ADVISORY COMMITTEE CHAIR PRESENTS AT TAHIT SYMPOSIUM

TAHIT Secretary and Chair of the Texas Advisory Committee on Healthcare Translators and Interpreters Qualifications, Mary Esther Diaz, presented an Update at the August 13th convening of the 4th Annual TAHIT Symposium on Language Access in Health Care. During Chairperson Diaz' Update, participants asked why the Texas Hospital Association is opposed to certification. As a follow-up, we would like to share a more detailed account of THA's testimony on this issue before the Advisory Committee in July 2010:

"The THA Board has a standing opposition to any further mandatory health care professional licensing and registration legislation.

Q. Why is there opposition on further licensure and registration?

A: It creates an artificial shortage of that category of allied health professionals and can affect the salary structure in an organization. THA supports the concept of access to interpreters and translators. The question arises over mandates."

Source: Meeting Minutes of July 16, 2010 meeting of the Advisory Committee on Qualifications for Health Care Translators and Interpreters. Testimony presented by Matthew Wall, Associate General Counsel, Texas Hospital Association.

To download a copy of Chairperson Diaz' presentation click here.

On the eve of the 3rd Annual TAHIT Symposium on Language Access, TAHIT Board Members were alerted that the hearing on HB 233 would be held on Tuesday, April 21, 2009. TAHIT Board Members had been preparing for months, selecting potential witnesses and preparing language access information packets to share with the Public Health Committee. Given such short notice, the Board moved to action quickly and did what was necessary to be available to support the bill. While the potential witnesses we had considered were not available, we were pleasantly surprised by the recent outreach of support from the Texas Society of Interpreters for the Deaf and the Texas Association for the Deaf both prior to and at the hearing.

HB 233, filed on November 14, 2008 by Rep. Eddie Rodriguez, would establish a multi-disciplinary advisory committee to recommend qualifications for interpreters and translators working in health care. A similar bill was filed in 2005 but died in committee after a long night waiting to testify.

On the day of the hearing, TAHIT members arrived promptly at 8:00 a.m. and diligently waited until 3:00 p.m. for their turn to testify.  After a brief introduction by Rep. Eddie Rodriguez, the Committee Chairperson, Rep. Lois Kolkhorst called Steve Baldwin, President of the Texas Association for the Deaf to testify first, which he did through an interpreter. Next up was Billy D. Collins, Jr. of the Texas Society of Interpreters for the Deaf. According to his biography on the TSID website, “Billy has worked in the field of deafness and management for both the state and in the private sector for over 20 years. He has been instrumental in getting legislation passed in the state of Texas in the areas of interpreting and services for individuals who are deaf and hard of hearing.” The testimony by Mr. Collins and his colleagues was effective in supporting the dire need for a bill like this. Consequently, the testimony seemed to strike a chord with the committee chair who has a family member who is deaf.

Esther Diaz was called next to testify for TAHIT and was able to build upon the foundation laid by the previous witnesses by explaining the historic and legal background for the bill. Mark Seeger, from Communication Services for the Deaf, spoke next in support of the bill. He underscored the need for specific training and qualifications for interpreters who work in the medical field. TAHIT founder, Tricia Yacovone, was called to testify last as a private citizen. To support her testimony, Tricia used parts of the presentation, “The Economics of Language Services” that TAHIT Director of Professional Development, Doug Green developed for the TAHIT Symposium. The committee members listened carefully and appeared to be impressed by all the data. Questions from the committee kept Tricia at the podium longer than any of the other speakers. Tricia was able to effectively address their questions and concerns. To listen to the testimony, click here (Click on 3:00 p.m. - 6:53 p.m. on April 21).
 
We also learned that several individuals and organizations—including Children's Medical Center, Children’s Hospital Association of Texas, Legal Community Health Services, Parkland Health and Hospital System, and the Texas Hospital Association (THA)—had registered positions in favor of the bill. We later learned that representatives from THA had visited with Erika Martinez from Rep. Rodriguez' office the day before to suggest changes to the bill. Esther and Tricia were able to meet THA representative, Jennifer Banda, shortly after the hearing.
 
The revised version of the bill was considered and favorably reported in the Committee on Friday, April 24, 2009. According to the website of the Texas Legislature, “After a bill has been reported favorably by a committee and the committee report has been printed, the bill is available for placement on a calendar. A calendar is a list of bills and resolutions that are scheduled to be considered by the full house or senate.” This proved to be a positive development for the future of the bill.

The substitute version of HB 233 became available on April 29, 2009 and can be viewed here. The suggested changes include incorporating language that would apply to both spoken and signed language interpreters as well as minor changes in wording of the training requirements and clarification on the differing qualifications of interpreters and translators.

