The Department of Health and Human Services regulation, 45 CFR 80.3(b)(2), requires all recipients of federal financial assistance from HHS to provide meaningful access to LEP persons. (3) Federal financial assistance includes grants, training, use of equipment, donations of surplus property, and other assistance.

For more details, see the guidance issued by the Office of Civil Rights

Q: What are the benefits of using an interpreter?
A: There are various benefits to using an interpreter, the most important being, equal access for limited English speakers. The Center for Cross Cultural Health has outlined four key benefits to using an interpreter*:

• Better health outcomes: “It’s common sense that clear communication can ensure more accurate diagnosis and follow-through with medications and treatment regimens. An interpreter can help a physician avoid costly, unnecessary diagnostic tests, which are inconvenient at best, and at worst expose a patient to the risks of false-positive results” (59).
• Ethical patient care: “Direct communication with a patient through a trained interpreter, not a family member, reduces the likelihood of misunderstanding and helps ensure informed consent. Informed consent and respect for the expressed wishes of the individual are the hallmarks of patient autonomy-a basic ethical principle in Western health practice. [Examples:] In on widely cited incident, a seven-year old girl was asked to tell her mother that an ultrasound examination had revealed: that the woman’s fetus was dead in utero. A teenager incorrectly interpreted a Minneapolis physician’s directive for x-rays, and told his mother that she was going to be microwaved” (59).
  
• Money and time saved: “Providers lose time trying to communicate with a patient through untrained intermediaries. Encounters can take longer, and expensive tests may be required. Systems lose money if frustrated patients take their business elsewhere, or if they cannot understand what they are told about the billing process. Patients whose medical problems go undetected and untreated as a result of miscommunication often show up later in the Emergency Room with much more serious complaints” (59).
  
• Legal action prevented: “Misdiagnosis and miscommunication regarding treatment can, of course, lead to costly lawsuits. Courts in various states have ruled in favor of plaintiffs who were unable to understand what a health care provider was trying to communicate to them, and have ruled that it is the provider’s professional responsibility to overcome any language barrier” (59).

• Knowledge of specialized vocabulary and concepts in areas such as medicine and law.
• A broad knowledge of both the languages and cultures in which they work
• The ability to grasp readily and completely what others say in either language
• A good memory for what is said
• The ability to find equivalent means of expression in each language even when there are no equivalent words
• Practice and adherence to a core set of competencies and a strict code of ethics.

(reference: Center for Cross Cultural Health, The Providers Guide to Cross Cultural Health, pg, 59-60)

1. Pre-session: A professional interpreter will start the appointment with a pre-session. This will consist of a short introduction; the interpreter will explain his/her role and will state their professional obligation to transmit everything that is said in the encounter to the other party and to maintain confidentiality. The interpreter will conduct the pre-session with both the client in their native language and the provider in English.
2. Speed of conversation: The interpreter may inform you during the pre-session that if he/she makes a hand signal to please stop so that the message can be transmitted. By using a hand signal, the interpreter has control over how much information can be transmitted at once to ensure accuracy.
3. Positioning: You can expect the interpreter to position his or herself in a place that is least disruptive and one that facilitates direct communication between the client and the professional. You will find that the interpreter will try and sit just beside and behind either the client or the professional. This way the interpreter is not the center of attention and the client and provider are able to make eye contact and have a direct conversation as if there were no language barrier. If the appointment is of a physical nature and requires privacy, the interpreter should ask the client their preference of where he/she should be positioned.
4. Use of 1st Person: The interpreter will mostly use the 1st person when transmitting what is said. They will use “I…” in reference to the speaker, rather than “he said that…” or “she said that…” The interpreter may use the tactic of looking down at the floor while interpreting, which is another tool used to facilitate direct communication. By looking down, the interpreter is able to deter both the client and the provider from looking at him/her and instead look directly at each other.