Lack of Discharge Translation Sparks Lawsuit

Pillars of a court building where cases about the lack of discharge translations in healthcare are heard

What Healthcare Providers Should Take Away from the Recent Section 1557 Lawsuit

A few months ago, Song Xie sued a hospital system in Texas saying that the hospital discriminated against him as a foreign-born, limited English proficient (LEP) person when it failed to supply him with translated discharge instructions.

In 2015, Song Xie was discharged from the hospital in late December with post-discharge instructions written in English — a language neither he nor his son could read. Days later, Song Xie suffered a stroke and found himself readmitted into the same hospital.

A ruling by the U.S. Department of Health and Human Services on Section 1557 of the Affordable Care Act (ACA) requires healthcare providers to offer translations of key documents in the patient’s native language and access to qualified interpreters free of charge. Providers had until October 2016 to comply with key provisions of the ruling.

Xie’s case seems to be the first to address language access under Section 1557. Healthcare facilities should be watching this case closely and taking notes to ensure their own language access plans are up to snuff.

Healthcare providers, especially, need to pay attention

Before you say, “This will never happen at my practice/hospital/clinic,” know that lawsuits like the one mentioned here are just the beginning. If you do not fully comply with Section 1557 and accommodate all languages spoken by your patients in your healthcare institution, or employ a “wait and see” approach, you could be facing penalties. According to Jaklyn Wrigley, an associate at Fisher & Phillips, Gulfport, “Aside from individual (or class-based) lawsuits, the government can also compel compliance. The penalty for non-compliance can be as insignificant as mandated implementation of a language access plan (i.e., the plan that speaks to an organization’s language access capabilities), or as serious as a total loss of federal funding.”

If monetary reasons aren’t enough for you to kick it into high gear when it comes to implementing or tightening your language access plan, here are some other incentives:

  • LEP individuals make up a very large percentage (we’re talking in the millions) of the U.S. population.
  • Studies (like this one) show a strong correlation between quality and speed of care and the strength of a healthcare system’s language access plan.
  • Section 1557 and the implementation of its requirements is relatively new. Meaning, while healthcare providers may have complied with regulations thus far, the spirit of the law may yet be embedded in the culture fostered by healthcare staff.

Related: Speaking of Your Health: Communication and The Affordable Care Act

Healthcare providers need to be proactive

If you’re worried you’re not in full compliance with the law when it comes to meaningful language access for your LEP patients, it’s never too late to get back on track. Ensuring your LEP patients have access to all their healthcare information before there’s a problem takes careful planning, but it will be well worth the effort in the end. Here are a few things healthcare facilities and systems can do to make sure their compliant with Section 1557 and to promote language inclusivity:

  • First, make sure you know your language demographics and are tracking them. This includes the number of interpreter requests made each month.
  • Then, take a quick look at your language access plan and evaluate it for flaws, gaps in coverage, and confusing workflows.
  • Double-check that both over-the-phone interpreting (OPI) and translation services are easy to access by staff members.
  • Create an internal engagement campaign to make sure your staff knows about this lawsuit, knows what to do when they encounter an LEP patient, and encourages them to embrace accessibility and inclusion.
  • Build in period reviews and audits of your plan. As mentioned, Section 1557 is only a few years old, so best practices may shift as times goes on.

Want more on Section 1557 and language access? Download our Guide to Section 1557 for more information about the ruling or check out our Language Access Workbook for inspiration on engaging your staff around language access.

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