‘‘(25) TRANSLATION.—The term ‘translation’ 
means the transmission of a written message in one 
language into a written message in another lan-
guage. 
‘‘(26) VIDEO
INTERPRETATION.—The term 
‘video interpretation’ means a method of inter-
preting/interpretation for which the interpreter is 
not in the physical presence of the provider of health 
care or related services and the limited English pro-
ficient recipient of such services but is connected via 
a video hook-up that includes both audio and video 
transmission. 
‘‘(27) VITAL DOCUMENT.—The term ‘vital doc-
ument’ includes but is not limited to applications for 
government programs that provide health care serv-
ices; medical or financial consent forms; financial as-
sistance documents, letters containing important in-
formation regarding patient instructions (e.g., pre-
scriptions, referrals to other providers, discharge 
plans) and participation in a program (such as a 
Medicaid managed care program); notices pertaining 
to the reduction, denial or termination of services or 
benefits; notices of the right to appeal such actions; 
and notices advising limited English proficient indi-
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viduals of the availability of free language services, 
and other outreach materials. 
‘‘SEC. 3101. IMPROVING ACCESS TO SERVICES FOR INDIVID-
UALS WITH LIMITED ENGLISH PROFICIENCY. 
‘‘(a) PURPOSE.—As provided in Executive Order 
13166, it is the purpose of this section— 
‘‘(1) to improve Federal agency performance re-
garding access to federally conducted and federally 
assisted programs and activities for individuals who 
are limited in their English proficiency; 
‘‘(2) to require each Federal agency to examine 
the services it provides and develop and implement 
a system by which limited English proficient individ-
uals can obtain meaningful access to those services 
consistent with, and without substantially burdening, 
the fundamental mission of the agency; 
‘‘(3) to require each Federal agency to ensure 
that recipients of Federal financial assistance pro-
vide meaningful access to their limited English pro-
ficient applicants and beneficiaries; 
‘‘(4) to ensure that recipients of Federal finan-
cial assistance take reasonable steps, consistent with 
the guidelines set forth in the Limited English Pro-
ficient Guidance of the Department of Justice (as 
issued on June 12, 2002), to ensure meaningful ac-
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cess to their programs and activities by limited 
English proficient individuals; and 
‘‘(5) to ensure compliance with title VI of the 
Civil Rights Act of 1964 and that health care pro-
viders and organizations do not discriminate in the 
provision of services. 
‘‘(b) FEDERALLY CONDUCTED PROGRAMS AND AC-
TIVITIES.— 
‘‘(1) IN GENERAL.—Not later than 120 days 
after the date of enactment of this title, each Fed-
eral agency that carries out health care-related ac-
tivities shall prepare a plan to improve access to the 
federally conducted health care-related programs 
and activities of the agency by limited English pro-
ficient individuals. Each Federal agency must ensure 
that such plan is fully implemented not later than 
one year after the date of enactment of this Act. 
‘‘(2) PLAN REQUIREMENT.—Each plan under 
paragraph (1) shall include— 
‘‘(A) the steps the agency will take to en-
sure that limited English proficient individuals 
have access to the agency’s federally conducted 
health care and health care-related programs 
and activities; 
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‘‘(B) the policies and procedures for identi-
fying, assessing, and meeting the language 
needs of its limited English proficient bene-
ficiaries served by federally conducted programs 
and activities; 
‘‘(C) the steps the agency will take for its 
federally conducted programs and activities to 
provide a range of language assistance options, 
notice to limited English proficient individuals 
of the right to competent language services, 
periodic training of staff, monitoring and qual-
ity assessment of the language services and, in 
appropriate circumstances, the translation of 
written materials; 
‘‘(D) the steps the agency will take to en-
sure that applications, forms, and other rel-
evant documents for its federally conducted pro-
grams and activities are competently translated 
into the primary language of a limited English 
proficient client where such materials are need-
ed to improve access to federally conducted and 
federally assisted programs and activities for 
such a limited English proficient individual; and 
‘‘(E) the resources the agency will provide 
to assist recipients of Federal funds to improve 
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access to health care or health care related pro-
grams and activities for limited English pro-
ficient individuals. 
