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LANGUAGE SERVICES
As the number of people with limited English proficiency (LEP) in the United States rises, the need for language services in health care settings also grows. Federal laws require health care providers to offer language services, such as interpretation and translation.


Community Access Monitoring Survey (CAMS) Project
The Access Project collaborated with community-based organizations to survey the uninsured about their experiences getting care at local, mainly safety-net, health care institutions. Called the Community Access Monitoring Survey (CAMS), the survey gathered data from over 10,000 uninsured people in 18 states.

The national report (available in English and Spanish) presents national findings from the Community Access Monitoring Survey. Based on responses of 4,161 uninsured respondents who received care at one of the 23 urban hospitals included in the study, it compares the perceptions and experiences of adults who needed and had ready access to an interpreter with both those of adults who needed and did not have an interpreter readily available and those who did not need an interpreter. The findings show that uninsured respondents with limited English proficiency (LEP) who have access to an interpreter have strikingly better experiences in a wide range of areas, including ability to understand medication instructions, ability to get financial assistance to pay for care, and overall satisfaction with their health care encounter, compared to those who did not have an interpreter.

There are also local reports for each participating community that presents the findings for that specific location. All the CAMS related reports are available for download below.

CAMS National Report:
What a Difference An Interpreter Can Make: Health Care Experiences of Uninsured with Limited English Proficiency
La Diferencia de Contar con un Interprete

Local CAMS Reports "Getting Health Care When You Are Uninsured" from the 24 Community Sites:

Arizona
A Survey of Uninsured Patients at Two Facilities in Somerton and Yuma Arizona

California
A Survey of Uninsured Patients at Six Health Care Facilities in Fresno California
A Survey of Uninsured Patients at Three Community Clinics in Berkeley California

Florida
A Survey of Uninsured Patients at Four Facilities in Volusia County Florida
A Survey of Uninsured Patients at Two Community Clinics in Miami-Dade County Florida
A Survey of Uninsured Patients Receiving Care from Five Providers In Tallahassee Florida

Georgia
A Survey of Uninsured Patients at Four Facilities in Southwest Georgia

Idaho
A Survey of Uninsured Patients at Four Facilities in Nampa and Twin Falls Idaho

Illinois
A Survey of Uninsured Patients at Mile Square Health Clinic in Chicago Illinois
A Survey of Uninsured Patients at Two Clinics in Chicago Illinois

Kentucky
A Survey of Uninsured Patients at Three Hospitals in Lake Cumberland District Kentucky

Louisiana
A Survey of Uninsured Patients at Earl K. Long Medical Center in Baton Rouge
A Survey of Uninsured Patients at the Istrouma School-Based Health Center Baton Rouge

Massachusetts
A Survey of Uninsured Patients at North Adams Regional Hospital

New York
A Survey of Uninsured Patients at North Central Bronx Hospital in The Bronx, New York

Nevada
A Survey of Uninsured Patients at Two Hospitals in Las Vegas Nevada

North Carolina
A Survey of Uninsured Patients at Wake Medical Center in Raleigh North Carolina

Ohio
A Survey of Uninsured Patients at Four Hospitals in Cleveland Ohio
A Survey of Uninsured Patients at University Hospital in Cincinnati Ohio

Oregon
A Survey of Uninsured Patients at Two Hospitals in Lincoln County Oregon

Tennessee
A Survey of Uninsured Patients at The Regional Medical Center In Memphis Tennessee

Texas
A Survey of Uninsured Patients at CHRISTUS Jasper Memorial Hospital in Jasper, Texas
A Survey of Uninsured Patients at Fannin Family Planning Clinic in Houston Texas

Virginia
A Survey of Uninsured Patients at Inova Alexandria Hospital in Alexandria Virginia

West Virginia
A Survey of Uninsured Patients at Four Facilities in West Virginia
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REPORTS AND PUBLICATIONS

Immigrant Access to Health Benefits (189 p., revised 2001)
In order to organize to improve immigrants' access to health care, advocates need to be knowledgeable about two very complex and often highly technical fields: immigration and health. This manual was written for use as a resource in conjunction with an intensive training program developed by The Access Project and the National Health Law Program. It is essentially a primer on health access for immigrants. It details and explains basic eligibility requirements for key federal and state programs and identifies issues that can be significant barriers to access to health care for immigrants and their families.
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La Diferencia de Contar con un Interprete (16 p., ©2002)
Este informe presenta resultados nacionales del CAMS (Community Access Monitoring Survey). El info rme tiene en cuenta las respuestas de 4,161 encuestados sin seguro médico recibiendo atención en uno de veintitrés hospitales urbanos que participaron en la investigación, comparando las percepciones y experiencias de adultos que necesitaban y pudieron usar intérprete con adultos que lo necesitaban pero no pudieron contar con ello y con adultos que no necesitaban intérprete. Indican los resultados que los encuestados sin seguro médico con conocimientos limitados del inglés (LEP-Limited English Proficiency) con acceso a servicio de intérprete solían tener experiencias mejores que los que no tenían acceso a intérprete. La diferencia se nota en varias áreas, por ejemplo, para comprender los consejos médicos e instrucciones de tratamiento, para acceder a asistencia financiera para pagar la atención médica y la satisfacción de los clientes con los servicios médicos.
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Language Services Action Kit: Interpreter Services in Health care Settings for People with Limited Proficiency (58 p., updated ©2004)
The Access Project and the National Health Law Program have developed a Language Services Action Kit for advocates and others working to ensure that people with limited English proficiency in their state get appropriate language assistance services in medical settings. The kit is available in both English and Spanish versions.

