• Governor Maura Healey and Lt. Governor Kim Driscoll

BOSTON — Today, Governor Maura T. Healey, joined by members of the Latino Advisory Council, signed Executive Order #615 to increase language access across state government. The Executive Order aims to make the delivery of services and resources more accessible and equitable for residents with limited English proficiency by requiring executive department agencies to develop Language Access Plans. Governor Healey also issued a proclamation declaring Hispanic Heritage Month in Massachusetts from September 15th to October 15th. 

“Everyone in Massachusetts, regardless of what language they speak, deserves equitable access to government services and resources, but we recognize that language often poses a major barrier,” said Governor Healey. “This Executive Order will help break down language barriers and bridge gaps by instructing state agencies to conduct a thorough assessment of their language access capabilities and develop a plan for improvement. We’re proud to take this important step toward making state government more accessible and equitable during Hispanic/Latino Heritage Month alongside members of the Governor’s Latino Advisory Council.” 

“One in four Massachusetts residents speak a language other than English – which underscores why this Executive Order is so critical,” said Lieutenant Governor Kim Driscoll. “It is essential that we are setting people up for success by ensuring that they are able to read and engage with information provided by their state government. This Executive Order will help us work to ensure that all residents have the chance to get their questions answered and interact with their government in a way they understand. I am excited to see the implementation of strong language access plans across our state agencies and all the benefits this will bring to our state.” 

The Executive Order directs executive department agencies to identify a Language Access Coordinator and develop a Language Access Plan. These plans should include assessments of the agency’s services for residents with limited English proficiency, the languages spoken by the people they serve, their current policies and practices regarding translations, and the capacity of their staff to deliver services in other languages other than English. The plans will also include specific actions and policy changes to reduce language access barriers.  

Professional Interpreting Careers Continue to Grow $$

Health Care Interpreter

Average Salary $43,000

Years Higher Education 2-5

Job Outlook Excellent

Health care interpreters facilitatecommunication between patients with Limited English Proficiency (LEP) and theDeaf and Hard of Hearing and their physicians, nurses, lab technicians andother health care providers. Because of the growing number of LEP patients, theneed for health care interpreters has grown swiftly in the last decade, sothere is good career potential in this profession.

When a patient has limited abilityto speak English, it is nearly impossible for even the most skilled clinicianto provide high-quality healthcare services without accurate interpretingperformed by a trained, qualified and credentialed interpreter who has aworking knowledge of medical terminology and medical systems. If familymembers, friends or staff who are not trained as health care interpreters tryto interpret in health care settings, errors in understanding and/orcommunication are more likely to occur, posing grave risks to the patient andimmense liability to the healthcare provider or institution.

Most health care interpreters areresponsible for providing face-to-face interpreting between patients andproviders. However, interpreters may also be asked to work with otherindividuals, such as family members or a patient representative, and they serveto help provide cultural information to facilitate support for a treatmentplan.

Health care interpreters oftenrender sight translation of basic health care documents by orally translating awritten document into the patient’s language. Health care interpreters may alsointerpret over the phone (OPI-over the phone or telephonic interpreting) orthrough video (VRI-video remote interpreting). Health care interpretersfrequently educate other members of the health care team regarding the duties,requirements, protocol and ethics and standards of practice involved in healthcare interpreting.

Despite the career’s challenges,most health care interpreters speak of the intense emotional rewards theyderive from their work. Like health care providers, on a daily basis they seethat their work in providing language access saves lives and protects healthand well-being.

Many health care interpretersperform their work over the telephone or using video technology. Due to limitedresources, particularly in rural areas and/or when specific language needsarise for Languages of Lesser Diffusion (LLDs) such as indigenous languages,telephonic interpreting is an industry that has seen considerable growth in thepast few years. Health care interpreters and providers may offer these optionseither full-time or in addition to on-site interpreting.

Throughout the United States,interpreters are key and highly valued members of the health care team. Theirresponsibilities have evolved greatly in the last decade and are continuing tochange to meet needs.


LanguageLine’s New Owner Says Tech Will Not Replace Interpreters

by FlorianFaes on August 25, 2016

By selling to French call centeroperator Teleperformance, over-the-phone interpreter LanguageLine Solutions(LanguageLine) enters another chapter. The company’s history stretches back to1982 when it was founded by a US marine and a policeman to help law enforcementofficers communicate with Vietnamese refugees.

