"Interpreting for Social Services: A New Federally-Mandated Field."     American Translators Association Chronicle, 33,5 (May,2004): 26-30, 51. [with Erik Camayd-Freixas]

Abstract

By John B. Jensen and Erik Camayd-Freixas

The history of any profession is marked with crucial events that help define its development, and interpreting is no exception. For instance, simultaneous interpretation can be said to have been born at the Nuremberg Trials after World War II, and baptized shortly thereafter with the charter of the United Nations. Court interpreting had its defining moment in the U.S. with the enactment of the Court Interpreters Act of 1978, which lead to federal certification, the establishment of college-level academic programs in interpretation, and emulation of the federal program at the state level. A more recent event, and one which went almost unnoticed by the interpreting profession, was the affirmation of the Guidance Memorandum from the United States Department of Health and Human Services. As the following will attest, besides giving strong legal impetus to medical interpreting, the affirmation of the DHHS Guidance Memorandum is also significant in that it has opened up a new area within the interpreting profession: social service interpreting (SSI).

The DHHS Guidance Memorandum, first promulgated in 1998 and legally approved in its final form in late 2002^{1, seeks to address the "national origin" clause of the 1964 Civil Rights Act, Title VI, Prohibition Against National Origin
Discrimination¾Persons with Limited-English Proficiency, which prohibits discrimination against members of minorities based on their provenance. While it is possible that the framers of the original Act did not foresee a linguistic corollary to their law, it has become clear over the years, particularly with the enormous multinational influx of non-English speakers, that guaranteeing the right of equal access to the country’s basic institutions regardless of one’s national origin implies non-discrimination against persons of "Limited English Proficiency" (LEPs), who do not speak or understand English sufficiently well to access or receive services. The primary provision of the Memorandum requires that any agency, public or private, which delivers health or human services, and which directly or indirectly receives federal funds from the DHHS, must provide interpreting services for LEP clients. This includes many government agencies, schools, hospitals, and other entities.}

The DHHS Memorandum suggests several ways in which services may be made available to LEPs:

In addition, agencies are required to conduct an assessment of their needs, develop a comprehensive written policy on language access, train staff in DHHS policy, and carry on vigilant monitoring of the program.

Some medical service providers may be well along in this process, even without the Memorandum. Many hospitals make use of one or all of the five delivery modes, and may even have a formal written and well-disseminated language policy. Many freelance interpreters are also contracted by healthcare providers on an individual assignment basis. Telephonic interpreters often handle health encounters as well. Moreover, there is institutional support in the form of state and national organizations of medical interpreters,2 and some training materials are available (for example, Mikkelson, Roat, and the MMIA Standards of Practice). What the law requires, however, is that services be made available anywhere that LEPs seek assistance, including away from major urban centers accustomed to large numbers of non-English-speaking clients. The law also requires service providers to be competent and well organized. Furthermore, the Memorandum essentially proscribes the frequent practice of requiring patients or clients to bring their own interpreters along (usually family members, often children), or seeking ad hoc interpreters from among unqualified bilinguals in the waiting room or on the support staff.

In the social services arena, however, interpretation on any formal basis has been virtually nonexistent. Either services are provided by staff members who happen to be bilingual but are untrained as interpreters, or else ad hoc interpreters are pressed into sometimes unwilling service. Frequently, no interpreting is provided at all, seriously jeopardizing access and the effectiveness of services. For example, in our case, there were no courses or training materials available in the social services sector until we began developing them in 2001 for the Florida Interpreter Services Program. There are still no professional associations of social service interpreters on the horizon, and we have been unable to find any websites dealing with the topic. The closest we have been able to come in our search for resources are sites related to the recent movement for community interpreting, which may incorporate SSI, but also includes medical, legal, and even sign language interpreting.

What are the types of social services that are considered appropriate for interpreting purposes? These services span the entire range of community outreach activities performed by government and volunteer agencies, such as those conducted by the Departments of Children and Families, welfare agencies, economic self-sufficiency offices, and private or faith-based entities such as Meals on Wheels, the YWCA, Catholic Charities, Lutheran Social Services, etc. These services include such diverse activities as adoption, battered spouse care, victim’s advocacy, rehabilitation, substance abuse treatment and therapy, child or elderly abuse prevention and care, food stamps, employment services, refugee and immigrant services, housing authorities, etc. However, they do not include issuance of drivers’ licenses, tax collection, or similar economic or regulatory activities.

