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Posting Notices of Nondiscrimination and Taglines in 15 Languages

Posting Notices of Nondiscrimination and Taglines in 15 Languages


Health Care Law Note
(September 22, 2016)

In May 2016, the United States Department of Health and Human Services ("HHS") issued a final rule providing guidance for protection of individuals from discrimination in health care based on race, color, national origin, age, disability, and sex. The Nondiscrimination in Health Programs and Activities final rule addresses in more detail Section 1557 of the Affordable Care Act ("ACA"), which has been in effect since 2010. 

Among other things, the final rule contains express requirements regarding posting detailed notices of nondiscrimination and notices of the availability of translation services in 15 non-English languages. 

Requirements

  1. Any entity that operates a health program or activity any part of which receives Federal Financial assistance is considered an entity covered by the Section 1557 requirements.

    This includes Medicare and Medicaid payments, or any other payments from HHS.
     
  2. Providers must post notices of nondiscrimination conveying the following specific information:
    1. The covered entity does not discriminate on the basis of race, color, national origin, sex, age, or disability;
    2. The covered entity provides appropriate auxiliary aids and services;
    3. The covered entity provides language assistance services;
    4. How to obtain applicable aids and services;
    5. Identification of and contact information for an employee who will coordinate efforts to comply with Section 1557 including investigation of grievances/complaints;
    6. The availability of a grievance procedure and how to file a grievance; and
    7. How to file a discrimination complaint with the Office of Civil Rights ("OCR").
       
  3. Providers must post taglines that alert individuals with limited English proficiency to the availability of language assistance services. The taglines:
    1. Must be posted in the top 15 non-English speaking languages in the applicable State.
    2. Can be very short, simply stating: "ATTENTION:  If you speak [insert language], language assistance services, free of charge, are available to you.  Call 1-xxx-xxx-xxxx (TTY: 1-xxx-xxx-xxxx)."
       
  4. The notice of non-discrimination and taglines in the top 15 non-English speaking languages must be posted:
    1. In a "conspicuously-visible font size";
    2. In physical locations where the provider interacts with the public;
    3. In a conspicuous location on the provider's website, accessible from the website's home page; and
    4. In significant publications and communications.
       
      • If a publication is small, such as the size of a postcard/trifold brochure, then a limited non-discrimination notice, as opposed to the full notice of discrimination, can be used, and the publication must only have taglines for the top two non-English languages in the State, not all 15.
      • A provider can continue distributing existing publications until the current stock is exhausted; they do not have to discard the publications just because they do not contain the notice and Non-English taglines.

Languages

OCR has identified the top 15 languages used in each state and territory.  This list can be relied on by providers when preparing the 15 non-English taglines. However, if a provider would like to rely on a different source to identify the top 15 non-English languages that is also permissible.

The top 15 non-English languages identified for North Carolina, South Carolina, and Georgia are:

North Carolina

South Carolina

Georgia

Spanish

Spanish

Spanish

Chinese

Chinese

Vietnamese

Vietnamese

Vietnamese

Korean

Korean

Korean

Chinese

French

French

Gujarati

Arabic

Tagalog

French

Hmong

Russian

Amharic

Russian

German

Hindi

Tagalog

Gujarati

French Creole

Gujarati

Arabic

Russian

Mon-Khmer, Cambodian

Portuguese

Arabic

German

Japanese

Portuguese

Hindi

Ukrainian

Persian

Laotian

Hindi

German

Japanese

Mon-Khmer, Cambodian

Japanese

See   https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Appendix-A-Top-15.pdf

Sample Documents -- The OCR website contains

  1. A sample Notice of Non-Discrimination
  2. A sample "Statement of Nondiscrimination" to be included on small publications/communications
  3. Taglines translated into 64 languages

    See  http://www.hhs.gov/civil-rights/for-individuals/section-1557/

To be compliant with the Notice Provisions of Section 1557, notices and taglines should be posted before October 17, 2016. If you need further guidance regarding the implementation of Section 1557 of the ACA, please contact us.

Authors
Susan McNear Fradenburg
T (336) 378-5482
F (336) 378-5400
Associated Attorneys
Associated Industries
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