Title VI Obligations of Healthcare Organizations
Title VI of the Civil Rights Act of 1964 is a federal law that requires any organization that receives financial assistance from
the federal government to provide services to individuals without discrimination based on race, color, or national origin. Enforcement of Title VI and other civil rights laws is the duty of the Office of Civil Rights (OCR) in the US Department of Health and Human Services (DHHS). Examples of common discriminatory practices that are
prohibited under Title VI can be found in the implementing regulation 45 CFR Part 80.
The following are among the requirements of Title VI that must be practiced by qualified healthcare organizations:
- Provide written and oral language assistance at no cost to patients who have limited English proficiency (LEP) or other special communication needs—eg, Braille, audio, or large type—at all points of contact and during all hours of operation. This includes providing competent language interpreters at the patient’s request. (Family members or friends should not serve as interpreters except at the explicit request of a patent. This is primarily to avoid issues of miscommunication or breach of confidentiality.)
- Provide patients oral or written notice (in their preferred language or other communication format) about their right to receive free language assistance services
- Post and offer easy-to-read signage and materials in the languages of the cultural groups that are common among patients in a healthcare organization’s service area. This includes making available vital documents, such as patient-information and treatment-consent forms
“Covered entities” are the types of facilities to which the provisions of Title VI apply—ie, any organization that receives either direct or indirect federal financial assistance. These can include, but may not be limited to:
- Family health centers and clinics
- Public health clinics
- Practitioners who accept Medicare or Medicaid reimbursement
- Mental health centers
- Alcohol and drug treatment facilities
- Extended-care facilities
- Nursing homes
Legal Implications of Noncompliance
Any patient who believes that he or she has been the target of discrimination has the right to file a complaint, which will be investigated by OCR. Whatever the finding of an OCR investigation, patients also have the right to file suit in federal court.
Potential penalties for violating the provisions of Title VI may include:
- Loss of federal and state funding, including future funding; eg, a healthcare organization could be prohibited from participating in Medicaid, Medicare, or other federal healthcare programs
- Legal action filed by the DHHS, legal service organizations, or private individuals
- Medical malpractice charges
More detailed discussion of some of these issues will be presented in other modules in this curriculum.