Limited English Proficiency Plan

Page 1

Limited English Proficiency Plan

Providing meaningful access to the TPO for people with limited or no ability to speak, read, write or understand English

www.polktpo.com


Table of Contents Introduction ...................................................................................................................................................... 3 Who the plan is intended to assist ............................................................................................................... 3 Four Factor Analysis .......................................................................................................................................... 4 1. The number or proportion of LEP persons eligible to be served or likely to encounter a TPO program, activity or service .......................................................................................................................................... 4 2. The frequency with which LEP individuals come in contact with TPO program, activity or service ........................................................................................................................................................... 4 3. The nature and importance of the program, activity or service provided by the TPO to LEP community .................................................................................................................................................... 4 4. The resources available to the TPO and overall costs to provide LEP assistance .................................... 5 How to identify a LEP person who needs language assistance ........................................................................ 6 Language assistance measures ..................................................................................................................... 6 TPO staff training .......................................................................................................................................... 6 Providing notice of available language service to LEP persons .................................................................... 6 Outreach techniques .................................................................................................................................... 7 Dissemination of the TPO Limited English Proficiency Plan ......................................................................... 7 Monitoring and updating the LEP Plan ............................................................................................................. 7 Appendix A Polk County Population and Primary Language Data.................................................................... 9 Appendix B "I Speak Cards"…………………………………………………………………………………………………………………..10-11 Appendix C Bilingual County Personnel Phone List........................................................................................ 12 Appendix D Title VI Complaint Form English Version..................................................................................... 13 Appendix E Title VI Complaint Form Spanish Version..................................................................................... 14 Appendix F Notice to TPO Grant and Program Subrecipients........................................................................ 15 Figure 1 Percent of Population with Limited English Proficiency………………………………………………..………………16 Figure 2 Hispanic Population in Polk County………………………………………………………….………………………………….17 Figure 3 Percent of Hispanic Population in Polk County…………………………………………………………….………………18


Introduction The purpose of the Transportation Planning Office (TPO) Limited English Proficiency (LEP) Plan is to clarify our responsibilities as a recipient of federal financial assistance from the U.S. Department of Transportation (DOT) and implement a plan detailing our responsibilities to LEP persons, pursuant to Title VI of the Civil Rights Act of 1964. This LEP plan was prepared in accordance with Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq., and its implementing regulations provide that no person shall be subjected to discrimination on the basis of race, color, or national origin under any program or activity that receives federal financial assistance. It also complies with Executive Order 13166 ``Improving Access to Services for Persons With Limited English Proficiency,'' reprinted at 65 FR 50121 (August 16, 2000), which directs each Federal agency that is subject to the requirements of Title VI to publish guidance for its respective recipients clarifying that obligation. Executive Order 13166 further directs that all such guidance documents be consistent with the compliance standards and framework detailed in the Department of Justice's (DOJ's) Policy Guidance entitled “ Enforcement of Title VI of the Civil Rights Act of 1964--National Origin Discrimination against Persons With Limited English Proficiency'' (See 65 FR 50123, August 16, 2000 DOJ's General LEP Guidance). Different treatment based upon a person’s inability to speak, read, write or understand English may be a type of national origin discrimination. It is the intent of the TPO that in providing language services to persons with limited English proficiency, the process achieves a balance that ensures meaningful access to programs and services while not incurring undue burdens on resources of the organization. A Limited English Proficiency person is one who does not speak English as their primary language and who has a limited ability to read, speak, write or understand English. This plan details how the TPO identifies people who may need language assistance, the ways in which assistance may be provided, how to notify LEP persons that assistance is available and information for future plan updates.

Who the plan is intended to assist This Limited English Proficiency Plan applies to individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English. For example, the scope of the plan would not extend to the following: • The hearing or visually impaired – Sign language interpretation and Braille text are accommodations provided under the Americans with Disabilities Act. • Illiteracy – The inability to speak read or write English and conditions that may trigger language assistance under Title VI are distinguished with a key factor. A LEP person cannot speak, read or write English, but primarily speaks, read or writes in a language other than English.


Four Factor Analysis To help determine the TPO’s extent of obligation to provide LEP services, the TPO followed the U.S. Department of Transportation four factor LEP analysis which considers the following: 1) The number or proportion of LEP persons eligible in the county to be served or likely to encounter a TPO program, activity or service; 2) the frequency with which LEP individuals come in contact with a TPO program; 3) the nature and importance of the program, activity or service provided by the TPO to the LEP population; and 4) the resources available to the TPO and overall costs to provide LEP assistance. A brief description of these considerations is provided in the following section.