Each agency shall send a copy of such plan to the 
Department of Justice, which shall serve as the cen-
tral repository of the agencies’ plans. 
‘‘(c) FEDERALLY ASSISTED PROGRAMS AND ACTIVI-
TIES.— 
‘‘(1) IN GENERAL.—Not later than 120 days 
after the date of enactment of this title, each Fed-
eral agency providing health care-related Federal fi-
nancial assistance shall ensure that the guidance for 
recipients of Federal financial assistance developed 
by the agency to ensure compliance with title VI of 
the Civil Rights Act of 1964 (42 U.S.C. 2000d et 
seq.) is specifically tailored to the recipients of such 
assistance. Each agency shall send a copy of such 
guidance to the Department of Justice which shall 
serve as the central repository of the agencies’ plans. 
After approval by the Department of Justice, each 
agency shall publish its guidance document in the 
Federal Register for public comment. 
‘‘(2) 
REQUIREMENTS.—The 
agency-specific 
guidance developed under paragraph (1) shall take 
into account the types of health care services pro-
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vided by the recipients, the individuals served by the 
recipients, and other factors set out in such stand-
ards. 
‘‘(3) EXISTING GUIDANCES.—A Federal agency 
that has developed a guidance for purposes of title 
VI of the Civil Rights Act of 1964 shall examine 
such existing guidance, as well as the programs and 
activities to which such guidance applies, to deter-
mine if modification of such guidance is necessary to 
comply with this subsection. 
‘‘(4) CONSULTATION.—Each Federal agency 
shall consult with the Department of Justice in es-
tablishing the guidances under this subsection. 
‘‘(d) CONSULTATIONS.— 
‘‘(1) IN GENERAL.—In carrying out this sec-
tion, each Federal agency that carriers out health 
care and health care-related activities shall ensure 
that stakeholders, such as limited English proficient 
individuals and their representative organizations, 
recipients of Federal assistance, and other appro-
priate individuals or entities, have an adequate op-
portunity to provide input with respect to the actions 
of the agency. 
‘‘(2) EVALUATION.—Each Federal agency de-
scribed in paragraph (1) shall evaluate the— 
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‘‘(A) particular needs of the limited 
English proficient individuals served by the 
agency; 
‘‘(B) particular needs of the limited 
English proficient individuals served by the 
agency’s recipients of Federal financial assist-
ance; and 
‘‘(C) burdens of compliance with the agen-
cy guidance and this section for the agency and 
its recipients. 
‘‘SEC. 3102. NATIONAL STANDARDS FOR CULTURALLY AND 
LINGUISTICALLY APPROPRIATE SERVICES IN 
HEALTH CARE. 
‘‘Recipients of Federal financial assistance from the 
Secretary shall, to the extent reasonable and practicable 
after applying the 4-factor analysis described in title V 
of the Guidance to Federal Financial Assistance Recipi-
ents Regarding Title VI Prohibition Against National Ori-
gin Discrimination Affecting Limited-English Proficient 
Persons (June 12, 2002)— 
‘‘(1) implement strategies to recruit, retain, and 
promote individuals at all levels of the organization 
to maintain a diverse staff and leadership that can 
provide culturally and linguistically appropriate 
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health care to patient populations of the service area 
of the organization; 
‘‘(2) ensure that staff at all levels and across all 
disciplines of the organization receive ongoing edu-
cation and training in culturally and linguistically 
appropriate service delivery; 
‘‘(3) offer and provide language assistance serv-
ices, including trained bilingual staff and interpreter 
services, at no cost to each patient with limited 
English proficiency at all points of contact, in a 
timely manner during all hours of operation; 
‘‘(4) notify patients of their right to receive lan-
guage assistance services in their primary language; 
‘‘(5) ensure the competence of language assist-
ance provided to limited English proficient patients 
by interpreters and bilingual staff, and ensure that 
family, particularly minor children, and friends are 
not used to provide interpretation services— 
‘‘(A) except in case of emergency; or 
‘‘(B) except on request of the patient, who 
has been informed in his or her preferred lan-
guage of the availability of free interpretation 
services; 
‘‘(6) make available easily understood patient- 
related materials, if such materials exist for non-lim-
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ited English proficient patients, including informa-
tion or notices about termination of benefits and 
post signage in the languages of the commonly en-
countered groups or groups represented in the serv-
