Civil Rights FAQs

What are civil rights?

Civil rights are personal rights guaranteed and protected by the U.S. Constitution and federal laws enacted by Congress, such as the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990. Civil rights include protection from unlawful discrimination.

Read the full answer for Civil rights are personal rights guaranteed and protected by the U.S. Constitution and federal laws enacted by Congress, such as the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990. Civil rights include protection from unlawful discrimination. The HHS Office for Civil Rights (OCR) enforces civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age, religion, and sex (including pregnancy, sexual orientation, and gender identity) by certain health care and human services entities: state and local social and health services agencies, hospitals, clinics, nursing homes, insurers who are participating in the Maketplaces and receiving premium tax credits, and other entities receiving federal financial assistance from HHS. Under these laws, all persons in the United States have a right to receive health care and human services in a nondiscriminatory manner.  For example, you cannot be denied services or benefits simply because of your race, color, national origin, or disability. For more information about these laws and our authority under them, see our Civil Rights home page.
The guidance makes reference to "vital documents" and notes that, in certain circumstances, a recipient/covered entity may translate such documents into other languages to help ensure compliance with Title VI. What is a vital document?

"Vital documents" are generally documents that affect access to, retention in, or termination or exclusion from a recipient’s program services or benefits.

Read the full answer for "Vital documents" are generally documents that affect access to, retention in, or termination or exclusion from a recipient’s program services or benefits. Vital documents include, but are not limited to: applications; consent forms; complaint forms; intake forms with potential for important health consequences, letters or notices pertaining to eligibility for benefits; letters or notices pertaining to rights and the reduction, denial or termination of services or benefits or that require a response from the LEP person; actions affecting parental custody or child support, written tests that test competency for a particular license, job, or skill for which knowing English is not required; documents that must be provided by law; and notices regarding the availability of free language assistance services for LEP individuals.
What can I do If my civil rights have been violated?

If you feel a health care provider, human services agency, or program or activity conducted by HHS has discriminated against you (or someone else) unlawfully, you may file a civil rights compliant with OCR.

How do I file a civil rights complaint?

If you believe you have been discriminated against because of race, color, national origin, age, disability, religion, or sex (including pregnancy, sexual orientation, and gender identity) by a state and local social and health services agency, hospital, clinic, nursing home, or other HHS entity, you may file a complaint with OCR. Disability discrimination complaints may also be filed with OCR.

Read the full answer for If you believe you have been discriminated against because of: race, color, national origin, age, sex (including pregnancy, sexual orientation and gender identity), disability, or religion. by an HHS entity  or by a recipent of federal financial assistance such as: state and local social and health services agencies, hospitals, clinics, nursing homes, insurers who are participating in Marketplaces and receiving premium tax credits, or other entities receiving federal financial assistance from HHS providers you or your representative may file a complaint with OCR. Discrimination complaints against a state or local health or social services agency on the basis of disability may also be filed with OCR. Find out how to file a civil rights complaint.
What information must be provided to file a civil rights complaint?
You may file electronically via the OCR Complaint Portal or use the Civil Rights Discrimination Complaint Form Package from OCR. You will need to save the PDF forms to your computer or other storage device. See full answer for instructions on filing a written complaint.
Read the full answer for You may file electronically via the OCR Complaint Portal or use the Civil Rights Discrimination Complaint Form Package. (You will need to save the PDF forms.) You may also file a written complaint. Please include the following: Your name Full address Telephone numbers (include area code) Email address (if available) Name, full address, and telephone number of the person, agency or organization you believe discriminated against you Brief description of what happened How, why, and when you believe your (or someone else's) civil rights were violated Any other relevant information Your signature and date of complaint For more information, see Filing a Complaint.
What is the time limit for filing a civil rights complaint?

Complaints must be filed within 180 days from the date of the alleged discrimination. (The Office for Civil Rights may extend this period if there is good cause.)

Where do I file a civil rights complaint?

You can file your complaint against an HHS entity via the OCR Complaint Portal, at [email protected], or you can mail or fax your complaint. See Filing a Complaint for more information.

Read the full answer for If you are filing a discrimination complaint against one of the following: the U.S. Department of Health and Human Services (HHS); a state or local social or health services agency; a private social service agency receiving federal financial assistance from HHS; a hospital, clinic, nursing home or other agency receiving federal financial assistance from HHS; or a health insurance Marketplace established under the Affordable Care Act, you can file your complaint via the OCR Complaint Portal, at [email protected], or you can mail or fax your complaint. See Filing a Complaint for more information.
Who can file a civil rights complaint?
Any individual or organization can file a civil rights complaint; you do not need to be the victim of discrimination in order to file a complaint, so long as the complaint is against an entity that is covered by one of the civil rights laws that OCR enforces and the complaint is on a basis covered by those laws, e.g., race, color, national origin, sex (including pregnancy, sexual orientation, and gender identity), age, or disability.
What qualifies as "Federal financial assistance" for purposes of civil rights complaints handled by OCR?

