Obtaining healthcare or homecare services can be daunting for someone who is not a native speaker of the language. Luckily, the United States has standards for providers and options for patients.
The US Department of Health and Human Services has developed nationwide standards for healthcare providers pertaining to language and culture. These standards include federal mandates, recommendations for new mandates, and suggestions for voluntary adoption.
The 14 Standards
Healthcare organizations must:
- offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient with limited English proficiency at all points of contact, in a timely manner during all hours of operation.
- provide to patients in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.
- assure the competence of language assistance provided to limited English proficient patients by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient).
- make available, easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area.
Healthcare organizations should:
- ensure that patients receive from all staff members, effective, understandable, and respectful care that is provided in a manner compatible with their cultural health beliefs and practices and preferred language
- implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area
- ensure that staff, at all levels and across all disciplines, receives ongoing education and training in culturally and linguistically appropriate service delivery.
- develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services.
- conduct initial and ongoing organizational self-assessments of CLAS-related activities and are encouraged to integrate cultural and linguistic competence related measures into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations.
- ensure that data on the individual patient’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated.
- maintain a current demographic, cultural, and epidemiological profile of the community, as well as, a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area.
- develop participatory collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient involvement in designing and implementing CLAS-related activities.
- ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and are capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by patients.
Healthcare organizations are encouraged to:
- regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information.
Even as an individual care provider, caregivers should hold themselves to the same standards as healthcare professionals to ensure the client is treated fairly and fully understands their care.
Options for Language Assistance Services
- Family members or friends
While family members and friends of the client are readily available and have a relationship with the patient, they likely lack training in medical interpretation and may choose not to interpret some messages accurately to “protect” the patient from the truth.
- Professional interpreters
Professional interpreters are screened for language skills and are trained in interpretation ethics and techniques specific to medical interpretation.
- Bilingual staff
Staff members in healthcare facilities or caregivers who are bilingual can often interpret information to the patient themselves.
- Language line services
Language line services are telephone interpreter services which can generally cover up to 140 languages and are available any time of day. These are a common option for languages which are uncommon in an area.
Although non-verbal cues may be a common way to communicate with others, these cues can mean different things in different cultures. It is necessary to understand the culture of the patient along with the language.
Searching for a Caregiver
If patients are searching for a caregiver who speaks their language and understands their culture, they can look for information at local, nearby, and state Area Agencies on Aging. Bilingual caregiver groups and individuals are likely to provide their information to these groups for non-native English speakers.