FAQ

  FAQ  

The following frequently-asked questions and answers are based on the knowledge of the members of Advisory Committee on Qualifications for Health Care Translators and Interpreters and does not constitute legal advice or endorsement.
 
Questions from Health Care Providers
1. Is there a difference between translators and interpreters? I thought they were synonymous.
Translators convert written documents from one language to another.Interpreters convert signed or spoken messages from one language to another.
 
2. Is there a law that says my office/clinic/hospital must provide interpreters?
Yes. See below.
 
Title VI of the Civil Rights Act (1964)
“No person in the United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.”  42 U.S.C. § 2000d.
 
Different treatment based on a person's inability to speak, read, write, or understand English may be a type of national origin discrimination.
 
Title II of the Americans with Disabilities Act (1990)
No qualified individual with a disability shall, by reason of such disability, be  discriminated against, excluded from participation in or be denied the benefits of the services, programs, or activities of a state or local government.  All state and local governments are required to take steps to ensure their communications with people with disabilities are as effective as communications with others.
 
Title III of the Americans with Disabilities Act (1990)
No individual shall be discriminated against on the basis of disability in any place of public accommodation, which includes the professional offices of a health care professional and hospitals. In addition, a public accommodation shall take steps to provide auxiliary aids and services, defined to include qualified interpreters, note takers, computer-aided transcription services and written materials.
 
Section 504 of the Rehabilitation Act (1973)
No qualified individual with a disability shall be excluded from, denied the benefits of, or be subjected to discrimination under any program activity that receives federal financial assistance. Requirements include effective communication with the deaf and hard of hearing.
 
Section 1557 of the Affordable Care Act (2010)
The Affordable Care Act (ACA) expressly extended the protections of Title VI, Title IX, Section 504 of the Rehabilitation Act and the Age Discrimination Act to apply to the Exchanges themselves through a nondiscrimination requirement. Section 1557 explicitly extends these civil rights provisions to “any health program or activity, any part of which is receiving federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an Executive Agency or any entity established under this title. ”
(Source: National Health Law Program, Short Paper #6:
The ACA and Application of § 1557 and Title VI of the Civil Rights Act of 1964 to the Health Insurance Exchanges)
 
3a.  What institutions are covered by these laws?
All entities receiving direct or indirect federal financial assistance through a grant, contract, or subcontract, are covered by these policies. Examples of institutions that may receive federal financial assistance include:
 
  • Hospitals (public and private)
  • Ambulatory/outpatient programs and services
  • Behavioral health services
  • Rehabilitative services
  • Pharmacies
  • Nursing homes
  • Physicians and other providers
  • Home health agencies
  • Managed care organizations
  • State, county, and local health agencies
  • State Medicaid agencies
  • Universities and other entities with health or social services research programs
 
(For further information, see The Joint Commission, Language Access and the Law.)
 
3b.  The Americans with Disabilities Act (ADA) is already out there, so what good are the 
Advisory Committee’s recommendations going to do?
The ADA does not cover foreign language interpreters. Also, not everyone complies with the ADA.
 
4.Who is going to enforce qualifications for health care interpreters?
If the Advisory Committee’s recommendations become law in Texas, a state agency will enforce them. In the meantime, they remain only recommendations for best practices. However, The Joint Commission performance standards concerning language access call for the use of qualified, trained, and assessed interpreters. Organizations accredited by The Joint Commission are evaluated based on these performance standards.
 
5. Everyone at my hospital/clinic speaks Spanish. Why do we need interpreters?
Communicating one on one with another person in a language other than English is not interpreting. Competency in medical interpretation requires more than fluency in a language or even knowledge of medical terms in that language. Trained medical interpreters are individuals who have received professional instruction in medical concepts and terminology, interpretation skills and process, communication skills, ethics, confidentiality and cultural issues.
(Source: American Medical Association, Office guide to Communicating With Limited English Proficient Patients, 2ndEdition)
 
Not all patients speak English or Spanish. Arrangements must be made for communicating effectively in other languages.
 
Qualifications for language interpreters and translators may be met through language proficiency assessment, education, training, and experience. The use of qualified interpreters and translators is supported by the ADA, Section 504 of the Rehabilitation Act of 1973, and Title VI of the Civil Rights Act of 1964.
(Source:  U.S. Department of Justice Civil Rights Division)
 
6. Must interpreters be certified/licensed to work in health care in Texas?
No. Texas does not require the use of certified interpreters for health care at this time. (July 2013) However, certification for foreign language medical/healthcare interpreters is available at the national level. There is no state or national medical/health care certification for sign language interpreters at this time.
 
7a.  How do I find qualified sign language interpreters?
Go to the BEI Interpreter Search.
Go to the RID Interpreter Search.
Go to the list of communication-access agencies (sign language interpreting agencies).
 
7b.  How do I find certified foreign language interpreters?
Go to the CCHI Interpreter Registry and Registry of Certified Medical Interpreters
(foreign language medical interpreters).
 
7c.  How do I find interpreters for languages of limited diffusion, such as refugee languages? 
Contact your local professional association of translators and interpreters.
 
8. Must translators be certified to work in health care in Texas?
No. At this time there is no requirement for health care translators to be certified. (July 2013)
 
9a.  Where can I find certified translators?
Through the American Translators Association (ATA) Directory of Translation and Interpreting Services. ATA certification is general, not health care specific.
 
9b.  How do I find translators for languages of limited diffusion, such as refugee languages? 
Contact your local professional association of translators and interpreters.
 
