Section 1557:Saved by the Final Rules

Section 1557 of the ACA Keeps Language Access Alive for Human Language Professionals
By: Bill Glasser

The Affordable Care Act (ACA) has played a pivotal role in expanding healthcare access to millions of uninsured Americans. A critical component of the ACA, Section 1557, focuses on non-discrimination and ensuring that all individuals, regardless of race, color, national origin, sex, age, disability or language, have equal access to healthcare services. As part of its ongoing commitment to reducing health disparities, Section 1557 of the ACA’s final rules, which took effect last year, provides significant clarifications regarding language access services for individuals with limited English proficiency (LEP).

A recent surge in inquiries from healthcare clients has highlighted growing interest in understanding how the final rules apply, particularly in the context of ensuring that human professionals remain central to the delivery and production of language access services within federally reimbursed healthcare settings, as mandated by Section 1557.

What the Final Rules Entail

The 2024 final rules represent a significant update to the language access provisions under Section 1557 of the ACA, focusing on ensuring that healthcare providers deliver effective language assistance to LEP patients. These updates apply to both spoken and written forms of language support, with key components including:

1. Expanded Access to Language Assistance Services: Healthcare providers are now required under Section 1557 to ensure that LEP patients have access to qualified interpreters and that written materials, such as consent forms, benefits information, and medical instructions, are available in the languages spoken by the patient.
2. Emphasis on Human Intervention: A major change in the 2024 rules under Section 1557 is the increased emphasis on human intervention for language assistance. Healthcare providers must now utilize qualified human interpreters for both spoken and written language support, instead of relying on automated translation tools or unqualified individuals. Translated materials must be reviewed by a human proofreader who is an expert in both the target and source languages. Professionally trained, screened, and supervised human interpreters are essential to conveying the nuances of medical information accurately, ensuring patients understand their diagnoses, treatment options, and medical rights. These interpreters also incorporate cultural, socio-economic, gender, and age considerations into their work, which are crucial for facilitating meaningful understanding and improving patient compliance with treatment plans—ultimately preventing costly emergency department visits.
3. Quality Standards for Interpretation Services: The final rules require healthcare providers to utilize interpreters who are trained in medical terminology and healthcare-related issues, in line with Section 1557. This ensures that interpreters can provide accurate and culturally appropriate communication, particularly for complex or chronic medical conditions.
4. Accountability and Reporting: Healthcare providers must track and report on the provision of language assistance services under Section 1557 to ensure that they are meeting the needs of their LEP populations. This increased accountability will help organizations identify areas for improvement and ensure compliance with language access standards. Simply displaying a poster offering telephonic interpretation services will no longer meet the requirements. Providers must offer demonstrable proof of when and how language access services were delivered.
5. Training Requirements: Healthcare providers must offer cultural competency and language assistance training to their staff, in accordance with Section 1557, ensuring they are equipped to work effectively with LEP patients. This includes recognizing when to call for interpreter services and understanding the limitations of relying on family members, apps, websites, or child interpreters.

Conclusion: Strengthening Access to Care for All

The 2024 ACA final rules, particularly Section 1557, represent a significant step forward in ensuring that LEP patients receive the high-quality care they deserve. By mandating the use of human intervention for language assistance, these regulations enhance the accuracy, professionalism, and cultural sensitivity of healthcare communication.

These changes reinforce the commitment outlined in Section 1557 to ensuring that all patients—regardless of language ability, ethnic background, socio-economic status, age, or gender—can access timely and accurate healthcare information. Promoting health equity through these updates is an investment that benefits everyone by keeping costs low and improving the quality of life for all.