Before professional interpreters accustomed to legal and medical work get too excited about the new horizons of social service interpreting, they should realize that freelancers or staff interpreters may get to do relatively little SSI. There are at least two reasons that suggest that SSI will never rival the medical/legal fields as a substantial source of income for interpreters: 1) the very different financial structure of SSI compared to medical or legal interpreting (there is significantly less money in the system); and 2) there is less legal inducement (i.e., threat of litigation) to hire interpreters.

Both legal and medical professionals (e.g., attorneys and physicians) are very highly paid, and the systems in which they work run on large amounts of money provided by the government, insurance companies, major corporations, and by well-off individuals whose life is on the line. Thus, paying a reasonable fee to an interpreter to enable and optimize the work of an expensive doctor or lawyer may not be much of a stretch. Social workers, on the other hand, are among society’s lesser-paid public servants, and hiring an interpreter at a much higher pay rate than that paid to a social worker may be possible only in rare instances.

An interpreting mistake in a legal case can lead to a mistrial, endless appeals, or an actual travesty of justice. In medicine, such a mistake can lead to redundant testing, misdiagnosis, or physical harm and consequent malpractice litigation. Thus, those fields offer strong motivation in the form of potential or real legal costs to make good use of quality interpretation. In social services, with a non-empowered clientele, the primary legal impetus toward good interpretation may be only the threat of a compliance order from the Department of Health and Human Services, a citation from the Office of Civil Rights, or perhaps a class-action suit to enforce compliance brought by a public interest law firm. While these are genuine motivators that will surely bring about eventual change to the profession, they are not the sorts of threats that make risk managers seek out an immediate solution at almost any reasonable cost.

The main inducement to provide SSI for LEPs remains twofold: the social worker’s altruistic desire to better serve the LEP clientele; and the agency’s practical need to communicate with the LEP client in order to be able to process his case. When an agency is unable to communicate effectively with an LEP client, various costly outcomes are to be expected: the client may be turned away without services, which is, of course, against the law; appointments may have to be rescheduled pending availability of an interpreter; or ineffective and time-consuming attempts at communicating may be made through an ad hoc interpreter or with no interpreter at all. Given their often tight budgets, social services agencies have commonly resorted to informal, makeshift half-efforts for bridging the language gap without realizing the hidden costs involved. This is precisely the situation the DHHS Memorandum seeks to remedy by mandating the formalization of language service delivery along acceptable guidelines. Recently, the Memorandum has been followed by the availability of federal funds to help the agencies implement its guidelines and come into basic compliance.

So, if freelance interpreters need not expect many calls from their local Department of Children and Families, who will bring about compliance with the DHHS Guidance Memorandum? We recall the five options listed in the law: bilingual service providers, in-house interpreters, contract interpreters, volunteers, and telephonic interpreting services. There will always be work for telephonic interpreters and volunteers, and an occasional freelancer, in the less-frequently encountered languages and in areas where few residents and even fewer agency employees represent linguistic minorities. However, from what we have observed in the extremely diverse state of Florida, even in rural areas, the bulk of the interpreting within social service agencies is being provided, and will continue to be provided, by bilingual in-house employees. Most of these employees are, first of all, caseworkers, managers, executives, clerical workers or receptionists, and then interpreters. Very few actually work as full-time in-house interpreters, and these are found mostly in large hospitals, volunteer agencies, and school systems.

And here we have the enormous challenge both to social service agencies and to the interpreting profession. How to bring about interpreting services by "competent and trained" interpreters within agencies when most of these potential interpreters are at the same time caseworkers, managers, executives, and receptionists? In our experience, the answer lies in a tailor-made, concentrated training and screening program offered by qualified interpreter trainers and suited to the schedule and needs of the busy agencies and those non-traditional students, their employees.

Professional interpreters may be skeptical about the benefits of such a "crash course." Can you really turn agency employees working in other capacities into professional interpreters after a few days of training? Well, you certainly cannot. Yet, it is not professional interpreters that we are trying to create. We have already said that there is little money and opportunity for working professional interpreters in social services. Rather, our aim is more modest: lifting social service providers out of the ranks of the makeshift and reluctant ad hoc interpreter and into that of the basically "competent and trained" to carry out the regular daily business of the agency. Keep in mind that these trainees are not starting from scratch. They are already fully bilingual and, in most cases, very knowledgeable of agency business and experienced in their line of work. Above all, these folks are already interpreting at work, day in and day out, and they are doing so without any training or screening, and with the unsettling feeling of not knowing what they are doing right or wrong or how to handle many situations. Under these circumstances, a properly focused training and screening program has a huge impact on the quality of services and is greatly appreciated by the agencies, their employees, and their clients. The following outlines our work in this regard, under a pioneering program that is helping the State of Florida comply with the new federal LEP guidelines from the Office of Civil Rights.

