Recent available census data are confirming what staff have experienced first hand over the last few years; there is an increase in the number of limited English proficient (LEP) consumers visiting our offices. In response to this increase, SRS has taken steps to assist staff in communicating with their LEP clients and to meet the provisions set out in the Department of Health and Human Services Policy Guidance of 2000 requiring agencies which receive federal funding to provide meaningful access to services by LEP consumers.

Changes to AE KAECSES and KsCares are being implemented in order to facilitate the collection of standardized and more accurate language data. With the information gathered we will be able to generate reports about communication preferences and determine the number of speakers/readers/ other media users we have in a given area (county and state) and for which programs. This will tell us how many interpreters we need and for which languages. It will also help us to determine how many forms (applications, notices, etc.) we will need to provide and in which languages or other media. In short, the information will be used to support the need for additional resources available to staff to assist in communication with LEP clients.

These changes are timed to coincide with the federal Office of Management and Budget (OMB) mandate that all federal programs begin using a new format for the reporting of race and ethnicity codes beginning on January 1, 2003.

Race and Ethnicity

To standardize reports on individual race and ethnicity, the Federal Office of Management and Budget has defined the values that states must use for federal reports. The use of these codes apply to all governmental entities and are the same values used for the 2000 Census. This new standardization splits out race and ethnicity. Individuals can declare their race type as one or up to any combination of five race types. Ethnicity is defined as either Hispanic or Not Hispanic. The new race and ethnicity codes are as follows.

RACE

* HealthWave premiums are waived for American Natives or Alaskan Natives, so it is important that if a person falls into this category it is recorded.

'O' is to be selected only if race is unknown to SRS or if the person declines to indicate a race code.

A person may choose any combination of one to five race codes, but if 'O' is selected, other race codes cannot be selected with it.

ETHNICITY

'H' should be selected if a person chooses to identify himself as Hispanic or Latino.

'N' should be selected if a person chooses to identify himself as an ethnicity other than Hispanic or Latino.

Only one ethnicity choice is allowed, i.e., a person cannot select both 'H' and 'N'.

Language Preference and Other Media

In order to comply with federal requirements that consumers receive equal access to services provided by SRS and to determine the kinds of resources necessary to assist staff in ensuring meaningful communication with limited English proficient clients, states are required to capture language preference information. As not all currently used applications gather this information, an "Addendum to Application" has been developed. Please see the Addendum to Application section below. Modifications have also been made to AE KAECSES and KsCares to capture the written and spoken language and any other communication needs of each client. The completion of these fields is mandatory for the PI on the case and is encouraged for other individuals on the case. These codes have been added to the KAECSES Code Cards (BN for Bosnian and UN for Unknown will need to be penciled in) and are now available to staff. Again these values are the same for AE KAECSES and KsCares. Staff will need to update the Language and Other Media fields the next time they access the ETRC or CHCI screens. Please note that the Spoken and Written Language fields allow only one two-character code to be entered for each field, whereas the Other Media fields allow two one-character codes to be entered per individual.

The following tables should be used to enter data provided by consumers.

Most Spoken Language and Written Language codes are self-defined. 'None' can indicate that the client does not have a written or a spoken language, or that they have one but not the other. The fields are separate, therefore the same code may not necessarily be entered in both fields. Having 'None' selected for both may indicate that the client uses Braille, Sign, etc. For example, if the person Signs and can read English then Spoken = NN, Written = English, Other Media 1 may = S, E, or O and Other Media 2 = T, R, O or whatever is appropriate.

For some languages it may be necessary to enter additional information such as country of origin (as with Spanish) or tribal/clan language (as with Sudanese, Somali). As with German Mennonite, for example, workers should enter “GE” in the appropriate language field and “German Mennonite” in the comments field on the INDA screen (KAECSES). Those not using KAECSES should use other electronic narrative or documentation method. It is best that the interpreter being used knows where the person they are interpreting for is from or which dialect of a language the client uses so that they can be more effective. In addition to documenting this additional information electronically, the Addendum to Application (attached) should be placed in the consumer's paper file.

Selecting OT indicates that the consumer's language preference is not included in the choices given in the table (Swahili, for example) and the appropriate language should be indicated in the comments section on the INDA screen (or other appropriate place). This will help the worker the next time the client comes in for a visit. They will know that they are going to need an interpreter (language is “Other”) and for which language (as indicated in the comments). If the client speaks Swahili, but reads French, then the worker will indicate OT in the Spoken field (and 'Swahili' in the comments), FR in the Written field, and whatever is appropriate in the OM fields. The Addendum to the Application should be kept in the consumer's paper case file.

