OptumHealth Behavioral Solutions of CA ("OHBS-CA" or the "Plan") and other health plans regulated by the California Department of Managed Health Care (DMHC), including their network providers, are required to offer language assistance services to members with limited English proficiency (LEP). Language assistance services include oral interpretation services for all LEP members and written translation of certain documents for CA LAP-eligible LEP members, free of charge.
The legislation outlines specific requirements for health plans and their contracted network when working with LEP members. Detailed information about these requirements can be found on the California Department of Managed Health Care (www.dmhc.ca.gov) Web site. In addition, here are the highlights regarding what these requirements mean to you as a contracted provider with OHBS-CA for members covered under these regulations.
The Language Assistance Program includes:
- Surveying members to determine language preferences
- Making the information collected about member language preferences available to network clinicians and facilities upon request
- Informing members and providers of the availability of free language services
- Providing information to members on the availability of bilingual clinicians in the online Provider Directory
- Free interpreter services in the caller’s language of choice via Language Line Services to any member who requires language assistance
- Written member documents interpreted via Language Line Services, for all relevant documents per the regulations
- Written translation of member documents is available in identified "threshold languages" if spoken interpretation is refused
What is required of Clinicians and Facilities?
- Offer free interpretation services to members with LEP, even when the member is accompanied by a family member or friend who can interpret, or if you can speak in the member’s language.
- Document the acceptance or refusal of interpreter services in the member’s treatment record.
- Post a notice in your waiting room /facility regarding the availability of language assistance. This notice will be available in the OHBS-CA Network Manual or you can access a copy of the notice itself further down on this page under the Manuals/Notices section.
- Make the DMHC’s grievance process and Independent Medical Review (IMR) application and instructions available to members upon request. Providers may access the DMHC grievance instructions and IMR application on the Department’s web site at www.dmhc.ca.gov. The IMR application and instructions are available from the Plan in more than 10 languages.
- Obtain the pre-translated versions of the grievance form (see Forms section below) in each threshold language as well as the English version, accompanied by the notice of availability of language assistance. You may also contact us to obtain a paper copy for the member by calling the number on the back of the member’s ID card.
- If language assistance is required, contact the number provided on the back of the member’s ID Card. You will then be connected with Language Line Services, where certified interpreters are available to provide telephonic interpretation services, free of charge to you and the member.
OHBS-CA will monitor provider compliance with the language assistance program, as required by the regulations, through site visits and treatment record reviews.
We will continue to post educational and resource links (below) here at Provider Express to assist you in working with diverse populations and members with language assistance needs so be sure to keep an eye on the site for new information.
The Industry Collaboration Effort (“ICE”) provides resources to assist providers in serving a diverse membership:
- Better Communication, Better Care: Provider Tools to Care for Diverse Populations - Toolkit
- Tips for Documenting Refusal of Interpretive Services
- Tips for Working with Interpreters
- Tips for Working with Limited English Proficient (LEP) Members
OptumHealth Behavioral Solutions of California Summary of Language Preferences and Ethnic Diversity
- U.S. Behavioral Health Plan, CA:
- All other CA members:
CDI Long Notice - No Disclaimer
DMHC Long Notice - No Disclaimer
|OptumHealth Behavioral Solutions of California (OHBS-CA):|
|Member Grievance Form|
|Member Grievance Form - LARGE PRINT|
|DMHC Independent Medical Review (IMR) Application|
|CA Dept of Insurance IMR Application and Instruction|