Language Testing Requirements for Health Care
A number of organizations are involved with setting requirements for language testing in health care. These range from the U.S. Government to health care accrediting organizations. A brief summary of the requirements is included below:
U.S. Government Requirements
Three separate areas of the U.S. Government have influence over health care language testing:
- Department of Health and Human Services, Office of Minority Health (www.omhrc.gov) - The Office of Minority Health has defined standards for providing Culturally and Linguistically Appropriate Services (CLAS) to patients. These Standards address language issues and are requirements for all organizations that receive Federal funds. These Standards identify the requirement to provide services in the language of the patient with the order of preference:
a. A bilingual employee. b. Face-to-face interpretation by trained staff, contract or volunteer interpreters. c. Telephone interpreter systems.
CLAS Standard 6 specifically identifies the need to verify the language skills of interpreters in both the target language and English and "... this should be verified by formal testing." - Equal Employment Opportunity Commission (EEOC, www.eeoc.gov) - The EEOC identifies requirements in employee selection. Section 1607 particularly addresses the use of testing in employee selection and identifies the need for the testing to be valid and describes the requirements for validity. These requirements apply to language testing as a part of employee selection.
- Department of Justice, Limited English Proficiency (LEP, www.lep.gov) - The LEP Working Group identifies the requirements for providing services to limited English proficient people by Federal agencies and by recipients of Federal funds. The Department of Health and Human Services further specifies requirements that interpreters must: "Demonstrate proficiency in and ability to communicate information accurately in both English and in the other language and identify and employ the appropriate mode of interpreting (e.g., consecutive, simultaneous, summarization, or sight translation); To the extent necessary for communication between the recipient or its staff and the LEP person, have knowledge in both languages of any specialized terms or concepts peculiar to the recipient's program or activity and of any particularized vocabulary and phraseology used by the LEP person."
"...Understand and follow confidentiality and impartiality rules to the same extent as the recipient employee for whom they are interpreting and/or to the extent their position requires; Understand and adhere to their role as interpreters without deviating into other roles--such as counselor or legal advisor--where such deviation would be inappropriate (particularly in administrative hearings contexts..."
State Government Requirements
State governments generally have few requirements for health care testing. The most active in this area are Washington, Massachusetts and California:
- State of Washington, Language Testing and Certification - Washington requires language proficiency certification and qualification for DSHS bilingual employees, applicants for bilingual positions, contracted interpreters, contracted translators, and licensed agency personnel.
- State of Massachusetts - Massachusetts has an emergency room interpreter law, and has defined best-practices for hospital interpreting.
- State of California - Specific recommendations have been made by the California Healthcare Interpreters Association (CHIA).
Accrediting Organization Requirements
The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, www.jointcommission.org) - The JCAHO identifies standards and provides information about the JCAHO standards relative to the CLAS standards and specifies standards.
Other Organization Requirements
A number of organizations identify recommended language requirements for health care including:
- Interpreter Organizations - National Council on Interpreting in Health Care (www.ncihc.org), California Healthcare Interpreters Association (www.chia.ws), Massachusetts Medical Interpreter Society (www.mmia.org)
- Other Organizations - Diversity Rx (www.diversityrx.org)
