14029.93.
(a) The department shall ensure that all written health education and informing materials developed by managed care plans are at or below the equivalent of sixth grade reading level in English.(1) Written health education in English shall meet the readability and suitability checklists established by Medi-Cal Managed Care Division’s (MMCD) the department by means of all-county letters, plan letters, including All Plan Letter 11-018.
11-018, plan or provider bulletins, or similar instructions.
(2) Written informing materials in English shall meet the readability and suitability checklists established through the department’s contracts with managed care plans.
(3) Managed care plans shall adopt any additional readability and suitability standards developed by the community review process described in subdivision (c) and recommended by the department in subdivision (d).
(b) The department shall ensure that all written health education and informing materials translated into threshold languages by managed care plans are at or below the equivalent of sixth grade reading level.
(1) For each threshold language for which an equivalent sixth grade reading level cannot be determined, the department shall require managed care plans to establish a process for
Medi-Cal beneficiaries, advocates, and stakeholders to review existing and new materials through a one-time community review described in subdivision (c), with sufficient time to provide meaningful feedback.
(2) Plans shall adopt any additional readability and suitability standards developed by the community review process described in subdivision (c) and recommended by the department pursuant to subdivision (d).
(c) The department shall require managed care plans or other contractors to conduct a one-time, targeted community review of health education and informing materials in English and each threshold language, in order for members to ensure the cultural and linguistic appropriateness of materials in community-based settings. The managed care plans or other
contractors shall structure the community review process, as follows:
(1) When determining who shall participate in the community review process, the managed care plans or other contractors shall do all of the following:
(A) Provide background information on plan members, including the ratio of threshold language speakers, and a summary of the plan’s current community review process.
(B) Include current Medi-Cal beneficiaries and community-based organizations that work directly with Medi-Cal beneficiaries to identify and recruit beneficiaries with varying levels of literacy.
(C) Identify and include native speakers of a specific threshold language
to review translated materials in their threshold language. The use of software shall not be used in lieu of a native speaker to evaluate consumer-facing materials.
(2) Outreach methods for participants in the community review process shall include, but not be limited to, e-mail, mail, and telephone calls.
(3) When conducting the community review process, the managed care plans or other contractors shall do all of the following:
(A) Incorporate both quantitative and qualitative approaches, including focus groups and surveys with a minimum of four participants.
(B) Allow 60 days for participants to provide feedback.
(C) Have a native speaker of the threshold language assess, conduct, and evaluate the community review process and provide feedback.
(D) Allow community feedback in both written and oral formats.
(4) Managed care plans or other contractors shall conduct a targeted community review when new informing materials are created.
(d) The managed care plans shall report the findings of the community review process described in subdivision (c). The department shall publish the findings of the community reviews and develop recommendations for additional readability and suitability standards based on the findings.
(e) The following definitions apply for
purposes of this section:
(1) (A) “Health education materials” means documents that are designed to assist members to modify personal health behaviors, achieve and maintain healthy lifestyles, and promote positive health outcomes, including updates on current health conditions, self-care, and management of health conditions, as detailed in MMCD the department’s All Plan Letter 11-018. 11-018, or subsequently published letters, bulletins, or similar instructions.
(B) Health education materials include, but are not limited to, topics about preventive care, health promotion, screenings, disease management, healthy living, and health communications.
(2) (A) “Informing materials” means vital documents that provide members with essential information about access to and
usage of plan services, as detailed in MMCD the department’s All Plan Letter 11-018. 11-018, or subsequently published letters, bulletins, or similar instructions.
(B) Informing materials include, but are not limited to, all of the following:
(i) Enrollment and disenrollment forms and information.
(ii) Evidence of coverage (EOC) booklets.
(iii) Facility directories.
(iv) Form letters.
(v) Information regarding members’ rights and grievance procedures.
(vi) Insurance plan documents.
(vii) New member welcome packets.
(viii) Notices of action.
(3) “Plans” refers to managed care plans.
(f) This section does not apply to statements that are specifically required by law to be included in written materials.