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2 Karmanos Cancer Center Respects Our Patient’s Rights

3 Objectives Understand ‘The Patient Bill of Rights’ Ensure all staff members are knowledgeable about our Interpreter Program Understand the Interpreter process List our resources for patients needing communication assistance

4 The Patient Bill of Rights ‘Our patients have rights’ Informed upon admission to the hospital & at registration for clinic appointments… Brochures are available in our 3 most frequently requested translator languages - Arabic, Spanish & Polish Wall mounted posters are placed at all entrances to KCC, in every Ambulatory Clinic & in every In-patient Unit

5 Federal & State Laws Federal & State Regulatory Agencies mandate that patients are informed of their rights It is our responsibility to inform patients and uphold their rights Major fines and penalties can result if strict guidelines are not diligently maintained

6 The Law Patients are provided with all contact information necessary to initiate a formal complaint to Regulatory Agencies, in the event they perceive their rights have been violated. KCC Policy CLN 001 ~ ‘Patient Rights and Responsibilities’ reflects our commitment to these rights.

7 Summary of Patient Rights 1. Knowledge & Plan of Care Pain management Qualifications & identification of all persons caring for them Information on all aspects of care & options for care …. Their Choice 2. Consent Be informed & involved in all decisions Refuse treatment with full understanding of consequences

8 3. Dignity & Respect Treated the same as others & not denied care based on race, creed, color, national origin, age, religion, sexual preference, marital status, sex or source of payment 4. Confidentiality Patient & medical record will be treated confidentially. Request for a confidential admission to KCC will be honored Summary of Rights con’t

9 5. Advance Directive A written document providing authorization to a person to direct all aspects of future care if the patient can no longer do it. 6. Continued Course of Care Discharge planning 7. General Information Ask for protective services All hospital policies & procedures regarding complaint resolution

10 Summary of rights con’t. 8. Complaint Process Contact information for Customer Service Department, Compliance Hotline, and the State level Regulatory Agencies 9. Medicare Rights All decisions that the hospital, MD or plan make for your care Discharge plans Second opinion on discharge readiness

11 Your Responsibility To know that our patients have rights To respect and uphold their rights Location of resources: * Brochures in Registration * Posted on walls throughout campus * Customer Service Department

12 Interpreter Program The Civil Rights Act of 1964 – “Title VI” requires that all healthcare providers offer oral and written language assistance to limited English proficiency (LEP) individuals. Title VI prohibits discrimination based on race, color or national origin. The State of Michigan, Office of Civil Rights mandates that healthcare providers ensure effective communication for all patients.

13 LEP individuals are knowledgeable about their rights, and we must respect our diverse language communities by facilitating effective communication. Patients are not financially responsible for interpreter services or communication assistance—this is a free service. Non-compliance to this law may result in major penalties, loss of federal funding and costly legal fines. Our top 2 language requests are Spanish & Arabic.

14 Services Certified interpreters and translations services must be provided to Non-English or LEP patients and their families. Sign language interpreters for deaf patients and the hearing impaired must also be accommodated. Hard of hearing individuals must be supported with the proper resources. Visually impaired patients must be supported with appropriate resources

15 Resources & Support It is our responsibility to assess patients’ language needs – providing support and resources to ensure effective communication. It is the law & every team member must be able to initiate the process assuring language is presented in an understandable manner.

16 Assessment is key It is our responsibility to assess the patient’s understanding of English, and if there is a deficiency, immediate support must be provided. When a KCC staff member recognizes the need for an interpreter, a 3-step assessment takes place: 1. What type of interpreter service is needed 2. When the interpreter service needs to be provided 3. Who should be present during the scheduled interpreter session

17 Tele-Interpreters 1st Tele-Interpreters should be the first choice for interpreter support. Virtual Interpreter Services are also available as needed in many of our Outpatient Clinics and may be initiated to support LEP conversations. Spanish & Arabic languages are available ‘on demand’ via clinic based mobile laptop computers. Other languages can be pre-scheduled for patient’s appointment. Tele-Interpreters is a telephone service that provides access to over 150 languages in minutes Just call * enter Client #14086 Conference telephone are available to facilitate multiple participants conversing thru the Interpreter. Refer to Policy ADM 304

18 Face to Face Interpretation There may be specific individuals or circumstances require face to face interpreter services. This may include: explanation of surgical procedures, initial appointments in Radiology Oncology or the Infusion Center, special procedures, or upon Physician request. Discharge instructions should always have a face to face interpreter to ensure understanding of plan and optimize compliance. Discharge teaching may be done throughout the patient’s entire hospitalization, and validated during the final discharge phase with a face to face interpreter.

