In summary: A step-by-step guide to developing a Language Access Plan
What is a Language Access Plan – An official policy document that outlines the steps an organization will take to ensure that patients with limited English proficiency have equal access to healthcare services.
Who should have one – All healthcare organizations that provide services to multilingual patients or customers should have a Language Access Plan.
The core components – An assessment of patient needs, identifying the right language services, providing notices, training staff, and evaluation.
Imagine being sick or injured in a foreign land, unable to communicate your needs, navigating an unfamiliar healthcare system, or understanding the care given to you. For millions of individuals in the United States, this is a harsh reality.
According to the Agency for Healthcare Research and Quality, over 25 million people (that’s close to the population of Texas) have limited English proficiency. Knowing this eye-opening fact, it is crucial that organizations understand the importance of language access and take steps to ensure that every individual, regardless of their language background, has equal access to information and services.
After all, communication is the foundation of all human interactions and the lack of it in the healthcare industry can lead to dire consequences.
With recent proposals to amend policies to improve access for LEP individuals, it’s recommended that healthcare providers and organizations invest in putting together a comprehensive language access plan to ensure they meet the needs of this underrepresented group.
But what is a Language Access Plan?
A Language Access Plan is an official policy document that outlines the steps an organization will take to ensure that patients with limited English proficiency have equal access to healthcare services. This includes providing language aid, such as interpretation and translation services, to patients and their families.
Further processes include identifying the languages patients speak, assessing existing language assistance services, developing strategies for providing holistic language assistance, and monitoring and evaluating the effectiveness of language assistance services.
Who should have a Language Access Plan?
All healthcare organizations that provide services to multilingual patients or customers should have a Language Access Plan. This includes managed care organizations, hospitals, clinics, nursing homes, rehabilitation centers, and specialized healthcare facilities.
Additionally, any organization that receives federal funding is required by law to provide language assistance services to its patients and consumers identified as being limited English proficient (LEP).
This provision is part of Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of national origin, and Title VI regulations which require recipients of federal financial assistance to take reasonable steps to ensure that LEP individuals have meaningful access to their programs and activities.
In the United States, the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) enforces Title VI and its implementing regulations, including those requiring language assistance services for LEP individuals.
So, what are the core components of language access planning?
Needs Assessment
Before you develop a language access plan, you need to identify all the information about the needs of your patients, clients, or consumers by way of an assessment. This includes identifying their written and spoken language preferences. Then, you need to identify individuals with additional communication challenges.
For example, individuals who are visually impaired or hard of hearing will need accessibility resources developed specifically for them to effectively navigate and use healthcare services. These resources can only be developed by understanding the challenges they face when they interact with your services.
Once you’ve pinned down the challenges they face, it’s time to think about the solutions!
Can you partner with third-party language service providers to implement translation and interpretation solutions into your operational model? What about adding internal linguistic and accessibility resources to support non-English speaking individuals?
You can benefit in the long term by partnering with a professional language service provider to translate critical materials. You can even access medical interpreting services on an as-needed basis when consulting with multilingual patients individually.
Once you’ve completed your assessment, it’s essential to remember that the needs of your patients, and the protocols of the healthcare system, change over time and your assessment should reflect that.
This means continuous reassessment, regularly.
Language Services
When designing a Language Access Plan, it is important to consider the language needs of the community you serve and to provide a comprehensive array of language services that meet those needs. This includes partnering with a qualified language service provider, ensuring your writing materials are translated accurately, and harnessing best-fit technology to make services widely available.
Critical content to consider:
- Healthcare Providers
- Application forms
- Complaint forms
- Consent forms
- Finance and legal policies
- Patient education forms
- Patient discharge instructions and follow-up forms
- Patient-facing portals
- Appointment cards
Remember, while some medical documentation will need to be translated verbatim, particularly when it comes to describing medication, diagnoses, symptoms, and legal information, some content will need to be linguistically and culturally adapted to best support the needs of your audience.
Using native linguists and working with people from the communities you serve will ensure the cultural relevancy of your translations and improve patient satisfaction.
Then there are interpreting services to consider.
Interpreting from bilingual relatives should not be relied on for several reasons. Essentially, relatives aren’t equipped with the deep medical knowledge to effectively communicate complex terminology effectively. This can lead to gaps in care and negative health outcomes.
For this reason, you’ll also need to consider how interpreting services will be provided, on-site and virtually, and the availability of assistive technology. When it comes to sourcing interpreters, be sure to understand your state licensing and certification policies requirements as some interpreters may not be certified.
