WE ARE A GLOBAL INTERPRETATION CONSULTANCY

We understand how infuriating it can be when you can’t communicate with the people around you. It gets even more frustrating when something as simple as going to the doctor for a checkup is almost impossible – they can’t understand you, and you can’t understand them. This is where we come in!

Spanish Interpreters Solution (SIS) is making sure you never feel unheard again! With almost 559 million people in U.S. who speak Spanish and don’t know any other language, we can only imagine how difficult little tasks can be for them. In order to reduce their struggles, SIS has come up with services that will help Spanish speaking residents with L.E.P (Limited English Proficiency) connect with other citizens and make communication possible.

With our highly professional staff we wish to eliminate the barriers that keep us apart, on every day basis!

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Services We Offer

SIS’s main focus is to remove any differences of language from legal, medical, or personal procedures. Our services are based on two major categories:

Professional Interpreting Services

We believe that if you’re heard and understood, you feel like you belong. SIS offers its interpreting services to various industries such as Business, Law, Social Services and Healthcare. Our trained professionals help interpret documents, legal notices, and conversations between two parties present together or on virtual spaces.

Our interpreting services include our officials catering to your needs in various ways such as telephone interpreting, conference interpreting, and personal interpreting. Our officials also do in-person sessions or move within the industries where vital information needs to be transmitted to Spanish people with L.E.P (Limited English Proficiency)!

Professional Translating Services

The other part of our services include translation services. When you need assistance in communicating to people, you definitely need someone to translate your legal documents for you. In retrospect, people who have L.E.P (Limited English Proficiency), understanding legal documents, or personal documents can become difficult and that is exactly where we come in to assist you!

Our translation services feature professionals who will help you in translating documents such as passports, adoption papers, legal documents, birth & marriage certificates, Sermons – Conferences, Bible Studies, Books, Medical forms, Concent forms, Immigration forms, Real Estate, and School documents.

MEDICAL INTERPRETERS IN OUTPATIENT PRACTICE

Medical professionals who work with LEP patients should rely on trained and, ideally, certified, medical interpreters to give them the best comprehension of what a patient is saying. Having a patient try to get by with limited English, using untrained bilingual staff or family members, or having clinicians use their limited language ability (for example, high school Spanish) to communicate in the patient’s language, can have dire consequences both for the patient and the clinician. Consider this well-known real-life example

On his initial medical history, a Spanish-speaking boy aged 18 years, of Cuban descent, presented with abnormal mental status complaining of “intoxicado.” An untrained interpreter understood this to mean that the boy was intoxicated - though in the Cuban dialect, the boy was actually saying that he was “nauseated.” He received care for a drug overdose attributed to substance abuse but developed paraplegia, subsequently found to be due to a ruptured intracranial aneurysm. The case led to malpractice lawsuit with a $71 million award to the plaintiff.3,4
Is Providing Interpreter Services a Requirement?

Discrimination on the basis of national origin or other protected categories in programs or activities receiving federal financial assistance has long been prohibited in the United States. To assure compliance with Title VI of the 1964 Civil Rights Act,5 Executive Order 13166,6 issued in 2000, required federal agencies to develop systems to improve access to their programs and services for persons with LEP, defined as those “whose primary language for communication is not English” and who have “a limited ability to read, write, speak, or understand English.”7 In 2003 the Department of Health and Human Services (HHS) published guidance about how to meet the provisions of the aforementioned executive order by providing LEP individuals with meaningful access to federal health care programs (HHS LEP Guidance).8,9 That guidance continues to be used today. In addition, the prohibitions against discrimination in health care programs were further addressed and codified in HHS regulations implementing Section 1557 of the Affordable Care Act (ACA).10,11

Consistent with HHS LEP Guidance, the regulations require all covered health care programs and providers to take “reasonable steps to provide meaningful access to each individual with limited English proficiency eligible to be served or likely to be encountered in its health programs and activities.”12 Required language assistance services must be free to patients, accurate and timely, protect patient confidentiality, and be provided by qualified interpreters.13

