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Limited English Proficiency (LEP) Plan

Purpose

The purpose of this plan is to document the policies and procedures as it applies to providing meaningful access (language access) to individuals with Limited English Proficiency (LEP) while accessing services and information at Medica Health Plans in Minnetonka, MN.

Authorities

• Title VI of the Civil Rights Act of 1964, 42 U.S.C. §2000 et seq.; 45 CFR §80, Nondiscrimination Under Programs Receiving Federal Financial Assistance through the U.S. Department of Health and Human Services Effectuation of Title VI of the Civil Rights Act of 1964.
• Section 1557 of the Affordable Care Act (ACA) (Section 1557). 
• Office for Civil Rights Policy Guidance, Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, 68FR 47311 (2003).
• Department of Justice regulation, 28 CFR §42.405(d)(1), Department of Justice, Coordination of Enforcement of Non-discrimination in Federally Assisted Programs, Requirements for Translation. 
• Communications Services, Minnesota Status § 15.441, subd (1), (2), (3), (4). 
• Information for persons with limited English language proficiency, Minnesota Status §256.01 subd 16. 

Definitions

Bilingual staff: Is the person who has met and demonstrated the minimum linguistic proficiency and fluency requirements in both languages (target and source languages), AND has demonstrated cultural responsiveness, AND Medica Health Plans has documented the above.

If the bilingual staff is going to act as interpreter for others, the above criteria are required in addition to at least one of the following:

• the bilingual staff is Healthcare Certified Interpreter (CHI, CoreCHI), Certified Medical Interpreter (CMI), Federal or State Court certified interpreter
• has received healthcare interpreting training (minimum of 40 hours)
• has received community interpreting training (minimum of 40 hours)
• has developed skills and abilities as an interpreter
• understands boundaries and roles as an interpreter
• abides by the National Code of Ethics and Standards of Practice for Healthcare Interpreters by NCIHC, or Canons and professional code of ethics
• maintains skills by receiving interpreting continuing education of at least 8 hours annually, AND
• Medica Health Plans keeps records and documentation of the above

Culturally appropriate services – Is the utilization or application of services, testing, and any other methodology that does not have the effect of subjecting individuals with LEP, and/or their families to discrimination because of their race, color, or national origin, or do not have the effect of defeating or substantially impairing accomplishment of the objectives of the program with respect to individuals of a particular race, color, or national origin. -45 CFR 80.3(b)(2).

Effective communication – In a healthcare and social services delivery settings, effective communication occurs when provider staff have taken the necessary steps to make sure that a person with Limited English Proficiency is given adequate information to understand the services and covered services available and receives the information and services for which they are eligible. Effective communication also means that a person with Limited English Proficiency (LEP) is able to communicate the relevant circumstances of their situation to the provider, and for the provider has access to the adequate information to do their job.

I Speak Cards – “I Speak” Cards say both in English and target language “I need a (target language) interpreter.”

Individual with Limited English Proficiency (LEP) – A person with Limited English Proficiency or “LEP” is not able to speak, read, write or understand the English language well enough to allow them to interact effectively with healthcare, social services agencies, and other providers.

Interpreting – Interpreting means the oral, verbal or spoken transfer of a message from the source language into the target language. There are different modes of interpreting such as consecutive, simultaneous, sight-translation, and summarization.

Language Block – Is a block of text that informs readers, in fifteen different languages, how they can get free help interpreting the information on a particular document or included as an insert in appropriate documents.

LEP Implementation Team (or responsible individuals for compliance) – Individuals appointed by State Public Programs department to review LEP Implementation activities within Medica Health Plan.

Meaningful access – Meaningful access to programs, information, and services in the standard of access required of federally funded entities to comply with language access requirements of Title VI of the Civil Rights Act of 1964. To ensure meaningful access for individuals with Limited English Proficiency, service providers must make available to clients, patients and their families language assistance that is free of charge and without undue delay resulting in accurate and effective communication.

Office for Civil Rights (OCR) – The Office for Civil Rights is the civil rights enforcement agency of the U.S. Department of Health and Human Services. OCR Region V is the regional office that enforces Title VI in Minnesota for health and human services agencies and providers.

Primary languages – Primary languages are the languages other than English that are most commonly spoken by clientele as identified by Medica Health Plan collection of demographic data. Currently there are 5 primary languages: Spanish, Mandarin, Somali, Vietnamese, Arabic and Russian.

