20-567 Language Assistance Program and Cultural Competency Services

Date: 07/20/20

This information applies to Physicians, Participating Physician Groups (PPGs) and Ancillary providers.

This information applies to Medi-Cal in Fresno, Kings and Madera counties.

Meet members’ language needs with the Language Assistance Program (LAP)

You can request free interpreter services for your patients:

• Contact CalViva Health Member Services at the telephone number on the member’s identification (ID) card or at  1-888-893-1569.
• Send the request as soon as the appointment is made, but not less than five business days before the appointment.
• Use telephone interpreter services for same day appointments or when an in-person interpreter is not available.

The LAP makes it easy for you to follow requirements

Health Net and CalViva Health have an LAP to support members who have limited English proficiency (LEP), are deaf or have hearing impairments. Our language assistance program requires contracted providers to adhere to the following:

 

FOR ALL PROVIDERS
Language assistance service or document	Explanation
Qualified Interpreter Services for LEP members that comply with California requirements	In-person or telephone interpreters are available. Telephone interpreters are available in more than 150 languages 24/7 at no cost. Use of telephone interpreters does not require advance notice. Interpreters can offer insights on common cultural communication issues. We also provide guidance on compliance with state requirements for the use of bilingual staff.
Sign language services	American Sign Language (ASL), Tactile, Certified Deaf, Pidgin Signed English (PSE) and Signed Exact English (SEE) interpreters are available.
Medical record documentation	Document the member’s language preference (including English) and the refusal or use of interpreter services in the member’s medical record.
Member complaint/grievance forms	Provide translated member grievance forms (available in the Provider Library under Forms > Member Grievance Form) to members upon request.

FOR PPGs ONLY
Language assistance service or document	Explanation
Independent Medical Review (IMR) application	Locate translated IMR applications on the Department of Managed Health Care (DMHC) website  and provide to members upon request.
Taglines and nondiscrimination notice	Include CalViva Health-specific taglines and nondiscrimination notice (available in the Provider Library under Forms > Nondiscrimination Notice and Taglines) with information sent to members.
Translation services	Utilization management (UM) or case management (CM) materials must be made available to members who have a preferred language or format listed on the eligibility file. If a member asks for a translation or another format of UM or CM materials the provider must refer the member to the CalViva Health Member Services telephone number on the member’s ID card. When Member Services receives the request, Health Net, on behalf of CalViva Health, will request the document from the participating physician group (PPG). The PPG must send the document within 48 hours. Refer to the list of threshold languages below.

Be sure your language services meet standards

Interpreter services must be provided to LEP CalViva Health members. Health Net and CalViva Health do not delegate the provision of interpreter services to providers. We encourage you to use the interpreters available from CalViva Health.

Language services requirements	Prohibited language service practices
Make sure that interpreters are available at no cost to members at the time of the appointment. Make sure that LEP members are not subject to unreasonable delays in the delivery of services, including accessing providers after hours. Extend the same program and activity to all members regardless of language preference. Provide services to LEP members that are as effective as those provided to non-LEP members. Record the member’s language needs, request or refusal of interpreter services, in the member’s medical record. Send requests for an alternate format or translation for UM documents to the plan within 48 hours of request from the member. Use qualified bilingual staff or interpreters to communicate with LEP members. Provide translated member grievance forms to members upon request.	To use a minor or attending adult to interpret or help communication, except: In an emergency where a qualified interpreter for the LEP person is not available right away. You must note the emergency in the member’s medical record. A parent cannot give permission for a minor child to interpret in any other circumstance. Or When the LEP person specifically asks that the attending adult interpret, that adult agrees to provide such assistance, and reliance on that adult is appropriate for circumstances. Please document in the member’s medical record the circumstances that resulted in the use of an attending adult as an interpreter. To ask or require anyone to bring their own interpreter. To rely on staff other than qualified bilingual/multilingual staff to communicate directly with LEP persons. Delaying the appointment time due to availability of interpreter services

Members have the right to file a grievance with CalViva Health and to file a discrimination complaint with the Office of Civil Rights if their language needs are not met.

Threshold languages information for delegated PPGs

Threshold languages for CalViva Health members are Spanish in Fresno, Kings and Madera counties, and Hmong in Fresno County.

PPGs have access to members’ preferred spoken and written languages through the Eligibility Report. Individual and ancillary providers can get members’ language preferences by contacting the Provider Services Center.

UM or CM delegated provider groups may send any member information that needs translation to the member’s threshold language or alternative formats to provider_services@healthnet.com. We cannot accept scanned or faxed documents. Be sure to follow these directions for materials sent for translation or alternate format:

• Send the material in a Word or unlocked PDF format.
• Care plans must be sent with proof that the document is at 6th grade reading level or below.
• The PPG must send the member’s name, member ID, the document requested, and the member’s address to Health Net.

Learn about CalViva Medi-Cal membership demographics

In 2019, CalViva membership was 5% African American/Black, 0% American Indian/Alaska Native, 10% Asian/Pacific Islander, 62% Latino/Hispanic, 12% White/Caucasian, and 11% unknown. Of this population, 34% were LEP members. The top member preferred non-English spoken languages were Spanish, Hmong, and Lao.

Remember to take the cultural competency training

All participating providers must take cultural competency training. We suggest that you take the training offered by the Office of Minority Health (OMH). The training is computer-based training for health care providers. OMH developed the no-cost educational training to give providers competencies to better treat an increasingly diverse population. Health Net does not sponsor the OMH training. However, the Cultural and Linguistic Department can customize cultural competency training to meet your needs.

The provider directory indicates a “Y” if the provider has completed two hours of cultural competency training within the last 24 months. Notify the plan after completing this training by sending an email to PSOps@healthnet.com. Include your practitioner’s name, a certificate of completion, the National Provider Identifier (NPI), and a statement that you have completed the training.

Provide race and ethnicity if you choose

Consider providing your race and ethnicity information to Health Net. The information is voluntary and is used for health disparity reduction efforts. You can provide this information on the Quarterly Active Physician Listing Report on the provider portal and select Provider Reports > Available Reports > Administrative > Active Physicians Listing.

Additional information

For more information about interpreter services, cross-cultural communication and health literacy, or to schedule training, refer to these resources below or contact the Cultural and Linguistic Department email, or by telephone at 1-800-977-6750.

Resource	Location
Non-English language identification poster	Provider Library under Forms > Language Identification Poster
Industry Collaboration Effort (ICE): Provider Tools to Care for Diverse Populations	Provider Library under Operations Manuals > Quality Improvement > Language Assistance Program and Cultural Competency.
Free Interpreter Reference sheet	Provider Library under Forms > Free Interpreter Reference
Interpreter services contact information	Provider Library under Contacts > Access to Interpreter Services