Inter-Departmental Correspondence

Health System



February 23, 2009


March 31, 2009







Honorable Board of Supervisors



Jean S. Fraser, Chief, Health System


SaraT L. Mayer, Director, Health Policy and Planning



Amendment to the Agreement between the County of San Mateo and Avid Translation



Adopt a Resolution

    1) Authorizing the President of the Board to execute an Amendment to the Agreement with Avid Translation, changing the agreement amount by $117,000 from $84,000 to a new maximum of $201,000, with no change to the term; and


    2) Authorizing the Chief of Health System or designee to execute contract amendments which modify the County's maximum fiscal obligation by no more than $25,000 (in aggregate), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.



Commitment: Ensure basic health and safety for all

Goal(s): Help vulnerable people – the aged, disabled, mentally ill, at-risk youth and others – achieve a better quality of life.


This Amendment contributes to this commitment and goal by allowing County health service providers to effectively communicate with limited English proficient people.


Performance Measure:


FY 2008-09

FY 2009-10

Number of clients using interpreters





In May 2004 the San Mateo County Health Department and the community convened for the first Healthy Communities Summit to focus on health disparities. Community members recognized that differences in health care and health outcomes in populations are often a result of social and economic factors. Summit participants voiced a commitment to eliminating these differences. One of the issues prioritized for initial focus was an assessment of access to healthcare services by limited English proficient (LEP) populations in San Mateo County. In October 2006 your Board accepted the “Linguistic Access Study: Summary of Findings and Recommendations Report.”


A key recommendation noted in the report included expanding the availability and use of oral language services and translation services to a wider range of settings and languages. As part of implementation of this recommendation, an agreement was developed with Avid Translation in July 2008 to provide in-person interpretation and translation services for Aging and Adult Services, Behavioral Health and Recovery Services, Family Health Services, Health Policy and Planning, and Public Health Divisions.



In July 2008 the Health Department adopted two policies on linguistic access to services, resulting in increased utilization of interpreter and translation services. The implementation strategy for these policies included the selection of vendors for interpretation and translation services, the training of all staff in accessing these services, and the development of a simplified access process including a single access line and a comprehensive website with forms, protocols and resources. Utilization of in-person interpretation rose sharply between the 1st and 2nd Quarters of FY 2008-2009 (representing the initial two implementation quarters). Behavioral Health and Recovery Services and Family Health Services represent the two divisions with the highest usage of interpreter services. As a result, it is necessary to increase the contract amount so as to encourage additional use by County employees.


The Agreement and Resolution have been reviewed and approved by County Counsel. Risk Management has reviewed and approved the insurance coverage.



The term of this agreement is from July 1, 2008 through June 30, 2010. This Amendment increases the contract amount from $84,000 by $117,000, for a new maximum obligation of $201,000. Behavioral Health & Recovery Services will pay $133,000, Family Health Services will pay $34,000, Aging & Adult Services will pay $16,000, Public Health will pay $10,000, and Health Policy & Planning will pay $8,000. Costs for the Amendment are included in the FY 2008-09 Adopted Budgets and will be included in the FY 2009-10 Recommended Budgets for each Division. There is no Net County Cost.