1. Health Care Interpreters : A Profession in the Making Shiva Bidar-Sielaff, MA Manager of Interpreter Services & Minority Community Relations- University of Wisconsin Hospital & Clinics Board Member, NCIHC Child Heath Services Research Meeting June 2005

2. The National Council on Interpreting in Health Care (NCIHC) 1994 - informal working group 1998 - formally established Multidisciplinary membership: medical interpreters interpreter service coordinators and trainers clinicians policymakers advocates researchers Mission: to promote culturally competent professional health care interpreting as a means to support equal access to health services for individuals with limited English proficiency Website: www.ncihc.org

3. Building a Profession Create and build support for a single Code of Ethics that will guide the practice of interpreters working in health care venues Develop a nationally accepted, unified set of Standards of Practice based on the Code of Ethics that will define competent practice in the field Develop standards for health care interpreter training Possibly create a national certification process that will set a standard for qualification as a professional health care interpreter (needs to be further discussed by profession and NCIHC)

4. The National Code of Ethics for Interpreters in Health Care (published in 2004) Code of ethics based on a national consensus building process (focus groups/survey) Final draft was also reviewed by a select number of health care providers and medical ethicists Companion document was created that offers a more thorough discussion of the issues raised places the code in the context of ethical behavior in general provides an elaboration and discussion of each principle and the interrelationships among them, acknowledging that controversies still exist while offering the working interpreter a way to think about these controversies

5. National Code of Ethics for Interpreters in Health Care The role of interpreter is atightrope balancing act: A code of ethics is a good guide for the bar carried on such a walk on the tightrope. It offers balance, some security and especially is a comfortable way to face the unknown risks faced on the interpreters path. Anonymous Respondent to Code of Ethics Survey

6. Core Values Support health and well-being of patient and do no harm Remain faithful to original message Take into consideration culture and cultural differences to ensure understanding

7. National Standards of Practice for Interpreters in Health Care Project Co-funded by The Commonwealth Fund and The California Endowment Project Directors: Shiva Bidar-Sielaff & Karin Ruschke Project Committee: NCIHC Standards, Training & Certification Committee Target date of completion – June 2005

8. Goal To define competent practices in the field To lead to more professional interpreting, resulting in clearer communication and better outcomes in health care To lead to standards for health care interpreter training To lay the foundation for a possible national certification process that will set a standard for qualification as a professional health care interpreter

9. Initial Efforts in This Area The Massachusetts Medical Interpreter Association, 1995. Reflected initial thinking; included feedback from national leaders in the field at the time it was created. Minnesota, 1999. Standards developed by a committee without much input from the field; not widely acknowledged. The California Healthcare Interpreter Association, 2001. Most recent document; only includes thinking of California. = > Learnings from these efforts are an integral part of the NCIHC Project

10. Creating National Standards of Practice for Interpreters in Health Care Conducted an environmental scan Conducted a series of seven targeted focus groups across the country Analyzed the focus group and environmental scan results and draft the standards document Presented draft standards document for national feedback Finalize, publish and distribute the standards document (in progress)

11. Over 23 regional interpreter association in the US Increasing number of hospital/clinics with staff interpreters and coordinated language access programs Increasing number of agencies/companies offering medical interpreter services Increased availability of interpreter training programs

12. Resources NCIHC www.ncihc.orgwww.ncihc.org Resources for Cross Cultural Health Care www.diversityrx.org www.diversityrx.org Massachusetts Medical Interpreters Association www.mmia.orgwww.mmia.org