Translation services may improve access to care, but rural hospitals have reservations

Doctor examining patient

Photo credit: Getty/kazoka30

Federal rules passed this summer require hospitals to provide translation services to patients who don’t speak English, but cash-strapped rural hospitals are concerned about the costs.

According to the rule, which went into effect in July, hospitals must offer printed content to the 15 most commonly spoken languages in their states, in addition to interpreters to ensure that medical messages are not misunderstood. The regulations apply to all health providers--including dental offices, primary care facilities and clinics--that accept federal money.

For some states, this means offering web posts, brochures and other written content for very small populations--for example, in Kansas, all hospitals must cater to 525 residents in the state that speak Swahili, and hospitals in Idaho must offer such services to the states 245 Ukrainian speakers, according to data (.pdf) from the Centers for Medicare & Medicaid Services.

Under these regulations, hospitals in rural areas--many of which are already struggling to stay open--must provide these services when they have no one in their patient population that uses them. Rosemary Blackmon, chief operating officer of the Alabama Hospital Association told The Pew Charitable Trust’s Stateline publication that the new rules may pose a challenge to some hospitals in her state. In Alabama, according to CMS, hospitals will have to cater to, for instance, 484 Japanese-speaking patients and 505 potential patients that speak Turkish statewide.

“They have to have notices in the top 15 languages spoken in the state,” Blackmon told Stateline, “but we have counties that probably don’t even have a single person who speaks a foreign language.”

The National Rural Health Association and America’s Essential Hospitals, professional organizations that represent rural facilities, according to the article, both expressed concern that their members may not be able to pay for the required services, though they support the rule’s goal of reducing discrimination and ensuring patients and doctors understand each other.

Advocates and policymakers say that that translation services will help ensure patients who don’t speak English get need preventative care, according to the article. Such patients may misunderstand instructions from doctors and may not be able to follow medication instructions.

“If someone can’t understand what their doctor says or what they are signing in a consent form, that is not considered equal access to health care,” Marina Hadjioannou Waters, a vice president of the National Council on Interpreting in Health Care, told Stateline.