1. A product of the ACA

2. Section 1557 states that an individual shall not, on the grounds prohibited under Title VI of the Civil Rights Act of 1964 (race, color, national origin), Title IX of the Education Amendments of 1972 (sex), the Age Discrimination Act of 1975 (age), or Section 504 of the Rehabilitation Act of 1973 (disability), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance or under any program or activity that is administered by an Executive Agency or any entity established under Title I of the ACA.

3.  If you employ 15 or more individuals, your service must designate at least one employee to coordinate efforts to comply with and carry out the entities responsibilities of this rule.

4.  If your service employs 15 or more individuals then it must adopt a grievance process that incorporates due process standards and provide for prompt and equitable resolutions.  The federal government has put together a sample process: https://www.federalregister.gov/articles/2016/05/18/2016- 11458/nondiscrimination-in-health-programs-and- activities#h-141 https://www.federalregister.gov/articles/2016/05/18/2016- 11458/nondiscrimination-in-health-programs-and- activities#h-141

5. Taglines in at least 15 Different Languages must be posted in a conspicuously-visible size font in:  A) significant communications targeted to beneficiaries (except small sized publications) AND  B) in a conspicuous location on the covered entity’s website from the home page  A tagline is a short statement written in non-English languages that indicates the availability of language assistance services free of charge

6. Small Sized Publications  Only need to include taglines in at least the two top languages spoken by individuals with limited English proficiency. Sample Notices and Taglines: http://www.hhs.gov/civil-rights/for-individuals/section- 1557/translated-resources/

7.  The general requirement is that a covered entity shall take reasonable steps to provide meaningful access to each individual with limited English proficiency eligible to be served or likely to be encountered in its health programs and activities.  Meaningful steps will be determine based on a factual determination.

8.  Covered entities must provide accurate and timely language assistance services to individuals being served. The language assistance services must be offered free of costs. The entity must also protect the privacy and independence of the individual with limited English proficiency, and offer a qualified interpreter when reasonable.  Covered entities are permitted to use video/audio remote interpreting services as long as the services are provided in real-time and have good quality.

9.  Plaintiff can use any mechanism offered under Title VI of the Civil Rights Act of 1964 (race, color, national origin), Title IX of the Education Amendments of 1972 (sex), the Age Discrimination Act of 1975 (age), or Section 504 of the Rehabilitation Act of 1973 (disability) to enforce the provisions of these new regulations. Compensatory damages may also be received by a plaintiff.  In addition, noncompliance with the rule could lead to a loss of federal funding.

10.  The rule became effective on July 18, 2016.  Notice requirements (taglines, etc.) become effective within 90 days from this rule becoming effective.

11.  The Rule Can Be Viewed at https://www.gpo.gov/fdsys/pkg/FR-2016-05-18/pdf/2016- 11458.pdf https://www.gpo.gov/fdsys/pkg/FR-2016-05-18/pdf/2016- 11458.pdf  An in-depth memo written on the new regulations can be seen at http://www.louisianaambulancealliance.org/resources/Docum ents/Nondiscrimination%20in%20Health%20Programs%20and% 20Activities%20Rule%20Summary%20Memo.pdf http://www.louisianaambulancealliance.org/resources/Docum ents/Nondiscrimination%20in%20Health%20Programs%20and% 20Activities%20Rule%20Summary%20Memo.pdf

12. NOTICE:  This information is for educational/informational purposes only. The information provided should be used only after endorsement by your own Legal Counsel.  Louisiana Ambulance Alliance/Curry Landry makes no warranties express or implied in offering this research. This is in no way meant to serve as legal or professional advice. Viewing this language and/or using information from it does not create any type of professional relationship with Louisiana Ambulance Alliance/Curry Landry.  There is no warranty or guarantee that using this language will be in compliance with state or federal law. Louisiana Ambulance Alliance/Curry Landry is not responsible for any reliance on this language.