The State of Florida Interpreter Services Program

One approach to training social service personnel and determining their competency is the Interpreter Services Program (ISP), run by the State of Florida since September 2001 and funded by a federal grant from the Office of Refugee Resettlement. It is currently administered by Command Technologies, Inc. for the Florida Department of Children and Families, and consists of four major components: strategic planning, translation of agency documents, telephonic interpretation (subcontracted to Pacific Interpreters, Inc. of Oregon), and interpreter training (subcontracted to language-service company Verb-A-Team, Inc., of which co-author Erik Camayd is the CEO). The following is a basic description of the training component of the program.

Erik is primarily responsible for developing the instructional program, while we work together on preparing the actual curriculum and materials. In addition to ourselves, we have a team of other instructors working with us. We have already trained more than 800 students in over 40 basic courses delivered onsite at 14 major cities throughout Florida. Around 70% have passed the written examination and received a certificate of completion. Not only does the training program seek to prepare employees of public agencies, such as the Department of Children and Families, the Department of Health, boards of education, and law-enforcement agencies, to serve as community interpreters, but also employees of volunteer and faith-based agencies who work with refugees and other "qualified" clients under the guidelines of the Office of Refugee Resettlement. As we have said, graduates of the program are not expected to become fully professional interpreters. However, they are expected to know what the job of interpreting entails in terms of ethics and procedures and to be ready to carry out basic assignments to the best of their linguistic abilities, thus essentially functioning as community interpreters.

Training consists of four different three-day modules, each team-taught by two instructors: the basic course, a train-the-trainer course, the intermediate course and, finally, an advanced course. Teaching is language-neutral, and delivered typically from Tuesday to Thursday (9:00 to 5:00). Training sessions are usually comprised of 20-30 participants representing a varied language background; with Spanish, Haitian Creole, Bosnian, and Vietnamese being the most frequently represented languages, along with more than 30 others, including Chinese, Russian, Korean, Tagalog, Dimka, Farsi, Arabic, French, Portuguese, German, Albanian, etc.

The first level addresses the DHHS guidance requirement that bilingual employees "must be trained" in interpreting methods and standards of practice. It covers a number of specific topics, divided among three main areas: 1) interpreting code of ethics and standards of practice; 2) interpreting techniques and training methods; and 3) methods of professional development and continuing education for interpreters. It ends with a written examination and awards a certificate of completion to those who pass and a certificate of attendance to those who fail. The latter are encouraged to repeat the course.

Those students who do well on the basic course written exam and show leadership qualities are invited to participate in the second course. Here, they receive training in the following areas: recognizing, evaluating, and recruiting new interpreting talent within their agency; conducting ISP promotion, orientation, and mentoring; maintaining interpreting standards among their peers, including refresher sessions, continuing education, and supervision; serving as an interpreting resource person and ISP liaison within the agency; and interfacing with their supervisor regarding DHHS compliance, interpreting policy, and administration of language services within the agency.

This level of instruction addresses the DHHS guidance requirement that bilingual employees "must demonstrate competency" in interpreting. The course is comprised of intensive practice in the medical, social services, legal, and law enforcement service areas, with an emphasis on consecutive interpretation. At the end of the course, students demonstrate competency in consecutive interpreting by passing an oral interpretation examination, which is tape-recorded and later evaluated by linguists in each of the respective languages. Those who pass the oral exam receive a certificate of competency.

Students who do well on the intermediate course oral exam are selected to participate in the advanced course. In addition to complying with the DHHS Memorandum, the State of Florida has a practical need for proficient interpreters who are able to interpret in certain civil court and administrative hearings, where, in addition to consecutive interpreting, skill in simultaneous interpreting is also necessary. The advanced course provides advanced theory and practice in all modes of interpretation, with emphasis on simultaneous interpreting, leading to an advanced oral exam and a certificate of proficiency.

Our current ISP training curriculum is the product of three years of development and adaptation of interpreter training methods to fit the realities of the social services context, the practical requirements of the agencies, and the particular instructional needs of their employees. Traditional assumptions about legal, medical, and freelance interpreter training often break down and have to be renounced or significantly adapted when confronted with the rigors of the social services arena. The instructional content has to fit in flexibly with the complex, multilayered policy frameworks of different government agencies and non-governmental organizations at the county, regional, state, and federal levels within a highly regulated field. The following are some of the key aspects in this adaptation:

Ethics. How does one negotiate between the social worker’s advocacy role and the interpreter’s neutrality? Is social service interpreting more like legal interpreting, with its strict adherence to standards of impartiality, which means virtually no contact with participants beyond the act of interpreting? Or is it more like medical interpreting, with its relative flexibility in allowing the interpreter to be a little more involved with clients and providers? It may be either, depending on the situation. We teach students to distinguish among the kinds of situations they may encounter, applying appropriate standards. We also deal with the potential problem of conflicts between interpreter ethics and participants’ obligations as employees of an agency, particularly in regards to confidentiality.