1. The number or proportion of LEP persons eligible to be served or likely to encounter a TPO program, activity or service The TPO examined the US Census Bureau’s 2009-11 American Community Survey data, included as Appendix A, and determined that approximately 18.9 percent of, or 106,519 people in Polk County age 5 and older spoke a language other than English at home and 8.0%, or 45,055, stated they speak English “less than very well”. Hispanics comprised the la r ge st n o n -English speaking language group. There were 84,759 Hispanic/Latinos or 15.0% of the Polk County population who spoke a language other than English at home and 6.6% of the population, or 37,494, said that they speak English less than very well.

2. The frequency with which LEP individuals come in contact with TPO program, activity or service The TPO assesses the frequency at which staff has or could possibly have contact with LEP persons. This includes documenting phone inquiries and surveying public meeting attendees. Our new website, www.polktpo.com, will track language assistance requests.

3. The nature and importance of the program, activity or service provided by the TPO to LEP community It is our intent to educate the LEP community about our Unified Planning Work Program (UPWP), Transportation Improvement Program (TIP) and Long Range Transportation Plan (LRTP). Based on data obtained from the 2010 Census (Appendix A), we expect to likely come in contact with Spanish, German, Haitian Creole or French speakers, with the Spanish community being the largest population and growing the fastest in Polk County.


Spanish community being the largest population and growing the fastest in Polk County. As such, the Hispanic population throughout Polk County is shown on Figure 2. Additionally, Figure 3 depicts the percentage of Hispanics within Polk County. The TPO acknowledges the increase in the Hispanic population in Polk County warrants the need to actively communicate with the Hispanic community. As such, the TPO has hired a Bilingual Transportation Planner to assist in public outreach in the Hispanic communities of Polk County.

4. The resources available to the TPO and overall costs to provide LEP assistance The TPO assessed the following available resources that could be used for providing LEP assistance: • Identifying what staff and volunteer language interpreters (Appendix B) are readily available • How much professional interpreters and/or translation service would cost • Identifying which documents should be translated • Taking an inventory of available organizations that the TPO could partner with for outreach and translation efforts • Examining which financial and in-kind sources could be used to provide assistance and what level of staff training is needed. TPO will utilize current staff and volunteer language interpreters and/or translators as needed. In addition, TPO has recently hired a Bilingual Transportation Planner to assist in communicating with the Hispanic population in Polk County. Should the need for additional language translation or interpretation rise, TPO could utilize language services available through www.servicescape.com, at a cost of approximately $20.00 per page if necessary. TPO could also use personal interpreter services through www.languageline.com at a cost of approximately $3.95 per minute if necessary. The following TPO materials are currently available in Spanish: Adviser brochure, Aging in Place & Transit infographic, 2035 Polk Mobility Vision Plan Newsletter and the Title VI complaint form. Title VI complaint forms in English and Spanish are included as Appendix C and D, respectively. Should a need rise for additional translation services, TPO will analyze cost and resources to provide LEP assistance. TPO has identified the following community groups who could aide in outreach and translation efforts: the Puerto Rican Hispanic Chamber of Commerce, the German American Club of Lakeland, the French American Business Council of West Florida, and the Haitian American Chamber of Commerce of Florida. After analyzing these four factors, the TPO h a s developed the plan outlined in the


How to identify a LEP person who needs language assistance TPO staff will set up a sign-in sheet at TPO sponsored workshops and/or conferences. The sign-in table will be staffed by our Bilingual Senior Transportation Planner to greet and briefly speak to each attendee. To informally gage the attendee’s ability to speak and understand English, ask a question that requires a full sentence reply. TPO staff will have the Census Bureau’s “I Speak Cards” at the workshop or conference sign-in sheet table. While staff may not be able to provide translation assistance at this meeting, the cards are an excellent tool to identify language needs for future meetings. Also, have the cards available at the TPO office reception area.

Language assistance measures When an interpreter is needed, in person or on the telephone, the TPO shall first determine what language is required. Polk county staff can provide Afrikaans, Creole, German, Haitian, Hindi, Filipino, Spanish and Vietnamese informal verbal interpretation. Appendix B details which Polk County employees can be contacted for immediate translation service in a variety of languages. Staff may be able to assist with written communications and small TPO document translation requests from LEP persons. Spanish teletypewriter (TTY) relay service is available through Florida Relay Service at 800-955-8771. TPO staff has been provided with a “how to respond to a Spanish caller index card”. This index card will provide a simple phrase in Spanish for TPO staff to instruct a Spanish caller to hold while their call is being transferred to our Bilingual Transportation Planner, Xiomara Meeks.

