General eligibility requirements that apply to all Apple Health programs

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LEP services

Revised Date: 
July 25, 2014

Purpose: To describe worker responsibilities (where applicable) in identifying the need for and providing services to LEP individuals.

WAC 182-503-0110 Washington apple health -- Limited-English proficient (LEP) services

WAC 182-503-0110 Washington apple health -- Limited-English proficient (LEP) services.

Effective March 31, 2014.

  1. We provide interpreter and translation services (limited-English proficient or LEP services) free of charge to you if you have limited ability to read, write, and/or speak English. Interpreter services are those used for oral communication between two parties who do not speak the same language. Translation services are those used for written communication.
  2. We provide LEP services in your primary language.
    1. A primary language is the language you tell us that you wish to use when communicating with us. You may designate at least one primary language for oral communications and at least one primary language for written communications, and you may designate a different primary language for oral and for written communications.
    2. We note your primary languages in a record available to the agency, its designee, and health benefit exchange employees.
  3. We can provide LEP services through bilingual workers and/or contracted interpreters and translators who are expected to be competent. We consider a bilingual worker or a contracted interpreter or translator to be competent if he or she is:
    1. Certified for interpreting and/or translating in the language by the language testing and certification program of the department of social and health services;
    2. Certified or otherwise determined to be competent for interpreting and/or translating in the language by an association or organization with a regional or national reputation for certifying or determining the competence of interpreters and/or translators; or
    3. Determined competent for interpreting and/or translating in the language by us, taking into account his or her:
      1. Demonstrated proficiency in both English and the other language;
      2. Orientation and training that includes the skills and ethics of interpreting;
      3. Fundamental knowledge in both languages of any specialized terms or concepts peculiar to Washington apple health;
      4. Sensitivity to cultural differences; and
      5. Demonstrated ability to convey information accurately in both languages.
  4. We provide notice of the availability of LEP services on printed applications and notices, in the Washington healthplanfinder web site, and during contact with persons who appear to need LEP services.
  5. LEP services include:
    1. Spoken language interpreter (oral) services in person, over the telephone, or through other simultaneous audio or visual transmission (if available); and
    2. Translation of our forms, letters, and other text-based materials, whether printed in hard-copy or stored and presented by computer. These include, but are not limited to:
      1. Our pamphlets, brochures, and other informational material that describe our services and your health care rights and responsibilities;
      2. Our applications and other forms you need to complete and/or sign; and
      3. Notices of our actions affecting your eligibility for health care coverage.
    3. Direct provision of services by our bilingual employees.
  6. We provide interpreter services and translated documents in a prompt manner that allows the timely processing of your eligibility for health care coverage within time frames defined in WAC 182-503-0060, 182-503-0035, and 182-504-0125.
  7. If you believe that we have discriminated against you on the basis of race, color, national origin, birthplace, or another protected status, you may file a complaint with the U.S. Department of Health and Human Services at http://www.hhs.gov/ocr/civilrights/complaints or Regional Manager, Office of Civil Rights, U.S. Department of Health and Human Services, 2201 Sixth Ave. – M/S: RX-11, Seattle, WA 98121-1831 (voice phone 800-368-1019, fax 206-615-2297, TDD 800-537-7697).

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

  1. LEP services are intended to ensure that persons limited in their ability to read, write and/or speak English have equal access to Apple Health programs and services.
  2. The provision of qualified interpreters and fully translated letters to LEP individuals is required by state (RCW 74.04.025) and federal laws (Title VI of the Civil Rights Act and implementing regulations at 45 CFR Part 80).

Interpreter Services

  1. If the individual needs assistance in communicating verbally with staff, the individual's case will be assigned to an authorized bilingual employee who speaks the individual's language or an interpreter will be scheduled to facilitate communication with the individual. These services are provided at no cost to the individual and without significant delay.
  2. Family members, friends and children should not be used as interpreters.
  3. HCA and DSHS have contracts with brokers who assign interpreters to DSHS appointments. These services are charged at a minimum hourly rate for the first hour of services and in fifteen minute increments thereafter. Contact your CSO Interpreter Services Coordinator to request an interpreter through the interpreter brokerage contract. Spoken language interpreter brokerage information is available at the following website:
  4. On-demand telephone interpreter services are also available by contract. Telephone interpreter contractor information is available at the following website:
    1. Services are paid for at a per-minute rate;
    2. On-demand telephone interpreter services are used as a backup to the brokered interpreter service contract that supplies in-person interpreters. It is also used for interpreting needs that are emergent and / or short in duration. As such, on-demand telephone interpreter services may be required for emergency applications and walk-ins.
    3. When calling an individual on the telephone or receiving an incoming individuals call, you can use conference call capabilities to get an interpreter on the line.
    4. Ensure that both the individual and the interpreter are aware that such phone calls are covered by DSHS confidentiality rules.
  5. The department has contracts with sign language interpreter providers who assign interpreters for appointments with persons who are deaf, deaf-blind, or hard of hearing. Contact your CSO Interpreter Services Coordinator to request the services of a sign language interpreter. Sign language interpreter contractor information is available through DSHS.