19 Face to Face Interpretation The process to request a face to face interpreter is: 1. Determine the time, place and persons that should be present for this scheduled meeting. (a 24 hour advance notice is required.) 2. Complete an ‘Request for Interpreter ‘Form – located in Policy ADM Fax completed form to Customer Service

20 Interpreter Request Form Monday to Friday, 0800 to form to & (All requests must be ed to BOTH address’s) (Please provide 24 hours notice) Today’s Date: ________________________ [ ] Sign Language [ ] Other Language (specify) _________________ Patient’s Name (please print):_________________________________________________________ Patient’s Date of Birth: _______________________________________________________________ Requested Service Date: ___________________________ Time of Service: __________________ Name of Clinic/Area of Service:_________________________________________________________ KCC Employee Requesting Service & Phone Number: ______________________________________ Will be Completed after Services are Confirmed Confirmation of Services will be sent back to Requester Name of Interpreter:_________________________________________________________________ Scheduled Start Time:_______________________________________________________________ Confirmed By:_________________________________________ Date/Time:___________________ Monday to Friday, 0800 to 1600 Fax form to: Customer Service

21 Vital Documents Numerous ‘vital documents’ have been translated into our 2 most frequently requested languages – Arabic & Spanish These are: 1. General Consent … Available in Braille 2. Consent for Surgery, Anesthesia, Invasive and/or Diagnostic Procedures … Available in Braille 3. Complaint Forms 4. Waiver of Rights

22 Vital Documents The ‘Waiver of Rights’ document gives our patients the right to refuse the use of our interpreters. There may be specific patients that do not want this service, and they have the right to refuse. In this case, we must obtain their signature of the ‘Waiver of Rights’ indicating that it was their decision not to have the interpreter support we offered to them.

23 Waiver of Rights Acknowledgement of Risk and Refusal of Interpreter Services Patient Name: __________________ Patient ID: ____________________________ Karmanos Cancer Center has a commitment to ensure all patients understand the language being spoken during their experience at our center. All Limited English Proficiency (LEP) individuals have the federal right to language assistance. We provide free interpreter services to assist all patients in effective communication. An individual may choose to have a friend or relative interpret for them instead of the interpreter service provided by the Karmanos Cancer Center. If an individual chooses to voluntarily use their own interpreter, our center waives the right to ensure your understanding of the communications. By signing this form below, I hereby acknowledge and assume the risks associated with refusing the assistance of qualified medical interpreters offered free of charge at the Karmanos Cancer Center. This waiver has been orally explained to you by a Karmanos Cancer Center representative proficient in the patient’s own language, and your signature indicates full acknowledgement of your refusal of this service and the risks taken by not accepting our interpreter services. Patient’s Signature:____________________________ Date: __________________

24 These ‘vital documents’ are available on all units and clinics. Brail documents are available in the Customer Service Department If additional support or resources are needed to assist with the use of these documents – please call the Customer Service Vital Documents

25 Interpreters Title VI mandates that in healthcare settings, LEP receive medical information through a Certified Medical Interpreter. A staff member that indicates they are proficient in another language cannot be utilized for important medical information interpretation – they must be Certified as a Medical Interpreter. There is a medical certification examination that can be completed. Interested candidates can call the Customer Service Department for more information.

26 Resources Tele-Interpreters ~ 24 hour availability to over 150 languages. Virtual Interpreter Services available in several Outpatient Clinics Face to face interpreters ~ through external agencies or by staff members that have obtained certification as a medical interpreter. Translated vital documents into the LEP's first language, including brail. Telecommunication device for the deaf (TDD) Amplified phone handsets for hearing impaired patients Picture boards, write on/ wipe off slates, Multi-language Pain Scale

27 Resources for the Visually Impaired Karmanos is committed to meeting the communication needs of all our patients. Visually Impaired Patients may request that additional medical documents be translated into Braille. There is about a 5 day turn- around-time on this service. This is a free, off-site service, conducted at the patient’s request.

28 Your Responsibility Policy ADM 304: Translator/Interpreter Policy outlines our commitment to effective communication with LEP, deaf and hard of hearing individuals. It is every team members responsibility to assess our patients for their language skills, identify gaps and support them with the resources to ensure effective communication.

29 References Patient Bill of Rights, Bill of 2001,United States Congress State of Michigan, Patient Rights and Responsibilities Civil Rights Act of 1964, United Stated Federal Legislation

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