April 2001
Executive Order on Access for Limited English Proficient Individuals
On August 11, 2000, President Clinton issued an Executive Order "to improve access to federally conducted and federally assisted programs and activities for persons who, as a result of national origin, are limited in their English proficiency." Many federal agencies provide funding to state, local and other entities to administer programs or services (i.e., health care or welfare programs). The federal agencies enforce Title VI of the 1964 Civil Rights Act against recipients of federal funding, to ensure that these programs or services provide "meaningful access" to limited English proficient (LEP) persons, including appropriate linguistic access. Executive Order 13166 requires each federal agency to issue a Title VI policy guidance specific to that agency's programs or services, in order to assist recipients of federal funding in complying with Title VI.
Although federal agencies enforce Title VI against state, local and other agencies that receive federal funding, federal agencies themselves do not necessarily provide LEP persons meaningful access to their own programs and services. The Executive Order requires each federal agency to develop a plan to improve access to its own programs and activities. In conjunction with the release of the Executive Order, the U.S. Department of Justice (DOJ) also released a guidance memorandum to help each federal agency in developing an agency-specific Title VI policy guidance as well as a plan to improve access to the agency's own programs and services. The Executive Order also requires federal agencies to ensure that stakeholders, including LEP persons and advocates, have an opportunity to provide input into each agency's process.
DHHS Publishes Policy Guidance on Access for LEP Individuals
On August 30, 2000, the Office for Civil Rights (OCR) of the Department of Health and Human Services (DHHS) published its guidance clarifying the Title VI responsibilities of providers of health and social services who receive federal funding. Title VI applies to any "recipient" of federal funding. Almost all health and human services programs, even those that are administered by state or local governments, receive some federal funding. Because almost all health care providers today receive some federal funding, almost every health care provider is required to follow Title VI and not discriminate against LEP individuals. For example, Title VI applies to hospitals; nursing homes; managed care organizations; state Medicaid programs; State Children's Health Insurance Programs; state, county and city health departments; state, county and city welfare agencies; and most programs for families, youth and children.
The guidance confirms OCR's interpretation that Title VI requires oral interpretation services for any LEP individual who requires language assistance. The policy guidance also:
- Repeats and emphasizes that Title VI makes discrimination against LEP individuals illegal.
- Discusses the policies, procedures and other steps that "recipients" or providers can take to ensure meaningful access to their program by LEP individuals.
- Clarifies that a provider's failure to take one or more of these steps does not necessarily mean a violation of Title VI.
- Emphasizes that OCR will decide whether there is a violation of Title VI on a case by case basis, and that such decisions will take into account the size of the provider, the size of the LEP population, the nature of the program, the resources available, and the frequency of use by LEP individuals.
- Explains that small providers with limited resources will have a lot of flexibility in following Title VI requirements.
- Explains that OCR is available to provide extensive technical assistance to providers on how to follow and implement Title VI requirements.
The DHHS OCR Guidance is available at: http://www.access.gpo.gov/su_docs/fedreg/a000830c.html.
Recent Attacks on LEP Executive Order
Recently, the implementation of the LEP Executive Order has come under attack from some provider groups, as well as some members of Congress. In the hopes that the new Administration may be sympathetic, the American Medical Association and other provider groups have urged the Secretary of DHHS, Tommy Thompson, to impose an immediate moratorium on the enforcement of the policy guidance issued by DHHS. In addition, a group of 43 House Republicans and one Democrat, led by Rep. Bob Stump (R-AZ) have introduced legislation (H.R. 969) to nullify the LEP Executive Order. These efforts have prompted the Administration to review the issue.
APIAHF drafted and sent a letter to President George W. Bush, urging continued implementation of Executive Order 13166 and emphasizing that the Executive Order affirms current legal requirements under Title VI of the 1964 Civil Rights Act which prohibit discrimination and ensure equal access to federally funded programs and services for individuals with Limited English Proficiency (LEP). The letter was signed by nearly seventy supporting organizations from around the nation including the American Psychological Association, American Public Health Association, and National Hispanic Medical Association. APIAHF continues to work with Federal agencies and advocacy organizations to support and enforce Title IV of the Civil Rights Act.
