Language Access and ACA Compliance
Since the final rule implementing of Section 1557 under the Affordable Care Act (ACA), we have received several questions regarding compliance with language assistance requirements.
This article will help you determine whether or not your language assistance services are compliant with Section 1557 requirements.
Overview of Section 1557
“Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities.”
If your organization is receiving funding from, or is associated with programs administered by the Department of Health and Human Services (HHS), you are obligated to comply.
Below are the most important points to remember regarding language assistance requirements.
1) Written Notice & Taglines:
You must provide a conspicuous nondiscrimination notice on all significant communications (i.e. website, marketing materials, and other larger communications sent to patients). The notice must contain the following seven elements:
The Covered Entity does not discriminate on the basis of race, color, national origin, sex, age, or disability in its health programs and activities;
The Covered Entity will provide appropriate auxiliary aids and services free of charge to individuals, when needed;
The Covered Entity will provide language assistance services free of charge, when needed;
Information on how an individual can obtain the auxiliary aids and language assistance services;
The contact information for the individual responsible for the Covered Entity’s compliance with Section 1557, if applicable;
Information regarding the grievance procedure for any action prohibited by Section 1557, if applicable; and
Information on how to file a discrimination complaint with the Office for Civil Rights.
You must also provide taglines in the top 15 languages in your state(s).
Note that for significant communications that are small in size (i.e. postcards, brochures, and pamphlets), you are only required to include the first notice, and taglines in the top two non-English languages spoken in your state(s).
2) Qualified Interpreters
You must provide a qualified medical interpreter to individuals with limited English proficiency (LEP) when oral interpretation is necessary for reasonable access to medical services.
A qualified interpreter must adhere to the accepted ethical standards, demonstrate proficiency in both spoken languages, and be able to accurately and comprehensively interpret complex medical terminology into both languages.
Note that you may not:
require an LEP individual to provide his/her own interpreter,
rely on an adult accompanying the LEP individual ,
rely on a minor for interpretation,
rely on any staff not considered a qualified interpreter.
3) Qualified Translators
You must use a qualified medical translator to translate documents in paper and electronic formats. A qualified translator must adhere to the accepted ethical standards, demonstrate proficiency in both written languages, and be able to accurately and comprehensively translate complex medical terminology.
Note that a qualified interpreter is not necessarily a qualified translator; the skills and tasks required are different for the two jobs. Furthermore, HHS recommends against the use of automated, or machine translation technologies without the involvement of a qualified human translator.
4) Designated Compliance Employee
Covered entities with 15 or more employees must designate at least one person to manage and ensure compliance with anti-discrimination requirements. This person will be responsible for addressing any complaints or grievances that may arise due to non-compliance.
5) Language Access Plan
Implementing a written language access plan is not necessarily required, but is an important factor in evaluating compliance for covered entities. Amongst other factors, your language access plan should address how your entity will identify non-English languages, and provide prompt language assistance services to the individual with limited English proficiency.
We have created a Language Access Plan Checklist with tangible resources to help simplify the planning process.
References and more information: