Maria Stewart has worked as an interpreter since 2011, but as of late, bridging communication between Limited English Proficiency (LEP) patients and their health-care providers has become a difficult profession.
Stewart said she hasn’t been paid since the end of June. She’s recently divorced, and was starting the process of getting her own place. Now, she’s supposed to move next month into an apartment she can’t currently afford.
“I’m desperate. I don’t know what to do anymore,” Stewart said.
Stewart is just one of many interpreters struggling to make ends meet since the Washington State Health Care Authority (HCA) put its interpretation services contract up for re-bid, according to Interpreters United Local 1671 President Leroy Mould.
Interpreters United Local 1671 is a union of freelance interpreters the state contracts with to provide language interpreting services to Medicaid and DSHS patients. On its website, Interpreters United said its movement began in 2009 as a result of “medical and social service spoken language interpreters’ frustration with the ‘broker system’ delivery model, unfair treatment and substandard pay.” The union has more than 1,500 active members.
In 2011, the DSHS certified Interpreters and the state of Washington agreed on their first union contract. One of the issues addressed by the current contract, which lasts until June 30, 2019, is pay. Starting July 1, interpreters covered under the agreement are to be paid $39.76 an hour for in-person interpreting appointments facilitated by HCA.
The HCA also contracts with a vendor to cover administrative duties for interpreter service appointments and payments through an online portal. Starting in 2012, that vendor had been Language Link, but in December 2017, HCA put its contract up for re-bid.
Through a scoring process, HCA determined a new winner for its contract: Universal Language Services (ULS). ULS took over HCA’s interpretation services as of July 1.
Mould, who is an interpreter himself, said that’s when everything started to go downhill.
“Universal was not ready in the least.” Mould said. “They were were not ready even — for anything whatsoever.”
Since ULS took over, Mould said many health-care providers haven’t been registered as approved “requesters” of language services. Without that distinction, providers’ requests for HCA-certified interpreters have to list jobs as private interpretation assignments, which means health-care providers have to pay out of pocket for interpretation services, and interpreters who work the jobs take a nearly $15-per-hour pay cut, Mould said.
But that’s assuming that interpreters are able to view the jobs on the online portal.
“There are a lot of jobs that are not filled, because one, interpreters aren’t (able) to see the job to accept it, and two, providers aren’t (able) to get into the system,” Mould said.
Mould said interpreters want the state to go back to using Language Link.
“I understand honoring a contract, but Universal was not ready from day one, and that’s not honoring a contract either,” Mould said.
“We’re pushing HCA — we want some accountability from them, rather than just getting excuses,” he said. “We want it to go back (to Language Link).”
But according to Suzy Redfern, who works as the Chief Quality Officer at ULS, a lot of the issues interpreters are facing comes down to a learning curve. Redfern said that ULS’s system is different from the previous vendor’s, and many of the issues raised will been solved as interpreters and health care providers familiarize themselves with the new system.
“It’s just the natural things that come up from one person, or vendor, or company (to the next),” Redfern said.
Redfern said the first payment to interpreters isn’t due until August. And many providers weren’t in ULS’s system because they hadn’t re-registered themselves, an action required by the change in vendor.
“We know it wasn’t as smooth of a transition as we would of liked,” Redfern said.
Preston Cody, assistant director of Medicaid program operations and integrity at HCA, said that while the state could chose to go back to Language Link, there would be consequences. For example, Cody said it would be difficult to reintegrate into a new system the 18,000 jobs listed in the online portal for July 24 and beyond.
So instead, the state is focused on fixing some of the issues brought up by Interpreters United.
“I would say that we’ve been very responsive,” Cody said.
In a document sent to The Olympian, Interpreters United compiled a list of issues sparked by HCA’s transition to ULS. Among its concerns are ULS’s interface making it difficult to distinguish between private sector jobs and union ones, and jobs disappearing from the online portal.
Interpreters United said that in the first week ULS was in charge, requests for interpretation services on the online portal went from 9,500 to 1,000.
Mould said there is another party harmed by this confusion: patients with limited English who need of interpretation services.
“In a lot of those cases, patients are not going to have interpreters because clinics can’t afford them,” Mould said.
Interpreters United and HCA met July 16 after a group of Interpreters United Local 1671 members marched from the Insurance Building on the Capitol Campus to the Washington State Health Care Authority (HCA) offices on Cherry Street. They also met on July 26.
Mould said interpreters had the chance to make their situation known, HCA not canceling ULS’s contract is like trying to remedy complicated issues “with a Band Aid.”
“They’re (HCA) still stuck on the mindset of staying with a system that is not ready and is not working,” Mould said.