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Update On Texas
Advisory Committee On
Qualifications For Health
Care Translators And
September 2012
Mary Esther Diaz
Advisory Committee Chair
HB 233 Timeline
HB 233 (2009) Rep. Eddie Rodriguez
Creation of an advisory
committee to establish
qualifications for certain
health care translators and
Status: Passed. Effective 9/1/09
HB 233 (continued)
The Executive Commissioner of the Health and
Human Services Commission shall establish the
Advisory Committee on Qualifications for
Health Care Translators and Interpreters.
HB 233 (continued)
Committee responsibilities
Establish and recommend qualifications for
healthcare interpreters and translators, that
 Ability
to fluently interpret another
language into and out of English
 Practical experience as a translator or
Committee Responsibilities
The committee shall advise the commission on the
following for health care interpreters and
 Language proficiency required for certification
 Training requirements
 Standards of practice
 Requirements, content, and administration of
certification examinations
 Procedure for testing, qualifying, and certifying
 Reciprocity agreements with other states
Advisory Committee Members
Health care interpreter working with people who
have limited English proficiency
 Esther
Health care interpreter working with people who
are deaf or hard of hearing
 Zee
Health care practitioner
 Irma
Advisory Committee (continued)
Representatives of:
Professional translators and interpreters association
Leonard Sepeda, Dell Children’s Medical Center
Mental health services provider
Nancy Miller, Shoal Creek Hospital
Jacqueline Burandt, University Health System
Insurance industry
Gel Detrick, Scott & White Health Plan
Advisory Committee (continued)
Business entity that provides translators and
interpreters to health care providers
Organization that provides services to immigrants and
Gabriel Martin, Lamar University
Health care consumers with limited English proficiency
Fabio Torres, Catholic Charities of Fort Worth
Institution of higher education
Ryan Foley, MasterWord Services
Miguel Fuentes, Scott & White Memorial Hospital
Health care consumers who are deaf or hard of hearing
Detra Stewart, Community Axess Ability Group
Non-Voting Committee Members
Health and Human Services Commission
Department of Aging and Disability Services
Randi Turner
Department of Family and Protective Services
Jonathan Cole
Department of Assistive and Rehabilitative Services
Laura Jourdan
Michael Roberts
Department of State Health Services
Patricia Hosey
Coordinator, Health and Human Services Commission
Paula Traffas
Summary Recommendations to HHSC
Stop requiring patients to bring their own interpreter.
Use qualified interpreters instead of friends and family
members as interpreters. (Except for emergency situations
when no qualified interpreter is available in person, by phone, or
Require anyone who interprets on a regular basis in a
healthcare setting to receive training on the code of
ethics and standards of practice for healthcare
Establish a statewide registry of healthcare interpreters
through a governmental or nonprofit organization.
Obtaining Stakeholder Feedback
Recommendations distributed to stakeholders, in
advance, with copies of:
 Language Access and the Law – The Joint Commission
 Office Guide to Communicating with LEP Patients –
American Medical Association
 Approved: New and Revised Hospital Elements of
Performance to Improve Patient-Provider
Communication – The Joint Commission
American Medical Association
Refugee Services of Texas
Society of Health Care Risk Managers
Teaching Hospitals of Texas
Texas Association of Health Plans
Texas Association of the Deaf
Texas Council of Community MHMR Centers
Texas Hospital Association
Texas Latino Council of the Deaf and Hard of Hearing
Texas Medical Association
Texas Society of Interpreters for the Deaf
Stakeholder Feedback
Most stakeholders expressed concern about funding for
interpreter services.
All stakeholders supported recommendation #1
Several stakeholders supported #2, but opposed strict
prohibition of friend/family interpreters
Several stakeholders supported #3, but expressed
concern about paying for and tracking training of
Most stakeholders supported concept of a registry of
health care interpreters per recommendation #4
Some TSID members support “specialty” but not
additional certification
Revised Recommendations
Two sets of recommendations submitted: one for
foreign language interpreters, the other for sign
language interpreters.
Recommendations for sign language interpreters
take into account existing certification programs.
Recommendations for foreign language interpreters
do not, given the recency with which these have
become available.
