; and (12) shall, if requested, regularly make available to the head of each Federal entity from which Federal funds are provided, information about the progress and successful innovations of the program or activity in implementing the standards under this section as required by the head of such entity. (c) Comments accepted through notice and comment rulemaking An agency carrying out a program described in subsection (a) shall ensure that comments with respect to such program that are accepted through notice and comment rulemaking be accepted in all languages and may not require such comments to be submitted only in English. 204. Culturally and linguistically appropriate health care in the Public Health Service Act The Public Health Service Act ( 42 U.S.C. 201 et seq.) is amended by adding at the end the following: XXXIV CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE 3400. Definitions (a) In general In this title: (1) Bilingual The term bilingual , with respect to an individual, means a person who has sufficient degree of proficiency in 2 languages. (2) Cultural The term cultural means relating to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups, including lesbian, gay, bisexual, transgender, queer, and questioning individuals, and individuals with physical and mental disabilities. (3) Culturally and linguistically appropriate The term culturally and linguistically appropriate means being respectful of and responsive to the cultural and linguistic needs of all individuals. (4) Effective communication The term effective communication means an exchange of information between the provider of health care or health-care-related services and the recipient of such services who is limited in English proficiency, or has a communication impairment such as a hearing, vision, speaking, or learning impairment, that enables access to, understanding of, and benefit from health care