Spanish-Speaking Immigrants' Access to Safety Net Providers and Translation Services Across Traditional and Emerging US Destinations.

Latino immigrants have recently spread beyond traditional US enclaves to “emerging destinations.” The arrival of limited English proficiency (LEP) Spanish-speakers to these areas can challenge the health care system, as translation services may not be readily available for LEP patients. Trained auditors posed as family members of LEP patients seeking primary care in a safety net setting. We found substantially lower appointment availability for LEP adults in emerging destinations compared to traditional destinations. Greater bilingual resources are needed within safety net clinics to accommodate LEP Spanish speakers as this population continues to grow and expand throughout the United States.