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Health Care Can Get Lost in the Translation

Complaints filed against two Ventura County hospitals are part of a group's effort to boost interpreter services for limited-English patients. Many are immigrant farm workers.

October 06, 2003|Fred Alvarez | Times Staff Writer

Spurred on by a growing number of immigrants who say they are unable to talk to their doctors, farm worker advocates have launched a statewide campaign to break down language barriers and boost the number of interpreters in hospitals and other health-care facilities.

The effort is aimed largely at people who are fluent in neither English nor Spanish, a population that includes recent arrivals from Southeast Asia and a rising number of Mexican immigrants who speak indigenous Indian languages.

Lawyers with the poverty law firm California Rural Legal Assistance contend that hospitals and medical clinics too often deny limited-English speakers equal access to health care by failing to provide adequate interpretive services, as required by state and federal laws.

The legal aid campaign includes efforts to inform immigrants of their rights to such services and to remind health-care providers of their language access obligations.

Lawyers also have flexed their legal muscle to force the issue, including a lawsuit filed this summer against a Fresno County hospital centering on language access and administrative complaints lodged last week accusing two Ventura County hospitals of failing to provide adequate language assistance to the region's growing limited-English farm worker population.

"We are trying to make sure our clients' rights aren't existing just on paper," said Jack Daniel, a director of litigation for California Rural Legal Assistance in Fresno. "I think it's an issue that has been largely ignored by health-care providers and we ought to be doing something about it."

Health-care providers dispute assertions that they are failing to do enough. Officials with the California Healthcare Assn., which represents 500 hospitals and medical facilities statewide, note that they held a series of seminars for providers earlier this year to review the legal requirements and discuss ways to meet language needs.

Association officials said they believe most health-care providers are doing all they can to provide language assistance, even in the face of tough economic times and a lack of reimbursement for those services.

"Hospitals do take this obligation very seriously," said Jan Emerson, spokeswoman for the Sacramento-based association. "We are willing to do our part. We would love to have as many interpreters as any community needs, but it gets back to a question of who pays for it."

The Ventura County complaints stem from the hospitalization earlier this year of Oxnard resident Celia Reyes, 18, a Mixtec Indian from the Mexican state of Guerrero. According to complaints filed with the California Department of Health Services, Reyes communicates almost exclusively in Mixteco Bajo, an indigenous language that bears little resemblance to Spanish.

Reyes was admitted to Ventura County Medical Center in early February and transferred to St. John's Regional Medical Center in Oxnard in March, the complaints say. Both hospitals failed to provide adequate interpretation, according to the complaints. In fact, the complaints allege that Reyes' live-in boyfriend, Gaudencio Diaz, was regularly called upon to provide translation, even though he too is a Mixtec Indian who speaks no English and limited Spanish.

Citing patient confidentiality, officials at St. John's hospital and the county medical center refused to speak directly about the case. However, a county hospital official said he was unaware of any patient who had failed to receive proper care because of a language barrier. A letter from the owner of St. John's, Catholic Healthcare West, to California Rural Legal Assistance said Reyes received ample language assistance.

At the couple's Oxnard apartment, where medical complications have left Reyes paralyzed from the waist down, Diaz said he missed more than three weeks of work trying to help bridge the language gap. He also said he struggled to understand what doctors and nurses were saying, lacking fluency in Spanish and the technical expertise to grasp complex medical terms.

"I shouldn't have to translate for my [girlfriend]," the 21-year-old fieldworker said through an interpreter. "Too many people are in the same position."

Jeffrey T. Ponting, a California Rural Legal Assistance attorney in Oxnard who represents the couple, does not allege that a lack of interpretive services exacerbated Reyes' condition.

But he argues that the hospitals had no business using a family member to interpret for her. And he maintains that both facilities need to do a better job of meeting the language needs of the region's burgeoning Mixteco farm worker population, estimated at more than 10,000 at peak agricultural season.

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