INTERPRETERS AND TRANSLATORS IN HEALTH CARE

1

• INTERPRETERS AND TRANSLATORS IN HEALTH CARE
• Wilma Alvarado-Little, MA
• National Council on Interpreting in Health Care
• April 25, 2007

New York State Conference on Increasing Language
Access to Healthcare Toward Effective State and
National Policies
2

INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• How to determine if an interpreter or translator
  is qualified
• Certification, testing and educational programs
  for training staff as interpreters and
  translators
• Criteria for contract interpreters and
  translators
• How to effectively utilize community-based
  interpreters
• The role of the National Council on Interpreting
  in Health Care

3

INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Staff interpreters
• on call, contingency, bilingual employees, sign
  language
• Telephonic
• Agency
• Community based organizations
• Volunteer employee Vs. non gratuitous staff

4
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• INTERPRETER CODE OF ETHICS
• CHIA
• IMIA
• NCIHC
• BRIDGING THE GAP

5
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Some roles of a medical interpreter
• Conduit
• Clarifier
• Educator
• Cultural Broker
• Advocate

6
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Different name for a role, similar role!
• Dont be afraid to ask!

7
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• How to determine if an interpreter or translator
  is qualified
• Educational Requirements
• Oral and/or written assessment
• Experience in the medical field
• Training in Interpretation Medical Terminology
• Ethical dilemmas and the awareness of the
  different roles

8
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Certification, testing and educational programs
  for training staff as interpreters and
  translators
• Translators
• Expertise to conduct written translations
• Knowledge of the culture of the population
  served
• Cost - i.e per word, editing, formatting

9
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Criteria for contract interpreters and
  translators
• Insurance
• Training program
• Flexibility
• Awareness of population served

10
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Criteria for contract interpreters and
  translators
• Language Interpreters
• Qualifications/Training
• Experience in the medical field?
• Rates... Additional fees i.e. Late emergency
  fees, travel fees, evening fees,
  weekends/holidays
• Availability i.e. Requests in advance at least 24
  hours
• Immediate availability?
• Contracts?..i.e. Per event, annual (of minimum
  of hours per month)

11
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• Criteria for telephonic interpreting
• Rates- Increments vs flat fee
• Languages
• Contracts
• Equipment double receiver vs cordless vs
  portable
• Tracking of calls monthly vs quarterly
• Training
• Terminology
• Style- consecutive vs simultaneous
• Customer Service

12
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• How to effectively utilize community-based
  interpreters
• Community-based organizations
• Mutual understanding of roles
• Compensation for services
• Dual role

13
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• The role of the National Council on Interpreting
  in Health Care
• The NCIHC is a multidisciplinary organization
  based in the United States whose mission is to
  promote culturally competent professional medical
  interpreting as a means to support equal access
  to health care for individuals with limited
  English proficiency.

14
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• The role of the National Council on Interpreting
  in Health Care
• Mission
• To promote culturally competent professional
  medical interpreting as a means to support equal
  access to health care for individuals with
  limited English proficiency.

15
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• The National Council on Interpreting in Health
  Care
• Governance
• 2 Co-chairs of the Executive Board of the Council
• Secretary
• Treasurer
• 2 co-chairs for the 5 committees
• Membership
• Organizational Development
• Outreach
• Policy and Research
• Standards, Training and Certification

16
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• The NCIHC website
• http//www.ncihc.org
• It provides valuable information regarding
• Monthly updates involving the interpreter
  profession
• Language access resources
• Policy Initiatives
• The NCIHC Working Paper Series

17
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• The National Code of Ethics for Health Care
  Interpreters
• The National Standards of Practice for Health
  Care Interpreters

