ADA and Non-discrimination

Non-discrimination Notice

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The Missouri Department of Health and Senior Services is committed to principles of equal employment opportunity throughout the Department and equal access to all of its programs, services, and activities. Accordingly, the public, Department employees, applicants for employment, contractors, regulated entities, and all other persons are to be treated equitably and fairly, and not be subjected to harassment, retaliation, or intimidation, regardless of age, ancestry, color, disability, genetic information, military/veteran status, national origin, pregnancy, race, religion, or sex (including sexual orientation and gender identity), or socioeconomic status. The Department complies with all requirements of the Missouri Human Rights Act, Chapter 213, RSMo, as amended; Title VI and Title VII of the Civil Rights Act of 1964, as amended; Title IX of the Education Amendments Act of 1972, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; the Americans with Disabilities Act of 1990, as amended; the Age Discrimination Act of 1975, as amended; and all other applicable laws, regulations, and executive orders.

The Department will provide equal opportunity for all in recruitment, hiring, training, promotion, transfer, compensation, and all other terms and conditions of employment. The Department will make reasonable modifications and accommodations to ensure that all persons have an equal opportunity to participate in, or benefit from, all Department programs, services, and activities. The Department will not grant, deny, or revoke a permit, license, registration, or certification on the basis of any protected category.

Limited English Proficiency Policy

DHSS Policy 30.20 Language Services

Purpose

It is the policy of the Department of Health and Senior Services (DHSS) to provide services on a nondiscriminatory basis based on national origin, race, sex, age, disability, color, religion, or genetic information.

Language barriers may interfere with the provision of services to clients, leading to misunderstandings and impacting program effectiveness. Effective language services can help prevent these problems.

Definitions

Communication: The transfer and understanding of a message from one person to another by means of speaking, writing (including Braille), sign language or illustration.

Interpretation: Spoken transfer and understanding of a message from one language to another.

Translation: Written transfer and understanding of a message.

Limited English Proficiency (LEP) Individual: An individual whose primary language is not English and who cannot speak, read, write or understand the English language at the level necessary for effective communication.

Methods of Administration: Document signed by DHSS and provided to the U.S. Department of Health and Human Services (USDHHS) specifying methods DHSS will use to implement and assure compliance with Title VI of the Civil Rights Act of 1964 as amended (42 USC 2000d et seq); the Rehabilitation Act of 1973 (29USC 794), hereinafter referred to as Section 504; and the regulations issued there under by USDHHS (45 CFR Parts 80 and 84). It is essential to communicate information in a language other than English when and as required by federal regulations (see Administrative Manual Section 3.2).

Policy

It is the intent of DHSS to:

  1. establish systems and procedures for the provision of services to any Limited English Proficiency (LEP) individual, particularly those who cannot communicate in spoken or written English;
  2. improve customer relations between DHSS and the people we serve;
  3. assure quality translation and interpretation services by obtaining feedback on the performance of translators and interpreters; and
  4. provide technical support to all DHSS programs.

2.0. Components

2.1 Responsibilities

2.1.1 All DHSS employees and programs shall utilize the state contracts for providing interpretation and translation services. Guidance and information on what contracts are currently being used by DHSS will be available through the Office of Human Resources or obtained through the contract search listing available on the Office of Administration’s web site.

2.1.2 All DHSS employees and programs will make reasonable efforts to offer interpretation and translation services when contact has been made with an individual of limited English proficiency. Contact should be recorded by the employee and the LEP Data Form (Attachment A), can be used for convenience in recording said contract. A copy of the recording should be kept in the client’s work file.

2.1.3 Each DHSS program will determine which materials and forms used by the public will be translated based on an assessment of the population in the services area.

2.1.4 Translation materials shall be linguistically and culturally appropriate to the client population.

2.1.5 DHSS will strive to provide visual and audio information in the appropriate language to LEP clients. Medically or legally complex materials may be contracted with a vendor for translation.

2.1.6 DHSS programs having state or federal funding cannot discriminate in the provision of services under Title VI. The Missouri Constitution, Article I, Section 34 of the Bill of Rights, which states English to be the official language in the state, does not affect Title VI expectations for provision of services.

2.2 Contracts for Translation or Interpretation
If vendors are contracted to provide interpretive services and/or perform the translation of materials to other languages, the program will be responsible for associated costs.

2.3 Contractors
The contractors shall comply with all applicable provisions of the Civil Rights Act (45 CFR 80), the Rehabilitation Act of 1973 (45 CFR 84), and all other federal and state laws and regulations relating to non-discrimination. The contractors shall assure that no person eligible for services shall on the ground of race, color, religion, national origin (this includes individuals of limited English proficiency), sex, disability, veteran status, age, or genetic information be excluded from participation in, be denied the benefits of, or be otherwise subject to discrimination for any service provided by the contract. The contractors shall, within resources available, ensure minority health issues are addressed in the delivery of services where disparities in health status exist between minority and majority Missourians.

2.4 Clients of DHSS:

  1. No client, applicant or their representative will be required to provide or pay for the services of a translator or interpreter.
  2. For LEP clients, DHSS employees will identify and document on client records the primary language/dialect of the client and need for translation or interpretation services.
  3. A family member or friend may be used as an interpreter if this is requested by the client and the use of such a person would not compromise the effectiveness of services or violate the client's confidentiality, and the client is advised that a free interpreter is available. The family member or friend must be 18 years of age or older.

