Updated On: May 20, 2021

Information about the COVID vaccine can be found in COVID-19 under the Advocacy tab.

As of September 22, 2014, Interpreters will not be able to accept HCA Medicaid appointments until immunization and TB status records have been provided. Interpreters who still have not provided the proper immunization documentation will have any HCA Medicaid appointments scheduled removed from their schedules by ULS.

Which immunizations/tests does HCA-Medicaid require of interpreters?

  • Rubella, rubella, mumps vaccine (or the combination vaccine commonly referred to as MMR) OR proof of immunity (commonly obtained through a blood test)
  • Varicella (chicken pox) vaccine OR proof of immunity (commonly obtained through a blood test)
  • Diphtheria, Pertussis (commonly given in a combination vaccine called TDap)
  • Flu vaccine: provide proof before November 30th of each year, unless the Department of Health declares a flu pandemic, in which case the start of the flu season could be earlier.
  • Tuberculosis (TB) screening: provide proof annually by one of three methods: 1) a skin test (commonly called a PPD); or 2) QuantiFERON; or 3) T-spot blood test.

What if I have a positive TB test/know that my TB test will always be positive?

If any test is positive the interpreter must provide:

1) Documentation of one negative chest x-ray as soon as possible after the initial test. For a chest x-ray to be considered valid, the interpreter must have had one completed within a reasonable time frame – six months or less.


2) Annually submit a symptoms checklist completed and signed by their health care provider.

If the interpreter has had a chest x-ray within the past six months, s/he may:

1) Complete a new test;


2) Submit the following:

  • Chest x-ray;
  • Letter from their provider indicating it has been reviewed and s/he is clear; AND
  • Recently completed symptoms checklist.

When an interpreter with a history of a positive TB test is notified by their doctor that they should not receive a new chest x-ray for medical reasons, interpreter may submit:

  • Results of their last completed chest x-ray;
  • A letter from her/his medical provider stating why the interpreter cannot receive a new chest x-ray and that s/he is clear, AND
  • A recently completed symptoms checklist.


Why is there an immunization requirement?

Hospitals must ensure interpreters working with their patients meet basic immunization/immunity standards in order to maintain their hospital accreditation through The Joint Commission, previously known as the Joint Commission on Accreditation of Health Care Organizations (JCAHCO). The Joint Commission (TJC) is a United States-based nonprofit tax-exempt IRS 501(c) organization that accredits more than 20,000 health care organizations and programs in the United States. A majority of state governments recognize The Joint Commission's accreditation as a condition of licensure and the receipt of Medicaid reimbursement.

In October 2012, when the new procurement system was implemented under a statewide coordinating entity (currently ULS and formerly CTS LanguageLink), the Washington State Hospital Association (WSHA) found out that interpreters were not required to be immunized to work with Medicaid medical enrollees through the HCA-Medicaid program. Many large hospitals therefore refused to use the HCA Interpreter Services program (and their vendor then CTSLanguageLink) until immunizations/proof of immunity is required and tracked.

HCA’s immunization requirements for interpreters were developed in consultation with major healthcare systems in Washington, with input from our union to ensure that standard guidelines would be provided and that the statewide coordinating entity (currently ULS) would have a clear process for implementation. Once the immunization requirements for interpreters were standardized and agreed upon between the major healthcare systems in Washington State and the HCA, the statewide coordinating entity (back then CTS LanguageLink) implemented an immunization tracking system to assure all providers that HCA Medicaid interpreters meet immunization standards. This resulted in more appointments for medical interpreters covered by our union contract!

Remember: any expenditure for the immunizations and tests required to work at HCA Medicaid appointments are business expenses and may be deducted as such when you file your taxes. Please consult your tax accountant for your particular tax case.

Are immunizations required under our union contract?

The immunization policy itself is not covered by our union contract. However, Interpreters United wishes to support our union members through the process of obtaining and submitting proof of immunization status. Part of the value of union membership is having access to information about different kinds of changes that affect union members, and having the support of your fellow members during such changes. For questions, please send email to local1671[at]

What if I object to being vaccinated?

HCA's goal has been to identify a policy that is in the best interest of the public health, supports its Medicaid provider’s responsibility to provide safe environments, and protects its Washington Apple Health (Medicaid) and medically fragile populations. HCA also understands and appreciates a private citizen’s right to make an informed consent to treatment and private business' right to choose to accept work.

For interpreters that cannot get the flu shot due to medical reasons, the interpreter may provide written documentation from their medical provider and an attestation. This is a matter between the statewide coordinating entity and their subcontractor, the interpreter. If the statewide coordinating entity agrees to accommodate its subcontractor in some way, they can propose to HCA alternatives that continue to meet the intent of HCA’s contract requirements. Please visit for additional information.

The HCA requirement only applies to HCA Medicaid appointments.

Who is considered an “employee” for the purposes of TB screening? 

According to CDC guidelines, persons who are part-time, temporary, contract, and full-time should be included in the TB screening program. Certain types of facilities have state laws that may define who is considered an employee and/or who is required to have a TB test. Always refer to the applicable state law or consult the state surveyor assigned to your facility if applicable, otherwise, follow the above mentioned CDC guidelines. For TB regulations and employers' responsibilities, please visit Washington State's Department of Health webpage. 

Why are immunizations recommended for medical interpreters?

According to the Center for Disease Control (CDC), Healthcare workers (HCWs) are at risk for exposure to serious, and sometimes deadly, diseases. If you work directly with patients or handle material that could spread infection, you should get appropriate vaccines to reduce the chance that you will get or spread vaccine-preventable diseases. In addition, the Washington State Department of Health has a very informative website.


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