TPO staff training All TPO staff are provided with the LEP Plan and educated on procedures and services available. This information will also be part of the TPO staff orientation process for new hires.

Providing notice of available language service to LEP persons TPO will post signs that language assistance is available to the public before public meetings. Our website www.polktpo.com is equipped with a language translator for Spanish, French, German and Haitian Creole. TPO staff will continue to monitor requests for additional languages and make modifications to this plan as needed.


Outreach techniques Per the strategies outlined in the TPO’s Public Participation Plan (PPP), if staff knows they will be presenting a topic that could be of potential importance to a LEP person, or if staff will be hosting a meeting or a workshop in a geographic location with a known concentration of LEP persons, meeting notices, fliers, advertisements and agendas will be printed in an alternative language, such as Spanish. When placing a general public meeting notice, staff will insert “Un traductor del idioma español estará disponible” This means “A Spanish translator will be available”. Or if not sure of the need, staff should insert, “Si usted necesita la ayuda de un traductor del idioma español, por favor comuníquese con Xiomara Meeks al teléfono (863) 534-6551, por lo menos 48 horas antes de la junta.” which asks persons who need Spanish language assistance to make arrangements with the TPO within two days of the publication notice. Spanish speaking staff or a hired interpreter should be on hand at public meetings intended for gathering public input when a topic or meeting location deems it appropriate.

Dissemination of the TPO Limited English Proficiency Plan The LEP Plan is posted at www.polktpo.com. Any person, including social service, nonprofit and law enforcement agencies and other community partners with internet access will be able to access the plan. For those without personal internet service, all Polk County libraries offer free internet access. Copies of the LEP Plan are provided to the Polk County Social Services, the Florida Department of Transportation, Federal Highway Administration, the Federal Transit Administration and any person or agency requesting a copy. Each TPO sub-recipient is provided a copy and informed of the importance of providing language assistance (Appendix E). LEP persons may obtain copies/translations of the plan upon request by calling (863) 534-6495 or it can be downloaded at www.polktpo.com.

Monitoring and updating the LEP Plan At a minimum, the TPO will follow the Title VI Program update schedule for the LEP Plan. The questions listed below will be considered in updating the LEP Plan. •

How many LEP persons were encountered?

Were their needs met?


Has there been a change in the types of languages where translation services are needed?

Have the TPO’s available resources, such as technology, staff and financial costs changed?

Has the TPO fulfilled the goals of the LEP Plan?

Were any complaints received?

Any questions or comments regarding this plan should be directed to TPO planner Diane Slaybaugh at 863-534-6495 or dianeslaybaugh@polk-county.net.


Appendix A The following data from the US Census Bureau provides insight into the racial diversity of Polk County and the primary languages that are commonly used. This data is useful to the TPO as it tailors its public outreach materials and mediums to the proper groups using accessible language.

US Census Bureau Quick Facts about Polk County (2013) Population, 2013 estimate Population, 2012 estimate Population, 2010 (April 1) estimates base Population, percent change, April 1, 2010 to July 1, 2013 Population, percent change, April 1, 2010 to July 1, 2012 Population, 2010 Persons under 5 years, percent, 2012 Persons under 18 years, percent, 2012 Persons 65 years and over, percent, 2012 Female persons, percent, 2012 White alone, percent, 2012 (a) Black or African American alone, percent, 2012 (a) American Indian and Alaska Native alone, percent, 2012 (a) Asian alone, percent, 2012 (a) Native Hawaiian/ Other Pacific Islander alone, percent, 2012 (a) Two or More Races, percent, 2012 Hispanic or Latino, percent, 2012 (b) White alone, not Hispanic or Latino, percent, 2012 Living in same house 1 year & over, percent, 2008-2012 Foreign born persons, percent, 2008-2012 Language other than English spoken at home, pct age 5+, 2008-2012 High school graduate or higher, percent of persons age 25+, 2008-2012 Bachelor's degree or higher, percent of persons age 25+, 2008-2012 Veterans, 2008-2012 Mean travel time to work (minutes), workers age 16+, 2008-2012 Housing units, 2012 Homeownership rate, 2008-2012 Housing units in multi-unit structures, percent, 2008-2012 Median value of owner-occupied housing units, 2008-2012 Households, 2008-2012 Persons per household, 2008-2012 Per capita money income in past 12 months (2012 dollars), 2008-2012 Median household income, 2008-2012 Persons below poverty level, percent, 2008-2012

