What if my client or family doesn’t speak English? Do I have to provide an interpreter?
If your agency gets federal money, including through Medicaid, federal rules require reasonable steps to give people with limited English meaningful access. That can mean qualified interpreters and translated notices. Do not rely on a family member or a caregiver by default. Check current rules with your state agency.
Under Section 1557 of the Affordable Care Act, health programs and agencies that receive federal funds, including through Medicare or Medicaid, must take reasonable steps to give people with limited English proficiency meaningful access. A 2024 rule also called for a notice of language help, in English and the most common languages in your state, shown on your website and given with key documents.
In plain terms:
- Ask each new client what language they like to use for care and for paperwork. Record it.
- Offer a qualified interpreter, by phone or video if needed, for intake, consent and care plan talks.
- Translate the important forms: rights, consent, service agreement.
- Do not make a child or a caregiver the interpreter unless the client chooses it and it is safe.
- Hire bilingual caregivers when you can, and note it in your matching.
The rules and deadlines have been in motion. The law firm summary I read gave a notice date of July 5, 2025, and I could not confirm today’s status. Ask your state Medicaid agency or counsel what applies now.
Sources
- Affordable Care Act Section 1557: new language accessibility requirements · Morgan Lewis (law firm)
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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