Under federal civil-rights requirements and the National CLAS Standards, what must an emergency department (ED) that receives federal funding do to meet the communication needs of patients with limited English proficiency (LEP)?
Translate written discharge instructions but conduct verbal communication in English, provided staff use simple, lay terminology.
Routinely allow family members or friends to interpret if the patient consents, eliminating the need for a formal language-access policy.
Offer interpreter services only during regular business hours; after-hours LEP patients may be asked to return when an interpreter is on-site.
Maintain a written policy that ensures qualified interpreter services are available at no cost to patients during every hour the ED is open.
Covered entities such as hospital EDs must take reasonable steps to ensure meaningful access for LEP individuals. Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act prohibit national-origin discrimination, requiring qualified interpreter services to be available free of charge and in a timely manner at every point of contact, 24 hours a day. The National CLAS Standards reinforce this by stating that language assistance must be provided "at all points of contact…during all hours of operation" and that organizations should maintain written policies to operationalize these requirements. Options that limit interpreter availability to business hours, rely routinely on family members, or depend solely on slow English explanations fail to meet these legal and accreditation standards.
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