ice area of the organization; 
‘‘(7) develop and implement clear goals, poli-
cies, operational plans, and management account-
ability and oversight mechanisms to provide cul-
turally and linguistically appropriate services; 
‘‘(8) conduct initial and ongoing organizational 
assessments of culturally and linguistically appro-
priate services-related activities and integrate valid 
linguistic competence-related measures into the in-
ternal audits, performance improvement programs, 
patient satisfaction assessments, and outcomes-based 
evaluations of the organization; 
‘‘(9) ensure that, consistent with the privacy 
protections provided for under the regulations pro-
mulgated under section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note)— 
‘‘(A) data on the individual patient’s race, 
ethnicity, and primary language are collected in 
health records, integrated into the organiza-
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tion’s management information systems, and 
periodically updated; and 
‘‘(B) if the patient is a minor or is inca-
pacitated, the primary language of the parent 
or legal guardian is collected; 
‘‘(10) maintain a current demographic, cultural, 
and epidemiological profile of the community as well 
as a needs assessment to accurately plan for and im-
plement services that respond to the cultural and 
linguistic characteristics of the service area of the 
organization; 
‘‘(11) develop participatory, collaborative part-
nerships with communities and utilize a variety of 
formal and informal mechanisms to facilitate com-
munity and patient involvement in designing and im-
plementing culturally and linguistically appropriate 
services-related activities; 
‘‘(12) ensure that conflict and grievance resolu-
tion processes are culturally and linguistically sen-
sitive and capable of identifying, preventing, and re-
solving cross-cultural conflicts or complaints by pa-
tients; 
‘‘(13) regularly make available to the public in-
formation about their progress and successful inno-
vations in implementing the standards under this 
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section and provide public notice in their commu-
nities about the availability of this information; and 
‘‘(14) if requested, regularly make available to 
the head of each Federal entity from which Federal 
funds are received, information about their progress 
and successful innovations in implementing the 
standards under this section as required by the head 
of such entity. 
‘‘SEC. 3103. ROBERT T. MATSUI CENTER FOR CULTURAL 
AND LINGUISTIC COMPETENCE IN HEALTH 
CARE. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the Agency for Healthcare Re-
search and Quality, shall establish and support a center 
to be known as the ‘Robert T. Matsui Center for Cultural 
and Linguistic Competence in Health Care’ (referred to 
in this section as the ‘Center’) to carry out the following 
activities: 
‘‘(1) INTERPRETATION SERVICES.—The Center 
shall provide resources via the Internet to identify 
and link health care providers to competent inter-
preter and translation services. 
‘‘(2) TRANSLATION OF WRITTEN MATERIAL.— 
‘‘(A) The Center shall provide, directly or 
through contract, vital documents from com-
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petent translation services for providers of 
health care and health care-related services at 
no cost to such providers. Materials may be 
submitted for translation into non-English lan-
guages. Translation services shall be provided 
in a timely and reasonable manner and in ac-
cordance with the guidelines and standards set 
forth in subsection (c) when such standards be-
come available. The quality of such translation 
services shall be monitored and reported pub-
licly. 
‘‘(B) For each form developed or revised 
by the Secretary that will be used by LEP indi-
viduals in health care or health care-related set-
tings, the Center shall translate the form, at a 
minimum, into the top 15 non-English lan-
guages in the United States according to the 
most recent data from the American Commu-
nity Survey or its replacement. The translation 
must be completed within 45 days of the Sec-
retary receiving final approval of the form from 
the Office of Management and Budget. 
‘‘(3) TOLL-FREE
CUSTOMER
SERVICE
TELE-
PHONE
NUMBER.—The 
Center 
shall 
provide, 
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through a toll-free number, a customer service line 
for LEP individuals— 
‘‘(A) to obtain information about federally 
conducted or funded health programs, including 
Medicare, Medicaid, and SCHIP; 
‘‘(B) to obtain assistance with applying for 
or accessing these programs and understanding 
Federal notices written in English; and 
‘‘(C) to learn how to access language serv-
ices. 