Entities covered by these anti-discrimination provisions include those who meet any of the following criteria: (a) operate a “health program or activity,” any part of which receives “federal financial assistance” from HHS (eg, hospitals, health clinics, state Medicaid agencies, health insurance issuers, nursing homes, physician practices, etc); (b) are administered by HHS (eg, Medicare programs, Medicaid programs, the Children’s Health Insurance Program [CHIP]); or most recently (c) were established under the Patient Protection and Affordable Care Act (ACA), such as state-based and federally facilitated Health Insurance Marketplaces.7 Pertinent to item (a), operating a health program or activity includes provision or administration of health-related services as well as health-related insurance coverage. If any part of the health program or activity of the covered entity receives federal financial assistance from HHS, then all of its programs and activities are subject to these anti-discrimination provisions.

The important point for outpatient practices is that receiving federal financial assistance includes submitting claims and receiving payments from federal government programs like Medicaid, most Medicare programs, or CHIP.14,15 The one exception to this rule is if the only federal financial assistance a clinician or practice receives is Medicare Part B.16 The Department of Health and Human Services has noted, however, that “almost all practicing physicians in the United States…accept some form of Federal remuneration or reimbursement apart from Medicare Part B” and therefore are subject to these requirements.16–18

Determinations of whether covered entities, including physicians and practices that receive federal financial assistance, have taken the required reasonable steps to provide meaningful access to LEP individuals must be made on a case-by-case basis. Factors that will be considered include the “nature and importance of the health program or activity and the particular communication at issue”19 and other relevant factors including whether the entity has “developed and implemented an effective written language access plan appropriate to its particular circumstances.”20

Although the development and implementation of a language access plan continue to be voluntary, it is a key component in evaluating compliance. Other relevant factors include: (1) the prevalence of LEP individuals in the population eligible to be served or likely to be encountered, (2) the frequency with which they are encountered in the practice, (3) the cost of providing language assistance services, and (4) whether the practice has availed itself of all available opportunities to lower costs.21–23

How to Meet the Requirements?

When entities are required to provide interpretation for LEP individuals, they must use the services of “qualified” medical interpreters. Unfortunately, when an interpreter appears in clinic or hospital settings to assist during a clinician-patient encounter, most clinicians assume the interpreter is qualified to interpret. But, that’s not always the case.24

A qualified interpreter for an individual with LEP is one who “(1) adheres to generally accepted interpreter ethics principles, including client confidentiality; (2) has demonstrated proficiency in speaking and understanding both spoken English and at least one other spoken language; and (3) is able to interpret effectively, accurately, and impartially, both receptively and expressly, to and from such language(s) and English, using any necessary specialized vocabulary, terminology and phraseology.”25

Federal regulations and guidance do not require interpreters to be licensed or certified. Use of certified interpreters is required in some states,26 however, and HHS considers certification helpful to establish competency.27

Certified medical interpreters have a high level of fluency in 2 or more languages, have been trained in the ethics and role of a medical interpreter, study medical terminology, and can facilitate the flow of a patient-clinician medical visit—including making clinic visits shorter than when telephonic or uncertified in-person interpreters are used.28 In contrast to “trained” interpreters, certified interpreters have participated in a formal medical interpreter education program and have passed written and oral examinations in medical interpreting. Just like medical professionals, they have a code of professional standards and ethics among which includes accuracy, confidentiality, and impartiality.

Currently, there are only 2 national organizations in the United States that provide formal certification of medical interpreters: The National Board of Certification for Medical Interpreters29 and the Certification Commission for Healthcare Interpreters.30 Whenever possible, clinicians and health systems should seek to use the services of interpreters who are certified by these organizations.

It is not appropriate to rely on health care staff to interpret unless they are “qualified bilingual/multilingual staff”—defined as individuals who meet the requirements listed in Table 1.31 Practices and health systems covered by the regulations cannot require patients to provide their own interpreters.32 The use of minor children accompanying a patient to serve as interpreters is also prohibited except in emergency situations involving “an imminent threat to the safety or welfare” of the patient when no qualified interpreter is available.33 In addition, adults accompanying the patient cannot be used as interpreters absent emergency conditions or where the patient specifically requests that the accompanying individual interprets and “reliance on that adult for such assistance is appropriate under the circumstances.”34

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