Additionally, it’s important to consider the experience your patients or customers have with your organization online. Since the Covid-19 pandemic, there’s been a boom in access to healthcare online.
From digital brochures to online consultations, the localization of your website and digital medical offering will be pivotal to reaching a wider demographic of patients and customers and improving patient satisfaction.
Notices
This process of a Language Access Plan refers to the steps taken by a healthcare organization to inform its multilingual patients about the availability of language assistance services. This process is critical for ensuring that LEP individuals have equal access to healthcare services.
The first step is to develop written notices in the languages spoken by LEP patients that inform them of their rights to language assistance services. These notices should be prominently displayed in healthcare facilities, such as in the lobby, waiting areas, and examination rooms. They should also be included on the organization’s website and in any written materials provided to patients.
The notices should include information on the types of language-assisted services available, such as interpretation and translation services, and how to request them. This may include providing information to patients during registration or mailing informational brochures to LEP patients before their appointments.
You should also provide information on how to contact the healthcare organization if there are any issues with these assisted services.
Additionally, you should develop a system for serving oral notices to LEP patients, such as having staff members inform patients of their rights to language-assisted services when they arrive at the healthcare facility.
Staff should be trained to communicate this information effectively and in a culturally and linguistically appropriate manner.
Lastly, the healthcare organization should have a process in place for monitoring and evaluating the effectiveness of the Notices process, such as surveying LEP patients to gather feedback on their understanding of the availability of language assistance services and making adjustments as needed.
Training
Training is a vital part of language access planning and should be provided to everyone who interacts with LEP individuals or those in need of communication support. This includes reception staff, clinicians, customer service personnel, and even security guards. All staff should be trained in the importance of language access and have full access to up-to-date policies and procedures on how to obtain further support, such as interpreting services.
You can also combine training with a professional language service provider. And just like your assessments, training courses or materials should be updated accordingly to remain compliant.
Your training should focus on:
- The importance of language access
- How to communicate with multilingual individuals and individuals with hearing or visual impairments in a respectful manner
- Policies and procedures on how to supply language access services at no extra cost to the client or patient
- Data capture of patient’s/client’s language needs and preferences
- How to request and use an interpreter
- The types of translated materials available and where to find them
Evaluation
The final part of your language access plan is laying out a framework to monitor the efficacy of your organization’s progress. To ensure you meet your goals, your framework should be adaptable to meet both current regulatory demands and the demands of your organization.
Work with your language services provider to outline metrics for success and meet regularly to review progress.
The first step is to gather data on the use of language assistance services. This may include tracking the number of requests for interpretation and translation services, the languages requested, the type of services provided, and meeting regularly with your LSP to review utilization metrics. It may also include tracking the number of complaints or concerns related to language assistance services.
Getting feedback from patients or customers is essential to understanding just how well you’re serving underrepresented communities. You should survey multilingual individuals and people with visual and hearing challenges to gather feedback on the quality of the language assistance services provided.
The survey should include questions on the patient’s understanding of the services provided, their satisfaction with the services, and their experience with the staff that provided the services. The survey results should be analyzed to identify trends and identify areas for improvement.
You should also review your language assistance services on a regular basis to ensure that they meet their needs. This may include conducting focus groups with LEP patients and their families or reviewing patient medical records to ensure that all necessary information has been provided in the patient’s preferred language.
Additionally, you should review any complaints or concerns related to language assistance services and take appropriate action to address them. This may include providing additional staff training, revising written materials, or addressing concerns with your language services provider.
Once the data has been collected and analyzed, you should use the information to make changes to your language assistance services as needed. This includes revising the Language Access Plan, providing additional staff training, or contracting with additional interpretation and translation services.
In conclusion
Having a Language Access Plan is vital to ensure that all individuals, regardless of their linguistic background, have equal access to the services and information that support their care. Without one, linguistic minorities and individuals with hearing and visual impairments may face barriers to effective care delivery that can result in preventable readmissions, low patient satisfaction, and negative health outcomes.
Language access planning not only supports linguistic minorities and individuals with hearing and visual impairments but also strengthens the overall community by promoting inclusivity and cultural awareness.
A community that values and supports linguistic diversity is one that values diversity in all its forms and is more likely to thrive. In today’s globalized world, it is increasingly important to recognize and address the language needs of our communities. A Language Access Plan is a concrete step toward creating a more equitable society, where every individual can fully participate and contribute.