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New York City Council Hearing: Access to Language Services and Equitable Care in NYC Hospitals During COVID-19

Matilde Roman, Esq., Chief Diversity and Inclusion Officer, Office of Diversity and Inclusion
Monday, March 1, 2021

Good afternoon Chairperson Rivera and members of the Committee on Hospitals. I am Matilde Roman, Chief Diversity and Inclusion Officer at NYC Health + Hospitals (Health + Hospitals). I am joined by Margarita Larios, Associate Director of Health Equity and Language Access at Health + Hospitals. Thank you for the opportunity to testify before you to discuss access to language services and equitable care in NYC Hospitals during COVID-19.

Health + Hospitals is the safety net for the uninsured and underserved in New York City, providing health care services to over one million New Yorkers each year. Our mission is to extend to all New Yorkers, comprehensive and equitable health services of the highest quality in an atmosphere of humane care, dignity, and respect regardless of their language spoken, immigration status, gender, sexual orientation, disability, or ability to pay. As such, it is a critical part of our mission to provide accessible, culturally, and linguistically appropriate services to ensure full access to comprehensive and quality care for all New Yorkers.

At Health + Hospitals, patients who receive care belong to many different racial and cultural backgrounds. An estimated 30% of patients served are limited English proficient, and more than 60% of patients self-identify as either Black/African American, Hispanic/ Latinx, or Asian. That is why Health + Hospitals offers free language services 24 hours a day, 7 days a week, 365 days a year in over 200 languages and dialects. We translate key patient documents, such as consent forms and patient education materials, into the top languages requested by limited English proficient (LEP) New Yorkers.

Health + Hospitals is a leader in providing culturally competent and linguistically appropriate services. In Fiscal Year (FY) 2020, Health + Hospitals facilities received more than one million requests for interpretation services that yielded 13 million interpretation minutes. System wide initiatives to support communication for persons who are LEP include:

  • Making available language access resources to inform the public of the availability of free language services, and tools to ensure quicker access like language ID desktop displays, and ‘I Speak’ cards and buttons to support facilities in the delivery of language assistance services;
  • Creation of a centralized database system to collect language service usage and key performance metrics to monitor for quality assurance and effectiveness; and
  • Having a designated Language Access Coordinator at each facility who is responsible for overseeing the provision of language services.

Our provision of culturally competent, equitable health services are guided by:

  1. An understanding of the important role of one’s culture, race, gender, and other social identity based categories in interpersonal and professional encounters in health care;
  2. An awareness of historical and socio-political factors such as racism, ableism, immigration patterns, and human rights violations and their impact on the health and well-being of minority populations; and
  3. The value in collaborating with ethnic and racial minority community-based organizations to ensure appropriate responses to individual health needs.

As mentioned, language services is a key component to eliminate barriers to care, improve patient safety, and enhance the patient care experience. As part of our ongoing efforts, Health + Hospitals promotes patient rights to language services by ensuring signage regarding the availability of free language services are posted in public areas, distributing “I Speak” cards to patients, and making available multilingual education and marketing materials.

When COVID-19 arrived in New York City last March, hospitals everywhere had to quickly adjust their service delivery approach, including Health + Hospitals. The pandemic ushered in a rapid expansion of telehealth and technological innovation at Health + Hospitals. With the shutdown order in place and in-person ambulatory services significantly reduced, Health + Hospitals clinicians turned to telephonic and video communication to serve the over 500,000 patients who rely on Health + Hospitals for outpatient care annually. One of the most emotionally devastating aspects of COVID-19 was the State mandated no-visitor policy. While necessary to curb the risk of spreading the virus, the State’s no-visitor policy in hospitals and nursing homes nationwide were heart-wrenching for patients, residents, families, and staff. From April to May 2020, Health + Hospitals deployed 1,000 donated tablets across the system through a patient-family connection program. Over 500 video calls were made a day to keep patients and their loved ones connected, and keep families abreast of the patient’s status and care. The system-wide language interpretation service supported our virtual communication with families in 183 languages.

For patients who did not require admission to the hospital, the System launched an at-home COVID-19 text message-based symptom monitoring program in the City’s top 13 languages for patients discharged from the Emergency Department. Enrolled patients received secure text messages every 12 to 24 hours to assess their symptoms in their language.

True to its mission, Health + Hospitals puts its patients first connecting them to language services while providing safe and quality health care services. Health + Hospitals will continue to provide health services in a culturally responsive manner to meet the needs of the City’s diverse population. Thank you for your attention to this important topic; we are happy to answer any questions you may have.