Office of Civil Rights

Fact Sheet on Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient (LEP) Persons

Overview: The Department of Health and Human Services is publishing revised Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient (LEP) Persons. The Revised HHS LEP Guidance, issued pursuant to Executive Order 13166, is effective immediately, replacing HHS' August 30, 2000, LEP Guidance, and seeks public comment for a 120 day period. The Department is providing this extended comment period to enable providers and consumers to tell us their experiences in using this revised Guidance, and to permit us to consider whether further revisions and guidance might be helpful.

In October 2001, The Department of Justice (DOJ) directed all Federal agencies that provided Federal financial assistance to republish their recipient LEP Guidance for additional public comment. HHS received nearly 200 public comments when it did so – mostly expressing support for the principles behind the Guidance, but also concern about coverage, compliance costs, and use of family members and friends as interpreters. Subsequently, in June 2002, DOJ issued LEP revised Guidance and, to reconcile different approaches in guidance offered by various federal agencies, directed other agencies to follow suit, using DOJ's Guidance as a model. This revised HHS LEP Guidance, adapted to the context of HHS recipients and beneficiaries, reflects the approach taken in the DOJ Guidance, and consideration of the public comments received.

The clarity that this Guidance provides and its uniformity with the DOJ Guidance will mean better services and greater consistency in language access for LEP persons.

Among other things, the revised Guidance:

Reaffirms our commitment to Title VI and its application to LEP.

The Department and OCR continue to be committed to LEP as a priority area.
The Department continues to be committed to enhancing access to HHS services by LEP persons and closing the health care gap.

Brings the HHS Guidance into conformity with the DOJ Guidance, as appropriate to HHS funded-programs.

For instance, rather than the seven factors identified in the prior HHS Guidance, the revised Guidance joins other federal agencies in adopting and applying the four Title VI balancing factors identified in the DOJ Guidance.

the number or proportion of LEP persons eligible to be served or likely to be encountered by the program or grantee;
the frequency with which LEP individuals come in contact with the program;
the nature and importance of the program, activity, or service provided by the program to people's lives; and
the resources available to the grantee/recipient and costs.

Better applies the factors in the context of LEP persons who seek services from recipients of Federal financial assistance from HHS.

The revised Guidance does not change the law of Title VI, as applied to LEP persons, but it enhances the quality of the technical assistance provided, by clarifying the nature and extent of recipient obligations and the rights of LEP persons. Among other things, the revised Guidance:

discusses how the four factors should be weighed in determining whether there is an obligation and how to meet it;
clarifies that where an obligation exists, LEP persons can make an informed choice of whether they want to use a family member or friend as an interpreter, if that choice is consistent with good care and practice. The Guidance explains that LEP persons should be made aware that they can have free interpretation services, and emphasizes that where concerns about competence, confidentiality, appropriateness or conflict of interest are present, interpretation services may still have to be provided.

Highlights the Department's focus on Technical Assistance, and its Efforts to Promote Voluntary Compliance.

The revised Guidance:

stresses that HHS is committed to assist covered entities through technical assistance;
provides examples of means of providing language assistance in a more cost effective manner,
provides helpful information concerning competency of interpreters and translators and when it is necessary to translate materials, and identifies safe harbor provisions that apply to the translation of materials.

Last revised: August 11, 2003

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