Interpreting is a professional field. What was once done by whoever was bilingual now has an established certification process. There are less and less reasons to work with unvetted providers. This timeline tells the story on the West Coast, where I live. I am from Oregon, where I am certified as a healthcare interpreter and a court interpreter. The story is told from an Oregon perspective. However, nothing happens in isolation. Oregon often works in partnership with the other West Coast states, or observes their work closely. What happens in the court interpreting field affects the work in the healthcare interpreting field. The story would not be complete without the federal context. Therefore, there are elements from all West Coast states and the history of court and healthcare certification is intermingled.
1964: Passage of the Civil Rights Act. Title VI prohibits discrimination on the basis of race, color, or national origin in any program or activity that receives Federal funds or other Federal financial assistance.
1974: Lau v Nichols, a case brought in California that was decided in the Supreme Court: This court case establishes that national origin includes language. When children arrive in school with little or no English-speaking ability, “sink or swim” instruction is a violation of their civil rights, according to the U.S. Supreme Court in this 1974 decision. Lau remains the major precedent regarding the educational rights of language minorities, although it is grounded in statute (Title VI of the Civil Rights Act of 1964), rather than in the U.S. Constitution. At issue was whether school administrators may meet their obligation to provide equal educational opportunities merely by treating all students the same, or whether they must offer special help for students unable to understand English. Lower federal courts had absolved the San Francisco school district of any responsibility for minority children’s “language deficiency.” But a unanimous Supreme Court disagreed. Its ruling opened a new era in federal civil rights enforcement under the so-called “Lau Remedies.” The decision was delivered by Justice William O. Douglas on January 21, 1974. (quoted from Lau v. Nichols excerpts at Languagepolicy.net)
1978: Federal Court Interpreter Act: determined that The Director of the Administrative Office of the United States Courts shall establish a program to facilitate the use of certified and otherwise qualified interpreters in judicial proceedings instituted by the United States. NAJIT provides a listing of currently certified Federal court interpreters. Currently, this certification program is limited to Spanish.
1981: Complaints are filed with the OCR, U.S. Department of Health and Human Services, on behalf of clients at three different hospitals in Washington State, under Title VI of the Civil Rights Act of 1965. The complaints allege that, by not providing service in a language their patients can understand, the hospitals are discriminating against patients on the basis of national origin. OCR and the hospitals sign voluntary agreements.
1982: MAA’s (Medical Assistance Administration of DSHS) reimbursement program decreases the hospitals’ share of financial reimbursement for those patients on Medicaid.
1989: Region X OCR issues a brief guidance on the need to provide qualified interpreter assistance if receiving federal funds. DSHS sends a reminder letter to Medicaid contracted providers that they must provide language access services to their clients
1989: WA State Court Interpreter Act creates court interpreter certification program under AOC and interpreter commission.
1991: WA State agrees to pay for interpreting services for Medicaid patients.
1991: Negotiations for consent decrees are the result of Evergreen Legal Service’s continuing complaints (and court dealings) that Washington State’s Department of Social and Health Services (DSHS) was not living up to its earlier agreed upon measures to provide translation/interpretation service. Reyes Consent Decree settles class action Title VI lawsuit and creates the DSHS interpreter certification exam.
1993: First certified WA DSHS Social Services exams.
1995: First certified WA DSHS Medical exam as part of the certification program for medical and social service interpreters.
1993: The Oregon court interpreter certification program was instituted by statute, and is now administered by the Oregon Court Language Access Services. An interpreter may be certified in Oregon by the State Court Administrator upon satisfactory proof that the interpreter is certified in good standing by the federal courts or by a state having a certification program that is equivalent to the program established under this section.