It is not the first timeLanguageLine is changing hands. In 1990, the company was acquired by AT&T, sold to private equity firmProvidence Equity in 1999 and ABRY Partners in 2014, which held it until theexit to Teleperformance. As growth stalled in 2012, CEO Louis Provenzano had tomake way for Scott Klein. To restartgrowth, Klein wasted no time and, in 2013, acquired PacificInterpreters.

LanguageLine is the dominant USplayer in remote interpreting. In 2015, the company generated revenues of USD388m and EBITDA of nearly USD 150m. Of LanguageLine’s 8,000 interpreters, 92%work from home; 86% of the business comes from over-the-phone (OTP)interpreting with video and onsite contributing the rest.

Paris-based Teleperformance is newto language interpretation services. One of the largest call center operatorsin the world, the company was founded in 1978 by current Executive ChairmanDaniel Julien. Its 190,000 employees share 147,000 workstations. LikeLanguageLine, Teleperformance is highly profitable with an EBITDA of EUR 492mon revenues of EUR 3.4bn in 2015.

Will LanguageLine be integratedquickly into this outsourcing juggernaut? Teleperformance CEO Paulo CesarSalles Vasques says no, according to an analyst call held on August 22, 2016.“We are going to keep LanguageLine as a standalone business,” he says. (A fulltranscript of the analyst call is available for download at the end of thisarticle.)

“How Teleperformance handles theintegration of LanguageLine into their operations will be watched veryclosely by other providers”—Barry Slaughter Olsen, co-President ofInterpretAmerica

Cautiously proceeding with theintegration is likely the right thing to do. According to Barry SlaughterOlsen, co-President of InterpretAmerica and professor of interpreting at the MiddleburyInstitute of International Studies, “how Teleperformance handles theintegration of LanguageLine into their operations will be watched veryclosely by other providers, who will no doubt be ready to capitalize on anycustomer or interpreter dissatisfaction and entice them away fromLanguageLine.”

Explained Olsen, “Although by farthe market leader, LanguageLine has seen many other remote interpreting shopseat into their client base and woo away unhappy interpreters. But if theacquisition means an improvement in customer experience and interpretersatisfaction, Teleperformance’s position will be strengthened.”

Monterey, home of LanguageLine

David Rumsey, President of theAmerican Translators Association, told Slator the acquisition “is just part ofthe trend of consolidation we have been seeing in the T&I industry inrecent years. What is perhaps unique this time is the size of the acquisitionand that the purchaser is a European business process provider. Otherwise, itis too soon to have a clear idea on what the impact of this may be.”

A spokesperson for Teleperformancetold us the company would not comment on the acquisition for the time beingbeyond what has been published. Slator also reached out to competitor CyraComfor comment, but has not received a response as of press time.


Teleperformance shareholders havereason to be pleased with the deal. The transaction is debt financed and avoidsdilution. There is no immediate lift to the stock from an earnings multipleperspective (Teleperformance trades at around 11–12x EBITDA, while LanguageLinewas acquired for around 10x EBITDA).

However, Teleperformance estimates theacquisition will widen EBITDA margins in 2016 by 250–300 basis points andincrease earnings per share by 10%. The debt incurred from the acquisition isexpected to be paid down within four years.


The deal’s USD 1.5b price tag makesit, by far, the largest transaction ever in the language services industry.

Joshua Gould told Slator he is “notsurprised that a sale of this size has gone through given the number of majorfunds who have contacted thebigword over the last 24 months, especially when youconsider the valuations that Smartling and Gengo have recently achieved.” Gouldis Chief Commercial Officer at thebigword Group and CEO at thebigword Inc., aUK language service provider, which recently inked a large OTP interpretation contractwith the UK’s Ministry of Justice.

InterpretAmerica’s Olsen said aboutthe price: “Given that frequently quoted estimates of the entire telephonicinterpreting market have been hovering around USD 1bn for the last few years,the USD 1.5bn price tag seems high based on the market size. However,LanguageLine does have between 40–45% market share and given the increasedclient base and sales opportunities that the acquisition offers, the price maywell be justified.”

