2055 Limited English Proficiency & Sensory Impairment

Georgia State Seal

Georgia Division of Aging Services
Administrative Manual

Chapter:

2050 Basic Considerations for Recipients of Services

Effective Date:

12/05/2023

Section Title:

Limited English Proficiency & Sensory Impairment

Reviewed or Updated in:

MT 2024-02

Section Number:

2055

Previous Update:

MT 2019-03

Summary Statement

Georgia Department of Human Services Division of Aging Services policy and procedures for Limited English Proficient (LEP) and Sensory Impaired (SI) Customers provides structure and requirements for DAS, Area Agencies on Aging, and service providers within the aging network.

Purpose

The DHS Division of Aging Services offers communication assistance by securing and utilizing interpreters, translators and other necessary communicative resources when serving LEP and SI customers. In all situations, language and other communication assistance is administered in accordance with the DHS’s Access Plan for Constituents with Limited English Proficiency (LEP) and Sensory Impairments (SI) MAN 2001.

The Division of Aging Services is responsible for implementing the DHS Language Access for Limited English Proficient and Sensory Impaired Customers Policy #1701. Area Agencies on Aging are responsible for providing meaningful access to LEP/SI customers as independent entities receiving federal funding and as contractors with the Division of Aging Services. Provider agencies are responsible as independent entities receiving federal funding and through their subcontractor relationship with the Division of Aging Services.

Definitions

Auxiliary Aids and Services – Includes but is not limited: to qualified sign language interpreters, telephone handset amplifiers, assistive listening devices, closed caption decoders, real time captioning, TTY/TTD relay services for deaf and hard-of-hearing, screen reader software, Braille Embossers, text to Braille converter, large print materials, alternative keyboards for individual who are blind and have low vision.

Constituents – Refers to individuals, families, clients, consumers, and all persons seeking, receiving, or providing assistance or services.

Interpretation – The act of listening to communication in ones language (source language) and orally converting it to another language (target language) while retaining the same meaning. Interpreting is the process of understanding and analyzing a spoken or signed message and re-expressing that message effectively, accurately, and impartially in another language, using any necessary specialized vocabulary, taking the social and cultural context into account.

Language – Refers to the method by which an individual communicates with another and includes languages other than English and generally accepted means of communication used by customers with sensory impairments.

Limited English Proficient – Refers to persons who do not speak English as their native/primary language and who have a limited ability to read, speak, write or understand English.

Meaningful Access - Meaningful access to programs and services is the standard of access required of federally funded entities to comply with language access requirements of Title VI of the Civil Rights Act of 1964. Meaningful access is accomplished by providing individuals with LEP with reasonable, timely, appropriate, accurate and effective language assistance services (qualified, competent interpreters and translated materials) at no charge when accessing DHS’s programs and activities. Language assistance services are meaningful when they are “provided at a time and place that avoids the effective denial of the service, benefit, or right at issue or the imposition of an undue burden on or delay in important rights, benefits, or services to the LEP person.” DOJ LEP Guidance at 41461

Mystery Shopper - Person selected by DHS to call or visit offices, posing as an LEP customer seeking access to programs and services for the purpose of collecting information about the office’s compliance with civil rights (e.g., collecting information on whether the office offered and provided free language access to programs and services).

Sensory Impaired - Refers to individuals who are deaf, deafened and hard of hearing, blind, low vision or deaf and blind, or have manual impairments and/or speech impairments.

The following links to DHS and federal sources explain the requirement for members of Georgia’s Aging Network (DAS, AAAs, and providers) to offer interpretation and translation services free-of-charge to consumers and, as appropriate, their caregivers.

DHS Policy 2001
“The policy of DHS is to provide meaningful access to constituents with LEP and equally effective communication for constituents with vision, hearing or speech disability (SI) within all programs and activities conducted or supported by the department.”

Americans with Disabilities Act, Title II

Part A - Prohibition Against Discrimination and Other Generally Applicable Provisions

Sec. 12132. Discrimination
“Subject to the provisions of this subchapter, no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of services, programs, or activities of a public entity, or be subjected to discrimination by any such entity.”