The following are recipients of federal financial assistance from HHS:

  • Health care providers participating in CHIP and Medicaid programs
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C)
  • Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D)
  • Human or social service agencies
  • Insurers who are participating in the Marketplaces and receiving premium tax credits.
Read the full answer for The following are recipients of federal financial assistance from HHS: Health care providers participating in CHIP and Medicaid programs Hospitals and nursing homes (recipients under Medicare Part A) Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C) Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D) Human or social service agencies Insurers who are participating in the Marketplaces and receiving premium tax credits. As recipients of federal financial assistance, these entities are subject to the nondiscrimination requirements under Title VI and its implementing regulations.
Does OCR investigate civil rights complaints against programs that provide free or reduced cost health care?
Yes, the HHS Office for Civil Rights can investigate such complaints if certain conditions are met.
Read the full answer for Yes, the HHS Office for Civil Rights can investigate such complaints if the following conditions are met: The facility receives federal financial assistance from HHS. The alleged discrimination must be on a basis in which we have authority (e.g., race, disability) and the subject matter must be covered by our regulations (e.g., we generally do not accept employment complaints based on race; the Equal Employment Opportunity Commission usually handles such complaints). In addition, if the alleged discrimination involves disability, we can accept complaints filed against a state or local government entity providing health or social services even if it does not receive federal financial assistance. We can also accept complaints of disability discrimination in programs conducted by HHS. The complaint must be filed within 180 days of the alleged discrimination, unless a waiver is granted.
Does OCR represent me in my civil rights complaint?
No. The HHS Office for Civil Rights (OCR) is a neutral fact-finding agency. You should consult an attorney as soon as possible about your right to file a private lawsuit in court if you wish to protect fully your individual rights and remedies.
Read the full answer for No. The HHS Office for Civil Rights (OCR) is a neutral fact-finding agency. We ensure that the laws under our jurisdiction are not violated. If your complaint is accepted for investigation, we may, for example, obtain a promise that the program will change its practices or provide you with a service. Although we will consult with you, you may not be satisfied with any individual remedies proposed. You should consult an attorney about your right to file a private lawsuit in court if you wish to protect fully your individual rights and remedies. You may lose your right to bring a lawsuit if you delay in doing so.
Can I pursue a private court action if I have filed a civil rights complaint?

In most cases, yes. Under most of the statutes enforced by the HHS Office for Civil Rights (OCR), a complainant who has been discriminated against may initiate private court action instead of, or in addition to, filing a complaint with OCR. To do so, you should consult an attorney as soon as possible.

What happens if OCR can't help me?

The HHS Office for Civil Rights will try to identify the appropriate federal agency and refer your case unless you advise us not to.

How does OCR investigate a civil rights complaint?

Once a complaint is received, OCR must determine if it has the legal authority to review and investigate the complaint. OCR’s primary authority is over certain health and human services entities only. Information is then gather in an investigation, and we will issue a closure letter, which presents OCR's decision on whether there has been a violation of a federal statute or regulation. If there is a violation finding, the recipient must take corrective action.

Read the full answer for Once a complaint is received, the HHS Office for Civil Rights (OCR) must determine if it has the legal authority to review and investigate the complaint.  OCR’s primary authority is over recipients of federal financial assistance from the Department of Health and Human Services (HHS). Once it is clear that OCR has jurisdiction to handle your complaint, the investigator will gather information through interviewing witnesses, obtaining documentation, and perhaps making site visits. You may be interviewed again as information is gathered. At the conclusion of an investigation, OCR issues a closure letter, which presents OCR's decision on whether there has been a violation of a federal statute or regulation. If there is a violation finding, the recipient is then allowed a specific time period to correct the violation or enter into an agreement with OCR to correct the violation. Corrective action may involve a change in policy or procedure, provision of a service, staff training, or other actions. If a recipient is unwilling to take corrective action to come into compliance, OCR may take certain enforcement actions, including steps to initiate enforcement proceedings. A final decision upholding a finding of a violation may result in the termination of federal financial assistance to the recipient.
What geographic area does OCR cover?

View the list of offices that address alleged discrimination by an HHS-funded health or human services entity.

Read the full answer for View the list of offices that address alleged discrimination by an HHS-funded health or human services entity.
What do Title VI and its implementing regulations require of recipients Federal financial assistance?

Title VI of the Civil Rights Act of 1964 is a federal law that protects persons from unlawful discrimination based on race, color, or national origin in programs and activities that receive federal financial assistance. Recipients of federal financial assistance are covered by Title VI and its implementing regulations. This means that such recipients may not treat people differently on the basis of race, color, or national origin or use criteria or methods of administration that have the effect of discriminating against persons on the basis of their race, color, or national origin.

