Senate committee hears bill to codify federal language-access rules, bar children as medical interpreters

The Nevada Senate Committee on Health and Human Services heard testimony on Senate Bill 188, which would require health-care facilities and providers to take “reasonable steps” to provide language assistance to people with limited English proficiency and to prohibit the routine use of children as interpreters.

The bill’s sponsor, Senator Donate, told the committee the measure would codify federal requirements and create state-level enforcement to protect patients, including deaf and hard-of-hearing Nevada residents, who lack reliable access to interpretation services.

SB 188 would mirror protections in federal law by requiring free, accurate and timely interpretation and translation services in health-care settings, prescribe standards for when interpreters and translators are considered qualified, and authorize discipline of certain providers or facilities for violations. The bill text, presenters said, is modeled on requirements in the Affordable Care Act (Section 1557) and related federal guidance.

Leticia Delgado, who presented the bill on behalf of the sponsor, summarized the measure: “SB 188 is an act relating to health care, requiring certain health care facilities and providers of health care to take reasonable steps to provide a person with limited English proficiency with language assistance under certain circumstances.” Delgado and the sponsor emphasized two goals: ensure meaningful access to language services and prevent children from being asked to facilitate conversations beyond their maturity.

Supporters from disability and deaf-community groups told the committee they frequently hear reports of failed or unavailable interpretation in hospitals and clinics. Eric Wilcox, chair of the Nevada Commission for Persons Who Are Deaf and Hard of Hearing, said the commission “supports SB 188” and that the commission’s town halls have documented “truly harrowing stories of lapses in communication in hospitals and clinics that risk the well-being and maybe even potentially the lives” of deaf community members.

Shelly Breed, representing Las Vegas Deaf Senior Citizens, described practical failures with existing video remote interpreting (VRI) machines at an unnamed Las Vegas hospital: three VRI units were present but “not running” or “not accessible,” she said. Breed stressed that “children used as an in person interpreter is not okay. They should not be interpreting for their parents. They should not be interpreting at all.”

Several health-care industry representatives spoke neutral to supportive while raising implementation concerns about cost, certification and technology. Jacqueline Nguyen of the Nevada State Medical Association said physicians and practices want patients to understand their care but noted interpretation can be expensive: “ASL services can run $125 an hour with a 2 hour minimum. For other language interpretation, even using phone or video services can run $3.95 per minute… which calculates to $237 per hour.” Patrick Kelly of the Nevada Hospital Association said hospitals are required under federal law to provide these services but acknowledged uneven implementation across smaller and larger facilities.

Committee members asked whether the bill would duplicate federal law and how it would treat technology such as phone- and video-based interpretation or emerging machine-translation tools. Senator Donate said the bill deliberately codifies the federal standard in state law to create a clear, enforceable state requirement and protect access if federal rules change. He also said the bill allows for technology but would require verification when machine translation is used so that output is accurate for clinical decision-making.

A caller, Denise Bolanos of Return Strong Nevada, said she supports the bill’s intent but urged the committee to clarify whether the measure applies to incarcerated individuals and prison medical facilities, noting that incarcerated people often cannot access cell-phone translation and sometimes rely on other inmates for interpretation.

Committee members and witnesses also discussed billing. Senator Donate noted an existing billing code, T1013, that CMS recognizes; the sponsor said managed-care organizations told him language services are already available to enrollees. Health-care representatives said reimbursement exists in some settings but argued reimbursement rates and administrative burden vary and merit further work.

No formal committee vote occurred. Senator Donate told the committee he plans to continue working with stakeholders on technical amendments — on certification, small-facility exceptions and technology verification — and the hearing was closed for public comment after testimony concluded. The committee did not adopt amendments during the hearing.

The full hearing audio and materials are available on the Nevada Legislature website, and the committee indicated it will continue work on SB 188 in subsequent meetings.