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Language Tiers for Establishing Language Proficiency
CCHI recognized classifies Languages Other Than English (LOTE) into three (3) tiers based on the following availability criteria:
- A Language Proficiency (LP) test that is reasonably accessible in the U.S.
- Education at the high school level or above with instruction in that language (these are usually official/national languages).
- Medical or healthcare information available in that language (authentic, created in that language, not a translation from another language, and considering that in some countries the language of teaching medicine is English).
The attribution of languages to a specific tier is subject to change based on the following factors:
- A language may gain the status of an official language due to political changes in a country.
- A language may gain the status of the language of instruction in education due to political changes in a country.
- A valid LP test may be developed for an official language that currently does not have an LP test.
- A valid LP test may be removed from public use by a testing vendor for a language that currently has such an LP test.
The specific language lists are provided for Tiers 1 and 2 based on the availability of LP tests from CCHI-approved LP testing vendors (see at Testing Vendors of the Language Proficiency (LP) Tests).
CCHI welcomes comments and suggestions regarding the inclusion of a specific language in a tier as long as an authoritative, easily verifiable reference is provided.
Tier 1 Languages
CCHI defines these as languages for which all three of the availability criteria are met, specifically:
- An LP test that is reasonably accessible in the U.S.
- Education at the high school level or above with instruction in that language (these are usually official/national languages).
- Medical or healthcare information available in that language (authentic, created in that language, not a translation from another language, and considering that in some countries the language of teaching medicine is English).
List of Tier 1 Languages (in effect as of October 15, 2023)
| 1. Afrikaans
2. Albanian 3. Amharic 4. Arabic 5. Armenian 6. Azerbaijani 7. Belorussian 8. Bengali 9. Bosnian 10. Bulgarian 11. Burmese 12. Cambodian 13. Cantonese 14. Catalan 15. Chechen 16. Mandarin 17. Croatian 18. Czech 19. Danish 20. Dari 21. Dutch 22. Estonian 23. Farsi (Persian) 24. Finnish 25. French 26. Georgian 27. German 28. Greek
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29. Gujarati
30. Haitian Creole 31. Hebrew 32. Hindi 33. Hungarian 34. Icelandic 35. Indonesian 36. Italian 37. Japanese 38. Kannada 39. Kashmiri 40. Kazakh 41. Kirghiz 42. Kirundi 43. Korean 44. Lao 45. Latvian 46. Lingala 47. Lithuanian 48. Macedonian 49. Malay 50. Marathi 51. Marshallese 52. Mongolian 53. Nepali 54. Norwegian 55. Oromo 56. Pashto/Pashtu
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57. Polish
58. Portuguese 59. Punjabi 60. Romanian 61. Russian 62. Samoan 63. Serbian 64. Slovak 65. Slovenian 66. Somali 67. Spanish 68. Swahili 69. Swedish 70. Tagalog 71. Tajik 72. Tamil 73. Telugu 74. Thai 75. Tigrinya 76. Turkish 77. Turkmen 78. Ukrainian 79. Urdu 80. Uzbek 81. Vietnamese 82. Wolof 83. Zulu
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Tier 2 Languages
CCHI defines these as languages for which only the first availability criterion (a) is met, i.e., an LP test is available, but they are not the languages of instruction in high schools or colleges in any country. Additionally, the availability of authentic medical and healthcare information in those languages is somewhat limited.
List of Tier 2 Languages (in effect as of February 8, 2024)
| 1. Akan-Twi
2. Apache 3. Assyrian 4. Baluchi 5. Cape Verdean 6. Cebuano (Visayan) 7. Chavacano 8. Dhivehi 9. Djerma/Zarma 10. Ewe 11. Fante (Akan) 12. Fon 13. Fula/Peul (Puula) 14. Fula/Toucouleur 15. Ga |
16. Haryanvi
17. Hausa 18. Hiligaynon 19. Hmong 20. Igbo 21. Ilocano 22. Jamaican creole English (Patois) 23. Javanese 24. Karenni 25. Kinyarwanda 26. Kikongo 27. Krio 28. Kurdish-Kurmanji 29. Kurdish-Sorani |
30. Luganda
31. Malayalam 32. Mandingo Malinke 33. Mandingo-Bambara 34. Mossi 35. Navajo 36. Quechua 37. Sindhi 38. Sinhalese 39. Taiwanese 40. Tausug 41. Tibetan 42. Uighur 43. Yoruba
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Tier 3 Languages
CCHI defines these as languages for which none of the availability criteria are met, i.e., no LP test exists; they are not the languages of instruction at educational institutions, and practically no authentic medical information is available in those languages, other than translations from English.
Languages that are not listed in Tiers 1 or 2 belong to this tier.