Saline County, Missouri has one of the highest COVID-19 infection rates in the state. The high rate is due in large part to local meat processing plants, with many limited English proficient employees, in the City of Marshall, the County seat. The County health department is responding to a nearly unprecedented health crisis. However, hindered by past budget cuts, staff reductions, and incomplete planning, the County is relying upon many different resources to meet emergency needs, including language assistance and communication with County residents who are limited English proficient, including the meat packing plants’ employees.
According to WFYI, one County resource is Glenda Cervantes. In the past, Cervantes’ health department responsibilities involved determining residents’ eligibility for social services. But since March, she has been central to the County’s COVID-19 response.
“I still remember the day they said we got our first positive [coronavirus test result] and we’re going to need someone’s help,” she says.
One of her most important functions now is language assistance. Cervantes, a native of El Salvador, is translating health department information into Spanish for the many meat processing plant workers who are Spanish-speaking immigrants.
As WFYI reports, Saline County has two Spanish speakers on staff. However, other rural health departments do not have similar resources and are not well positioned to handle language access during a medical emergency.
“An hour north of Kansas City in St. Joseph, nearly 700 people have tested positive for COVID-19. More than 400 work at a local meat processing plant.
City health director Debra Bradley had to ask a state agency for translating help.
Missouri health director Randall Williams says his department is now providing translation services from the state capital in Jefferson City instead of sending staffers out to overwhelmed health departments. At a recent press briefing, he explained, ‘Some will want us to send boots on the ground but in that case it was very interesting; we found that we needed to keep some people back because here in Jeff City, we have access to multiple translators.’
Language Access Planning and Funding
There are also some resources for health departments beyond the state level. Lori Freeman heads the National Association for City and County Health Officials. She says the Centers for Disease Control and Prevention has provided support for health departments dealing with meat processing outbreaks. But she says more is needed.
‘Over the past 10 years or so, our local health departments have lost about a quarter of their workforce due to fiscal austerity, budget cuts, and lack of overall resources and support,’ she says.”
As in Saline County and St. Joseph, the pandemic has revealed how years of budget reductions and incomplete planning have left local governments scrambling to provide vital, emergency health information to people who do not speak English. But such planning is essential for real-time responses to a pandemic crisis. Such planning and providing language resources are also legally required.
In the Sioux City area of South Dakota, KTIV reports that “We are all going through the same challenges during the pandemic, but for those who don’t fluently speak or understand the English language it can be even harder to deal with.”
To help meet an urgent, need for language services connected to a Smithfield Foods meat processing plant where employees speak eight languages, including Spanish, Oromo, and Kunama:
“Lutheran Social Services in Sioux Falls, South Dakota offers several programs including adoption services, pregnancy counseling, and foster care services. During this pandemic, interpreters from the facility are helping break language barriers. Lutheran Social Services says panic was setting in for those whom English isn’t their first language.”
When counties, states, and cities receive federal funds, they are legally obligated to use such funds to provide information in multiple languages. Of vital importance is information critical to life and health as is true during the current pandemic. Such information must be provided in languages other than English, to preserve and protect individuals’ health and to comply with the law.
Federal agencies have long stressed the need for sufficient planning and budgets to ensure legally compliant language services are available at all times, but most especially during emergencies. Such planning includes having a compliant, implemented language access plan, ready to go for any emergency so no one is left out of life-preserving emergency information.
As the U.S. Department of Health and Human Services stated in March 2020:
“HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal… Persons with disabilities, with limited English skills, or needing religious accommodations should not be put at the end of the line for health services during emergencies. Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism.”
Title VI Regulations
According to the U.S. Department of Justice:
“Title VI [of the 1964 Civil Rights Act] and its implementing regulations obligate recipients of federal financial assistance to ensure nondiscrimination in federally-assisted emergency preparedness, response, mitigation, and recovery programs and activities. All [federal funding] recipients must comply with Title VI, as well as other antidiscrimination laws, at all times including during emergencies. Title VI provides that “[n]o person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.
Recipients of federal financial assistance engaged in emergency management activities, as well as recipients that provide emergency-related services, such as health providers and law enforcement agencies, must comply with Title VI at all times.
Proper planning to comply with Title VI requirements avoids complications imposed by the exigencies of emergencies and disasters.
[Federal funding] recipients should make language services available in all their public-facing programs or activities. Language services may include in-person interpretation, telephonic interpretation, translation services, monolingual communication in the LEP person’s language, and sight translation. Including input from and addressing the needs of LEP populations in evacuation and disaster preparedness plans that are made widely available helps ensure that communities have access to them when needed.
[Federal funding] recipients should assess the language needs of the service community and develop a language access plan, which is a management tool that provides an administrative blueprint for bringing the agency into compliance with language access requirements. Such plans outline the recipient’s policies and standards for delivering services to LEP individuals and describe how the agency will implement those policies and standards, including explaining how the agency will increase its capacity to address the language service and resource needs identified in the self-assessment.
Recipients should periodically review their plans to evaluate whether changes need to be made, including addressing changing demographics of their service populations. “
Language Access During the Pandemic
Saline County is relying upon available resources to address communication issues during the pandemic. However, adequate planning and funding would have enabled a more nimble, comprehensive response. While Glenda Cervantes is working hard to serve her community, more is legally needed, including additional language access resources and assessment of her Spanish language proficiency in emergency services to ensure that the community’s Spanish speaking population receives accurate, timely emergency health information.
Sioux City is making unexpected use of a local social services agency to assist with critical, life-saving language services. However, while laudable, such resources should be ready, vetted, and in in-place once an emergency is declared, for example, as soon as the World Health Organization declared the coronavirus a global pandemic in March 2020.
Language Assistance as Part of Emergency Management
Among the coronavirus lessons learned must be that language assistance planning, funding, and implementation are critically vital and must be part of all local government emergency planning. Indeed, failing to do so has life threatening consequences.
According to the Department of Justice:
“Failing to plan for and serve immigrant communities in emergencies can undermine response efforts and increase safety risks for both local communities and first responders… emergencies and disasters highlight a recurring lesson: we need to take proactive measures to ensure that all members of our communities are appropriately incorporated into emergency management activities.”
© Bruce L. Adelson 2020. All Rights Reserved The material herein is educational and informational only. No legal advice is intended or conveyed.
Bruce L. Adelson, Esq., is nationally recognized for his compliance expertise. Mr. Adelson is a former U.S Department of Justice Civil Rights Division Senior Trial Attorney. Mr. Adelson is a Department of Family Medicine faculty member at Georgetown University School of Medicine where he teaches organizational culture, implicit bias, cultural and civil rights awareness.
Mr. Adelson’s blogs are a Bromberg exclusive