On May 21, 2009, Director of Outreach, Doug Green, took the stand and delivered testimony to the Senate Committee on Health & Human Services. Doug's testimoy centered around the economic impact of using trained, qualified medical interpreters in health care. Doug's testimony can be viewed here.

After House Bill 233 was voted on in the Senate, it was signed into law on June 19, 2009 by Governor Rick Perry.

We’d like to thank TAHIT Secretary & Co-Founder, Esther Diaz who, besides attending the Public Health Committee hearing on such short notice, delivered language access information packets to each committee member late on Monday before the hearing. We’d also like to thank Doug Green and Tricia Yacovone for their unfaltering support of HB 233.

A BRIEF SUMMARY OF THE LIFE OF HOUSE BILL 1341

On February 22, 2005, Representative Mark Strama (D-Austin) filed HB 1341, which called for the establishment of an advisory committee on qualifications for health care interpreters and translators.  Within days, Representatives Rafael Anchia (D-Dallas) and Hubert Vo (D-Houston) also signed onto the bill.  After the first reading on the floor of the House, following protocol, the bill was sent to the House Public Health Committee, chaired by Rep. Dianne White-Delisi (R-Temple). 

HB 1341 languished there for weeks, although Rep. Strama had requested a hearing soon after the bill reached committee.  Rep. Delisi is the sole person responsible for deciding which bills will be heard by her committee, and she apparently didn’t see a need for HB 1341 to be considered.  So we took action.  After repeated phone calls and a letter-writing campaign* (and what I am sure was divine intervention), HB 1341 was heard in the Public Health Committee meeting on the last possible day for hearings…at 2 a.m.! 

Despite heroic efforts by TAHIT board member Ms. Esther Díaz, who had remained at the State House since 2 p.m. the previous afternoon—the appointed time for the hearing—and testified before a rather unwelcoming committee, the bill was tabled and eventually abandoned by the chair, who refused to call for a vote.  Because a vote was never called on the bill before the cutoff date—the date after which all bills “die”—HB 1341 perished at the hands of a power-wielding state representative (Delisi) with interests other than the provision of adequate language services to the LEP population of Texas

It should be underscored at this time that Texas LEP population stands at nearly one-third of the entire population of Texas according to the 2000 Census.  Thus, Rep. Delisi neglected the needs of nearly one-third of the state, simply by refusing to call for a vote.

On a brighter note, House Public Health committee member Rep. Jim McReynolds (D-Lufkin) argued brilliantly in favor of the bill, taking the place of Rep. Strama who had to leave the hearing at midnight.  Rep. McReynolds obviously had read the letters we sent to him, as he used phrases from those letters in his argument.  He even stated some personal experience which demonstrated the need for quality interpretation in the medical arena.* Past TAHIT Co-presidents Evelyn Ferrer and Tricia Yacovone wrote a letter on behalf of TAHIT stating our support for the bill.  We sent this letter out to all the members of the House and Public Health Committees, as well as the members of the Health and Human Services Committee.  A similar letter was sent to the same people from the Austin Area Translators and Interpreters Association, and Driscoll Children’s Hospital sent a letter of support for HB 1341 to Rep. Strama.

To obtain a copy of our latest legislative update, click here.

Lessons learned and strategies for the future

1. Find the right legislative backer. It helps to have as a sponsor for the bill someone who is enthusiastic about the bill AND a member of the Committee where the bill will be heard.  We will look to find those House and Senate members early on and get them thinking about this issue.
   
2. Have bipartisan, bicameral support.
   
3. File a companion bill in the other chamber as soon as possible.  We actually had received the support of Senator Rodney Ellis (D-Houston) for a companion bill in the Senate. 
4. Build support in the department of state government that will oversee the program.  After the restructuring of the entire Health and Human Services entity in Texas, there was little energy for a new initiative that would require some (even though minimal) reallocation of state resources. 
   
5. Minimize or eliminate the fiscal impact.  We actually learned this in time to do something about it!  Some modifications were made to the bill at the last minute in order to eliminate the use of state funds for travel by the Advisory Committee members to the meetings.  Consequently, there was no fiscal impact on the state’s treasury.
   
6. Build support for the next legislative session so that the acceptance of the bill will be smoother next time.  We are rather optimistic about this possibility, with the passage of SB 376 and its companion in the House—the hospital interpreter bill.  This provides an excellent opportunity for us to raise awareness about the use of qualified interpreters in healthcare.
   
7. Emphasize that program established by the Advisory Committee is voluntary on the part of the interpreters.
   
8. Identify local cases of undesirable consequences that occurred after the use of ad-hoc or untrained interpreters in the medical setting.