By Manuel Valdes
The Associated Press
SEATTLE — About 70,000 Washington residents who have limited English may lose access to interpreters during medical visits under a proposed budget cut.
The spending cut proposed by Gov. Chris Gregoire would eliminate a state-financed program that subsidizes interpreter services to medical clinics and hospitals who serve Medicaid patients.
At about $2 million, the proposed cut is a moderate one out of the governor’s emergency budget reductions, but one of the dozens needed as Gregoire and legislators grapple with a state budget that keeps falling in deeper deficits.
Lawmakers met in a special session Saturday to approve steps for trimming a $1.1 billion budget deficit through June.
Another, larger deficit in the next two-year budget also awaits when lawmakers return for regular meetings in January.
The interpreter program is conducted by the Department of Social and Health Services, which had been ordered to cut $113 million from its spending, spokesman Jim Stevenson said.
Under federal law, health care providers are required to make sure their Medicaid patients are able to communicate their needs well and for years the state felt it wasn’t fair to let providers carry that burden, Stevenson said.
So the state created the interpreter program, in which the state pays for the interpretation services. Stevenson said Washington is one of 13 states to have such a program.
Cutting the program would shift the cost of hiring interpreters to doctors, hospitals and clinics, or it will be another reason for health care providers to stop serving Medicaid patients, representatives for medical and interpreters services aid.
“No one here has argued it’s a good idea, but it’s the only way to get that big chunk of dollars (from the budget),” Stevenson said.
The impact warning from the budget writers says that cutting the program may result in “family members, including children, or other unqualified individuals” being used to relay complex medical information to patients.
Poor communication is a risk, the DSHS budget writers said, as well as an increase of emergency room visits due to lack of health care providers.
While the cut of state money is about $2 million, the annual budget for the program is around $14 million.
Because it’s a Medicaid program, the federal government matches 65 percent of what the state contributes.
The cut was originally set to be implemented next month, but after heavy lobbying, that date has been pushed back to March, giving lawmakers time to reconsider.
Last year, the governor’s office also ordered DSHS to also draw up plans for alternatives to cutting the program.
Those alternatives included transforming interpreters to state employees instead of contractors eliminating costs of going through a broker company. Other cost reducing ideas include remote video-linked and phone interpretation, said Todd Slettvet, who supervises the interpreter program for the state.
But the program is one of the easier ones to cut. Interpretation is an optional matching program under Medicaid and most optional programs are on the chopping block, Slettvet said.
The state draws from 1,500 interpreters who are contracted by a third-party broker. There are around 166 languages spoken in the state, but interpreters are mainly used for eight, which include Russian and Spanish, Slettvet said.
Many interpreters around the state have formed a union under the Washington Federation of State Employees.
The union helped lobby for the delay in implementation and has pushed to make interpreters state employees.
Tim Welch, a union organizer, said the state could face civil rights lawsuits if the program is eliminated. Lack of correct communication, Welch said, could also mean mistakes could be made by doctors, putting them at risk of litigation as well.
Welch said that the state would be giving up millions of federal dollars by cutting this program.
At the South Lake Clinic in Renton, Russian, Ukrainian and Spanish-speaking people often visit the clinic. After learning of the proposed cut, CEO Don Robertson said his clinics are considering fully withdrawing from DSHS programs.
“I think a lot of physicians will stop seeing patients that are covered under the program. For us, we’re going to discuss that here,” Robertson said.
The program “is absolutely crucial, everything from a patient understanding a treatment program to medications.
They have to understand what the diagnosis is and what is necessary to treat the conditions.”
Narscisa Hodges, a 44-year-old interpreter from Panama, said her job goes beyond translating languages. She sees herself as a cultural bridge between doctors and foreign-born patients. Without proper interpretation,
Hodges says patients may be reluctant to provide vital information and doctors may assume incorrect information.
“Assumptions are not good in the medical field,” Hodges said. In the medical field, “little things make a difference because if the doctor says to take four pills twice a day, that’s not the same as taking two pills twice a day.”
