One of the reasons that Casa has been successful is the access we provide to quality interpretation, both through our trained volunteers and, for languages other than Spanish, via our outstanding partner  Language Access Multicultural People. 

 

The importance of such access cannot be overstated. A  recent study found that more than 250,000 people in the U.S. die every year from medical mistakes. Your odds of being a statistic rise steeply if you have limited or no English language skills. This is a pressing issue, given that U.S. Census data tells us that more than 63 million Americans speak a language other than English at home, and more than 25 million self-identify as having limited English proficiency.

 

In one sense, this problem was solved before I was even born.  Title VI of the Civil Rights Act of 1964 prevents discrimination based on race, color, religion, sex or national origin by any organization receiving federal funding. In the 1974 case  Lau v. Nichols, the Supreme Court ruled that language is a legal substitute for national origin, which guarantees equal educational opportunities to students who do not speak English as their first language. This ruling set the precedent that all healthcare providers that accept Medicare, Medicaid or some other form of federal funding cannot discriminate based on language and must supply an interpreter for Limited English Proficiency (LEP) patients.

 

And yet, all too often patients have no one to interpret for them or are forced to rely on a friend or family member. Why? Title VI did not come with targeted funding. Neither state nor federal agencies have a mandate to fund interpreter services. The states, of course, could take matters into their own hands, but as of last year only 13 states and the District of Columbia had agreed to reimburse the costs of medical interpreters through Medicaid.

 

This has to change, not only because it is the right thing to do, but because failure to do so can  increase exposure to liability. Furthermore, systematic reviews  have found that the use of professional interpreters improves communication substantially and helps reduce disparities across a range of medical services. In addition, access to interpreters is  associated with  patient satisfaction, patient-reported health status, and adherence with medication and follow-up visits.

 

Interpretation shouldn't be viewed as a convenience. It should be part and parcel of our care for patients.