How does low health literacy, non-literacy, non-written languages, blindness and deafness among LEP populations affect the responsibilities of federal fund recipients?

Effective communication in any language requires an understanding of the literacy levels of the eligible populations. However, where a LEP individual has a limited understanding of health matters or access to the program is complicated by factors not related to national origin or English language proficiency Title VI compliance is not an issue. Under these circumstances, a recipient should provide information to the same extent that it would provide such information to similarly situated English-speakers. Similarly, a recipient should provide language assistance services to LEP individuals who cannot read or understand written materials to provide meaningful access to the same extent as could be provided to non-literate English-speakers. A non-written language precludes the translation of documents, but does not affect the recipient’s ability to orally communicate the vital information contained in a document or to provide oral notice of the availability of oral translation at no cost. Of course, with respect to persons with LEP that are also blind or deaf, other law may be implicated in this context. For instance, Section 504 of the Rehabilitation Act of 1973 requires that federal fund recipients provide sign language and oral interpreters for people who have hearing impairments and provide materials in alternative formats such as in large print, braille or on tape for individuals with visual impairments; and the Americans with Disabilities Act imposes similar requirements on health and human service providers.