1. Limited-English Proficiency Pines Behavioral Health

2. Background  Civil right laws have been challenged as a result of suits alleging that rights have been violated when services are not provided in a language that is of the person’s preference  These lawsuits have been won, and the Centers for Medicare and Medicaid Services has taken stock in making sure that these accommodations are made for people receiving federally funded services  Why? Because the U.S. does NOT have an official language

3. What is “limited-English” proficiency?  When a person’s primary or preferred language is something other than English  People may be able to speak English, but something as personal as therapy may only be understood in their own primary language  People have the right to choose which language they would like to receive services in, and by law, we must abide by this request free of charge

4. Legal Basis  Many legal basis’ are being used to uphold court challenges in this area. They include:  The Civil Rights Act of 1964  The Rehabilitation Act of 1973  The American’s with Disabilities Act  The Rehabilitation Act states:  “No otherwise qualified individual with a disability in the United States...shall solely by reason of his or her disability be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance”. Disability is being defined as not understanding or speaking English well and Federal financial assistance is being defined as Medicaid.

5. Disparate Impact  Not only is blatant discrimination illegal (example: sorry, we do not serve those who can’t understand English) but so too is “disparate impact”.  Disparate impact is discrimination that has resulted in different treatment outcomes than those understanding English. Example: if the co-occurring group is the best treatment for persons with both an MI and SA diagnosis, disparate impact would result if non-English speaking people were not afforded this opportunity.

6. What Do We Need to Do?  Determine number of people in our service area who would not have English as their primary language.  People must be informed of their ability to state their preferred language. Pines uses posters and has “I speak kits” to help people tell us their preferred language.  Translation services must be offered free of charge when requested, in fact “vital documents” must be available in the languages prevalent for our area.  Interpreter services must be offered free of charge when requested.

7. Vital Documents, Interpreters and Translators  Vital documents are forms that have to do with grievance procedures, anything needing a response, or anything associated with the reduction or termination of services.  Interpreters are people who are competent to speak the preferred language of the person. *Should not be a minor, family member or spouse for clinical reasons  Translation is putting written materials into formats understood in the preferred language.

8. Dos and Don’ts  Do document any instance which warrants the use of an interpreter  Do document anytime that a friend, family member or spouse interprets despite having been told that they have a right to free interpreter services.  Don’t suggest or allow a minor to act as an interpreter  Don’t suggest a spouse or family member to be an interpreter (if the issue is domestic violence how likely will the spouse adequately interpret the client’s complaints?)