‘‘(4) 
HEALTH
INFORMATION
CLEARING-
HOUSE.— 
‘‘(A) IN GENERAL.—The Center shall de-
velop and maintain an information clearing-
house to facilitate the provision of language 
services by providers of health care and health 
care-related services to reduce medical errors, 
improve medical outcomes, reduce health care 
costs caused by miscommunication with individ-
uals with limited English proficiency, and re-
duce or eliminate the duplication of effort to 
translate materials. The clearinghouse shall 
make such information available on the Internet 
and in print. Such information shall include the 
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information described in the succeeding provi-
sions of this paragraph. 
‘‘(B) DOCUMENT TEMPLATES.—The Cen-
ter shall collect and evaluate for accuracy, de-
velop, and make available templates for stand-
ard documents that are necessary for patients 
and consumers to access and make educated de-
cisions about their health care, including the 
following: 
‘‘(i) Administrative and legal docu-
ments, including— 
‘‘(I) intake forms; 
‘‘(II) Medicare, Medicaid, and 
SCHIP forms, including eligibility in-
formation; 
‘‘(III) forms informing patient of 
HIPAA compliance and consent; and 
‘‘(IV) documents concerning in-
formed consent, advanced directives, 
and waivers of rights. 
‘‘(ii) Clinical information, such as how 
to take medications, how to prevent trans-
mission of a contagious disease, and other 
prevention and treatment instructions. 
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‘‘(iii) Public health, patient education, 
and outreach materials, such as immuniza-
tion notices, health warnings, or screening 
notices. 
‘‘(iv) Additional health or health care- 
related materials as determined appro-
priate by the Director of the Center. 
‘‘(C) STRUCTURE OF FORMS.—The oper-
ating the clearinghouse, the Center shall— 
‘‘(i) ensure that the documents posted 
in English and non-English languages are 
culturally appropriate; 
‘‘(ii) allow public review of the docu-
ments before dissemination in order to en-
sure that the documents are understand-
able and culturally appropriate for the tar-
get populations; 
‘‘(iii) allow health care providers to 
customize the documents for their use; 
‘‘(iv) facilitate access to these docu-
ments; 
‘‘(v) provide technical assistance with 
respect to the access and use of such infor-
mation; and 
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‘‘(vi) carry out any other activities the 
Secretary determines to be useful to fulfill 
the purposes of the clearinghouse. 
‘‘(D) 
LANGUAGE
ASSISTANCE
PRO-
GRAMS.—The Center shall provide for the col-
lection and dissemination of information on cur-
rent examples of language assistance programs 
and strategies to improve language services for 
LEP individuals, including case studies using 
de-identified patient information, program sum-
maries, and program evaluations. 
‘‘(E) CULTURAL
AND
LINGUISTIC
COM-
PETENCE MATERIALS.—The Center shall pro-
vide information relating to culturally and lin-
guistically competent health care for minority 
populations residing in the United States to all 
health care providers and health care-related 
services at no cost. Such information shall in-
clude— 
‘‘(i) tenets of culturally and linguis-
tically competent care; 
‘‘(ii) cultural and linguistic com-
petence self-assessment tools; 
‘‘(iii) cultural and linguistic com-
petence training tools; 
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‘‘(iv) strategic plans to increase cul-
tural and linguistic competence in different 
types of providers of health care and 
health care-related services, including re-
gional collaborations among health care or-
ganizations; and 
‘‘(v) cultural and linguistic com-
petence information for educators, practi-
tioners, and researchers. 
‘‘(F) INFORMATION
ABOUT
PROGRESS.— 
The Center shall regularly collect and make 
publicly 
available 
information 
about 
the 
progress of entities receiving grants under sec-
tion 3104 regarding successful innovations in 
implementing the obligations under this sub-
section and provide public notice in the entities’ 
communities about the availability of this infor-
mation; 
‘‘(b) DIRECTOR.—The Center shall be headed by a 
Director who shall be appointed by, and who shall report 
to, the Director of the Agency for Healthcare Research 
and Quality. 