What is “Federal financial assistance” for purposes of civil rights complaints handled by OCR?
"Federal financial assistance” is assistance in the form of any grant, loan, or contract (other than a contract of insurance or guaranty). See the full answer for details.
Read the full answer for Title VI regulations define the term “federal financial assistance” broadly to include: (1) grants and loans of federal funds, (2) the grant or donation of federal property and interests in property, (3) the detail of federal personnel, (4) the sale and lease of, and permission to use federal property or interest in such property without consideration or at a nominal consideration, and (5) any federal agreement, arrangement, or other contract which has as one of its purposes the provision of assistance. 45 C.F.R. § 80.13(f). Thus, “federal financial assistance” means assistance in the form of any grant, loan, or contract (other than a contract of insurance or guaranty). See 42 U.S.C. § 2000d-4. This includes use of equipment, donations of surplus property, and other forms of assistance. Under Section 1557 of the Affordable Care Act, federal financial assistance also includes tax credits.
Are Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare considered Federal financial assistance?

Medicaid and CHIP are considered federal financial assistance. Medicare Part A is also considered federal financial assistance.  However, the receipt of Medicare Part B is not considered federal financial assistance. Medicare Part C and Part D are considered federal financial assistance.

What are examples of "recipients" of Federal financial assistance?

Recipients of federal financial assistance include:

  • Health care providers participating in CHIP and Medicaid
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C)
  • Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D)
Read the full answer for Recipients of federal financial assistance include: Health care providers participating in CHIP and Medicaid Hospitals and nursing homes (recipients under Medicare Part A) Medicare Advantage Plans (e.g., HMOs and PPOs) (recipients under Medicare Part C) Prescription Drug Plan sponsors and Medicare Advantage Drug Plans (recipients under Medicare Part D) As recipients of federal financial assistance, these entities are subject to the nondiscrimination requirements under Title VI and its implementing regulations.
What is the purpose of the guidance on language access released by the Department of Health and Human Services (HHS)?

HHS’s LEP policy guidance implements a provision of Executive Order 13166, Improving Access to Services for Persons With Limited English Proficiency, that directs Federal agencies to work to ensure that recipients of their funds provide meaningful access to LEP customers.

Must Medicaid, CHIP and Medicare Part A providers, and organizations offering Medicare Part C and Part D plans, provide interpreters for limited English proficient (LEP) beneficiaries and translate their documents into languages other than English?
Under Title VI and its implementing regulations, recipients of federal financial assistance must take reasonable steps to ensure meaningful access to their programs, services, and activities by eligible limited English proficient (LEP) persons. See the full answer for details.
Read the full answer for Under Title VI and its implementing regulations, recipients of federal financial assistance must take reasonable steps to ensure meaningful access to their programs, services, and activities by eligible limited English proficient (LEP) persons. To comply with these federal requirements, Medicaid and CHIP providers, Medicare Part A providers, and organizations offering Medicare Part C and Part D Medicare Advantage Plans and Prescription Drug Plans may need to provide language assistance services, such as interpreters and translated documents. Also, for markets with a significant non-English speaking population, Medicare regulations for the Medicare Advantage Program and Voluntary Medicare Prescription Drug Benefit program require recipients to provide materials in the language of these individuals. See 42.C.F.R. 422.2264(e) and 423.2264(e).
How can states get Federal funds to help pay for language services?
Federal funding to help states and health providers pay for language services is primarily available through Medicaid and the Children’s Health Insurance Program (CHIP).
Read the full answer for Federal funding to help states and health providers pay for language services is primarily available through Medicaid and the Children’s Health Insurance Program (CHIP). Under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), enhanced federal funding for Medicaid and CHIP is available for state expenditures for translation or interpretation services in connection with the enrollment, retention and use of services provided under these programs by non-English speakers. CHIPRA also authorized the Centers for Medicare and Medicaid Services (CMS) to make grants to eligible entities and to conduct a National Enrollment Campaign to improve the enrollment of underserved child populations in Medicaid and CHIP, including individuals with limited English proficiency (LEP) and populations with cultural and linguistic barriers to enrollment.
What other Federal agencies exist to protect my civil rights?

Please see Civil Rights Enforcement through Other Agencies.
 

If OCR can't represent me, can the ACLU help?

The American Civil Liberties Union (ACLU) is not a government agency, and it decides what issues to become involved in on a case-by-case basis. “Civil liberties” encompasses many more rights than those enforced by the HHS Office for Civil Rights. It also concerns freedom of speech, association, and religion. For further information, call the local ACLU office in your area.

Why can't OCR help me, if my constitutional and human rights have been violated?

OCR enforces laws prohibiting discrimination on the basis of disability, age, race, color, national origin, religion, and sex (including pregnancy, sexual orientation, and gender identity) in the provision of health and social services only. OCR can investigate only matters that are covered by the laws it enforces.

I was fired from my job because of my age. Why can't OCR accept my complaint?

Most employment discrimination complaints, especially those against private employers, should be addressed to the local Equal Employment Opportunity Commission (EEOC) that services your state.

