Make Your Grant Count Igniting Change Through Research ASHA News
ASHA News  |   November 01, 2002
Make Your Grant Count
Author Notes
  • Andrea Moxley, is project manager for ASHA’s Office of Multicultural Affairs. Contact her at
    Andrea Moxley, is project manager for ASHA’s Office of Multicultural Affairs. Contact her at×
Article Information
Cultural & Linguistic Diversity / Healthcare Settings / Research Issues, Methods & Evidence-Based Practice / Regulatory, Legislative & Advocacy / Speech, Voice & Prosody / ASHA News
ASHA News   |   November 01, 2002
Make Your Grant Count
The ASHA Leader, November 2002, Vol. 7, 14-31. doi:10.1044/leader.AN.07202002.14
The ASHA Leader, November 2002, Vol. 7, 14-31. doi:10.1044/leader.AN.07202002.14
Survival skills teach us that if you rub two sticks together long enough, you will get a fire. Here’s how it can work.
Stick #1
The National Research Service Award training grant was awarded in July 1992 to UCLA/RAND Health Services Research Training Program by the U.S. Agency for Healthcare Research and Quality (AHRQ). This program funded Kathryn Piktin Derose of the University of California, Los Angeles, and David M. Baker of Case Western University for a study to be carried out in conjunction with the AHRQ. Based on the researchers’ findings, AHRQ released a report in March 2000.
The report noted that 465 Spanish-speaking Latinos and 259 English speakers of various ethnicities were interviewed regarding their care and the follow-up recommendations they received during hospital emergency department visits in 1993 and 1994. An English literacy examination was administered to the Spanish-speaking group to assess their level of language proficiency. There was no difference in the follow-up care reported between Latinos with good English proficiency and English-speaking non-Latinos. Latinos with fair and poor English proficiency, however, reported about 22% fewer follow-up physician visits than non-Latinos whose native language was English.
Further investigation by the Office for Civil Rights revealed that persons who lack proficiency in English were frequently unable to access various benefits and services to which they are entitled. Title VI of the Civil Rights Act of 1964 prohibits discrimination based on national origin. Federally funded programs must ensure that all persons have “meaningful access” to their activities.
Stick #2
President Clinton subsequently issued Executive Order 13166 on Aug. 11, 2000, to guide federal agencies to extend assistance in accordance with Title VI. The executive order clarified that all agencies shall develop and implement a system by which persons who are limited English proficient (LEP) can access those services and shall ensure that LEP persons have the opportunity to provide input to federally funded agencies. Agencies were ordered to provide a written plan delineating how they intended to improve this access. They were then to implement the plan within 120 days.
The U.S. Department of Justice (DOJ) released a directive providing guidance on the standards in the policy document, “Enforcement of Title VI of the Civil Rights Act of 1964—National Origin Discrimination Against Persons with Limited English Proficiency,” originally published Aug. 16, 2000. This document stated what constitutes reasonable steps to ensure meaningful access for LEP persons. These reasonable steps were contingent upon four factors: the number or proportion of LEP persons receiving services, frequency of visits, importance of the program, and resources available. It was further directed that there must be adequate provisions for equal access to oral and written documents.
The document was republished for the public on Jan. 18, 2002. The DOJ received several inquiries regarding the document and, in response, republished it for public comment on April 18. Based on the comments received, changes were made, including technical or stylistic changes that “more clearly articulate the underlying principle, guideline or recommendation detailed in that Guidance.”
This final revision was released to the public on June 18. For more information, visit
A Good Fire
One grant ignited a change in the medical services, which will have a profound impact on many people. One grant turned into an executive order. An executive order sparked the DOJ to release a directive. Several collective, not necessarily united, voices then started the fire to help modify this directive.
It is incumbent upon us—as speech-language pathologists, audiologists, and speech, language, and hearing scientists—to consider the potential impact of our individual and collective voices and to use them to advocate for change and keep the fire burning.
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November 2002
Volume 7, Issue 20