‘‘(3) develop formal training programs for indi-
viduals interested in becoming dedicated health care 
interpreters and culturally competent providers; 
‘‘(4) provide staff language training instruction 
which shall include information on the practical limi-
tations of such instruction for non-native speakers; 
and 
‘‘(5) develop other language assistance services 
as determined appropriate by the Secretary. 
‘‘(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to entities that have 
developed partnerships with organizations or agencies with 
experience in culturally competent and language access 
services. 
‘‘(e) EVALUATION.—An entity that receives a grant 
under this section shall submit to the Secretary an evalua-
tion that describes the activities carried out with funds 
received under the grant, and how such activities improved 
access to health care services and the quality of health 
care for individuals with limited English proficiency. Such 
evaluation shall be collected and disseminated through the 
Robert T. Matsui Center for Cultural and Linguistic Com-
petence in Health Care established under section 3003. 
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‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$5,000,000 for each of fiscal years 2008 through 2012. 
‘‘SEC. 3005. RESEARCH ON CULTURAL AND LANGUAGE COM-
PETENCE. 
‘‘(a) IN GENERAL.—The Director of the Agency for 
Healthcare Research and Quality, in collaboration with 
the Deputy Assistant Secretary for Minority Health, shall 
expand research concerning— 
‘‘(1) the barriers to health care services includ-
ing mental and behavioral services that are faced by 
limited English proficient individuals; 
‘‘(2) the impact of cultural and language bar-
riers on the quality of health care and the health 
status of limited English proficient individuals and 
populations; 
‘‘(3) health care providers’ and health adminis-
trators’ attitudes, knowledge, and awareness of the 
barriers described in paragraphs (1) and (2); 
‘‘(4) the means by which language access serv-
ices are provided to limited English proficient indi-
viduals and how such services are effective in im-
proving the quality of care; 
‘‘(5) the cost-effectiveness of providing language 
access; and 
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‘‘(6) optimal approaches for delivering language 
access. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
‘‘SEC. 3006. INFORMATION ABOUT FEDERAL HEALTH PRO-
GRAMS FOR LIMITED ENGLISH PROFICIENT 
POPULATIONS. 
‘‘The Secretary shall provide for a means by which 
limited English proficient individuals who are seeking in-
formation about, or assistance with, Federal health care 
programs may obtain such information or assistance.’’. 
SEC. 102. STANDARDS FOR LANGUAGE ACCESS SERVICES. 
Not later than 120 days after the date of enactment 
of this Act, the head of each Federal agency that carries 
out health care-related activities shall develop and adopt 
a guidance on language services for those with limited 
English proficiency who attempt to have access to or par-
ticipate in such activities that provides at the minimum 
the factors and principles set forth in the Department of 
Justice guidance published on June 12, 2002. 
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SEC. 103. FEDERAL REIMBURSEMENT FOR CULTURALLY 
AND LINGUISTICALLY APPROPRIATE SERV-
ICES UNDER THE MEDICARE, MEDICAID AND 
STATE 
CHILDREN’S 
HEALTH 
INSURANCE 
PROGRAM. 
(a) DEMONSTRATION PROJECT PROMOTING ACCESS 
FOR MEDICARE BENEFICIARIES WITH LIMITED ENGLISH 
PROFICIENCY.— 
(1) IN GENERAL.—The Secretary shall conduct 
a demonstration project (in this subsection referred 
to as the ‘‘project’’) to demonstrate the impact on 
costs and health outcomes of providing reimburse-
ment for interpreter services to certain Medicare 
beneficiaries who are limited English proficient in 
urban and rural areas. 
(2) SCOPE.—The Secretary shall carry out the 
project in not less than 30 States or territories 
through contracts with— 
(A) MA plans (under part C of title XVIII 
of the Social Security Act); 
(B) small providers; 
(C) hospitals; and 
(D) community-based clinics. 
(3) DURATION.—Each contract entered into 
under the project shall extend over a period of not 
longer than 2 years. 
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(4) REPORT.—Upon completion of the project, 
the Secretary shall submit a report to Congress on 
the project which shall include recommendations re-
garding the extension of such project to the entire 
Medicare program. 
(5) EVALUATION.—The Director of the Agency 
for Healthcare Research and Quality, in consultation 
with the Office of Minority Health and the National 
Center on Minority Health and Health Disparities, 
shall award grants to public and private nonprofit 
entities that demonstrate experience and capability 
with respect to cultural and linguistic competence, 
including Historically Black Colleges and Univer-
sities, Hispanic-serving institutions, and other enti-
ties directed by and serving representatives of racial 
and ethnic minority groups, for the evaluation of the 
project. Such evaluations shall focus on access, utili-
zation, efficiency, cost-effectiveness, patient satisfac-
tion, and select health outcomes. 