What does the policy guidance do?
HHS’s LEP guidance identifies criteria that its recipients can use to assess whether they are operating their programs in compliance with Title VI of the Civil Rights Act of 1964. The LEP guidance also identifies specific actions recipients can take to improve access by persons with LEP to their programs and activities, such as providing interpreters and translating important documents. The guidance is also a resource to members of the public who want to learn more about steps that health and human providers can take to make their programs accessible to persons with LEP.
Read the full answer for The policy guidance does the following: Reiterates the principles of Title VI with respect to LEP persons Discusses the reasonable policies, procedures and other steps that recipients can take to ensure meaningful access to their program by LEP persons Provides four factors recipients should use to assess whether they are taking reasonable steps to provide meaningful access to their programs by persons with LEP: (1) the number or proportion of LEP persons eligible to be served or likely to be encountered by the program, activity or service provided by the recipient; (2) the frequency with which LEP individuals come in contact with the recipient's program, activity or service; (3) the nature and importance of the recipient's program, activity, or service; and (4) the resources available to the recipient and costs Clarifies that these four factors should be applied in balance to the unique circumstances of a recipient's program, which means some programs with limited resources may provide different language assistance services than recipients with greater resources Provides that OCR will offer extensive technical assistance for recipients
What are the civil rights laws governing TANF agencies?

TANF agencies must comply with:

  • Title VI of the Civil Rights Act of 1964
  • Section 504 of the Rehabilitation Act of 1973
  • The Age Discrimination Act of 1975
  • Title IX of the Education Amendments of 1972

Additionally, TANF agencies are typically part of state or local governments and must comply with Title II of the Americans with Disabilities Act of 1990.

Read the full answer for TANF agencies receive funding from the Federal government. As such, they must comply with certain Federal civil rights laws that apply to entities that receive Federal funding. These laws include: (1) Title VI of the Civil Rights Act of 1964, 42 United States Code (U.S.C.) §§ 2000d, et seq., and its implementing regulations at 45 Code of Federal Regulations (C.F.R.) Part 80 (Title VI); (2) Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §§ 794, et seq., and its implementing regulations at 45 C.F.R. Part 84 (Section 504); (3) the Age Discrimination Act of 1975, 42 U.S.C. §§ 6101, et seq., and its implementing regulations at 45 C.F.R. Part 91 (Age Discrimination Act); and (4) Title IX of the Education Amendments of 1972, 20 U.S.C. §§ 1681, et seq., and its implementing regulations at 45 C.F.R. Part 86 (Title IX). TANF agencies are typically part of state or local governments. As such, they must comply with Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12131, et seq., and its implementing regulations at 28 C.F.R. Part 35 (ADA), which apply to State and local governments. All of these Federal civil rights laws prohibit certain types of discrimination. Title VI prohibits discrimination on the basis of race, color, or national origin. Section 504 and the ADA prohibit discrimination on the basis of disability. The Age Discrimination Act prohibits discrimination on the basis of age. Title IX prohibits discrimination on the basis of sex (including pregnancy, sexual orientation, and gender identity).
What are a TANF agency's obligations with regard to not discriminating on the basis of race, color, or national origin?
TANF agencies are required to ensure that their programs do not discriminate against people on the basis of their race, color, or national origin.
Read the full answer for TANF agencies are required to ensure that their programs do not discriminate against people on the basis of their race, color, or national origin. A TANF agency may violate Title VI if it: (1) excludes a person or people from program participation based on race, color, or national origin; (2) denies benefits or services to a person or people based on race, color, or national origin; or (3) provides different or lesser benefits to a person or people based on race, color, or national origin. For example, a TANF agency may violate Title VI if, on the basis of a person's race, color, or national origin, it provides different job or training activities, applies sanctions (which can stop cash assistance) differently, or allows/disallows exemptions or extensions of TANF time limits.
Did the DRA change the obligations of TANF agencies with respect to these civil rights laws?

No. TANF agencies have the same legal obligations to comply with Title VI, Section 504, the ADA, the Age Discrimination Act, and Title IX that they had prior to the DRA and its changes to TANF.

What are a TANF agency's obligations with regard to not discriminating on the basis of disability?

Under Section 504 and the ADA, TANF agencies must: (1) ensure equal access to people with disabilities; (2) reasonably modify policies, practices, and procedures for people with disabilities where necessary; and (3) ensure that methods of administration do not discriminate on the basis of disability.

