About thirty-two million people in the United States, or 13.8 percent of the population, speak a language other than English at home. This population of people with Low English Proficiency (LEP) represents new and distinct challenges to health and human services providers. Language barriers pose challenging communication issues at almost every level of the health care delivery system. In North Carolina, the increase of the Spanish speaking, Hispanic/Latino population has created a critical need for linguistically appropriate services in health and human services agencies around the state.
WHAT IS TITLE VI?
Title VI of the Civil Rights Act of 1964 is the Federal law that protects individuals from discrimination on the basis of their race, color, or national origin in all programs that receive Federal Financial Assistance.
WHO IS BOUND BY TITLE VI?
All entities that receive any Federal funding, either directly or indirectly through a sub-grant or sub-contract, are obligated to comply with Title VI. Because Federal funding in health care is pervasive, nearly every health care provider and all health departments in NC are bound by the requirements of Title VI. Covered entities would include, but are not limited to these facilities that receive federal funding:
- All facilities that accept Medicare or Medicaid.
- Hospitals
- Physician offices
- All County Local Health Departments in North Carolina
- Community and migrant health centers who receive federal grants.
- Social Service Agencies
- Mental Health Services
WHAT ARE MY RESPONSIBILITIES UNDER TITLE VI?
Title VI requires linguistic accessibility to health and human services. The U.S. Office for Civil Rights has interpreted Title VI to require all recipients of federal funds to consider the following:
- Offer translation services at no cost to LEP patients;
- Have written policies for staff awareness of the existence of such policies.
- Ascertain the language needs of prospective recipients at the earliest possible opportunity.
- Have a system for tracking LEP clients and client needs.
- Identify a single individual or department that is charged with ensuring the provision of language access services.
- Publicize the availability of no cost programs and services in non-English community newspapers and on non-English radio and television stations.
- Provide written notices to clients in their primary language informing them of their right to receive interpretive service.
- Ask family and friends of LEP patients to provide interpretive service only after alternative, no-cost methods have been explained (Minors should not be used to interpret).
- Ensure the availability of a sufficient number of qualified interpreters on a 24-hour basis, or whenever the facility is open.
- Ensure that interpreters are qualified and trained with demonstrated proficiency in both English and the other language, as well as knowledge of specialized medical and other technical terms and concepts in both languages.
- Limit the use of telephone interpretation to situations where there is no bilingual staff person or contracted interpreter available.
- Have translated materials available.
- Conduct community outreach to immigrant communities.
HOW CAN I GO ABOUT PROVIDING INTERPRETATION SERVICES?
Some ways that you, as a health care provider, can overcome linguistic barriers include:
- Hire qualified bilingual staff.
- Hire staff interpreters.
- Use volunteer staff interpreters.
- Arrange for the services of volunteer community interpreters.
- Contract with an outside interpreter service.
- Use a telephone interpreter service such as the AT&T Language Line.
- Monitor quality and competence of interpreters.
WHERE CAN I TURN FOR HELP?
National Resources:
Civil Rights Division
U.S. Department of Justice
1-888-TITLE06 (1-888-848-5306)
Or call Interpreters on Call!
(918)630-8244 or interpretersoncall@hotmail.com