‘‘(c) INTERPRETATION AND TRANSLATION GUIDE-
LINES AND STANDARDS.—The Center shall convene a 
working group to develop and adopt interpretation and 
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translation quality guidelines and standards for use by the 
Center. The guidelines and standards must be sufficient 
to ensure that LEP individuals have the equal opportunity 
to benefit from health care services to the same extent 
as non-LEP individuals. The guidelines and standards 
shall address the training, assessment and certification of 
individuals to provide competent interpreter and trans-
lator services to work in health care and health care-re-
lated settings and of bilingual staff who provide services 
directly in non-English languages. The working group may 
develop different guidelines and standards for bilingual 
staff, interpreters, and translators. 
‘‘(d) MEMBERSHIP.— 
‘‘(1) QUALIFICATIONS.—The Working Group 
shall consist of 14 members as follows: 
‘‘(A) Four members from organizations 
that advocate on behalf of LEP individuals. 
‘‘(B) One member who represents a profes-
sional interpreter association (that is not the 
National Council on Interpreting in Health 
Care) or translator association. 
‘‘(C) One member from a non-profit com-
munity based organization that provides lan-
guage services. 
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‘‘(D) Three members recommended by the 
National Council on Interpreting in Health 
Care, including one who individual who is a 
professional interpreter. 
‘‘(E) Four members who are health care 
providers or represent health care provider as-
sociations, including one individual who rep-
resents a health care practice of fewer than 5 
clinicians. 
‘‘(F) One member who works in or has ex-
tensive knowledge of issues related to health 
care risk management. 
‘‘(2) 
GEOGRAPHIC
REPRESENTATION.—The 
membership of the Working Group shall reflect a 
broad geographic representation including both 
urban and rural representatives, including represent-
atives of the United States territories. 
‘‘(3) PROHIBITED
APPOINTMENTS.—Members 
of the Working Group shall not include Members of 
Congress or other elected Federal, State, or local 
government officials. 
‘‘(4) VACANCIES.—Any vacancies in the Work-
ing Group shall not affect the power and duties of 
the Working Group but shall be filled in the same 
manner as the original appointment. 
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‘‘(5) SUBCOMMITTEES.—The Working Group 
may establish subcommittees if doing so increases 
the efficiency of the Working Group in completing 
its tasks, including subcommittees to develop dif-
ferent guidelines and standards for interpreters, 
translators, and bilingual staff. 
‘‘(6) ADVISORY
PANEL
TO
THE
WORKING 
GROUP.—The Working Group shall consult with the 
Advisory Panel in the development of the guidelines 
and standards. The Advisory Panel shall include— 
‘‘(A) representatives from the American 
Translators Association, Association of Lan-
guage Companies, the National Center for 
State Courts, and States which have developed 
interpreter standards such as California, Mas-
sachusetts and Oregon who have experience in 
the development or implementation of their or-
ganizations’ interpreter and translator certifi-
cation programs; 
‘‘(B) Federal agencies including the Office 
for Civil Rights, the Office of Minority Health, 
and the Centers for Medicare & Medicaid Serv-
ices and the National Center on Minority 
Health and Health Disparities; and 
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‘‘(C) other individuals or entities deter-
mined appropriate by the Secretary who have 
specific expertise that will be useful to the 
Working Group. 
‘‘(7) PUBLICATION.— 
‘‘(A) DRAFT STANDARDS.—Not later than 
18 months after the date of enactment of this 
title, the Working Group shall— 
‘‘(i) prepare and make available to the 
public through the Internet, the Federal 
Register, and other appropriate public 
channels, a proposed set of interpretation 
and translation guidelines and standards 
for training, assessment, and certification; 
and 
‘‘(ii) accept public comment on such 
guidelines and standards for a period of 
not less than 90 days. 
‘‘(B) FINAL STANDARDS.—Not later than 
120 days after the expiration of the public com-
ment period described in subparagraph (A), the 
Director of the Agency for Healthcare Research 
and Quality shall publish, after consultation 
with and the approval of the Working Group, 
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final guidelines and standards in the Federal 
Register and on the Internet. 
‘‘(C) TESTING DEVELOPMENT.—Not later 
than 120 days after the publication of the final 
recommendations described in subparagraph 
(B), the Director of the Agency for Healthcare 
Research and Quality shall, if deemed necessary 
by the Working Group, enter into a contract 
with an entity experienced in the development 
of designing certification tests in language re-
lated fields to develop such tests as may be nec-
essary to implement the guidelines and stand-
ards. 