What are a TANF agency's obligations with regard to serving applicants and beneficiaries with limited English proficiency?
Under Title VI regulations, to avoid discrimination on the basis of national origin, TANF agencies must take reasonable steps to provide meaningful access for people with limited English proficiency (LEP). Since every TANF agency serves a different population, TANF agency obligations to people with LEP may vary.
Read the full answer for Another way that Title VI may be implicated is in the way a TANF agency serves limited English proficient (LEP) individuals. Under Title VI regulations, to avoid discrimination on the basis of national origin, “TANF agencies must take reasonable steps to provide meaningful access for LEP individuals. The manner in which TANF agencies meet this obligation to LEP individuals may vary.” Federal guidance has set forth the following four factors that recipients of Federal financial assistance, including TANF agencies, may use in determining their responsibilities to provide meaningful access for LEP individuals: (1) The number or proportion of LEP individuals eligible to be served or likely to be affected by the program or service; (2) The frequency of contact that the program or service has with LEP individuals; (3) The nature and importance of the program, activity, or service; and (4) The costs and resources available to the program or service. Depending on the results of a TANF agency's analysis of these factors, it may be necessary for the agency to provide interpreter services to LEP individuals or translate certain documents into languages other than English to ensure that the TANF agency provides meaningful access for LEP individuals. Example: A TANF agency that serves a substantial LEP population has determined that interpreter services are needed when questioning LEP applicants about critical eligibility issues. In lieu of providing competent and timely interpreter services, the TANF agency advises the applicants to bring friends or relatives to serve as interpreters during these appointments. This is an example of conduct that may violate Title VI's obligation to take reasonable steps to provide meaningful access.
How can a TANF agency reasonably modify its policies, practices, and procedures for people with disabilities?
Sometimes people with disabilities are unable to participate in or benefit from a TANF program without modifications to policies, practices, and procedures. Under Section 504 and the ADA, TANF agencies must reasonably modify policies, practices, and procedures to avoid discrimination on the basis of disability, unless the modification would fundamentally alter the nature of the service, program or activity.
Read the full answer for Sometimes people with disabilities are unable to participate in or benefit from a TANF program without modifications to policies, practices, and procedures. Under Section 504 and the ADA, TANF agencies must reasonably modify policies, practices, and procedures to avoid discrimination on the basis of disability, unless the modification would fundamentally alter the nature of the service, program or activity. One size does not fit all in regard to modifications. TANF agencies should assess the needs of each applicant or beneficiary with a disability and make reasonable modifications tailored to meet those needs. Modifications may be needed in the: (1) TANF application process; (2) procedures related to notifying TANF applicants and beneficiaries of their rights; (3) requirements of TANF programs; (4) policies and practices concerning exemptions, extensions and sanctions; and (5) policies and practices that aid individuals in sustaining TANF program participation. Examples: ~A TANF agency requires face-to-face eligibility interviews. Due to a disability, a person is unable to physically access the TANF office for an eligibility interview. As a reasonable modification, the TANF agency could meet with the client at an accessible location, or conduct this eligibility interview over the phone. ~A TANF agency has education and training programs, and has instituted time limits for completing the programs. A client with a learning disability has difficulty completing the education and training program within the required time limit. As a reasonable modification, the TANF agency could grant an extension to the time limit if the extension would not fundamentally alter the nature of the program.
Is a TANF agency legally obligated to provide a program modification or accommodation even if it results in the state not being able to count a person with a disability in its Federal work participation rate?

Yes. Section 504 and the ADA require nondiscriminatory treatment of people with disabilities by TANF agencies. By focusing on what applicants and beneficiaries with disabilities need in order to move from government dependency to self-sufficiency, TANF agencies can ensure compliance with civil rights laws. If a TANF client with a disability needs a program modification or accommodation and providing the modification means that the State will not be able to count the person in its Federal work participation rate, the State is still obligated to provide the program modification.

Read the full answer for Yes. Section 504 and the ADA require nondiscriminatory treatment of people with disabilities by TANF agencies. By focusing on what applicants and beneficiaries with disabilities need in order to move from government dependency to self-sufficiency, TANF agencies can ensure compliance with civil rights laws. If a TANF client with a disability needs a program modification or accommodation and providing the modification means that the State will not be able to count the person in its Federal work participation rate, the State is still obligated to provide the program modification. Example: ~ The TANF statute only allows a State to count people in its Federal work participation rate that participate in work activities for at least a minimum average of 30 hours per week. A TANF client has a disability that limits his/her ability to participate in work activities for more than 15 hours per week. Even though the State may not be able to count this client in its Federal work participation rate, Section 504 and the ADA may require the State to continue serving the client.
How can a TANF agency ensure that its methods of administration do not discriminate on the basis of disability?
To ensure that its methods of administration are not discriminatory, a TANF agency may develop and implement official written policies related to meeting the needs of people with disabilities, as well as actual practices (i.e., ways of ensuring that TANF agency staff are knowledgeable about policies) to meet the needs of people with disabilities.
Read the full answer for To ensure that its methods of administration are not discriminatory, a TANF agency may develop and implement official written policies related to meeting the needs of people with disabilities, as well as actual practices (i.e., ways of ensuring that TANF agency staff are knowledgeable about policies) to meet the needs of people with disabilities. Examples: ~A TANF agency has clearly written policies that describe in detail how to respond when a TANF client needs a reasonable modification. ~A TANF agency implements training for TANF agency employees, contractors, and vendors on working effectively with TANF applicants and beneficiaries with disabilities. ~A TANF agency periodically monitors its policies and procedures in regard to meeting the needs of TANF applicants and beneficiaries with disabilities. Such monitoring determines whether existing screening and assessment tools are adequate, whether the assistance provided is meeting the needs of individuals with disabilities in moving toward self-sufficiency, whether staff is knowledgeable about policies and procedures and how to implement them, and whether sources of and arrangements for assistance are current and viable.
Who is considered a person with a disability under Section 504 and the ADA?
Section 504 and the ADA define the terms "handicap" or "disability" with respect to an individual to mean a physical or mental impairment that substantially limits one or more of the major life activities of such an individual. Included in the definition are people who have a record of such an impairment, or are regarded as having such an impairment.
Read the full answer for Section 504 and the ADA define the terms "handicap" or "disability" with respect to an individual to mean a physical or mental impairment that substantially limits one or more of the major life activities of such an individual. Included in the definition are people who have a record of such an impairment, or are regarded as having such an impairment. The definition of disability under Section 504 and the ADA differs from that typically used to determine eligibility in programs that provide cash assistance based upon disability such as the Federal Supplemental Security Income and Social Security Disability Insurance programs. This definition may also be different from that used by some States to determine whether an individual may be exempt from certain program rules in TANF. For more information on the definition of disability under Section 504, see 29 USC 705; under the ADA, see 42 USC 12102.
What other information is available to help TANF agencies meet their civil rights obligations for applicants and beneficiaries?