(b) MEDICAID.—Section 1903(a)(3) of the Social Se-
curity Act (42 U.S.C. 1396b(a)(3)) is amended— 
(1) in subparagraph (E), by striking ‘‘plus’’ at 
the end and inserting ‘‘and’’; and 
(2) by adding at the end the following: 
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‘‘(F) 100 percent of the sums expended 
with respect to costs incurred during such quar-
ter as are attributable to the provision of lan-
guage services on behalf of individuals with lim-
ited English proficiency who apply for or receive 
medical assistance under the State plan under 
this title (including any provisions of the plan 
implemented pursuant to any waiver authority 
of the Secretary) or child health assistance 
under a State child health plan under title XXI; 
plus’’. 
(c) SCHIP.—Section 2105(c)(2)(A) of the Social Se-
curity Act (42 U.S.C. 1397ee(c)(2)(A)) is amended by in-
serting before the period at the end the following: ‘‘except 
that expenditures described in, and reimbursable under, 
section 1903(a)(3)(F) shall not count towards this total’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section take effect on October 1, 2007. 
SEC. 104. INCREASING UNDERSTANDING OF AND IMPROV-
ING HEALTH LITERACY. 
(a) IN GENERAL.—The Secretary, acting through the 
Director of the Agency for Healthcare Research and Qual-
ity and the Administrator of the Health Resources and 
Services Administration, in consultation with the Office of 
Minority Health, shall award grants to eligible entities to 
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improve health care for patient populations that have low 
functional health literacy. 
(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), an entity shall— 
(1) be a hospital, health center or clinic, health 
plan, or other health entity (including a nonprofit 
minority health organization or association); and 
(2) prepare and submit to the Secretary an ap-
plication at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
(c) USE OF FUNDS.— 
(1) AGENCY FOR HEALTHCARE RESEARCH AND 
QUALITY.—Grants awarded under subsection (a) 
through the Agency for Healthcare Research and 
Quality shall be used— 
(A) to define and increase the under-
standing of health literacy; 
(B) to investigate the correlation between 
low health literacy and health and health care; 
(C) to clarify which aspects of health lit-
eracy have an effect on health outcomes; and 
(D) for any other activity determined ap-
propriate by the Director of the Agency. 
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(2) HEALTH RESOURCES AND SERVICES ADMIN-
ISTRATION.—Grants awarded under subsection (a) 
through the Health Resources and Services Adminis-
tration shall be used to conduct demonstration 
projects for interventions for patients with low 
health literacy that may include— 
(A) the development of new disease man-
agement programs for patients with low health 
literacy; 
(B) the tailoring of existing disease man-
agement programs addressing mental, physical, 
oral, and behavioral health conditions for pa-
tients with low health literacy; 
(C) the translation of written health mate-
rials for patients with low health literacy; 
(D) the identification, implementation, and 
testing of low health literacy screening tools; 
(E) the conduct of educational campaigns 
for patients and providers about low health lit-
eracy; and 
(F) other activities determined appropriate 
by the Administrator of the Health Resources 
and Services Administration. 
(d) DEFINITIONS.—In this section, the term ‘‘low 
health literacy’’ means the inability of an individual to ob-
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tain, process, and understand basic health information 
and services needed to make appropriate health decisions. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
such sums as may be necessary for each of fiscal years 
2008 through 2012. 
SEC. 105. REPORT ON FEDERAL EFFORTS TO PROVIDE CUL-
TURALLY 
AND 
LINGUISTICALLY 
APPRO-
PRIATE HEALTH CARE SERVICES. 
Not later than 1 year after the date of enactment 
of this Act and annually thereafter, the Secretary of 
Health and Human Services shall enter into a contract 
with the Institute of Medicine for the preparation and 
publication of a report that describes Federal efforts to 
ensure that all individuals have meaningful access to cul-
turally and linguistically appropriate health care services. 
Such report shall include— 
(1) a description and evaluation of the activities 
carried out under this Act; 
(2) a description of best practices, model pro-
grams, guidelines, and other effective strategies for 
providing access to culturally and linguistically ap-
propriate health care services; and 
(3) an assessment of the implementation of the 
Department of Health and Human Services National 
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Standards on Culturally and Linguistically Appro-
priate Services (CLAS) in Health Care, in particular 
the implementation of CLAS mandates by recipients 
of Federal funds. 
SEC. 106. DEFINITIONS. 
In this title: 
(1) INCORPORATED DEFINITIONS.—The defini-
tions contained in section 3000 of the Public Health 
Service Act, as added by section 101, shall apply. 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
SEC. 107. TREATMENT OF THE MEDICARE PART B PRO-
GRAM UNDER TITLE VI OF THE CIVIL RIGHTS 
ACT OF 1964. 
A payment provider of services or physician or other 
supplier under part B of title XVIII of the Social Security 
Act shall be deemed a grant, and not a contract of insur-
ance or guaranty, for the purposes of title VI of the Civil 
Rights Act of 1964. 
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