English title: Know Your Rights! Linguistic assistance in the medical field.
I had reached out to a local community center that serves the immigrant population in Richmond, asking if there was any way I could give a presentation in Spanish on LEP patients’ rights when seeking healthcare services. Not only did they agree to hosting the presentation, but they hope it will become a repeat feature every semester for their community-based classes!
Unfortunately, I’ve encountered many healthcare facilities being unaware of their obligation to provide language assistance to LEP (limited English proficient) patients, and LEPs believing wholeheartedly that they don’t even have rights, let alone the right to language assistance. This lack of knowledge results in an underutilization of language services and a lack of accountability for it. Giving this presentation was a way to inform the local Spanish-speaking community at attempt to rectify this.
Topics Covered
Part 1: Legal
I gave a quick overview of the Department of Health and Human Services (DHHS) and how any entity receiving funds from DHHS must comply with federal discrimination laws. I clarified a common misunderstanding that many LEP patients have: just because an individual does not have Medicare or Medicaid does not mean their doctor’s office is exempt from such requirements when providing them with treatment. I gave a brief description of the following legislation and how they relate to language access:
- Title VI of the Civil Rights Act of 1964
- Section 1557 of the Affordable Care Act
I felt it necessary to define what “LEP” means as it was an acronym I used frequently during the rest of the presentation. If a covered entity denies an LEP language assistance, this is considered discrimination.
What is a “qualified” interpreter?
Going deeper into the implications of the ACA’s Section 1557, I explained what constitutes a “qualified” interpreter, and how this differs from a certified interpreter. I also emphasized that patients had the right to language assistance, but this does not mean they have the right to choose the type of language assistance they receive. LEP patients can express a preference (phone, video, in-person) but the practice is not legally required to honor this request.
One very detailed slide delved into the risks of using an unqualified interpreter:
- Longer and/or repeat visits
- Clinical errors
- Lack of privacy
- Conflicts of interest
- And more…
Part 2: Be Your Own Advocate
While it is an interpreter’s job to step into an advocacy role in certain situations, interpreters or other advocates may not always be present and uninformed staff may still not honor an LEP patient’s right to language assistance.
Appointment Scheduling
A common instance in which LEP patients can be their own advocate is during the scheduling process of their appointments. LEPs can make sure when they schedule an appointment that interpretation services will be available. It’s also important for LEPs to make sure interpretation services are not being lost during the rescheduling of appointments or referrals to specialty providers.
“Interpreter, please!”
I took some time to teach the attendees to say “Interpreter, please!” in English in instances where they are not being provided language assistance.
Filing a Complaint
If a facility is a covered entity and is not providing language assistance services to LEP patients, a complaint should be filed. I laid out a step-by-step process to escalate complaints and bring them to the attention of the proper authorities:
- Supervisor
- Practice or Hospital
- Network or Group of Practices or Hospitals
- State of Virginia
- Department of Health and Human Services (federal government)
Attendees were given a run-down of what sort of information would be needed to file a complaint.
This portion of the presentation was quite extensive and contained information about how to navigate local healthcare facilities’ websites and/or contact them in order to file complaints.
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