranging from faith-based organizations to consumers seeks to improve access to affordable and insurable health care for low-income, uninsured and under insured Greater Cincinnati residents.

        Mr. Daly said the group's finding is contrary to federal law that requires health care providers to remove language barriers to care, Mr. Daly said.

        Last year, the health alliance translated a financial assistance application for its six hospitals into Spanish and began distributing it to advocacy groups for the Tristate's Hispanic-Latino community.

        Within the past year, the health alliance also has posted financial assistance signs in Spanish in its admitting areas, emergency rooms and waiting rooms for patients, said Marina Shelton, financial counseling manager for the health alliance.

        To serve its growing Hispanic population, the St. Luke hospitals in Florence and Fort Thomas now print consent forms for circumcision and radiology procedures in Spanish, and are in the process of printing patient handbooks in Spanish, said Mary Ann Beetem, patient representative at St. Luke Hospital West.

        The hospitals also have patient rights in Spanish posted in every outpatient unit.

        “It's very challenging, but it's certainly a need that we want to address,” Ms. Shelton said of efforts to break down health care language barriers.

        Tonya Huggins, director of diversity for the Health Alliance of Greater Cincinnati, said a task force has been studying the language barrier issue since September.

        “This summer, we'll have a rollout of our policy and discuss how we're making some changes in our system to remove language barriers,” Ms. Huggins said. “We're in the process of designing an extensive communication and education plan and will make sure that knowledge of our policy reaches those who have patient contact.”

        Within the past three months, Hamilton County hospitals and clinics have shown an increased awareness of the need to use interpreters when they deal with patients with limited English proficiency, said Maritza Dyer, a case worker and advocate for the Price Hill-based Bienestar program, a Hispanic resource center funded by the Greater Cincinnati Health Foundation. She added Children's Hospital, which draws patients from throughout the world, has used interpreters for years.

        “The hospitals and other (health care) providers are making sure that their employees are learning about the Hispanic-Latino culture and are getting the proper training (to break down language barriers),” Mrs. Dyer said. “There are a lot of things which are not yet in place, but everyone is very willing to learn and willing to change.”


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