The NewStandard ceased publishing on April 27, 2007.

Language Discrimination Hinders Access to Health Care for Latinos

by Kari Lydersen

Health care resources offered to poor people in Washington, DC are far more easily obtained by English speakers than by Spanish-speakers - a situation which researchers fear extends nationally.

Feb. 9, 2005 – Spanish-speaking residents of the Washington, DC area often have trouble accessing Medicaid benefits to which they are entitled, according to a recently released study that blames language discrimination in the city’s human services agency and a lack of resources for Spanish speakers.

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Commissioned by the National Council of La Raza and conducted by the Equal Rights Center, the study focused on two local Department of Human Services (DHS) offices, but those involved with the research believe Spanish-speaking residents face similar hurdles at different government agencies in other parts of the country as well.

The study’s administrators say that the Department’s failure to comply with federal laws that prohibit agencies that receive federal funds from discriminating against people on the basis of national origin and language, has grave health and economic implications for Spanish-speaking households.

"If you don’t get insurance the children might not get the medical care they need, or you’ll need to take money away from other things to pay for it," said Rabbi Bruce Kahn, executive director of the Equal Rights Center. "So that might mean you go without food or electricity or [you] can’t pay to educate your children."

The study paired ten Spanish-speaking Latino testers with ten English-speaking African-American or white testers and compared their experiences trying to access Medicaid or other services at the DHS offices, both in person and over the phone. Testing pairs used similar story lines so as to control for various eligibility factors.

Out of seventeen phone calls, Spanish speakers were able to reach a Spanish-speaking attendant only six times. Ten of the calls were transferred to English language voicemails.

The study evaluated DHS on five factors, including whether services were provided in the appropriate language, whether a benefits application was offered or the tester was told how to obtain one in the appropriate language, whether information about needed documentation was provided in the correct language, whether the tester was asked for information irrelevant to their eligibility, and whether the tester received discouraging comments.

The study found that only 20 percent of Spanish-speaking testers received appropriate treatment based on those factors, compared to non-Latino testers, who received appropriate treatment 60 percent of the time. Additionally Spanish-speaking testers were forced to wait more than twice as long to access services; an average of two and a half hours for an in-office visit compared to less than an hour for English speakers.

"The results are appalling," said National Council of La Raza CEO Janet Murguia in a statement. "People are at their most vulnerable when seeking medical help for themselves and their children. They deserve better. Any time a group of people is shut out of accessing basic medical care, it becomes a public health crisis for all of us."

Seventy percent of Spanish speakers were offered services in Spanish, though they often had to wait long periods for a translation. Only 30 percent of Spanish speakers were told how to get a benefits application in their language, compared to 60 percent of English speakers.

The study is a small part of a larger effort to make sure people of different origins and backgrounds are able to access government services.

Twenty percent of the Spanish-speaking testers were asked questions unrelated to their eligibility requirements and received discouraging comments, while no English speakers reported such treatment. For instance, one tester was lectured, "It is very important that you tell the truth when you fill out the Immigration Form and then they will not investigate you, but if you lie you will be in big trouble."

Both the Spanish- and English-speaking testers were inquiring about medical coverage for their American-born children only, not themselves. Nevertheless, some Spanish speakers were questioned about their immigration status, including requests for their social security number or green card, neither of which is required for one’s children to obtain Medicaid.

Out of seventeen phone calls, Spanish speakers were able to reach a Spanish-speaking attendant only six times, or 35 percent of the time. Ten of the calls were transferred to English language voicemails.

Overall, the study concluded that the Spanish speakers "faced a 20 to 30 percent discrimination rate on each factor analyzed;" and they "faced substantial barriers at each phase of the process of seeking assistance at DHS."

In an interview with The NewStandard, DHS spokesperson Debra Daniels defended the agency’s services for non-English speakers as comprehensive and adequate and called the report "unfounded."

"The Department of Human Services works with translation service companies that provide services in 140 languages," said Daniels. "We are very aware of the need to provide services for non-English speaking customers. Our brochures and other materials are always printed in Spanish and other languages."

Daniels pointed to a list of efforts the Department is taking to meet the needs of people who have limited English language skills, which notes that "For more than five years, IMA (Income Maintenance Administration, a division of DHS) has made available immediate access to an interpreter (over the phone) in more than 100 languages" through the language line. A yearly memo reminds staff of their obligation to utilize this service and "emphasizes the importance of protecting the civil rights of customers," Daniels said.

A Department press release reports that the agency hired a language access manager in 2004, who, among other duties, conducted blind tests of Spanish-speaking telephone services.

"Management was very unhappy with the initial results of test calls made in June," relates the release. "Based on this testing, it was determined that refresher training…was warranted."

Daniels said the Department does not currently have plans to further upgrade language accessibility. "We have everything in place we need to service the needs of non-English speaking people," she said.

The Equal Rights Center is working with the Washington Lawyers’ Committee to help Latinos access services and push DHS to improve its performance.

Denise Gilman, director of immigrant and refugee rights for the Lawyers’ Committee, said DHS needs to hire more bilingual personnel and make sure translators are more quickly available. "They need serious hiring efforts to get more bilingual staff, and they also need to make sure there are enough floating interpreters who can fill in if someone else is out," she said.

Gilman thinks many people do end up without Medicaid or with delays in obtaining it as a result of the language barrier.

"I think quite a few attempt and give up, and others get the services eventually by going through community organizations," she said. "But it’s not fair that they have to go through an extra layer that an English speaker doesn’t."

Gilman said the study is a small part of a larger effort to make sure people of different origins and backgrounds are able to access government services.

"Not getting Medicaid could be devastating for a family," said Rabbi Kahn. "All because they weren’t able to access the services they are entitled to. We don’t want families being put at risk because of DHS’s failure to meet their responsibilities.

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The NewStandard ceased publishing on April 27, 2007.

Kari Lydersen is a contributing journalist.

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