Using interpreters to help deliver medical care can be costly, so area health centers have taken different routes to bridge the language gap.
At Golden Valley Health Centers, "dual-role employees" have replaced professional medical interpreters.
Dual-role staff members have a primary job, such as medical assistant or receptionist, but they also have language abilities that allow them to interpret for non-English-speaking patients, said Felicia Batts, research program manager with Golden Valley.
That method has saved the health center a lot of money over the years while ensuring patients get the information they need, she said.
"We can't afford medical interpreters," Batts said. "For us, our answer and our belief is that you have to create the infrastructure that prepares yourself to provide these services."
According to 2010 statistics from the U.S. Department of Labor, the median pay for interpreters was $20.88 per hour.
For more than 40 years, Golden Valley has had bilingual staff who at times have interpreted for patients. But it wasn't until 2005 that the health center began to develop a formal system for language-access services, Batts said.
That's when the centers began to hire dual-role employees.
But such employees need to be well-qualified to interpret, patient safety otherwise could be compromised, costing medical facilities a lot more than hiring professional interpreters.
A 2007 study found that about one in five dual-role staff interpreters at a large health care organization had insufficient bilingual skills to serve as interpreters in a medical situation, according to the Sutter Health Institute for Research and Education, which did the study.
Health care organizations that depend on dual-role staff interpreters should consider assessing their English and second-language skills, the study said.
Golden Valley does just that.
Staff members have to pass a phone screening and a language-proficiency assessment, Batts said. They can be placed at three levels -- basic, intermediate and advanced.
Only those at the intermediate and advanced levels are allowed to interpret, she said. Those who place in the basic level can schedule appointments in the non-English language, when needed, but can't translate for doctors.
"We call it patient safety," she said.
Based on a federal study, it's estimated that 52 percent of the people in Merced County speak a language other than English at home, public health officials have said. That amounts to about 134,500 people. The county's population is slightly more than 258,000.
Out of those 134,500 people, about 80 percent, or about 107,600, are Spanish speakers, officials have said.
Area health centers always try to hire bilingual and bicultural employees, officials said.
Peter Mojarras, director of operations at Castle Family Health Centers, said Castle does something similar to Golden Valley, simply because Castle also can't afford interpreters.
Castle also does internal competency testing and training, he said.
It trains employees to make sure their language skills are sufficient to be qualified interpreters, Mojarras said. "There needs to be appropriate communication, because it can compromise patient care if you don't have good and effective communication," he said.
Misunderstanding between a patient and a doctor can lead to potential safety issues, he added, especially when it comes to medication that's being prescribed.
Castle has anywhere from 15 to 20 employees who can interpret, he said.
In 2009, Golden Valley conducted a study that found that out of 88 dual-role employees, 16 percent were at the basic level, 51 percent were intermediate and 33 percent advanced, Batts said.
The next study will see how much money Golden Valley has saved, she said.
Employees don't see it as additional work because that's part of the job description when they apply, Batts said. They know about it from the start.
"I'm sure there's people who won't apply," she said.
Leslie McGowan, chief executive officer for the Livingston Medical Group, didn't return a call seeking comment.
Mercy Medical Center contracts with Healthy House Within a MATCH Coalition for interpreting services, officials said.
The interpreters are mainly stationed at the emergency department, but they help with patients throughout the hospital if requested.
Every room at the hospital is equipped with a phone that offers translating services for up to 150 languages, officials said.
All agencies say they are ready to meet the increased demand for interpreting services as more people gain health care coverage in January 2014, under the federal Affordable Care Act.
Reporter Yesenia Amaro can be reached at (209) 385-2482 or firstname.lastname@example.org.