Language Assistance & the ACHC: What You Need to Know
The Accreditation Commission for Health Care (ACHC) is an organization that provides accreditation for healthcare facilities and providers in multiple specialties nationwide.
Each year, the ACHC publishes accreditation standard revisions to its accreditation requirements. Most of the time, these are minor revisions, including additions, deletions, and clarifications. It's important for healthcare organizations to stay up to date on the latest changes to ensure a smooth accreditation process and make adjustments to care as needed to meet the requirements.
Providing services to patients in a format they can understand is critical for the accreditation process. The ACHC standards include clear guidelines on meeting limited-English proficient (LEP) patients' needs by providing information about their treatments in their native language.
Here's what you need to know about the ACHC accreditation process and language assistance requirements.
Who is the ACHC?
The ACHC began in 1985 with a group of home care aide organizations in North Carolina that wanted to provide a better way for patients and providers in their state to evaluate whether a home care agency was consistently providing quality care. Before that, it was difficult to compare organizations because each one would adhere to different standards (often claiming they were the highest standard).
Since that time, the ACHC has grown to become a national accrediting body. In the mid-2000s, they were approved by the Centers for Medicare and Medicaid Services (CMS) as the "deeming authority" for:
Home health agencies (HHAs)
Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
They also create standards and provide accreditation for:
Pharmacies and compounding pharmacies
ACHC accreditation must be renewed every three years. The process includes "a comprehensive review process of your organizational structure, policies and procedures, and compliance with state and federal laws."
Benefits of Accreditation
Accreditation in healthcare is generally voluntary through non-governmental and sometimes nonprofit organizations. They can set their own standards for what healthcare providers must do to achieve accreditation and hire qualified experts to evaluate compliance based on those standards.
There are several reasons that healthcare providers should go through the accreditation process:
Show your commitment to quality care. A qualified third-party expert reviews your patient services and outcomes and determines whether they meet nationally recognized standards of care. Plus, you know what the criteria are in advance so that you can evaluate your own quality. If you find areas where you do not meet the standard, you have an opportunity to improve.
Stay up to date with changing best practices. Accreditation is not a one-and-done thing. It happens every three years, so you must stay up to date with the latest advancements in your field and continually work to reduce costs and improve quality.
Benchmark against your competitors. Measuring yourself against a national standard is the best way to see how you perform on a level playing field. It also gives you targets for improvement when a competitor outperforms you.
Differentiate from other care providers. Accreditation also helps patients differentiate among providers and find the best care.
Your home health agency (HHA) must be in compliance with all federal, state, and local laws and regulations. ACHC recently added Section 1557 of the Patient Protection and Affordable Care Act (ACA) to that list of federal regulations.
Broadly, Section 1557 states that healthcare providers cannot discriminate on the basis of race, color, national origin, sex, age, or disability in specified health programs. More specifically, this section requires that all healthcare providers must take "reasonable steps" to offer language support to LEP patients. You are also required to post a notice to patients that language support is available and that information must be communicated in all of the top 15 languages spoken in the state(s) where you provide care.
HH2-2A, HH2-4B, HH2-6A: Written Policies & Procedures
HHAs must provide written notification of Patient Rights and Responsibilities to every patient. The notice now must include:
Contact information for your HHA administrator, including name, phone number, and business mailing address
Details about transfer and discharge policies and procedures
The ability to be informed about and consent or refuse care before receiving any treatment
The names, addresses, and phone numbers for the Agency on Aging, Center for Independent Living, Protection and Advocacy Agency, Aging and Disability Resource Center, and Quality Improvement Organization
This section addresses provisions of care for patients with language barriers (LEP patients). Previously, language support was only a requirement of ACHC. Now, it is a condition of participation (CoP) for Medicare. Care providers must communicate information to every patient in plain language that is both accessible and timely.
Offering patients with disabilities access to auxiliary aids and services at no cost, in accordance with the Americans with Disabilities Act (ADA)
Offering patients with limited-English proficiency language support at no cost (both oral and written translations)
Meeting Language Assistance Requirements
Home health agencies looking to prepare for, achieve and maintain accreditation need to understand the requirements for language support and the resources available to offer them to your patients. More than 8% of the U.S. population has limited English proficiency, so it is very likely you serve patients who need these services. However, with more than 350 languages spoken in U.S. homes, it's impractical to try and hire someone fluent in every language you might encounter.
The best way to begin is by creating a language access plan (LAP). It's a strategic overview of your policies that identifies the need for language support in your area, what you currently offer, and what you need to add. It should also address staff training, procedures, feedback, and reporting.
A language support partner gives you access to qualified medical interpreters who are fluent in hundreds of languages, including American Sign Language (ASL). Before choosing a language service, make sure they offer:
It's also important that a language provider has options that meet the needs of your practice and your patients. That includes several interpreting methods, so you can get the one that works best in each situation, including: