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Office for Civil Rights

Hospitals and Effective Communication

 

General Background Information

Good medical care depends upon effective communication between patients and providers. Ineffective communication can lead to improper diagnosis and delayed or improper medical treatment. Effective communication with persons who have limited English proficiency - as well as persons who are deaf or hard-of-hearing - often requires interpreters or other services. Many hospitals are actively taking steps to address these needs. However, hospitals face increasing challenges to meet the communication needs of an increasingly diverse population. At the same time, Federal agencies are addressing a significant number of complaints regarding the lack of effective communication in hospital settings.

The U.S. Department of Health and Human Services Office for Civil Rights is responsible for enforcing Title VI of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, and national origin, and Section 504 of the Rehabilitation Act of 1973 which prohibits discrimination on the basis of disability by recipients of financial assistance from HHS. The Office for Civil Rights is also responsible for ensuring compliance with Title II of the Americans with Disabilities Act as it applies to health and human service activities of state and local governments. The Department of Justice is responsible for coordinating civil rights enforcement across the Federal government and for enforcing Title III of the ADA as it applies to public accommodations, including hospitals. The Department of Justice can also bring court actions to enforce any of these statutes or intervene in private actions.

Under these laws, hospitals must communicate effectively with patients, family members, and visitors who are deaf or hard-of-hearing and must take reasonable steps to provide meaningful access to their programs for persons who have limited English proficiency. Complementing these obligations are the new accreditation provisions promulgated by the Joint Commission on Accreditation of Healthcare Organizations, including the recently adopted requirement that hospitals collect information about the language and communications needs of patients.

To assist hospitals in meeting these responsibilities and to help ensure access to quality health care, the following information and resources are available.

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Effective Communication in Hospitals Initiative Materials


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Laws and Regulations


  • 45 CFR Part 84: Implementing Section 504 of the Rehabilitation Act of 1973 - Nondiscrimination on the basis of disability in programs or activities that receive financial assistance from DHHS [as amended at 70 FR 24319, May 9, 2005]
  • 28 CFR PART 35: Implementing Title II of the Americans with Disabilities Act -Nondiscrimination on the basis of disability in state and local government services, including public hospitals.
  • 28 CFR Part 36: Implementing Title III of the Americans with Disabilities Act - Nondiscrimination on the basis of disability by places of public accommodation and commercial facilities.
  • 45 CFR Part 80: Implementing Title VI of the Civil Rights Act of 1964 - Nondiscrimination on the basis of race, color, or national origin in programs or activities that receive financial assistance from DHHS. [as amended at 70 FR 24319, May 9, 2005]

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Educational Materials


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Case Resolutions, Settlement Agreements, and Consent Decrees


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Links to HHS Programs


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Other Resources


  • LEP.gov is a clearinghouse, providing and linking to information, tools, and technical assistance regarding Limited English Proficiency and language services for federal agencies, recipients of federal funds, users of federal programs and federally assisted programs, and other stakeholders.
  • "I Speak" Language Identification Flashcard (PDF) from the Department of Commerce, Bureau of the Census; the "I Speak" Language Identification Flashcard is written in 38 languages and can be used to identify the language spoken by an individual accessing services provided by federally assisted programs or activities.
  • Language Identification Card created by the State of Ohio Office of Criminal Justice Services, the National Association of Judiciary Interpreters and Translators, the Summit County Sheriff's Office, and the American Translators Association

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