title: Association of mandated language access programming and quality of care provided by mental health agencies.
abstract: OBJECTIVE
  This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP).
  
  
  METHODS
  In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years.
  
  
  RESULTS
  On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days.
  
  
  CONCLUSIONS
  This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.
authors.affiliation: Dr. McClellan is with the Palo Alto Medical Foundation Research Institute, Mountain View, California (e-mail: mcclellans@gmail.com ). Dr. Snowden is with the School of Public Health, University of California, Berkeley. Portions of the paper were presented at the AcademyHealth Annual Research Meeting, Baltimore, June 23-25, 2013.
authors.forename: Sean R
authors.initials: SR
authors.lastname: McClellan
authors.forename: Lonnie
authors.initials: L
authors.lastname: Snowden
mesh_terms: D000328:Adult; D002140:California; D005260:Female; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000592:standards / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D014175:Translating; D014481:United States