"This is America. You should speak English." many Americans say, though speech is an civil liberty guaranteed by the First Amendment in the Bill of Rights. Ironic, that in the land of the free, some Americans characterize being American with the oppression of one's civil liberties, rather than liberation from societal norms. Though many Americans equate being "American" with speaking the English language, the truth is that the inability to read, write, speak, and understand English is protected by Federal civil rights laws, specifically Title VI of the U.S. Civil Rights Act of 1964.
Title VI, 42 U.S.C. § 2000d et seq., was enacted as part of the landmark Civil Rights Act of 1964. It prohibits discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance. As President John F. Kennedy said in 1963, "Simple justice requires that public funds, to which all taxpayers of all races [colors, and national origins] contribute, not be spent in any fashion which encourages, entrenches, subsidizes or results in racial [color or national origin] discrimination."
In a landmark U.S. Supreme Court Case Lau Vs. Nichols, which initially began as an education case based on the Fourteenth Amendment, the Supreme Court unanimously ruled in favor of the plaintiffs and established that the same treatment, programs, services, facilities, and textbooks to limited English proficient students of Chinese ancestry as to English proficient students did not equal non-discrimination based on Title VI of the U.S. Civil Rights Act of 1964. The case established that language, by proxy, is national origin and that linguistic characteristics that are inherently common to a particular national origin minority group is equal to national origin. Though the government did not cause the language deficiency, the government had the legal obligation to take affirmative steps to rectify the lack of equal and comparable access and to create the linguistic access, enabling meaningful participation in the programs and activities, funded by Federal dollars. It was a victory for bilingual education and the case had a myriad of ramifications for programs and activities, funded by Federal dollars.
Title VI of the U.S. Civil Rights Act of 1964 spells it out for entities, which receive any monetary form of Federal assistance, in how they are to provide equal and comparable access to programs and activities to persons regardless of race, color, or national origin. For most people, the national origin portion is difficult to grasp simply because most people do not understand how a service or program could discriminate against people based on national origin. Some of the arguments I have heard is that language is a skill set, not necessarily a reflection of national origin. I would be a good example of this. Though my nation of origin is Korea, I now speak English as my primary language. The forces of assimilation and acculturation play significant roles in how an immigrant's linguistic skills evolve over time.
The most troubling aspect of my grandfather's death was learning how few people, including lawyers, knew about Title VI and that language interpretation for those with limited English proficiency was required by law in health and human services, whenever federal dollars were involved. As a Medicaid and Medicare recipient, my grandfather was entitled to language assistance, but never received it during the last 15 years of his life.
As a result of the circumstances of my grandfather's tragic death, I began this documentary film (amongourkin.org) as a means of highlighting the plight of many Asian Americans with limited-English proficiency and mental illness. They are often doubly discriminated against first based on disability in their culture of origin, and then discriminated against based on national origin by the broader English-dominant society. For many limited-English proficient Americans who speak a primary language other than English, he/she may not be aware of their rights and, as a result of their limited English proficiency, have a limited capacity to assert their linguistic needs in healthcare settings. My grandfather, as a recipient of Medicaid and Social Security Disability Insurance, was definitely entitled to interpretation services at every point of contact per Standard 4 of the National Standards for Culturally and Linguistically Appropriate Services (CLAS).
Many health agencies have difficulties meeting their criteria for a myriad of reasons, including the costs of having a interpreters on staff and the sheer number of foreign languages spoken by patients in a given healthcare setting. However, the current research indicates that less than .5% is required to implement interpretative services and the costs in the long-term are actually reduced with linguistically appropriate care due to the resulting efficiency of health care, which allows the patient meaningful participation. It makes sense. When trust and authenticity are high in doctor-patient relationship, health outcomes are highly favorable. Health inequities contribute greatly to the escalating costs of healthcare.