--- title: "The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting. | Sutter Health" description: "To examine impact of threshold language policy-required language assistance programming on limited English proficient persons' access to mental health services." url: "https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting. # The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting. McClellan SR, Wu FM, & Snowden LR. _Med Care. 50(6):554-8. doi: 10.1097/MLR.0b013e3182463432._ 2012-06-01 ## Abstract BACKGROUND: Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. RESEARCH DESIGN: We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. RESULTS: Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P < 0.01) and Vietnamese (3.3, P < 0.01) language speaking persons. CONCLUSIONS: Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/22581014) ## Research topics - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Policy](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Policy%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Association of mandated language access programming and quality of care provided by mental health agencies.](https://www.sutterhealth.org/research/publications/lang-access-care-quality-mental-health-agencies-1055312895) McClellan SR, Snowden L. Psychiatr Serv. 2014 Sep 15. doi: 10.1176/appi.ps.201300522. \[Epub ahead of print\] 2014 Sep 15 - Publication ### [Patient and physician race and the allocation of time and patient engagement efforts to mental health discussions in primary care: an observational study of audiorecorded periodic health examinations.](https://www.sutterhealth.org/research/publications/pt-md-race-empathy-mental-health-primary-care-1055312353) Foo PK, Frankel RM, McGuire TG, Zaslavsky AM, Lafata JE, Tai-Seale M. J Ambul Care Manage. doi: 10.1097/JAC.0000000000000176. \[Epub ahead of print\] 2017 Mar 27 - Publication ### [Periodic health examinations and missed opportunities among patients likely needing mental health care.](https://www.sutterhealth.org/research/publications/health-exams-missed-opports-mental-health-care-1055312291) Tai-Seale M, Hatfield LA, Wilson CJ, Stults CD, McGuire TG, Diamond LC, Frankel RM, MacLean L, Stone A, Lafata JE. Am J Manag Care. 22(10):E350-7. 2016 Oct 01 - Publication ### [Voting with their feet: patient exit and intergroup differences in propensity for switching usual source of care.](https://www.sutterhealth.org/research/publications/pt-exit-intergrp-diffs-switch-care-source-1055312541) Tai-Seale M. J Health Polit Policy Law. 29(3):491-514. 2004 Jun 01 - Publication ### [The long-term effects of Medicaid managed care on obstetrics care in three California counties.](https://www.sutterhealth.org/research/publications/medicaid-managed-care-obstetrics-ca-counties-1055312574) Tai-Seale M, LoSasso AT, Freund DA, Gerber SE. Health Serv Res. 36(4):751-71. 2001 Aug 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803#medicalscholarlyarticle","name":"The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.","headline":"The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.","abstract":"BACKGROUND: Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a \"threshold language access policy\" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. RESEARCH DESIGN: We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. RESULTS: Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P \u003c 0.01) and Vietnamese (3.3, P \u003c 0.01) language speaking persons. CONCLUSIONS: Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.","description":"To examine impact of threshold language policy-required language assistance programming on limited English proficient persons' access to mental health services.","keywords":["Mental Health","Health Disparities","Health Policy","Health Services"],"datePublished":"2012-06-01","url":"https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"22581014"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1097/MLR.0b013e3182463432"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/22581014/","https://doi.org/10.1097/MLR.0b013e3182463432"],"isPartOf":{"@type":"Periodical","name":"Med Care"},"author":[{"@type":"Person","name":"McClellan SR"},{"@type":"Person","name":"Wu FM"},{"@type":"Person","name":"Snowden LR"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Mental Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Mental+Health%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Policy","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Policy%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/language-help-and-access-to-mental-health-services-1055312803#breadcrumblist"}}} ```