Excerpt from Limited English Proficiency (LEP): A Federal Interagency Website www.lep.gov/:

Q: “What is Executive Order 13166?

“A: An Executive Order is an order given by the President to federal agencies. The LEP Executive Order (Executive Order 13166) says that people who are LEP should have meaningful access to federally conducted and federally funded programs and activities.

Q: What is a recipient of federal financial assistance?

“A: Federal financial assistance includes grants, training, use of equipment, donations of surplus property, and other assistance. Subrecipients are also covered, when federal funds are passed from one recipient to a subrecipient. Recipients of federal funds range from state and local agencies, to nonprofits and other organizations. A list of the types of recipients and the agencies funding them can be found at Executive Order 12250 Coordination of Grant Related Civil Rights Statutes.

“Title VI covers a recipient’s entire program or activity. This means all parts of a recipient’s operations are covered. This is true even if only one part of the recipient receives the federal
assistance.

Relevant laws include the following:

Limited English Proficiency:
Title VI of the Civil Rights Act of 1964, 42 U.S.C. Section 2000d.et. seq.

Sensory Impairment:

  • Section 504 of the Rehabilitation Act of 1973

  • Title II of the Americans with Disabilities Act of 1990 (ADA)

The Older Americans Act of 1965, as Amended in 2006, sets forth the following standards for delivering services and information to Limited English Proficient individuals:

  • Section 307 (State Plans): See 15 (A), (B), and 16 (A)

  • Section 321 (Supportive Services and Senior Centers Program Authorized): See (a)(3)

Needs Assessment

The DHS Division of Aging Services must conduct routine assessments of need at least every five years considering at a minimum the following four factors:

  • The number or proportion of LEP persons eligible to be served or likely to be encountered within the area served by DAS, AAAs, and providers

  • The frequency at which LEP persons come in contact with the program, benefits, services or activity.

  • The Nature and importance of the program, benefits, service, or activity to the LEP person. The more important the program, or the greater the possible consequences of the contact to the LEP persons, the more likely language services are needed.

  • The resources that are available and the costs of providing the assistance service(s).

DAS, AAAs, and providers will apply the four factors to the various kinds of contact that its offices will have with the public to assess language needs and will decide what reasonable steps it should take to ensure meaningful access for LEP persons

A copy of the DHS Language Access Self-Assessment of Need Survey can be found in MAN 2001 attachment 1. However, the survey will be conducted through the DHS online form located in the DHS LEP/SI SharePoint site which can be found at:
forms.office.com/g/wMC9gZwPwk

For SI access, DAS, AAAs, and Providers must conduct routine self-evaluation of need at least every five years. See the ADA Tool Kit: Chapter 3, Addendum Checklist.

Demographic Data

In conjunction with the self-assessment of need, demographic data of LEP and SI constituents for the state of Georgia will be produced by DHS at least every 5 years based on U.S. Census data, at minimum, to determine language access needs throughout the state for LEP constituents and disability access needs for SI constituents. Census data can be found in MAN 2001 Attachment 2.

Training and Technical Assistance

New DAS employees are to receive a copy of LEP/SI customer service guidelines and a link to LEP/SI Training on DHS' Learning Management System (LMS) within two weeks of their start date. They are to complete the training within two weeks from the date of receiving the link.

DAS will offer basic LEP/SI training (either in-person or online) to DAS employees on at least an annual basis. Additionally, DAS will offer online basic LEP/SI training developed for AAA staff and providers on at least an annual basis. Basic LEP/SI training includes, but is not limited to, the following:

  • Legal Authority

  • Procedures

  • Quality Control

  • Documentation

Each AAA must designate a Language Access Coordinator to receive DAS LEP/SI resources and training, provide PSA-level technical assistance, and offer training to AAA staff and providers as needed. The DAS Statewide Language Access Coordinator will provide resources, customized training, and technical assistance to AAA Language Access
Coordinators as needed.