10.  How do I know if a translation is accurate?
Use a translator who meets the ILR Skill Level Descriptions for Translation Performance
Use the Translation Quality Assessment Tool by Hablamos Juntos.
Follow the procedures described in Recommendation #6 by the Advisory Committee.
 
Questions from Interpreters
11.  How do I get certified?
a.    Foreign language interpreters.
The requirements and procedures for certification in Texas are being developed by the Advisory Committee on Qualifications for Health Care Translators and Interpreters. Meetings are open to the public. For meeting dates see theHHSC Advisory Committee webpage.
 
There are currently two organizations that certify foreign language health care interpreters on a national level.
   
b.    Sign language interpreters.
The requirements and procedures for certification in Texas are being developed by the Advisory Committee on Qualifications for Health Care Translators and Interpreters. Meetings are open to the public. For meeting dates see theHHSC Advisory Committee webpage.
 
At this time, there is no state or national medical certification for sign language interpreters.
(July 2013)
 
12.  Where can I get training as a health care interpreter?
There are many training opportunities for health care interpreters. For a partial list of classroom and online training providers, see the IMIA Training Directory and the list of Sign Language Interpreter Training Programs in Texas.
 
13.  What practical steps can I take to stay ahead of the game?
See the National Standards for Healthcare Interpreter Training Programs by the National Council on Interpreting in Health Care. There you will find the topics that health care interpreters should know. You can use the Interpreter Training Self Assessment to identify and fill any gaps in your training.
 
14.  Is training required for certification? If so, what is involved?
Yes, training is required.
 
There are currently two organizations that certify foreign language health care interpreters on a national level. Each has its own training requirements. For details, see:
   
The Advisory Committee recommends training in the following subjects. This training is not language-specific.
 
 
For Foreign Language Interpreters:
··   Interpreting Skills
  • Consecutive Interpreting
  • Sight Translation
  • Protocols (managing the session)
··   Code of Ethics for Health Care Interpreters
··   Standards of Practice for Health Care Interpreters
··   Roles of the Health Care Interpreter
··   Cultural Awareness
··   Legislation and Regulations (Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, Title VI of Civil Rights Act, Health Information Portability and Accountability Act (HIPAA), Health Information Technology for Economic and Clinical Health Act (HITECH),
National Standards on Culturally and Linguistically Appropriate Services (CLAS)
··   General Medical Knowledge
  • Anatomical Terms for Major Body Systems
  • Medical Tests and Diagnostics
  • Common Specialties and Medications (including physical and mental health)
  • Acronyms and Abbreviations
  • Routine Medical Equipment
  • Infection Control
  • Mental/Behavioral Health
    • Common disorders of adults, children/adolescents
    • Common Medications
    • Psychiatric Tests and Diagnostics
    • Treatment Plans
    • Acronyms and Abbreviations
    • Legal Status (Voluntary, POEC, OPC)
For Sign Language Interpreters:
··   Interpreting Skills
  • Consecutive and Simultaneous Interpreting
  • Sight Translation
  • Protocols (managing the session)
··   Code of Ethics for Health Care Interpreters
··   Standards of Practice for Health Care Interpreters
··   Roles of the Health Care Interpreter
··   Cultural Awareness
··   Legislation and Regulations (ADA, Section 504 of Rehabilitation Act, Title VI of Civil Rights Act, HIPAA, HITECH, CLAS)
··   General Medical Knowledge
  • Anatomical Terms for Major Body Systems
  • Medical Tests and Diagnostics
  • Common Specialties and Medications (including physical and mental health)
  • Acronyms and Abbreviations
  • Routine Medical Equipment
  • Infection Control
  • Onsite Mentoring
  • Mental/Behavioral Health
    • Common disorders of adults,children/adolescents
    • Common Medications
    • Psychiatric Tests and Diagnostics
    • Treatment Plans
    • Acronyms and Abbreviations
    • Legal Status (Voluntary, POEC, OPC)

 
15.  Is mentoring required?
No. However, the committee strongly recommends 40 hours of mentoring (supervised and documented healthcare interpreting).
 
16.  How many hours of training should I take?
The Advisory Committee recommends a minimum of 120 hours of training.
(Reference:  Flores GAbreu MBarone CPBachur RLin H. Errors of medical interpretation and their potential clinical consequences: a comparison of professional versus ad hoc versus no interpreters.
Ann Emerg Med. 2012 Nov ;60(5):545-53. doi: 10.1016/j.annemergmed.2012.01.025. Epub 2012 Mar 15.http://www.ncbi.nlm.nih.gov/pubmed/22424655. Accessed 09/20/13).
 
17.  I am fluent in Spanish or another foreign language. Can I be exempted from all or part of the interpreter training?
No. At this time, the ability to evaluate prior training is not available. (July 2013)
 
18.  I’m a doctor/nurse from another country. Can I be exempted from all or part of the interpreter training?
No. At this time, the ability to evaluate prior training is not available. (July 2013)
 
19.  I’m a doctor/nurse who speaks another language fluently. Must I use an interpreter to talk to patients who speak my language?
No. If you can provide the same quality of communication and standard of care in the other language as you can in English, there is no need for an interpreter.
 
20.  As a bilingual doctor/nurse in a health care facility, may I also interpret?
Yes, if you meet the qualifications of an interpreter. Also note that the interpreter with an additional role limits his or her professional practice to interpreting and adheres to all interpreting standards of practice while interpreting.