AB 1242: Language Access
¹ The Impact of Limited English Proficiency on Healthcare Access and Outcomes, National Institutes of Health (2023).
SUMMARY
AB 1242 addresses the systemic and widening
disparity in access to services in California by
ensuring individuals with limited English proficiency
(LEP) and individuals who are deaf or hard of
hearing have meaningful access to health and
human services. The bill: 1) establishes a
Language Access Director within the California
Health and Human Services Agency (CalHHS) to
coordinate and oversee agency-wide language
access efforts; 2) ensures there is human review
when using AI for translation or interpretation in
language assistance; and 3) improves the
determination of languages covered by state and
local agencies by amending the Dymally Alatorre
Act.
BACKGROUND
California is home to one of the most
linguistically diverse populations in the country,
with residents speaking over 200 languages,
variants, and dialects. Nearly 6.4 million
Californians have limited English proficiency
(LEP), making up the largest population with
LEP in the nation. Almost 44% of the population
speak a language other than English at home
and 17.1% do not read, write, or understand
English very well and are considered individuals
with LEP. Statewide, most of the households
with LEP prefer to speak Spanish, followed by
Asian and Pacific Islander languages.
While Spanish is the most commonly spoken
non-English language in California, many
communities with LEP speak
languages that are often overlooked in
statewide policy. Nearly 13% of LEPs are from
Asian American & Native Hawaiian Pacific
Islander (AA&NHPI), Latin American, African
and Caribbean communities that have
indigenous language needs. It is not uncommon
that these communities are often concentrated
in specific geographic areas where the lack of
culturally and linguistically appropriate services
becomes an even greater barrier to equitable
access. For these individuals, language barriers
can create significant obstacles to obtaining
essential health care services and
understanding their rights, responsibilities, and
available benefits.
Numerous studies have documented the health
disparities experienced by individuals with LEP
and persons who are deaf or hard of hearing,
including miscommunication with providers,
lower satisfaction with care, and worse health
outcomes. Inadequate language services
contribute to longer hospital stays, higher rates
of readmission, and increased risk of medical
errors—leading to avoidable costs for both
patients and the state.
A recent review published by the National
Institutes of Health found that LEP individuals
face higher barriers to health care access and
significantly worse clinical outcomes compared
to English-proficient populations. These findings
underscore “the urgent need for targeted
interventions and policy initiatives in the U.S. to
address disparities in conditions ranging from
chronic diseases to surgical outcomes for the
LEP population.”¹
California has long led the nation in recognizing
the importance of language access. In 1973,
the state enacted the Dymally-Alatorre Bilingual
Services Act, which requires state agencies
serving a substantial number of non-English-
speaking people to provide services and
materials in those individuals’ languages. Since
then, additional laws and policies have
reinforced the commitment to in-language
access. However, these efforts have not always
been implemented, monitored, or enforced
effectively.
In 2023, California Executive Order N-16-22,
which called for stronger equity and language
access across state agencies, CalHHS
released a Language Access Policy and
Guidance Document in 2023. Despite this
progress, there lacks a centralized Language
Access Director within CalHHS tasked with
overseeing all of its departments to ensure
consistency, coordination, and accountability
across its departments.
More troubling, Executive Order 14224
designated English as the official language of
the U.S., the first such designation in the
country’s history. This EO also rescinded
President’s Clinton’s Executive Order 13166,
which threatens crucial access to federal, state,
and local services for individuals with LEP
individuals, as protected under Title VI of the
Civil Rights Act of 1964. Weakening language
access protections could exclude millions from
essential services while undermining their
ability to fully participate in society.
Given the size of the state’s populations with
LEP and the federal push to decrease language
access, it is imperative that California take
steps forward in protecting and strategically
increasing access to LEP individuals.
SOLUTION
Building upon the Governor’s Language Access
Executive Order and CalHHS’ current efforts, this
bill pushes to bridge some remaining gaps in
access to health care by:
1. Establishing a Language Access Director at
CalHHS whose responsibilities include
implementing its Language Access Plan,
overseeing and coordinating the language access
coordinators in every CalHHS department and
office to implement their Language Access Plans,
supporting the collection of data for, and
submission of, the biennial report to the legislature
and posting the report on its website for greater
transparency, establishing mechanisms for
community level input and engagement, and very
importantly, ensuring that there is human review
when using machine, online or Artificial Intelligence
(AI)-generated language assistance for both
interpretation and translation services.
2. Amending the Dymally Alatorre Bilingual
Services Act to improve the determination of
languages covered by state and local agencies
through the use of relevant data sources, including
but not limited to, the most recent data from the
U.S. Census Bureau, the state Department of
Education, the state Department of Finance, and
other relevant databases, community-level input
from various mechanisms, such as evidence-based
data, focus groups, roundtables, and any other
relevant factors, i.e, linguistic isolation and
percentages of limited English proficiency within
each language group, etc.
By beginning to close long-standing gaps in
language access oversight and coordination, AB
1242 will help eliminate avoidable disparities,
improve health outcomes, and reduce costs across
the system—while advancing health equity for
millions of Californians.
SPONSORED BY
Asian Health Services
Asian Resources, Inc.
Center for Asian Americans in Action
Orange County Asian Pacific Islander Community
Alliance
Regional Pacific Islander Taskforce
CONTACT
Mike Sharif, Chief of Staff
[email protected]
(916) 319-2010