California has a number of laws concerning the documentation of linguistic and cultural differences in medical records.   Specifically, California requires that all licensed health facilities, including clinics, record the patient’s principal spoken language in the patient’s health record.1

Health plans are required to provide services to those with language assistance needs.  In order to properly provide services, each health plan must conduct an assessment of its consumers’ languages.  Based on the assessment, the health service plan must report its policies on cultural appropriateness to the Department of Managed Care in order to evaluate the health plan’s management of diverse enrollees.2

The law also requires health insurance plans to collect and document information for language assistance and health care quality improvement purposes, which is then reported to the Department of Health Services.  However, in collecting this information, the health plan must maintain patient confidentiality.3  Additionally, every two years, the Department of Insurance must report on an insurance company’s compliance with requirements to provide insureds with translated materials and language assistance in getting benefits.4 The information collected is then used by the Department to make recommendations to the insurance companies regarding the language assistance programs and development of forms to notify insureds of their rights.5

California also imposes requirements on plans participating in its Medicaid program.  California law prohibits discrimination or the denial of health benefits funded through the state on the basis of ethnicity, religion, age, sex, color, or mental/physical disability.6  Each Medicaid participating plan must implement cultural and linguistic services requirements, such as requirements for interpreters, translated signs, translated written materials, and culturally and linguistically appropriate community service programs. 7