NYS audit says NYC health department needs to improve access to language services

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In a city in which hundreds of languages are spoken, the New York City Department of Health and Mental Hygiene isn’t doing enough to reach residents who may have limited proficiency in English, according to a new audit from the Office of the New York State Comptroller.

The March report by State Comptroller Thomas DiNapoli sought to better understand whether the health department, one of the biggest in the world with more than 7,000 employees, was complying with state regulations and local laws to provide “sufficient oversight” of language access services for the millions of New Yorkers with limited English proficiency.

Citing a 2023 American Community Survey conducted by the U.S. Census Bureau, the study points out that an estimated 1.7 million New Yorkers speak hundreds of languages and have limited English proficiency.

The audit, released Wednesday, spans a period from January 2019 to December 2024.

The health department is one of four city agencies required by law to provide free language access services to clients who have limited English proficiency, the audit reported. As such, these agencies are required to provide services such as telephone interpretation, multilingual signage, and document translations, and create a language access implementation plan.

Telephone interpretation must be available in at least 100 languages and handy translations of key documents must be available in 10 designated citywide languages: Spanish, Chinese, Russian, Bengali, Haitian Creole, Korean, Arabic, Urdu, French, and Polish.

A language services unit in the health department’s office of external affairs is responsible for receiving, tracking, and resolving related complaints.

In his report, the comptroller identified “numerous deficiencies in DOHMH’s administration and operation of its LAS that led to potential non-compliance with relevant standards and local laws.”

Key findings include:

The health department does not have a systemwide repository for recording and tracking language access services as required. Language access requests may be underreported and offer an incomplete picture of potential needs.Health department officials are unaware of the number of instances in which an interpreter could not be located.The health department has a required fluency assessment, but there are uncertified bilingual staff providing clinical services. The health department inconsistently reports the number of bilingual staff who have completed the fluency tests. A survey of 50 restaurants and food establishments and review of food inspection data found that many owners and workers were unaware of language access resources or of a bill of rights that states the right to language access services during inspections.

In its audit, the comptroller’s office made seven recommendations, which include:

Develop a system-wide database for collecting and tracking clients’ language preferences across all facilities, and collaborate with vendors to gather relevant data on LAS delivery and unfulfilled requests.Ensure all communication is geared toward people with limited English proficiency, including telephone systems and appropriate signage.Ensure staff who provide interpretation complete the health department’s fluency assessment.Test language access services equipment for each program and facility periodically to ensure access to language access services.

In a response that was included in the audit, the health department said it “generally agrees” with all of the recommendations. The health department noted that a database used for restaurant inspections was set up in 2010, and making changes to “this outdated technology is difficult and costly.”

“Currently this information is captured manually, and we are not able to generate reports,” the department said.

In a separate statement, a health department spokesperson said the agency’s language access services “in 2026 represents the gold standard” and the agency is making improvements.

The statement noted that the audit’s time span overlaps with the pandemic, “when many city services faced disruption and setbacks.”

“Since this audit was launched two years ago, and particularly since receiving the preliminary report in December, we have improved our language access services. Of the seven recommendations, nearly half are complete and the remainder are underway.”

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Trenton Daniel is a reporter covering public health in New York for Healthbeat. Contact Trenton at tdaniel@healthbeat.org or on the messaging app Signal at trentondaniel.88.