“We are not surprised that a sale ofthis size has gone through”—Joshua Gould, Chief Commercial Officer, thebigwordGroup

ComparingClient Lists

The acquisition opens up significantcross-selling opportunities. Most Teleperformance clients are also clients ofLanguageLine. Yet LanguageLine has a broader base in terms of number ofclients, according to Executive Chairman Daniel Julien of Teleperformance,which offers “commercial synergies.”

LanguageLine’s presence in the USwas also attractive. “North America has always been a key priority for us,”Julien told analysts. He highlighted LanguageLine’s strong presence inhealthcare, financial services, and the public sector (law enforcement).

ToEurope and China

In addition to cross-sellingTeleperformance’s services into LanguageLine’s diverse client base, Julienwants to expand LanguageLine’s geographic footprint. The hands-on founder andmentioned LanguageLine’s revenues still come almost exclusively from NorthAmerica (94%) and the UK (6%).

Describing the competitive landscapefor OTP in Europe as fragmented, Julien sees opportunity in Europe, where thelegal framework for access to services for people with limited proficiency inthe local language is less well developed than in the US.

Olsen agrees, saying there is a“virtually untapped market for remote interpreting in continental Europe, atthe same time that there has been a surge in demand for interpreting servicesassociated with the huge influx of migrants and refugees into Europe. Thus far,no European language service provider has been able to tap into this demandsuccessfully…yet.”

Paris, home of Teleperformance

But while still not operating on thescale of LanguageLine, European interpretation providers like Semantix, thebigword, and Hero Tolk, will not cedemarket share without a fight.

Asked by an analyst to clarify whatopportunity he sees for LanguageLine in China, Julien points to the lack ofEnglish skills outside the large Chinese cities; which he thinks creates anopportunity for providers of interpretation from European languages intoChinese.


Despite the numerous ventureslooking to disrupt translation and interpretation via cloud, crowdsourcing,machine translation, and artificial intelligence models, Julien sees no threatto his USD 1.5bn bet on human-powered interpretation.

“A translation engine cannot do thejob of an interpreter”— Daniel Julien, Executive Chairman, Teleperformance

Julien said the first question theyasked themselves when they looked at LanguageLine was if Google Translate posesa risk to the business in the long-term. They came to the conclusion that itdid not. As a big user of machine translation, Julien said MT is useful as atool, but not as a replacement for human translation. “A translation enginecannot do the job of an interpreter,” he concluded.

NewBuyer in Town?

Teleperformance is unlikely toemerge as a significant buyer for other language service companies in the nearfuture. Julien told analysts they are going to slow down the pace ofacquisition until they finish deleveraging the company, three to four yearsfrom now. So it seems private equity firms looking for an exit toTeleperformance for their LSP portfolio companies should not hold their breath.


Olsen cautions Teleperformance notto underestimate the complexities of the remote interpreting ecosystem in theUS. “There is a great deal of mistrust between interpreters and large languageservice companies. With the acquisition, Teleperformance could reset therelationship and help change that. The big unknown here is what happens ifTeleperformance later on decides to pivot away from providing remoteinterpreting services,” he said.

He added, “Language Line Solutionshas been acquired and spun off previously. And other large communicationscorporations have flirted with and ultimately abandoned remote interpreting inthe past. Interpreting is a unique and complex market that requires dedicationand patience to succeed. Hopefully, Teleperformance has enough of both.”


9/11 award given to driver who helped nab kidnap suspect

BOSTON — A livery driver who helped police thwart a suspected kidnapping was honored Friday with a bravery award named for a flight attendant who was aboard one of the two planes that were hijacked from Boston's Logan International Airport and flown into the twin towers of the World Trade Center 14 years ago.

The Madeline Amy Sweeney Award for Civilian Bravery was given Friday to Albeiro Gomez, a Worcester resident, during an annual observance at the Statehouse marking the anniversary of the Sept. 11, 2001, terror attacks.

"All I did was (act) as a good citizen," Gomez, a native of Columbia, said through an interpreter from Baystate Interpreters, Inc.

On July 20, 2014, Gomez unwittingly picked up a kidnapping suspect and his two captives, a woman and her 11-month-old baby, said Major Gen. Scott Rice, head of the Massachusetts National Guard, in presenting the award.

Gomez realized something was wrong when state police, alerted to the kidnapping, converged on the vehicle on the Massachusetts Turnpike. Rice said Gomez then turned to the back seat and saw the male passenger holding a gun.

