Print Icon Apr 02, 2017

Between 2003 and 2012, DSHS and HCA-Medicaid were paying interpreters through a brokerage system with two layers of intermediaries. The brokerage system was unmanageable, expensive and of low interpreting quality.

The current procurement model for DSHS and HCA-Medicaid was implemented on September 24, 2012. All requests for interpreting services are scheduled, invoiced and paid through a web portal. This scheduling includes both spoken and sign language interpreters delivering their services on-site and remotely by phone or video. This program operates with one statewide coordinating entity, currently CTS LanguageLink headquartered in Vancouver, WA. You can read the contract here.

For HCA-Medicaid, the coordinating entity reviews HCA contracted healthcare providers' requests to ensure that the patient is Medicaid eligible and the interpreting is for a service that HCA will pay. HCA then seeks reimbursement from the federal government. There is no need to verify eligibility for DSHS requests.

The brilliance of the coordinating entity procurement model is that it divorces interpreters’ pay from the intermediary’s pay. The state has negotiated a flat fee not to exceed 15% of the entire program’s budget paid in monthly installments to the language company for the leasing of the web portal regardless of the volume of requests. Payment to interpreters simply passes through the language services company. Interpreters’ rates of pay are now collectively bargained between the Governor and the Washington Federation of State Employees  / AFSCME Council 28 AFL-CIO. Sign language interpreters are not included in the bargaining unit. Accordingly, there is no union contract covering sign language requests. Sign language interpreters' rates, however, are double than those for spoken languages and were established by a contract amendment in December 2012. Despite this, their filled rates hover around 40% because the lack of 100% reimbursement for patient/provider no shows and late cancelations makes the HCA-CTS contract a risky proposition for sole proprietors.

The statewide consolidation and centralization of requests, invoicing, and payment processing has made it easier for the state, the interpreters, and the public at large to constantly audit the contract’s performance. Summary reports are publicly posted  by the state and the data is subject to public disclosure.
ASL rates HCA-CTS K618-Amendment #2 2012-12-17.pdf
SFY 2015 Signed Language Filled Rates & Pay.pdf
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