As our valued network providers, you are well-versed in the significant needs of CCA’s member population, and how imperative it is that we ensure an equitable healthcare experience for those we mutually serve. CCA is available to help ensure that your practice has the resources you need to communicate with the CCA members you see in-office.
Interpretation
Title VI of the Civil Rights Act of 1964 requires providers to supply interpreter services for patients with limited English proficiency at no cost to the patient, as well as provide communications in an accessible format for patients with a disability, such as sign language interpreters or TTD/TTY services. Once you’ve determined a patient’s preferred language, you must find a way to communicate in the patient’s language/format to reduce the risk of medical errors and empower patients to advocate for themselves. CCA is available to help providers locate interpreter and/or accessibility services, if requested.
If a provider is unable to offer needed interpreter services for a CCA member, CCA can provide telephonic language assistance services. A provider, along with the member, may contact the CCA Provider Services team at 866-420-9332 between the hours of 8 a.m. to 5 p.m., Monday–Friday and they will be connected to the appropriate interpreter telephonically. For assistance during evening hours (5-8 p.m.) or weekends (8 a.m.-6 p.m.), providers may call CCA Member Services at 866-610-2273. Please have the member’s name and CCA ID number available.
Language Assistance Tips & Resources
Tips for providers to identify a patient’s preferred language
- Ask each patient about which language(s) they speak and which language(s)/format(s) they read/write.
- If you are unsure which language a patient understands, try using a language identification poster or flyer. These tools explain a patient’s right to language assistance and ask the patient to point to the language that they read. The description is repeated in many different languages. Observe which language the patient points to so you will know in which language to seek an interpreter/translator.
- You can also provide your patients with an “I Speak” card to make it even easier for them to indicate their preferred languages. These are typically small pieces of paper that a patient can keep in their wallet that explains their preferred languages in both their preferred language and in English. This will make it easier for the patient to notify office staff or other providers that they need a translator. Additional examples and printable resources are available at lep.gov.
Helping patients who do not speak the same language as you (interpretation)
- Use a qualified interpreter. Interpreters should be trained in the languages they are speaking and in medical interpretation. Interpreters from an outside vendor can be in-person, over the phone, or on video. If you use your own bilingual staff, they should have specialized training as an interpreter as well.
- Minors should never be used to interpret. It can cause stress for the child and lead to medical errors due to incorrect interpretation.
- Always make eye contact with the patient and not with the interpreter.
- Pause in between sentences to allow for interpretation.
- Use first person language (e.g., refer to the patient as “you” instead of “they”). Do not use medical jargon. Explain medical terms with easy-to-understand phrases.
- Do not have side conversations with the interpreter or anyone else in the room. Side conversations can make the patient feel ignored or belittled.
- Allow extra time for the visit since every sentence will need to be repeated by the interpreter. Give the patient opportunities to ask questions.
- Use the “teach back” method to confirm the patient’s understanding. This is particularly important when discussing medications.
- When using an American Sign Language (ASL) interpreter (for a patient who is deaf or hard of hearing), look directly at the patient so they can see your mouth. Speak normally and clearly and reduce background noise. If the interpreter is not able to join in-person, you will need to set up a video call (rather than a phone call).
- Follow all other tips provided by the interpreter.
Helping patients who do not read/write in the same language/format as you (translation)
- Provide written materials in the patient’s preferred written language. Use a qualified translator who is trained and certified to translate materials. Note: There are different certifications and trainings for interpreters (spoken language) vs. translators (written language).
- To get the correct information from patients, all patient completed forms and questionnaires should be translated into the patient’s language. Some standardized forms and questionnaires have already been translated for use in many languages (For example, the depression screener, PHQ-9, has been translated into many languages and is available online). You can use a translator to help you understand what the patient writes on the form.
Educational materials provided to patients should always follow health literacy principles
- Use plain, non-medical language. Define all abbreviations and acronyms.
- Use font that is large enough and use space between lines to make the document easy to read.
- Keep sentences and paragraphs short.
- Do not use idioms or culture-specific references.
- Use graphics and pictures, when applicable. Make sure pictures reflect the community that you serve.
- When possible, seek feedback from patients to ensure materials are easy to understand in their preferred language.
For patients who are blind or have low vision
- Always ask the patient how they would like to receive materials.
- You may need to provide written materials in a different format, such as in braille, in an auditory format (like an audio recording), or in an electronic format (to be used with technology that can read words aloud).
- Work with a qualified outside translator or vendor, when necessary, to produce written documents in alternate formats.
Resources for Interpretation/Translation
Below are some searchable directories with interpreters/translators in your area and the languages they offer.
Find a certified medical interpreter (for spoken interpretation)
Certification Commission for Healthcare Interpreters https://cchi.learningbuilder.com/Search/Public/MemberRole/Registry
National Board of Certification for Medical Interpreters https://www.certifiedmedicalinterpreters.org/search-cmi-registry
Find a certified translator (for written documents)
American Translators Association: https://www.atanet.org/directory/
As always, if you have any questions or need assistance connecting with language or interpretation resources, CCA’s Provider Services team is available to help. Call 866-420-9332 between 8:00 a.m. and 5:00 p.m., Monday through Friday.