WASCLA Tools for Health

In keeping with WASCLA’s mission to eliminate language barriers to essential services in Washington State, the Tools for Health Project was created to help solve an unmet need in healthcare.  Our Healthcare Committee identified the need for a centralized information hub of language access topics relevant to health and healthcare information for consumers with limited English proficiency (LEP) and the providers and advocates who work with them.  Simply put, this project aims to make information about language access rights and communication services available directly to those who need it.  The Tools for Health project offers a collection of materials about consumer rights and how to obtain language services in the 31 most-commonly spoken languages   in Washington. The toolkit includes  an “ISpeak” card for consumers to bring with them when seeking care which identifies the language they speak,  and a “Know Your Rights”  flyer to inform both consumers and providers regarding the use of interpreter services in healthcare settings.  These items are available to download for free from the Tools for Health section of the WASCLA website. Limited quantities of print materials are available upon request while supplies last. In addition, the Tools for Health webpage  includes direct links to multilingual consumer health resources  published by the National Libraries of Medicine and other reliable sources of health information.

Click here to go to the Tools For Health resources page to download electronic copies of these materials.


How the Tools for Health Languages were Selected
The project began with careful research and planning, building on WASCLA’s practical knowledge in the field. The need for comprehensive language access services for healthcare consumers has never been greater in Washington, just as on the national level, due to major demographic changes in recent years.  As a result of immigration, secondary migration, and refugee resettlement, population diversity in many communities has increased greatly. So understanding today’s state population across age groups was the first step in the planning process.  We knew that a one-size-fits-all approach would not work, and that we needed to achieve maximum reach with a limited project budget.

We faced additional challenges because  there is no single source for the information we needed, and the collection of data in the healthcare sector on race, ethnicity, and language is still very limited..  By using multiple data sources, we were able to get a helpful snapshot of language service needs in Washington.

In  general, half of all Spanish-speakers, speakers of all Asian languages combined, and all newcomer populations, are LEP persons.  There are wide variations of course on the individual level, linked to age, national origin, education, income, immigration status, and length of time in the US.  Language access needs across the state vary greatly at the community level: in some areas, virtually all LEP persons speak Spanish, while in other areas, dozens of different languages are spoken. From the systems that collect language data, we learned that:

Drawing from this data, we identified 50 languages which  represent  the top 15 languages spoken across all of Washington’s counties, for the project focus.. The list was narrowed down to 31 spoken languages (30 written languages, corresponding to the difference between spoken and written Chinese languages) For budgetary reasons,. If adequate funding is obtained, our goal is to expand these resources to include the  additional languages from the original fifty.   At a minimum,  we want to make sure that the top 15 languages spoken in any given county would be included.


What does Language Access Have to do with Health?
Decades of evidence show that racial and ethnic inequalities in health and healthcare exist across the USA, including in Washington State. It is well-documented that overall, patients from racial and ethnic minority groups have worse health and receive healthcare of lower quality than do Whites, and LEP status adds another layer of disparities.  Specifically we know that LEP persons are:

All of these factors have their roots in communication barriers between patients and providers and the lack of utilization of qualified medical interpreters as a routine part of healthcare service delivery. Lack of language access services creates major patient safety risks,  and a financial burden for patients and their families as well as for healthcare systems, insurers, and governments alike.

The implementation of the Affordable Care Act this year makes ensuring language access to healthcare services even more urgent. Under the ACA, many LEP persons now have, often for the very first time, the opportunity to enroll in public and private health insurance plans and to seek care for themselves and their families. The ACA created additional nondiscrimination requirements expanding on laws and policies already in place. These include  requirements for language services to assist consumers to enroll and to use their new insurance benefits, and to manage their own personal and family health issues and concerns. While it is still too early to know how newly-insured LEP persons are faring, language access issues during enrollment have surfaced at the national and state levels .

How WASCLA Tools for Health Can Help
The first step to assuring that all LEP persons get communication assistance when needed,  is to raise public awareness of the right to receive language services at no cost  in healthcare service settings.  Making the multilingual I Speak cards and consumer rights notices readily available on a statewide basis is a part of the process.  Despite all that we know about Washington’s population today, and the harms caused by lack of language access, availability of this critical service remains uneven across care settings.  These new tools will help close an information gap for the benefit of all.


Plans for the Future
The publication of the multilingual I Speak cards and consumer flyers is the first phase of an ongoing WASCLA project. Please visit this site frequently to see new resources being developed, including FAQs and special materials for healthcare providers, and information about WASCLA’s training and consultation services..  We are seeking additional funding support  to add more languages to the collection, and to create audiovisual versions of Tools for Health, to increase access for the LEP public.


The information contained here is presented for general educational and informational purposes only and is not legal advice. WASCLA is not responsible for the outcomes of efforts of individuals to secure language access services. Every effort has been made to assure that all information contained on this website is accurate and current as of its date of publication. However WASCLA cannot be responsible for changes in program information and availability of services or resources from any entity listed here. WASCLA has done careful due diligence to secure accurate professional translations of all Tools for Health materials. We welcome your comments about these publications and your suggestions for additional multilingual consumer resources.
All web-based materials are Section 508 compliant.


The Tools for Health project was made possible by a Health Information Services Award from the National Network of Libraries of Medicine, Pacific Northwest Region to WASCLA, and a grant  from  the Governor’s Interagency Council on Health Disparities, along with the invaluable assistance of dedicated language access advocates. In particular we would like to acknowledge the support of the WASCLA Healthcare Committee, the Interpreter Services Department at Harborview Medical Center, Northwest Health Law Advocates, National Council on Interpreting in Health Care, National Health Law Program,  Migration Policy Institute, Open Doors for Multicultural Families, American Red Cross Western Region Language Bank, Northwest  Translators  and Interpreters Society, and InDemand Interpreting.