For further information on TANF agency civil rights compliance and meeting the needs of TANF applicants and beneficiaries with disabilities or limited English proficiency, please contact the Office for Civil Rights or your regional TANF program manager in the HHS Administration for Children and Families, Office of Family Assistance.

I have a complaint against a major university and was told by OCR to file with the U.S. Department of Education. Why?
Generally, HHS does not investigate educational institutions unless the complaint is against a health-related portion of the university (e.g., the university's school of medicine). Several departments could have provided federal financial assistance to that university. We coordinate with other agencies to determine the most appropriate agency to handle your complaint.
Read the full answer for Several departments could have provided federal financial assistance to that university. In order to avoid duplication of effort and to be more efficient, we coordinate with other agencies to determine the most appropriate agency to handle your complaint. This decision is made on a case-by-case basis with many factors considered, including: the subject matter, which department provides the largest portion of federal financial assistance, and whether an agency has started an investigation. Generally, HHS does not investigate educational institutions unless the complaint is against a health-related portion of the university (e.g., the university's school of medicine).
Does the guidance impose new requirements on recipients?
No. Since its enactment, Title VI of the Civil Rights Act of 1964 has prohibited discrimination on the basis of race, color or national origin in any program or activity that receives Federal financial assistance.
Read the full answer for No. Since its enactment, Title VI of the Civil Rights Act of 1964 has prohibited discrimination on the basis of race, color or national origin in any program or activity that receives Federal financial assistance. Title VI requires that recipients take reasonable steps to provide meaningful access to their programs and activities by LEP persons. Over the past three decades, OCR has conducted thousands of investigations and reviews involving language differences that affect the access of LEP persons to medical care and social services.
Who is covered by the guidance?
Covered entities include any state or local agency, private institution or organization, or any public or private individual that (1) operates, provides or engages in health, or social service programs and activities, and (2) receives Federal financial assistance from HHS directly or through another recipient/covered entity.
Read the full answer for Covered entities include any state or local agency, private institution or organization, or any public or private individual that (1) operates, provides or engages in health, or social service programs and activities, and (2) receives Federal financial assistance from HHS directly or through another recipient/covered entity. Examples of covered entities include but are not limited to the following entities, which may receive federal financial assistance: hospitals, nursing homes, home health agencies, managed care organizations, universities and other entities with health or social service research programs; state, county and local health agencies; state Medicaid agencies; state, county and local welfare agencies; federally-funded programs for families, youth and children; Head Start programs; public and private contractors, subcontractors and vendors; physicians; and other providers who receive Federal financial assistance from HHS.
How does the guidance affect small practitioners and providers who are recipients of federal financial assistance?
Small practitioners and providers will have considerable flexibility in determining precisely how to fulfill their obligations to take reasonable steps to provide meaningful access for persons with limited English proficiency. OCR will assess compliance on a case by case basis.
Read the full answer for Small practitioners and providers have some flexibility in determining how to fulfill their obligations to take reasonable steps to provide meaningful access for persons with limited English proficiency. OCR will assess compliance on a case by case basis by evaluating whether a recipient is administering its programs in a manner that has the effect of delaying or denying services to persons on the basis of their national origin. OCR will continue to be available to provide technical assistance to HHS recipients, including sole practitioners and other small recipients, seeking to operate an effective language assistance program and to comply with Title VI.
The guidance identifies some specific circumstances which OCR will consider to be strong evidence that a program is in compliance with its obligation under Title VI to take reasonable steps to provide meaningful access to persons with LEP by translating written materials in languages other than English. Does this mean that a recipient/covered entity will be considered out of compliance with Title VI if its program does not translate its documents into languages other than English?
No. The circumstances outlined in the guidance are intended to identify circumstances which amount to a "safe harbor" for recipients who desire greater certainty of Title VI compliance by translating their written documents, including written information posted to their websites.
Read the full answer for No. The circumstances outlined in the guidance are intended to identify circumstances which amount to a "safe harbor" for recipients who desire greater certainty of Title VI compliance by translating their written documents, including written information posted to their websites. This means that if a recipient provides written translations under these circumstances, such action will be considered strong evidence of compliance with the recipient's written-translation obligations. However, the failure to provide written translations under the circumstances outlined in the "safe harbor"does not mean there is non-compliance. Rather, the safe harbor provides a tool which recipients may use to consider whether the number or proportion of LEP persons served call for written translations of vital documents into frequently encountered languages other than English. However, even if the safe harbors are not used, if written translation of certain documents would be so financially burdensome as to defeat the legitimate objectives of its program, the translation of the written materials is not necessary. Other ways of providing meaningful access, such as effective oral interpretation of certain vital documents, might be acceptable under such circumstances when, upon application of the four factors, translation services are required.
May an LEP person use a family member or friend as his or her interpreter?
Depending on the circumstances, it is often not in the best interest of the person being served to use a family member or friend to interpret important and possibly confidential information. When interpreter services are necessary in order for a recipient to comply with Title VI, the interpreter must be competent and provided at no cost to the person being served.
Read the full answer for A qualified interpreter is an individual who is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any specialized vocabulary required by the circumstances. In many cases, especially when information about important medical decisions or consent is at issue, friends and family members may not have the ability to ensure the LEP person being served fully understands what a health provider is communicating to them. In other cases, a family member or friend may have an interest in misrepresenting what is being said, such as when domestic abuse is the cause of a medical visit. Therefore, when important information is being conveyed and providing interpretation is a reasonable step for providing meaningful access to a program by a person with LEP, it is the provider’s responsibility to provide competent interpreter services at no cost to the person being served. A person with LEP can always decline using an interpreter provided by a recipient.
May a recipient/covered entity require an LEP person to use a family member or a friend as his or her interpreter?