623,009 616,083 602,095 3.5% 2.3% 602,095 6.2% 23.0% 18.8% 51.0% 80.0% 15.6% 0.6% 1.8% 0.1% 1.9% 18.6% 63.4% 82.8% 10.5% 19.0% 82.1% 18.2% 53,220 25.8 281,385 70.9% 14.2% $120,200 222,081 2.66 $21,674 $43,606 17.5%


台山话

台湾语/福建话

Taiwanese/Fukienese

闽语

Min

國語

Mandarin

台山話

Toisanese

台灣語/福建話

Taiwanese/Fukienese

閩語

Min

Hmong

Hmoob

Hindi

Ǒ¡ Ȳ ȣ

Japanese

日本語 通訳を無料でご利用になれます。該当 する言語を指示して下さい。通訳を手 配いたしますのでお待ち下さい。

Italiano

Avete diritto ad un interprete. Il servizio è gratuito. Indicate la vostra lingua e attendete; un interprete sarà chiamato al più presto.

‫יש לך את הזכות למתורגמן ללא כל עלות‬ ‫ המתורגמן‬.‫ אנא הצבע על השפה שלך‬.‫לך‬ .‫ אנא המתן‬.‫ייקרא‬

‫עברית‬

Hebrew

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Sie haben kostenlosen Anspruch auf eine/n Dolmetscher/in. Bitte deuten Sie auf Ihre Sprache. Ein/e Dolmetscher/in wird gerufen. Bitte warten Sie.

Vous avez droit gratuitement aux services d’un interprète. Veuillez indiquer votre langue. Nous allons contacter un interprète. Veuillez patienter si’il vous plaît!

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ȓî ŷ Ƅ

Khmer

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] Ȫ ǒ ȡ Ȫ_ ã ȡ ȡ ȯ ु Ǒ f ु ȡͪ ȡ ȯ

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언어

Korean

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Ελληνικά

Deutsch

Français

Greek

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廣東話

Cantonese

中文

German

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国语

广东话

Toisanese

Chinese - Traditional

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Հայերեն

Armenian

French

Italian

Ou gen dwa a yon entèprèt gratis. Tanpri montre nou lang pa w la. N ap rélé yon entèprèt pou ou. Tanpri ret tann.

Kreyòl Ayisyen

Haitian Creole

‫ﺷﻤﺎ ﺣﻖ دارﯾﺪ ﮐﮫ ﯾﮏ ﻣﺘﺮﺟﻢ داﺷﺘﮫ ﺑﺎﺷﯿﺪ ﺑﺪون‬ ‫ ﻟﻄﻔﺄ ﺑﮫ زﺑﺎن ﺧﻮد‬.‫آﻧﮑﮫ ﭘﻮﻟﯽ ﺑﺎﺑﺖ آن ﺑﺪھﯿﺪ‬ ‫ ﯾﮏ ﻣﺘﺮﺟﻢ ﺑﺮاﯾﺘﺎن درﺧﻮاﺳﺖ ﺧﻮاھﺪ‬.‫اﺷﺎره ﮐﻨﯿﺪ‬ ‫ ﻟﻄﻔﺄ ﻣﻨﺘﻈﺮ ﺑﻤﺎﻧﯿﺪ‬.‫ﺷﺪ‬

‫دری‬

Dari

Nhôs tem direito a um intérprete gratuíto di ä ăĂđĉ ã Ēāï đĉ ĉĘĠĘõ ĒąĂđćĕ ĘĊƟ ë ï ö Ă nhôs língua. Mostra qual qui nhôs língua pa nô podi tchoma intérprete. Nhôs aguarda ĺĀđĆ đČē ăđí ĠđĉÞ ã ĂĔ ƣĎ ï Ęĉ ä ăĂđĉ um momento, por favor. Ć đČđ ĺï đĂDž þ đ ĺĀĒð ĘĠ ĒĀĂÞ ë ï ö Ă ĺĀđĆ đČēĘï û đï đ ĎĘąÞã ĂĔ ƣĎ ï Ęĉ ã Ęăǘ đ ï ˙ ĂÞ Mandarin

中文

Criolu di Cabu Verdi

বাংলা Cantonese

Chinese - Simplified

Cape Verdean Creole

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Bengali

‫ﻋﺮﺑﻲ‬

Arabic

.‫ﯾﺤﻖ ﻟﻚ اﻟﺤﺼﻮل ﻋﻠﻰ ﺧﺪﻣﺎت ﺗﺮﺟﻤﺔ ﻓﻮرﯾﺔ دون أي ﻣﻘﺎﺑﻞ‬ ‫ﯾُﺮﺟﻰ ﻣﻨﻚ أن ﺗُﺸﯿﺮﺑﺈﺻﺒﻌﻚ اﻟﻰ ﻟُﻐَﺘﻚ ﻛﻲ ﻧﺴﺘﺪﻋﻲ اﻟﻤﺘﺮﺟﻢ‬ .‫ﯾُﺮﺟﻰ ﻣﻨﻚ اﻹﻧﺘﻈﺎر ﻟﺤﯿﻦ اﺳﺘﺪﻋﺎء اﻟﻤﺘﺮﺟﻢ‬. ‫اﻟﻤﻌﻨﻲ‬

አማርኛ

Amharic

You have the right to an interpreter at no cost to you. Please point to your language. An interpreter will be called. Please wait.

