On January 21, 2011, the Department of Health and Human Services (DHHS) issued a press release regarding a new resolution agreement between the Office of Civil Rights (OCR) and the Rhode Island Department of Human Services (RIDHS) requiring RIDHS to develop new compliance policies and procedures to meet its Limited English Proficiency (LEP) obligations under Title VI of the Civil Rights Act of 1964. (We know the OCR as the folks who respond to HIPAA privacy complaints, but they do much more.)
Essentially, Title VI requires that all entities and agencies that receive financial assistance from DHHS administer their programs in ways that do not delay or deny services to persons on the basis of their race, color, or national origin.
The resolution agreement resolves a complaint filed with OCR by the Rhode Island Chapter of the American Civil Liberties Union, alleging that RIDHS termination of four Southeast Asian staff interpreters denied meaningful access to programs for eligible LEP clients. While an investigation concluded that RIDHS was not in violation of Title VI, OCR’s simultaneous review of RIDHS’ compliance with existing agreements exposed gaps in RIDHS’ compliance activities. Mainly, RIDHS had not adequately implemented improved access to its programs and services for people with LEP.
Lack of funding is no excuse, according to the OCR. “While OCR recognizes States as well as other covered entities are experiencing ongoing and significant fiscal tension, it remains of nonnegotiable importance for providers to uphold compliance with Title VI and the other laws protecting the civil rights of individuals seeking health care,” says OCR Director Georgina Verdugo.
Take away lessons your your practice?
1) If you receive any federal funding, including Medicare or Medicaid reimbursement, make sure that your organization understands and can meet its language access and translation obligations.
2) IMPORTANT! Even though RIDHS was NOT found to have violated Title VI, once the OCR was on site, it looked at everything, locating other compliance gaps. This is not at all uncommon. And while is seems that RIDSH was already on the OCR’s radar in terms of LEP compliance, the concept still holds true: Once the regulators are under your roof, all bets are off. You don't get to say "don't look over there..."
With the current and ever-increasing emphasis on compliance enforcement, this case is a good reminder to put your compliance house in order.
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