1995: Oregon and Washington, with New Jersey and Minnesota, founded the Consortium for State Court Certification. This came about as a consequence of findings and professional relationships established during research conducted by the National Center for State Courts between 1992 and 1995. (NCSC FAQs)
1996: California passed the California language assistance law and began administering its medical certification exam and its court administrative hearings exam
In the opening paragraph, the California language assistance law says: As used in this article, “language assistance” means oral interpretation or written translation into English of a language other than English or of English into another language for a party or witness who cannot speak or understand English or who can do so only with difficulty. […] The cost of providing an interpreter under this article shall be paid by the agency having jurisdiction over the matter if the presiding officer so directs, otherwise by the party at whose request the interpreter is provided.
1996: The Federal Government passed the Health Insurance Portability and Accountability Act (HIPAA), which defines confidentiality. Contract health care interpreters are considered business associates and are required to comply with this law.
2001: The federal executive order 13166 was signed. EO 13166 requires Federal agencies to provide meaningful access to services to people with limited English proficiency, and to ensure that beneficiaries of Federal financial assistance also comply with this requirement. This is to ensure that their programs and activities normally provided in English are accessible to LEP persons and thus do not discriminate on the basis of national origin in violation of Title VI’s prohibition against national origin discrimination. The Department of Justice provides detailed information on this topic, as well as resources to fulfill this guidance, at lep.gov.
Court interpreters are now required to show proof of continuing education every two years in order to maintain their credential.
2001: The Oregon Health Care Interpreter law was passed. This law defines qualifications for health care interpreters in Oregon, creates a registry for certified and qualified interpreters, and encourages the use of certified health care interpreters or qualified health care interpreters whenever possible to ensure the accurate and adequate provision of health care to persons with limited English proficiency and to persons who communicate in sign language.
2010: Bill granting unionization rights to interpreters rendering services to WA DSHS and their Medicaid clients, directly or indirectly passes. WFSE wins PERC election. Interpreters elect their first bargaining team.
2012: National medical interpreting certification programs NBCMI and CCHI were accredited by NCCA. See this comparison chart of interpreting certification programs in the Northwest.
2012: The US Department of Justice updates its Language Access Plan, clarifying the definition of vital documents and qualifications of interpreters and translators. There is more information on www.lep.gov.
2014: Oregon health care interpreters gave public testimony on HB 2419, a bill related to their profession, for the first time.
2016: Interpreter services provided by a health care interpreter certified by the Oregon Health Authority were specifically included in the Oregon Worker Compensation rules based on testimony submitted by Helen Eby, OSTI President at the time, in November 2015.
2018: Language defining the qualifications of interpreters and translators was included in the regulations for the Affordable Care Act.
2018: Bill grants unionization rights to interpreters working WA L&I and DES appointments. It also requires centralized online scheduling system for all executive branch state agencies.
2019: Bill granting Oregon healthcare interpreters the right to unionize, making the State of Oregon the public employer of record of health care interpreters, passes.
We have come a long way!
The field of language access has grown in professionalism, based on laws and court proceedings. We could not have done this without the support of those who came before us. Now we have to continue to grow in applying professional standards, so interpreters are united in their application and those who work with us know what to expect from a professional in our field.
2020: Approximately 700 certified and qualified interpreters on the OHA registry and approximately 150 certified and registered interpreters on the Oregon Court Language Access Services registry. A search of RID members in Oregon yields 212 results when selecting all available certifications. There are approximately 1000 professional interpreters in Oregon, assuming no overlap. As a point of comparison, in 2013 the Oregon Health Authority listed 41 certified and qualified health care interpreters on its registry, compared to 700 today.
Related articles: The National Health Law Program published a Summary of state law requirements addressing language needs in healthcare on April 29, 2019.
Resources I consider very useful:
1994: The Interpreters Rx, by Holly Mikkelson, was published. This was written to support interpreters who prepared for the medical-legal exam, which is all that existed in California at the time. It was really testing for medical-legal evaluations.
2007: Eta Trabing published the Manual for Interpreters in School Settings. This is one of the earliest resources for school interpreting available.