What’s required under Title VI of 1964 Civil Rights Act
What’s required under Title VI of 1964 Civil Rights Act
Demographics no longer the same as 40 years ago
When the 1964 Civil Rights Act was signed into law, there probably were few places in the country where health care providers would be faced with more than the occasional patient with limited English proficiency (LEP).
Shifts in the nation’s demographics over the past 40 years and more recent changes in immigration patterns have changed this landscape considerably. Now towns as small as Columbus, NC, which has a population of under 2,000, have found it necessary to place Spanish-language signs in front of businesses and in public buildings.
Likewise, rehabilitation facilities increasingly are seeing the need for interpretation and translation services, which no longer can simply be handled by the nurse who had four years of Spanish or the Asian aunt of a therapist.
Due to the nation’s demographic changes, the federal government has spread the word to health care facilities that it’s high time they get into compliance with Title VI of the Civil Rights Act, which requires health care organizations receiving federal funds to ensure that patients with limited English proficiency (LEP) have access to language assistance, because enforcement will become more stringent.
Here are some ways a rehab facility can meet the guidelines set by the Office for Civil Rights (OCR) in Washington, DC:
— hiring bilingual staff for patient and client contact positions;
— hiring staff interpreters;
— contracting for interpreter services;
— recruiting community volunteers;
— contracting with a telephone interpreter service.
The law also states that practices that may violate Title VI are as follows:
— providing services to LEP people that are more limited in scope or are lower in quality than those provided to other people;
— subjecting LEP people to unreasonable delays in the delivery of services;
— limiting participation in a program or activity on the basis of English proficiency;
— providing services to LEP people that are not as effective as services provided to those who are proficient in English;
— failing to inform LEP people of the right to receive free interpreter services and/or requiring LEP people to provide their own interpreter.
OCR also suggests that health care providers ensure effective communication by developing and implementing a comprehensive written language assistance program that includes these features:
— policies and procedures for identifying and assessing the language needs of LEP applicants/ clients;
— a range of oral language assistance options;
— notice to LEP people of the right to language assistance;
— periodic training of staff;
— monitoring of the program;
— in certain circumstances, the translation of written materials.
The law specifies that the necessity to translate written documents may vary depending on these factors:
— the size of the population being served;
— the size of the agency or provider.
OCR will enforce the regulations through these procedures:
— complaint investigations;
— compliance reviews;
— efforts to secure voluntary compliance and technical assistance.
For more information about the Title VI standards, visit the OCR web site at www.hhs.gov/ocr/lep or call a regional office of OCR. The regional offices are as follows:
• Region I - Boston (CT, ME, MA, NH, RI, VT): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, Government Center, J.F. Kennedy Federal Building, Room 1875, Boston, MA 02203. Telephone: (617) 565-1340. Fax: (617) 565-3809. TDD: (617) 565-1343.
• Region II - New York (NJ, NY, Puerto Rico, Virgin Islands): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza, Suite 3312, New York, NY 10278. Telephone: (212) 264-3313. Fax: (212) 264-3039. TDD: (212) 264-2355.
• Region III - Philadelphia (DE, DC, MD, PA, VA, WV): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 150 S. Independence Mall West, Suite 372, Public Ledger Building, Philadelphia, PA 19106-9111. Telephone: (215) 861-4441. Fax: (215) 861-4431. TDD: (215) 861-4440.
• Region IV - Atlanta (AL, FL, GA, KY, MS, NC, SC, TN): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, Atlanta Federal Center, Suite 3B70, 61 Forsyth St. SW, Atlanta, GA 30303-8909. Telephone: (404) 562-7886. Fax: (404) 562-7881. TDD: (404) 331-2867.
• Region V - Chicago (IL, IN, MI, MN, OH, WI): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, IL 60601. Telephone: (312) 886-2359. Fax: (312) 886-1807. TDD: (312) 353-5693.
• Region VI - Dallas (AR, LA, NM, OK, TX): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 1301 Young St., Suite 1169, Dallas, TX 75202. Telephone: (214) 767-4056. Fax: (214) 767-0432. TDD: (214) 767-8940.
• Region VII - Kansas City (IA, KS, MO, NE): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 601 East 12th St., Room 248, Kansas City, MO 64106. Telephone: (816) 426-7278. Fax: (816) 426-3686. TDD: (816) 426-7065.
• Region VIII - Denver (CO, MT, ND, SD, UT, WY): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 1961 Stout St., Room 1185 FOB, Denver, CO 80294-3538. Telephone: (303) 844-2024. Fax: (303) 844-2025. TDD: (303) 844-3439.
• Region IX - San Francisco (American Samoa, AZ, CA, Guam, HA, NV): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 50 United Nations Plaza, Room 322, San Francisco, CA 94102. Telephone: (415) 437-8310. Fax: (415) 437-8329. TDD: (415) 437-8311.
• Region X - Seattle (AK, ID, OR, WA): Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 2201 Sixth Ave., Suite 900, Seattle, WA 98121-1831. Telephone: (206) 615-2290. Fax: (206) 615-2297. TDD: (206) 615-2296.
Need More Information?
- Bonnie Breit, OTR, MHSA, Administrative Director of Rehabilitation Services, Crozer-Keystone Health System, Crozer-Chester Medical Center, One Medical Center Blvd., Upland, PA 19013. Telephone: (610) 447-2429.
- Bill Martin, Executive Director, Phoenix Language Services, 2337 Philmont Ave., Huntington Valley, PA 19006. Telephone: (215) 632-9000.
- Cindy Roat, MPH, Quality Assurance Specialist, Pacific Interpreters; Executive Director, Pacific Language Consultants, 520 Southwest Yamhill, Suite 320, Portland, OR 97204. Telephone: (800) 311-1232, ext. 5638.
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