1. Using Interpreter Services For Nurse Delegation

2. 2 Using Interpreter Services Why would a delegating nurse need an interpreter? Client does not speak English Client speaks English as a second language Client is unable to speak or to hear Clients authorized representative does not speak/understand English

3. 3 Using Interpreter Services Interpreter service for nurse delegators is limited to use for ADSA clients Not to be used for caregivers* Not available for private clients If an agency you currently work with provides interpreterssign language interpretation, for examplecontinue to use those interpreters * Except deaf caregivers per ADA

4. 4 Using Interpreter Services Why clients may need interpreters To understand the ND process To sign the consent for the ND process To interact when the delegating nurse does the physical exam (may not be necessary every 90 days)

5. 5 Using Interpreter Services When clients may need interpreters An ADSA client requests one RND requests one Necessary for client to receive services Available to client only, not for client caregivers interaction (except deaf caregivers per ADA)

6. 6 Using Interpreter Services Who will pay for interpreter services? ADSA Headquarters

7. 7 Using Interpreter Services What different kinds of interpreter services are available? AND How does a nurse delegator access an interpreter?

8. 8 Types of Interpreter Service 1. Telephonic interpreter service 2. Written translation 3. Spoken language face-to-face 4. Sign language interpretation

9. 9 1. Telephonic Like 3-way conference call Used to set up an appointment Used to get verbal consent For deaf, deaf/blind or HOH client, TTY Relay may be used, if client has a TTY machine

10. 10 To Access Telephonic Interpreters Call Language Line Services directly at 1-877-261-6608 with this information Client ID # Language needed Organization Personal Code

11. 11 To Access Telephonic Interpreters

12. 12 To Access Telephonic Interpreters Send the completed form by fax, email or regular mail to: Patty McDonald, LEP Coordinator ADSA Headquarters, PO Box 45600 Olympia WA 98504-5600 Email: mcdonpm@dshs.wa.govmcdonpm@dshs.wa.gov Fax: 360/438-8633

13. 13 To Access Telephonic Interpreters Demo Language Line service number 1-800-996-8808

14. 14 2. Written Translations ND Consent form has been translated Languages available on DSHS Forms include Cambodian Russian SomaliSpanish VietnameseChinese KoreanLaotian

15. 15 2. Written Translations Translated forms may be found at http://www1.dshs.wa.gov/msa/Forms/eform s.html Use the control button, and hit F Type in form #13-678. Select the appropriate translated form.

16. 16 Written Translations For other language translations, Contact Patty McDonald at mcdonpm@dshs.wa.gov mcdonpm@dshs.wa.gov Allow 2 weeks Check DSHS Forms website periodically at the address on slide 15

17. 17 3. Face to Face Interpreters Nurse delegator, client and interpreter are all present An interpreter speaks clients primary language RND speaks English to the client Interpreter translates English into clients language and vice versa

18. 18 To Access Face to Face Interpreters Brokers are contracted with DSHS Select a broker/vendor that serves your clients county Request an interpreter who speaks clients primary language The broker will find an interpreter for you

19. 19 To Find A Contracted Broker/Vendor Go to: http://fortress.wa.gov/dshs/maa/Interpret erServices/SpokenLanguageVendor.htm http://fortress.wa.gov/dshs/maa/Interpret erServices/SpokenLanguageVendor.htm Or consult the Word document handout Spoken Language Providers in the pink packet.

20. 20 Setting Up An Appointment Call a broker/vendor in the correct county to facilitate RND 3-day response time Identify yourself Fax the brokers request form (each uses a different formpink packet handout)

21. 21 Setting Up An Appointment Indicate specific language needed Tell broker your name, phone. Client name, address, length of visit Contact an ND Program Manager for the correct payment codes

22. 22 Face to Face Interpreters Be prepared with alternate dates Interpreters should be available within 2 weeks Let Case Manager know if availability of interpreters will delay the start of delegation

23. 23 Face to Face Interpreters At the visit, sign interpreter paperwork that validates amount of time interpreter provided service Keep a copy, and send a copy of the signed paperwork to Patty McDonald, PO Box 45600, Olympia WA 98504-5600

24. 24 Face to Face Interpreters ADSA will be billed directly, but your paperwork helps determine which client received services, and for how long. If you have concerns about the interpreter, complete the Interpreter Brokerage Complaint form and send to Patty McDonald, ADSA LEP Coordinator, mcdonpm@dshs.wa.gov, FAX 360/438-8633. mcdonpm@dshs.wa.gov

25. 25 Interpreter Brokerage Complaint Form

26. 26 4. Interpreters for Deaf/HOH Clients who are deaf/HOH may use a variety of ways to communicate. Their manner of communication should be reflected on the referral form you receive from the case manager. TTYtext-telephone or teletypewriter Text messaging per cell phone Email OR Sign Language or tectile interpretation

27. 27 Interpreters for Deaf/HOH--TTY TTY is specialized telephone equipment If both the client and the speaker have access to a TTY, they type questions and answers to each other. If one party does not have a TTY, you can use the Washington Relay Service.

