Accommodations in the Classroom: Not Just an Issue for People with Disabilities

Every day we accommodate for our own incapacities. We also manage to accommodate for the incapacities of others. I was reminded of this when I came cross this email from a middle school principal to the parents of enrolled students.

Accommodations Letter from Principal

What I found ironic is that the email itself did not address the fact that there is a student among the 12 – 13 year olds who is blind. The principal’s concern was focused on the other students and the parents of the other students — allergies and fears of animals.

I applaud the comprehensive concern and was so intrigued by it that I decided to look at accommodations in the classroom not from the student’s with disability perspective but from the students and faculty who learn, teach and live around him and how together, we can all create environments where students thrive.

Three Critical Success Factors for Accommodations in the Classroom

When we compared our own experiences at NWI Global with research of attitudes in the classroom, readiness by school administration, and compliance to laws, we found there to be three factors that play into the successes of schools enrolling students with disabilities.

1. Process: Being Prepared for Enrolling Students with Disabilities

The email from the middle school principal was sent in August. This particular middle school is located in Northern Virginia — an area known to welcome military families frequently throughout the school year. I’m not making the assumption that this student is military but I am drawing the comparison to the unforeseen reasons why any school, K-12 or higher education, needs to be ready to manage the accommodations of students with disabilities.

In fact, in the United States and in accordance with Title III of the ADA and Section 504 of the Rehabilitation Act, public and private schools and colleges & universities must provide an equal opportunity to students with disabilities, so they can participate in and benefit fully from school services and classroom instruction. This is not an option, but that doesn’t mean it’s happening in all educational instructions throughout the country.

A proactive process for handling accommodations in the classroom will inevitably make relationships between peers, between student and faculty, and between school and parent a much smoother and more productive experience.

2. Culture: Attitudes Surrounding Accommodations in the Classroom

A program for managing accommodations is one that can be and should be replicated and the repetition will help to build greater understanding, tolerance, and cooperation among all of the stakeholder groups comprising an educational institution. These characteristics and attitudes will build a culture that is supportive of diversity and disability.

Despite the fact that accommodations are beneficial to the wellbeing of students with disabilities and their success in the classroom, a recent Rowan University study found that a significant number of students at the college and university level may not avail themselves to accommodation services.

The study found that one of the factors that may influence the decision of college students with disabilities to request or avoid accommodations is the attitudes of surrounding students and faculty; hence, researchers have strongly suggested that ensuring a more tolerate and accepting culture for diversity, including disability, will in turn create more positive attitudes towards requesting accommodations for students with disabilities and help to make their educational experiences successful ones.

3. Compliance: Defining Accommodations and Requirements

The aforementioned study of attitudes toward accommodations in the classroom, surveyed its respondents to understand the types of accommodations that they were requesting or in some cases availing due to the tenuous culture.

Below is a chart of responses:

Accommodations Survey

From our own experiences, we can add translation and interpretation services for the non-English speaking, Deaf, and hard of hearing communities which can come in the form of spoken and sign language interpreters, remote captioning (CART), and other technologies to assist in the communication translation/interpretation process.

Service Dog

No matter what the specific accommodation, whether digital book or a Golden-doodle, the Americans with Disabilities Act (ADA) requires businesses, services providers, and schools, colleges & universities to provide equal opportunity to persons with disabilities.

Further, any of these types of organizations receiving federal financial assistance in the form of grants, tax payer funded programs and/or student tuition assistance must be ready to offer necessary accommodations to any student who is requesting and who shows need.

Creating Success for Schools and All Students

For more information on how you can create successful environments where accommodations come into play, we suggest you contact NWI Global to review your current state and how we can help you prepare a proactive process for future enrollment of students with disabilities, to share experiences about creating positive attitudes around accommodations, and to ensure that your school is compliance with ADA and Section 504 requirements.

Additionally, here are some links to resources that you may find useful and/or were referenced in this article:

Need assistance with language access services in classroom settings?

Let’s discuss your specific needs. Contact us.

Sign Language Interpreting, ADA and Section 504 Compliance Explained

Providing Accommodations for the Deaf and Hard of Hearing Individuals in Educational Settings

Imagine going through life without the ability to fully hear what’s going on around you. This would certainly impact your communication with others around you in both personal and professional life.

For a person who can speak and hear, it’s just a matter of talking and listening. Both are fairly mundane and repetitive tasks that we don’t think twice about.

For a Deaf or hard of hearing person, it’s a hurdle that must be overcome on a daily basis especially when communicating with someone who can hear.

Thankfully, unlike in many other parts of the world, the U.S. laws offer protections to persons with disabilities. It is up to the educational institutions to comply with those laws.

