What's happening with telephonic and video remote interpreting at medical Medicaid and DSHS appointments in Washington State?
Our 2011-2013 interpreter bargaining team negotiated the first-ever union rate of pay for spoken language interpreters providing services via telephonic and video remote modalities. Check out the "know your rights" section of this website for more info on our union contract.
Learn more below about the history of our campaign to win standards for remote interpreting services that protect clients, ensure quality, and provide union-scale pay for interpreters.
Are you signed up with the State's vendor for DSHS and Medicaid appointments and want to start working from your home to provide remote interpreter services?
Sign up today with the State's vendor for DSHS and Medicaid appointments - CTS LanguageLink by sending the following information to email@example.com: interpreter ID, first name, last name, phone number. Read their VRI requirements and their video remote installation guide. Contact them directly with further questions about how to get set up to accept jobs by video and telephone.
You can also learn more by reading the IMIA's guide to telephonic interpreting for medical interpreters.
Health Care Authority (HCA) manages an Interpreter Services Program for DSHS and Meidcaid enrollee medical appointments. While the State has used telephonic interpreters for social services appointments for years, all medical appointments for Medicaid enrollees used in-person interpreters only. In January 2010 the State suddenly proposed moving to 80% telephonic and video remote interpreting as a cost-savings measure. At the time, the State was spending over 42% in administrative costs.
We successfully advocated in the Legislature to mandate reductions in administrative costs before riskly moving almost entirely to telephonic or video remote.
The Legislature required the Health Care Authority (HCA) to "identify the circumstances under which it is appropriate to use telephonic or video remote interpreting". Hundreds of concerned medical providers, interpreters, and citizens emailed the State with recommendations for these guidelines. But in December 2011, HCA released preliminary "Interpreting Screening Guidelines" that appeared to ignore months of input from stakeholders and subject area experts - even federal CLAS guidelines.
The preliminary guidelines stated that "telephonic interpretation is the default modality to be utilized for interpreter services medical appointments, followed by video remote and in-person" and the requirement that healthcare providers submit a signed written statement to choose a non-telephonic mode of interpreter services delivery. The proposed screening guidelines would have gone into effect June 2012 after HCA finished a bidding process to select a new scheduling entity for delivering interpreter services.
Highlights from HCA's December 2011 proposal:
Allow the interpreter scheduler to decide based on cost whether phone, video or in-person is most appropriate - unless a health care provider submits a written request otherwise.
The state is NOT planning to require that medical providers meet minimum international equipment standards for telephonic and video remote interpreting.
The state is NOT planning to limit the types of appointments that will move to phone or video. Despite ALL major hospitals using such exceptions to protect patients and their own liability!
HCA's proposal to move primarily to telephonic interpreting went against the recommendation of doctors, hospitals, patient advocates, and interpreters that HCA continue using in-person interpreters, with telephonic and video interpreting available as a supplemental system. We had serious concerns that Medicaid healthcare providers would instead drop out of the Medicaid provider network, further jeopardizing access to health care for all Washington residents.
Other organizations joined Interpreters United in expressing concerns to HCA. Read supporting letters from organizations to HCA:
After a series of meetings, and hundreds of telephone calls and emails from union members and concerned citizens, HCA decided to leave it up to requestors to choose - at the time of the initial request - which modality to request.
While this was welcome news to interpreters, medical providers, and patient advocates, our Union is still concerned that HCA is not going to have basic equipment guidelines before authorizing medical staff to request telephonic or video interpreters.
Many questions remain about the State's current plan for remote interpreting services. There are serious consequences to the use of improper equipment to provide remote interpreter services, but remote technologies also offer an opportunity to increase acecss to healthcare for people in rural areas or who speak languages of lesser diffusion.
Why does HCA assume telephonic interpreting will be cheaper than other modes in all scenarios when academic research suggests in-person interpreters are more cost-effective in some scenarios?
How will the 12-15,000 Medicaid healthcare providers in Washington state afford new equipment and training?
How will providers in rural areas learn about the option to receive interpreter services via remote technologies?
Our Union continues to work with the State, their vendor CTS LanguageLink, and professional associations on educating medical providers on the equipment and training needed for various modalities.