Healthcare Hurdles for Limited English Proficient Patients

People whose first language is not English deal with
additional hurdles to their healthcare. For non-native English speakers,
talking to a doctor or dentist can mean listening to unfamiliar medical terms
that may be difficult to understand. Trained medical interpreters can bridge
the gap between patients, doctors, nurses, and hospital staff.
Often, unqualified but well-intentioned friends and
relatives help limited English proficiency (LEP) patients navigate the
healthcare system. This often means that immigrant children serve as translators for
parents whose English is limited, or who don’t speak it at all.
LEP patients often don’t know laws exist that allow them to
obtain qualified language assistance. Title VI of
the Civil Rights Act of 1964 ensures the right to medical interpretation in a
patient’s language, including the right to documents containing information in
all programs that receive federal funding. However, Title VI didn’t specify who
would fund interpreters and services for people who are LEP.
To try to solve the problem, President Bill Clinton signed Executive Order 13166 in
2000. It called for federal agencies to look at their current programs, find
gaps in access for those who are LEP, and create plans to help the LEP
community participate in these programs in a meaningful way.
Supervision of programs for LEP beneficiaries of programs
with federal funding was never standardized because all federal agencies have a
Civil Rights division that oversees the enforcement of the Civil Rights Act of
1964.
Section 1557 of the
Affordable Care Act (ACA) further clarified that healthcare institutions can’t
deny or stall language assistance to people with LEP. Regulation for the
implementation of Section 1557 was issued in
2016 and required that
medical interpreters be trained, important documents were to be translated into
the 15 most spoken languages in a given state, and family or relatives could
only act as translators per patient request.
Once again, the lack of a central measure to ensure the
right to language assistance for the LEP community affects the life of patients
and medical staff every day. This is especially the case in rural areas. Hannah
Bascomb is a nursing professor at the Mississippi University for Women who
spoke about her experience as a bedside nurse for labor and delivery in
northeast Mississippi. Of her experience working interpreters, she says
circumstances were best when a translator could arrive in person “[You] could
go to a room and ask questions on the spot.”
Things got more complicated when patients spoke a language
other than Spanish, something that complicated Bascomb’s job. She stated that
staff often had to use a Dictaphone machine, which was usually locked and
required the user to push correct buttons and wait until an interpreter could
answer.
The good news is that at least, in Bascomb’s experience, it
seems as if medical staff and patients did what they could to ensure patients
had some language assistance. However, until governmental agencies, state
governments, and medical professionals can decide who pays for interpreters,
discrepancies in service will continue to exist.


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