18
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• References
• Fernandez, A. Schillinger D, Grumbach K,
  Rosenthal A, Stewart AL, Wang F, Perez-Stable
  EJ. Physician Language Ability and Cultural
  Competence An Exploratory Study of
  Communication with Spanish- speaking Patients. J
  Gen Intern Med. 200419(2)167-174
• Flores G, Laws MB, Mayo SJ, Zuckerman B, Abreu
  M, Medina L, Hart EJ. Errors in Medical
  Interpretation and Their Potential Clinical
  Consequences in Pediatric Encounters.
  Pediatrics. 2003111(1)6-14
• Johnson RL, Saha S, Arbelaez JJ, Beach, MC,
  Cooper LA. Racial and Ethnic Differences in
  Patient Perceptions of Bias and Cultural
  Competence in Health Care. J Gen Intern Med
  2004 19101-110.
• Flores, G. Language Barriers to Health Care in
  the United States The New England Journal of
  Medicine. July 2006, 225-231

19
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• References
• Working Together to End Racial and Ethnic
  Disparities One Physician at a Time
• www.ama.assn.org/go/healthdisparities
• Proceedings of the 2005 White House Conference on
  Aging Mini-Conference on Health Literacy and
  Health Disparities, American Medical Association,
  2005
• www.ama-assn.org/go/aging
• Language as a Barrier to Health Care for New
  York City Children in Immigrant Families
  Haitian, Russian and Latino Perspectives. A
  Report of the Division of Health Policy and the
  New York Forum for Child Health The New York
  Academy of Medicine, May 2006

20
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• RESOURCES
• HHS- Office for Civil Rights http//www.hhs.gov/oc
  r/lep/.
• The National Health Law Program
  http//www.healthlaw.org/langaccess/fedadmin.html
  or http//www.healthlaw.org/langaccess/promisingpr
  actices.htmlinterpreters
• http//www.healthlaw.org/langaccess/stateactivitie
  s.html
• Language Services Action Kit produced by NHeLP
  and The Access Project. It can be downloaded free
  from www.accessproject.org

21
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• References
• Working Together to End Racial and Ethnic
  Disparities One Physician at a Time
• www.ama.assn.org/go/healthdisparities
• Proceedings of the 2005 White House Conference on
  Aging Mini-Conference on Health Literacy and
  Health Disparities, American Medical Association,
  2005
• www.ama-assn.org/go/aging
• Language as a Barrier to Health Care for New
  York City Children in Immigrant Families
  Haitian, Russian and Latino Perspectives. A
  Report of the Division of Health Policy and the
  New York Forum for Child Health The New York
  Academy of Medicine, May 2006

22
INTERPRETERS AND TRANSLATORS IN HEALTH CARE

• References
• Vasquez, C., Javier RA. The problem with
  interpreters Communicating with Spanish-speaking
  patients. Hospital and Community Psychiatry. Feb
  1991, 42 (2) 163-165
• Institute of Medicine Unequal Treatment
  Confronting Racial and Ethnic Disparities in
  Healthcare. Washington, D.C. National Academic
  Press 2002
• Centers for Disease Control and Prevention.
  Office of Minority Health-Eliminating Racial and
  Ethnic Health Disparities. www.cdc.gov/omh/AboutUs
  /disparities.htm or www.cdc.gov/omhd/OMHD_at_cdc.gov
  
• Karliner LS, Perez-Stable EJ, Gildengorin G. The
  Language Divide. The Importance of Training in
  the Use of Interpreters for Outpatient Practice.
  J Gen Intern Med 200419(2)175-83

23
INTERPRETERS AND TRANSLATORS IN HEALTH
CARE

• Office of Minority Health
• http//www.omhrc.gov/OMHRC
• New York State
• www.dos.state.ny.us/info/register/2006/sep13/pdfs
  /rules.pdfgt
• American Translators Association
• http//www.atanet.org
• California Health Care Interpreting Association
• http//chia.ws
• Massachusetts Medical Interpreter Association
• http//www.mmia.org

• National Council on Interpreting in Health Care
  (NCIHC) http//www.ncihc.org
• Diversity RX
• http//www.diversityrx.org/
• The California Endowment
• http//www.calendow.org/
• National Health Law Program (NHeLP)
• http//www.healthlaw.org
• Health and Human Services Office for Civil Rights
• http//www.hhs.gov/ocr

24
Thank you!

• National Council on Interpreting in Health Care
• 270 W. Lawrence Street
• Albany, NY 12208
• info_at_ncihc.org
• Wilma Alvarado-Little, MA
• Interpreter_at_walvarado-little.net