Top

Published in:

Open Access 01-11-2007 | Commentary

The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond

Authors: Alice Hm Chen, MD, MPH, Mara K. Youdelman, JD, LLM, Jamie Brooks, JD

Published in: Journal of General Internal Medicine | Special Issue 2/2007

Abstract

Over the past few decades, the number and diversity of limited English speakers in the USA has burgeoned. With this increased diversity has come increased pressure—including new legal requirements—on healthcare systems and clinicians to ensure equal treatment of limited English speakers. Healthcare providers are often unclear about their legal obligations to provide language services. In this article, we describe the federal mandates for language rights in health care, provide a broad overview of existing state laws and describe recent legal developments in addressing language barriers. We conclude with an analysis of key policy initiatives that would substantively improve health care for LEP patients.

Ask Doctor Alice: Is the Doctor In? Not if You Don’t Speak English. Asian Journal Publications. October 29–November 4, 2004; p. 23.

Andrulis DP, Goodman N, Pryor C. What a Difference an Interpreter Can Make: Health Care Experiences of Uninsured With Limited English Proficiency. Boston, MA: The Access Project; 2002 (April).

Crane JA. Patient comprehension of doctor-patient communication on discharge from the emergency department. J Emerg Med. 1997;15:1–7.PubMedCrossRef

Gordon RG, ed. Ethnologue: Languages of the World, 15th Edition. Dallas, TX: SIL International. Available at: http://www.ethnologue.com/. Accessed February 22, 2007. 2005.

42 U.S.C. §2000d.

Lau v. Nichols, 414 U.S. 563 (1974).

45 Fed. Reg. 82972 (Dec. 17, 1980) (Notice).

Perkins J, Youdelman M, Wong D. Ensuring Linguistic Access in Health Care Settings: Legal Rights And Responsibilities, 2nd Edition. Washington, DC: National Health Law Program; August 2003.

65 Fed. Reg. 50121 (August 16, 2000).

10.

68 Fed. Reg 47311 (August 8, 2003).

11.

68 Fed. Reg 47311, 47315.

12.

Perkins J. Summary of State Law Requirements Addressing Language Needs in Health Care. Washington, DC: National Health Law Program; updated 2006 (January).

13.

N.J. Rev. Stat. §26:2–168.

14.

Mich.Stat.Ann. §14.15(b) and (c); Mich.Stat.Ann. §33.5133; Mich.Stat.Ann. §333.9161; Mich.Stat.Ann. §333.17015.

15.

Ark.Stat. §20-16-904; Kan.Stat.Ann. §65-6710; 40 La.Rev.Stat.Ann. §1299.35.6.B(2)(4); Minn. Stat. Ann. §145.4243; N.D. Cent. Code §14-02.1-02.1; Nev.Rev.Stat. §442.253(1) and (3); 63 Okl. St. §1-738.3; Tex.Health & Safety Code Ann. §245.023; Va. Code Ann. §18.2-76(D).

16.

Mass. Ann. Laws Ch.111, §25J(b), Ch.123, §23A(b); Ill. Admin. Code tit. 59, §111.25.

17.

6 Colo. Code Regs. § 1011-1 12.1.6(4); N.J. Admin. Code tit. 8, § 36-4.15; N.J. Admin. Code tit. 8 § 43-4.17; R.I. Gen. Laws § 23-17-54.

18.

Cal. Health & Safety Code § 1367, 1367.04, 1367.07; Cal. Insurance Code § 10133.8, 10133.9.

19.

N.J. Rev. Stat. C.45:9-7.2-7.4.

20.

Cal Bus & Prof Code § 2190.1.

21.

Rev. Code Wash. (ARCW) § 43.70.615.

22.

Marinopoulos SM, Dorman T, Ratanawongsa N, et al. Effectiveness of continuing medical education. Rockville, MD: Agency for Healthcare Research and Quality; January 2007. Available at: http://www.ahrq.gov/clinic/tp/cmetp.htm. Accessed July 18, 2007.

23.

National standards of practice for interpreters in health care. Santa Rosa, CA: National Council on Interpreting in Health Care; September 2005.

24.

WAC (Washington Administrative Code) §§ 388-271-0010, 0020, and 0030.

25.

Oregon Revised Stat. 409.615-625. Or. Admin. R. 333-002-0010-333-002-0230.

26.

Ind. Code IC 16-18-2-62.

27.

Westmoreland TM. SMD Letter—Policy guidance on Medicaid for persons with limited English proficiency. August 31, 2000. Available at http://www.cms.hhs.gov/smdl/downloads/smd083100.pdf. Accessed July 18, 2007.

28.

Youdelman M. Medicaid and SCHIP Reimbursement Models for Language Services. Washington, DC: National Health Law Program; 2007 (May).

29.

Connecticut Public Act No. 07–185.

30.

Shin HB, Bruno R. Language Use and English Speaking Ability: 2000. Census 2000 Brief. Washington, DC: U.S. Census Bureau; 2003 (October).

31.

Medi-Cal Language Access Services Taskforce Participation Agreement. Available at: http://www.dhs.ca.gov/director/omh/PDFs/News%20Articles/Agenda_12-13-2006_Participation_Agreement.pdf. Accessed July 7, 2007.

32.

Medicaid interpreter services pilot: report on program effectiveness and feasibility of statewide expansion. January 2007. Available at: http://www.hhsc.state.tx.us/reports/RPCMemo121906LangInterpretPilotRept.pdf. Accessed July 9, 2007.

33.

Scioscia A. Critical connection. Phoenix New Times. July 29, 2000. Available at: http://www.phoenixnewtimes.com/2000-06-29/news/critical-connection/. Accessed July 7, 2007.

34.

Ku L. Paying for Language Services in Medicare: Preliminary Options and Recommendations. Washington, DC: Center on Budget and Policy Priorities; 2006 (October).

35.

Grubbs V, Chen A, Bindman A, Vittinghoff E, Fernandez A. Effect of awareness of language law on language access in the health care setting. J Gen Intern Med. 2006; 21(7):683–88.PubMedCrossRef

Title: The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond
Authors: Alice Hm Chen, MD, MPH
Mara K. Youdelman, JD, LLM
Jamie Brooks, JD
Publication date: 01-11-2007
Publisher: Springer-Verlag
Published in: Journal of General Internal Medicine / Issue Special Issue 2/2007
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-007-0366-2

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Special Issue 2/2007

The Impact of Language Barriers on Documentation of Informed Consent at a Hospital with On-Site Interpreter Services

Assessing Dual-Role Staff-Interpreter Linguistic Competency in an Integrated Healthcare System

Improving Quality of US Health Care Hinges on Improving Language Services

Language Access Services for Latinos with Limited English Proficiency: Lessons Learned from Hablamos Juntos

Validating Measures of Third Year Medical Students’ Use of Interpreters by Standardized Patients and Faculty Observers

Patient Satisfaction with Different Interpreting Methods: A Randomized Controlled Trial

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage