Hire Medical Sign Language Interpreters: How Does a Medical Manager Decide Who to Hire?

~ Authored by Shelly Tisius, MT&A CEO

After being in business since 2013, we recognize that medical managers often do not know the value sign language interpreters bring to their medical office.  Why and how should you, as the office’s or hospital’s decision maker, hire medical sign language interpreters for your patients or Deaf employees?  First, ethically, you want to ensure that you understand the Deaf patient’s medical condition so that you can provide an appropriate accurate treatment and involve them in their healthcare decisions.  Additionally, you want to be in compliance with the laws.

Why? The Law

In Missouri there are three areas of legal focus relating to enforcement of sign language interpreting services to comply with equal access to communication.  All three are extremely detailed, so here is a simplified summary of the requirements below.

  1. The American’s with Disabilities Act (ADA), Title III requires equal access to communication regardless of the organization size. The ADA states that a qualified interpreter using effective communication is required.  Fortunately, the states of Missouri and Illinois define interpreter qualifications and effective communication for us.  Reputable sign language interpreting companies manage their interpreter hiring process using these guidelines.  (See number 3 below.)
  2. The Affordable Care Act (ACA) is often stricter than the ADA. For example, anyone receiving funding from the US Department of Health and Human Services (Medicare/Medicaid) is required to comply.  The ACA also adds primary consideration of services where it is customary for the Deaf consumer to choose what access they need for effective communication.
  3. Missouri and Illinois laws require all sign language interpreters be certified and licensed in order to practice. This means it would be illegal to use a family member who is not a certified licensed interpreter.  Further, a family member who is certified and licensed needs to be qualified and in compliance with the Code of Professional Conduct (CPC).  If they interpret for a family member, they would be in violation of this code of ethics since they cannot be impartial.

How? Equal Access to Effective CommunicationHire Medical Sign Language Interpreters

Equal access to effective communication has several forms depending on the Deaf person or how severe the hearing loss.  Ask the individual requesting services what is most effective for them.  Consider a few examples:

Culturally Deaf – Native/First Language Users of Sign Language

Since sign language has its own grammar and has a different structure than the English language, writing back and forth in English is typically not effective.  Miscommunications occur most often in written conversations, mimed or mouthed communication, and communication through family members (since information is often relayed in a biased or filtered way).  A sign language interpreter is often the only effective method with a culturally Deaf patient.

Late Deafened Adults

Anyone who loses their hearing later in life or who is not culturally active in the Deaf community may not have a working knowledge of American Sign Language (ASL) and may prefer other avenues for communication.  In this case you may not need to hire a medical sign language interpreter, but instead ask the patient what their preferred method is.  Typing, writing, or lip-reading may be effective but be sure to follow appropriate guidelinesVeterans are an example of this category of people.


These are the basics of Why and How to consider when you hire medical sign language interpreters.  Local firms who specialize in sign language interpreting services will keep up to date with all laws in their area, so reach out to if you have further questions.


Additional Resources:

Disability Nondiscrimination Accessibility Laws Resource Sheet

ACA Section 1557 Final Ruling

Sign Language Interpreters at Doctors, Dentists, and Hospitals

Accuracy is Critical to Sign Language Interpreting

Certified Qualified Sign Language Interpreters in Medical Settings


Photo Credit:

MT & Associates, LLC – By Pearl Photography

MT & Associates | Sign Language Interpreting Practice BBB Business Review