Office for Civil Rights
Medicare Certification Civil Rights Information Request Form
Communication with Persons Who Are Limited English Proficient
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In certain circumstances, the failure to ensure that
Limited English Proficient (LEP) persons can effectively
participate in, or benefit from, federally-assisted
programs and activities may violate the prohibition under
Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d,
and the Title VI regulations against national origin
discrimination. Specifically, the failure of a recipient
of Federal financial assistance from HHS to take
reasonable steps to provide LEP persons with a meaningful
opportunity to participate in HHS-funded programs may
constitute a violation of Title VI and HHS's
implementing regulations. It is therefore important
for recipients of Federal financial assistance, including
Part A Medicare providers, to understand and be familiar
with the requirements.
Applicable Regulatory Citations:
Title VI of the Civil Rights Act of 1964: 45 CFR
Part 80
§80.3 Discrimination prohibited.
(a) General. No person in the United
States shall, on the ground of race, color, or national
origin be excluded from participation in, be denied the
benefits of, or be otherwise subjected to discrimination
under any program to which this part applies.
(b) Specific discriminatory actions
prohibited. (1) A recipient under any program to
which this part applies may not, directly or through
contractual or other arrangements, on ground of race,
color, or national origin:
(i) Deny an individual any service, financial aid, or
other benefit under the program;
(ii) Provide any service, financial aid, or other benefit
to an individual which is different, or is provided in a
different manner, from that provided to others under the
program;
(iii) Subject an individual to segregation or separate
treatment in any matter related to his receipt of any
service, financial aid, or other benefit under the
program;
(iv) Restrict an individual in any way in the enjoyment
of any advantage or privilege enjoyed by others receiving
any service, financial aid, or other benefit under the
program;
(v) Treat an individual differently from others in
determining whether he satisfies any admission,
enrollment, quota, eligibility, membership or other
requirement or condition which individuals must meet in
order to be provided any service, financial aid, or other
benefit provided under the program;
(vi) Deny an individual an opportunity to participate in
the program through the provision of services or otherwise
or afford him an opportunity to do so which is different
from that afforded others under the program (including the
opportunity to participate in the program as an employee
but only to the extent set forth in paragraph (c) of this
section).
(vii) Deny a person the opportunity to participate as a
member of a planning or advisory body which is an integral
part of the program.
(2) A recipient, in determining the types of services,
financial aid, or other benefits, or facilities which will
be provided under any such program, or the class of
individuals to whom, or the situations in which, such
services, financial aid, other benefits, or facilities
will be provided under any such program, or the class of
individuals to be afforded an opportunity to participate
in any such program, may not, directly or through
contractual or other arrangements, utilize criteria or
methods of administration which have the effect of
subjecting individuals to discrimination because of their
race, color, or national origin, or have the effect of
defeating or substantially impairing accomplishment of the
objectives of the program as respect individuals of a
particular race, color, or national origin.
Go to 45 CFR Part 80
for the full regulation.
Resources
For further guidance on the obligation to take reasonable
steps to provide meaningful access to LEP persons, see
HHS' "Guidance to Federal Financial Assistance
Recipients Regarding Title VI Prohibition Against National
Origin Discrimination Affecting Limited English Proficient
Persons," available at http://www.hhs.gov/ocr/lep/.
This guidance is also available at http://www.lep.gov/ , along
with other helpful information pertaining to language
services for LEP persons.
"I
Speak" Language Identification Flashcard (PDF)
From the Department of Commerce, Bureau of the Census, the
"I Speak" Language Identification Flashcard is
written in 38 languages and can be used to identify the
language spoken by an individual accessing services
provided by federally assisted programs or activities.
Technical Assistance for Medicare and Medicare+Choice
organizations from the Centers for Medicare and Medicaid
for Designing, Conducting, and Implementing the 2003
National Quality Assessment and Performance
Improvement (QAPI) Program Project on Clinical
Health Care Disparities or Culturally and Linguistically
Appropriate Services-
Examples of Vital Written Materials
Vital written materials could include, for example:
- Consent and complaint forms.
- Intake forms with the potential for important
consequences.
- Written notices of eligibility criteria, rights, denial,
loss, or decreases in benefits or services, actions
affecting parental custody or child support, and other
hearings.
- Notices advising LEP persons of free language assistance.
- 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.
- Applications to participate in a recipient's program
or activity or to receive recipient benefits or services.
Nonvital written materials could include:
-
Hospital menus.
- Third party documents, forms, or pamphlets distributed by
a recipient as a public service.
- For a non-governmental recipient, government documents and
forms.
- Large documents such as enrollment handbooks (although
vital information contained in large documents may need to
be translated).
- General information about the program intended for
informational purposes only.
Go to Main Technical Assistance Page
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