Health care workers in Northumberland County won't have nearly as many non-English speaking clients to whom they'll have to explain the Affordable Care Act.

Still, there are 22 foreign languages other than English spoken by 3,615 county residents, including 985 who say they speak English "less than very well," according to a recent survey.

The American Community Survey, conducted by the U.S. Census Bureau over a five-year period starting in 2007, Spanish was the most commonly spoken foreign language in the county of those who said they couldn't speak English very well. Following Spanish at the top of the list were West Germanic (including "Pennsylvania Dutch"), German, Polish and French.

Feds, state prepare

As to whether Pennsylvania is ready to explain the law to those people, it'll be up to the U.S. Department of Health and Human Services (DHS), said Rosanne Placey, spokesperson for the Pennsylvania Department of Insurance. DHS will manage the health care exchanges, the government-regulated and standardized health care plans from which individuals may purchase health insurance eligible for federal subsidies for Pennsylvania that begin in 2014.

"How they communicate will be up to federal authorities using the methods they choose," Placey said.

Gov. Tom Corbett released a statement in December announcing Pennsylvania would not pursue a state-based exchange at this time, citing concerns that the state will be fully funding the program one year after implementation.

"It would be irresponsible to put Pennsylvanians on the hook for an unknown amount of money to operate a system under rules that have not been fully written," Corbett said.

The state, however, is working to make its own information accessible to all to understand. Recently, Pennsylvania expanded its Pa. Fair Care program, providing health insurance coverage for those with pre-existing conditions. In making program guidelines available to the public, the state printed the information in both English and Spanish.

"For other languages, we have a translation service that helps us relay information back and forth," Placey said.

Under Title VI, the Civil Rights Act of 1964, Pennsylvania cannot discriminate on any federally funded programs because of race, color or national origin. On Compass, the Pennsylvania Department of Welfare's website, where residents can apply for benefits online, there are choices for Spanish, Russian, Chinese and Vietnamese.

MARTTI helps

At Geisinger Medical Center, Danville, varied languages can be a daily issue, but MARTTI helps overcome any obstacles. That's "My Accessible Real Time Trusted Interpreter."

"Basically, it's a webcam-enabled monitor that brings up a live person to help translate. The service includes hundreds of languages and dialects," said Michael Ferlazzo, public relations specialist for Geisinger Health System. "It is available campus-wide in Danville and GMC nurses are educated in using the system."

To obtain the device, an emergency department nurse can simply page the nurse supervisor on call.

As for Geisinger Health Plan members, a program called "Language Line" is available that provides translation services for members.

The American Community Survey, conducted from 2007 to 2011, shows the following results for Northumberland County:

(Language followed by the number who speak it followed by the number of those who still speak English "very well:"

Spanish or Spanish Creole: 1,497; 1,052

French (including patois and Cajun): 95; 49

Italian: 156; 134.

German: 378; 264.

Other West Germanic languages (including "Pa. Dutch"): 706; 508.

Scandanavian: 7; 7.

Russian: 31; 25.

Polish: 217; 160.

Other Slavic languages: 96; 96.

Gujarati (an Indo-European language): 6; 6.

Hindi: 7; 7.

Urdu: 16; 0.

Other (Indo-European language): 48; 25.

Chinese: 22; 22.

Japanese: 9; 7.

Korean: 14; 8.

Vietnamese: 35; 9.

Tagalog: 47; 32.

Other Pacific Island languages: 10; 10.

Arabic: 122; 117.

Hebrew: 92; 92.

Other and unspecified languages: 4; 0.