Federal funding for interpreter and other language services can benefit everyone: health care providers, state governments, and patients with limited English skills in need of services. This offers an unusual opportunity for these stakeholders and others to come together to advocate for reimbursement for language services in their state Medicaid and SCHIP programs. We hope the materials in this Action Kit will assist you in undertaking such an effort in your state.
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Servicios en Idiomas: Guia para Tomar Accion (58 p., ©2003)
El material de este Servicios de Idiomas: Guía para Tomar Acción se diseñó para apoyar a los defensores y otras personas que trabajan para asegurar que los individuos con conocimientos limitados de inglés que residen en sus estados reciban la adecuada asistencia de servicios de idiomas en las instituciones de atención médica. Este material fue desarrollado por el Programa de la Ley de Salud Nacional y el Proyecto de Acceso.
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What a Difference and Interpreter Can Make: Health Care Experiences of Uninsured with Limited English Proficiency (14 p., ©2002)
This report presents national findings from the Community Access Monitoring Survey. Based on responses of 4,161 uninsured respondents who received care at one of the 23 urban hospitals included in the study, it compares the perceptions and experiences of adults who needed and had ready access to an interpreter with both those of adults who needed and did not have an interpreter readily available and those who did not need an interpreter. The findings show that uninsured respondents with limited English proficiency (LEP) who have access to an interpreter have strikingly better experiences in a wide range of areas, including ability to understand medication instructions, ability to get financial assistance to pay for care, and overall satisfaction with their health care encounter, compared to those who did not have an interpreter.
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COMMUNITY/STATE SPECIFIC REPORTS:

Florida
The Miami Dade County Immigrant Health Access Task Force Access to Public Health Trust Services: Success and Challenges (14 p., ©2002)
This report documents the efforts of the Immigrant Health Access Task Force in their collaboration to broaden access to services provided with Public Health Trust (PHT) Funds. It is based on interviews with the advocacy group leaders, representatives of the PHT, and discussions with thirteen uninsured residents who accessed or attempted to access this care.
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Illinois
Health Care Access for Immigrants and Refugees: A Guide to Understanding Eligibility for Health Care in Illinois (53 p., ©2001)
This guide was created for Illinois health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to emrolling immigrant families in health programs.
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Massachusetts
Health Care Access for Immigrants and Refugees: A Guide to Understanding Eligibility for Health Care in Massachusetts (51 p., ©2000)
This guide was created for Massachusetts health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to enrolling immigrant families in health programs.
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New Hampshire
Assessing Language Interpretation Capacity among NH Health Care Providers (48 p.,©2004)
The Access Project partnered with a diverse coalition of New Hampshire organizations on an effort to assess language service issues for limited English proficient and Deaf/ Hard of Hearing patients and the health care system’s capacity to serve such patients. With funding from the Endowment for Health, The Access Project collaborated with Beau Stubblefield-Tave of the Cultural Imperative. The research process was designed to build on existing data resources while collecting new data from:

  • Health care providers at hospitals, community health centers, community mental health centers and oral health clinics;
  • Interpreters serving both the LEP and Deaf communities;
  • LEP patients and community residents as well as advocates from the D/HoH and LEP communities; and
  • Policy makers and content experts at the state, local and national levels.

In addition to these data sources, this report is informed by the strategic planning process of the Medical Interpretation Advisory Board (MIAB)

This report identifies and addresses language service issues in New Hampshire and suggests a set of next steps to reduce the gap between the medical interpretation needs of limited English proficient (LEP) and Deaf/ Hard of Hearing patients and the health care system’s capacity to serve those needs.

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New Jersey
Health Care Access for Immigrants and Refugees: A Guide to Understanding Eligibility for Health Care in New Jersey (62 p., ©2001)
This guide was created for New Jersey health outreach workers and immigrant advocates to help them understand immigrants' eligibility for health care and the barriers that exist to enrolling immigrant families in health programs.
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LINKS

California Healthcare Interpreters Association
Crosscultural Healthcare Program
Diversity Rx
Grantmakers Concerned with Immigrants and Refugees
Hablamos Juntos
The Health Consumer Alliance
Interpreter Access Collaborative
Let Everyone Participate
National Council of La Raza
National Council for Interpreting in Health Care
National Hispanic Medical Association
National Immigration Law Center
Office of Civil Rights, Department of Health and Human Services
Office of Minority Health, Department of Health and Human Services



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Last Updated December 2007