The Other Media field captures a client's need for TDD/TTY, Braille, sign language interpretation, etc. Other Media refers to communication methods used by visually or hearing impaired individuals. Braille, large print and voice synthesizer (JAWS and other such programs) may be used by visually impaired, whereas Signed English (signed English-like sentence structure), American Sign (sign language of another structure), Relay (use of telephone by one party and a mechanical assistive device by another), or TDD/TTY (mechanical telephonic device) may be used by hearing impaired individuals.

Remember that it is possible to list more than one Other Media option. For example, V may be entered in the first Other Media field and B in the second (or N, O, or whichever is indicated by the consumer).

The codes that should be entered in the language preference and other media fields will be determined from information consumers provide. Do not assume the language/other media preferences of consumers. Entering “English” because the majority living in Kansas speak English does not make it easier to communicate with a limited English proficient person when they call or come in to the office. Moreover, it will under-represent the needs of your Area. Similarly, having knowledge that someone is from Mexico does not mean that that person speaks Spanish. They may speak one of the indigenous languages or even German. If a consumer does not provide a response to the language or other media questions, workers should enter UN in the Language Preference fields and N in the Other Media fields with a note in the appropriate comments section (on INDA, or whichever narrative section is available for the system being used) that the language or other media preference is unknown or that the client did not specify, etc. Additionally, the paper Addendum to Application (attached) should be placed in the client's paper case file. When a case is pulled up during interview or other time when communication with the consumer is possible, UN and N should be updated with the appropriate information. The consumer should choose a primary language or other media preference for staff to enter. Staff should indicate any other language or other media preferences in the comments field. This will assist staff in the event an interpreter for the primary language/other media preference is temporarily unavailable. If that is the case, then an interpreter of another language or use of another media may be temporarily substituted.

KsCares/KAECSES System Changes

Effective 10/13/03 AE KAECSES and KsCares will have been modified to support these changes. New fields will have been added for Language and Other Media Preference. Codes will be supplied by new tables (refer to “Language Preference and Other Media” above). In addition, a conversion program is being run over the weekend of 10/10/03 to convert the current race and ethnicity values to the new ones. Starting 10/13, the KAECSES ETRC screen and the KsCares CHCI, CAMA, CARE, MACR and MOCL screens will have changed (the changes on MACR will be the same as on CARE, and the changes on MOCL will be the same as on CAMA). Values for race and ethnicity will be indicated by placing an 'X' in the fields of all race codes provided by consumers, and an 'X' in one of the two ethnicity fields.

Conversion of current Race/Ethnicity Codes to new Race Codes and new Ethnicity Codes will be as follows:

Examples of the new AE KAECSES and KsCares screens:

Reports available to those interested

The following five Management Reports will be available on SAR. They capture unduplicated information at county and state levels for written and spoken languages and other media needs entered. These are quarterly reports, the first ones becoming available in early January 2004. These may be viewed by supervisory or administrative staff for the determination of staffing needs or as deemed necessary for any other reason.

Addendum to Application

As you are aware, not all of the program application forms currently available allow for responses from consumers regarding language/other media preference. On others, the race codes are now out dated. In order to begin collecting the appropriate data, an addendum (see below) has been created for consumers to be able to provide us with this information. This addendum should be collected from consumers along with the following application forms.

• 3100
• 3100.2
• 3100.3
• 3100.4
• 3100.7
• 3500 (LIEAP - Codes are different on the current application.)
• Any other communication where this information is not currently being gathered.
  

In addition, in order to more quickly add this information to the KAECSES and KsCares systems, consumers paying a visit to the office or otherwise communicating with SRS (telephone or mail correspondence included) should also be given the opportunity to provide this information. Please ensure that the information is properly entered in the system, and place the addendum in the case file.

Having this information available to us will greatly enhance our abilities to provide staff with the tools necessary for accurate service delivery while at the same time provide quality service for our consumers. If our agency does not gather this information or chooses not to enter it correctly according to what clients provide, we are not providing equally accessible service delivery, thereby putting the agency at risk of violation of Title VI. But by gathering accurate data and working toward making appropriate assistance available, staff will find it easier to get messages across to clients, and clients will come away feeling more positive and secure with what is expected of them.

Please direct questions or requests for further information to Melanie Manares, LEP Program Manager, EES. She may be reached by phone at 785-368-8122 or by e-mail at MUK@srskansas.org.

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Attachment: Addendum to Application 3100.1