Abstract
With 80% of US hospitals seeing limited English proficient patients on a regular basis, language assistance services are a pivotal component of ensuring equal access to health care. State and federal civil rights policies guarantee the provision of language assistance services to limited English proficient hospital patients. However, local civil rights advisory committees report hospitals do not adequately comply with these policies. Through the development and analysis of an original dataset of qualitative interviews with compliance officers, language assistance services administrators, and healthcare workers from five Chicagoland health systems, this study examines what these civil rights policies look like in practice and how actors’ self-interests affect implementation. Informants’ unfamiliarity with the civil rights law landscape, a healthcare provider interest in ‘prudentiality,’ and a lack of accountability between actors were found to impede implementation efforts. This study’s findings may be used to inform the development and implementation of future civil rights and healthcare policy and, more generally, contribute to our understanding of how actors respond to and interpret public policy at different levels of authority.