National culturally and linguistically appropriate services standards--mandates or not?

The U.S. Department of Health and Human Services' Office of Minority Health (OMH) promotes National Standards for Culturally and Linguistically Appropriate Services. According to the Office, four of these standards are "mandates" that are considered federal requirements for all recipients of federal funds. These standards focus on increasing language access to health care services for limited English proficient (LEP) people. Relying on this statement, multiple organizations, scholars and advocates promote these mandates in their communities. However, the DHHS Office of Inspector General stated in a 2010 report that these standards are only voluntary and not mandated. This contradiction deserves the attention of public health advocates for LEP people. This article seeks to clarify this contradiction so that public health advocates and experts can provide accurate information to people they serve and consider whether they should work with to develop truly mandatory language access standards as a condition of federal funding.