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Posted on 12.08.2016

Translated Resources for Health Programs

In May 2016 the U.S. Department of Health & Human Services (HHS) issued its final rule to advance health equity and reduce health care disparities under Section 1557 of the Affordable Care Act. The Nondiscrimination in Health Programs and Activities final rule prohibits discrimination based on race, color, national origin, sex, age or disability; enhances language assistance for individuals with limited English proficiency; and protects individuals with disabilities.

That “enhancing language assistance” part alone, it turns out, can be quite the daunting challenge to implement for covered entities – at least from this communicator’s perspective.

First, let’s clarify what’s considered – for these purposes – a covered entity. They include:

  • Any health program or activity any part of which receives HHS funding
  • Any health program or activity that HHS itself administers
  • Health Insurance Marketplaces and all plans offered by issuers that participate in those Marketplaces.

So that’s a lot of organizations!


Under the Section 1557 final rule, covered entities are required to post a notice of individuals’ rights with a tagline that indicates the availability of language assistance for individuals with limited English proficiency. Additionally, this tagline must be posted in at least the top 15 languages spoken by individuals with limited English proficiency in that state.

So consider an organization with operations in 40 states. The top 15 languages in Tennessee are not the same as the top 15 languages in Arizona, or Connecticut, etc., etc. Those of you who’ve managed production on projects requiring customization are tracking with me now, right?

One approach to this challenge could be to develop state-specific notices of individuals’ rights that include the tagline in that state’s top 15 languages. Another might be to develop notices that encompass all 64 non-English languages – yes, friends, I said 64 – triggered by the new standard.

Independent of the tagline requirement, covered entities are also responsible for providing timely and accurate language assistance services, such as oral interpretation and written translation, in non-English languages (even if the language is not shown on the Office of Civil Rights’ list) when doing so is a reasonable step to provide meaningful access to an individual with limited English proficiency.

To be clear, I do not for a moment question that taking steps to protect the civil rights of individuals is anything other than the right thing to do! My point is simply that it does present an interesting logistical challenge for communicators.

Fortunately, those good folks from the government are here to help! Take advantage of these resources as you work to ensure you’re meeting the new translated resources requirements.


State lists. The HHS Office for Civil Rights has posted the top 15 languages by state. In Tennessee, for example, they are:

1. Spanish
2. Arabic
3. Chinese
4. Vietnamese
5. Korean
6. French
7. Laotian
8. Amharic
9. German
10. Gujarati
11. Japanese
12. Tagalog
13. Hindi
14. Russian
15. Persian (Farsi)

Who knew?


Sample resources. HHS has also posted a sample notice of nondiscrimination, statement of nondiscrimination and tagline in English and 64 non-English languages triggered by the new standard. Each document is available as a PDF and a Word template.

The tagline, for instance, is: ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Call 1-xxx-xxx-xxxx (TTY: 1-xxx-xxx-xxxx).

Or to put that in Tagalog – #12 on Tennessee’s list of 15: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-xxx-xxx-xxxx (TTY: 1-xxx-xxx-xxxx).

Learn more about protections for individuals with limited English proficiency here or check out these frequently asked questions about Section 1557 and its languages provision.

Is there a communicator somewhere in your organization dealing with this challenge? If so, a kind word and a big “thank you” are likely in order as they work to help keep your organization compliant and accommodating for individuals with limited English proficiency.


Dana Coleman is a Vice President at Lovell Communications. Connect with Dana here: Dana@lovell.com.

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