"He lunged over the seat and grabbed the gun," said Rice, who called Gomez a "hero in our midst." During the ensuing struggle, he said the woman escaped the vehicle with her baby and state troopers were able to arrest the suspect.

Together with police, "we were able to prevent what could have been a very violent act," said Gomez, who has lived in the U.S. for 15 years. The award was made more special, he said later, because his wife and two daughters in Columbia will soon be able to join him.

Sweeney, an Acton resident, was a flight attendant on American Airlines Flight 11, the first of two planes hijacked from Boston.

She was credited with discreetly contacting authorities and providing the first key information about the hijackers.

"Amazingly, Amy had the courage and the focus and the bravery to contact the airline's ground services to convey critical information about the five hijackers and their actions," said Polito.

Earlier Friday, Sweeney's daughter, Anna, who was 6 years old when her mother was killed, was among several relatives of 9/11 victims who joined state officials in reading the names of the more than 200 people with Massachusetts connections who died in the attacks.

Other Boston observances included a wreath-laying ceremony at the 9/11 Memorial at the Public Garden, and a moment of silence at the airport at 8:46 a.m., the moment the first hijacked plane struck the World Trade Center.

June 9, 2015
Untrained interpreters make 10 times more medically significant errors. How many errors would you accept?

Federal and New York state law on language access calls for "qualified" interpreters without requiring specific credentials; although, interpreters work in realms where understanding can be the difference between life and death. Research suggests that many of those interpreting in a medical settings are not truly qualified to give another a voice. A 2013 study in the journal Pediatrics found that 57 percent of pediatricians in the US still use friends and family to communicate across the language barrier, even when professional interpreters are available. Even paid staff and contract interpreters may have minimal or no training.

Using under-qualified interpreters saves money up front but will likely incur large costs later. California State Assembyman Phillip Y. Ting, explains the financial risks of unskilled interpreting: expensive emergency care, higher diagnostic and testing costs, increased liability. The greatest risk is a poor health outcome for patients like Poulinna's dad.

Research by Dr. Glenn Flores lights a way forward. The more medical interpreter training, the fewer medically significant errors, like omitting allergies or misstating drug dosages. Compared to interpreters with over 100 preparation hours, less well-trained interpreters make six times more medically significant errors, and untrained interpreters, 10 times more. How many errors would you accept?

If training is the first step, certification is the second. Certification provides objective proof of competency. We wouldn't dream of using an unlicensed nurse, doctor or lawyer. Statistically verified exams now exist on the national level for medical interpreting. Surprisingly, few health care facilities require certification, and interpreters are reluctant to spend the time and money needed to get it. Could we fear that a certified interpreter will cost more?

Unless certification brings status and pay, interpreters will likely not invest the time and money required. The missing piece appears to be reliable funding for medical interpreting. The current practice requiring the health care provider to pay does not seem fair – or productive. "Physicians don't deny the need for effective communication. But, they say, the unfunded legal mandates leave doctors to bear the expense," American Medical News reported.

Many recommend shifting the funding burden to health insurers, private and governmental. Already, insurers reimburse preventive care: immunizations, screenings, regular check-ups; interpreting may be added. Some insurers like Health Partners in Minnesota offer interpreting directly. Medicaid covers a portion of interpreting costs in DC and 13 states, including New York. Under the Affordable Care Act, California is now proposing a bill to provide a state/ federal match – anticipating a thousandfold greater contribution from the federal government. We in New York must explore these payment options – without delay.

"Of all the forms of inequality, injustice in health care is the most shocking and inhuman." Dr. King said this in 1964. Let's take action.

May 5, 2015

Deaf immigrant jailed 6 weeks with no access to interpreter

WASHINGTON — He knew he was in jail, but he didn’t know why.

Eventually, Abreham Zemedagegehu learned that he’d been accused of stealing an iPad — an iPad whose owner later found it. He spent the next six weeks in jail, unable to communicate with his jailers because he is deaf. He described a frightening, isolated experience in which medical procedures were performed without his consent and he feared for his safety.

Zemedagegehu sued the Arlington County sheriff last month in federal court, saying his treatment failed to meet the standards of the Americans with Disabilities Act.

“I felt like I was losing my mind,” Zemedagegehu said through an interpreter in an interview at his lawyer’s office. “I thought Virginia would give me an interpreter and they said no. That’s why I felt lost.”

