Galen Institute Opposes LEP Regulations

March 27, 2002

Ms. Deeana Jang
Attn: LEP Comments
200 Independence Avenue, SW
Room 506F
Washington, DC 20201

Dear Ms. Jang:

This letter is in response to the policy guidance on Title VI’s prohibition against national origin discrimination as it affects Limited English Proficient (LEP) persons issued on February 1, 2002. After reviewing the guidance carefully, we have concluded that enforcement of these regulations would be detrimental to patient privacy and may have the opposite effect of their intention. For these reasons, expanded upon below, we strongly oppose the LEP regulations.

  1. The use of third-party interpreters would violate the privacy of LEP persons, making confidential medical information available to total strangers. Encouraging, instead of discouraging, family members to act as interpreters would not only be more cost-effective, but would keep sensitive medical information within a family. LEP persons likely would be more comfortable and open about important medical problems with family members than with unfamiliar strangers. The guidance encourages strangers to be the first choice of interpreters for LEP persons; we believe family members should be the first choice.

  2. Providing interpreting services to LEP persons dramatically increases costs for providers and hospitals. Small practitioners with limited resources would be especially hard hit. At a time when health care costs are rising rapidly and provider reimbursements have been cut, providers have little choice but to pass the cost of interpreting services onto their patients, making access to care even more difficult. This could also limit the ability of providers to continue accepting low-income patients on government programs.

  3. We believe doctors and hospitals should have flexibility in deciding how best to communicate with patients, without excessive government involvement and oversight. Threat of legal proceedings by the Department of Justice and/or loss of Federal assistance would seriously deter doctors in accepting LEP patients.

In conclusion, the LEP guidance would infringe on the privacy of LEP persons, significantly drive up costs for providers, and undermine the patient/physician relationship. Furthermore, the guidance has the potential to limit access for LEP persons, precisely the opposite effect than intended. For these reasons, we strongly recommend the Office of Civil Rights and Department of Health and Human Services not adopt the LEP guidance as written.


Grace-Marie Turner


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