HHS Continues to Improve Access for LEP Individuals – 12/1/2015

Over the course of our daily lives, we interact with members of the health care and service provider community regularly and, for some, quite often.  Each time we pick up a prescription at the local pharmacy, visit a family member in a nursing home or make an unexpected trip to the emergency room, we are accessing and participating in the health care system.  Often times these encounters require individuals to communicate about serious and sometimes complex issues.  For individuals with limited English proficiency (LEP), these experiences can be overwhelming and challenging to navigate if competent language assistance services are not provided in a timely manner.

Our mission at the HHS Office for Civil Rights (OCR) is to ensure that people have equal access and opportunity to participate in HHS-funded health care and human services programs as well as participate in health programs and activities administered by HHS.  Part of our work is focused on reducing the barriers for individuals with LEP and assisting covered entities in understanding their language assistance obligations. 

In September 2015, OCR issued a proposed rule to advance health equity and reduce disparities in health care under Section 1557, the civil rights provision of the Affordable Care Act.  Among many other key areas, the rule includes provisions addressing access by people with LEP to certain health programs and activities.  It is critically important for covered entities to take reasonable steps to provide meaningful access to individuals with LEP so they can communicate effectively with health care providers and minimize poor health outcomes. 

Under the proposed rule, covered entities would need to:

• Post a notice of consumer rights providing information about the availability of free language assistance.
• Inform individuals that these services are available by posting taglines in the top 15 languages spoken by individuals with LEP nationally.

To help entities meet these requirements, OCR will provide a sample notice and taglines in these 15 languages. 

In 2014, OCR worked with the Centers for Medicare and Medicaid Services (CMS) to improve accessibility for individuals with LEP applying to participate in the Federally-facilitated Marketplace (FFM).  Before some individuals can get health care coverage through the FFM, they must contact the Help Desk to verify their identity.  Until recently, the contracting firm who operated the Help Desk only provided telephonic interpretation services in Spanish and in no other non-English language.  As a result, many individuals with LEP had difficulty communicating with the Help Desk and thereby securing health care coverage. 

OCR collaborated with CMS to address this issue and as a result, the Help Desk has been providing telephonic interpretation services to individuals with LEP in more than 200 languages since November 2014.  

Collectively, HHS language access activities tackle issues relevant to more than 25 million persons with LEP and nearly 61 million people who speak a language other than English at home.  For example, HHS received a complaint about a mental health clinic that refused to accept a patient with LEP for services despite the fact that interpreter assistance was available. Through further investigation, OCR found that the clinic had a practice of not accepting patients that needed interpreters because they believed having an interpreter limited the therapeutic process.  Through its enforcement of Title VI of the Civil Rights Act of 1964, OCR was able to help the mental health clinic develop strategies to ensure its patients with LEP have meaningful access to its programs.  As a result, in February of 2015, the clinic voluntarily implemented a comprehensive policy for providing free language assistance services to patients with LEP at all of its facilities; conducted a language needs assessment and identified its five most frequently encountered non-English languages; instituted a comprehensive training course for its staff; and performed other corrective actions.  This case is only one example of the many success stories OCR has had in expanding language assistance services for individuals with LEP.

In addition, the Department established the HHS Language Access Steering Committee to update the HHS Language Access Plan and lead Departmental efforts to improve access by persons with LEP to programs and activities administered by HHS. The Steering Committee helped every HHS granting agency include civil rights language in grant and funding opportunity announcements, providing links to technical assistance and contact information for OCR’s Regional Offices so funding recipients can get help to ensure their programs are accessible to individuals with LEP.

As we continue the Open Enrollment period for those individuals who are seeking health care and service coverage plans, we know that some of those individuals will be LEP.  It is our priority that those individuals, along with all other persons interacting with the health care and service provider community, are not improperly delayed or denied access to plans because they are LEP.

OCR is committed to ensuring that covered entities comply with the obligations under Section 1557 and Title VI and to protecting the rights of individuals with LEP.

To learn more about OCR, visit our webpage.