A coalition of immigration and health care advocates will launch a campaign on Monday urging the D.C. government to require pharmacies to provide interpreters for customers with limited English skills, a measure that could lead city lawmakers to mandate for the first time that the private sector offer language services.

"It's definitely a life or death thing," said Sapna Pandya, the executive director of D.C.-based Many Languages One Voice. "90 million Americans have trouble understanding prescriptions. They are challenging to understand even if you are an English speaker."

Under the proposal Pandya and other supporters are pressing, pharmacies that receive any kind of money from the government -- including Medicare or Medicaid payments -- would have to offer free interpretation services and translated medication labels in many instances. Pharmacies would not have to provide on-site translators but could use services like LanguageLine, a California company that provides interpreters by telephone.

According to a survey that will be released on Monday, 68 percent of D.C. pharmacies do not offer any translation services.

Ward 1 Councilman Jim Graham, who authored a 2004 law that expanded the spectrum of language services that D.C. government agencies must provide, is expected to introduce legislation containing the proposal next month.

The new measure the advocates are floating is modeled after a New York City law that requires pharmacies to offer interpretation services, and they contend that it is far from inappropriate for the city government to consider new guidelines for private companies.

"These pharmacies are receiving public dollars because they're serving a great number of Medicaid dollars," said Pandya. "It's not an overreach because these are tax dollars that we all pay for."

Supporters said they believed the required services would cost pharmacies about $2 per location per day.

Several national pharmacy chains that operate in the District, including CVS and Walgreens, did not respond to requests for comment.

But Dave Toth, a co-owner of the local Tschiffely Pharmacy chain, said he worried about the financial effects.

"It's not a bad idea. I don't have a problem with communication," Toth said. "I just see it as a financial burden when there's really no way of squeezing any more from the lemon."

Ward 7 Councilwoman Yvette Alexander, who chairs the council's health committee, said she would be interested in expanding the scope of Graham's anticipated legislation to include other medical offices.

"Before you even get to the pharmacy, your doctor should be ensuring that you understand what your diagnosis and treatment is," Alexander said. "You don't get to your pharmacy before you get to your doctor."