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DocuSign Envelope ID:3FDDF183-DEOC-45F5-AE17-OB9CF99E613F <br /> b. When state DHHS forms and other written material contain <br /> spaces in which the local entity is to insert information, this <br /> inserted information will also be in the individual's primary <br /> language. When such forms are completed by <br /> applicants/recipients in their primary language, the <br /> information must be accepted. <br /> C. If, as a result of the local language assessment, it appears <br /> there are a substantial number of potential applicants or <br /> recipients of the agency(defined as 5% or 1,000 people <br /> whichever is less)who are LEP and speak a language other <br /> than Spanish, the agency will translate and provide vital <br /> documents in the appropriate language. (We prefer counties <br /> do not translate DHHS forms. Please notify DHHS and <br /> DHHS will translate or verify county translation) <br /> d. The agency will keep a record of all vital documents <br /> translated, and will submit this information to DHHS at <br /> their request. <br /> 3. If the primary language of an LEP applicant or recipient is a <br /> language other than Spanish AND the language does not meet the <br /> threshold for translation as defined in the preceding paragraph, the <br /> LEP individual will be informed in their own language of the right <br /> to oral translation of written notices. The notification will include, <br /> in the primary language of the applicant/recipient, the following <br /> language: IMPORTANT: IF YOU NEED HELP IN READING <br /> THIS, ASK THE AGENCY FOR AN INTERPRETER TO HELP. <br /> AN INTERPRETER IS AVAILABLE FREE OF CHARGE. <br /> D. Documentation of Applicant/Recipient Case Records <br /> 1. The agency will maintain case record documentation in sufficient <br /> detail to permit a reviewer to determine the agency's compliance <br /> with this policy. <br /> 2. The agency will ensure that case record documentation, including <br /> computerized records if appropriate, identifies the <br /> applicant's/recipient's ethnic origin and primary language. In <br /> those cases where the applicant/recipient is non-English speaking, <br /> the agency will: <br /> a. Document the individual's acceptance or refusal of forms <br /> or other written materials offered in the individual's <br /> primary language. <br /> 8 <br />