How to Budget for Translation in a Small Healthcare Setting

Budgeting for translation and interpretation is tough. It depends on your needs, the people you serve, the complexity of the communications you translate or interpret and other factors. But, if you’re in the United States, here are some general guidelines to get you started.

A few years ago Mara Youdelman of the National Language Access Advocacy Project and Diane M. Carr of Health Net of California were the experts on an informative Polyglot Webinar called “Funding Sources and Strategies for Languages Services”.

Mara mentioned Medicaid and CHIP, two state and federal joint partnerships that can help pay for some interpreter services. Medicaid will reimburse based on four models: contract with language service agencies, reimburse providers, reimburse the healthcare provider or provide access to a language line. This varies greatly by state. Mara also said that if your insurance is through a managed care plan you may have some language interpretation services available free of charge.

In California the state law requires language services to be provided by health insurance companies and their plans. Other states seem to be moving in this direction. The California law applies to all HMOs, PPOs, POSA, Medicare Supplemental, Healthy Families, SCHIP, AIM and Healthy Kids. It does not apply to Medicare or Medicaid. The language access services that are free to the healthcare consumer are an interpreter at medical points of contact, translation of some printed materials, and oral translation of vital documents

Why Language Services Is Critical For Healthcare

What’s the business case for providing language services throughout the healthcare system? Let us count some of the reasons:

1. It’s part of the cost of doing business in a multilingual state
2. it keeps healthcare accessible as part of an efficient healthcare system
3. Language services improve communication between the health plan and the insureds
4. Language services improve communication between physicians, the healthcare provider and the patient

Controlling Your Language Services Budget

Controlling the language services budget, like any other budgetary item, is all about planning and being prepared. Here are some basic guidelines on how to budget and how to control your budget in a healthcare institution:

1. Designate a staff member to coordinate all language services activities. With one person in charge you can capture the entire picture on expenditures and needs.
2. Have tracking mechanisms. Many hospitals introduce language access as soon as a patient enters the facility. Posters or cards in waiting areas announce the availability of interpreters. The first healthcare staff member who speaks with the person should ask a standard question or two about their native language. If the facility mainly serves a Spanish-speaking population, consider asking questions like: “Are you most comfortable having us communicate with you in Spanish?” and/or “What language are you most comfortable speaking in?”
3. Review the number and percentage of people on staff who are bilingual. Is the current staff able to handle any language issues as they arise? If not, where do the language services fall short and how can you best correct that shortfall? Do you have language services companies that you can quickly and easily reach for help?
4. Interview 2-4 local language service providers. Ask them to educate you more on the language needs of the local communities and the language service issues they see. They may be able to share some statewide or national budgetary numbers for institutions like yours. Be specific with them. Have a list of typical scenarios in which you may have to call on them and ask them what the charge would be.
5. Talk to people you know at other local healthcare facilities. See if they’re willing to share with you how they budget and what they budget for language services. Ask them what they’ve learned over the years about the best way to provide language services.
6. Consider whether you need to add a dedicated interpreter to your staff.
7. Research technology options. What software might aid you in providing better language services? Some hospitals offer telephone language lines so they always have access to interpreters over the phone. Video remote interpreting (VRI) is another of the many technology options. Technology can increase your language services while keeping your budget lower.
8. Utilize any bilingual staff members you already have working in your office. Be sure to test their language proficiency before asking them to perform any daily tasks in a language besides English. Being bilingual does not mean you are qualified to be an interpreter and how are you supposed to know they are qualified to give care in a different language just because they can have conversations that said language?

Utilizing bilingual staff members is one of the best ways to lower your language service costs. However, you want to ensure that they are properly prepared and trained! Click here to download our FREE guide on how to use bilingual employees to increase the quality of patient care.