‘‘(D) PILOT PROJECT.— 
‘‘(i) Not later than 120 days after 
completion of the test development de-
scribed in subparagraph (C) or after publi-
cation of the final guidelines and stand-
ards, whichever is later, the Secretary shall 
design, fund, and implement a pilot project 
in up to 50 geographically and demo-
graphically diverse sites, two of which must 
be in the U.S. territory, to test and evalu-
ate implementation of the recommenda-
tions. 
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‘‘(ii) The Secretary shall consult with 
the Working Group and the Advisory 
Panel in development of the pilot project 
and report progress to the Working Group 
on an ongoing basis. 
‘‘(iii) The pilot project shall include 
interpreters and translators working with 
various provider types, including small 
group practices, hospitals, and community 
health clinics, and shall include broad geo-
graphic 
representation 
including 
both 
urban and rural representatives. 
‘‘(iv) The pilot project shall operate 
for not less than two nor more than four 
years, as determined by the Secretary. 
‘‘(v) If the Working Group determines 
that any revisions to guidelines and stand-
ards are necessary as a result of the pilot 
project, it shall revise such guidelines and 
standards and the Director of the Agency 
for Healthcare Research and Quality shall 
publish the revisions in the Federal Reg-
ister for notice and comment. Not later 
than 120 days after the expiration of the 
public comment period on such revisions, 
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the Director of the Agency for Healthcare 
Research and Quality shall publish, after 
consultation with and the approval of the 
Working Group, final revisions to the 
guidelines and standards in the Federal 
Register and on the Internet. 
‘‘(8) ADMINISTRATION.— 
‘‘(A) CHAIRPERSON.—Not later than 15 
days after the date on which all members of the 
Working Group have been appointed under sub-
section (d), the Working Group shall designate 
its chairperson. 
‘‘(B) COMPENSATION.—While serving on 
the business of the Working Group (including 
travel time), a member of the Working Group 
or the Advisory Panel shall be entitled to com-
pensation at the per diem equivalent of the rate 
provided for level IV of the Executive Schedule 
under section 5315 of title 5, United States 
Code, and while so serving away from home and 
the member’s regular place of business, a mem-
ber may be allowed travel expenses, as author-
ized by the chairperson of the Working Group. 
For purposes of pay and employment benefits, 
rights, and privileges, all personnel of the 
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Working Group shall be treated as if they were 
employees of the House of Representatives. 
‘‘(C) INFORMATION FROM FEDERAL AGEN-
CIES.—The Working Group may secure directly 
from any Federal department or agency such 
information as the Working Group considers 
necessary to carry out this section. Upon re-
quest of the Working Group, the head of such 
department or agency shall furnish such infor-
mation. Any information that contains individ-
ually identifiable information received by the 
Working Group shall not be disseminated or 
disclosed outside of the Working Group and 
shall not be used except by the Working Group. 
‘‘(D) DETAIL.—Not more than 10 Federal 
Government employees employed by the Depart-
ment of Health and Human Services may be 
detailed to staff the Working Group under this 
section without further reimbursement. Any de-
tail of an employee shall be without interruption 
or loss of civil service status or privilege. 
‘‘(E) TEMPORARY
AND
INTERMITTENT 
SERVICES.—The Working Group may procure 
temporary and intermittent services under sec-
tion 3109(b) of title 5, United States Code, at 
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rates for individuals which do not exceed the 
daily equivalent of the annual rate of basic pay 
prescribed for level V of the Executive Schedule 
under section 5316 of such title. 
‘‘(F) 
AUTHORIZATION
OF
APPROPRIA-
TIONS.—There are authorized to be appro-
priated to carry out this section such sums as 
may be necessary for the activities of the Work-
ing Group and Advisory Panel for each of fiscal 
years 2010 through 2014, and for the funding 
of the pilot project. 
