[Congressional Record Volume 147, Number 137 (Friday, October 12, 2001)]
[Extensions of Remarks]
[Page E1863]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            OPPOSE DELAYS IN ENFORCING EXECUTIVE ORDER 13166

                                 ______
                                 

                       HON. JANICE D. SCHAKOWSKY

                              of illinois

                    in the house of representatives

                       Thursday, October 11, 2001

  Ms. SCHAKOWSKY. Mr. Speaker, I rise in strong opposition to the 
amendment offered by the gentleman from Oklahoma, which would delay 
enforcement of Executive Order 13166 that requires federal agencies and 
organizations that receive federal funding to provide translators to 
limited English proficient individuals.
  Executive Order 13166 promotes actions consistent with, but not 
unduly burdensome to, the fundamental mission of federal programs. 
Flexibility is recognized as essential--states and providers need only 
do what they can, given their circumstances, to assist limited English 
proficiency (LEP) individuals. For example, street signs do not need to 
be translated into characters and doctors who serve LEP individuals on 
an infrequent basis are not required to have full-time interpreters or 
bilingual staff, this would be considered undue burden.
  The need for Executive Order 13166 and its implementing guidance 
cannot be overstated. LEP individuals--many of whom initially enter the 
United States as refugees and asylees--endure restricted access to 
critical public health, hospital and medical services which they often 
desperately need. The most recent Census data that documents over 31 
million individuals, over one in nine Americans, speak a language other 
than English at home. While this reality should be viewed as a cultural 
strength of our nation, in the health care context an individual's 
limited English proficiency often results in inadequate health care. An 
inability to comprehend the patient, mixed with a fear of liability, 
can also lead some doctors to order expensive, otherwise avoidable 
tests. Conversely, because of communication problems, non-English 
speakers often avoid seeking treatment until it is absolutely 
necessary, which disproportionately causes them to under utilize cost-
effective preventive care. This is not only unhealthy, but often more 
expensive. Without Executive Order 13166 and translation services for 
LEP populations, citizens and non-citizens alike suffer.
  Parents of citizen children, who have limited knowledge of English, 
can not explain to the doctor what is wrong with their child nor do 
they understand what the doctor tells them to do for treatment. If a 
LEP individual arrives at a hospital with symptoms of tuberculosis--or 
smallpox--without an interpreter, hospital staff and public health 
officials would be unable to communicate with the patient and a public 
health hazard could easily spiral out of control.
  Here are additional stories that have resulted from inadequate LEP 
translation services available.
  A Korean woman appeared for a gynecology exam, but no interpreter or 
language line assistance was provided. The clinician used the 16-year-
old son of a complete stranger to translate.
  A woman requiring treatment for a uterine cyst was unable to receive 
treatment on two separate occasions because an interpreter was 
unavailable.
  A man suffering from a skin condition requiring laser treatment 
underwent treatment for over a year. The man endured days of pain after 
each treatment, but was unable to communicate this because he was never 
provided with an interpreter. Only after a community organization 
intervened did the clinic understand the patient's pain and adjust the 
treatment.
  A Russian-speaking woman experienced life-threatening complications 
from prescribed medications. Without an interpreter or use of a 
language line, doctors in the emergency room were unable to treat her. 
Only because a Russian-speaking young girl happened by and agreed to 
help were doctors able to save the woman's life.
  A Russian-speaking woman's none-year-old son had to translate before 
and after his mother's angioplasty. The hospital refused to use a 
language line and the child translated for several hours each time.
  This Executive Order will have a profoundly positive impact on 
ensuring that all individuals, regardless of language, receive quality 
care and that disparities in health care access and outcomes due to 
language barriers are being addressed. There is no good reason to delay 
the full enforcement of Executive Order 13166. Therefore, I strongly 
urge my colleagues to vote against this amendment.

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