Laws Applicable to Educational Institutions

Whether it’s a private or state-funded educational institution, the following laws may apply and have to be complied with.

1. Americans with Disabilities Act (ADA)

According to the Title III of the ADA, businesses and services providers (including private trade schools, colleges & universities), must provide an equal opportunity to persons with disabilities, so they can participate in and benefit from their services.

Similar to the above, Title II of the ADA applies to state and local government agencies (including public trade schools, colleges & universities).

2. Rehabilitation Act of 1973

Section 504 of the Rehabilitation Act requires public and private entities that are recipients of federal financial assistance to ensure effective communication with people who are Deaf and hard of hearing.

Federal financial assistance includes grants, tax payer funded programs and student tuition assistance (FAFSA).

Complying with the Laws

While compliance may seem fairly straight forward, it is not always easy to implement.

One of the easiest ways to comply with both the ADA and Section 504 is by providing appropriate auxiliary aids and services to the Deaf and hard of hearing students, such as qualified sign language interpreters.

Sign language interpreters will help to ensure effective communication between all parties involved.

Working with Sign Language Interpreters

There are four ways you can work sign language interpreters.

1. Hire Individual Interpreters as Employees

Recommended for single campus schools that have an ongoing need to communicate with Deaf and hard of hearing students. One of the benefits of going this route is that the interpreters are your employees and are available for continuous work.

Of course, if you don’t have any Deaf students at any given time, you are still paying the interpreters for idle time. Something to think about when you prepare your annual budget.

2. Contract with Individual Interpreters on a Freelance Basis

Recommended for single or multi-campus schools. Having the ability to contract with individual interpreters to supplement a pool of employed interpreters is highly recommended.

This approach will fill the gap in the event your employed interpreters are unavailable for whatever reason.

Contracted interpreters generally bill out at a higher rate, but you are not committed to them as you would be to employed interpreters. So, the overall impact on your budget is less in the long run.

3. Contract with Language Service Companies

Recommended for multi-campus schools located around the United States. Contracting with language service companies will simplify your scheduling processes and other logistics.

It is important that you find a company that can handle nationwide service delivery with quality and consistency. This will save you time and money, while meeting all of the necessary compliance requirements.

Learn how to request an interpreter from a language service company here.

4. All of the above

Why not have options?

Having interpreters on staff and contract basis, as well as a pool of language service companies, will surely help you cover all the bases.

However, from a management and budgetary perspective it could be a bit cumbersome.

Going this route is recommended for large educational institutions.

What Happens if You Don’t Comply

If you are not currently in compliance with the ADA and Section 504, I recommend you adjust your organizational processes immediately. Some of the concerns you should think about include federal audits, suspensions from federally funded programs, fines, penalties and discrimination law suits.

Thinking proactively and focusing on compliance now will save you money in the long run.

Recently, a Deaf man sued a Washington state-based university for discrimination. His claim was that the school refused to allow him to study medicine because he is Deaf.

Even though the university involved in this case claims that it does not discriminate against Deaf people, the fact that the law suit was filed alleging discrimination is already detrimental to its operations.

I believe the law suit could’ve been avoided entirely if the university fully complied with the ADA and Section 504 requirements.

Steps toward Compliance and Improved Organizational Processes

I recommend assessing your existing ADA and Section 504 compliance processes. You are most likely already compliant, but there’s always room for improvement.

One of the areas you should focus on is your current sign language interpreting process. If you employ in-house interpreters, that’s terrific.

But what if one of those interpreters gets sick, can’t make it to work or goes on maternity leave?

These are the kinds of things you should be thinking about. Having a contract with a language service company would help you mitigate that.

Overall, your focus should be on your students and making sure they have access to effective communication, regardless of whether they can hear or not.

More Information on Compliance

Here is list of some great resources on ADA and Section 504 compliance:

You can also download this article in PDF format. Click here to download.

Feel free to share your thoughts on this topic in the comments.

Need assistance with ADA and Section 504 compliance?

Let’s discuss your specific needs.

Contact us to get started.

The ACA Section 1557 Checklist for a Busy Professional

The October 17, 2016 compliance deadline has come and gone.

If you work for a covered entity under Section 1557 of the Patient Protection and Affordable Care Act, being compliant with this law is a must.

The good news is that compliance doesn’t have to be difficult or costly. In reality, it will most likely be more costly in the long run if you fail to comply.

So, what exactly is Section 1557 and how do you ensure compliance?

Being a busy healthcare professional, you don’t have time to waste. To save you time, I’ve put together the following checklist on Section 1557.

