Regulatory Training

1. Regulatory Training Interpreter Services

2. Learning Objectives Upon completion of this training, you will be able to: • Recognize the legal and ethical obligations of providing qualified medical interpreters to patients • Document the provision or refusal of interpreter services • Request an interpreter either face-to-face or over-the-phone • Identify your options when contacting patients outside of the hospital

3. Interpreter Services The interpreter services office is available to provide language services twenty-four hours a day, seven days a week. Interpreter Services Office • 774-441-6793 (Main #) • 774-441-8627 (Fax #) Additional Information is available on OurNet: Resources --> Interpreter Services

4. Our Patient Population UMass Memorial serves a diverse patient population that includes patients who have Limited English Proficiency (LEP) or are Deaf or Hard of Hearing (D/HH). It is UMass Memorial's Policy (#1005 & #2116) to provide an effective means of communication to all of our LEP and D/HH patients in their preferred language. At UMass Memorial, qualified medical interpreters are available for providers and patients twenty-four hours a day, seven days a week, through our onsite Interpreter Services Office (ISO). The ISO can also provide resources and referrals for other necessary auxiliary aids and services (e.g., CART, assistive listening technology, etc.) for D/HH patients who do not use American Sign Language (ASL). UMass Memorial is required by both Federal and State laws to provide interpreter services and auxiliary aids to all people requesting care in another language.

5. Hospital Responsibility Legal ObligationsTitle VI of the 1964 Civil Right’s Act, Title II and Title III of the Americans with Disabilities Act, and Emergency Room Interpreters Law (Chapter 66 of the Acts of 2000), all outline UMass Memorial's legal obligation to provide interpreter services and accommodations in a non-discriminatory environment to our LEP and D/HH patients. Ethical ObligationsWithout a qualified medical interpreter present, research shows health care quality decreases for patients needing care in another language. LEP patients are more likely to be in poor health, miss appointments, have drug complications, and not have a regular health care provider.

6. Hospital Responsibility UMass Memorial Hospital Policy (#1005 & #2116)It is UMass Memorial's policy to provide medical interpreters to our LEP and D/HH patients and family. While all patients have the right to have an interpreter or auxiliary aid, a patient may waive his or her right and, instead, prefer to use a family member, friend, or other means of communication. This practice is not recommended and his or her refusal must be documented. Assessing a Patient's Communication NeedsEach LEP and D/HH patient will have different communication needs and one size truly does not fit all. UMass Memorial staff and providers should ask the patient his or her preferred language in which to receive health care services, document this preference, and request the appropriate services from the ISO.

7. About Qualified Medical Interpreters A medical interpreter is not simply someone who is bilingual: he or she is a professional who is trained and proficient in the ethics and skills of interpreting and is knowledgeable about specialized medical terminology and concepts. She is responsible for conveying the messages and meanings of both parties without additions, omissions, or personal opinion, and must identify cultural differences, bridge gaps, and overcome barriers that will impede the patient and provider from effectively communicating. Interpreters should not be expected to assume the role and responsibilities of social workers, case managers, advocates or health care providers.

8. Interpreter Options: Face-to-Face Some medical situations may benefit from the use of a face-to-face interpreter. When to use a Face-to-Face interpreter: • Serious diagnoses or potentially upsetting news • Patient's first appointment • Family meetings or group discussions • Interactions requiring visual elements • Complicated or personal medical procedures

9. Other Methods of Communication Use of Non-Qualified and Untrained InterpretersFamily members or friends of patients should not serve as interpreters unless the patient expressly requests such an arrangement. In the case of uncommon languages, however, a qualified medical interpreter may not be available in person or via telephonic interpretation. Therefore, you may be required to utilize a patient’s family member or friend to interpret. Bilingual Employees are not InterpretersBilingual employees should not be used as ad-hoc interpreters or for the translation of medical documents. Translation of Medical DocumentsA fax request form for the translation of medical documents is available on OurNet (Resources --> Interpreter Services).

10. Other Methods of Communication Other Auxiliary Aids or ServicesSome D/HH patients do not use ASL and, instead, communicate with spoken or written English. These patients may rely partially or entirely on lip reading, or additional assistive technology, to understand the provider. While a medical interpreter is not needed for non-ASL users, additional services, including CART and personal amplification, are available.

11. More about our D/HH Population The majority of our D/HH patients use ASL to communicate and may identify themselves as culturally Deaf. Some key points to this perspective are: • ASL is a linguistically accepted, fully developed, natural language of the Deaf community in the United States with syntax and grammar that differ from English. • Deafness is not necessarily viewed as a disability and patients may be offended by the use of “hearing impaired”, "hearing loss", or a purely pathological/auditory view of deafness. As members of a cultural and linguistic minority, there is sometimes mistrust of the majority (hearing people) from both real and perceived experiences of oppression.

12. Accessing Interpreter Services Qualified medical interpreters are available 24/7 for emergency visits, inpatient use, and outpatient appointments at the Memorial, University, Hahnemann campuses as well as many off-site locations. Interpreter Services Office 24/7 774-441-6793