Language access policy: Laws, funding, and certification

Over 23 million Americans speak English less than “very well,” and for medical purposes may be considered LEP.  Providing language services is critical to ensuring the provision of quality healthcare as poor communication between patient and provider can lead to substandard health care due to inaccurate or incomplete information.   More and more healthcare providers frequently encounter LEP patients.  In recent studies conducted with the support of the presenter’s organization, we determined that 80% of hospitals encounter LEP patients frequently (63% daily/weekly; 17% monthly); 81% of general internal physicians treat LEP patients frequently (54% at least once a day or a few times a week; 27% a few times per month); and 84% of federally qualified health centeres provide clinical services daily to LEP patients (45% see more than 10 patients a day; 39% see from 1-10 LEP patients a day).

While federal laws, including Title VI, require recipients of federal funds to provide language services to ensure non-discrimination, these laws may not be effectively enforced and language barriers remain widespread throughout the healthcare system.  Until changes are made at the federal level to improve education about and accountability for compliance with Title VI, the states remain a better stage for improving language access.

This workshop will discuss the recent developments at the federal and state level to improve language access.  Congress has considered legislation to improve payment and resources for language access.  The presentation will outline proposals considered and identify the potential opportunities for success. 

Also, the workshop will discuss results from a comprehensive state-by-state survey of statutes and regulations related to language access and healthcare.  This 150-page report provides information on existing state laws for which education and implementation may be useful.  But it also offers, by comparing one state’s progress with another’s, opportunities to engage policymakers to improve language access and quality healthcare for LEP individuals. 

In the past few years, trends in the development of state laws have included:  requirements to develop state-based certification or competency standards for healthcare interpreters; implementation of laws requiring education of health profession students or continuing education for health care providers; enactment of sector-specific laws governing, for example, hospitals, pharmacies, or state agencies; and states have initiated payments for interpreters in Medicaid. For example, CA, NJ and OR have enacted laws requiring the education of some or all health professions students on issues of cultural competency.  And Connecticut recently enacted a requirement to pay for interpreters in Medicaid.  We will share how organizations in CA, CT, NH, NY, OR, and UT have used other states’ existing laws as a lever to improve policies in their states.