Medical interpreters are a critical link between patients and providers. BY CARLOS L. GARCÍA, CMI

Medical interpreters are those language specialists that help patients and providers communicate when they do not speak the same language.

This critical link that needs to be established between health care providers and patients has gone widely unchecked since 1964, with the passing of the Civil Rights Act, which goes on to say in its Title VI, Section 602 that “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.”

Issue of Discrimination

The issue of discrimination on the grounds of nationality was later interpreted by the U.S. Supreme Court in Lau v. Nichols in 1974 as also including language discrimination, and has been addressed thereafter on several occasions by the federal government.

Regarding health, the Office of Minority Health of the U.S. Department of Health and Human Services published their Culturally and Linguistically Appropriate Services (CLAS) Standards in 2001 for health care organizations that received funds from the Federal Government.

For health care organizations in general, the Joint Commission—an organization that accredits and certifies more than 18,000 health care institutions and programs—recently issued their new standards for patient-centered communication, which address the issue of language access.

The Standards are at their pilot phase of implementation, and will be fully enforced in 2012.

Many organizations and states like Oregon and Washington, among others, already have a program set up. California’s State Personnel Board is in the process of revising its policy regarding medical interpreting since state certification for medical interpreters is no longer issued.

Measuring Competence

Before October 2009, there was no valid and reliable measuring instrument on a nationwide scale that could measure interpreter competence. There were some attempts by several individual stakeholders to put in place exams to accomplish this feat, but only two main efforts remain.

The first to offer an examination was the National Board of Certification for Medical Interpreters, a non-profit organization that began testing in 2009. The Certification Commission for Healthcare Interpreters, also a non-profit, followed the next year with their own exam. Both organizations offer a written English exam regarding regulations and ethics, which must be successfully completed in order to take the oral language-specific exam.

So far, they have only developed oral exams for Spanish, but the National Board recently received a grant from the Oregon Office of Multicultural Health & Services to develop exams in Cantonese, Mandarin, Korean, Vietnamese and Russian. They will be ready by year’s end.

Oregon was the first state to recognize and approve the Certified Medical Interpreter (CMI) credential extended by the National Board as embodying the requirements for certification of Oregon interpreters.

The Certification Commission has plans to develop oral exams in languages other than Spanish, but there is no timetable yet.

For more information on either exam, please visit:

National Board of Certification for Medical Interpreters

Certification Commission for Healthcare Interpreters

The Need to Advocate

The International Medical Interpreters Association (IMIA) is the only national trade association in the U.S., and the largest professional association in the world dedicated to medical interpreters.

Its National Medical Interpreter Forum, also known as the May 1 Forum, is the biggest movement seeking to improve language access in health care for patients who have limited English proficiency.

IMIA includes several Task Forces that advocate to different stakeholders, specifically providers, health insurance, and government.

They have been gathering annually since 2007, and met in Washington, D.C. last year. They rallied for patient rights, reimbursement of language services, and they made more than 80 visits to members of Congress.

This year, they will be convening in Redondo Beach, California on April 30. The Forum is free to attend, but space is limited. Registration is strongly advised.

Register here.

Click here for more information on the work the National Medical Interpreter Forum is doing. CG