‘‘(9) DEEMED STATUS.— 
‘‘(A) CERTIFICATION BY PRIVATE ORGANI-
ZATION.—If a private accreditation organization 
establishes training, assessment, or certification 
standards for interpreters or translators in 
health care which the Secretary determines are 
at least equivalent to the training, assessment, 
or certification standards promulgated by the 
Secretary as described in subsection (c), the 
Secretary shall find that all organizations or in-
dividuals accredited by such organization com-
ply also with the standard described in sub-
section (c) if— 
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‘‘(i) such organization or individual 
authorizes the organization to release to 
the Secretary upon the Secretary’s request 
(or such State agency as the Secretary 
may designate) a copy of the most current 
accreditation survey of such organization 
or individual made by the organization, to-
gether with any other information directly 
related to the survey as the Secretary may 
require (including corrective action plans); 
and 
‘‘(ii) such organization releases such a 
copy and any such information to the Sec-
retary. 
‘‘(B) CERTIFICATION BY A STATE OR LO-
CALITY.—If a State or locality has or estab-
lishes training, assessment, or certification 
standards for interpreters or translators in 
health care which the Secretary determines are 
at least equivalent to the training, assessment, 
or certification standards promulgated by the 
Secretary as described in subsection (c), the 
Secretary shall find that all organizations or in-
dividuals accredited by such State or locality 
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comply also with the standard described in sub-
section (c) if— 
‘‘(i) such organization or individual 
authorizes the State or locality to release 
to the Secretary upon his request (or such 
State agency as the Secretary may des-
ignate) a copy of the most current accredi-
tation survey of such organization or indi-
vidual made by such State or locality, to-
gether with any other information directly 
related to the survey as the Secretary may 
require (including corrective action plans); 
and 
‘‘(ii) such State or locality releases 
such a copy and any such information to 
the Secretary. 
‘‘(C) TIMELY ACTION ON APPLICATION.— 
The Secretary shall determine, within 210 days 
after the date the Secretary receives an applica-
tion by a private accrediting organization, 
State, or locality whether the process of the pri-
vate accrediting organization, State, or locality 
meets the requirements with respect to training, 
assessment, or certification standards for inter-
preters or translators with respect to which 
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standards the application is made. The Sec-
retary may not deny an application on the basis 
that it seeks to meet the requirements with re-
spect to only one, or more than one, training, 
assessment, or certification standards for inter-
preters or translators. 
‘‘(D) DISCLOSURE
OF
ACCREDITATION 
SURVEY.—The Secretary may not disclose any 
accreditation survey made and released to him 
by the National Council on Interpreting in 
Health Care or any State or locality of an ac-
credited organization or individual, except that 
the Secretary may disclose such a survey and 
information related to such a survey to the ex-
tent such survey and information relate to an 
enforcement action taken by the Secretary. 
‘‘(E) DEFICIENCIES.—If the Secretary 
finds that an accredited organization or indi-
vidual has significant deficiencies (as defined in 
regulations pertaining to the training, assess-
ment, or certification standards), the organiza-
tion or individual shall, after the date of notice 
of such finding to the organization and for such 
period as may be prescribed in regulations, be 
deemed not to meet the conditions or require-
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ments the organization or individual has been 
treated as meeting pursuant to subparagraph 
(A). 
‘‘(e) AVAILABILITY OF LANGUAGE ACCESS.—The Di-
rector shall collaborate with the Administrator of the Of-
fice of Minority Health, the Administrator of the Centers 
for Medicare & Medicaid Services, and the Administrator 
of the Health Resources and Services Administration to 
notify health care providers and health care organizations 
about the availability of language access services by the 
Center. 
‘‘(f) EDUCATION.—The Secretary, directly or through 
contract, shall undertake a national education campaign 
to inform providers, LEP individuals, and health profes-
sional and graduate schools about— 
‘‘(1) Federal and State laws and guidelines gov-
erning access to language services; 
‘‘(2) the value of using trained interpreters and 
the risks associated with using family members, 
friends, minors, and untrained bilingual staff; 
‘‘(3) funding sources for developing and imple-
menting language services; and 
‘‘(4) promising practices to effectively provide 
language services. 
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‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—In ad-
dition to the amounts authorized under subsection 
(e)(8)(F), there are authorized to be appropriated to carry 
out this section such sums as may be necessary for each 
of fiscal years 2010 through 2014. 
