Part Four: How Do I Choose the Best Language Agency to Serve my Institution?

(Back to Part 3.)

When you contact a prospective language agency, you will want to inquire about a wide range of issues in order to gauge the likely quality of the services.

Quality of interpreting
• How does the agency recruit interpreters/translators?
The most successful agencies recruit interpreters on an ongoing basis from a wide
range of sources. They will maintain close on-going relationships with the
immigrant and refugee communities from which interpreters may come, as well as
with professional interpreter organizations and training programs. Agencies which
are vague about how they recruit may have difficulty filling your needs long term.

• How does the agency screen interpreter candidates?
Different agencies will have different minimum requirements for interpreters.
While there is some debate whether it is necessary (or even possible) to require that all interpreters have a college degree, all interpreters should certainly be screened for their language skills in both active languages. Screening techniques range from an informal conversation to standardized testing, so ask specifically about how screening is done. As is often the case, standards for common language interpreters (like Spanish) are likely to be higher than standards for interpreters of “hard-to-find” languages.

• Does the agency require interpreters to have received professional training in
interpreting?
As few health and human service interpreters come with degrees in interpretation,
it is very important that interpreters receive some form of professional training as
interpreters. Does the agency require training? If so, how many hours? Trainings
can run from four hours to over 200. Obviously, the longer the training, the better,
but 40 hours is a common length for basic training programs. What does the
training cover? Ask to see the curriculum. The course should, at a minimum, cover
the interpreter role, ethics, modes, basic conversion skills, handling the flow of the session, intervening and medical terminology. The more participatory the course,
the more skill building and practice included, the more effective the course will be. Ask also about the credentials of the trainer. The impact of a course often depends on who is teaching.

• Does the agency require any continuing education of its contractors? If so, how much and what sort of proof do the contract interpreters have to offer?
Continuing education is important and reasonable to expect of interpreters who
provide services regularly. The California Healthcare Interpreter Association (CHIA)
has chapters in the Bay Area, the Los Angeles area, the Central Valley and the
Sacramento area that may provide continuing education for health care interpreters.

• What percentage of the agency’s interpreters is certified?
It is useful to know how many certified interpreters the agency has in each language; however, true certification programs are rare. At the time of this writing, there is no publicly available certification process for health care interpreters in California. However, there are several other forms of interpreter certification of which you should be aware.

The Federal Court system certifies interpreters in Spanish, Haitian Creole and Navajo. The California Personnel Board also certifies court interpreters in Spanish, Arabic, Cantonese, Japanese, Korean, Portuguese, Tagalog and Vietnamese. There is a “Medical Interpreter” certification for legal interpreters providing services for Workers Compensation exams, but this test is not designed to certify clinical interpreters and is offered only in Spanish.

Language Line Services (LLS), a for-profit telephonic interpreting agency, has developed a valid internal certification process, which at this time is available only to LLS interpreters.

American Sign Language interpreters may be certified by the National Association of the Deaf (NAD) or the Registry for Interpreters of the Deaf (RID), with a variety of special certificates for particular venues. The two organizations have also formed a joint task force, the National Council on Interpreting which is developing a new, joint certification process.

The American Translators Association (ATA) accredits translators into English from Arabic, Danish, Dutch, French, German, Hungarian, Italian, Japanese, Polish, Portuguese, Russian, and Spanish; and from English into Chinese, Dutch, Finnish, French, German, Hungarian, Italian, Japanese, Polish, Portuguese, Russian and Spanish.

The Department of Social and Health Services of the State of Washington also has a certification program for health care interpreters who speak Spanish, Russian, Korean, Chinese (Mandarin and Cantonese), Cambodian, Lao and Vietnamese. The state also offers a “qualification” test to interpreters of other languages. Especially with telephonic providers, you may find interpreters in their pools who are certified through this process.

If an agency tells you that all its interpreters are certified, ask who has certified them. If the certification is internal to the agency, ask to see the reliability and validity data to make sure that it is truly a certification test and not simply an assessment. Obviously, you would like to see more certified interpreters than not in an agency’s interpreter pool. However, if it appears that few of the agency’s interpreters are certified, take a careful look before assuming that interpreter quality will be poor. It may be that the agency provides services largely in uncertifiable languages, or that training is being used in lieu of certification to guarantee quality.

