Limited English Proficiency (LEP)

If English is not your primary language and you have difficulty communicating effectively in English, you may need an interpreter or document translation in order to have meaningful access to programs funded by the Department of Health and Human Services (HHS). Title VI of the Civil Rights Act of 1964 requires recipients of Federal financial assistance to take reasonable steps to make their programs, services, and activities accessible by eligible persons with limited English proficiency.

2023 HHS Language Access Report

OCR has released a report summarizing the progress the Department has made on improving the provision of meaningful access to language assistance services to persons with limited English proficiency (LEP). The report also identifies steps to continue and strengthen this work across HHS moving forward.  Effective communication is critical in health care and human services, where miscommunication may lead to misdiagnosis, improper or delayed medical treatment, and barriers to necessary services and programs. The report was issued in response to President Biden’s Executive Order 13985, Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, which seeks to increase access to government services to address barriers in federal programs and services. This is the first such report HHS has issued since 2016. The report is also in line with Executive Order 14012, Restoring Faith in Our Legal Immigration Systems and Strengthening Integration and Inclusion Efforts for New Americans, which directed the Federal Government to develop welcoming strategies to promote integration and inclusion and embrace the full participation of the newest Americans, many of whom come with LEP, in our democracy. In addition, earlier this year, OCR relaunched the Department’s Language Access Steering Committee.  This first annual report summarizes the Department’s progress to date and charts a course to increase meaningful language access across the Department.

*People using assistive technology may not be able to fully access information in this file. For assistance, contact the HHS Office for Civil Rights at (800) 368-1019, TDD toll-free: (800) 537-7697, or by emailing OCRMail@hhs.gov.

Medicaid Unwinding

HHS Reminds States of Legal Obligations to Federal Civil Rights Protections as States Transition from Medicaid Continuous Coverage Changes as the Public Health Emergency Ends – April 5, 2023

OCR has issued a letter, reminding states of their obligations under federal civil rights laws as the Public Health Emergency for COVID-19 and the continuous Medicaid coverage comes to an end, and states restart Medicaid and Children’s Health Insurance Program (CHIP) eligibility reviews.  The Families First Coronavirus Response Act (FFCRA) allowed for continuous Medicaid and CHIP coverage during the COVID-19 Public Health Emergency.  The expiration of this requirement presents the single largest health coverage transition event since the first open enrollment period of the Affordable Care Act.  As a result of the Consolidated Appropriations Act, 2023, this continuous enrollment condition ended March 31, 2023; states must, over time, return to normal eligibility and enrollment operations, in a process referred to as “unwinding.” As states begin unwinding, they are communicating with individuals and families to receive more information to make a coverage decision, provide information on eligibility and marketplace plans, and send people a renewal letter in the mail. Most children can still be covered through the Children’s Health Insurance Program.  The letter makes clear that states have independent obligations under federal civil rights laws to ensure that individuals and families continue to have access to Medicaid and Children’s Health Insurance Program coverage upon the expiration of the FFCRA continuous enrollment condition.

LEP Resources

  •  Title VI: Language Access During the COVID-19 Pandemic & Other Health Emergencies: Training for Recipients of Federal Financial Assistance (Department of Homeland Security, HHS Office for Civil Rights, and FEMA) - January 25 and February 2, 2023 - View the training
  • Revised HHS LEP Guidance
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