For the last decade, Section 1557 has been at the center of many changes and today, it continues to be as the Biden administration is working to take giant steps towards restoring and strengthening some civil rights protections for people in many health-related programs and activities that receive funding from the federal government.
Section 1557, known as the “Health Care Rights Law,” is the main nondiscrimination provision of the Affordable Care Act (ACA). It prohibits discrimination in healthcare based on factors like race, ethnicity, language, age, disability, and sex. Part of this landmark regulation asserts that language barriers must not hinder patients’ access to quality care. For healthcare providers, compliance with these regulations is not only a legal obligation but also critical to addressing health disparities and improving patient outcomes.
Recently, the Biden administration proposed changes to the current regulations implementing Section 1557 that would restore and strengthen nondiscrimination protections and improve access to care for millions of people.
When Section 1557 came into effect in 2016 under President Obama, it was a testament to the power of health equity as it was designed to support existing legislation like Title VI – the Civil Rights Act of 1964. With changes in subsequent administrations, including reversals by President Trump, Section 1557’s significance remains a constant area of focus.
Focus on Language
The effective delivery of healthcare is more than just a commitment to medical excellence; it’s also a commitment to cultural competency and equitable access for all patients. Under Section 1557, regulations set forth by the Centers for Medicare & Medicaid Services (CMS), the importance of providing language assistance services has been magnified, emphasizing the critical role of qualified medical interpreters in ensuring equal access to healthcare for all patients, regardless of their language proficiency.
From a language access perspective, Section 1557 is a call for equity and inclusivity and qualified medically trained interpreters become critical to bridging the language gap. Qualified medical interpreters bring accurate communication to patients, eliminating the potential pitfalls of misinterpretation that could lead to life-altering consequences.
Language barriers that exist between healthcare providers and patients with limited English proficiency (LEP), is one of the most significant challenges to achieving compliance for Section 1557. Effective communication is the cornerstone of safe and quality healthcare delivery, encompassing accurate diagnosis, informed consent, medication management, and post-treatment instructions. Qualified medical interpreters become indispensable assets, breaking down language barriers and facilitating meaningful conversations between healthcare professionals and LEP patients and therefore are an essential part of the care team.
Trained medical interpreters bring a unique skill set to the healthcare setting that automated translation tools and bilingual staff may not replicate. These professionals possess a high level of language fluency, a deep understanding of medical terminology, cultural nuances, and ethical considerations, allowing them to convey complex medical information accurately while preserving patients’ cultural beliefs.
There are several keys to achieving compliance to Section 1557 when it comes to language, which includes the following:
Accurate Communication: Medical jargon is intricate and precise, and any miscommunication can have dire consequences. Qualified medical interpreters ensure that medical information is accurately conveyed, reducing the risk of medical errors, misdiagnoses, and inappropriate treatments.
Cultural Competence: Healthcare encompasses diverse cultural backgrounds and beliefs. Qualified medical interpreters are adept at navigating cultural nuances, ensuring that patients’ beliefs and values are integrated into their care plans. This enhances patient satisfaction and fosters trust in the healthcare provider-patient relationship.
Ethical Considerations: Qualified medical interpreters adhere to strict codes of ethics that prioritize patient confidentiality, impartiality, and professionalism. This ensures that patients can openly discuss sensitive matters with confidence.
Reduced Legal Risks: Section 1557 violations can result in significant legal repercussions. Qualified medical interpreters can play a crucial role in minimizing these risks by facilitating clear communication and promoting adherence to the regulations.
A Collaborative Approach to Compliance
Achieving compliance to Section 1557 is not solely the responsibility of medical interpreters; it requires a collaborative effort across the healthcare system. Healthcare institutions must invest in training and certification for interpreters, integrate interpreter services into their workflows, and emphasize the importance of language access in their organizational culture.
As the healthcare industry evolves to become more inclusive and patient-centered, Section 1557 stands as a symbol of equity and access. Qualified medical interpreters form the bridge that connects healthcare providers with patients, both from different cultures and who speak different languages, ensuring that quality care is provided to all, regardless of language. By recognizing the invaluable role of these interpreters, healthcare organizations can not only meet potentially new regulatory requirements but also champion a new era of compassionate, culturally competent, and patient-focused care.
As we wait for any changes in this space from the current and future administrations, one thing is clear: we must continue to pursue equitable and quality care for all patients no matter what language they speak.
About Carla Fogaren R.N.
Carla is currently with AMN Language Services. She has served as the System Director of Diversity Initiatives, Interpreter Services and ADA/504 and Section 1557 Coordinator for a large health care system with forty-two hospitals and 46,000 employees in eleven states. Carla is known nationally as a pioneer in the field of medical interpreting as well as a national consultant on language access, health disparities, disabilities, and regulatory requirements for hospitals. She had created and implemented bilingual clinical staff language assessment to comply with Section 1557. Carla has performed over sixty gap analysis for hospitals and clinics to assess compliance with Joint Commission, DNV, ADA and other federal and state requirements. She is currently the President of the National Council on Interpreting in Health Care (NCHIC).