No.

How does OCR respond to my concern for privacy and confidentiality?

Privacy Act notice and confidentiality rules are in place. In Office for Civil Rights (OCR) investigations, the name of the complainant usually is kept confidential unless its disclosure is necessary to the case. If OCR determines that release of your identity is required for the processing of the case, you will be asked to sign a release. If you choose not to provide a release, the investigation may be impeded or stopped.

How does low health literacy, non-literacy, non-written languages, blindness and deafness among LEP populations affect the responsibilities of federal fund recipients?
In the case of LEP persons, a recipient is required to take reasonable steps to provide meaningful access to its programs and activities. In the case of LEP persons that are blind or deaf, under Section 504 of the Rehabilitation Act of 1973, recipients must provide equal access through auxiliary aids and services.
Read the full answer for Effective communication in any language requires an understanding of the literacy levels of the eligible populations. However, where a LEP individual has a limited understanding of health matters or access to the program is complicated by factors not related to national origin or English language proficiency Title VI compliance is not an issue. Under these circumstances, a recipient should provide information to the same extent that it would provide such information to similarly situated English-speakers. Similarly, a recipient should provide language assistance services to LEP individuals who cannot read or understand written materials to provide meaningful access to the same extent as could be provided to non-literate English-speakers. A non-written language precludes the translation of documents, but does not affect the recipient’s ability to orally communicate the vital information contained in a document or to provide oral notice of the availability of oral translation at no cost. Of course, with respect to persons with LEP that are also blind or deaf, other law may be implicated in this context. For instance, Section 504 of the Rehabilitation Act of 1973 requires that federal fund recipients provide sign language and oral interpreters for people who have hearing impairments and provide materials in alternative formats such as in large print, braille or on tape for individuals with visual impairments; and the Americans with Disabilities Act imposes similar requirements on health and human service providers.
What assistance is available to help to recipients who wish to come into compliance with Title VI?
OCR provides substantial technical assistance to recipient/covered entities seeking to ensure that LEP persons can meaningfully access their programs or services.
Read the full answer for For over three decades, OCR has provided substantial technical assistance to recipient/covered entities who are seeking to ensure that LEP persons can meaningfully access their programs or services. Our regional staff is prepared to work with recipients to help them meet their obligations under Title VI. As part of its technical assistance services, OCR can help identify best practices and successful strategies used by other federal fund recipients, identify sources of federal reimbursement for translation services, and point providers to other resources. In addition, the entire Department is also committed to assisting recipients of HHS financial assistance in complying with their obligations under Title VI of the Civil Rights Act of 1964. Through its Administration on Children and Families, Administration on Health Care Quality and Research, Administration on Aging, Centers for Medicare and Medicaid Services, Health Resources and Services Administration, Office for Civil Rights, Office of Minority Health and Substance Abuse and Mental Health Services Administration, HHS provides a variety of practical technical assistance to recipients to assist them in serving LEP persons. This technical assistance includes translated forms and vital documents; training and information about best practices; and grants and model demonstration funds for LEP services. OCR believes that, on the whole, its recipients genuinely desire to comply with their obligations, and that increased understanding of compliance responsibilities and knowledge about cost-effective resources that are increasingly available to them, will assist recipients/covered entities in meeting Title VI obligations. Accordingly, OCR is committed to providing outreach to its recipients and to being responsive to queries from its recipients. It is also committed to working with representatives of state and local health and social service agencies, organizations of such agencies, hospital associations, medical and dental associations and managed care organizations to identify and share model plans, examples of best practices, cost-saving approaches, and information on other available resources, and to mobilize these organizations to educate their members on these matters. The HHS Office for Civil Rights, in conjunction with other HHS components, will continue to provide technical assistance and outreach to HHS recipients to assist them in understanding and complying with their obligations under Title VI and to provide information to recipients and the public through its website at www.hhs.gov/ocr . LEP information and resources can also be found at www.lep.gov.
How will OCR enforce compliance by recipient/covered entities with the LEP requirements of Title VI?

