The ACA also makes the distinction between untrained and qualified bilingual medical staff. Too often, healthcare professionals are called on to interpret because they speak more than one language, but their bilingual abilities are usually subpar compared to professional linguists.
According to the law, a “qualified” bilingual staff member is someone who has:
Using under-trained or unqualified medical staff has been shown to cause poor patient outcomes for LEP (Limited English Proficiency) individuals. But these doctors and nurses are still too often utilized when interpretation services are needed.
Businesses, agencies and other public facilities are required to provide accessibility for specified disabilities and for Deaf clients. This means they are being provided access to communication. Thus, the cost falls upon those who are providing the accommodations. The use of qualified sign language interpreters is a convenient, cost-effective way to provide such access. A surcharge cannot legally be imposed on an individual with a disability directly or indirectly to offset the cost of the interpreter. The cost of the interpreter should be treated as part of overhead expenses for accounting and tax purposes. The doctor may not charge the patient for the cost of interpreter service, either directly or by billing the patient’s insurance carrier: A public accommodation may not impose a surcharge on a particular individual with a disability or any group of individuals with disabilities to cover the costs of measures, such as the provision of auxiliary aids, barrier removal…and reasonable modifications… that are required to provide that individual or group with the nondiscriminatory treatment required by the Act or this part.
All healthcare providers are expected to treat the cost of providing auxiliary aids and services as a part of the annual overhead costs of operating a business. Interpreting services should be budgeted as part of your annual planning for accessibility services. It is true that on a per-encounter basis, you may pay more for interpreting services than you generate in revenue for your company. However, if you consider the cost over the course of a year as an overhead cost of doing business, providing accessible services is quite reasonable.
The Deaf consumer is not responsible to place a service request, but the entity (paying party) is. All places should have predetermined protocols and trained staff members to ensure they know how to obtain interpreter services and other communication aids and services when needed by persons who are Deaf or Hard of Hearing. The public entity, no matter whether they are a profit or non-profit organization. This especially holds true for any public entity who receives any kind of federal funding (including Medicare/Medicaid).