1. Is my organization a covered entity?

Start off by determining if this law is applicable to you and your organization. Section 1557 extends non-discrimination protections to individuals participating in any health program or activity receiving funding from U.S. Department of Health and Human Services (HHS).

If you’re not a covered entity, skip the rest of this article. If you are, check this item off and continue reading!

Checklist Item

I work for a healthcare organization or a health insurance marketplace that has a health program or activity which receives funding from HHS.

2. Does my organization currently provide language access services?

How are you currently communicating with your limited-English proficient (LEP) patients?

I bet you already work with an interpreter referral agency or employ interpreters directly. But did you know that language access services also includes written translations of medical documents?

If you are not providing written and spoken language access services, find a reputable interpreter referral agency and/or a translation services provider and contract with them as soon as possible!

The last thing you want to do is have a patient’s relative or a bilingual employee do the interpreting or send a patient home with post-op instructions they don’t understand.

Checklist Item

My organization provides written translated materials and employs professional interpreters and/or contracts with interpreter referral agencies.

3. Do our patients know that language access services are available to them at no cost?

Healthcare organizations must provide LEP patients with qualified interpreters and cannot charge the patients for provision of such services.

The final rule of Section 1557 requires that covered entities post notices of nondiscrimination and taglines that alert individuals with limited English proficiency to the availability of language assistance services. You can view sample notices here.

To customize such notices, reach out to your translation services provider or contact us for assistance.

Checklist Item

My organization communicates to its patients about language access services being available to them at no cost.

4. What are the top 15 languages in our area?

This will depend on the state you’re located in. For example, here are the top 15 languages for Oregon and Washington as of August 2016.

Top 15 Languages in Oregon

RankLanguage
1Spanish
2Vietnamese
3Chinese
4Russian
5Korean
6Ukrainian
7Japanese
8Arabic
9Romanian
10Cambodian (Khmer)
11Cushite (Oromo & Somali)
12German
13Farsi (Persian)
14French
15Thai

Top 15 Languages in Washington

RankLanguage
1Spanish
2Chinese
3Vietnamese
4Korean
5Russian
6Tagalog
7Ukrainian
8Cambodian (Khmer)
9Japanese
10Amharic
11Cushite (Oromo & Somali)
12Arabic
13Punjabi
14German
15Laotian

For a complete listing of the top 15 languages in your area, visit this page.

Checklist Item

My organization knows the top 15 languages in our area and makes written and oral communication available in those languages.

5. Does my organization have a formal Language Access Plan?

To get your Section 1557 compliance under control, HHS recommends you develop a formal Language Access Plan.

If you don’t have a formal Language Access Plan in place, don’t worry. By providing language translation and interpreting services, you are closer to being compliant.

However, to survive an HHS audit, you may consider putting a plan in place sooner than later.

Work with your language services provider or reach out to us for assistance with your Language Access Plan.

Checklist Item

My organization has a formal Language Access Plan in place and we feel confident about it.

6. We feel confident that our organization is in compliance with Section 1557.

If you do, fantastic! If not, I recommend having your in-house compliance team or legal counsel review your processes to confirm.

If you find that you are lacking in some areas related to this law, it’s never too late to implement changes and improve your business practices.

Checklist Item

My organization had its Section 1557 compliance processes reviewed by a compliance officer and legal counsel.

Conclusion

Section 1557 compliance seems like a daunting task, and it can be if you don’t feel confident in your processes. This checklist will help you get on the right track.

Here are some additional resources to help you, but may take a while to read:

If you have any questions about this topic, feel free to ask in the comments or reach out to me directly.

How Visual Design Plays a Role in eLearning Localization

A Roadmap for Instructional Designers

Earlier this month I attended and participated in the Learning Solutions Conference & Expo in Orlando.

Even though I was there on behalf of NWI Global, exhibiting at the expo, I couldn’t pass up the opportunity to learn something new. It was a great place to learn, with so many training and eLearning professionals sharing ideas.

One of the topics that intrigued me in particular was a Crash Course in Visual Design, presented by an industry expert, Connie Malamed.

A Crash Course in Visual Design

Visual design is a fundamental part of eLearning and has a direct effect on how the audience will accept the course content.

But as an instructional designer, you already knew that, right?

My goal is to teach you something new in this article, so you can feel more confident in your design process for multicultural audience. Specifically, I will show you how visual design plays a role in eLearning localization.

The Purpose of Visual Design

According to the Social Science Research Network, 65% of people are visual learners. That means more than half of your organization’s customers and employees prefer visual content over other media.

Visual design will be integrated in your eLearning content and the main purpose behind it is to make things easy to understand for your audience. That will lead to increased knowledge acquisition and retention rates.

