Title VI Of The Civil Rights Act And LEP Patient Compliance Requirements For Healthcare Providers
What Is Title VI?
Title VI of the Civil Rights Act of 1964 protects persons from discrimination based on their race, color, or national origin. This also extends to Healthcare services, so compliance to this very important regulation is critical.
Here are some of the key provisions of Title VI:
A. Scope and Coverage
Institutions or programs that are required to comply with Title VI are:
- Hospitals and health clinics
- Medicaid and Medicare agencies
- Alcohol and drug treatment centers
- Extended care facilities
- Public assistance programs
- Nursing homes
- Adoption agencies
- Day care, mental health and senior citizen centers
B. Prohibited Discriminatory Acts
Under Title VI, all federal agencies are required to ensure that federal funds do not subsidize programs or activities that discriminate on the basis of race, color, or national origin. A recipient of federal financial aid cannot:
- Deny services, financial aid or other benefits provided as a part of health or social service programs.
- Provide a different service, financial aid or other benefit, or provide them in a different manner from those provided to others in the program.
- Segregate or separately treat individuals in any matter related to the receipt of any service, financial aid or other benefit.
C. Requirements For Healthcare Providers
For Limited English Proficiency (LEP) patients, i.e. if English is not their primary language or they have difficulty communicating effectively in English and need interpretation or document translation, Title VI requires Healthcare Providers receiving Federal financial assistance to take reasonable steps, such as the translation of labels on pharmacy prescriptions, in order to provide meaningful access and understanding of their programs, services, and activities by LEP persons.
Title VI Enforcement and Legal Rights Of LEP Patients
Enforcement of Title VI is a legal responsibility for the heads of all government agencies. The below is an excerpt from the Code of Federal Regulations, as relates to compliance of Title Vi by any organization receiving funding from a Federal Agency:
Primary responsibility for prompt and vigorous enforcement of title VI rests with the head of each department and agency administering programs of Federal financial assistance. Title VI itself and relevant Presidential directives preserve in each agency the authority and the duty to select, from among the available sanctions, the methods best designed to secure compliance in individual cases. The decision to terminate or refuse assistance is to be made by the agency head or his designated representative.
LEP Patients that believe they have been discriminated against due to their language abilities, have two pathways for relief:
- 1. The most common form of relief sought and obtained through a Title VI private right of action is an injunction ordering a recipient to do or to stop doing something.
- 2. LEP individuals may also obtain monetary damages for claims of intentional discrimination under Section 601 of Title VI.
Conclusion
While the original intent of the Civil Rights Act was to eliminate discrimination on the basis of race, color of skin, origin, Title VI extended these basic rights to Healthcare Access, including at Pharmacies. Under Title VI, LEP patients are to be afforded the same level of treatment as other patients. There are legal ramifications to organizations for not adhering to this ruling, and compliance is taken very seriously.
Section 1557 of the Affordable Care Act (ACA), signed into law by President Obama, takes the protection of LEP individuals to an even higher level. It stipulates that reasonable steps be taken by Healthcare providers, which may include language assistance services, such as oral language assistance or written translation of medical materials.