ያለምንም ወጪ አስተርጓሚ የማግኘት መብት አለዎት። የሚናገሩትንና የሚርዱትን ቋንቋ በመጠቆም ያመልክቱ። አስትርጓሚ እስኪጠራ ድረስ እባክዎ ይታገሱ።

Shqip

Albanian

Your Right to an Interpreter

Appendix


Ikaw ay may karapatan na magkaroon ng tagapagsalin na walang bayad. Ituro ang iyong wika. Ang tagapagsalin ay tatawagin. Maghintay.

Swahili

Ni haki yako kuwa na mtafsiri bila malipo yoyote. Tafadhali chagua lugha yako kati ya hizi. Mtafsiri ataitwa. Tafadhali ngoja.

‫آپ ﻣﻔﺖ ﺗﺮﺟﻤﺎﻧﯽ ﮐﯽ ﺧﺪﻣﺎت ﮐﮯ ﻣﺴﺘﺤﻖ‬ ‫ﮨﯿﮟ۔ ﺑﺮاﮦ ﮐﺮم اﭘﻨﯽ زﺑﺎن ﮐﯽ ﻃﺮف اﺷﺎرﮦ‬ ‫ﮐﯿﺠﺌﮯ۔ آپ ﮐﮯ ﻟﺌﮯ اﯾﮏ ﺗﺮﺟﻤﺎن ﮐﺎ اﻧﺘﻈﺎم‬ ‫ﮐﯿﺎ ﺟﺎﺋﯿﮕﺎ۔ ﺑﺮاﮦ ﮐﺮم اﻧﺘﻈﺎر ﮐﯿﺠﺌﮯ۔‬

‫اردو‬ Quý vị có quyền được một thông dịch viên miễn phí. Xin chỉ vào ngôn ngữ của quý vị. Chúng tôi sẽ gọi một thông dịch viên. Vui lò ng chờ trong giây lát.

Tiếng Việt

Vietnamese

Tagalog

Swahili

Urdu

Thai

Tagalog

Вы имеете право на услуги бесплатного переводчика. Укажите, пожалуйста, на Ваш язык. Переводчик будет вызван. Пожалуйста, подождите.

ทานมีสิทธิ์ขอลามแปลภาษาโดยไมเสียคาใชจายใ ดๆ กรุณาชี้ที่ภาษาของทาน กรุณารอสักครู เราจะโทรศัพทเรียกลามใหทาน

Waxaad xaq u leedahay in tarjumaan lacag la’aan ah laguugu yeero. Fadlan farta ku fiiq luqaddaada. Tarjumaan ayaa laguugu wacayaa. Ee fadlan sug!

Vi imate pravo na besplatnog prevodioca. Molimo vas da pokažete na vaš govorni jezik. Prevodilac ce biti pozvan. Hvala i molimo vas da sačekate.

ไทย

Soomaali

Srpsko-Hrvatski jezik

У Вас є право на безплатного перекладача. Будь ласка, вкажіть на Вашу мову, і Вам покличуть перекладача. Почекайте, будь ласка.

Україньска

Ukrainian

Usted tiene derecho a un intérprete gratis. Por favor, señale su idioma y llamaremos a un intérprete. Por favor, espere.

Español

Spanish

Русский

Você tem o direito a um intérprete de graça. Por favor aponte para a língua que você fala. Um intérprete será chamado. Por favor espere.

