CSN interviews industry expert, Armando Ezquerra Hasbun
CSN – Armando, what is the current status of Health Care and Medical Interpreting?
Armando – Health Care and Medical Interpreting is one of the fastest growing segments in our industry. Medical interpreting is also in the process of becoming formalized along the lines of what the Legal and Court Interpreting community pioneered years ago. Presently, the most visible part of this process is the emergence of a national medical and health care interpreting certification.
CSN – Who is leading the effort behind medical interpreter certification?
Armando – There are two main groups leading this effort at this time: The National Board of Certification for Medical Interpreters (the Board) and the Certification Commission for Health Care Interpreters (the Commission).
CSN – What is the difference between the Board and the Commission?
Armando – Both groups have very similar structures and a common goal, and both can trace their origins to the former National Coalition on Health Care Interpreter Certification. They both have representation of multiple stakeholders in their ranks but one key difference is that the Commission is truly independent and restricts the role and influence of commercial and business supporters, while the Board, which originated in them, does not. Two of the seats on the Board are reserved for representatives of two language service providers; one of them has a direct role in the creation, organization and funding of the Board’s activities and can, at any time, add more members at will. Board members are also prohibited from cooperating in the creation of other examinations. Finally, all royalties created every time the Board’s exam is administered are not channeled back to the Board but, instead, to the lead language service provider that spearheaded this effort.
CSN – Does LSA support one group over the other? Why so?
Armando – LSA supports the implementation of any and all valid and reliable examination-based certifications for medical and health care interpreters. However, the company prefers the process the Commission is carrying out because it is truly a transparent, vendor-neutral group.
CSN – As an active Spanish interpreter yourself, do you personally support one group over the other? Why so?
Armando – I, like many other freelancers that have worked in many settings in this industry, favor a process that is led by interpreters and is ultimately accountable to them – not one guided by businesses whose primary consideration may be their shareholders’ concerns. As such, this process differs from the court interpreting segment: both states and the national governmenthandle all aspects of certification. Since, so far, these national initiatives are being handled privately, I prefer a group that includes the private enterprise but is not beholden to it.
CSN – What are the mandatory requirements and steps for an interpreter to become certified through the Board and the Commission?
Armando – Given the complexity and scope of the process, only health care and medical interpreters in Spanish can become certified, although, more languages are expected to be represented. There are specific requirements that are listed on the websites of the two groups but they generally ask for evidence of having attended a training course or having been an interpreter in the field for some time.
CSN – Does certification make medical interpreters more competitive?
Armando – I think that that is the goal; the extent of it will depend primarily on how purchasers of interpreting services behave. There may not be any or enough certified interpreters in some languages but as standards and credentials become better known, one expects that consumers will prefer to count on interpreters that have been screened through certification.
CSN – Do you think hospitals and health care systems will begin requesting only medically certified interpreters?
Armando – No; at least not in the foreseeable future. Hospitals and health care systems may still have to rely on a mix of providers to do the job: certified interpreters, qualified interpreters, staff and freelancer interpreters, volunteers and (hopefully competent) dual-role employees. The hope is that the practice of relying on family members and unqualified bilinguals will come to an end.
CSN – Are there any laws currently in place or in development regarding the use of certified medical interpreters?
Armando – The state of Oklahoma and the state of Washington have been certifying their medical and health care interpreters but there are no nationwide regulations yet regarding the exclusive use of certified health care interpreters. There are legislative initiatives and proposed bills coming from many states, including Oregon, Indiana and, most recently, Texas, where bill 233 was adopted in regards to the certification and licensing of health care and medical interpreters, but none explicitly address the circumstances in which a certified would be deployed or not.
CSN – Does the use of certified medical interpreters lead to higher quality health care for the limited-English speaking patient population? How so?
Armando – Given the dismal lack of academic offer in the interpreting field in this country, most interpreters ‘come’ into the profession from allied fields and acquire on-the-job training supplemented by continuing education in the discipline. The assumption is that having a valid credential that is the result of a careful screening of competent linguists will help choose the best and help remove the interpreter who is improvised, or a generalist not specialized in the field, from the rosters of eligible interpreters, thus, improving the linguisticaccess of LEP populations, resulting in health care of higher quality.
CSN – Are hospitals and health care systems currently asking about medical interpreter certification? In general, are they for or against it?
Armando – There is a great deal of misinformation and lack of information on the part of purchasers of language services. They have always asked, and keep on asking, for ‘certified’ interpreters when none existed. This is an area where a lot needs to be done in terms of client education. I am afraid that their expectations do not jell with reality; many are very interested in only having qualified interpreters or in having their interpreters qualified. Many interpreters and clients are asking about the certification but there are still misconceptions and some confusion, as can be expected when change is first established.
CSN – What do you foresee happening in the next 6 to 12 months in terms of medical interpreter certification?
Armando – The Board is conducting an international job analysis so I suppose the goal is to make the credential be recognized or adopted internationally. Their lobbying efforts to include certification in the recent national legislation reforming health care did not bear fruit yet but may be adopted as circumstances change. Probably both examinations will coexist and be recognized as alternative products by both interpreters and purchasers of interpreter services. Once the processes pick up speed, it is my hope that related areas will be addressed, such as: training for health care and medical interpreters, education for medical providers on how to work with the newly certified corps of interpreters, creation of examinations for languages other than Spanish, screening interpreters for languages of limited diffusion (LLD) and the thorny issue of policing compliancewith the ethical standards all certified interpreters are expected to uphold.
Armando Ezquerra Hasbun – Bio
Armando Ezquerra Hasbun is the Director of Quality Assurance for Language Services Associates (LSA), a federally-certified court interpreter, a certified trainer for the nationally recognized “Bridging the Gap” medical interpreter training program and an adjunct professor of interpretation at La Salle University. He has been invited by many industry associations to present on the topic of medical interpreting, including the Society for Healthcare Consumer Advocacy (SHCA), the International Medical Interpreters Association (IMIA) and the Texas Association of Healthcare Interpreters and Translators (TAHIT).