One often neglected legal requirement by telehealth practitioners involves translation or language access services for limited English proficient (LEP) patients. This article will outline the federal and state laws, when and to whom they apply, then offer two case scenarios (one medical, another behavioral) to illustrate how they typically work in telehealth and relevant resources.
Laws to Better Serve Limited English-Proficient People
Federal LEP Laws
The federal provisions for limiting healthcare disparities between people with limited language proficiency are based on civil rights laws, including Title VI of the Civil Rights Act of 1964 and the Affordable Care Act (ACA).
The following are some key points to consider:
Civil Rights Act of 1964, Title VI. Prohibits discrimination based on race, color, or national origin in programs and activities that receive federal financial assistance. This law applies to includes hospitals, clinics, and other healthcare providers that receive federal funding in any form, including Medicare or Medicaid. Under Title VI, healthcare providers must take reasonable steps to ensure effective communication with LEP patients, which may include providing interpreter services.
Affordable Care Act (ACA). Section 1557 of the ACA prohibits discrimination in healthcare based on race, color, national origin, sex, age, or disability. The US Department of Health and Human Services (HHS) issued regulations under Section 1557, including language access services requirements. These regulations require covered entities, including healthcare providers, to provide meaningful access to LEP individuals, possibly providing interpreters or language assistance services for people who prefer to receive services in languages other than English, including sign language for deaf and hard-of-hearing people.
State LEP Laws
Many states in the US have language access laws, particularly those with diverse populations and large numbers of non-English speakers. In contrast, other states might have less comprehensive or specific laws, leading to potential disparities in the quality and accessibility of language services for LEP individuals. Tracking and adhering to these differences can pose challenges to practitioners who work in multiple states.
State LEP laws typically aim for public services, including healthcare and education. The details, such as the size of the facility, type of service, and specific languages required, can also change depending on the state. Additionally, some healthcare facilities and specialty independent practice or small group professionals voluntarily provide interpreter services without legal requirements, recognizing the importance of effective communication for patient safety and quality of care.
States requiring some of the most comprehensive LEP laws include the following:
California. California’s Dymally-Alatorre Bilingual Services Act requires that state and local agencies provide language services when many non-English speaking people access them. The Department of Managed Healthcare (DMHC) also manages the relevant laws and regulations for California practitioners and their employers. Interested parties can search the DMHC violation database to see if specific parties have been found guilty of violating the CA laws related to LEP.
Florida. In Florida, hospitals must provide interpreter services to patients with limited English proficiency.
Illinois: Illinois law mandates that healthcare providers offer interpretation and translation services to patients with limited English proficiency.
Massachusetts. In Massachusetts, healthcare providers that receive state funding must provide
