Interpretive and Translation Services

Policy

Title VI of the 1964 Civil Rights Act prohibits discrimination on the basis of race, color, and national origin for entities that receive federal financial assistance. In accordance with Title VI and to ensure equal access to services and information, Kaiser Permanente and its contracted providers are required to provide interpretive services for patients who have communication barriers. This includes individuals who speak a primary language other than English, and individuals who are deaf, deaf-blind, or hard of hearing.

A certified interpreter is required upon patient request, if referring provider indicates a language need, or when language is causing a communication barrier. You must provide interpretive services for all interactions between the patient. This includes, but is not limited to:

• All appointments with any provider for any covered services
• Emergency services
• All steps necessary to file complaints and appeals.

Payment for interpretive services

Payment for interpretive services is the responsibility of the contracted provider or the entity where care is delivered. There should never be a charge to the person for language services, regardless of enrollment status or coverage.

Contracting with interpretation agencies and interpreters

Contracting with certified in-person, video, or phone interpreters is necessary to ensure patient safety and quality of care. Phone and video can be the primary interpretation modalities for patients who speak a language other than English. Video or in-person interpreters must be used to communicate with patient using American Sign Language (ASL). Patients who are both deaf and blind require an in-person tactile interpreter.

Minimum interpreter requirements

• Interpreter is fluent in both languages in question. The interpretation vendor should conduct tests to assess the interpreter’s fluency.
• Interpreter is properly trained and certified, and has experience interpreting medical terminology.
• Interpreter cannot be a family member, friend, or a child. Family members, friends, and children play a role in providing patient support, but they are not appropriate interpreters. They may introduce bias in the interpretation, may be unfamiliar with complex medical terminology, or may have difficulty interpreting if negative diagnoses need to be shared.

Video interpretation

Video is an alternative to in-person interpretation. Video interpretation provides real-time, visual access to an interpreter through a secure web-based camera. Video can frequently serve as an alternative for members requiring sign language. However, there are some limitations including:

• Patient’s inability to see the video screen due to limited vision or physical positioning.
• Patient’s ability to move his or her head, hands, or arms.

Please consider these limitations and accommodate the patient if they indicate the need for an in-person interpreter.

Telephone Interpretation

Telephonic interpreting is another alternative to in-person interpreting. If a phone interpreter is used during the course of a visit, speakerphone is usually the most efficient method and should be used in a confidential area. Telephonic interpreting is not effective for individuals who use ASL or who have hearing impairments. In these cases, use an in-person interpreter or video interpreter. Patients who are both deaf and blind require an in-person tactile interpreter.

In addition to contracted phone interpretation vendors and interpreters, Washington State’s Office of Deaf and Hard of Hearing offers a Telecommunication Relay Service (WATRS) to communicate with people who are deaf, deaf-blind, hard of hearing, or speech disabled. Information to access WATRS is included on the Washington Relay Services web page.

Documentation of interpreter services

When interpretation is provided, a note must be entered in the patient's chart indicating that communication assistance was provided, and the quality of the assistance provided.

Interpretation vendors

Kaiser Permanente uses several vendors in our owned and operated facilities. If you do not already have your own contracts and agreements with a vendor for interpretive services, you may choose to establish contracts with one of these agencies:

Vendor	Language	Modality	Service Area	Phone Number
A2Z Interpreting	ASL	In-person	Eastern Washington	509-596-6922
AMN Healthcare	ASL & Foreign	Video	Statewide	855-865-8778
ASAP Translations	Foreign	In-person	Eastern Washington	509-747-5121
Deaf-Blind Service Center	Tactile	In-person	Seattle & Greater Puget Sound	206-323-9178
Dynamic Language	ASL & Foreign	In-person	Seattle & Greater Puget Sound	206-244-6709
Hearing, Speech, and Deaf Center	ASL	In-person	Seattle & Greater Puget Sound	206-323-5770
Language Line	Foreign	Phone	Statewide	800-752-6096
Spokane International Translation/PGLS	Foreign	In-person & phone	Eastern Washington	509-327-8064
TERP Sign Language Services	ASL	In-person	Seattle & Greater Puget Sound	425-687-0413
United Language Group	Foreign	Phone	Statewide	855-786-4833

Translation

Translation is distinct from interpretation. Translation is when written documents are translated into another language, whereas interpretation is physically communicated via an in-person, video, or phone interpreter. Legally, Kaiser Permanente and its contracted providers must provide all general and patient-specific written materials in a format that will be understood by each individual patient. You may meet this requirement by:

• Contracting with a translation vendor to translate the material into the member's preferred reading language or alternative format (e.g. braille, large print, audio, or accessible PDF).
• If an interpreter is already available, have the interpreter provide sight interpretation where they read the material to the member in the member's primary language.

Translation vendors

Kaiser Permanente contracts with several translation vendors. If you do not already have your own contracts and agreements with a vendor for translation services, you may choose to establish contracts with one of these agencies:

Vendor		Phone number
Access Ingenuity	Alternative format – large print, braille, audio, accessible PDF	707-579-4380
Akorbi	Electronic or written materials – foreign language	214-256-9222
Avant Page	Electronic or written materials – foreign language	530-750-2040
Lionbridge	Electronic or written materials - foreign language	877-277-3173