Zemedagegehu, who is homeless, is a U.S. citizen who was born in Ethiopia. He grew up using Ethiopian Sign Language. He has learned American Sign Language, but he has never learned more than rudimentary written English.

Maj. Susie Doyel, a spokeswoman for the sheriff’s office, which runs the jail, declined to comment on the specific allegations. She generally defended the jail’s ability to handle deaf inmates and others with disabilities, and said several deputies in the jail are proficient in sign language.

But she also acknowledged that communication with a deaf inmate is more problematic in cases where the inmate can’t communicate in written English.

In court papers filed Monday, lawyers for the sheriff ask a judge to dismiss the case, arguing that even if Zemedagegehu’s allegations are true, they fail to show intentional discrimination because they attempted various different ways to communicate with him, including handwritten notes.

And even if the discrimination were intentional, the lawyers write that it would not violate federal law because there is a rational basis for the discrimination: “it takes extra resources and creates additional security considerations to bring in an ASL interpreter,” they write.

Zemedagegehu’s ordeal began Feb. 2, 2014, as he sought a warm place to sleep at Reagan National Airport. According to Zemedagegehu’s lawsuit, officers from the Metropolitan Washington Airports Authority arrested him on a complaint that he had stolen another man’s iPad.

Zemedagegehu says he requested an ASL interpreter to explain what was happening, but instead was taken to the Arlington jail for processing. He said the booking process was bewildering, with someone speaking on a video screen and he not understanding what was happening.

After he was booked, he underwent a medical screening, and says he was given forms to sign. He didn’t know what they were, and refused to sign them. He says they stuck a needle in his arm without explaining what was occurring — he later learned it was tuberculosis test, to which he suffered a bad reaction.

It was not until he was arraigned Feb. 4, and a court interpreter was present, that he understood the charge against him.

When he was offered an opportunity to communicate, he said the jail provided a TTY device. Zemedagegehu said the machine was useless — it types out English text he doesn’t understand, and as a practical matter, he said, no one in the deaf community still uses a TTY device. He needed instead access to a videophone or video relay service that is more commonly used, he said.

Maj. David Kidwell, director of the jail for the sheriff, also declined to comment specifically on Zemedagegehu’s care, but generally defended the use of a TTY machine.

“It gets used, absolutely. It’s an accepted practice, and we’ve had great success with it,” he said.

On March 14, 2014, Zemedagegehu struck a plea deal, pleading guilty to lesser misdemeanor charges in exchange for time served. Zemedagegehu says he only took the deal to get of jail, and that he didn’t steal the iPad.

Zemedagegehu’s public defender filed a motion after the guilty plea seeking to have the conviction overturned, saying prosecutors failed to turn over evidence that the man who claimed his iPad was stolen actually had found it some time before the guilty plea. Prosecutors deny withholding evidence.

A judge refused to overturn the conviction, saying the appeal had been filed too late.

Zemedagegehu said he doesn’t understand why it was so difficult for the legal system to accommodate him with an interpreter.

“They’re doing this 25 years after the Americans with Disabilities Act was passed. They know better,” he said.

Caroline Jackson, an attorney with the National Association of the Deaf, who is helping on Zemedagegehu’s case, said cases like his are “distressingly common. There’s an assumption that persons behind bars have no rights.”

The ADA itself does not spell out exactly what kind of accommodations a jail must make for deaf inmates. But since the law was passed, several lawsuits have addressed similar issues. In 2010, the Virginia Department of Corrections reached a settlement requiring it to provide qualified interpreters during the booking process and when providing medical care, among other things.

Doyel said the county jail, which isn’t part of the state prisons system, has passed audits conducted by the state Department of Corrections and has received accreditation from outside groups.

Larry Tanenbaum, a lawyer with Akin Gump, the firm that took Zemedagegehu’s lawsuit on a pro bono basis, said he thinks the jail failed to meets its standards in its incarceration of his client.

“To me, it’s a matter of human kindness. You see a person in your care who’s lost. How do you not help him?” Tanenbaum asked.

Idaho Gov. Otter Vetoes New Regulations on Sign-Language Interpreters
April 24, 2015

Idaho governor Butch Otter (R) vetoed a bill required government licensing by a state board for the practice of interpreting and translating sign language for the hard of hearing.