2.5 Responsibility for coordination of this policy is assigned to the DHSS Office of Human Resources.

The Department will make every effort to provide appropriate auxiliary aids, equipment, and services for the visually or hearing impaired, as well as for persons with language barriers who require alternate means of communication (e.g., qualified interpreters and translators, readers, Braille or large print materials, closed-captioned video programs, American Sign Language, etc.). Individuals who require special services or accommodations to participate in a Department program, service, or activity should make arrangements by contacting the Department as soon as possible, but no later than 48 hours before the scheduled event, if reasonable. Individuals should contact the Department liaison listed for the respective Department program, service, or activity. General inquiries for assistance may be made by calling 573-751-9832 or emailing DHSSHumanResources@health.mo.gov. Hearing and speech-impaired individuals may reach the Department contact through Relay Missouri at 800-735-2966.

Notice Regarding the Americans with Disabilities Act

The Department will not place a surcharge on a particular individual with limited English proficiency, with a disability, or any group of individuals with disabilities, to cover the cost of providing auxiliary aids/services, or reasonable modifications of policy, such as retrieving items from locations that are open to the public but are not accessible to persons who use wheelchairs. The Department is not required to take any action that would fundamentally alter the nature of its programs or services or impose an undue financial or administrative burden.

Complaint Procedures

The Department does not intimidate or retaliate against any individual or group because they have exercised their rights to participate in or oppose actions protected or prohibited by 40 C.F.R. Parts 5 and 7, or for the purpose of interfering with such rights. Any person who believes they have been subjected to unequal treatment or discrimination or retaliation by a Department employee, or based on a Department policy or practice, should report the incident(s) to the contact listed below. Hearing and speech-impaired individuals may reach the Department through Relay Missouri at 800-735-2966. The Department is committed to completing prompt and fair investigations of complaints received, and evaluates each complaint based on the preponderance of the evidence.

Contact Information

Department of Health and Senior Services
912 Wildwood Drive
P.O. Box 570
Jefferson City, MO 65102-0570
United States
573-751-6400
info@health.mo.gov

Jamie Battle, Human Resources Specialist/Nondiscrimination Coordinator
Missouri Department of Health and Senior Services
912 Wildwood Drive
Jefferson City, MO 65102-0570
Telephone: 573-751-9832
DHSSHumanResources@health.mo.gov

Demographic Data

The Missouri Department of Health and Senior Services (DHSS) is required by federal nondiscrimination law to “collect, maintain, and … provide the following information: … Racial/ethnic, national origin, age, sex and handicap data….” 40 C.F.R. § 7.85(a)(2). DHSS collects demographic data from the U.S. Census Bureau, using the most recent data available. Citations are available for each type of data collected...

Total Population: 6,196,156

  • Race
    • White: 5,104,983
    • Black or African American: 725,454
    • American Indian and Alaska Native: 39,283
    • Asian or Pacific Islander: 156,968
    • Two or more races: 169,468
  • Hispanic or Latino
    • Hispanic or Latino: 330,979
    • Not Hispanic or Latino: 5,865,177
  • Language Spoken at Home:
    • 7% ± 0.2%
    • Language Other Than English Spoken at Home in Missouri
    • 22.5% ± 0.1%
    • Language Other Than English Spoken at Home in United States
  • Types of Language Spoken at Home:
    • English Only: 93.0%
    • Spanish: 2.9%
    • Other Indo-European languages: 2.0%
    • Asian and Pacific Islander languages: 1.4%
    • Other languages: 0.7%
  • Age:
    • 19 years and Under: 1,532,467
    • 20-24 years: 406,038
    • 25-29 years: 395,273
    • 30-34 years: 417,394
    • 35-39 years: 401,184
    • 40-44 years: 398,042
    • 45-54 years: 719,855
    • 55-64 years: 789,288
    • 65 years and over: 1,136,615
  • Sex:
    • Male: 3,057,604
    • Female: 3,138,552
  • Disability:
    • With a disability: 15%
    • With hearing difficulty: 4.2%
    • With a vision difficulty: 2.6%
    • With a cognitive difficulty: 6.4%
    • With an ambulatory difficulty: 7.4%
    • With a self-care difficulty: 2.6%
    • With an independent living difficulty: 6.5%
    • No disability: 85%

Sources:
Race/Sex/Ethnicity/Age: Missouri Department of Health and Senior Services. Bureau of Health Care Analysis and Data Dissemination. 2023 Population Estimates created based on the Census Population Branch’s Vintage July 1, 2023, estimates.
Language Spoken at Home: U.S. Census Bureau, U.S. Department of Commerce. "Language Spoken at Home." American Community Survey, ACS 1-Year Estimates Subject Tables, Table S1601, 2023, https://data.census.gov/table/ACSST1Y2023.S1601?q=language+spoken+at+home+missouri+and+united+states. Accessed on May 23, 2025.
Disability: U.S. Census Bureau, U.S. Department of Commerce. "Disability Characteristics." American Community Survey, ACS 1-Year Estimates Subject Tables, Table S1810, 2023, https://data.census.gov/table/ACSST1Y2023.S1810?q=disability+MISSOURI. Accessed on May 23, 2025.