Recommendation #2
Recommend an amendment to the applicable
statutes, including the Texas Health and Safety
Code, to limit the use of uncertified [and] or
unqualified individuals including but not limited to
friends, family members, associates, and others to
assist with communication to medical emergency
situations—both physical and mental health
emergencies— in which an interpreter not
associated with the patient is not available by any
other means, including but not limited to in-house,
contracted, and remote interpreters.
Recommendation #2 (continued)
In routine situations a provider will use a certified
[and] or qualified interpreter not associated with
the patient at no cost to the patient. The health care
facility staff will inform the patient—in the patient’s
preferred language—that a qualified interpreter
will be provided at no cost to the patient. However,
the patient may bring another person to assist with
Recommendations (August 2010)
Recommend that a
registry of healthcare
interpreters be
established through a
nonprofit organization
in which interpreters
who have successfully
completed an HHS
agency approved
training may register.
Recommend that a
registry of healthcare
interpreters be
established through a
nonprofit or government
organization in which
interpreters who have
successfully completed an
HHS agency approved
training may register.
 Date
January 2011
January 2011
Rep. Eddie Rodriguez introduced HB 1719 relating to proposed
Review of healthcare interpreter qualifications.
Discussion of two national certification programs.
February 2011 Discussion about translation.
Discussion of interpreter screening criteria used in healthcare institutions.
Committee members’ reports on language services definitions.
March 2011
Report on members presentations to or communication with stakeholders
on the committee’s recommendations.
April 2011
Report data on hospital customer satisfaction surveys
Discussion of Bureau of Labor Statistics information on Interpreter job
May 2011
HB 1719 died in committee.
May 2011
Continue discussion of language services definitions.
Discussion of resources to post on Advisory Committee web site.
June 2011
Review of definitions for Advisory Committee web site.
August 2011
Stakeholder feedback on proposed qualifications and training.
September 2011 Discussion of stakeholder input and TAHIT survey
October 2011
Ideas for resource website
Established new subcommittees for Translation, Certification Mental Health
December 2011 Discussion of national certification programs: CCHI, NBCMI
Ideas for resource website
January 2012
Decision to recognize certification by CCHI and NBCMI
Discussion of mental health qualifications
March 2012
Discussion of resource website
Discussion of translation quality
May 2012
Discussion of interpreter training
Discussion of translation quality
July 2012
Discussion of possible recommendations for HHSC
Ideas for resource website
September 2012 Discussion of translation outsourcing
Finalize recommendations for HHSC
Next Steps
For Interpreters
 Recommend training
for Foreign Language
and Sign Language
For Translators
Recommend training
Qualifications Under Consideration
Foreign Language Interpreters
Certification by CCHI or
Age 18
High School Education
Fluency in English and a
Language Other Than
Experience as a
Translator or Interpreter
in a healthcare setting
Sign Language Interpreters
BEI or RID Certification
at level _____
Experience as an
Interpreter in a
healthcare setting
Training Under Consideration
General Medical Knowledge
 Anatomical terms for
major body systems
 Medical Tests and
 Common Specialties and
Medications (including
physical and mental
 Acronyms
 Medical Equipment
 Infection Control
 Onsite Mentoring
Training Under Consideration
Mental/Behavioral Health
 Common
disorders of adults, children/adolescents
 Common Medications
 Psychiatric Tests & Diagnostics
 Treatment Plans
 Acronyms & Abbreviations
 Legal Status (Voluntary, POEC, OPC)
Training Under Consideration
Interpreting Skills
 At least consecutive
Interpreting (for foreign
 At least simultaneous
interpreting (for ASL)
 Sight Translation
 Protocols (managing the
session, multiple
participants, family
Code of Ethics for
Healthcare Interpreters
Standards of Practice for
Healthcare Interpreters
Roles of the Healthcare
Interpreter (i.e., cultural
mediator, advocate, etc.)
Cultural Awareness
Legislation and Regulations
(ADA, Section 504 of
Rehabilitation Act, Title VI
of Civil Rights Act, HIPAA,
Recommend that national interpreter certification
for foreign languages be recognized in Texas
 Certification
Commission for Healthcare Interpreters
 National
Board of Certification for Medical
Shall Texas develop certification for sign language
interpreters in healthcare?
Participate in the discussion
For a schedule of future Advisory Committee meetings
and minutes of past meetings, see:
Meetings are free, and open to the public.
Contact: Paula Traffas, Civil Rights Office, HHSC
[email protected]
Also see Resources for Interpreters and Translators in