Language Access Requirements

Title VI of the Civil Rights Act 1964  prohibits discrimination and requires covered entities to provide individuals an equal opportunity to participate in a program activity, regardless of race, color, national origin, age, disability, or (under certain conditions) religion or sex.  The federal Department of Health and Human Services’ Office for Civil Rights issued its guidance to clarify the need for quality and accuracy in the provision of language services:

“VI.A. Competence of Interpreters. Recipients should be aware that competency requires more than self-identification as bilingual. Some bilingual staff and community volunteers, for instance, may be able to communicate effectively in a different language when communicating information directly in that language, but not be competent to interpret in and out of English.” Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons

Please visit the Civil Rights division of HHS for more information, resources and tools for healthcare organizations to help ensure the effective communication that is essential to quality health care for all persons.

See examples of hospitals reviewed by the Office of Civil Rights due to complaints regarding the provision of language assistance to patients and families with limited English proficiency.

The Joint Commission presents hospitals and health organizations with guidance on compliance and implementation of the new standards for improving patient- and family-centered communication across the care continuum in its publication Advancing Effective communication, Cultural competence and patient-and Family-Centered Care – A Roadmap for Hospitals.

CCHI’s certification helps hospitals, health organizations and healthcare providers fulfill standards and elements of performance critical for accreditation:

• In the Leadership Domain:
  • LD.02.01.01: The mission, vision, and goals of the hospital support the safety and quality of care, treatment, and services;
  • LD.04.01.01: The hospital complies with law and regulation;
  • LD.04.03.07: Patients with comparable needs receive the same standard of care, treatment, and services throughout the hospital.

By choosing CCHI-credentialed and certified interpreters to assist the care team with effective communication for their culturally and linguistically diverse patient population, organizations demonstrate their leadership commitment to create an environment of care that is culturally competent, linguistically appropriate and patient and family centered.

• In the Workforce Domain
  • HR Requirement HR. 01.02.01: The hospital defines staff qualifications.

CCHI certification of interpreters helps facilitate HR tasks to ensure that individuals who provide language services have specific qualifications and competencies required to perform their job functions in a safe and efficient manner.

• In the Provision of Care, Treatment, and Services Domain
  • PC.02.01.21: The hospital effectively communicates with patients when providing care, treatment, and services.

CCHI-credentialed and certified interpreters can help increase effective communication and improve patient-and family-centered communication across the care continuum. From admission to assessment, to treatment or end-of-life care, to discharge and transfer, healthcare interpreters that are qualified through CCHI certification can help:

• communicate information about the unique needs of the patient to the care team;
• identify patient’s cultural, religious, spiritual beliefs or practices that may impact health outcomes;
• engage patients and families in care planning, decision making, treatment compliance, discharge and transfer instructions.

The National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care encourage health and healthcare organizations to ensure that patients’ communication needs are met.  CCHI’s certification process helps organizations meet the requirements of Standard 7:

“Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.” CLAS Standards

Mara Youdelman, J.D., CCHI’s first Chair and Managing Attorney at the National Health Law Program, discusses opportunities and challenges related to language access that face us over the coming year. Healthcare issues are front-and-center in the looming Presidential campaign cycle and Congressional debates to increase access to health care. This should provide new opportunities to advance language access. Yet, with anti-immigrant sentiment on the rise, we must also fight to protect the rights of limited English proficient individuals. So how can interpreters and advocates engage in national and state conversations around improving health care access while fighting back against proposals that create fear in communities about accessing health care? The keynote took place on October 12, 2019, during CCHI’s first National Healthcare Interpreter Certification Summit in Minneapolis, MN (http://cchicertification.org/10-years/summit/).