7.2 Language Access & Accessibility: Dual-Language Labels, Registry Interpreters & Prescription Readers
Key Takeaways
On request of a prescriber, patient or agent, an Oregon pharmacy must label drugs for self-administration in English plus one of 14 languages.
Oregon's 14 required label languages are Spanish, Russian, Somali, Arabic, Simplified Chinese, Vietnamese, Farsi, Korean, Romanian, Swahili, Burmese, Nepali, Amharic and Pashtu.
An Oregon pharmacy must tell every patient a prescription reader is available and provide one, with compatible labels, to blind or print-disabled patients for the duration of the prescription.
Oregon pharmacists and interns must use a free OHA-registry interpreter unless the pharmacist is proficient, no registry interpreter is available after a documented effort, or the patient declines one.
Oregon pharmacies must record each interpreter's name, registry number and language, and post signs about free interpretation and translated labels.
Why this matters
Oregon has some of the most detailed pharmacy language-access law in the country. ORS 689.564 (2019) requires dual-language labels. ORS 689.561 requires prescription readers. ORS 413.558–.559 and OAR 855-041-1133 require registry interpreters. Board rules also require signage and records. The MPJE treats these as part of counseling and patient-safety obligations.
Dual-language labels and inserts (ORS 689.564; OAR 855-041-1132)
- When a prescriber, patient or patient's agent requests it, every drug dispensed for the patient's self-administration must bear a label in English and the requested language. Where required, it also comes with an informational insert in both languages.
- Limited English proficiency means a person who is not fluent in English.
- Labels and inserts must be available in at least 14 languages: Spanish, Russian, Somali, Arabic, Simplified Chinese, Vietnamese, Farsi, Korean, Romanian, Swahili, Burmese, Nepali, Amharic and Pashtu. The Board reassesses the list at least every 10 years, using American Community Survey data, with OHA.
- The rule does not apply to drugs intended for administration by a health care worker, and the statute does not apply to institutional drug outlets.
- A pharmacy may contract with a third party for translation. A pharmacy, pharmacist or intern that contracted in good faith and was not negligent is not liable for the translator's errors (ORS 689.564(2)).
Prescription readers (ORS 689.561; OAR 855-041-1131)
- A pharmacy must notify each person to whom a prescription is dispensed that a prescription reader is available on request. A prescription reader is a device that audibly conveys label information.
- If a person identifies as blind, visually impaired or print disabled, the pharmacy must provide a reader that is appropriate for the impairment and available for at least the duration of the prescription.
- The pharmacy must make sure the label is compatible with the reader.
- Institutional outlets dispensing drugs for administration by a provider are exempt.
Interpreters (OAR 855-041-1133; OAR 855-115-0145(5); ORS 413.558–.559)
When a pharmacist or intern communicates with a patient who prefers a language other than English or uses signed language, they must work with a health care interpreter from the OHA Health Care Interpreter Registry. The exception is a pharmacist who is proficient in that language. "Communicating" includes counseling, patient care services and even billing.
| Requirement | Detail |
|---|---|
| Cost | Interpretation is provided at no charge to the patient |
| Non-registry interpreter allowed only if | (a) the pharmacist or intern made a good-faith effort to get a registry interpreter and none was available, or (b) the patient was offered a registry interpreter and declined, choosing another |
| On-site interpreters | The pharmacy furnishes PPE meeting national standards at no cost. It may not require interpreters to bring their own |
| Records | Document each registry-interpreter encounter, or each good-faith effort when using a non-registry interpreter. Include the interpreter's full name, registry number if applicable, and the language |
Interns face an added limit. An intern may not communicate with such a patient at all unless the intern is a registered interpreter or the supervising pharmacist is fluent (OAR 855-120-0150).
Warning
Using a patient's child or other family member as the interpreter does not satisfy the rule unless the registry exceptions apply. Either no registry interpreter was available despite a documented good-faith effort, or the patient was offered one and chose someone else.
Signage and patient records
- Pharmacies must post signs, easily seen by the public, giving notice of the right to free, competent oral interpretation and sign-language interpretation, and to translation services including translated labels, in each of the 14 languages (OAR 855-041-1035(1)(e)(B); OAR 855-041-1133; ORS 689.564(5)). The Board publishes a dual-language labeling sign.
- The patient record must include the patient's preferred language for communication and prescription labeling (OAR 855-041-1165(5)).
- Each pharmacist must ensure services are provided with interpretation and translation as ORS 689.564 requires (OAR 855-115-0105(8)). The pharmacy's policies must cover interpretation, translation and prescription-reader services (OAR 855-041-1040).
Federal overlay
Pharmacies receiving federal financial assistance, including Medicare Part D or Medicaid payments, must also give meaningful access to people with limited English proficiency under Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act. They must provide effective communication for people with disabilities under the ADA and Section 504. Oregon's rules are more specific and set the practical standard.
Exam scenario
A Somali-speaking patient brings a new prescription for metformin, and her teenage son offers to interpret. The pharmacist is not proficient in Somali. The pharmacy should:
- Offer a registry interpreter (in person, by phone or by video) at no charge.
- Print the label in English and Somali if the patient requests it, which she may.
- Tell her a prescription reader is available on request.
- Document the interpreter's name, registry number and language.
The son may interpret only if the patient declines the registry interpreter, or if a documented good-faith effort finds none available.
Under ORS 689.564 and OAR 855-041-1132, who may request that an Oregon prescription be labeled in English and another language?
Only the patient, in writing
Only the prescribing practitioner
The prescriber, the patient or the patient's agent
Only an OHA-certified interpreter
When may an Oregon pharmacist counsel a Vietnamese-speaking patient through an interpreter who is not on the OHA Health Care Interpreter Registry?
Whenever the pharmacy prefers to save time
After a documented good-faith effort finds no registry interpreter available, or when the patient declines a registry interpreter and chooses another
Only if the interpreter is a pharmacy technician
Never; only registry interpreters may ever be used
Which accessibility duty applies to every Oregon retail pharmacy under ORS 689.561 and OAR 855-041-1131?
Notifying each person receiving a prescription that a prescription reader is available on request, and providing a compatible reader for blind or print-disabled patients
Printing every label in Braille
Providing large-print labels only for Medicaid patients
Delivering all prescriptions to patients who are blind
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