Quality interpreting will be tougher and less profitable.

Dear colleagues:

Government officials are entrusted with taxpayer’s money and they should be good stewards when allocating said resources. Good governments are charged with guaranteeing equality and quality services to those who elected them, and they must wisely decide where to invest and where to cut expenses. Sometimes well-intentioned authorities get it wrong, and unless they rectify, consequences can be ugly.

There are two instances where the United States federal government has adopted policies, and is considering even more steps, that will negatively affect our profession: One of such actions, already in place, impacts those interpreters practicing before the immigration courts; the other one will make accurate interpreting extremely difficult in the healthcare sector.

Even though we have read and heard many voices protesting these government decisions, and that is very good, they all argue the negative effects from the perspective of the beneficiary of the professional service: the millions of individuals living in the United States who do not speak English, but nobody has argued why these changes must be opposed from the interpreters’ perspective. My following comments result from conversations I had with fellow interpreters, immigration attorneys, and my own experience and observations as an interpreter, and from my days when I saw the immigration court system up close as part of an immigration law firm. This should complement what others have said.

Interpreting immigration proceedings.

The Executive Office for Immigration Review (EOIR) which runs the immigration courts, a branch of the Executive Branch of the federal government, not part of an independent judiciary, and run by officials appointed by the current administration, to lower its operational costs, replaced in-person interpreting services during an individual’s first court appearance with “pre-recorded, subtitled orientation videos, or telephone calls…”

These initial appearance hearings, called “Master Calendar Hearings” are the procedural moment when a person sees the immigration judge for the first time, after receiving a “Notice to Appear” (NTA) in court because of a removal proceeding the U.S. government, through the Department of Homeland Security (DHS) has instituted against him or her. The notice informs the individual of the charges, gives the time and place of the hearing, and it informs immigrants of their right to have an attorney to represent them at no cost to the government (remember, immigration court is Civil Law. Only criminal cases are covered by the constitutional right to have a defense attorney free of charge).

Master Calendar Hearings are very important. During this appearance, a person, technically called the “respondent,” who apparently is not an American citizen, learns of the charges against him, the facts of his case, is informed of his legal rights, and is given the chance to retain an attorney at his own expense or appear without legal representation (pro-se) during the proceedings. The person could request bond or ask for a bond redetermination hearing before the immigration court.

Respondents are told of their rights as a group. In some courts between 80 to 100 people at a time. During the hearing, the judge briefly addresses each individually, asking them their name, date of birth, address, and whether or not they plan to retain an attorney. Judges also ask them if they have questions, if they understand English, and when needed, an interpreter is appointed at no charge. This is very important because respondents need to know that failure to appear to any subsequent hearings will be held without them been there (in absentia) and the result will be a final order of removal and a 10-year bar to any future immigration benefits in the United States. Occasionally, people ask for voluntary departure or concede removability at this hearing.

Before the pre-recorded policy was implemented, judges listened to respondents’ answers to their questions, and conveyed information through an interpreter in close to 90 percent of the cases, this is immigration court where English speakers are the exception. If respondent’s language rarely was spoken in the area, and there were no staff or contract interpreters readily available, judges would use a telephone interpreting service, and for those cases where interpreters were not found, immigration courts would continue the hearing to a future date when an interpreter would be available.

I cannot imagine, and it shows a lack of knowledge on the way immigration courts work, how could a judge ask questions, provide information, and communicate with a non-English speaker. I can even see how a judge can even know that the individual understood the recordings. Some will not understand the spoken language in the video; others cannot read the subtitles in their own language because they may be functionally illiterate. Some may not pay attention to the video. I know how important is to know what to do if an emergency occurs when on an airplane, but I rarely pay attention to the video airlines show teaching me how to buckle my seatbelt. The most logical outcome will be: The judge continues the Master Calendar Hearing until there is an interpreter for the respondent. The consequence of this outcome: a second Master Calendar Hearing, easily avoidable when interpreters are available the first time. Taxpayers’ savings: gone.

Unfortunately, many respondents will be embarrassed to admit they did not understand the video, others may choose a hearing they do not understand instead of sitting in detention for a few weeks waiting a rescheduled hearing with an interpreter; others may concede removability when they had relief because nobody told them so.

Under this new policy, interpreters will encounter the respondent at the hearing on the merits, called “individual hearing”, for the first time. From the interpreter’s perspective, these hearings are similar to a traditional trial, there are legal arguments by the parties, direct and cross-examination of witnesses, references to caselaw, and quotations of official documents on the situation of countries, regions, and other relevant information. When an interpreter is involved from the Master Calendar Hearing, she has time to prepare for the assignment, research country conditions reports, get acquainted with the relief the client is seeking, and develop a glossary of terms relevant to the case and to the respondent’s speech.

