How Changes to Section 1557 Could Affect Healthcare Organisations

How Changes to Section 1557 Could Affect Healthcare Organisations


In summary: What solutions do you need to remain compliant?

  • The current landscape – The lack of English language proficiency in the U.S (and the use of non-English languages) is often tied to national origin. The demand for language services for LEP individuals is growing
  • Language access essentials – The provision of free and effective language assistance services to LEP individuals is essential to ensure compliance with nondiscrimination laws
  • How to get compliant – Staff training in language access is essential and qualified human translators need to review machine-translated content for healthcare-related communications

Miscommunication due to language barriers in the healthcare sector can often lead to life-threatening consequences. To achieve high levels of satisfaction among medical professionals and patients, high-quality healthcare and maintain patient safety, healthcare institutions need to ensure they provide the right level of language access to limited English proficient (LEP) Individuals.

It’s no surprise that on August 4, 2022, the U.S. Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking to reinterpret section 1557 of the Affordable Care Act (ACA), which prohibits discrimination based on race, colour, national origin, sex, age, or disability in a health program or activity, any part of which is receiving federal financial assistance.

Enacted in 2010, the Affordable Care Act expanded healthcare access eligibility to people previously without health insurance in the US.

According to the proposed rule, “For [limited English proficiency] individuals, the lack of proficiency in English and the use of non-English languages is often tied to their national origin. The provision of free and effective language assistance services to LEP individuals is essential to ensure compliance with nondiscrimination laws.”

LEP.gov states that “Individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English can be limited English proficient, or ‘LEP.’”

At the time of the 2020 U.S. census, 21.5% of households spoke a language other than English at home. Furthermore, The Migration Policy Institute reports that the immigrant population in the United States has nearly tripled since 1980, with the “lion’s share” coming from countries where English is not an official language. As a result, the demand for language services for LEP individuals in the U.S. is growing.

What does this mean for the healthcare sector?

The 97-page document also outlines requirements for staff training in language access and defines when and how machine translation (MT) may be used for healthcare-related communications.

In particular, MT output must be reviewed by a “qualified human translator” for content that is “critical to the rights, benefits, or meaningful access of an LEP individual; when accuracy is essential; or when the source documents or materials contain complex, non-literal, or technical language.”

Other provisions restored by the proposed rule include standards for video remote interpreting (VRI) and a requirement that healthcare entities with 15 or more employees designate an individual to coordinate compliance.

To remain compliant, the most prudent approach for healthcare institutions is to invest in language services to meet their LEP patient’s expectations.

What solutions do Healthcare providers need to be compliant?

At TOPPAN Digital Language, we provide deep knowledge and expertise to successfully implement machine translation and networks of professional, industry-sector experienced translators to review automated translations. In fact, our post-edited and post-edited plus revision machine translation services place the linguist at the center of the MT process to ensure the best results for all translation projects.

Whether it’s simultaneous or consecutive interpreting, we also provide a uniquely tailored service based on the needs of each healthcare provider and can be adapted, at scale, to meet any last-minute changes, delivered either remotely or on-site.

With New York State Governor, Kathy Hochul, expanding services immediately for LEP residents, it seems like the landscape for language access is in a state of positive change for LEP individuals.

We’re keeping a close eye on the developments of the proposed changes to Section 1557 and what this means for the growing number of LEP people in the U.S. and the healthcare sector as a whole.

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