Assistance in communicating by phone with persons who are deaf, deaf-blind or hard of hearing is available through the Washington Relay Service.

Written Translation Services

  1. Letters must be sent to LEP individuals in their primary language and in English. These letters, including all worker fill-ins, must be fully translated for individuals whose primary language is anything other than English.
  2. For these individuals, if an English letter is sent or if the individual has signed an English form that must be fully translated, the Department must reissue the translated letter and give the individual time to respond. As a result, actions taken based on the previously released English letter must be rescinded.

Translated ACES Correspondence

  1. The following letters are generated by ACES and mailed from State Office:
    1. All Automated Case Maintenance (ACM) Letters in supported languages. These letters cannot be added to or changed.
    2. Letters that are the result of the worker taking an action on a case when the Primary Language Code is a "supported" language.
  2. The following ACES letters must be printed locally and translated by an authorized bilingual employee or sent to an authorized contracted translation agency for translation:
    1. Letters that are the result of the worker taking an action on a case when the individual's primary language is a "nonsupported" language.
    2. Letters that have free-form text.
    ACES supported languages include the following:
    Cambodian Chinese
    Korean Laotian
    Russian Spanish
    Vietnamese Somali

Worker Responsibility

  1. To ensure LEP individuals receive adequate services:
    1. Identify the individual’s primary language at first contact.
    2. Enter the correct Primary Language Code (PLC) into the Primary Language field in ACES. Primary language should be periodically discussed with the individual, and the PLC should be reviewed and updated as necessary. Care should be taken to not inadvertently change the PLC. Incorrect PLCs result in untimely and inadequate notice to individuals, as well as increased translation costs.
    3. Inform LEP individuals of their right to interpreter (verbal) and translation (written) services and that these services are available to them without charge or significant delay. This includes informing walk-in individuals.

      Note: Use the services of an interpreter if you feel you are unable to communicate with the individual well enough to provide quality services, even if the individual tells you they do not need an interpreter.

    4. Provide interpreter and translation services in a timely manner so that LEP cases can be processed timely.
    5. Indicate any language needs on all referrals of LEP individuals to other divisions, administrations, or agencies.
    6. Provide LEP individuals with the same safeguards of confidentiality as provided to English proficient individuals.
    7. Provide assistance to LEP individuals in understanding and completing forms. Remember that LEP individuals may have learning disabilities, cognitive problems and/or may not be literate in their native language. Include screening for Equal Access -- See Equal Access Chapter.
    8. In the event that there are no available employee or contractor resources to serve an LEP individual in their primary language, an exception to policy may be made. This may include contacting refugee service providers, client advocates, member’s of the individual’s community (e.g., church or community center), and as a last resort, friends or family members (children should never be used as interpreters) to ask for their assistance in facilitating communication with the individual. Any exception to policy must be documented in the ACES narrative.
  2. Provide fully translated forms in the primary language of the LEP individual whenever appropriate:
    1. Many forms are available in non-English languages on the HCA website.
    2. If the form is not available online, and has not been translated into the language needed for the individual, make a request for the form to be translated through your the agency or office Translation Coordinator (for example, the CSO Translation Coordinator (CSO TC)). The Translation Coordinator will submit a translation request. Translation work is usually completed in 1-2 weeks.
  3. Provide fully translated publications in the primary language of the individual whenever appropriate.
    1. Some translated publications are on the HCA website.
    2. Publications needed in languages not available online can be ordered.
  4. Provide locally generated/individual specific documents in the primary language of the individual whenever appropriate.
    1. Translation of locally generated, specific documents are provided by authorized bilingual employees or requested directly from an authorized translation services contractor.
  5. Upon receiving completed translation work:
    1. Make a copy of the English and translated documents.
    2. Mail the originals of both documents to the individual.
    3. Send copies of the English and translated documents to DMS to be imaged into the electronic case record. If an exact duplicate of the English document is already in the ECR, do not send another copy to DMS.
  6. Continue benefits through the advance notice period if the action requires advance notice and the fully translated letter is mailed within the 10-day advance notice period.

ACES Documentation

  1. On the Address (ADDR) screen (mainframe) or ACES.Online screening Applicant Page:
    1. Enter the individual's PLC for the language the individual reads and understands. For individuals that do not read any language, the PLC should be "EN" for English. The PLCs are listed in alphabetical order by language on F1 Help from the PLC field. If the individual's language is not listed, enter "OT" (for other language) and enter the name of the language in REMARKS behind the ADDR screen.
    2. If the individual needs assistance with communicating verbally, indicate that an interpreter is needed in the Interpreter Needed field and enter the name of the language in REMARKS behind the ADDR screen if it is different than the language identified in the Primary Language field.
  2. Document the following information in the ACES Narrative:
    1. All efforts to secure LEP services, including when efforts are unsuccessful. Document how the client was served if an exception to policy was made.
    2. The date a translation request was given to the CSO translation coordinator.
    3. The date a translated letter, form or publication was mailed or given to the individual.
    4. The name a the interpreter who provided services for an interview with an LEP individual.

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