If House Bill 152 had been signed into law, anyone performing sign language translation in a “general setting” would have had to pay thousands of dollars for government licenses and permits.

‘Slower Employment Growth’

University of Minnesota Center for Human Resources and Labor Studies Professor Morris Kleiner says occupational licenses make it more difficult for people to find employment, reducing employment rates and slowing job growth.

“States that license more workers have much lower employment growth,” he said. “If you compare occupations that are licensed in some states and not in others, those states that license more workers have slower employment growth.”

Kleiner says occupational licensing requirements do not increase quality of services or products for consumers.

“In a lot of cases, the question is, should the input in the production process be licensed, or should it simply be the final product?” he said.

‘Fairly Onerous and Expensive’

Idaho Freedom Foundation Vice President Fred Birnbaum says the bill would have reduced the number of sign-language translators, making things more difficult for people with hearing impairments.

“The sponsor of the legislation actually said it would reduce the number of people who can practice, because the requirements for the license are fairly onerous and expensive,” he said.

Birnbaum says the bill would have had effects far beyond its intended scope.

“This bill requires a license for a sign language interpreter in a general setting, including medical, legal, professional, business and commercial, governmental, post-secondary, video call centers,” he said. If two friends went to buy a TV at Best Buy, that's a ‘commercial setting.’”

Board Control Seen as Critical

Birnbaum says the bill was poorly written, and gave the government too much power over everyday interactions.

“If you and I were friends, and I was someone who learned some sign language skills but I didn't want to go through licensing, I was just going to help you buy a TV or a car, I couldn't do that without a license. It's so broadly written,” he said. “Their counterclaim is that nobody is going to be charged for doing that; that's not the intent of the bill. But the bill gives people who are going to get the license control of the board.

“Once they control the board, they'll have a lot of power over who's licensed and who can be excluded,” Birnbaum said.

Jeff Reynolds ( writes from Portland, Oregon.

Trained Interpreters For Patients With Limited English Can Help Avoid Medical Mishaps

Topics: Delivery of Care, Health Disparities, Hospitals

By Michelle Andrews

May 21, 2012

A visit to the emergency department or a physician's office can be confusing and even frightening when you're trying to digest complicated medical information, perhaps while you're feeling pain or discomfort. For the 25 million people in the United States with limited English proficiency, the potential for medical mishaps is multiplied.

A trained medical interpreter can make all the difference. Too often, however, interpreter services at hospitals and other medical settings are inadequate. Family members, including children, often step in, or the task falls to medical staff members who speak the required language with varying degrees of fluency.
According to a study published in March, such ad hoc interpreters make nearly twice as many potentially clinically significant interpreting errors as do trained interpreters.
The study, published online in the Annals of Emergency Medicine, examined 57 interactions at two large pediatric emergency departments in Massachusetts. These encounters involved patients who spoke Spanish at home and had limited proficiency in English.
Researchers analyzed audiotapes of the visits, looking for five types of errors, including word omissions, additions and substitutions as well as editorial comments and instances of false fluency (making up a term, such as calling an ear an "ear-o" instead of an "oreja")

