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| What is interpreting? | ||||||
| Interpreting is taking information spoken in one language and rendering it into a second language with the same meaning and intent. | ||||||
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| What is a LEP patient? | ||||||
| LEP stands for Limited English Proficient. A LEP patient is a patient who does not speak English as their primary language and has a limited ability to read, write, speak, or understand English. The U.S. Census Bureau collects data on language proficiency in the United States; in 2006 the percentage of the population that spoke no English at all was 11%. | ||||||
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| Why do I need to provide interpreters for LEP patients? | ||||||
| Title VI of the Civil Rights Act of 1964 requires all hospitals and physicians who receive federal funds, without regard to the amount of federal funds they receive, to provide language assistance services when needed (including physicians who treat Medicaid patients). The U.S. Department of Health and Human Services Office for Civil Rights can assist you in determining your responsibilities regarding LEP patients. | ||||||
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| Why can't I require LEP patients to provide their own interpreters? | ||||||
| Requiring patients to provide their own interpreters can lead to many significant issues. Imagine the impact on a child required to tell a parent they have a life-threatening illness, or one related to sexual dysfunction. Or, even adult family members, imagine the impact on a patient when a well-intentioned family member decides the patient "is better off" not knowing all the details of an illness or injury related by their physician. These and many more issues can arise, significantly impacting patient care, which is partly why current law requires all health care facilities receiving any federal reimbursements (such as Medicaid) to supply interpreters for their LEP patients. | ||||||
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| What are the pitfalls of using bilingual staff to interpret for LEP patients? | ||||||
| Properly skilled and trained bilingual staff can certainly provide interpreting services for your LEP patients. In some cases, such as public contact positions (such as emergency room receptionists and workers), bilingual staff may be used as part of a hospital's full-time staff, particularly when certain languages are encountered often. First, make sure certain internal staff are properly skilled through written and oral language proficiency testing. Don't just assume anyone who speaks multiple languages speaks them at the level required to interpret detailed and complex medical information. Second, all staff you intend to use as interpreters should successfully complete a comprehensive training program that includes the latest industry standards, such as NCIHC National Code of Ethics and Standards of Practice, as well as real-world experience under the guidance of an experienced interpreter. It's important not to assume anyone who can speak a second language, or even someone who can pass a written test, can properly and effectively manage an intense medical interpreting encounter. Also, after testing, training and real-world skills experience, use full-time dedicated staff interpreters, not employees randomly pulled from otherwise full-time positions who will be under time pressure to speed up or summarize interpreting encounters in order to return to their main duties. Dual-role employees can also confuse patients who see their X-ray technician now assuming the role of their interpreter. | ||||||
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| How are ILS interpreters trained? | ||||||
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All International Language Services interpreters have passed a proficiency exam which assesses medical terminology, biculturalism, and understanding of the interpreter role. Every ILS interpreter has passed a 50-hour training course, "Curriculum for Interpreting in Health Care©" (CIH), which was developed by ILS President Karin Ruschke after years of leadership with the National Council on Interpreting in Health Care (NCIHC) as the co-chair of the Standards, Training, and Certification Committee. The CIH fully incorporates both the National Code of Ethics and the Standards of Practice published by the NCIHC, training all ILS interpreters to the latest and most demanding national standards. No other training program in the country goes beyond the scope and professional development offered by the CIH. Upon completion of the CIH course ILS interpreters begin an internship, during which they will accompany senior interpreters to gain real world experience. Only after these requirements are met (or exceeded) are interpreters invited to join the agency. ILS interpreters are also expected to participate in continuing education workshops offered throughout the year. |
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| Are ILS interpreters certified? | ||||||
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We wish we could answer this question with a simple "yes", but the issue of medical interpreter certification is too complex for that. ILS issues its interpreters certificates of completion after they have a) successfully completed the CIH; b) successfully completed an internship with senior interpreters; and c) successfully completed 50 hours of interpreting following their internship. Getting an ILS certificate of completion is a lot of work, but it still isn't the same thing as certification. Medical interpreter certification — at least on the national level — doesn't exist, unlike ASL interpreters who are certified by RID (Registry of Interpreters for the Deaf) and court interpreters, who must be certified by the court system in which they work. However, that's changing; in 2008 the National Coalition on Health Care Interpreter Certification, comprised of over twenty organizations dedicated to the professionalization of health care interpreting, held its inaugural meeting. This historic meeting launches a multi-year project during which the coalition will work toward creating a single, national certification process. |
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| What is the status of national certification of healthcare interpreters? | ||||||
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In late 2007,
representatives from the
National Council on Interpreting in Health Care (NCIHC)
began holding meetings with counterparts from other state and
national organizations to discuss the best organizational structure
to support the work that needs to be done in order to create a
national certification process. As a direct result, the
"National Coalition on Health Care Interpreter Certification" was
formed, comprised of stakeholders across the nation. The
National Coalition held its first meeting at the end of May, and
agreed to
a
statement of principles, including a commitment by each to develop
"a single and collaborative national certification process for
healthcare interpreters". Coalition members agreed to "commit
to being loyal to the process and all existing efforts of Coalition
members will coalesce into a single national certification
process". "It’s a significant step," according to ILS President
Karin Ruschke and member of the coordinating committee of the
Coalition, "it means that, moving forward, previous (and sometimes
competing) approaches will be merged for the future good of the
profession."
