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Language Access: Improve Health Outcomes for Limited English Proficient Patients

An Akorbi worker with a patient at the doctor's office

Originally Posted by The Joint Commission on January 23, 2019

Language access rules and regulations have significantly strengthened as public policy related to medical insurance coverage as well as federal and state funding requirements evolve throughout the United States.

Furthermore, patient rights and awareness, along with community healthcare advocacy efforts, have increased the need for healthcare organizations – including ambulatory care providers – to deliver compliant interpretation (spoken word) and translation (written word) solutions.

Health plans and systems are subject to comply with multiple regulations including, but not limited to: Section 1557 of the Affordable Care Act (ACA).

As of July 18, 2016, healthcare providers are now mandated to comply with Section 1557, the nondiscrimination provision of the ACA, which broadly prohibits discrimination in healthcare or health coverage on the basis of:

  • Race
  • “Color”
  • National Origin
  • Immigration Status
  • English Language Proficiency

It also requires health care providers to provide patients with access to qualified interpreters. If a qualified interpreter is not provided, patients have the right to sue the provider for language access violations. Section 1557 of the ACA also:

  • Prohibits the use of minor children to serve as interpreters, except in emergency situations when a qualified interpreter is not available.
  • Limits the use of adult family members, friends and bilingual or multilingual staff as medical interpreters when certain criteria are not met.
  • Makes it illegal to require an individual with limited English proficiency to provide his or her own interpreter during medical encounters.
  • Requires document support for up to the top 15 languages in our area as outlined by CMS.
  • Requires all notifications, including notice of interpreter support, to be in the native language of the Limited English Proficient (LEP) member.

Title VI of the Civil Rights Act of 1964

Under Title VI of the Civil Rights Act of 1964, discrimination on the basis of race, color or national origin is prohibited. As a result, all organizations that receive federal funding such as Medicaid and Medicare are required to provide interpretation and translation services to their limited English proficient patients.

Section 508 of the United States Workforce Rehabilitation Act of 1973

Nearly 20 percent of today’s web audience has a disability that requires assisted technology. Section 508 requires that all information technology produced, maintained, or used by the federal government is accessible to people with disabilities. Among other things, this includes language access and accommodations that make information accessible to blind, deaf, and hard-of-hearing individuals.

Steps to Compliance: Designing a Road Map

To stay compliant with the ever-changing rules and regulations as well as successfully obtaining and retaining Joint Commission accreditation, your healthcare organization may want to develop a language access plan. While The Joint Commission doesn’t have a requirement explicitly stating an organization must develop a language access plan, it does help to demonstrate that the organization is addressing many of our standards in this area.

Language access plans:

  • Provide a roadmap for compliance
  • Mitigate risk
  • Allow for the deployment of translation and interpretation solutions that can deliver improved patient health outcomes

A trusted language service provider will guide your healthcare organization through the rules and regulations above as well as navigate additional relevant laws while also addressing all aspects required of an effective plan.

Read the Full Post on the Joint Commission Website

About the Author

Stacy Harjer is a Strategic Business Development Executive with Akorbi Interpretations, LLC, in Plano, TX. She has nearly a decade of experience working with Language Service Providers (LSPs) in the United States and globally. Ms. Harjer’s expertise is in delivering high-quality language solutions that mitigate risk, increase organizational compliance and improve patient health outcomes for Limited English Proficient (LEP) patients in healthcare, legal and commercial markets.

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