• What Code of Ethics are the interpreters/translators asked to follow?
At present, there is no one code of ethics for health care interpreters that is
nationally accepted, although California Healthcare Interpreters Association
(CHIA) has recently published a draft code of ethics8 and the National Council on
Interpreting in Health Care is currently working to build national consensus
around a single code of ethics. As a result, at this time each agency may have its
own code. Ask to see it, and ask how interpreters/translators are instructed about
it. If the code is simply mailed to interpreters, it will be doubtful that they will
really understand it.

• What protocols are interpreters expected to use?
Are the interpreters expected to use first person interpreting, that is to say “I have a stomach ache” instead of “The patient says she has a stomach ache”? Are they
expected to do a pre-session with the patient and provider to clarify their role and
how they will interpret? Do they provide culture-related information if
communication has broken down due to cultural reasons? Will they advocate if
necessary? How are in-person interpreters told to dress and present themselves?
How are the interpreters instructed to handle difficult situations? Many agencies
will have an orientation apart from formal training to teach interpreters the
accepted protocols of that particular agency. Ask to see any instructional materials
that are given out and make sure the protocols are in keeping with professional
practice and your internal guidelines.

• How does the agency provide long-term quality assurance for interpretation?
After the interpreters start to provide services, is there any mechanism in place to see how they are doing? Are interpreters periodically monitored in any way? Or will the agency rely on complaints from you as a quality assurance technique?

• What mechanisms does the agency have to instruct interpreters about specific policies and procedures of your institution?
How does the agency communicate with its interpreters? Is there a newsletter,
monthly meetings, a Listserv? As you work together, it will certainly be necessary
for the agency to communicate details to interpreters about working at your
institution, whether there has been a change in parking designations or there are
new instructions on getting encounter forms signed. Make sure the agency has
some structured way of contacting its interpreter pool.

• Does the agency specialize in any particular industry(ies)?
Some agencies serve all venues: legal, medical, insurance, social service, financial, customer service, educational, etc. Others will specialize in only one or two industries. While a more focused agency will not necessarily give better service, it is easier for interpreters to interpret effectively in fewer venues, simply because this requires a smaller range of specialized vocabulary and protocols. Some large agencies may have different cadres of interpreters to serve different venues, or may provide assistance with vocabulary development to interpreters who serve multiple venues. If the agency serves a wide range of venues, you might want to ask specifically how the agency guarantees quality across so many different situations.

Interpreter service

• Available languages
You will want to ask the agency about the depth and breadth of its interpreter pool.
How many interpreters does it have actively available on a daily basis? How many
in each language? How many are really qualified? Some agencies seem to have an
awfully long list of “available languages,” making one wonder if those interpreters
would really be available if and when you needed them.

To evaluate what you learn about the agency’s capacity, you will need to know your organization’s language needs, both by language and by demand. What are your top five languages? Which language requests have you found especially difficult to fill? Some agencies specialize in certain language groups: Spanish only, Asian languages only, “hard to find” languages only, ASL only. Instead of expecting one agency to cover all your language needs, it may be better to have multiple contracts with various agencies, and use each for the service in which it specializes.

• Back-up alliances
Some agencies have agreements with other agencies to back each other up if one
agency cannot cover a request. While this practice will certainly expand the
agency’s capacity, you will want to make sure that the allied agencies maintain the
same standards that you would expect from the contracted agency.

• Responsiveness
What percentage of all requests is the agency able to fill? This data the agency
should be tracking and should be willing to share. Remember that no agency can
fill 100 percent of requests.

• No-show rates
How often do this agency’s in-person interpreters fail to show at appointments? As
with response rates, the agency should track this and be willing to share the data.

• Connect times (for telephonic interpreter services)
What is the average connect time? Connect times of 45 seconds or less are
competitive; more than that is questionable. Also, ask how connect times are
calculated. They should be counted from when the call starts to ring at the agency
until an interpreter is on the line. You also might want to ask about connect times
on your most common languages. Since it may well take longer to get an interpreter
in a rare language than in a common one, chances are that connect times for
Spanish will be less than the average.