Accurate interpreting during individual hearings is difficult because of the wide variety of issues that can be discussed. This is complicated even more due to the cultural differences and level of education of many respondents.  Interpreting during an individual hearing when a pro-se respondent went through a Master Calendar Hearing with a pre-recorded video will be a very difficult task. It is almost impossible to interpret without context, and the Executive Office for Immigration Review expects accurate quality interpreting services under these deplorable circumstances.

In an environment where the federal government wants to slash down all language resources needed in immigration proceedings, therefore compromising the quality of the interpreting services in immigration court, it is very telling that SOSi, the sole agency providing interpreting services in immigration courts nationwide, under a public contract reviewable every year until 2021, has remain silent on this issue. They already showed how willing they were to win that contract a few years ago when their lowest bid ousted long-time provider LionBridge. We all remember how the first thing SOSi did was to reduce interpreter fees from $60 to $35 dollars per hour (they later lost to the interpreters before the National Labor Relations Board NLRB). We must not forget SOSi is a well-established, powerful contractor with the U.S. Department of Defense (DOD) with a vested interest and a priority to keep its client: The United States federal government happy.

Dear colleagues, all immigration interpreters: staff or contractors, will face a terrible environment where they must do more, much more, with a high probability of a less than perfect rendition, because of the erroneous, and in the long-run more expensive policy enacted by the EOIR. Independent contractors will also have a less profitable immigration practice because all Master Calendar Hearings will be gone. How do you like this: tougher work, less income, providing interpreting services for an agency focused on keeping a federal contract, that cares nothing about interpreters or quality service, all to comply with an absurd government policy that brings nothing favorable to the interpreter to the table?

Healthcare interpreting.

In compliance with Title VI of the Civil Rights Act, which prohibits discrimination based on national origin, including language proficiency, and President Bill Clinton’s Executive Order 13166 (2000) during President Barack Obama’s administration the U.S. Congress passed the Patient Protection and Affordable Care Act, popularly known as “Obamacare” in 2010.  Section 1557 of the Act prohibits discrimination in federally-funded or administered healthcare programs on basis of national origin, including language proficiency.

Once the law came to full force, healthcare providers had to provide “qualified” interpreters to those who are not English proficient. Since then, we have come a long way; there are now healthcare interpreter certification programs in several languages, criteria to resort to other qualified individuals in those languages lacking certification programs, and explicitly banning interpreting services by children and relatives of the patient. Interpreting services for languages of lesser diffusion, and for remote areas of the country where in-person certified interpreters were not physically available, a video remote interpreting (VRI) option was developed. I want to make it clear: I dislike VRI for many reasons, but I understand that it was better than the alternative: having a child doing the rendition or no interpreter.

On May of this year, the Office of Civil Rights (OCR) of the United States Health and Human Services Department (HHS) issued a proposed change to Section 1557 which affects many segments of the population, including the elimination of written translated notices informing non-English speakers of their right to have an interpreter, and the option to get interpreting services by video in regions where no interpreters were physically available. Citing savings of $3.2 billion dollars over a 5-year period, the 204-page amendment proposes telephone interpreting instead of the more expensive video remote interpreting.

The patient-physician relationship is very private, often it happens during difficult times, and it could include communicating the worse possible news. Medicine is an imperfect science and it depends on accurate diagnosis, precise instruction, and strict compliance by the patient. Unless a patient is English proficient, none are possible without an interpreter.

VRI is a horrible solution, interpreters who provide this service are at the mercy of the weather, the speed of the internet service, the reliability of the electric company, and the quality of sound, among other things that have nothing to do with interpreting. Telephonic interpreting, maybe good for a 9-11 emergency call, or to make an appointment to the hairdresser, when used for healthcare interpreting is borderline criminal.

Those who think interpreting is all about hearing what a person says and translating it into a different language show their ignorance. Interpreting is much more than that. Communication includes facial expressions, tone of voice, body language, and many other factors that need to be picked by the interpreter to do a good job. Interpreting for a medical examination, laboratory work, therapy session, need this visual component more than many other human interactions.

How can an interpreter be satisfied and confident of a telephonic interpretation where the doctor asks the patient: “Is the pain sharper here… or here?”  How can a physician diagnose correctly if the patient reveals his injury by pointing to a body part and nothing else?

