When it comes to determining what a quality and effective language access program looks like, language access managers need to refer to ACA 1557. The provisions in the most recent update to ACA 1557 states that clinicians can no longer rely on bilingual staff, family, or children. Rather, a qualified interpreter must be secured. A qualified interpreter will have demonstrable interpreting competency, fluency in English and at least one other target language, in addition to interpreting ethics adherence.
As the interpreting industry continues to grow and patient language diversity blooms, it is necessary for medical facilities and interpreting vendors to remain vigilant in securing qualified interpreters for every patient encounter. Part of that vigilance and commitment to quality should include regular audits of VRI vendors for compliance even after the contracts have been signed.
The interpreting industry has long established that national certification is necessary to work as a professional interpreter with Deaf and Hard of Hearing interpreters. National certification through the Registry of Interpreters for the Deaf (RID) allows for consumers (hearing and Deaf) to hold interpreters to professional standards, ethics and practices while also allowing for professional consequences if an interpreter violates the code of conduct.
Additionally, several states across the country have passed legislation that requires ASL interpreters to obtain state licenses to practice in their state, including remote interpreters. These laws were passed to provide extra protections for consumers by legally requiring national certification with RID, documented experience and education while also having legal recourse for consumers. Many of these laws were passed before VRI was as prevalent as it is today, but there are some states that have written into their laws that out of state ASL VRI interpreters must obtain an interpreting license.
Currently the spoken language interpreting industry doesn’t require professional interpreters to hold a national certification. A spoken language interpreter however must have an interpreter language assessment on file that was completed in English and the target language to substantiate their skills as an interpreter.
It is worth noting that an interpreting language assessment, whether developed and performed internally or by a 3rd party, should be medically focused, have clearly outlined testing development and methodology by trained and qualified language assessors, with test result mapping to ILR or ACTFL or CEFR scales. An audit should include the test results but also the validity and reliability of the interpreting language assessment itself.
Spoken language interpreters have their own national certifications available to them that offer similar consumer protections that ASL certification has for Deaf patients. NBCMI and CCHI are two national healthcare interpreting organizations that offer a written exam for all interpreters regardless of their target language. NBCMI offers an oral exam for Cantonese, Korean, Mandarin, Russian, Spanish, Vietnamese while CCHI offers an oral exam for Arabic, Mandarin, and Spanish. InDemand is actively and aggressively pursuing certification to the fullest extent for all spoken language interpreters in an effort to raise the bar for all participants.
Finally, every interpreter should have a signed copy of the industry ethics on file as confirmation of receipt and adherence to interpreting ethical standards.
A VRI vendor may state compliance with the ACA and state licensure laws, but only an audit of their interpreters will truly determine their level of compliance and record keeping. If they cannot provide this information, medical providers are opening themselves up to potential violations and legal consequences if a patient were to ever file a complaint against the interpreter and the VRI vendor for ineffective interpreting services.
Regular audits of randomly selected interpreters for compliance offer peace of mind for hospitals, clinics, and patients and help hold VRI vendors accountable to quality and effective communication access.