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Addressing Language Barriers in HHS Agencies: 2023 Language Access Plan

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About 68 million people in the U.S. speak a language other than English at home, with 8.2 percent having limited English proficiency (LEP), as defined by the U.S. Department of Health and Human Services (HHS). LEP is more prevalent in certain communities of color and among lower-income individuals, contributing to a lack of understanding of and inequitable access to HHS programs and services.

In April 2022, the HHS Equity Action Plan was developed to address language access goals and requirements, extending beyond EO 1316610 and Section 1557 of the Affordable Care Act. This plan, aimed at individuals with LEP, also encompasses effective communication with persons with disabilities, including those who rely on sign language. One aspect of the HHS Equity Action plan is the requirement for Departments to strengthen its Language Access Plan. Outlined in this blog are the elements required for each HHS agency. This plan and its required steps illustrate HHS’s commitment to accessibility and equity.

Language Access Plan

The Language Access Plan outlines the Department’s policies and strategies to enhance access for individuals with LEP to HHS-funded programs and activities. It details specific steps and timelines that HHS agencies must follow to fully implement the policy at the program level.

Elements of HHS Language Access Plan

The following elements, which must be implemented, are detailed in the HHS Language Access Plan.

ELEMENT 1: Assessment—Needs and Capacity

Each March, HHS agencies must evaluate their customers’ and partners’ demand for language assistance or in-language materials. Agencies must develop a budget request for the upcoming year to meet anticipated language assistance needs. The assessment involves identifying non-English languages (including American Sign Language) spoken by the relevant population and identifying barriers (including resource constraints) that hinder effective communication with LEP individuals.

ELEMENT 2: Interpretation Language Assistance Services

HHS agencies must offer free interpretation services (face-to-face, virtual, or telephone) to meet identified language assistance needs. Additionally, each agency must designate a point of contact, such as an office or official, along with an email or phone number, for LEP individuals to access these services.

ELEMENT 3: Written Translations

HHS agencies must identify, translate, and make vital documents accessible in various formats for LEP individuals. Translation, based on assessments under Element 1, aims to provide meaningful access to public health and social services information. Although no universal threshold is set, agencies must proactively determine vital documents and develop a translation strategy, especially for top languages spoken by those with LEP. Documents, including those related to public health emergencies, should be translated using qualified translators, ensuring cultural appropriateness, plain language, and health literacy. Machine translation should not be used without human translator involvement to ensure accuracy before reaching the intended audience. The translated materials should be easily accessible on the agency’s website.

ELEMENT 4: Policies Procedures, and Practices

HHS agencies must annually review, update, and implement policies and procedures to ensure meaningful access for LEP individuals to agency programs. They must establish and maintain an infrastructure, using the Element 1 assessment results, to develop practices promoting accessibility for LEP individuals served by the agency.

ELEMENT 5: Notification of the Availability of Language Assistance at No Cost

HHS agencies must proactively inform LEP individuals about the availability of no-cost language assistance. Methods include multilingual materials, signs, and statements on application forms and other informational materials. The Element 1 assessment guides the translation of notifications into relevant languages, with agencies providing information in the 15 most spoken languages in the state. At a minimum, information on nondiscrimination rights and language assistance availability should be provided in these languages, as recommended by the Office of Civil Rights (OCR), along with notifications for people with disabilities about their entitlement to effective communication through auxiliary aids and services. OCR will supply model notices in all relevant languages.

ELEMENT 6: Staff Training

HHS agencies must allocate resources and provide necessary training to ensure staff comprehend and implement the Language Access Plan policies. Training, designed by HHS and agencies, will equip employees to effectively communicate with LEP individuals. Online training should be regularly accessible to all employees. Components of staff training include

  • Understanding and abiding by legal obligations

  • Locating language access resources

  • Identifying language needs

  • Collaborating with interpreters

  • Requesting translations

  • Utilizing multilingual staff

  • Considering ethical issues

  • Tracking language assistance use

  • Providing meaningful assistance

  • Understanding how the public can request services or file complaint

ELEMENT 7: Assessment & Accountability—Access, Quality, Resources, Reporting

HHS agencies must regularly evaluate the accessibility and quality of language assistance for individuals with LEP and/or disabilities. Agencies must keep records of provided services, document allocated resources, and annually report progress on plan implementation. To enhance services, agencies will designate an office to assess the program, considering waiting times, translation quality, communication channels, barriers, and customer satisfaction. Recommendations for improvements will be made based on these assessments.

ELEMENT 8: Consultation with Health Care and Human Services Partners

HHS agencies must actively engage with health care and human services partners and consumers to identify language assistance needs for LEP individuals. They will implement strategies based on customer need and agency capacity, continually evaluating progress. Shared information within agencies and the Department aims to prevent redundant data requests. The importance of readily available language assistance is emphasized, as individuals unaware of these services may not fully participate or benefit from HHS programs. Collaborating with organizations in contact with LEP populations, such as schools and community groups, is encouraged for effective outreach, input, and assistance in identifying target populations for HHS programs. Community-based organizations can contribute to language access planning, recommend translated materials, and assess the appropriateness of translated documents for their respective audiences.

ELEMENT 9: Digital Information

HHS agencies must establish policies and procedures to make digital information accessible to LEP individuals and people with disabilities. Each agency will designate an office to ensure online access to in-language program information and services for LEP individuals. The designated office will monitor the effectiveness, quality, readability, and accessibility of translated materials online to enhance ease of use and access.

ELEMENT 10: Grant Assurance and Compliance by Recipients of HHS Funding

HHS granting agencies must ensure that recipients of awards comprehend and fulfill their obligations under civil rights statutes, including providing language assistance services. These agencies will also strive to allocate direct funding for language access to enhance resources. Recipients of federal funds must notify and adhere to civil rights laws, with program reviews serving as opportunities to assess compliance. Grant announcements, requirements, and policies should include civil rights guidance and increased compliance monitoring to support recipients in meeting program and civil rights obligations. Timely and reasonable resolution of complaints is emphasized.

Conclusion

The Language Access Plan outlined in this blog underscores HHS’s dedication to ensuring accessibility and equity in its programs and activities. The HHS Equity Action Plan, developed in April 2022 and updated in 2023, addresses language access goals beyond statutory requirements. The plan not only focuses on individuals with LEP but also extends its scope to effective communication with persons with disabilities. The detailed steps and timelines specified for HHS agencies within this plan reflect a commitment to addressing language barriers and fostering inclusivity in health care and human services.

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