‘‘(3) TOLL-FREE
CUSTOMER
SERVICE
TELE-
PHONE
NUMBER.—The 
Center 
shall 
provide, 
through a toll-free number, a customer service line 
for individuals with limited English proficiency— 
‘‘(A) to obtain information about federally 
conducted or funded health programs, including 
the Medicare program under title XVIII of the 
Social Security Act, the Medicaid program 
under title XIX of such Act, and the State Chil-
dren’s Health Insurance Program under title 
XXI of such Act, marketplace coverage avail-
able pursuant to title XXVII of this Act and 
the Patient Protection and Affordable Care Act, 
and other sources of free or reduced care in-
cluding federally qualified health centers, title 
X clinics, and public health departments; 
‘‘(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-
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house to facilitate the provision of language 
services by providers of health care services and 
health-care-related services to reduce medical 
errors, improve medical outcomes, improve cul-
tural competence, reduce health care costs 
caused by miscommunication with individuals 
with limited English proficiency, and reduce or 
eliminate the duplication of efforts to translate 
materials. The clearinghouse shall include the 
information described in subparagraphs (B) 
through (F) and make such information avail-
able on the internet and in print. 
‘‘(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 tem-
plates for each of the following: 
‘‘(i) Administrative and legal docu-
ments, including— 
‘‘(I) intake forms; 
‘‘(II) forms related to the Medi-
care program under title XVIII of the 
Social Security Act, the Medicaid pro-
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gram under title XIX of such Act, 
and the State Children’s Health In-
surance Program under title XXI of 
such Act, including eligibility informa-
tion for such programs; 
‘‘(III) forms informing patients 
of the compliance and consent re-
quirements pursuant to the regula-
tions under section 264(c) of the 
Health Insurance Portability and Ac-
countability Act of 1996 (42 U.S.C. 
1320–2 note); 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. 
‘‘(iii) Public health, patient education, 
and outreach materials, such as immuniza-
tion notices, health warnings, or screening 
notices. 
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‘‘(iv) Additional health or health-care- 
related materials as determined appro-
priate by the Director of the Center. 
‘‘(C) STRUCTURE
OF
FORMS.—In oper-
ating the clearinghouse, the Center shall— 
‘‘(i) ensure that the documents posted 
in English and non-English languages are 
culturally and linguistically appropriate; 
‘‘(ii) allow public review of the docu-
ments before dissemination in order to en-
sure that the documents are understand-
able and culturally and linguistically ap-
propriate for the target 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 
‘‘(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-
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lection and dissemination of information on cur-
rent examples of language assistance programs 
and strategies to improve language services for 
individuals with limited English proficiency, in-
cluding case studies using de-identified patient 
information, program summaries, and program 
evaluations. 
‘‘(E) CULTURALLY
AND
LINGUISTICALLY 
APPROPRIATE
MATERIALS.—The Center shall 
provide information relating to culturally and 
linguistically appropriate health care for minor-
ity 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 appropriate care; 
‘‘(ii) culturally and linguistically ap-
propriate self-assessment tools; 
‘‘(iii) culturally and linguistically ap-
propriate training tools; 
‘‘(iv) strategic plans to increase cul-
tural and linguistic appropriateness in dif-
ferent types of providers of health care 
services and health-care-related services, 
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including regional collaborations among 
health care organizations; and 
‘‘(v) culturally and linguistically ap-
propriate information for educators, practi-
tioners, and researchers. 
‘‘(F) 
TRANSLATION
GLOSSARIES.—The 
Center shall— 
‘‘(i) develop and publish on its website 
translation glossaries that provide stand-
ardized translations of commonly used 
terms and phrases utilized in documents 
translated by the Center; and 
‘‘(ii) make these glossaries available— 
‘‘(I) free of charge; 
‘‘(II) in the 15 languages in 
which the Center translates materials; 
and 
‘‘(III) in alternative formats in 
accordance with the Americans with 
Disabilities Act of 1990 (42 U.S.C. 
12101 et seq.). 
‘‘(G) INFORMATION
ABOUT
PROGRESS.— 
The Center shall regularly collect and make 
publicly 
available 
information 
about 
the 
progress of entities receiving grants under sec-
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tion 3402 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) AVAILABILITY OF LANGUAGE ACCESS.—The Di-
rector shall collaborate with the Deputy Assistant Sec-
retary for Minority Health, the Administrator of the Cen-
ters for Medicare & Medicaid Services, and the Adminis-
trator of the Health Resources and Services Administra-
tion to notify health care providers and health care organi-
zations about the availability of language access services 
by the Center. 
