Language Needs Assessments of Virginia's Health Districts
The Virginia Department of Health 2010 Language Needs Assessment Report
The 2010 Language Needs Assessment Report captures limited English proficiency (LEP) population data unique to Virginia’s 35 local health districts for 2007-2008. The report identifies district LEP populations and outlines recommendations to consider as each district reviews its plan of action to address local language barriers and increase health care quality to all LEP patients while meeting all federal requirements. The report, conducted by the Virginia Department of Health’s (VDH) Office of Minority Health and Health Equity (OMHHE,) provides highlights governing LEP guidelines and addresses recommendations for future analysis.
Click the links below to review the report:
Note: VDH, 2010 Language Assessment Report assessment conducted by OMHHE
LEGAL REQUIREMENTS OF HEALTH CARE PROVIDERS
Title VI of the Civil Rights Act of 1964
prohibits recipients of federal funds from discriminating against
individuals on the basis of race, color, or national origin. The courts
have applied this statute to protect national origin minorities who are
Limited English Proficient (LEP).
Executive Order 13166
issued on August 11, 2000, requires every federal agency that provides
financial assistance to non-federal entities to publish guidance on how
their recipients can provide meaningful access to LEP persons and thus
comply with Title VI regulations.
to Federal Financial Assistance Recipients Regarding Title VI
Prohibition Against National Origin Discrimination Affecting Limited
English Proficient Persons
- Requires all recipients of federal
financial assistance (including grants, loans and reimbursements like
Medicaid and Medicare) to take reasonable steps to provide meaningful access to LEP persons, and at no additional cost to the patient.
The Guidance explains that the obligation to provide meaningful access
is fact-dependent and starts with an individualized assessment that
balances four factors:
(1) the number or proportion of LEP persons eligible to be served or likely to be encountered by the program or grantee;
(2) the frequency with which LEP individuals come into contact with the program;
(3) the nature and importance of the program, activity or service provided by the recipient to its beneficiaries; and
(4) the resources available to the grantee/recipient and the costs of interpretation/translation services.
is no "one size fits all" solution for Title VI compliance with respect
to LEP persons, and what constitutes "reasonable steps" for large
providers may not be reasonable where small providers are concerned.
However, the Guidance states specifically that recipients cannot require LEP persons to bring their own interpreters or use family members or friends as interpreters.
Identifies the following as “safe harbors” for compliance with
meaningful access to translated written documents. The following
actions will be considered as “strong evidence” that an
agency/organization has complied with its written translation
- Written translations of
vital documents are provided for each eligible LEP language group that
constitutes 5% or 1,000, whichever is less, of the population of
persons eligible to be served or likely to be affected or encountered.
Oral translation of other non-vital documents is permitted.
there are fewer than 50 persons in a language group that reaches the 5%
trigger, the practice may, as an alternative to translating vital
written materials, provide written notice in the primary language of
the LEP language group of the right to receive competent oral
interpretation of the written materials without cost.
Translation of vital documents such as:
- consent and complaint forms
- notices advising LEP persons of free language assistance
- intake forms with potential for important health consequences
written tests that do not assess English language competency, but test
competency for a particular license, job or skill for which knowing
English is not required
- written notices of eligibility criteria, rights, denial, loss, or decreases in benefits or services
- applications to participate in a recipient's program or activity or to receive recipient benefits or services.
- actions affecting parental custody or child support, and other hearings
National Standards for Culturally and Linguistically Appropriate Services in Health Care
Additionally, the DHHS Office of Minority Health (OMH) issued National
Standards on Culturally and Linguistically Appropriate Services (CLAS)
in Health Care in December 2000. There are 14 standards. Four of the standards relate to language access services and are mandated for recipients of federal funds. These include:
Standard 4: Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact in a timely manner during all hours of operation.
Standard 5: Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.
Standard 6: Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (unless requested by the patient/consumer).
Standard 7: Health care organizations must make
available easily understood patient-related materials and post signage
in the languages of the commonly encountered group and/or groups represented in the service area.
Legal requirements notwithstanding, health care quality research* shows that providing meaningful language access can and does:
- Improve health outcomes
- Increase patient compliance
- Be more cost effective
- Increase patient satisfaction
- Increase access to health care