HHS Office for Civil Rights Issues Letter to Health Care Officials to Clarify Civil Rights Language Access Requirements

Providing language access services is essential for equitable outcomes and quality care for persons with limited English proficiency and persons with disabilities

Today, the U.S. Department of Health & Human Services (HHS), Office for Civil Rights (OCR), issued a “Dear Colleague” letter to help federally funded health care providers, plan grantees, and others better understand their civil rights obligations under the new final rule on Section 1557 of the Affordable Care Act (“Section 1557”).  Section 1557 provides nondiscrimination protections by requiring covered entities (e.g., recipients of Federal financial assistance, programs administered by HHS, and entities established under Title I of the Affordable Care Act (ACA)) to provide language assistance to individuals with limited English proficiency (LEP) or disability.

“Health care is a right – and providing language assistance is a critical component to help ensure equitable outcomes and quality care for every person,” said OCR Director Melanie Fontes Rainer. “OCR is deeply committed to ensuring that all individuals across the nation can understand the vital information and services they need when seeking health care and human services, regardless of language or ability.”

OCR enforces federal civil rights laws in health and human services, including Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, or national origin in all federally funded programs; Section 504 of the Rehabilitation Act of 1973, which prohibit recipients of federal financial assistance from discriminating on the basis of disability; Title II of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability by state and local governments; and Section 1557, which prohibit health programs and activities receiving federal financial assistance from discriminating on the basis of race, color, national origin, sex, age, or disability.

OCR has continually found a lack of compliance with federal law requirements for language access and has prioritized this work because it is directly tied to health equity, patient safety, and effective communication.  All individuals, regardless of language ability, should have access to and benefit from essential health services.  This important rule comes at a critical time, since according to recent census data, approximately 68 million people in the United States speak a language other than English at home.

Section 1557 provides clear, easy-to-follow steps in order for covered entities to ensure meaningful access for individuals with limited English proficiency or disability.  For example, important documents should be translated, and interpreters should be provided, free of charge.  Covered entities must also make sure that communications with individuals with disabilities are as effective as communications with others.  This may require the provision of auxiliary aids and services, such as Braille, large print, captioning, plain language explanations, qualified sign language interpreters, qualified readers, qualified speech-to-speech transliterators, and accessible websites, at no cost to the individual.  These important protections will help ensure an equal opportunity to participate in and benefit from programs.

The language access requirements on meaningful access and effective communication of the Section 1557 final rule went into effect on July 5, 2024.  Covered entities should carefully study the rule and the attached “Dear Colleague” letter to make sure they are in compliance.

Language access, through meaningful access for people with limited English proficiency or effective communication for people with disabilities, is critical and is the law.  To date, HHS has taken numerous steps to ensure this access and equality:

• HHS-wide Language Access Plan can be viewed here: www.hhs.gov/LanguageAccess.
• Resources on Section 1557 can be viewed here: www.hhs.gov/1557.
• Additional resources on language access, please visit www.hhs.gov/LanguageAccess or email LanguageAccess@hhs.gov.

For the full text of OCR’s “Dear Colleague” letter, please see: https://www.hhs.gov/sites/default/files/ocr-dcl-section-1557-language-access.pdf

If you believe that you or someone else has been discriminated against because of race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with the HHS Office for Civil Rights at: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html.

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