Section 1557: A Quick Review for Healthcare Providers

Several regulations have been put in place to help ensure Limited English Proficiency (LEP) and Deaf and Hard of Hearing (HoH) patients are provided meaningful access to pertinent information surrounding their health care and well-being. These laws include:

  • Title VI of the Civil Rights Act of 1964
  • National Standards on Culturally and Linguistically Appropriate Services
  • Americans with Disabilities Act
  • The Hill Burton Act
  • Section 1557 of the Affordable Care Act (ACA)

Revisiting the Most Recent Regulation: Section 1557

Section 1557 is the nondiscrimination provision of the ACA. The law prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities. Section 1557 builds on long-standing and familiar Federal civil rights laws, including Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973 and the Age Discrimination Act of 1975. Section 1557 extends nondiscrimination protections to individuals participating in:

  • Health programs or activities, any part of which received funding from HHS
  • Any health program or activity that HHS itself administers
  • Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces

Section 1557 has been in effect since its enactment in 2010 and the HHS Office for Civil Rights has been enforcing the provision since it was enacted. On May 13, 2016, the HHS Office for Civil Rights issued the final rule of Section 1557. These last standards titled, Nondiscrimination in Health Programs and Activities, were put into effect to further improve access to health care, ensuring the same level of health-care services and coverage is available to all patient populations regardless of preferred language.

To comply, facilities receiving federal funding have to:

  • Provide meaningful access to each LEP individual to be served or likely to be encountered in its health programs and activities
  • Publish taglines, which are short statements in non-English languages, in significant publications and post in prominent locations and on its website to notify the individual about the availability of language assistance services
  • Offer a qualified interpreter when oral interpretation is a reasonable step to provide an individual with meaningful access
  • Provide language services free of charge and in a timely manner
  • Adhere to certain quality standards in delivering language assistance services

And cannot:

  • Require an individual to provide his or her own interpreter
  • Rely on a minor child to interpret, except in a life threatening emergency where there is no qualified interpreter immediately available
  • Rely on interpreters that the individual prefers when there are competency, confidentiality or other concerns
  • Rely on unqualified bilingual or multilingual staff or use low-quality video remote interpreting services

Medically Qualified Interpreters Can Help

Medically qualified interpreters possess the necessary skills and knowledge to surpass obstacles that would otherwise be detrimental to both the patient-provider communication and patient outcome. Section 1557 emphasizes the importance of using a qualified medical interpreter versus an ad-hoc one and prohibits the use of unqualified interpreters barring extreme circumstances.

Watch this webinar recording, hosted by Patricia Alonzo, Spanish Language Operations Manager at Stratus Video and Trilingual Interpreter (ASL & Spanish), to learn more about the latest regulations surrounding language access in healthcare.

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