‘‘(d) 
EDUCATION.—The 
Secretary, 
directly 
or 
through contract, shall undertake a national education 
campaign to inform providers, individuals with limited 
English proficiency, individuals with hearing or vision im-
pairments, health professionals, graduate schools, and 
community health centers about— 
‘‘(1) Federal and State laws and guidelines gov-
erning access to language services; 
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‘‘(2) the value of using trained and competent 
interpreters and the risks associated with using fam-
ily members, friends, minors, and untrained bilin-
gual staff; 
‘‘(3) funding sources for developing and imple-
menting language services; and 
‘‘(4) promising practices to effectively provide 
language services. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2021 through 2025. 
‘‘SEC. 3402. INNOVATIONS IN CULTURALLY AND LINGUIS-
TICALLY 
APPROPRIATE 
HEALTH 
CARE 
GRANTS. 
‘‘(a) IN GENERAL.— 
‘‘(1) GRANTS.—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 evalu-
ate innovative, cost-effective programs to improve 
culturally and linguistically appropriate access to 
health care services for individuals with limited 
English proficiency. 
‘‘(2) COORDINATION.—The Director of the 
Agency for Healthcare Research and Quality shall 
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coordinate with, and ensure the participation of, 
other agencies including the Health Resources and 
Services Administration, the National Institute on 
Minority Health and Health Disparities at the Na-
tional Institutes of Health, and the Office of Minor-
ity 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— 
‘‘(A) a city, county, Indian Tribe, State, or 
subdivision thereof; 
‘‘(B) an organization described in section 
501(c)(3) of the Internal Revenue Code of 1986 
and exempt from tax under section 501(a) of 
such Code; 
‘‘(C) a community health, mental health, 
or substance use disorder center or clinic; 
‘‘(D) a solo or group physician practice; 
‘‘(E) an integrated health care delivery 
system; 
‘‘(F) a public hospital; 
‘‘(G) a health care group, university, or 
college; or 
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‘‘(H) any other entity designated by the 
Secretary; and 
‘‘(2) prepare and submit to the Secretary an 
application, at such time, in such manner, and con-
taining such additional information as the Secretary 
may reasonably require. 
‘‘(c) USE OF FUNDS.—An entity shall use funds re-
ceived through a grant under this section to— 
‘‘(1) develop, implement, and evaluate models of 
providing competent interpretation services through 
onsite interpretation, telephonic interpretation, or 
video remote interpreting services; 
‘‘(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 entity; 
‘‘(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 the service area of the entity; 
‘‘(4) develop a strategic plan to implement lan-
guage services; 
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‘‘(5) develop participatory, collaborative part-
nerships with communities encompassing the patient 
populations of individuals with limited English pro-
ficiency served by the grant to gain input in design-
ing and implementing language services; 
‘‘(6) develop and implement grievance resolu-
tion processes that are culturally and linguistically 
appropriate and capable of identifying, preventing, 
and resolving complaints by individuals with limited 
English proficiency; 
‘‘(7) develop short-term medical and mental 
health interpretation training courses and incentives 
for bilingual health care staff who are asked to pro-
vide interpretation services in the workplace; 
‘‘(8) develop formal training programs, includ-
ing continued professional development and edu-
cation programs as well as supervision, for individ-
uals interested in becoming dedicated health care in-
terpreters and culturally and linguistically appro-
priate providers; 
‘‘(9) provide staff language training instruction, 
which shall include information on the practical limi-
tations of such instruction for nonnative speakers; 
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‘‘(10) develop policies that address compensa-
tion in salary for staff who receive training to be-
come either a staff interpreter or bilingual provider; 
‘‘(11) develop other language assistance services 
as determined appropriate by the Secretary; 
‘‘(12) develop, implement, and evaluate models 
of improving cultural competence, including cultural 
competence programs for community health workers; 
and 
‘‘(13) 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 and 
any applicable State privacy laws, data on the indi-
vidual patient or recipient’s race, ethnicity, and pri-
mary language are collected (and periodically up-
dated) in health records and integrated into the or-
ganization’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 in improving language access. 
