A recent audit conducted by New York State Comptroller Thomas P. DiNapoli found that the New York City Health and Hospitals Corporation (H+H) is not fully providing interpretation services required for patients who need language assistance.
“The Health and Hospitals Corporation has a tall order given the diversity of languages spoken in New York City, but it needs to do better,” DiNapoli said. “It is critical that those in need of medical care can communicate with health care providers. This audit found a number of shortcomings and offers recommendations that H+H can use to improve critical language services to its patients.”
H+H oversees 11 acute care hospitals, five post-acute/long-term care centers, and 30 community health centers. It reported providing 35.6 million minutes of interpretation services across 255 languages and dialects in fiscal year 2024, responding to 2.6 million requests—more than double the amount from five years prior.
Despite this volume, auditors identified several problems during their review. They made 55 phone calls to six H+H facilities in languages including Spanish, Chinese, Russian, Hindi, Haitian Creole, and Tagalog. Interpreters were provided on only 12 calls; on the remaining 43 calls, auditors encountered obstacles such as failed connections or lack of information. In some cases, staff hung up or interrupted interpreters.
Auditors also found the automated call system difficult to navigate in multiple instances and discovered that options for “other” languages did not work nor allow voicemail messages.
Documentation about these calls was shared with H+H without employee names at H+H’s request. However, H+H declined to address most issues raised by auditors because they could not verify the calls without staff names.
When staff are unable to identify a patient’s language, they may contact a vendor’s help line for assistance; however, an auditor’s test call with H+H officials failed to connect with a live operator.
Problems were also found during visits to mobile health vans operated by H+H. For example, although signs at one location indicated services were available in Chinese, only Spanish and English interpretation was available at the time of visit. At another visit at the same site, Google Translate was used for Tagalog communication but led to misunderstandings. Some locations lacked bilingual staff altogether or did not have access to phone or video interpretation services offered by vendors.
State regulations require hospitals like H+H to conduct annual assessments of community language needs; however, the audit found that such assessments had not been performed from 2019 through 2024.
Regarding training requirements for staff on language service provision, H+H policy mandates annual training but records were incomplete or missing for certain hospitals reviewed by auditors. For instance, over 4,000 out of more than 30,000 training sessions recorded at Bellevue Hospital were not completed.
Bilingual staff are also trained as interpreters for patients. Auditors noted gaps in record keeping regarding how many qualified interpreters there are at facilities such as Bellevue and Woodhull hospitals; lists of trained interpreters were unavailable or outdated.
Additionally, when bilingual staff provided interpretation services directly to patients rather than through vendors, those instances often went unrecorded—a part of broader problems with accurate record keeping on language services provided by H+H.
The audit also reviewed monthly reports submitted by vendors contracted by H+H for language access services and identified errors and missing data in these reports. Auditors questioned whether data on service failures was accurate since one major vendor reported no failures over almost three years while handling a majority share (73%) of phone-based assistance requests during early 2024.
These record-keeping deficiencies resulted in $215,879 in overpayments to vendors according to the audit findings.
The report made nine recommendations aimed at improving oversight and delivery of language access services at public hospitals managed by H+H.
Officials from H+H largely disagreed with both the findings and recommendations presented in the audit report. Their full response is included within the published document.
