‘‘(i) administrative and legal docu-
ments such as informed 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; 
‘‘(iii) patient education and outreach 
materials such as immunization notices, 
health warnings, or screening notices; and 
‘‘(iv) additional health or healthcare- 
related materials as determined appro-
priate by the Director of the Center; 
‘‘(B) ensuring that the documents the 
posted in English and non-English languages 
and are culturally appropriate; 
‘‘(C) allowing public review of the docu-
ments before dissemination in order to ensure 
that the documents are understandable and cul-
turally appropriate for the target populations; 
‘‘(D) allowing healthcare providers to cus-
tomize the documents for their use; 
‘‘(E) facilitating access to these docu-
ments; 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
‘‘(F) providing technical assistance with 
respect to the access and use of such informa-
tion; and 
‘‘(G) carrying out any other activities the 
Secretary determines to be useful to fulfill the 
purposes of the Clearinghouse. 
‘‘(5) PROVISION OF INFORMATION.—The Cen-
ter shall provide information relating to culturally 
and linguistically competent healthcare for minority 
populations residing in the United States to all 
healthcare providers and healthcare organizations at 
no cost. Such information shall include— 
‘‘(A) tenets of culturally and linguistically 
competent care; 
‘‘(B) cultural and linguistic competence 
self-assessment tools; 
‘‘(C) cultural and linguistic competence 
training tools; 
‘‘(D) strategic plans to increase cultural 
and linguistic competence in different types of 
healthcare organizations; and 
‘‘(E) resources for cultural competence in-
formation for educators, practitioners and re-
searchers. 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
‘‘(b) DIRECTOR.—The Center shall be headed by a 
Director who shall be appointed by, and who shall report 
to, the Deputy Assistant Secretary for Minority Health 
Disparity Elimination. 
‘‘(c) AVAILABILITY OF LANGUAGE ACCESS.—The Di-
rector shall collaborate with the Administrator of the Cen-
ters for Medicare and Medicaid Services and the Adminis-
trator of the Health Resources and Services Administra-
tion, to notify healthcare providers and healthcare organi-
zations about the availability of language access services 
by the Center. 
‘‘(d) 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 
2006 through 2011. 
‘‘SEC. 2904. INNOVATIONS IN LANGUAGE ACCESS GRANTS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Centers for Medicare and Med-
icaid Services, the Administrator of the Health Resources 
and Services Administration, the Secretary of Education, 
and the Deputy Assistant Secretary for Minority Health 
Disparity Elimination, shall award grants to eligible enti-
ties to enable such entities to design, implement, and 
evaluate innovative, cost-effective programs to improve 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
language access to healthcare for individuals with limited 
English proficiency. 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a) an entity shall— 
‘‘(1) be a city, county, Indian tribe, State, terri-
tory, community-based and other nonprofit organiza-
tion, health center or community clinic, university, 
college, or other entity designated by the Secretary; 
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 real-time interpretation services through 
in-person interpretation, communications, and com-
puter technology, including the Internet, teleconfer-
encing, or video conferencing; 
‘‘(2) develop short-term medical interpretation 
training 
courses 
and 
incentives 
for 
bilingual 
healthcare staff who are asked to interpret in the 
workplace; 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
‘‘(3) develop formal training programs for indi-
viduals interested in becoming dedicated healthcare 
interpreters; 
‘‘(4) provide staff language training instruction 
which shall include information on the practical limi-
tations of such instruction for non-native speakers; 
‘‘(5) provide basic healthcare-related English 
language instruction for limited English proficient 
individuals; and 
‘‘(6) 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 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 healthcare services and the quality of healthcare 
for individuals with limited English proficiency. Such eval-
uation shall be collected and disseminated through the 
Center for Linguistic and Cultural Competence in 
Healthcare established under section 2903. 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
‘‘(f) GRANTEE CONVENTION.—The Secretary, acting 
through the Director of the Center for Linguistic and Cul-
tural Competence in Healthcare, shall at the end of the 
grant cycle convene grantees under this section to share 
findings and develop and disseminate model programs and 
practices. 
‘‘(g) 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 
2006 through 2011. 
‘‘SEC. 2905. RESEARCH ON LANGUAGE ACCESS. 
‘‘(a) IN GENERAL.—The Director of the Agency for 
Healthcare Research and Quality, in collaboration with 
the Deputy Assistant Secretary for Minority Health Dis-
parity Elimination, shall expand research concerning— 
‘‘(1) the barriers to healthcare services includ-
ing mental and behavioral services that are faced by 
limited English proficient individuals; 
‘‘(2) the impact of language barriers on the 
quality of healthcare and the health status of limited 
English proficient individuals and populations; 
‘‘(3) healthcare provider attitudes, knowledge, 
and awareness of the barriers described in para-
graphs (1) and (2); 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
‘‘(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 
‘‘(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 
2006 through 2011. 
‘‘SEC. 2906. 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 healthcare 
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-
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
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. 
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 section referred to 
as the ‘‘project’’) to demonstrate the impact on costs 
and health outcomes of providing reimbursement 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 through contracts 
with— 
(A) health plans (under part C of title 
XVIII of the Social Security Act); 
(B) small providers; 
(C) hospitals; and 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00024
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
(D) community-based clinics. 
(3) DURATION.—Each contract entered into 
under the project shall extend over a period of not 
longer than 2 years. 
(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 shall award 
grants to public and private nonprofit entities for 
the evaluation of the project. Such evaluations shall 
focus on access, utilization, efficiency, cost-effective-
ness, patient satisfaction, and select health out-
comes. 
(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: 
‘‘(F) 90 percent of the sums expended with 
respect to costs incurred during such quarter as 
are attributable to the provision of culturally 
and linguistically appropriate services, including 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00025
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
oral interpretation, translations of written ma-
terials, and other cultural and linguistic services 
for individuals with limited English proficiency 
and disabilities who apply for, or receive, med-
ical assistance under the State plan (including 
any waiver granted to the State plan); plus’’. 
(c) SCHIP.—Section 2105(a)(1) of the Social Secu-
rity Act (42 U.S.C. 1397ee(a)) is amended— 
(1) in the matter preceding subparagraph (A), 
by inserting ‘‘or, in the case of expenditures de-
scribed in subparagraph (D)(iv), 90 percent’’ after 
‘‘enhanced FMAP’’; and 
(2) in subparagraph (D)— 
(A) in clause (iii), by striking ‘‘and’’ at the 
end; 
(B) by redesignating clause (iv) as clause 
(v); and 
(C) by inserting after clause (iii) the fol-
lowing: 
‘‘(iv) for expenditures attributable to 
the provision of culturally and linguistically 
appropriate services, including oral inter-
pretation, translations of written materials, 
and other language services for individuals 
with limited English proficiency and dis-
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00026
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS
abilities who apply for, or receive, child 
health assistance under the plan; and’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section take effect on October 1, 2006. 
SEC. 104. INCREASING UNDERSTANDING OF HEALTH LIT-
ERACY. 
(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, shall award grants to eligible en-
tities to improve healthcare 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; 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— 
VerDate Aug 31 2005 
00:26 Oct 06, 2006
Jkt 049200
PO 00000
Frm 00027
Fmt 6652
Sfmt 6201
E:\BILLS\H6275.IH
H6275
bajohnson on PROD1PC77 with BILLS