‘‘(e) EVALUATION.— 
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‘‘(1) BY GRANTEES.—An entity that receives a 
grant under this section shall submit to the Sec-
retary an evaluation that describes, in the manner 
and to the extent required by the Secretary, the ac-
tivities carried out with funds received under the 
grant, and how such activities improved access to 
health care services and health-care-related 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 Culturally and Linguistically Ap-
propriate Health Care established under section 
3401. The Director of the Agency for Healthcare 
Research and Quality shall notify grantees of the 
availability of technical assistance for the evaluation 
and provide such assistance upon request. 
‘‘(2) BY
SECRETARY.—The Director of the 
Agency for Healthcare Research and Quality shall 
evaluate or arrange with other individuals or organi-
zations to evaluate projects funded under this sec-
tion. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2021 through 2025. 
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‘‘SEC. 3403. RESEARCH ON CULTURAL AND LANGUAGE COM-
PETENCE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Agency for Healthcare Research and 
Quality, shall expand research concerning language access 
in the provision of health care services. 
‘‘(b) ELIGIBILITY.—The Director of the Agency for 
Healthcare Research and Quality may conduct the re-
search described in subsection (a) or enter into contracts 
with other individuals or organizations to conduct such re-
search. 
‘‘(c) USE
OF FUNDS.—Research conducted under 
this section shall be designed to do one or more of the 
following: 
‘‘(1) To identify the barriers to mental and be-
havioral services that are faced by individuals with 
limited English proficiency. 
‘‘(2) To identify health care providers’ and 
health administrators’ attitudes, knowledge, and 
awareness of the barriers to quality health care serv-
ices that are faced by individuals with limited 
English proficiency. 
‘‘(3) To identify optimal approaches for deliv-
ering language access. 
‘‘(4) To identify best practices for data collec-
tion, including— 
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‘‘(A) the collection by providers of health 
care services and health-care-related services of 
data on the race, ethnicity, and primary lan-
guage of recipients of such services, taking into 
account existing research conducted by the Gov-
ernment or private sector; 
‘‘(B) the development and implementation 
of data collection and reporting systems; and 
‘‘(C) effective privacy safeguards for col-
lected data. 
‘‘(5) To develop a minimum data collection set 
for primary language. 
‘‘(6) To evaluate the most effective ways in 
which the Secretary can create or coordinate, and 
subsidize or otherwise fund, telephonic interpretation 
services for health care providers, taking into consid-
eration, among other factors, the flexibility necessary 
for such a system to accommodate variations in— 
‘‘(A) provider type; 
‘‘(B) languages needed and their frequency 
of use; 
‘‘(C) type of encounter; 
‘‘(D) time of encounter, including regular 
business hours and after hours; and 
‘‘(E) location of encounter. 
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‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for each of fiscal years 2021 through 2025.’’. 
SEC. 205. PILOT PROGRAM FOR IMPROVEMENT AND DE-
VELOPMENT 
OF 
STATE 
MEDICAL 
INTER-
PRETING SERVICES. 
(a) GRANTS AUTHORIZED.—The Secretary of Health 
and Human Services shall award 1 grant in accordance 
with this section to each of 3 States (to be selected by 
the Secretary) to assist each such State in designing, im-
plementing, and evaluating a statewide program to provide 
onsite interpreter services under the State Medicaid plan. 
(b) GRANT PERIOD.—A grant awarded under this 
section is authorized for the period of 3 fiscal years begin-
ning on October 1, 2021, and ending on September 30, 
2024. 
(c) PREFERENCE.—In awarding a grant under this 
section, the Secretary shall give preference to a State— 
(1) that has a high proportion of qualified LEP 
enrollees, as determined by the Secretary; 
(2) that has a large number of qualified LEP 
enrollees, as determined by the Secretary; 
(3) that has a high growth rate of the popu-
lation of individuals with limited English proficiency, 
as determined by the Secretary; and 
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102 
U.S.C. 18116) as published in 
the Federal Register on May 18, 
2016; and 
(II) that, in the case of inter-
preter 
services, 
are 
provided 
through— 
(aa) onsite interpretation; 
(bb) telephonic interpreta-
tion; or 
(cc) 
video 
interpretation; 
and 
(ii) the direct provision of health care 
or health-care-related services by a com-
petent bilingual health care provider. 
(C) EXCEPTIONS.—The requirements of 
subparagraph (B)(i)(I) do not apply, with re-
spect to interpreter and translation services and 
a grantee— 
(i) in the case of a Medicare bene-
ficiary who is an English learner if— 
(I) such beneficiary has been in-
formed, in the beneficiary’s primary 
language, of the availability of free in-
terpreter and translation services and 
the beneficiary instead requests that a 
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