More From This Series Insuring Your Health

They recorded 1,884 errors, of which 18 percent had potential clinical consequences.
For professionally trained interpreters with at least 100 hours of training, the proportion of errors with potential clinical significance was 2 percent. For professional interpreters with less training, the figure was 12 percent. Ad hoc interpreter errors were potentially clinically significant in nearly twice as many instances -- 22 percent. The figure was actually slightly lower -- 20 percent -- for people with no interpreter at all.
A Civil Rights Issue
It makes sense that trained interpreters, especially those with more experience, would make fewer errors, says Glenn Flores, a professor and director of the division of general pediatrics at UT Southwestern Medical Center and Children's Medical Center of Dallas, who was the study's lead author. Experienced interpreters "know the medical terminology, ethics, and have experience in key situations where you need a knowledge base to draw on," he says.
Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color or national origin. Courts have interpreted that to mean that all health-care providers that accept federal funds -- because they serve Medicare and Medicaid recipients, for example -- must take steps to ensure that their services are accessible to people who don't speak English well, according to the National Health Law Program, a nonprofit that advocates for low-income and underserved people. (Doctors whose only federal payments are through Medicare Part B are exempt from this requirement, however.)
The Census Bureau estimates that nearly 9 percent of the population age 5 or older has limited English proficiency, which the bureau defines as people who describe themselves as speaking English less than "very well."
Hospitals and other medical providers are in a tough spot, say experts. The law prohibits them from asking patients to pay for translation services, and they may not receive adequate or in some cases any other reimbursement.
"It's a civil rights law, not a funding law," says Mara Youdelman, managing attorney in the Washington office of the National Health Law Program.
A dozen states and the District reimburse hospitals, doctors and other providers for giving language services to enrollees in Medicaid, the joint federal-state program for low income people, and in CHIP, a federal-state health program for children, according to Youdelman.
A 2008 survey by America's Health Insurance Plans, an industry trade group, found that 98 percent of health insurers provide access to interpreter services, but providers and policy experts question that figure. According to a survey by the Health Research and Educational Trust, in partnership with the American Hospital Association, 3 percent of hospitals received direct reimbursement for interpreter services, most of that from the Medicaid program.
"Most hospitals that make this a priority make it a budget item," says Youdelman.
Lost In Translation
Hospitals and other providers realize that providing competent interpreter services can help ensure that they don't miss or misdiagnose a condition that results in serious injury or death, say experts. Trained interpreters can also help providers save money by avoiding unnecessary tests and procedures.
Youdelman cites the example of a Russian-speaking patient in Upstate New York who arrived at an emergency department saying a word that sounded like "angina." The emergency staff ran thousands of dollars' worth of tests, thinking he might be having a heart attack. The real reason for his visit: a bad sore throat.
Like many hospitals, Children's Medical Center of Dallas provides interpreter services around the clock via varying modes of communication -- face-to-face, telephone and video -- delivered by a mix of trained staff interpreters and outside contractors.
When Nadia Compean, 23, was six months pregnant, her doctor in Odessa, Texas, told her that her baby had spina bifida, a condition in which the spinal cord doesn't close properly, leading to permanent nerve and other damage.
The local hospital wasn't equipped to handle the birth and subsequent surgery that her daughter would require, so Nadia and the child's father traveled to Dallas, about 350 miles away.
Neither speaks much English, but at Children's Medical Center of Dallas, interpreters helped them understand what to expect, Nadia said (through an interpreter).
Nadia says she learned that her daughter, Eva, would be born with a lump on her back and would require immediate surgery. She also learned about problems that Eva may experience walking and using the toilet, she says.
Eva was born on March 6. Because of her medical needs and the lack of adequate interpreter services in Odessa, the couple is considering relocating to Dallas, where the father hopes he can find construction work.
Please send comments or ideas for future topics for the Insuring Your Health column to

We want to hear from you: Contact Kaiser Health News


All original KHN material – articles, graphics and videos – can be used for free, if you credit us and link to us. Learn more

Interpreters in ER may limit medical errors, study suggests

Published April 18, 2012

Having professional translators in emergency rooms for non-English-speaking patients may help limit potential miscommunications, according to a U.S. study.
The study, conducted at two pediatric ERs and published in the Annals of Emergency Medicine, found that mistakes which could have "clinical consequences," like giving the wrong medication dose, were about twice as likely if there were no interpreters or if the translator was an amateur.
"The findings document that interpreter errors of potential clinical consequence are significantly more likely to occur when there is an 'ad hoc' or no interpreter, compared with a professional interpreter," said lead researcher Glenn Flores, of the University of Texas Southwestern Medical Center in Dallas.
An estimated 25 million U.S. residents have limited English proficiency - that is, they say they speak the language less than "very well."
By law, U.S. hospitals that receive federal funds have to offer some type of translation help for those patients. That can mean a professional interpreter who works for the hospital or telephone or video-based translation services.
Studies have found that patients like to have a translator available, and that it may improve care and cut costs, by avoiding unnecessary tests, for instance. But it hadn't been clear how well professional interpreters performed against amateurs, or no interpreter at all.
The current study was based on 57 families seen in either of two Massachusetts pediatric emergency rooms. All were primarily Spanish-speaking and 20 families had help from a professional interpreter.
Ten had no translation help and 27 had a non-professional interpreter. The reasons for the difference was unclear.
When trained interpreters were available, 12 percent of translation slips could have potential health risks to a child. But when the interpreter was somebody such as a family member or a bilingual member of the hospital staff, 20 to 22 percent of their translation errors were potentially risky.
In one example from the study, an amateur interpreter - a family friend - told the doctor that the child was not on any medications and had no drug allergies. But the friend had not actually asked the mother whether that was true.
A number of questions remain about professional interpreters, such as whether in-person interpreters are more effective than phone or video interpreters and what are the most cost-effective measures, Flores said.
Another issue is training, including the question of how much is enough.
Errors were least common when the interpreters had 100 hours of training or more. In these cases, only two percent of their translation slips had the potential for doing the child harm.
Few training programs for medical interpreters provide at least 100 hours of training, Flores said. Even when hospitals run their own programs, the hours involved vary widely.
"These findings suggest that requiring at least 100 hours of training for interpreters might have a major impact on reducing interpreter errors and their consequences in health care, while improving quality and patient safety," the researchers wrote.

