What are the laws regarding the care of LEP patients (federal and state)? Were you aware of these laws? Do you see these laws being followed?

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Some laws regarding the care of LEP (Limited English Proficiency) patients are:

1) Title VI of the 1964 Civil Rights Act. This is a federal law which states that health providers must not discriminate in terms of race, nationality, or color. Under Title VI, all health care providers that receive federal funds must comply with the Department of Human Services' directive on Culturally and Linguistically Appropriate Services (CLAS) in health care. This means that federally-funded health care providers must provide (at no charge) bilingual medical staff or professional interpreter services for LEP patients at every point of contact during health care visits.

Another federal law that concerns the care of LEP patients is EMTALA (The Emergency Medical Treatment & Labor Act). According to this law, healthcare providers and hospitals must post notices about their obligations to provide non-discriminatory care to LEP patients. Notices should be in languages spoken by 10% or more of the households within the service area.

Another federal law that deals with the care of LEP patients is section 1557 of the Affordable Care Act (ACA). Under this law, healthcare providers and nursing home operators must provide trained interpreters for LEP patients. Trained interpreters must be able to provide both oral and written translation services to LEP patients. Section 1557 makes it illegal for hospitals and healthcare providers to use minor children of immigrants or untrained bilingual staff as interpreters. Additionally, professional interpreters must adhere to all ethics and privacy protection regulations under the ACA.

2) As for state laws, all 50 states have laws that comply with the ACA requirements for LEP patients. For example, California's Dymally-Alatorre Bilingual Services Act makes it mandatory for state-funded and private practices to provide medical services in languages other than English. California's laws regarding the care of LEP patients are broader than those in other states. For example, Maryland's Equal Access to Public Services for Individuals with Limited English Proficiency Act only applies to state-funded healthcare providers. To date, New Jersey, California, and Washington require its healthcare providers to take courses in cultural competency education.

Many people may or may not be aware of such laws concerning LEP patients. Those who are aware may consist of healthcare professionals, healthcare officials, and students/graduates of medical/healthcare programs.

As for whether these laws are being followed, we have to gauge this on a state by state basis. For example, in California, healthcare businesses such as Kaiser Permanente and California Pacific Medical Center placed the greatest number of job postings for medical interpreters in 2011. The trend appears to be rising. In New Jersey, the state collaborated with the Rutgers New Jersey Medical School to develop a nationally-recognized medical interpreter course. So, we see that laws pertaining to the care of LEP patients are being followed in particular states. For more information, please refer to the excellent links below.