Transcript Language and Communication Mandates

Meeting and Exceeding Language
and Communication Mandates
Todd Blickenstaff
Hablamos Juntos
Gisela Prieto
Caliente Communications
June 2-3, 2003
Cultural Competency Standards for NJ HIV/AIDS
Service Providers: Princeton, NJ
What are the barriers between
provider & patient?
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Culture
Education
Language
Physical and Communication impairments
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How can these barriers be reduced?
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What are the consequences of
language barriers?
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Increased chance for medical error
Lack of patient trust in provider
Lower patient satisfaction
Lower patient outcomes
The Civil Rights mandate explained
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Title VI of the 1964 Civil Rights Act
Prohibits discrimination by federally funded entities
based on race, color, and national origin
“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 subject
to discrimination under any program or activity
receiving Federal financial assistance.”
Title VI of the 1964 Civil Rights Act
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Prohibited practices under Title VI
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Denying a benefit or opportunity to participate
Providing different services or benefits
Providing services or benefits in a different manner
or in a segregated environment
Restricting privileges
Using policies or procedures that have the effect of
discriminating
HHS Title VI Regulations
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Requires recipients of federal financial
assistance to provide meaningful access to
LEP Persons
To ensure meaningful access, language
assistance should result in:
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Accurate and effective communication
At no cost to the LEP person
45 CFR Part 80.3(b)(2)
Executive Order
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Signed August 2000 by President Clinton
Improving Access to Services for Persons with
Limited English Proficiency
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designed to better enforce and implement Title VI
requires federal agencies to meet the same
standards as federal financial assistance recipients
in providing meaningful access for LEP individuals
to federally conducted programs
Equates language with national origin
Federal Goals
Take
reasonable steps to ensure meaningful access to
programs and activities by LEP persons.
To ensure that Federally-assisted programs aimed at the
American public do not leave some behind simply
because they face challenges communicating in English.
To identify constructive methods to reduce the costs of
LEP requirements on small businesses, small local
governments, or small non-profits that receive Federal
financial assistance.
To establish criteria for evaluating and monitoring
programs at all levels.
HHS LEP Policy Guidance
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Explains Title VI and “meaningful access”
Provides detailed information about complying
with the law
Outlines a model plan that identifies promising
practices
DOJ Revised LEP Guidelines
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Issued June 2002
July 2002- memo from DOJ instructing federal
agencies to use the DOJ LEP guidance as a model for
republication of recipient LEP guidance
HHS and other federal agencies in the process of
conforming to DOJ revised guidance
HHS has issued guidance and taken public input
These guidelines are in effect now, pending release of
revised guidelines.
Who is covered?
All public or private agencies that receive financial
assistance from any of 30 Federal agencies (directly
or indirectly) through a grant, contract or
subcontract. “Covered entity” examples:
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State, county, local welfare agencies
Hospitals and clinics
Managed care organizations
Nursing homes
Mental health centers
Senior Citizen Centers
Head Start Programs
What language services are you
obligated to provide?
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Depends on four factors:
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# or proportion of LEP individuals
Frequency of contact with the program (how often
an interpreter is needed)
Nature and importance of the program
Resources available and costs
Three ways of providing language
services
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Oral Interpretation- requires proficiency in
English and another language, knowledge of
specialized terms, understanding of ethics
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Dedicated
Dual Role
Contract
Telephonic
Volunteers
Minors
Can family and friends interpret?
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Only if offered professional interpreter
Confidentiality and Privacy issues
Conflict of interest
Minors
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What the law says-
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Bottom line- using friends and family as interpreters
is discouraged
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Three ways of providing language
services
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Written Translation
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Consent and complaint forms
Notices about eligibility, changes in benefits
Application for services, intake forms
Notice of free language services
What should be available, and in what languages?
Cultural Adaptation and cross-cultural communication
Methods and Guidelines for Translation
Three ways of providing language
services
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Signage
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In patient’s language
May include pictograms, symbols, etc.
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Consideration of literacy levels
CLAS Standards
Language in DOJ guidance
Infrastructure needed to provide
services in required languages
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Bilingual staff interpreters
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Dual role
Dedicated
Translators
Signage
Alliances w/organizations or academic
institutions that can provide TA/staffing re:
language/culture needs
Cultural Competence
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Recognize the importance of home remedies in some
cultures
Offer language options for your patients
Provide educational brochure in multiple languages
Hire staff that represent your patients population
Assure that members' of your staff are culturally
competent
Understand patient health needs and local resources
Partner with local agencies and organizations that
have subject matter expertise in cultural competence
and health disparities
Linguistically appropriate services
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Establish procedures for communication with
LEP speakers at all hours of operation
Use open-ended questions to learn cultural
beliefs, expectations, and practices that may
affect patient health
Create an environment that helps patients from
diverse, cultural backgrounds feel more
comfortable
Use 'trained medical interpreters'
For more information…
Todd Blickenstaff
[email protected]
www.hablamosjuntos.org
Gisela Prieto
[email protected]