Sec. 2001. Definitions; findings

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In this title, the definitions in section 3400 of the Public Health Service Act, as added by section 2004, shall apply. Congress finds the following: Effective communication is essential to meaningful access to quality physical and mental health care. Research indicates that the lack of appropriate language services creates language barriers that result in increased risk of misdiagnosis, ineffective treatment plans, and poor health outcomes for individuals with limited English proficiency and individuals with communication disabilities such as cognitive, hearing, vision, or print impairments.

The number of limited English speaking residents in the United States who speak English less than very well and, therefore, cannot effectively communicate with health and social service providers continues to increase significantly. The responsibility to fund language services in the provision of health care and health care-related services to individuals with limited English proficiency and individuals with communication disabilities such as cognitive, hearing, vision, or print impairments is a societal one that cannot fairly be placed solely upon the health care, public health, or social services community.

Title VI of the Civil Rights Act of 1964 ( 42 U.S.C. 2000d et seq. ) prohibits discrimination based on the grounds of race, color, or national origin by any entity receiving Federal financial assistance. In order to avoid discrimination on the grounds of national origin, all programs or activities administered by the Federal Government must take adequate steps to ensure that their policies and procedures do not deny or have the effect of denying individuals with limited English proficiency with equal access to benefits and services for which such persons qualify.

Both the Americans with Disabilities Act of 1990 ( 42 U.S.C. 12101 et seq. ) and the Rehabilitation Act of 1973 ( 29 U.S.C. 701 et seq. ) prohibit discrimination on the basis of disability and require the provision of appropriate auxiliary aids and services necessary to ensure effective communication with individuals with disabilities. The type of auxiliary aid or service necessary to ensure effective communication will vary in accordance with the method of communication used by the individual, the nature, length, and complexity of the communication involved, and the context in which the communication is taking place.

A public accommodation should consult with individuals with disabilities whenever possible to determine what type of auxiliary aid is needed to ensure effective communication. The public accommodation should use the individual’s preferred method of communication whenever possible, unless it would be an undue burden to the public accommodation and an alternative would provide an equally effective means of communication. The ultimate decision as to what measures to take rests with the public accommodation, provided that the method chosen results in effective communication.

Section 1557 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18116 ) builds on title VI of the Civil Rights Act of 1964 ( 42 U.S.C. 2000d et seq. ) and section 504 of the Rehabilitation Act of 1973 ( 29 U.S.C. 794 ), prohibits discrimination on the basis of race, color, national origin, disability, sex, and age, requires the provision of language services to ensure effective communication with individuals with limited English proficiency, and requires the provision of appropriate auxiliary aids and services necessary to ensure effective communication with individuals with disabilities.

Linguistic diversity in the health care and health care-related services workforce is important for providing all patients the environment most conducive to positive health outcomes. All members of the health care and health care-related services community should continue to educate their staff and constituents about limited English proficient and disability communication issues and help them identify resources to improve access to quality care for individuals with limited English proficiency and individuals with communication disabilities such as cognitive, hearing, vision, or print impairments.

Access to English as a second language, foreign language, and sign language interpreters, translated and alternative format documents, readers, and other auxiliary aids and services, are essential to ensure effective communication and eliminate the language barriers that impede access to health care. Culturally competent language services in health care settings should be available as a matter of course.

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Sec. 2001

Definitions; findings

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