• Special equipment requirements (for telephonic interpreter services)
Many telephonic interpreter services will be able to recommend specific speaker
phone technologies. A few require particular equipment in order to provide their
service. Since additional technology will certainly add to cost while potentially
improving quality, it is important to hear what technology upgrades you may need
to work with each agency.

• Disaster recovery system (for telephonic interpreter services)
If there were to be some sort of national disaster, access to telephonic interpreters would become more important than ever. Or, if there were a local disaster near your agency’s call center, communications might be interrupted. Since your agency depends entirely on phone lines and computerized switching systems, what plan is in place if the lines go down? Some telephonic interpreting agencies now have completely redundant communication systems, allowing them to easily switch
systems if one technology fails. It is especially important to ask about disaster
recovery systems if you are contemplating using a telephonic service as the sole
provider of your interpreter services.

• Switching equipment (for telephonic interpreter services)
For those with experience with call centers and telecommunications, information
on the agency’s switching system can tell you a great deal about how prepared it
will be to handle a large volume of calls, track connectivity statistics and provide
accurate billing and reporting.

• What additional services are offered?
As mentioned above, some agencies offer ancillary support services that may be of
use to you. The more services they offer, the more of a partner they can become.

Administrative
• Fees
Of course you will want to ask about fees. In-person interpreter services are usually charged by the hour, with a one-hour minimum, although this may vary based on location. Telephonic interpreter services are usually charged by the minute. Fees
may vary based on language or by the time of day of the service. In addition, there
may also be a one-time set-up fee, a monthly minimum, volume discounts and
cancellation fees. Make sure you know all the fees before you sign up.

• Cancellation policies
What is the agency’s cancellation policy? If you cancel a request for an interpreter, will you be charged? Most agencies will not charge if the cancellation is more than 24 hours before the appointment. Some agencies will charge, as they feel it only fair to pay the interpreter whose time has been reserved and who may not be able to get another appointment to replace the cancelled one. Same-day cancellations are almost always charged.

• Company history
Learn as much as you can about the people at the agency. Who started it? What
was the founder doing beforehand? Does the founder have previous experience in
the language field? How long has the agency been in business? How quickly has it
grown? Who are the key players at the agency and what are their backgrounds?
These questions can give you a feel for the people behind the logo: the people with
whom you will be dealing, and the people whom you will need to trust in order to
build a working business relationship.

• Industry involvement
Is the agency at all involved in helping to build the health care interpreting field? Is the agency a member of CHIA, of the American Translators Association (ATA), of the National Council on Interpreting in Health Care (NCIHC)? Does the
agency provide scholarships for interpreters to get training, or support local
training efforts? Agencies that are supportive of the field are demonstrating
commitment to quality interpreting that may be reflected in their services.

• Key documents
Ask to see a standard contract and an example of a billing statement. If you are
going to need specific data on your bill that is not routinely provided, bring that up in negotiations to assure that the agency has the capacity to track that data.

Finally, after you have asked all your questions and reviewed all the materials provided to you, ask for references. While it is not appropriate to request a complete client list, agencies should be able to put you in contact with a few current clients. When you talk to the references, ask for specific information as opposed to general impressions.

If you are contracting for telephonic interpreter services, your last step is to request a test call. This means that the agency allows you to put through one interpreter request free of charge in order to test how the service works. You may want to try an uncommon language to see if the agency can really come through, or you may want to request your most commonly needed language, to see how the agency will respond in the situation for which you will most use it.
Either way, a test call can be most revealing and will give you a good feel as to how the agency will really function.

Choosing an agency (or agencies) may seem rather complicated, however a quality agency will be your best partner in meeting your language needs. Having to recontract with new agencies because the old ones didn’t work out is a major investment of effort. It’s worth the time up front to choose an agency that can serve your needs well so that you can both get about the business of providing language access.

Source: Roat, Cynthia E. “How to Choose and Use a Language Agency: A Guide for Health and Social Service Providers Who Wish to Contract With Language Agencies.” Los Angeles: The California Endowment, February 2003.

(Go to Part 5.)