The SBCMS is among 32 organizations comprising the Medical Leadership Council on Cultural Proficiency. In addition to county medical associations, the MLC includes medical specialty societies, health systems and advocacy groups. The MLC works to improve language access in healthcare and to increase the diversity and cultural proficiency of the state's healthcare workforce.

The MLC met in Sacramento in late 2007 and will meet again in May 2008. Presenters at the 2007 meeting called for increasing the number and diversity of physicians and other healthcare professionals in California, using state and federal legislation to improve language access and increase culturally proficient care, and supporting physicians in their efforts to provide both to patients.

Addressing the provider shortage.
Anmol Mahal, MD, immediate past president of the CMA, called for increasing the number of physicians trained in California to help meet the growing need and increase diversity. Currently, 7.8 million Californians live in geographic areas designated as Health Care Professional Shortage Areas, where there is at most one physician for every 3,500 residents.

The Office of Statewide Health Planning and Development administers several programs to help address the physician shortage, including the Song-Brown Healthcare Workforce Training Program, the National Health Service Corps/State Loan Repayment Program, and the healthcare professionals Shortage Designation Program.

Better coordination of efforts among the entities training new healthcare professionals and the entities wanting to employ them also would help address the shortage and improve diversity.

State and Federal legislative opportunities to advance policy changes.
Under current healthcare reform proposals, "70% of the newly insured would be from communities of color," says Ellen Wu, MPH, executive director of the California Pan-Ethnic Health Network. "Among the newly insured, more than 50% will speak a primary language other than English and almost 80% will be low-income," she says.

One state law and three federal bills promise to improve language access and culturally competent care. In California, SB 853, which passed in 2003 and goes into effect in 2009, requires all health plans and insurers to cover interpreter services and to have systems in place to provide interpreters as well. By 2009, all patients with insurance should be covered for interpreter services.

The State Children's Health Insurance Program reauthorization language would increase the reimbursement for interpreter services. HR 3014 would further increase reimbursement for interpreter services and would establish several measures to improve language access. S 1576/HR 3333 would apply several ways to improve cultural proficiency and end disparities.

Supporting physicians in providing language access.The California Endowment is funding several projects to expand the MLC's Language Access Resources database; train medical office staff in ways to provide interpreter services; compile best practices in health professions recruitment strategies; and find regional solutions for providing language access and culturally proficient care. The SBCMS received two of those grants--we just completed one and will start the second in early 2008.

Resources
For interpreter services, translation and culturally competent care, you can find additional information at:
www.medicalleadership.org
www.futurehealth.ucsf.edu
hwtc/languageaccess.html
www.hrsa.gov
healthliteracy/training.htm