The Importance of Language Access in Community-Based Long-Term Care Settings

En español | The U.S. Census Bureau estimates that 55.4 million Americans speak a language other than English when they are at home. In addition to Spanish, growing numbers of Americans speak Portuguese, Russian, Hindi, Chinese, Vietnamese, Tagalog, Arabic and other languages.

This represents a 140 percent jump since 1980. The Census Bureau also predicts that the United States will continue to be a linguistically diverse nation and home to large numbers of people with limited English proficiency (LEP).

This has significant implications for the provision of community-based long-term supports and services (LTSS) to LEP older adults and people with disabilities. States are moving to provide these services through managed care, and that creates an imperative for managed care organizations to take language access seriously.

To provide high-quality LTSS, managed care plans need to understand how to meet the language needs of LEP individuals. Language barriers complicate the issue of caring for older adults and people with disabilities. They also increase costs for managed care companies because they could lead to medical errors, avoidable emergency room visits, poorer health outcomes and less consumer satisfaction.

While much is known about the provision of language services in acute and primary health care settings, we know little about how adequate language access is provided in home- and community-based long-term care settings.

Successfully addressing the language access barrier in other settings has been shown to improve the overall patient and family member experience. Bridging the language gap in community-based LTSS settings has the potential to lead to a better understanding of client needs and care preferences, a better understanding of how to support non-English-speaking family caregivers, and may lead to improvements in the overall bottom line for managed care companies.

The AARP Public Policy Institute is working with other stakeholders to explore promising practices in providing language access across a range of LTSS settings (home, adult day care, assisted living facilities) to share more broadly.

Lynda Flowers is a senior strategic policy advisor at the AARP Public Policy Institute. Her areas of expertise include Medicaid, social determinants of health (including social isolation), oral health, and health prevention/promotion.