Qualified Interpreter – A person who either has met training and competency requirements or who is a certified healthcare, certified federal or state court interpreter and in good standing before their certifying body, AND adheres to the interpreter National Code of Ethics and Standards of Practice for Interpreters in Health Care (National Council on Interpreting in Health Care –NCIHC), the canons of ethics and conduct for court interpreters, etc.

Sight translation – The verbal translation (transfer) of a written document from the source language into the target language.

Translation – Translation means the written transfer of a message from the source language into the target language.

Methods of Providing Services to individuals with LEP

The primary methods used are: Telephonic, in-person, and written

Contracted Qualified Interpreters:

• ASL Interpreting Services
• Children’s Health Care Minneapolis
• Hennepin County Medical Center
• Intelligere Solutions
• Intercultural Mutual Assistance
• Association
• Jewish Community Center
• Kim Tong’s Translation Service Inc.
• Pillsbury United Communities
• Project FINE
• The Bridge World Language Services
• West Central Interpreting

Telephone Interpreter Services – TransPerfect

Video Remote Interpreting (VRI) Services – TransPerfect

Qualified and competent bilingual staff – None

LEP Liaison and Coordinator	LEP Liaison Backup
1-866-269-6811 (toll-free) TTY: 711 401 Carlson Parkway  CP320 Minnetonka, MN 55305 LEP@medica.com	1-866-269-6811 (toll-free) TTY: 711 401 Carlson Parkway CP320 Minnetonka, MN 55305 LEP@medica.com

Interpreter Services

Medica Health Plans, without undue delay and at no cost to individuals with LEP and/or their families, provides meaningful access to information and service to all individuals with LEP and/or their families receiving services.

Translation of Documents

Medica Health Plans contracts qualified translators or translating agencies to assist individuals with LEP in translating all vital documents, or documents needed to perform services.

Dissemination and Mandatory Training to Agency Staff, Volunteers and Others

Medica Health Plans is committed to providing LEP training to:

• All staff at new employee orientation who may interact with enrollees, AND
• At least once a year to all staff, volunteers, and contractors who may interact with enrollees

Medica Health Plans will keep record of those training sessions and individual record of attendance to training will be part of personnel files. Record of this training will be kept for a minimum of five years and readily available during DHS audits, investigations, or any proceeding and as required by the law.

This training is to include at least the following:

• Title VI of the Civil Rights Act of 1964
• How to work effectively with interpreters, and
• Any other cultural issues related to delivery of information and services to individuals with LEP served by Medica Health Plans.

This policy is added to the Manual of Policies and Procedures of Medica Health Plans.

Dissemination of Language Access Information in Public Areas

Medica Health Plans makes available to individuals with LEP:

• Notice of language access services by posting in public areas the "Language Poster," available through DHS public Web site
• "I need an interpreter" card available in fifteen languages and from DHS public Web site
• Catalogue of Languages

Annual Review of LEP Plan

Medica Health Plans reviews annually its LEP plan to adjust or modify its contingencies based on demographic data collected by Medica Health Plans during its delivery of information and services to individuals with LEP throughout the year.

Medica Health Plans upon DHS request will complete and submit DHS LEP Plan review on an annual basis or as often as requested by DHS.

Collection of Data and Its Analysis

Medica Health Plans is committed to monitor and make reasonable adjustments to comply with Title VI requirements. Medica Health Plans will collect:

• We collect DOB, gender, preferred spoken language, preferred written language, needs interpreter, cultural background, ethnicity, etc.
• The purpose of collecting this data is to ensure that we have appropriate language resources for members
• We measure the outcome from this data by tracking outgoing documents in languages other than English

Complaint Process

Individuals with LEP have the right to file a formal complaint with:

Medica Health Plans	Minnesota Department of Human Services (DHS), Limited English Proficiency (LEP) Coordinator	Office for Civil Rights (OCR), Region V – Chicago, IL
Medica Health Plans State Public Programs P.O. Box 9310, Route CP340 Minneapolis, MN 55440-9310 952- 992-2580 or 1-888-347-3630 (toll-free) TTY: 711	Alejandro Maldonado 651-431-4018 P.O. Box 64997 Saint Paul, MN 55164-0977 alejandro.maldonado@state.mn.us Fax: 651-431-7444 TTY: 711 or 1-800-627-3529	Celeste Davis, Regional Manager Office for Civil Rights U.S. Department of Health and Human Services 233 N. Michigan Ave., Suite 240 Chicago, IL 60601 Phone: 1-800-368-1019 Fax: 312-886-1807 TTY: 1-800-537-7697 HHS Website

This LEP Plan is available in public areas of Medica Health Plans, to all staff, volunteer, and contractors, and to members of the community.