Masz prawo do korzystania z usług polskiego tłumacza. Usługa ta jest na nasz koszt. Proszę wskazać swój język. Proszę czekać. Lączymy z tłumaczem. Somali

Português

Portuguese

Język Polski

Polish

Serbo-Croatian

‫ﺷﻤﺎ ﺣﻖ دارﯾﺪ ﮐﮫ ﯾﮏ ﻣﺘﺮﺟﻢ داﺷﺘﮫ ﺑﺎﺷﯿﺪ ﺑﺪون آﻧﮑﮫ‬ ‫ ﯾﮏ‬.‫ ﻟﻄﻔﺄ ﺑﮫ زﺑﺎن ﺧﻮد اﺷﺎره ﮐﻨﯿﺪ‬.‫ﭘﻮﻟﯽ ﺑﺎﺑﺖ آن ﺑﺪھﯿﺪ‬ .‫ ﻟﻄﻔﺄ ﻣﻨﺘﻈﺮ ﺑﻤﺎﻧﯿﺪ‬.‫ﻣﺘﺮﺟﻢ ﺑﺮاﯾﺘﺎن درﺧﻮاﺳﺖ ﺧﻮاھﺪ ﺷﺪ‬

‫ﻓﺎرﺳﯽ‬

Persian

Russian

ກະຣນາລຖາ ຸ ໍ ້ .

ກະຣນາຊໃສພາສາຂອງທານ . າຍພາສາຈະຖກເອນມາ . ຸ ່ ີ້ ່ ື ີ້

່ໍ ັ ່ . ທານມສດຂນາຍແປພາສາໂດຍບເສຽຄາ ່ ີ ິ ໍ

ລາວ

Laotian


Appendix C Bilingual County Personnel Phone List Afrikaans Christa JansenvanNuuren Creole Janet Hanciles Filipino Maria Duncan GERMAN Gundula Williams Haitian Jivinson St. Juste Hindi (Language of India) Shri Kulkami Spanish Xiomara Meeks Ana Martinez Ana Bonilla Carmen Nieves Maria Fuentez Juan Garcia Harry Acevedo Roberto Davila Janett Ray Alex Valazquez Celia Alavarado Robinson Cancel Miriam Orellana Jessica Reynoso Armando Quintana Jose Ralat Hector Betancourt Julian Garcia Mary Huggins Petra Hernandez Naddie Sanchez Angelita Hernandez Rosalinda Beza Vietnamese Tuan Tran

Rohr Home

519-7579

Rohr Home

519-7579

Elderly Services Lakeland Adult Day Care

499-2606

Parks & Natural Resources

499-2613

Fire Rescue

519-7350

Information Technology

534-7541

Transportation Planning Office Transportation Planning Office Building & Codes Building & Codes Code Enforcement County Probation - Lakeland County Probation - Winter Haven County Probation - Lakeland County Probation - Winter Haven Equal Opportunity Facilities Management Healthy Families Healthy Families Information Technology Information Technology Risk Management Transit Services Rohr Home Rohr Home Rohr Home Rohr Home Rohr Home Rohr Home

534-6551 534-6468 534-6080 534-6557 534-7662 603-6654 401-2411 603-6653 401-2414 534-5901 899-8899 603-6687 401-2498 534-7575 534-7522 534-5281 534-5357 519-7579 519-7579 519-7579 519-7579 519-7579 519-7579

Elderly Services

534-5323


Appendix D TITLE VI COMPLAINT FORM ENGLISH VERSION Name

Home Phone

Address (Street No., P.O. Box, Etc.)

Work Phone

City, State, Zip Code

Name of Person(s) Who Discriminated Against You, Position (if known), and Name of Agency:

Address (Street No.)

City, State, Zip Code

Date of Alleged Incident: Discrimination Because of: (Circle one or more) • • • • • • • • •

Race Retaliation Sex Familial Status Religion Color National Origin Age Disability

Explain as briefly and clearly as possible on the back of this form what happened and how you were discriminated against. Indicate who was involved. Be sure to include how other persons were treated differently than you. Also attach any written material pertaining to your case.

Signature Date Mail to: Diane Slaybaugh, Polk TPO Title VI Specialist, Drawer TS05, P. O. Box 9005, Bartow, Florida 338319005.


Appendix E Title VI Complaint Form Spanish Version Nombre

Número de teléfono (Residencia) Dirección de residencia (número y calle, número de departamento)

Número de teléfono (Trabajo) Ciudad, estado, y código postal de residencia

Nombre de la persona que discriminó contra usted, y la posición de trabajo (si conocido):

Dirección

Ciudad, Estado, Código postal

Fecha del incidente discriminatorio: Causa de la discriminacion (SELECCIONE POR LO MENOS UNA RAZON): • • • • • • • • •

Raza Retaliación Sexo Estado Civil Religión Color de Piel Nacionalidad Edad Impedimento Físico o Mental

Por favor explique brevemente el incidente que provocó una infracción de Título VI, incluyendo quienes participaron y cualquier otros detalles necesarios para una investigación. (Puede utilizar el otro lado de este papel y/o conectar un documento adicional.) Firma Fecha Envie por correo a: Diane Slaybaugh, Polk TPO Title VI Specialist, Drawer TS05, P. O. Box 9005, Bartow, Florida 33831-9005. Correo Electronico: dianeslaybaugh@polk-county.net

Fax: 863-534-6471


Appendix F NOTICE TO TPO GRANT AND PROGRAM SUBRECIPIENTS All programs and operations of entities that receive assistance from the federal government including the Transportation Planning Office (TPO) and its sub-recipients must comply to the fullest reasonable extent for improving access to services for Limited English Proficiency (LEP) persons. Sub-recipients are encouraged to have in place written policies on the provision of interpreter and translation services. I acknowledge that a copy of the TPO Limited English Proficiency Plan has been provided to our organization and I have read the contents and fully understand the LEP Plan obligations and responsibilities.

