SECTION 1. The legislature finds that persons with limited English proficiency are often unable to interact effectively with health care providers. Because of spoken language differences, persons with limited English proficiency are often excluded from health care services, experience delays or denials of health care services, or receive health care services based on inaccurate or incomplete information.

The legislature further finds that the lack of competent health care interpreters in the provision of health care services impedes the free flow of communication between the health care provider and patient, preventing clear and accurate communication and the development of empathy, confidence, and mutual trust that is essential for an effective relationship between a health care provider and patient.

The purpose of this Act is to establish a health care interpreter certification system within the department of health, with standards to be established by a board of health care interpreters.

It is the intent of this legislature that the health care interpreter certification system be guided by the policy statement issued by the United States Department of Health and Human Services, Office for Civil Rights, titled, "Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficiency Persons", dated August 8, 2003, and "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care: A Blueprint for Advancing and Sustaining CLAS Policy and Practice", as established by the United States Department of Health and Human Services, Office of Minority Health, dated April 2013.

SECTION 2. Chapter 321C, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part II. Health care interpreters

§321C-A Definitions. As used in this part, unless the context otherwise requires:

"Board" means the Hawaii board of health care interpreters, established pursuant to section 321C-B.

"Health care" means medical, surgical, or hospital care or any other remedial care recognized by state law, including dental and mental health care.

"Health care interpreter" means a person who is readily able to communicate with a person with limited English proficiency, accurately translate the written statements or interpret the oral statements of the person with limited English proficiency into English, and translate the written statements or interpret the oral statements of other persons into the language of the person with limited English proficiency.

§321C-B Hawaii board of health care interpreters; established. (a) There is established the Hawaii board of health care interpreters, which shall be placed within the department of health for administrative purposes only. The board shall consist of the following members to be appointed by the governor:

(1) One consumer of health care services who uses health care interpreters for the consumer's self or others;

(2) One educator who teaches interpreters or persons in related educational fields, or who trains recent immigrants and persons with limited English proficiency;

(3) One health care practitioner who utilizes interpreter services regularly in the practitioner's practice;

(4) One representative of a hospital, health system, or health plan that predominantly serves persons with limited English proficiency;

(5) One representative from a community health center that serves persons with limited English proficiency;

(6) One representative from a professional interpreter's organization registered with the department of commerce and consumer affairs;

(7) One representative of an advocacy organization that provides services to persons with limited English proficiency;

(8) One representative from an accredited institution of higher learning who provides professional training in spoken language interpretation;

(9) One member representing the department of health;

(10) One representative residing in the county of Hawaii who has shown interest in language access in health care;

(11) One representative residing in the county of Kauai who has shown interest in language access in health care;

(12) One representative residing in the county of Maui who has shown interest in language access in health care;

(13) The executive director of the office of language access, as an ex officio member;

(14) The program manager of the board, as an ex officio member; and

(15) One at-large member.

(b) All board members except ex officio members shall be appointed in accordance with section 26-34. The terms of the members shall be four years. The board shall select one of its members to serve as chair and one of its members to serve as vice-chair. No member of the board shall receive any compensation for board services but shall be allowed necessary expenses for travel, board, and lodging incurred in the performance of board duties.

§321C-C Board duties. The board shall work in cooperation with the office of language access and the department of health to:

(1) Develop standards for testing, qualification, and certification requirements for health care interpreters for persons with limited English proficiency;

(2) Coordinate with other states to develop and implement educational and testing programs for health care interpreters;

(3) Examine operational and funding issues, including but not limited to the feasibility of developing a central registry and annual subscription mechanism for health care interpreters; and

(4) Adopt rules pursuant to chapter 91 to establish procedures and fees for testing, qualification, and certification of health care interpreters for persons with limited English proficiency, including but not limited to:

(A) Minimum standards for qualification and certification requirements as a health care interpreter;

(B) Oral and written language skills in English and in the language for which health care interpreter qualification or certification is granted;

(D) Categories of expertise of health care interpreters based on the English and non-English skills and medical terminology skills of the person seeking qualification or certification;

(E) Procedures for receiving applications and for examining applicants for qualification or certification;

(F) The content and administration of required examinations;

(G) The requirements and procedures for reciprocity of qualification and certification for health care interpreters qualified or certified in another state or territory in the United States; and

(H) Fees for application, examination, initial issuance, renewal, and reciprocal acceptance of qualification or certification as a health care interpreter and other fees deemed necessary by the board.

§321C-D Application for qualification or certification; eligibility. (a) Any person seeking qualification or certification as a health care interpreter shall submit an application to the board. If the applicant meets the requirements for qualification or certification established by the board under this section, the board shall issue an annual certificate of qualification or a certification to the health care interpreter. The board shall collect a fee for the issuance of the certificate of qualification or the certification and for any required examinations in the amount established pursuant to rules adopted by the board.

(b) A person may be qualified as a health care interpreter under this section only if the person:

(1) Is able to fluently interpret or translate the dialect, slang or specialized vocabulary of the non-English language for which the qualification is sought;

(2) Has had at least sixty hours of health care interpreter training that includes anatomy, physiology, and concepts of medical interpretation; and

(3) Has had practical experience as an intern with a practicing health care interpreter;

provided that the person shall not use the title "qualified health care interpreter" unless the person has met the requirements for qualification established in this section and by rule, and has been issued a valid certificate of qualification by the board.

(c) In addition to the requirements for certification established in this section, a person may be certified as a health care interpreter only if the person:

(1) Has met all the requirements for certification established under this section; and

(2) Has passed written and oral examinations required by the board in English, in the non-English language that the person wishes to interpret or translate, and in medical terminology;

provided that the person shall not use the title "certified health care interpreter" unless the person has met the requirements for certification established under this section and has been issued a valid certification by the board."

SECTION 3. Chapter 321C, Hawaii Revised Statutes, is amended by amending the title to read as follows:

"[[]CHAPTER 321C[]

~~OFFICE OF~~] LANGUAGE ACCESS"

SECTION 4. Chapter 321C, Hawaii Revised Statutes, is amended by designating sections 321C-1 to 321C-7, Hawaii Revised Statutes, as part I to be entitled "Office of Language Access".

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $250,000 or so much thereof as may be necessary for fiscal year 2015-2016 and the same sum or so much thereof as may be necessary for fiscal year 2016-2017 to effectuate section 2 of this Act, including the establishment of at least four positions consisting of a program manager, two program specialists, and a clerk within the office of language access.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 6. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 7. Statutory material to be repealed is bracketed and stricken.

SECTION 8. This Act shall take effect on July 1, 2015.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	904
TWENTY-EIGHTH LEGISLATURE, 2015
STATE OF HAWAII