Medical Manager Decisions: Considerations for Hiring Medical Sign Language Interpreters

~Authored by Shelly Tisius, MT&A CEO

As a medical manager, why you should hire medical sign language interpreters is critical to understanding patients.  There is a huge impact, potentially negative or positive, to your medical institution depending on the type of solution you choose.  For example, is it better to hire an independently contracted interpreter or to have a contract with a reputable sign language interpreting company?  What type of services fit the needs of your patients?  Should you go with the cheapest services you can find?

Type of Services: Video Remote Interpreting or In-Person

Note that in-person sign language interpreting services are not the same as Video Remote Interpreting (VRI).  If you as the medical manager setup an patient appointment in advance, then there is plenty of time to reserve in-person services; which are recommended.  VRI can be effective in emergency or last-minute situations, but it never trumps in-person interpreters because it’s often not effective.  Additionally, consider the nature of the appointment. For example, if the patient had eye surgery recently, then VRI is generally not effective and in-person interpreting services.

To complicate it further, there are not laws that protect VRI providers out-of-state.  If the medical managers are using an out-of-state VRI or interpreting provider, they may not be protected under Missouri or Illinois laws.  Additionally, including VRI, all interpreters must be certified and licensed to work in the State of Missouri or Illinois.  If vendors are out of state they may not be aware of State laws; which again pushes the liability to your office.

Due to ongoing “abuse” of VRI in the State of Missouri there has been a lot of push to enforce laws to protect patients.  These laws could be in place as early as 2019.

Independent Contractor or Company: Qualified Providermedical manager decisions

Unfortunately, Missouri and Illinois do not have a legal requirement as to who can open an interpreting business.  Do your homework and make sure you are using a reputable provider.  Additionally, as the medical manager, you don’t want an interpreter to show up so that you’re in compliance with laws.  You want a qualified interpreter who can interpret accurately and ethically and have knowledge and ideally experience interpreting in the medical field.  A company with a mid to large selection of interpreters to should have a large staff to interpret whatever you may need as far as quality but also assist when a last-minute request occurs is best.

For this reason, it is not recommended that you hire an independent contract interpreter.  Companies have backup interpreters in case of emergencies, appropriate liability insurance, BAAs, NDAs, and business standards to ensure confidentiality and adherence to the interpreter Code of Professional Conduct.  Additionally, most independent sign language interpreters do not have appropriate insurance coverage.

Cost of Interpreting Services

Cost is the main reason we hear as to why a medical manager in an office does not comply with ADA, ACA, and Missouri law.  But consider the cost of not providing services.  In addition to high fines when found non-compliant (i.e. $55,000- $150,000), you may also lose accreditation.  Your institution may be hit with negative social or news media coverage (example: Hurricane Irma) which can tarnish your reputation irreparably.

Consider ethics.  If a patient does not understand their medical diagnosis, medications, or risks (What to do if Hospital Refuses Services) they could be put in harms way.  Just because they shake their head yes does not mean they understand what you think they understand.

“Do no harm” should be the primary reason why equal access to communication should always occur.  Cost for interpreting services (in-person or VRI) is minimal when compared to the risk.


Additional Resources:

ADA Tax Credit

Deaf Services Advocates Program

ADA Effective Communication

Disability Nondiscrimination and Accessibility Laws Resource Sheet


Photo Credit:

MT & Associates | Sign Language Interpreting Practice BBB Business Review