Read more:

January 31. 2012 12:00AM

Lack of interpreter stalls sex-assault trial in Dudley

DUDLEY, MA — The arraignment of a local man accused of inappropriately touching a woman as she slept in a spare bedroom was continued until Feb. 17, when a Polish interpreter will be available in Dudley District Court.

Jakub Bors, 62, of 14 W. Main St., Apt. 2, was charged Friday with indecent assault and battery on a person 14 or older.

About 12:30 a.m. Friday, the 35-year-old alleged victim and a man entered the Dudley Police Station. The woman said Mr. Bors, her friend, had inappropriately touched her, a police report said.

The woman said she had been staying temporarily with Mr. Bors, and the night in question, she and Mr. Bors had been drinking, police said.

The woman said she was awakened in the spare bedroom by Mr. Bors lying in bed next to her. As he touched her, she ordered him to stop. He allegedly replied, “Nothing me, and you, everything.”

She said Mr. Bors tried to get on top of her, and they struggled. She said she left the bedroom and called the man who accompanied her to the station for help. While on the phone Mr. Bors allegedly pushed her and grabbed the phone.

After speaking with police, the victim went to Hubbard HealthCare at Harrington in Webster, authorities said.

Order the Telegram & Gazette, delivered daily to your home or office!

PORTO SANTO STEFANO, Italy - The first course had just been served in the Costa Concordia’s dining room when the wine glasses, forks, and plates of cuttlefish and mushrooms smashed to the ground. At the magic show in the theater, the trash cans tipped over and the theater curtains turned on their side. Then the hallways turned upside down, and passengers crawled on bruised knees through the dark. Others jumped alone into the cold Mediterranean Sea.

The terrifying, chaotic escape from the luxury liner was straight out of the movie “Titanic’’ for many of the 4,000-plus passengers and crew on the cruise ship, which ran aground off the Italian coast late Friday and flipped on its side with a 160-foot gash in its hull. At least three bodies had been recovered, and rescuers searching the wrecked ship for the missing found two survivors late yesterday in a cabin on board. They were in good condition, rescuers told the ANSA Italian news agency. Close to 40 remained unaccounted for.

The Friday the 13th grounding of the Concordia was one of the most dramatic cruise ship accidents in recent memory. It immediately raised a host of questions: Why did it hit a reef so close to the Tuscan island of Giglio? Did a power failure cause the crew to lose control? And why did crew members tell passengers they weren’t in danger until the boast was listing perilously to the side?



Travel Alerts are issued to disseminate information about short-term conditions, either transnational or within a particular country, that pose significant risks to the security of U.S. citizens. Natural disasters, terrorist attacks, coups, anniversaries of terrorist events, election-related demonstrations or violence, and high-profile events such as international conferences or regional sports events are examples of conditions that might generate a Travel Alert.

    Thailand   01/12/2012  Potential Terrorism
    Chile 01/10/2012
    Philippines 12/22/2011
    Senegal 12/12/2011
    South Pacific    12/12/2011 Cyclone Season
    Bahrain 11/18/2011
    Egypt 11/07/2011
    India -    10/18/2011 Potential Terrorism
    Worldwide 10/11/2011
    Japan 10/07/2011
    Tunisia 10/05/2011
Get Your FREE Quote
Sitemap  |  Privacy Policy  |  Terms & Conditions  |  Copyright  |  © 2024. Baystate Interpreters, Inc. All Rights Reserved