Many of the non-English proficient patients come from cultures when it is difficult to take about the human body, even to mention human parts by their name. They solve this uncomfortable situation by pointing to their intimate body parts instead. Hated VRI at least allows the distance interpreter to see what the patient is doing and render an accurate interpretation. Same is true for those patients, many farmers and construction workers from Spanish-speaking countries, wrongly name a body part, or refer to their own body by the name generally applied to animal parts. Hearing “my foot hurts” when they hold their thigh, or “my gizzard is swollen” can be accurately interpreted when the interpreter sees on the screen how the patient holds his thigh or points at his stomach. With telephonic interpreting this would take a lot of time and many questions to the patient. Sometimes it is impossible.

Medical insurance paperwork without a translated notice informing non-English speakers they can request an interpreter for their medical appointment, and long, often uncomfortable telephonically interpreted doctor visits will cause many discouraged patients, who are not proficient in English, staying home, skipping medical appointments, and waiting until it is too late, and more expensive, to provide medical treatments. To say that healthcare services, arguably the most profitable activity in the United States, needs to cut expenses by amending Section 1557 is difficult to buy. This is the business that charges you $75 for the plastic pitcher of water you used during your hospital stay.

To the interpreter, it will mean a more difficult task, a professional practice that goes beyond interpreting and into the world of having to divine what a patient said. More difficult work, same pay, and a diminished rentability. When patients stop going to the doctor because of telephonic interpreting, when people stay away from hospitals because nobody ever told them they could have an interpreter during the medical examination, the need for interpreters will plummet. If implemented, on top of the thousands of deaths it will cause, HHS decision to eliminate right to an interpreter translated written notices, and to replace VRI with a telephone line will be remembered as the decision that killed healthcare interpreting as a profitable practice.

If you are a practicing immigration court or healthcare interpreter, and you want to continue in your filed, working in a fulfilling profession that makes you a nice profit, join the activists working on behalf of immigrants, patients, immigration attorneys associations, the immigration judges union, and healthcare rights activists, and share with them your perspective, make them understand that the quality of your service will suffer because of reasons with nothing to do with the way you practice your craft; explain to them that less profitability will be the easiest way to show the door to the best interpreters practicing immigration and healthcare, leaving only (with a few exceptions) those of a lesser quality and professionalism. Share stories like the ones I have included here. I now ask you to tell us what are you doing as a contingency strategy if profitability leaves immigration court and healthcare interpreting.

“Your fee is well over the budget for this assignment”.

Dear colleagues:

Have you noticed mediocre agencies always say: “unfortunately, your fee is way over the budget this client has for the event”? This seems to be the answer I get most of the time, even from the big multinational interpreting services agencies, and it is the main reason I reject an assignment offered.

It makes me wonder how those huge multinational agencies, worshipped by their colleagues in the “industry”, who claim to be service providers to the biggest corporations and organizations in the world, can be as big and profitable as their financial statements show, (and believe me, thanks to public litigation records from lawsuits involving some, market share values, and their own bragging about their success, we know they are turning profits never seen before) when according to their conversations with interpreters, our fees are almost always above their clients’ budgets for their main, once-a-year conference, launching of a new product presentations, multi-million dollar fundraisers, or award ceremonies.  I find it difficult to believe these agencies would only work with “starving” clients.

The main issue is how these agencies’ clients decide on a budget for their events. I would think that corporations have little knowledge about interpreting services, and for that reason they go to language service agencies to find out about interpreting costs, just as they go to the caterer for information on the cost of food, or to the hotel to see how much it costs to rent a ballroom for the weekend. The agency informs the client or event organizer how much interpreters will charge, and what else they need to factor in (equipment, booths, technical support) before determining the amount needed for interpreting services. The agency tells the client what interpreters will cost. Then, armed with all necessary information, the corporation of association sets a budget. It is not the other way around.

The problem is that agencies want to pay interpreters very little so they can have great margins, and they tell their clients they can get interpreters for very low fees; even when the agency knows they will never get the best human talent for such a tiny paycheck. They have offered lower quality interpreters willing to work for below market non-professional fees.

If an ignorant client contacts the agency and tells them they want an interpreter for no more than a certain amount, and the amount is below prevailing professional interpreter fees, that is the time for an agency to educate the client and tell them: “…sorry, but a team of interpreters would cost you such and such professional fee per interpreter per day…” and then explain that interpreters charge by the day, that every time they are retained to work four hours or less, they must be paid for half a day, unless the four-hour (or less) assignment encompasses both morning and afternoon hours, because in that case interpreters need to be paid for a full day since they cannot generate any other income on that day.  During this conversation, an agency interested in quality interpretation would add: “…by the way, half days are handled this way…”

Then, if the event requires interpreters from out of town, the agency must make it very clear to the client these interpreters will charge at least half of the full-day fee for each travel day. Finally, the agency should clarify that, separate from their fees, these out-of-town professional interpreters will need for the client to cover their travel costs: travel, lodging, in-town transportation, and Per Diem.