Service Delivery

Providing Notice

A Notice of Free Interpretation Services must be posted in the reception area of all DAS offices statewide and in the reception area of each Area Agency on Aging. This notice informs the public of DHS’s Language Access policy to provide free interpretation services (in the major languages spoken in Georgia, Sign Language and Braille). Notices are available through the DAS Statewide Language Access Coordinator or the DHS LEP/SI Office.

Services may be delivered to LEP/SI customers by Departmental employees, Area Agencies on Aging, or providers. All entities are required to provide meaningful access to service recipients and their qualified caregivers as described below.

Identifying LEP/SI Customers

Individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English can be limited English proficient, or "LEP." These individuals may be entitled to language assistance with respect to a particular type or
service, benefit, or encounter.

Source: Commonly Asked Questions and Answers Regarding Limited English Proficient (LEP) Individuals – www.LEP.gov (retrieved 8/22/18)

The term “disability” means, with respect to an individual

  1. A physical or mental impairment that substantially limits one or more major life activities of such individual;

  2. A record of such impairment

  3. Being regarded as having such an impairment

Source: Americans with Disabilities Act, Sec. 12102. Definition of disability

The constituent’s primary language, method of communicating and special needs should be identified at all constituent contact points. DAS staff are to use qualified bilingual staff when available, the DHS “I Speak” flash card (see Attachment 3 of MAN 2001), or the appropriate qualified language interpretation vendors to identify the language assistance needs of LEP persons. (DHS staff refer to Attachment 6 of MAN 2001 for state-contracted vendors.) Identification also can be accomplished in one of the following ways:

  • Self-identification by the non-English speaker, LEP individual or companion.

  • Reviewing records of past Department.

  • Asking open-ended questions to determine whether the individual understand and/or respond in English or need an auxiliary aid or service.

  • Asking the individual if he or she can speak English, their primary language, or preferred method of communication.

    LEP individuals may be competent in English for certain purposes (e.g., speaking), but still be LEP for certain types of communication (e.g., reading, writing, or discussing medical, legal, or other complicated or highly specialized topics)

Providing Language Assistance

Interpreters and/or assistive technology and adaptive equipment are used in the following situations when:

  • Requested by a customer

  • Requested by a service provider of a LEP/SI customer

  • Necessary to establish or maintain a customer’s eligibility for DHS or Older Americans Act programs or services

  • Interpreter services are necessary to access public meetings sponsored by DHS or those under contract to DHS, including Area Agencies on Aging

  • Necessary for the customer to access any service funded directly or indirectly by DHS, including through Area Agencies on Aging and provider agencies.

DAS, AAA, and Provider staff are to respond affirmatively to LEP constituents that request language assistance services and SI constituents that request auxiliary aids or services or offer these services in advance if staff identifies a communication issue during the intake process.

Communication Assistance Resources

Language assistance services include qualified oral interpreters for languages other than English and written translations in other languages. Auxiliary aids and services include, but are not limited to, American and other sign language interpreters, materials in Braille and large print, and assistive listening devices.

In all situations, DHS, its local agencies, and subrecipients will provide competent interpreters, translators, and other communication assistance in a timely manner and at no-cost to DHS constituents. If language assistance services and auxiliary aids and services are not secured, staff must document all attempts made to obtain an interpreter or provide the requested auxiliary aid or service for the LEP/SI constituent.

For a list of state contracted vendors, please see Attachment 6.

The DAS & DCSS LEP/SI Service Delivery Checklist is distributed and utilized by offices to provide meaningful access to constituents with LEP and equal opportunity for constituents with SI. Please see Attachment 7, of MAN 2001 for the DAS & DCSS LEP/SI Service Delivery Checklist.

Providing Language Assistance for Constituents with LEP

Interpretation Services are provided through three primary resources:

  • Qualified telephone interpretation services

  • Professional, qualified on-site, in-person interpreters

  • Video Remote Interpretation (VRI)

Bilingual Staff that speak a language other than English may qualify as a bilingual employee by taking and passing a language proficiency test offered by the contracted language testing vendor. Staff that qualify as bilingual employees and receive the Bilingual TSS may communicate directly with the LEP constituent in his/her native language to provide meaningful access to services and programs.

