U.S. Investigating Bias Complaint Against Bay Harbor Hospital

A federal agency is investigating charges that Bay Harbor Hospital discriminates against non-English-speaking patients by failing to provide adequate interpreters and essential printed information in languages other than English, and by generally treating non-English speakers differently than English speakers during the hospital admissions process.

The investigation, by the U.S. Department of Health and Human Services, stems from a complaint filed on Oct. 16 by Herlinda Rodriguez of San Pedro, a former nursing secretary who says that she was forced to quit her job last summer because of harassment stemming from her complaints about hospital procedures. Rodriguez, who said she is on state disability because of emotional and physical stress, also has filed two legal actions charging the hospital with job discrimination.

“We have had no complaints about patient treatment based on languages,” said hospital spokeswoman Monica Hall, who described Rodriguez as a “disgruntled employee” who quit. “This area of Harbor City is very ethnically mixed, and if you walk through our halls we have patients and employees of all races,”Hall said.

Health and Human Services investigator Jonathan Botelho said the intent of the probe is to determine whether the 150-bed nonprofit, community-owned hospital--whose patients include federal Medicare and state Medi-Cal recipients--is in violation of Title 6 of the Civil Rights Act of 1964, which prohibits unequal medical services because of race, color or national origin. If violations are found and not corrected, the hospital could lose its right to obtain federal funds, he said.

“I cannot speak to the validity of any of these allegations,” said Botelho, adding that the hospital has asked for additional time to submit written responses to the charges. Botelho said hospital records will be looked at and employees and patients interviewed during the investigation, which he said will take several weeks.

“There is no foundation of fact in any of these allegations,” said hospital administrator Robert W. Murch. “But if they question any of our practices, we will comply.”

Botelho said that while Rodriguez’s complaint mentions Spanish-speaking patients, the investigation will extend to any language that is spoken by a substantial number of patients. The hospital could not provide ethnic information about its patients, but officials said that the two major languages, other than English, spoken by hospital patients are Spanish and Tagalog, the native language of the Philippine Islands.

In her complaint, Rodriguez asserted that while Bay Harbor has a policy of providing “official interpreters” when needed, it has no guidelines for such people and routinely calls on Spanish-speaking housekeepers to interpret, even though most feel incompetent “because of a lack of English skills and (knowledge of) medical terminology and procedures.”

She said patient information booklets are in English only, so that Spanish speakers “are not adequately informed on procedures or treatment that will be rendered, giving them the right or opportunity to refuse treatment of surgery.”

Rodriguez contended that upon admission, English-speaking patients are smoothly processed while Spanish speakers may be asked for so-called “green cards” to prove legal residency and may not receive referrals to other agencies when warranted. The hospital denies those allegations.

“The people who speak good English don’t have a problem,” she said in an interview. “The people who don’t, do.”

Hall said the hospital has three people who are designated as interpreters: two nurses and a business office employee.

Murch said housekeepers, who number about 20, “possibly are called on to interpret” if they are in the vicinity but, he said, “complex issues” are interpreted by the medical staff and 25 other volunteer hospital employees who speak a variety of languages, including Croatian, Greek, Thai, Arabic, Farsi, Samoan--even sign language. He said it is “presumed” that the volunteer interpreters are capable, but he does not know if the hospital has a procedure for determining their qualifications.

Murch said that when a patient speaks no English the hospital’s first choice is to telephone a “good English-speaking member of the family” to establish communication.

Several Practices

Random interviews with Bay Harbor employees, who did not want to be identified, reflected several practices.

A housekeeper who said she has a “grammar school education” said she has been called on to give general information, take medical histories, interpret medical terminology and explain therapies to Spanish-speaking patients. “If I don’t understand, I refuse,” she said, adding that supervisors sometimes pressure housekeepers to interpret even though they are busy with other duties.

A kitchen worker said that when there is a need for a Spanish interpreter, an announcement is made over the public address system requesting that a Spanish speaker report to the unit in question. “There are plenty of Spanish-speaking people who will translate,” the worker said. “It’s voluntary.”

A janitor said he interprets a “couple of times a week. . . . I tell patients what the doctor says. I feel I understand it. I’ve never felt I did not want to translate.”

An intensive-care nurse who speaks Spanish said that on a point of medical terminology or procedure, a nurse is called on to interpret. “Usually we have someone,” she said.

Consent Forms

On the question of providing published information in Spanish, Hall displayed medical consent forms written in Spanish. But in the hospital’s patient information kit, the only material in Spanish is a statement about patient rights and a list of visiting hours and emergency telephone numbers. Information about such things as surgical preparation procedures, hospital charges, accommodations and meals are in English only.

Murch conceded that the kit puts non-English speakers at a disadvantage, but he said this disadvantage does not extend to the treatment they receive at Bay Harbor. “This does not depend on having a pamphlet in English or Tagalog,” he said.

Hall said the information kit is obsolete and soon will be replaced by a booklet. But she said, “I don’t know if we will have the time and money to make a full brochure in Spanish.”

Rodriguez also criticized a hospital policy requiring that only English be spoken by employees while on duty in patient areas. Murch said the longtime policy--stemming from complaints by patients who were concerned that people “were talking about them” in other languages--was changed six months ago because of Rodriguez’s complaints. He denied Rodriguez’s assertions that some employees had been disciplined for speaking Spanish and said he thought the policy had a “reasonable basis.” But the administrator, who has been at Bay Harbor for a year, added, “I’m not sure I would have created it.”

He also said the hospital does not ask Spanish-speaking patients for green cards.

Variety of Approaches

A Times survey of some other hospitals near Bay Harbor found a variety of approaches to the language barrier.

Harbor-UCLA Medical Center, a large Los Angeles County facility in Torrance, employs six full-time Spanish-speaking interpreters who are trained in medical terminology. Other employees who are proficient in other languages receive bonus pay for interpreting they provide in addition to their regular duties. Information ranging from admission procedures to educational material is available in Spanish.

Torrance Memorial Hospital, Little Company of Mary Hospital in Torrance and San Pedro Peninsula Hospital utilize medical staff and community volunteers as interpreters. Volunteers do not receive special training.

San Pedro Peninsula publishes pre-admission instructions, surgical consent forms and after-care instructions in Spanish. The only Spanish-language material at Little Company is an emergency room brochure. Torrance Memorial publishes in Spanish an intensive-care guide and brochures on maternity services and the burn center.

Rodriguez has also filed a complaint with the state Department of Fair Employment and Housing, accusing Bay Harbor of job discrimination because of her complaints about the hospital and her refusal to act as an interpreter. In addition, she is pursuing a state workers’ compensation claim against the hospital, asserting that her physical and emotional stress are a result of harassment at Bay Harbor.