HHS Releases Report to Increase Language Access for Persons with Limited English Proficiency

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Office for Civil Rights issues report to reduce barriers and increase access to persons with limited English proficiency

Last week, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) released a report summarizing the progress the Department has made on improving the provision of meaningful access to language assistance services to persons with limited English proficiency (LEP). The report also identifies steps to continue and strengthen this work across HHS moving forward.

Effective communication is critical in health care and human services, where miscommunication may lead to misdiagnosis, improper or delayed medical treatment, and barriers to necessary services and programs.

“The need for meaningful access to language services continues to grow across America and HHS is taking important action to ensure individuals with limited English proficiency can fully access federal resources and programs,” said Secretary Xavier Becerra. “As a child, I often needed to translate insurance and medical documents for my parents. That is still necessary for many families in this country today, which is why we are working so hard to ensure everyone has access to health care and advance health equity for all people.”

Last week’s report was issued in response to President Biden’s Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, which seeks to increase access to government services to address barriers in federal programs and services. This is the first such report HHS has issued since 2016. The report is also in line with Executive Order 14012, Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans, which directed the Federal Government to develop welcoming strategies to promote integration and inclusion and embrace the full participation of the newest Americans, many of whom come with LEP, in our democracy. In addition, earlier this year, OCR relaunched the Department’s Language Access Steering Committee.

“HHS is taking important steps to ensure that people have full and equal access to programs and services across the Department, so that no one is left behind because of the language they speak, or other communications barriers based on ability,” said OCR Director Melanie Fontes Rainer. “OCR is committed to guaranteeing that health and human services are inclusive, equitable, accessible, and in compliance with civil rights laws for limited English proficient persons and their families.”

This first annual report summarizes the Department’s progress to date and charts a course to increase meaningful language access across the Department. Recent accomplishments include:

  • OpDivs and StaffDivs have greatly increased the amount of in-language online content;
  • In response to a complaint alleging 19 states failed to provide meaningful access to their COVID testing, inoculation, and treatment programs, OCR is collaborating with the DHS and FEMA to provide technical assistance: and
  • HHS added taglines in multiple languages at the bottom of HHS.gov homepage.

It discusses the need for reducing barriers and increasing language access in the four key areas identified in the Equity Plan:

  • Internet access;
  • Telephone access;
  • Access to programs and activities; and
  • Federal funds to provide needed language services.

The report also maps specific benchmarks and progress to date, including OCR’s collection and analysis of 25 HHS agency and component-level Language Access Plans, and a review of work by the HHS Language Access Steering Committee to assess needed improvements and to share best practices. The report discusses how work will continue in 2023 and beyond, including:

  • The creation of a new HHS Language Access Coordinator position;
  • The setting up of a centralized language access center hub for HHS;
  • Updating and revising HHS’s 2013 Language Access Plan; and
  • Taking steps to address problems identified in OCR investigations of LEP complaints filed against HHS

Read the Report:

Read the Press Release:

HHS is committed to ensuring that all people can access health care and human services free from discrimination. If you believe that you or another person have been discriminated against based on national origin or another protected category, you can file a complaint with OCR at: https://www.hhs.gov/ocr/complaints/index.html.

*People using assistive technology may not be able to fully access information in this file. For assistance, contact the HHS Office for Civil Rights at (800) 368-1019, TDD toll-free: (800) 537-7697, or by emailing OCRMail@hhs.gov.

Ambulance Desert Report Highlights Severity in Rural Communities  

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The Maine Rural Health Research Center released its Ambulance Desert Chartbook. This chartbook analyzes 42 states in 2021-2022 and identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert. The report found that out of 4.5 million people living in an ambulance desert, 2.3 million (52%) were in rural counties. The reports also found that 84% of rural counties are an ambulance desert.

Congress Introduces Farmer Mental Health Bill 

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Sens. Baldwin (D-WI), Bennet (D-CO), and Ernst (R-IA), introduced S. 1736, the Farmers First Act of 2023, to address the mental health crisis in rural communities and expand access to mental health support for farmers and ranchers. This legislation reauthorizes the Farm and Ranch Stress Assistance Network (FRSAN) and provides additional funding to help agricultural workers access behavioral health specialists and services. NRHA is proud to endorse this legislation and supports expanding the network of rural providers to deliver critical services to farming and ranching populations.

