Some states, such as Michigan, require that information about HIV testing be made available in English and Spanish. New Jersey requires its health department to disseminate information on breast cancer in English and Spanish.
Photo of girl and mother in exam room with doctor and interpreter; National Technical Institute for the Deaf, RIT. (American Sign Language is considered a language)
The Civil Rights Act of 1964 prohibits discrimination on the basis of race, color, religion, sex or national origin. In 2000, President Bill Clinton issued an executive order reiterating that hospitals and other health care providers that receive federal financial assistance under health plans such as Medicaid, Medicare and the Children’s Health Insurance Program have to meet the language needs of non-English speaking patients.
But Clinton's order didn't specify how to do so. Without any guidance, many providers have been relying on family members — even minor children — to serve as interpreters.
An article published in August in the journal Health Affairs found that a quarter of the hospitals with the greatest need for language services (based on the surrounding population) did not provide such services in a systematic way, and nearly a third of all US hospitals don't offer language services at all.
"The services are definitely not matching the need," said Melody Schiaffino, an assistant professor at the Graduate School of Public Health at San Diego State University and one of the coauthors of the Health Affairs paper.
Using an interpreter unfamiliar with medical terminology can produce dangerous misunderstandings. A study published in 2012 found that serious medical errors were less likely to occur with professional health care interpreters than with interpreters who don’t have special training, such as bilingual friends or family members, or no interpreters at all.
A provision in the 2010 Affordable Care Act (ACA) aimed to shore up interpreting services and this month the federal government is finally rolling out rules that detail the specific steps that health care providers must take. The rules apply to about 900,000 physicians, and 133,343 hospitals, home health agencies, nursing homes and other health facilities. It also applies to at least 180 insurers.
Under the rules, health care providers must post notices telling patients and their families that language services are available. Websites and other written materials must be translated into the 15 most frequently used non-English languages spoken in the state.
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