28. 28 Interpreters for Deaf/HOH WA Relay Service WA Relay Service is a three-way process that allows communication between a client using a TTY, a caller (the RND) without a TTY, and a third party, the Communication Assistant (CA) The CA dials the number the RND requests and relays a conversation between the two callers There is no charge for using WA Relay Services in the United States

29. 29 Interpreters for Deaf/HOH To Access WA Relay Service Dial 711 to connect with a CA Give the CA the clients name and phone number Speak slowly and clearly to allow time for the CA to relay the conversation If you have problems connecting, or need more information, go to http://www.washingtonrelay.com/

30. 30 Deaf/HOH ClientsUsing text Text messaging or email RND must have access to either text messaging or email in order to communicate with client in this manner If you are unable to access the mode of communication used by the client, contact the clients case manager

31. 31 Deaf/HOH Clients Using Sign Language There are several types of sign languagethe referral from the case manager will indicate which type of sign language the client uses. These might include American Sign Language (ASL) or pidgin signed English. If the client is Deaf/Blind they may use a tactile interpreter.

32. 32 To Access Sign Language Interpreters Check the Sign Language Interpreter Service website at http://www1.dshs.wa.gov/hrsa/odhh/interpcon. shtml At the website, scroll to the region map Select your region; double click on map Find the contact information for the listed interpreters by scrolling down through the list

33. 33 To Access Sign Language Interpreters

34. 34 To Access Sign Language Interpreters Print and complete the Request for Sign Language Interpreter form DSHS 17- 123A (5/2007) Find the form on the DSHS Forms website http://asd.dshs.wa.gov/forms/word forms/word/17_123a.doc http://asd.dshs.wa.gov/forms/word forms/word/17_123a.doc

35. 35 Deaf/HOH Clients using Sign Language Consult the instruction page attached to the form. You may have questions about some of the fields in specific sections The requestor section refers to the nurse delegator In field 5, list Nurse delegator with state ND program at ADSA HQ In field 6, enter Patty McDonald, PO Box 45600, Olympia WA 98504-5600

36. 36 Deaf/HOH Clients using Sign Language In the appointment section Field 8 refers to the clients ACES ID which you receive from the C/RM Field 9, specify the type of sign language the client uses, which is indicated on the CM referral form Field 10, specify long term care appointment

37. 37 Deaf/HOH Clients using Sign Language The bill goes directly to Patty McDonald at ADSA HQ PO Box 45600, Olympia WA 98504-5600

38. 38 TIPS for WORKING WITH Spoken and Sign Language Interpreters Patty McDonald, Program Manager 360/725-2559

39. 39 TIPS for WORKING WITH Sign Language Interpreters Trained professional Code of ethics Includes strict confidentiality

40. 40 Code of Ethics for Sign Language Interpreters Accuracy Cultural Sensitivity Confidentiality Disclosure Proficiency Compensation Non-discrimination

41. 41 Code of ethics -- continued Self-evaluation Impartiality Professional Scope of practice Reporting obstacles Ethical violations Prof development

42. 42 Before the interviewspoken language When requesting an interpreter, RND should consider Gender Age Social/ethnic issues Dialects Family/social ties

43. 43 Before the interview RND/interpreter should Establish rapport Learn to pronounce the clients name Establish culturally sensitive protocols around communicationeye contact, etc Discuss non-verbal cues Discuss technical terms, forms to sign Wait till delegating nurse arrives to go inside

44. 44 During the interview Introduce self and interpreter Ground rules for using interpreter Everything RND and client says will be interpreted Reinforce with client that conversation is confidential

45. 45 During the interview Ask if client has questions about interpreting process Speak TO the client, not the interpreter Speak slower, not louder Do not leave the client and the interpreter alone together

46. 46 After the interview Discuss impressions about success or problems with the process Thank the interpreter

47. 47 Tips for Working with Sign Language Interpreters Ask client for any interpreter preferences Speak in a normal tone and speed Use first and second person, not third person YES--I would like to explain the Nurse Delegation process to you, and ask you to sign the consent NOI will explain the ND process to him and ask him to sign a consent form

48. 48 Tips for Working with Sign Language Interpreters Interpreter should sit next to the speaker; then the client can watch both in the same field of vision Allow for lag time between asking a question and waiting for the clients response For meetings longer than 1 ½ hours, two interpreters are required to rotate

49. 49 Tips for Working with Sign Language Interpreters Check with the client afterward to see if the interpreter service was satisfactory

50. 50 Spoken Language Providers specific request forms Review of the pink packet Listing by county of spoken language providers Review of individual broker/vendor request forms

51. 51 List of Spoken Language Providers Must use specific form for each broker/vendor Where to find the specific form

52. 52 Using Interpreter Services With the availability of interpreter services for non-English speaking and deaf or hard of hearing clients, the RND now has additional support to provide ND services to this population

53. 53 Using Interpreter Services For questions, contact one of your Nurse Delegation Program Managers: Doris Barret, 360/725-2553 Kay Sievers, 360/651-6828 Anne Vander Beek, 360/651-2558 OR Patty McDonald, LEP Program Coordinator 360/725-2559