Signature

Organization

Date


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39

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LAKE ALFRED

FT. MEADE

WAUCHULA

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557

17

7 6 5 4

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POLK

LAKE

7 6 5 4

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POLK CITY 48

Green Swamp

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18

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7 6 5 4

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Crooked Lake

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240

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244

Lake Tohopekaliga

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17

) "

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SEBRING - AVON PARK UA

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630

7 6 5 4

Lake Weohyakapka

Lake Rosalie

Lake Hatchineha

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531

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Makinson Island

) "

14

249

KISSIMMEE

417

10

ORLANDO INTERNATIONAL " ) AIRPORT 22

Riv

ö ?

6

FROSTPROOF

HILLCREST HEIGHTS

Lake Clinch

) 72 "

) 71 "

POINCIANA

3

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LAKE WALES

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HAMILTON

Lake Marion

HAINES CITY

7 6 5 4 580

2

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) "

) "

DAVENPORT

A z A o

) "

) 64B "

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7 6 5 4

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65

67

68

ORLANDO

Ï LAKE ?

58

429

) 6 "

11

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LAKELAND

) "

25

32

33

" $ ! #4

) "

38

Green Swamp

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7 6 5 4

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22

31

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7 6 5 4

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LAKE

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LA

HILLSBOROUGH POLK

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" $ ! #4

) "

19

21

PLANT CITY

â ?

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535

7 6 5 4

ZEPHYRHILLS

A {

PASCO

HILLSBOROUGH

DADE CITY

l A

POLK

e s Kis

OS O CE

County Boundary

Interchange/Exit Number Other Major Roads

City Limits

0

2.5

5

10

April 23, 2014

¹

Miles 15

Source: American Community Preference Survey

) "

38

Other Map Features

30% - 49.99%

20% - 29.99%

10% - 19.99%

5% - 9.99%

0% - 4.99%

2012 Percent LEP

Legend

Polk TPO Limited English Profiency Plan

Percent Population with Limited English Profiency (LEP)


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39

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A z

27

28 " )

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3

7 6 5 4

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7

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Lake Parker

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7 6 5 4

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7 6 5 4

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23

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WINTER HAVEN

LAKE ALFRED

FT. MEADE

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557

17

7 6 5 4

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LAKE

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Reedy Lake

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) "

11

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19

East Lake Tohopekaliga

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Bramha Island

Lake Kissimmee

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523

7 6 5 4

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Lake Marian

OSCEOLA

HIGHLANDS

POLK

RIVER RANCH

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) "

Cypress Lake

) "

242

240

) "

244

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17

) "

er

SEBRING - AVON PARK UA

64

La ke

630

7 6 5 4

Lake Weohyakapka

Lake Rosalie

Lake Hatchineha

7 6 5 4

531

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14

) "

249

KISSIMMEE

417

10

ORLANDO INTERNATIONAL " ) AIRPORT 22

Riv

ö ?

6

FROSTPROOF

HILLCREST HEIGHTS

Lake Clinch

) 72 "

) 71 "

POINCIANA

3

) "

HIGHLAND PARK

LAKE WALES

Ï ?

DUNDEE

HAMILTON

Lake Marion

HAINES CITY

7 6 5 4 580

2

) "

) "

) "

DAVENPORT

A z A o

62

) 64B "

) "

65

) "

64A

54 LOUGHMAN

7 6 5 4

) "

) "

) 1A "

) "

A ¢

67

68

ORLANDO

Ï LAKE ?

58

429

) 6 "

11

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MANATEE HARDEE

) "

LAKELAND

) "

25

32

33

" $ ! #4

) "

38

Green Swamp

iv er

7 6 5 4

Rive r

) "

) "

22

31

A {

oche e Riv er

7 6 5 4

35A

Wit hlac o

SUMTER

LAKE

ce R Pe a

LA

HILLSBOROUGH POLK

Ala fia

" $ ! #4

) "

19

21

PLANT CITY

â ?

