ULG’s Language Solutions Blog

Accessibility in Healthcare: Language Access & Alternative Formats


Is the information your healthcare plan provides truly accessible to all of your members? A number of barriers can stand in the way of understanding needed information, including language and disability. Helping your members overcome these barriers is a key part of providing equal access as required under laws like Section 1557 of the Patient Protection and Affordable Healthcare Act or Section 508 of the Rehabilitation Act. It also makes it easier for people to enroll in and maintain health insurance coverage. 

This can require that information be available in members’ preferred languages or in alternative formats, like audio files, large print, or Braille. California now requires Medi-Cal managed care plans to track members’ alternative format selections, so now is a great time to re-examine your procedures for handling these requests. Here are our top tips for ensuring that all of your members’ language access and alternative formatting needs are met as efficiently and thoroughly as possible. 


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Types of Accessibility

To keep their members informed and comply with applicable laws, health plans must be able to accommodate both language access requests and alternative format requests. 

Language Access 

Language access means providing members with limited English Proficiency (LEP) the information they need in the languages of their choice. According to the Center for Immigration Studies, “21.9 percent of U.S. residents speak a foreign language at home — more than double the 11 percent in 1980. As America becomes more culturally diverse, it becomes more important (and more challenging) to provide linguistically and culturally appropriate communication options. 

Ensuring language access means offering written translations as needed, as well as over-the-phone interpreting for phone calls. Additionally, health plans must notify members that these services are available by including translated statements to that effect in important plan communications. 

Alternative Formatting

According to the CDC, 1 in 4 US adults live with a disability. Members with certain disabilities will require alternative formatting for written documents. Alternative formatting is not “one size fits all.” Your organization needs to be prepared to accommodate a range of alternative formatting requests. For example: 

  • Audio: Audio files are usually offered in an MP3 format. Some expertise is required to ensure that listeners can accurately understand the information conveyed in the original document. 
  • Braille: Braille is often the most effective way for visually impaired people to access complicated texts. Braille is a code/writing system, not a language of its own.
  • Large print: Large print is useful for people who are visually impaired, as well as those with certain cognitive conditions. Documents will often need to be reformatted from the original layout.
  • Digital Accessibility: Online content or electronic documents may require adjustments  to ensure accessibility by individuals with visual, auditory, mobility, or other disabilities.  

It’s important to note that some individuals may have both language access needs and alternative formatting needs. Also, keep in mind that your members know their own needs best, and your organization should provide information in the language and format they prefer as much as possible. 

What ULG Recommends 

Whether a patient has LEP, has a disability that requires alternative formatting, or both, here are some expert tips to help you offer full access to all of your members. 

Be prepared

Audit and streamline procedures for requesting translations in the most commonly spoken languages in your area. Our experts are happy to offer recommendations!  

Also, have commonly used documents immediately available in alternative formatting whenever possible. For example, ULG works with a number of clients every year to translate their plans’ annual enrollment documents, as well as to provide large print versions at the same time. Having these alternative formats on hand, in both English and your threshold languages, can greatly save on time and costs.

Be responsive 

Blind and visually impaired members have a number of ways they could access printed information. Ask them what works best for them. 

Have a plan in place for members who are LEP and visually impaired, including a way to produce audio files, Braille, and large print documents in other languages. You will need qualified translators who are also well-versed in reformatting print information to ensure accessibility for the visually impaired. 

Be efficient 

Consider how to make your procedures more efficient, both for members with LEP and for members who are blind, visually impaired or otherwise disabled. ULG has worked with clients to create and implement a Language Access Plan to facilitate effective communication with their specific membership populations, including their members with LEP and/or disabilities.

A Language Access Plan involves assessing the needs of your members and developing procedures to meet these needs. Having all of this in writing ensures that everyone in your organization knows what their role is when it comes to accessibility. And it protects your organization by demonstrating the steps you’re taking to comply with applicable regulations.  

How ULG Can Help: Language Access and Alternative Formatting Services    

United Language Group has been offering language solutions for the healthcare industry for over 35 years. We offer “one-stop shopping” for full language access expertise, healthcare compliance knowledge, and improving health access and equity. We use our deep knowledge of the healthcare industry to design innovative solutions that ensure organizational compliance and an exceptional member experience. 

To learn more, contact us for a free consultation today. 


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