At the beginning, these agencies may have to sacrifice part of their margin, but in the long run they will turn more profitable than those who turn their backs on the interpreting profession and embrace the low-quality ranks of the so-called “industry”, because their clients will notice the difference in the quality of the service and will go back to the same agency time and again. These are the agencies interpreters look for. These are the real interpreting services agencies. I would like to hear your ideas on this issue, and please share any relevant experiences you had.

A despicable practice in healthcare interpreting.

Dear Colleagues:

For several months I have received phone calls and emails from some of our healthcare interpreter colleagues in the United States complaining about the same situation: Unscrupulous interpreting agencies asking them to work for laughable fees. I know this is not breaking news to you; we all run from time to time into these glorious representatives of the “industry”.  What makes this situation different, and motivated me to write this post, are the shameless tactics used by these agencies’ recruiters. They have decided that giving the interpreter a guilt trip will soften us up enough to work for a miserable fee that will not even pay for gas and parking, or for the babysitter.

Oftentimes when interpreters provide their fee schedule for healthcare interpreting services, these programmers, recruiters, project managers, or whatever may be their official title in that particular agency, throw the ball right back in the interpreter’s court, not to negotiate a professional fee that is fair considering the complexity of the service requested, but for the interpreter to feel awful about turning down an assignment. The argument goes like this: “…but the patient does not speak English and he is really sick… we cannot afford the fee you requested; his condition will get worse unless you help him… the patient really needs you…”  Another version they use brings up the issue of all patients’ right to an interpreter derived from Title VI of the Civil Rights Act.  In that case, the agency representative would add something like: “…but you know these people must have an interpreter if they don’t speak English, and you are the only one in town. We all need to comply with the law. It is your duty as a healthcare interpreter. You cannot use the fee as an excuse…”  To make a long story short, these agencies are passing the ball to the interpreter through guilt trips and fear.

The good thing, dear colleagues, is that interpreters are not obligated to provide professional services under Title VI of the Civil Rights Act.  The fact that there may not be an interpreter to assist the patient may be something awful, but it is not your problem. Let me explain:

Title VI of the Civil Rights Act of 1964, 42 USC Section 200d et seq. prohibits discrimination on the basis of race, color, or national origin (including language, according to President Clinton’s Executive Order No. 13166, Aug. 11, 2000, 65 F.R. 50121) in any program or activity that receives federal funds or other form of federal financial assistance. The term “program or activity” and the term “program” mean all of the operations of a department, agency, special purpose district, or other instrumentality of a State or of a local government; or the entity of such State or local government that distributes such assistance and each such department or agency (and each other State or local government entity) to which the assistance is extended, in the case of assistance to a State or local government. It also includes colleges, universities, or a public system of higher education; and a corporation, partnership, or other private organization, or an entire sole proprietorship if assistance is extended to such corporation, partnership, private organization, or sole proprietorship as a whole, or if it is principally engaged in the business of providing health care, or social services.

Therefore, it is the hospital who has the obligation to provide the interpreter. Not you. In fact it is not the interpreting agency’s legal obligation either. Federal funds and other types of assistance are very important to hospitals and universities for research and other purposes. It is extremely unlikely that one of these institutions would risk losing those resources just because they are unwilling to pay the healthcare interpreter’s professional fee.

If the interpreter is contacted by an agency, it means that said company has a contractual relationship with the hospital or medical institution to provide interpreters in order to comply with the mandate of Title VI. The agency is getting paid by the hospital, but they now want to profit a little more at the expense of the interpreter. When an agency has this plan of action to be more profitable, they direct their agents to generate the highest profit possible. This is when they resort to despicable practices like the ones described above.

It is important that we as interpreters understand the law, and recognize these horrible practices. It is also essential that we take action in two different ways: (1) Always turn down these agencies, and (2) Let the hospital know that their contractor agency is jeopardizing the hospital’s Title VI compliance by scaring away the professional interpreters because of low interpreting fees and disgusting practices such as these guilt trips. I am sure that hospital administrators will put an end to this “activities” very quickly.

I now invite you to share with the rest of us any experiences like the ones above that you, or another colleague had with an agency, and what action you took to stop this from happening again.