R gh ro u o b s Hill

535

7 6 5 4

ZEPHYRHILLS

A {

PASCO

HILLSBOROUGH

DADE CITY

l A

POLK

e s Kis

OS O CE

County Boundary

Interchange/Exit Number Other Major Roads

City Limits

0

2.5

5

10

April 25, 2014

¹

Miles 15

Source: American Community Preference Survey

) "

38

Other Map Features

2000 - 4900

1000 - 1999

500 - 999

200 - 499

0 - 199

2012 Hispanic Population

Legend

Polk TPO Limited English Profiency Plan

Hispanic Population


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39

Û A

A z

27

28 " )

) "

3

7 6 5 4

676

4

) "

á ?

WILLOW OAK

" ) )1 "

) "

7

) "

9

Lake Parker

) "

540A

7 6 5 4

BRADLEY

PIERCE

õ ?

630

7 6 5 4

640

7 6 5 4

A z

23

A {

) "

44

´ A

17

) "

) "

A o

EAGLE LAKE

BARTOW

ª A

¨ A

A {

Lake Buffum

ò ?

ALTURAS

WAHNETA

Eloise

ELOISELake

© A

A s

) "

55

WINTER HAVEN

LAKE ALFRED

FT. MEADE

WAUCHULA

A o

A o

Lake Hancock

¨ A

× A

INWOOD

557

17

7 6 5 4

" $ ! #4

POLK

LAKE

7 6 5 4

) "

POLK CITY 48

Green Swamp

AUBURNDALE

18

) "

EATON PARK 14 ) "

10

Ù A

áMULBERRY ? ò ?

) "

5

¸ A

) "

) "

) "

41

ß ?

474

7 6 5 4

A s

) "

8

) "

60

62

62

A s

Crooked Lake

) "

" $ ! #4

Lake Pierce

7 6 5 4 542

BABSON PARK

A s

Ï ?

AVON PARK

Reedy Lake

) "

) "

11

) "

bu c

Ar

kl e

INDIAN LAKE ESTATES

ò ?

Tiger Lake

19

East Lake Tohopekaliga

) "

AVON PARK AIR FORCE RANGE

Bramha Island

Lake Kissimmee

k ?

523

7 6 5 4

23

Alligator Lake

ORANGE

A ¢

ò ?

Lake Marian

OSCEOLA

HIGHLANDS

POLK

RIVER RANCH

Ì ?

ST. CLOUD

) "

Cypress Lake

) "

242

240

) "

244

Lake Tohopekaliga

) "

17

) "

er

SEBRING - AVON PARK UA

64

La ke

630

7 6 5 4

Lake Weohyakapka

Lake Rosalie

Lake Hatchineha

7 6 5 4

531

7 6 5 4

Makinson Island

) "

14

249

KISSIMMEE

417

10

ORLANDO INTERNATIONAL " ) AIRPORT 22

Riv

ö ?

6

FROSTPROOF

HILLCREST HEIGHTS

Lake Clinch

) 72 "

) 71 "

POINCIANA

3

) "

HIGHLAND PARK

LAKE WALES

Ï ?

DUNDEE

HAMILTON

Lake Marion

HAINES CITY

7 6 5 4 580

2

) "

) "

) "

DAVENPORT

A z A o

) "

) 64B "

) "

64A

54 LOUGHMAN

7 6 5 4

) "

) "

) 1A "

) "

A ¢

65

67

68

ORLANDO

Ï LAKE ?

58

429

) 6 "

11

ee im m

MANATEE HARDEE

) "

LAKELAND

) "

25

32

33

" $ ! #4

) "

38

Green Swamp

iv er

7 6 5 4

Rive r

) "

) "

22

31

A {

oche e Riv er

7 6 5 4

35A

Wit hlac o

SUMTER

LAKE

ce R Pe a

LA

HILLSBOROUGH POLK

Ala fia

" $ ! #4

) "

19

21

PLANT CITY

â ?

R gh ro u o b s Hill

535

7 6 5 4

ZEPHYRHILLS

A {

PASCO

HILLSBOROUGH

DADE CITY

l A

POLK

e s Kis

OS O CE

County Boundary

Interchange/Exit Number Other Major Roads

City Limits

0

2.5

5

10

April 23, 2014

¹

Miles 15

Source: American Community Preference Survey

) "

38

Other Map Features

42.9% - 70.5%

25.3% - 42.8%

15.33% - 25.24%

6.78% - 15.32%

0% - 6.77%

2012 Percent LEP

Legend

Polk TPO Limited English Profiency Plan

Percent Hispanic Population in Polk County


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