‘‘SEC. 3104. INNOVATIONS IN CULTURAL AND LINGUISTIC 
COMPETENCE GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality, shall award grants to eligible entities to enable 
such entities to design, implement, and evaluate innova-
tive, cost-effective programs to improve language access 
in health care for individuals with limited English pro-
ficiency. The Director of the Agency for Healthcare Re-
search and Quality shall coordinate with, and ensure the 
participation of, other agencies including but not limited 
to the Health Resources and Services Administration, the 
Center on Minority Health and Health Disparities at the 
National Institutes of Health, and the Office of Minority 
Health, regarding the design and evaluation of the grants 
program. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a) an entity shall— 
‘‘(1) be— 
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‘‘(A) a city, county, Indian tribe, State, 
territory or subdivision thereof; 
‘‘(B) an organization described in section 
501(c)(3) of the Internal Revenue Code of 
1986; 
‘‘(C) a community health center or commu-
nity clinic; 
‘‘(D) a solo or group physician practice; 
‘‘(E) an integrated health care delivery 
system; 
‘‘(F) public hospital; 
‘‘(G) health care group, university, or col-
lege; or 
‘‘(H) other entity designated by the Sec-
retary; and 
‘‘(2) prepare and submit to the Secretary an 
application, at such time, in such manner, and ac-
companied by such additional information as the 
Secretary may require. 
‘‘(c) USE OF FUNDS.—An entity shall use funds re-
ceived under a grant under this section to— 
‘‘(1) develop, implement, and evaluate models of 
providing competence interpretation services through 
on-site interpretation, telephonic interpretation, or 
video interpretation; 
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‘‘(2) implement strategies to recruit, retain, and 
promote individuals at all levels of the organization 
to maintain a diverse staff and leadership that can 
promote and provide language services to patient 
populations of the service area of the organization; 
‘‘(3) develop and maintain a needs assessment 
that identifies the current demographic, cultural, 
and epidemiological profile of the community to ac-
curately plan for and implement language services 
needed in service area of the organization; 
‘‘(4) develop a strategic plan to implement lan-
guage services; 
‘‘(5) develop participatory, collaborative part-
nerships with communities encompassing the LEP 
patient populations being served to gain input in de-
signing and implementing language services; 
‘‘(6) develop and implement grievance resolu-
tion processes that are culturally and linguistically 
sensitive and capable of identifying, preventing, and 
resolving complaints by LEP individuals; or 
‘‘(7) develop short-term medical interpretation 
training courses and incentives for bilingual health 
care staff who are asked to interpret in the work-
place; 
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‘‘(8) develop formal training programs for indi-
viduals interested in becoming dedicated health care 
interpreters and culturally competent providers; 
‘‘(9) provide staff language training instruction, 
which shall include information on the practical limi-
tations of such instruction for non-native speakers; 
and 
‘‘(10) develop other language assistance services 
as determined appropriate by the Secretary; and 
‘‘(11) ensure that, consistent with the privacy 
protections provided for under the regulations pro-
mulgated under section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note), and any applicable State pri-
vacy laws, data on the individual patient or recipi-
ent’s race, ethnicity, and primary language are col-
lected (and periodically updated) in health records 
and integrated into the organization’s information 
management systems or any similar system used to 
store and retrieve data; 
‘‘(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to entities that pri-
marily engage in providing direct care and that have devel-
oped partnerships with community organizations or with 
agencies with experience language access. 
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channels, 
proposed 
payment 
amounts 
under this subsection based on hospital-re-
ported costs; and 
‘‘(ii) accept public comment on such 
reimbursement standards for a period of 
not less than 90 days. 
‘‘(B) 
FINAL
REIMBURSEMENT
STAND-
ARDS.— 
‘‘(i) IN
GENERAL.—Not later than 
120 days after the expiration of the public 
comment period described in subparagraph 
(A), the Secretary shall publish, after con-
sultation with and the approval of the 
Working 
Group, 
final 
reimbursement 
standards in the Federal Register and on 
the Internet. The final reimbursement 
standards shall go into effect within six 
months of the date of such publication. 
‘‘(ii) TRAINING.—Between such publi-
cation and effective dates, the Secretary 
shall provide training and technical assist-
ance to hospitals on the final reimburse-
ment standards. As necessary, the Sec-
retary shall continue to provide training 
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