**GAO-08-535**                      Published: May 28, 2008. Publicly Released: May 28, 2008.                  

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## Highlights

The Department of Veterans Affairs (VA) faces challenges in bridging language and cultural barriers as it seeks to provide quality health care services to an increasingly diverse veteran population in terms of race, ethnicity, sex, and age. To meet the needs of veterans with limited English proficiency (LEP), VA issued an LEP Directive that provides guidance for medical centers in assessing language needs and, if needed, developing language access services designed to ensure effective communication between English-speaking providers and those with LEP. In addition, VA is also challenged to deliver health care services in ways that are culturally appropriate--that is, respectful of and responsive to the cultural values of a diverse veteran population. In light of these challenges, GAO was asked to discuss the (1) actions VA has taken to implement its LEP Directive and the status of veterans' utilization of language access services, and (2) efforts VA has made to provide culturally appropriate health care services. GAO reviewed VA's policies and the LEP Directive, interviewed VA officials and reviewed efforts by 6 VA medical centers and 10 other VA facilities to implement VA's LEP Directive and to provide culturally appropriate health care services. GAO also reviewed documents from 17 other VA medical centers related to implementation of the LEP Directive.

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## Topics

Veterans

Access to health careDiversity managementEmployee developmentEmployee trainingForeign languagesHealth care facilitiesHealth care programsHealth care servicesHealth centersHospital care servicesMilitary health servicesMinoritiesOn-the-job trainingPatient care servicesTraining utilizationVeteransVeterans benefitsVeterans hospitalsCultural awareness