Oct. 5, 2009 MA HDC Meeting1 MA Health Disparities Council Working Group on Interpreter Services Update from Meeting #1 Measurable Standards of Practice Held September 23, 2009 (ppt rev. 9/24/09) Georgia Simpson May, Director, MDPH-Office of Health Equity (OHE) James Destine, Coordinator of Interpreter Services, MDPH-OHE Iyah Romm, Intern, MDPH-OHE

Oct. 5, 2009 MA HDC Meeting2 Health Disparities Council Interpreter Services Working Group Today we will update on: 1.Impetus for this Work 2.Scope, Process, Work Plan 3.Future Decision Point

Oct. 5, 2009 MA HDC Meeting3 1.Impetus for this Work The 2007 Massachusetts Legislative Commission to End Racial and Ethnic Health Disparities - Chapter 65 of the Acts of 2004 Three recommendations “to expand access to quality health care:” 1.Uniform standards modeled after the national standards developed through the National Council on Interpreting in Health Care (NCIHC). 2.Reimbursement procedures for interpreter services by all payers, public and private. 3.Statewide regulations to certify medical interpreters

Oct. 5, 2009 MA HDC Meeting4 September 2009 Meeting Update 2. Scope, Process, Work Plan

Oct. 5, 2009 MA HDC Meeting5 Presented for Review “Hospital Interpreter Services: An Overview of Historical Perspectives, Current Initiatives, and Steps for Moving Forward” Provides… I. History of Medical Interpretation II. Certification Terms, Definitions and Processes III. Reimbursement – Who and How IV. Standards of Practice – Current Efforts V. Recommendations for Our (ISWG) Work

Oct. 5, 2009 MA HDC Meeting6 I. Offered a Definition for Certification II. Reviewed Models for Certification - Washington State - MA Courts - Registry of Interpreters for the Deaf, Inc - Language Line University III. Reviewed Reimbursement for Medical Interpretation - 12 states currently reimburse - No two are exactly alike IV. Reviewed Standards of Practice - International Medical Interpreters Assoc/MDPH - National Council on Interpreting in Health Care V. Discussed The Work of ISWG - Analytic Framework - Five Areas of Work - Expectations of Recommendations - Meeting Schedule and Agendas

Oct. 5, 2009 MA HDC Meeting7 What do people in the Commonwealth want and need in this area? What is this area’s current status in Massachusetts? (What do we know, or don’t know?) Are there documented “best practices” in this area (locally and nationally)? What has been tried (locally or nationally)? What has/hasn’t worked? What are the main barriers to good practice/ improvement? How can each of those barriers be overcome? What kind(s) of data exist or could exist to demonstrate quality in this area? What kind(s) of accountability for quality are possible that would drive/ensure improvement? What resources would be needed? What are possible sources? Suggested Analytic Framework for ISWG MA EOL Expert Panel, 2009

Oct. 5, 2009 MA HDC Meeting8 Perform SWOT and Interview- Based Stakeholders Analysis Develop Commonwealth- Specific Standards of Practice with Measurability Metrics Explore Creative Reimbursement Models (within and beyond CMS) Resolve Potential for Quality Tiering (especially as it pertains to reimbursement models) Determine Optimal Model for Regulation and Implementation (Mandates?) Recommendations for ISWG Five Areas of Work

Oct. 5, 2009 MA HDC Meeting9 Expectations of Our (ISWG) Recommendations That All Recommendations Be 1.Actionable 2.Achievable 3.Measurable 4.Equitable 5.Cost-Effective 6.Sustainable 7.Monitored

Oct. 5, 2009 MA HDC Meeting10 ISWG Meetings and Tentative Agendas September 23, 2009 √ October 28 th, 2009 November 18 th, 2009 (changed from Nov. 25 th ) December 16 th, 2009 (changed from Dec. 23 rd ) January 27 th, 2010 February 24 th, 2010 March 24 th, 2010* Location : 250 Washington Street, Boston Commissioner’s Conference Room, 2 nd Floor Time : 3:15 – 4:45

Oct. 5, 2009 MA HDC Meeting11 October – December 2009 Oct 2009 – Mtg #2 (Certification Part I) Consensus on Standards Recommendation Presentation from IMIA on National Certification (proposed, not confirmed) How Should MA Build A Certification Mandate or Recommendation Nov 2009 – Mtg #3 (Certification Part II) Continuation and completion of Mtg #2 Dec 2009 – Mtg #4 (Reimbursement Part I) Consensus on Certification Recommendations Cost Quality Analysis Presentation – the cost of medical errors resulting from language discordance in clinical settings (presenter to be identified)

Oct. 5, 2009 MA HDC Meeting12 January – March 2010 Jan 2010 – Mtg #5 (Reimbursement Part II) Continue and complete Feb 2010 – Mtg #6 (Wrap Up ) Consensus on Reimbursement Recommendation Review Full Set of Recommendations Draft A Presentation for HDC Meeting *March 2010 – If needed

Oct. 5, 2009 MA HDC Meeting13 Future Decision Points National Certification, State Certification, or both? Who will serve as the state’s certifying and oversight body – existing or new? Sustainability of effort, ongoing monitoring. Need to explore and decide on mechanism for drawing down federal Medicaid dollars to reimburse for Interpreter Services.