293 Hospitals at Immediate Risk of Closure

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There are 293 rural hospitals at immediate risk of closure due to inflation, staffing shortages and other financial stress, according to the Center for Healthcare Quality & Payment Reform.

Hospitals at immediate risk of closure have lost money on patient services for multiple years, excluding 2020 during the pandemic, and aren’t likely to receive sufficient funds to cover the losses with public assistance ending, according to the report. These hospitals also have low reserves and more debt than assets.

Click here to see the state-by-state list.

New 2020 Census Data Released

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The U.S. Census Bureau released the 2020 Census Demographic and Characteristics File (DHC). These products provide the next round of data available from the 2020 Census, adding more detail to the population counts and basic demographic and housing statistics previously released.

This release includes population counts (total, by race and Hispanic ethnicity, age, and sex) as well as housing counts. These data are available through the U.S. Census Bureau’s data dissemination platform data.census.gov.

PA Census 2020 Data Portal

Today, in conjunction with the release of the 2020 DHC data, the PA State Data Center launched the Census 2020 Data Portal. The portal serves as a tool to host data localized to Pennsylvania and also provides guidance, overviews, and interactive reports/visualizations to help users make sense of the Census 2020 data.

View the portal at: https://census2020-pasdc.opendata.arcgis.com/

While you’re there, check out our latest dashboard and report which make DHC data for the state, counties, and municipalities easy to view!

This resource is a living catalog of data releases and supporting documentation and analysis from the U.S. Census Bureau and the PA State Data Center. Existing data, resources, and reports/visualizations, such as those for the Redistricting (P.L. 1994) data, have been added to the portal, and more will come soon!

Updated Coverage to Care Partner Resources Now Available

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Coverage to Care has updated its partner resources! Now available on the C2C website, these materials are designed to help partners across the country share more information about C2C with their communities on how to make the most of their health coverage.

Coverage to Care is one of CMS OMH’s signature initiatives to help consumers understand their health coverage and connect them to the primary care and preventive services that are right for them. C2C offers resources to assist community partners in their outreach. Please be sure to use the newly updated C2C Partner Toolkit and presentation resources linked below!

Resources

  • C2C Partner Toolkit provides prepared information and graphics for partners to use in their own emails, listservs, or social posts, as well as ideas on how to get started with health literacy in your community. Spanish coming soon!
  • Updated C2C Community Presentation slide deck, a visual aid featuring the 8 Steps of the Roadmap to Better Care with prepared script and slides.
  • C2C Presenter’s Guide (PDF) provides an overview of the C2C Community Presentation slide deck and tips for a better discussion.
  • Accompanying Resources handout (PDF) with additional links to help with consumers’ health care journey.

Be sure to check out these and other resources on the C2C partner resources webpage.

To learn more about C2C, please visit go.cms.gov/c2c.

To continue receiving updates from about new C2C resources and programs, please sign up for our C2C listserv.

Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability Stratified Report

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The Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA).

The Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability report presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.

Overall, the report showed that people who were dually eligible for Medicare and Medicaid or eligible for the Low-Income Subsidy received worse clinical care than those who were not. The largest differences between the two groups were in the areas of Follow-up After Hospital Stay for Mental Illness (within 30 days of discharge), Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with Dementia, and Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with a History of Falls. Disparities by dual eligibility status/Low-Income Subsidy eligibility status were least common among Hispanic individuals and most common among White individuals. The report also shows more pronounced disparities in clinical care for dually eligible/Low-Income Subsidy eligible individuals in urban areas as compared to rural areas.

This report is based on an analysis of data from the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare Advantage enrollees receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for Medicare Advantage enrollees who are dually eligible for Medicare and Medicaid/Low- Income Subsidy eligible and those with disabilities, and implement quality improvement efforts that improve health equity.

Help CMS to advance equity by sharing this report and our resources on prevention and health equity initiatives. Also, sign up for our listserv or visit https://go.cms.gov/omh for more information.