To read more about the National Coalition, click here, and be sure to check back for updates! |
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| How do I schedule interpreters with ILS? | ||||||
| Whether you're coordinating dozens of interpreter requests a day, or only one a month, ILS has the tools to make scheduling interpreters a no-hassle proposition. ILS clients are automatically given access (free of charge) to the on-line ILS scheduling database. You can request interpreters and relax while ILS fills your order. At any time, you can view your schedule — for as far in advance as you'd like. No more wondering whether or not an interpreter has been assigned - just log in, point, and click. | ||||||
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| How will I be billed? | ||||||
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ILS charges an hourly rate for on-site interpreting, with rates designed to meet your organization's unique needs. ILS offers flat pricing per language, which can be the most economical and efficient way to pay for a high volume of interpreting services in a single language. ILS bills its clients on a monthly basis. Each month you will receive an itemized summary of all requested appointments. We can also provide you with electronic copies of the information, so that you may sort the information based on your criteria. ILS also offers retainer packages to help make interpreting services more affordable. For a more detailed discussion about our rates, please contact ILS Vice-President Brad Snook at(773) 525-8590 ext. 229, or e-mail him at bsnook@ilschicago.com |
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| How will my patients' confidential information be kept private? | ||||||
| HIPAA is an acronym for the Health Insurance Portability and Accountability Act. HIPAA prevents a patient's medical record from being released to anyone who is not part of the patient's healthcare team without the patient's permission. ILS and all of its interpreters have signed statements agreeing to HIPAA confidentiality standards. | ||||||
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| What is sight translation? | ||||||
| Sight translation is where an interpreter reads a document written in one language and then orally interprets it into a second language. In medical interpreting, sight translation is common but often overused inappropriately, as health care is filled with documents for patients to read and often sign. | ||||||
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| What types of documents can I expect the interpreters to sight translate? | ||||||
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In some cases, it is appropriate for the interpreter to sight translate materials. In other instances, sight translation is not appropriate. General guidelines on appropriate vs. inappropriate use are: 1. Documents that contain general background information such as educational materials are often quite long. It is not a good use of an interpreter’s time to have him or her sight translate more than one page, as it takes much too long and the patient is unlikely to recall all of the information. 2. Brief documents with specific instructions, such as discharge instructions, are generally appropriate to sight translate, but the translation should be done with the provider present, as the patient is very likely to have questions that the interpreter should not, and often simply cannot, answer. 3. Legal documents, such as consent forms, present a special challenge. Patients certainly have the right to fully understand anything they are being asked to sign; however, these documents are usually written in “legalese”, making them very difficult to sight translate accurately. In many cases, it is questionable how much some patients understand of what they are hearing even if it is read to them in their language. Patients from certain cultures are often startled and even offended by the clear depiction of risks often contained in such documents. And, again, patients often have questions that the interpreter cannot answer (also, see below). Therefore, these types of documents are inappropriate for sight translation. |
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| How does the Joint Commission define informed consent? | ||||||
| The Joint Commission’s standards for obtaining informed consent mean that leaving an English-speaking patient alone to read a consent form, and then returning to simply ask if there are any questions is not an accepted standard of practice for physicians. The provider is expected to explain the procedure to the patient, including risks and alternate options, and to ensure that the patient has understood the explanation. This means that interpreters cannot be expected to simply sight translate a consent form without a provider present. | ||||||
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2707 North Halsted Street Chicago, IL 60614 773-525-8590 773-525-8591 (Fax) |
What you say is what they'll hear.
