Translation of written documents
The necessity to translate written documentation will vary depending
on four factors, including the size of the population(s) being served
and the size of the agency or provider. All state-generated documents
will be translated by DHHS.
Please note, even when the population does dictate translation of written
documents, the provider must still provide oral interpretation of the
written document(s).
The four factors are:
1. The number or proportion of LEP individuals served or
encountered in the eligible service population. Potential sources
of data may include
encounter data, or data from Census, school systems, community agencies
and data from client files.
2. The frequency with which LEP individuals come in contact
with your program, activity or service.
3. The nature and importance of the program, activity,
or service. Consider the importance of the recipient’s activity,
information, service or program. Consider the possible consequences
if effective communication
is not achieved. Also consider whether denial or delay of access to
services or information could have serious life threatening implications.
4. Available resources and costs.
DHHS Assistance
Terry Hodges is the NC DHHS compliance attorney for Title VI, in the
Office of General Counsel. He is assisted by an advisory committee, comprised
of representatives from all the divisions within the Department along
with input from the Institute of Medicine, advocacy groups and the Justice
Center. Mr. Hodges can be reached at (919) 715-7449 or by e-mail at terry.hodges@ncmail.net
Through Mr. Hodges, local agencies can receive the following types of
assistance with in meeting their Title VI responsibilities:
- A standard monitoring and reporting system for state-wide use is being
developed.
- A standard complaint form for Spanish/English has been developed. Please
fill in the local contact information before distributing this form.
NCDHHS Complaint Form for Title VI
- A translation contract has been developed, which will provide a list
of contractors that are approved by the Department.
- A model local plan has been developed to assist the local agencies
in developing plan in full compliance with Title VI.
- A timeline is being developed to notify agencies when their plans were
approved and/or corrections.
- All the Divisions are in the process of translating written documents
(vital documents, critical forms, etc.) into Spanish, which is the only
language at this time which meets the state threshold population number.
- Language preference has been added to the reporting system for all
DHHS generated documents. A total of 25 language preferences have been
listed in the race, ethnicity and language R/E/L project administered
by the DHHS Division of Information Resource Management (DIRM).
- Developing “standards” for interpreters and a universal
training curriculum. Certification is presently not required by DHHS.
- Assistance in the training of management teams in Title VI requirements.
- Assistance in developing partnerships with local advocates and legal
services organizations.
- Assistance in developing standard contract language for independent
contractors.
Frequently Asked Questions about Title VI
What Constitutes Discrimination?
Be aware that discrimination takes many forms:
- Differences in services from the general or traditional population.
- Differences in program benefits from the general or traditional population.
- Differences in treatment in obtaining services than the general or
traditional population.
- Intentional lack of information/communication
- Barriers or delays in participation which differ from the general
or traditional population.
Is it necessary to have interpreters present at times?
When interpretation is needed and is reasonable, it should be provided
in a timely manner. To be meaningfully effective, language assistance
should be timely. While there is no single definition for "timely" applicable
to all types of interactions at all times by all types of recipients,
one clear guide is that the language assistance should be provided at
a time and place that avoids the effective denial of the service, benefit,
or right at issue or the imposition of an undue burden on or delay of
important rights, benefits, or services to the LEP person.
What happens when LEP individuals insist upon using their own interpreter
and refuses the services of the agency-provided interpreter?
Explain to the LEP individual (through your interpreter) that they
have a right to a “free of charge” interpreter. Explain
the complications of interpreting and if they refuse, they have a right
to use their own (except not children). Be sure to document this action
for liability and compliance purposes.
What is a vital document?
Whether or not a document (or the information it contains or solicits)
is "vital" may depend upon the importance of the program,
information, encounter, or service involved, and the consequence to
the LEP person if the information in question is not provided accurately
or in a timely manner. Where appropriate, recipients are encouraged
to create a plan for consistently determining, over time and across
their various activities, what documents are "vital" to the
meaningful access of the LEP populations they serve. Thus, vital documents
could include, for instance, consent and complaint forms, intake forms
with potential for important health consequences, written notices of
eligibility criteria, rights, denial, loss, or decreases in benefits
or services, actions affecting parental custody or child support, and
other hearings, notices advising LEP persons of free language assistance,
written tests that do not assess English language competency, but test
competency for a particular license, job or skill for which knowing
English is not required, or applications to participate in a recipient's
program or activity or to receive recipient benefits or services.
Does this apply to the private sector?
All recipients of U.S. DHHS and Federal financial assistance channeled
by the NC DHHS either directly or indirectly, through a grant, contract
or subcontract are covered. Common types of Federal assistance can be
defined as loans, grants, grants and loans of federal property, use of
equipment and donation of surplus property, training and any other agreement
or contract to provide assistance.
Examples of common recipients may be hospitals, home health care agencies,
managed care organizations, universities and other health or social service
research programs. Physicians and other providers (especially, clinics)
who receive federal financial assistance (Medicaid and Medicare).
What is the “real” penalty for non-compliance with
Title VI?
- Loss of future federal and state funding
- Subject to legal actions from the NCDHHS, legal services organizations
and private individuals.
- Possible “Informed Consent” issues which could lead to
medical malpractice charges for both the public and private sector.
