Servicing Members With Limited English Proficiency
Cultural Competency, as defined by the Pennsylvania Department of Public Welfare (DPW), is the ability of individuals to understand the social, linguistic, moral, intellectual, and behavioral characteristics of a community or population, and translate this understanding systematically to enhance the effectiveness of healthcare delivery to diverse populations.
Further, Section 601 of Title VI of the Civil Rights Act of 1964 states that:
No person in the United States shall, on the grounds of race, color or national origin, be excluded from participation in, be denied of, or be subjected to discrimination under any program or activity receiving federal financial assistance.
A form of discrimination against a recipient of Medical Assistance funds on the basis of national origin may be discriminatory actions against those of Limited English Proficiency (LEP). Therefore, these recipients must be allotted equal access to all services and benefits of AmeriHealth Caritas Pennsylvania.
Recipients of federal financial assistance would include the Pennsylvania Medical Assistance Program, and by extension, Medical Assistance Managed Care Organizations, i.e., AmeriHealth Caritas Pennsylvania and their participating providers.
Title III of the Americans with Disabilities Act (ADA) states that public accommodations must comply with basic non-discrimination requirements that prohibit exclusion, segregation, and unequal treatment of any person with a disability. Public accommodations (such as healthcare providers) must specifically comply with, among other things, requirements related to effective communication with people with hearing, vision, or speech disabilities, and other access requirements.
Communication, whether in written, verbal, or "other sensory" modalities is the first step in the establishment of the patient/practitioner relationship. The key to ensuring equal access to benefits and services for Limited English Proficiency (LEP) and sensory impaired members is to ensure that our providers can effectively communicate with these members. AmeriHealth Caritas participating providers are obligated to offer translation services to LEP members, and to make reasonable efforts to accommodate members with other sensory impairments.
If an AmeriHealth Caritas member requires or requests translation services because they are either a non-English speaking or a limited English speaking member, or, the member has some other sensory impairment, the provider has a responsibility to make arrangements to procure translation services for those members, and to facilitate the provision of health care services to such members.
In order to be in compliance with federal law and state contractual requirements, AmeriHealth Caritas and its participating providers have an obligation to provide interpreter services to LEP members and to make reasonable efforts to accommodate members with other sensory impairments.
Providers who are unable to arrange for translation services for an LEP member should contact AmeriHealth Caritas Health Plan's Member Services (1-888-991-7200 - TTY line – 1-888-987-5704), who will assist with locating a professional interpreter that communicates in the member's primary language.