The requirement to take reasonable steps to provide meaningful access to LEP persons is enforced by OCR through the procedures identified in the Title VI implementing regulations. These procedures include complaint investigations, compliance reviews, efforts to secure voluntary compliance, and technical assistance.

Read the full answer for The requirement to take reasonable steps to provide meaningful access to LEP persons is enforced and implemented by OCR through the procedures identified in the Title VI implementing regulations. These procedures include conducting complaint investigations and compliance reviews, providing technical assistance, and the requirement to secure voluntary compliance whenever possible. The Title VI regulations provide that OCR will investigate whenever it receives a complaint, report, or other information that alleges or indicates possible noncompliance with Title VI or its regulations. If the investigation results in a finding of compliance, OCR will inform the recipient in writing of this determination, including the basis for the determination. However, if a case is fully investigated and results in a finding of noncompliance, OCR must inform the recipient of the noncompliance through a Letter of Findings that sets out the areas of noncompliance and the steps that must be taken to correct the noncompliance. It must attempt to secure voluntary compliance through informal means. If the matter cannot be resolved informally, OCR may secure compliance through the termination of federal assistance after the recipient has been given an opportunity for an administrative hearing. OCR may also refer the matter to the Department of Justice to secure compliance through any other means authorized by law. At all stages of an investigation, OCR engages in voluntary compliance efforts and provides technical assistance to recipients. During these efforts, OCR proposes reasonable timetables for achieving compliance and consults with and assists recipients in exploring ways of coming into compliance. In determining a recipient's compliance with the Title VI regulations, OCR's primary concern is to ensure that the recipient administers its programs in a manner that does not delay or deny services or benefits to eligible persons on the basis of race, color or national origin. As a result, the vast majority of all complaints have been resolved through such voluntary efforts.
How can a TANF agency ensure equal access to people with disabilities?
A TANF agency ensures equal access to TANF applicants and beneficiaries with disabilities by delivering services that: (a) are appropriate in view of their particular physical or mental impairment; and (b) provide an equal opportunity to benefit from the agency's job placement, education, skills training, employment, and other TANF activities.
Read the full answer for A TANF agency ensures equal access to TANF applicants and beneficiaries with disabilities by delivering services that: (a) are appropriate in view of their particular physical or mental impairment; and (b) provide an equal opportunity to benefit from the agency's job placement, education, skills training, employment, and other TANF activities. In ensuring equal access to people with disabilities, TANF agencies should have comprehensive and effective screening and assessment tools in place. TANF agencies should offer to conduct an initial screening of each applicant and beneficiary to identify those individuals with possible disabilities, and inform applicants and beneficiaries that their participation in screening and disclosure of disability is voluntary. This screening should be conducted by trained staff, using validated screening tools. If there is an initial indication that an individual has a disability that may impact his/her ability to successfully complete or benefit from a current or proposed program assignment, the TANF agency should give the individual an opportunity for a more comprehensive assessment that is conducted by quailed professionals. Example: A TANF agency offers free screening for disabilities to all TANF applicants and beneficiaries. The TANF agency conducts screening for disabilities only upon receipt of the program participant's written, informed consent. If screening indicates a potential disability, the TANF agency offers a free diagnostic assessment conducted by a qualified clinical diagnosticians. The results of the diagnostic assessment are documented in a report that identifies the nature of the disabilities, describes the effect of such disabilities on the individual's ability to benefit from and participate in TANF activities, and includes a description of the accommodations and/or modifications that may be necessary to help the individual fully participate in the TANF program. This individualized report guides the TANF agency's provision of services to the TANF beneficiary.
What is HHS doing to promote access for LEP persons to its own programs and services?

HHS agencies provide a variety of services for LEP persons. These services include oral language assistance services such as language lines and interpreters; translation of written materials; and foreign language web sites. HHS continues to explore how it can share language assistance measures, resources, cost-containment approaches, and other information and knowledge, developed with respect to its own federally conducted programs and activities, and welcomes any suggestions.

Does issuing this guidance mean that OCR will be changing how it enforces compliance with Title VI?

No. OCR enforces Title VI in accordance with the Title VI implementing regulations. The methods and procedures used to investigate and resolve complaints, and conduct compliance reviews, have not changed.