Case studies. We make extensive use of case studies showing interpreters caught in difficult situations, wherein they must sort through the various aspects of ethics and the requirements of their jobs in order to decide the best course of action. The cases usually generate very lively discussions, which often produce accounts of similar real-life situations faced by the students. Case studies are included on the written examination at the end of the basic course.

Practice materials. While we use standard practice materials developed for medical interpreting (Mikkelson, Interpreter's Rx), we have also developed specific materials (handbooks and a manual and tapes) with social service content (Camayd and Jensen, Jensen and Camayd). The sample dialogues on the tapes cover such matters as immigrant status, spousal abuse, food stamp eligibility, mental health issues in the family, and adoption. We have prepared a set of tapes containing "language-neutral" dialogues, with both sides of the conversations in English, and another for Spanish, with interview questions in English and the answers in Spanish. In the near future, we will prepare a version in Haitian Creole and then possibly in other languages.

Professional development. Because we know that the students have limited opportunities for engaging in ongoing interpreter training, we take special care to emphasize how they may continue their professional preparation on their own. Practice sessions in the basic course are designed to be illustrative rather than intensive, and the array of practice materials distributed and their corresponding methods are discussed and demonstrated. Where possible, we take time to surf the Internet together with students, showing them how to access glossaries and where to find the major professional organizations. We urge students to join ATA or the Florida Chapter of ATA (www.atafl.org) in order to become professionally connected, and also encourage them to form language-specific networks among themselves.

Adaptation of methods to the delivery system and non-traditional students. Because these are not college students meeting for a couple of hours a week, but rather working people pulled from their jobs for three intensive days, we have to specifically adapt our teaching techniques for their situation, using many varied activities, reiteration, discussion, audio-visual aids, and illustrative cases about interpreting. Above all, we keep in mind that most of these students are experienced professionals in their respective areas, and we encourage them to share their knowledge of agency policy and practices, as well as their rich and diverse field experience derived from years of working at the frontlines.

The ISP has had resounding success through its initial contract period, and is now on a new three-year contract. It has surprised us that after three years and hundreds of students trained, there is still such a large potential student clientele, numbering in the thousands among social service agencies alone. So far, we have barely scratched the surface in such areas as law enforcement, education, and healthcare.

We are currently working with Command Technologies, Inc. on alternative delivery systems to shorten the three-day instructional period of each module through automation of the factual part of instruction: an interactive CD-ROM and/or website that students would use before coming in for the first day of class. Such streamlining will open the door to many students whose agencies cannot afford to spare them for three consecutive days of instruction away from their desks. It also enables us to more effectively deliver hybrid courses (combined distance and onsite teaching) anywhere in the U.S. At the same time, we are working on a traditional published textbook, and are considering ways of helping other states to set up a program like ours.

1. Read the Memorandum at www.hhs.gov/ocr/lepfinal.htm.

Camayd-Freixas, Erik and John B. Jensen. 2002. ISP Interpreter Training Basic Course Handbook. Miami: Verb-A-Team, 94 pp.

Jensen, John B. and Erik Camayd-Freixas. 2003. Interpreter Training Skits in the Social Services. Miami: LinguaSONIC, 45 pp. (Transcript manual plus two cassette tapes in Spanish/English and two in English/English.)

Massachusetts Medical Interpreters Association. 1995. Medical Interpreting Standards of Practice. Boston: MMIA & Education Development Center, 39 pp.

Mikkelson, Holly. 1994. The Interpreter’s Rx: A Training Program for Spanish/English Medical Interpreting. Spreckels, CA: Acebo, 248 pp. (Transcript manual plus three cassette tapes in Spanish/English.)

Roat, Cynthia E, et al. 1999. Bridging the Gap: A Basic Training for Medical Interpreters. 40 hours for multilingual interpreter groups. Seattle: The Cross Cultural Health Care Program, 176 pp. + 7 appendices.

Pull-Quote:

"…In the extremely diverse state of Florida, even in rural areas, the bulk of the interpreting within social service agencies is being provided, and will continue to be provided, by bilingual in-house employees…"