CLAS Standard 4
Standard 4's intent is to ensure meaningful access to health services. This is done through effective communication between the entity and the person with Limited English Proficiency.
Limited English Proficiency (LEP): This is defined as not being able to speak, read or understand the English language at a level permitting him/her to interact effectively with clinical or administrative staff. No Cost: Title VI requires all entities receiving federal financial assistance, including health care organizations, to make available FREE of charge language assistance services.
Timely Responsiveness at All Points of Entry and Contact at All Hours: Uniform entry procedures include time frames for the effective delivery of all language assistance services.
The preferred methods for delivery of language assistance are as follows:
- The first choice of service delivery is a face to face interpretation provided by a bilingual interpreter who can communicate directly with the individual served in their preferred language.
- The second choice of service delivery is a face to face interpretation provided by "trained staff or volunteer interpreters".
- The third choice of services delivery is the supplemental use of telephonic interpretation when an interpreter is needed instantly or in an unusual or infrequently encountered language.
It is not uncommon to have difficulty in gathering demographics and other important information especially when there is limited English proficiency. The following example illustrates this issue:
A hospital did not advise a mother of her right to free language assistance and encouraged her to use her eleven year old daughter as her interpreter. The daughter did not understand the terminology being used and relayed inaccurate information to her mother whose benefits were now jeopardized by the failure to obtain accurate information.
There are several CLAS standards playing out in this case. The lack of an offer for language assistance services led to the inaccurate and incomplete collection of patient information and ultimately to payment issues and the unavailability of care.