Use of Family and Friends as Interpreters is allowed, however, DHS and its subrecipients cannot require a person to bring someone to interpret for him or her and cannot require the constituent to use the free interpretation services. A companion may interpret for a person with LEP in only two situations:

  • In an emergency involving an imminent threat to the safety or welfare of a constituent or the public, an adult or minor child accompanying a person may be relied upon to interpret or facilitate communication only when a qualified interpreter is not available.

  • In situations not involving an imminent threat, an accompanying adult who is able to interpret may be relied upon to interpret or facilitate communication when a) the constituent requests this, b) the accompanying adult agrees, and c) reliance on the accompanying adult is appropriate under the circumstances. This exception does not apply to minor children.

Nonetheless, DHS and its subrecipients are discouraged from using family or friends as interpreters. If a LEP person desires to use family or a friend as an interpreter based on the above conditions, they must do so at their own expense and only after staff remind the constituent that a qualified interpreter is available free of charge. When a constituent decides to use his/her own interpreter, staff must utilize either an on-site or telephone interpreter to observe communication or to listen in, respectively, to ensure accurate interpretation from the constituent’s own interpreter. If issues of competency, confidentiality, or conflict occur on the part of the constituent provided interpreter, staff must secure a qualified interpreter to assume interpretation responsibilities, even if an LEP person wants to use his or her own interpreter.

Translation

Vital documents and information on websites and online systems (i.e., online applications), must be translated either in writing or orally into languages needed by constituents. When translating documents, a qualified, competent translator must be used. Translation request shall be directed to the DAS LEP/SI Coordinator who will submit documents to a state contracted vendor for translation.

Copies of documents in languages other than English must be available to the public. These are generally documents, forms, and brochures such as applications, and consent forms.

Area Agencies on Aging and providers are independently responsible for the costs of translating local materials. They may use qualified professional translators of their choice; however, DAS strongly encourages them to use the services of State- approved vendors. Some vendors may extend State rates to Area Agencies on Aging and providers.

Providing Equally Effective Communication for Constituents with SI

DAS, AAAs and services providers must ensure that communication with constituents with SI is equally effective as communication with people without SI. Primary consiteration for the type of auxiliary aid or service is given to the person with SI. If the choice expressed by the person with SI would result in an undue burden or a fundamental alteration, there is still an obligation to provide another aid or service that provides effective communication, if possible, that would not result in an undue burden.

The decision that a particular aid or service would result in an undue burden must be made by a member of DHS leadership, DAS leadership at minimum, and must include a written statement of the reasons for reaching that conclusion.

DAS, AAAs, provider agencies and public accommodations must:

  • Notify constituents with SI about the availability of reasonable modifications and auxiliary aids and services and how to request them in a format that they can understand.

  • Provide auxiliary aids and services when needed to communicate effectively with constituents with SI at no cost to them unless doing so would result in a fundamental alteration.

  • Take into consideration the nature, length, and complexity of the communication, as well as the constituent’s normal method(s) of communication when choosing an auxiliary aid or service.

  • Use qualified interpreters and not require an individual with SI to bring another individual with them to interpret e.g., sign language interpreters.

  • Limit the use of adult or minor child as interpreters to emergency situations involving an imminent threat to the safety of welfare of a constituent or the public when a qualified interpreter is not available.

  • Only use an accompanying adult as an interpreter when a constituent requests this, the accompanying adult agrees to interpret, and reliance on the accompanying adult is appropriate under the circumstances.

  • Require reasonable advance notice from constituent requesting aids or services, based on the length of time needed to acquire the aid or service but may not impose excessive advance notice requirements.

  • Honor “walk-in” requests for aids and services to the extent possible.

  • Ensure Video Remote Interpreting (VRI) technologies meet ADA performance standards (28 C.F.R. 35 and 28 C.F.R. 36.303(f).

