Words Matter

January 23rd, 2018

By Westy Egmont, Boston College

On a typical Monday, the social worker at the health clinic is pressed with too many open cases needing immediate attention and along comes Mr. Bayani Rayes.  He is one of 1.6 million Tagalog speakers in the US.  How will the social worker explain to him why a procedure is necessary?  The work of interpreters and translation is a legal obligation, though the interpreters are often undervalued and the protocol not fully developed. Professional communication is protected under HIPAA and from both the perspective of privacy and legal liability, service providers are obligated to prepare to work with a multilingual society in which more than 22 million Limited English Proficient speakers reside. Access is a civil rights requirement.

Do interpreters matter? Beyond the legal threat of ‘willful neglect’, failing to communicate necessary information, our society in its laws seeks to protect linguistic minorities by setting standards of care.  Employees, contractors and even volunteers are protected as interpreters but they are obligated to insure accuracy, privacy and access. Civil rights laws address interpretation and HIPAA establishes the code. The AMA is attentive to practice risks but in many community-based social services, staff are unaware of language obligations and best practices.  The accompanying current materials are offered as a basis for continuing education to foster staff competency using interpretation and translation services.  The Massachusetts Language Access Plan embodies a positive state model for courts and the Federal Justice Department created its own court initiative. Each public serving agency should have a language access plan.

While no organization has capacity in all languages (Mexico includes 62 indigenous languages and 15% of Native Americans speak a language other than English at home), all face the challenge. “English Only” rhetoric may have political value but it is contrary to both values and legal obligation in many settings from nursing homes to universities. Providers have limited choices:

  1. bilingual staff,
  2. written translations of primary forms, explanations and documents,
  3. contracted interpreters available by appointment,
  4. Video Remote Interpreters (like Skype), or
  5. phone interpreters.

Training and budgeting for interpreters is an easily overlooked institutional response to the diversification of a community.  The professional development of interpreters and translators is championed by the American Translators Association and the National  Association for Interpreters.

Language inclusion may begin with a website that is available in multiple languages, reflecting preparedness to serve the surrounding community and also symbolizing a welcome of the foreign born.  How many landing pages are reviewed for accuracy and clarity?  Front desk staff, whether answering the phone or greeting walk-ins, need protocols on how to respond to the individual. Who is asked to interpret? When? The NY Language Identification Tool is useful at a front desk. Staff who regularly interpret need to be valued for their skill in their remuneration and supported with continued training. The whole organization is served by thinking about a culture that supports interpretation. (See tips for interpretation)

Google Translate, a translation and increasingly an interpretation tool, has improved significantly with its neural machine based (NMT) software that approaches sentences rather than phrases.  It serves the tourist well and many families can make their needs known to providers by being encouraged to use this technology. Patient teachers will find it a bridge to any parent asking about their child.  As beneficial as is this mobile and readily accessible tool (and its competitors), it is not comprehensive professional translation or interpretation. Some estimates of accuracy are 85%  for common subjects but not accurate in specialized communications.  It will suffice for many daily functions but if there is a legal element, a medical communication, issues of mental health or government procedure, the limits quickly become evident. (Improving alternatives exist as well).

Language Line Solutions is the biggest of the remote providers. Recently spending $30 million on their state of the art system, it offers on-demand access to 11,000 employed interpreters and translators. Language Line’s focus on HIPAA standards, security, and array of services gains trust, while it is their ability to provide on demand interpreting in over 200 languages that makes them global.  As a major corporate provider one recognizes their encryption protection, record procedures, as well as their vetting of professional interpreters as the industry standard bearer. LLN Interpreters have up to 130 hours of training available and are screened for background as well as passing language skill assessment.  More than 50 major cities, thousands of government agencies and all top 10 major US medical facilities use the company.

Cost and desire for a personal connection are major obstacles for many human service and education organizations in providing the needed professional language services.  Given the volume of work and lack of attention by central administrations to the issue, many staff are left functioning without access to the deep resources that exist.  Building a staff consensus and calling for a strategic investment in proper handling of limited English speakers will protect agencies from future law suits and build a bridge to the changing community, action vital to most agencies mission fulfillment.  Even as social service agencies historically were slow to invest in insurances, benefits and technology, the current need is for operating investment in annual budgets to remove barriers – the language walls – that millions experience as insurmountable during critical years of their adjustment to their new country.

*No endorsement is intended by the specific illustration of named providers


The Boston University Interpreter Program

The Boston University Interpreter Program, a part of Boston University’s Center for Professional Education, trains individuals to become certified interpreters in a variety of settings. The program offers certificates in the focuses areas of Community Interpreting, Legal Interpreting, and Medical Interpreting.  All of the concentrations are offered to professionals who can speak, read, and write Chinese, Portuguese, or Spanish fluently. All courses require an entrance exam and four to five required courses. Interpreting plays a key role in helping immigrants and speakers of other languages have access to critical services and resources. Interpreters act as a bridge between professionals and their clients.

Community: Community interpreters play an important role in facilitating access to resources for immigrants. They serve clients in a range of organizations, from neighborhood clinics to non-governmental organizations. Depending on the client, their workload can consist of interpreting on medical, educational, legal and social services manners.

Medical:  The medical interpretation program prepares participants to interpret in a medical setting with compassion and caring. The courses involved role-playing, a review of medical procedures, and material to help interpreters serve as a bridge between medical professionals and patients.

Legal: This certificate acquaints participates with various courts, forums, and procedures where legal interpreting will take place. Students will learn the expectations, protocols, ethics, and vocabulary necessary to interpret in this setting.

OTHER Programs

Source: Reprinted with permission from The Immigrant Integration Lab at Boston College School of Social Work (December 2017)

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