  • Accept telephone calls placed through TRS and VRS, and staff who answer the telephone must treat relay calls just like other calls.

  • Train frontline staff on the requirements for communicating effectively with constituents with SI.

The Division of Aging Services, Area Agencies on Aging, and service providers are encouraged to use Georgia Relay, a free state-funded service, for TDD/TTY calls with the deaf and hard of hearing. See Attachment 11, of MAN 2001, for a description of how to use the GA Relay Service, which is available for incoming and outgoing calls.

Communication with the visually impaired is generally through voice, Braille, large print, email (if they have accessibility software and screen-read devices), storage media, and other computer accessories.

Reporting and Monitoring

Reporting

DHS Division of Aging Services employees are required to provide the following information to the DAS Statewide Language Access Coordinator upon request:

  • Number of LEP/SI clients served

  • Types of language assistance provided

The Division of Aging Services recommends that Area Agencies on Aging keep the above information on record in clients' DAS Data System (DDS) files and in separate reports.

Monitoring

LEP/SI services provided by DHS employees are subject to DHS monitoring.

LEP/SI services provided by Area Agencies on Aging are monitored by the DAS Statewide Language Access Coordinator in coordination with DAS Regional Coordinators. Each Area Agency on Aging is required to perform the following activities:

  • Designate a Language Access Coordinator to provide AAA technical assistance and training

  • Post the Notice of Free Interpretation Services and related signage in the building’s public waiting area. Also attempt to inform customers orally, or by other means, of the right to free interpretation services.

  • Provide LEP/SI customers with timely access to certified interpreters or other forms of communications assistance, free of charge.

  • Provide LEP/SI customers with professionally translated key forms and documents, as needed.

  • Maintain quarterly records of language assistance provided.

  • Include demographic information and language assistance strategies in the Area Plan, as described in the “Planning” section.

Complaint Resolution

The Division of Aging Services and Area Agencies on Aging must follow Grievance Procedures for Participants in Non-Medicaid Home and Community- Based Services Programs, found in DAS Manual 5300, Chapter 110.

If a LEP/SI customer or his/her alleges discrimination based on prohibited areas, the complainant must be informed of their right to file a discrimination complaint with the appropriate federal agency. The complainant als must be advised of confidentiality and Privacy Act requirements. Written, oral and anonymous complaints must be accepted. If the LEP/SI constituent wishes to file a verbal complaint, the constituent can contact the DHS LEP/SI office at (404) 657-5244.

Forms and Documents

Notice of Nondiscrimination in Services must be posted in DAS offices. English and Spanish Notices can be found in MAN 2001 attachments 15 and 16 respectively.

The process, in both English and Spanish, for filing a Discrimination Complaint can be found in MAN 2001, attachments 19 and 20 respectively.

References

Refer to the following Attachments in MAN 2001:

Attachment 1-DHS Language Access Self-Assessment of Need
Attachment 2-Census-Language Spoken at Home
Attachment 3-I Speak Flashcard
Attachment 4-DAS & DCSS Guide for Providing Meaningful Access and Effective Communication to LEPSI Constituents
Attachment 6-Interpretation-Translation Service Vendors
Attachment 7-DAS & DCSS LEP/SI Service Delivery Checklist
Attachment 9-Tips for Using an Interpreter
Attachment 10-Translation Request Procedure
Attachment 11-GA Relay Services How to Guide
Attachment 12-Standards and Qualifications for Interpreters and Translators
Attachment 13-Language Access/SI Vendor Feedback Form and Instructions
Attachment 14-Notice of Free Interpretation Services Poster
Attachment 15-DAS & DCSS Notice of Non-discrimination in Services
Attachment 16-DAS & DCSS Notice of Non-discrimination in Services-Spanish
Attachment 19-DAS & DCSS Discrimination Complaint Process
Attachment 20-DAS & DCSS Discrimination Complaint Process-Spanish
Attachment 21-DAS & DCSS Discrimination Complaint Form
Attachment 22-DAS & DCSS Discrimination Complaint Form-Spanish