Make things less confusing

If you are a global organization, your customers and employees may not necessarily speak English. To further increase knowledge acquisition and retention rates for those customers and employees, you need to deliver your eLearning content localized for the target audience.

Where Do I Start?

Plan ahead.

I know what you’re thinking… boring!

And I agree with you. Sometimes I just want to do and not plan.

You have these great ideas and are ready to put them in practice.

There are even awesome Captivate and Storyline templates you can download to get things done more efficiently.  And you believe you are ready to localize your English training content into other languages.

Why not get things started now?

Planning is a good thing

“Can’t you just translate this quickly for me?” is the question that you are ready to ask your translation vendor and get the project over with.

After all, planning is a boring task at times. Visual design is fun.

But to make your training course successful, I urge you to consider planning as the first step.

You may end up having to go back to the drawing board with your English content to make it localization-friendly, but it will be worth it.

Here are some sample questions to ask your stakeholders during the planning stage:

  • Are we trying to reach a broader eLearning audience?
  • Are we positioning our brand for global success?
  • How do we ensure consistent and reliable results from our training content?
  • Do we need to make our content accessible for the Deaf and hard of hearing individuals?
  • Have we researched the cultural background of our target audience?
  • Are we targeting global in-country markets or are we focusing on the U.S.-based LEP (limited-English proficient) population?
  • What is the reading level of our target audience?

The questions above will help you get in the right frame of mind when planning for localized eLearning content.

Not only will a solid eLearning localization plan help set your audience up for success, it will also save your company money.

Don’t be an organization that never has the time or money to do it right the first time, but always has the time and money to do it over and over again.

Plan and do it right the first time.

Components of Visual Design

Now that you have a plan in place for localizing your eLearning content, let’s take a look at some of the components of visual design.

It’s important that you think about these components as you design your source materials in English before having your translation vendor start on the localization process.

1. Images, Graphics & Photos

Pay attention to cultural relevancy of images, graphics and photos. What’s considered appropriate in the United States, may come off as offensive in other countries.

Localizing text during the translation process is a standard process. Localizing images, graphics & photos is often overlooked. Your translation vendor may be able to help with this aspect if you don’t know where to start.

Photographer in action

If your audience is factory workers in Mexico, I’d consider using actual photos of factory workers in Mexico in the visual design of the scenario. The workers will then be able to relate to the content more, because they can now visualize themselves in that scenario.

Some cultural imagery considerations include body positions, social contexts, symbols and aesthetics.

Another aspect to consider is how the members of your target audience see themselves. Are they individualistic or collectivistic? Your content should appeal to them.

When working with images, graphics and photos, always take the layered approach. In Photoshop, you can save layered files in PSD format. Other applications have similar options.

Layers in Adobe Illustrator

Using this approach will not only enable you to update the graphical content easier should the training content need to be updated in the future, your localization vendor will also be able to produce a higher quality product in the target languages by having access to the layered files.

Put it in practice: If you think something is funny, effective and politically correct, consider other points of view. Chances are others won’t have the same views as you. This is especially true for other cultures, and you’ll want to be sensitive to your audience’s perspectives. Additionally, always keep layered files handy when working with visual elements, and be ready to provide them to your localization vendor.

2. Fonts & Text

As you create your source content in your preferred authoring tool, be sure to use fonts that are translation-friendly. To make this easy, stick to Unicode fonts. Unicode is one of the best standards available for localized fonts.

You should also make sure that the LMS (Learning Management System) you will be working in can support multilingual content. Some systems are designed to serve only English-speaking audiences or the Latin script. Such systems are probably not right for you if you are localizing your training content.

Different types of fonts

When choosing fonts, focus on simplicity. Avoid non-standard fonts. The main reason behind this is the accent marks that certain languages have. For example, Spanish and Vietnamese have accent marks that are not supported by all fonts, as most fonts were developed with English characters in mind, and non-English symbols, accents and characters will not work. Arial and Times are usually a safe bet for the majority of languages.

Finally, either embed the fonts into your project file or be prepared to provide them to your localization vendor as standalone files. Don’t assume your localization vendor will have the fonts you’re using in the source file.

Put it in practice: Use standard Unicode fonts when possible. Embed the fonts into your source files or provide them as standalone files. Make sure the LMS you’re designing for has multilingual support for a better user experience.

3. Colors

The psychology and cultural relevancy of colors is an important factor in visual design. Colors should be used properly and within proper context.

People from different cultures see colors differently and there are certainly emotional meanings tied to their perception.

Localize colors to send a positive brand message

The color blue is probably the safest color you can use, but what if it doesn’t fit your content? You may have to do more research before implementing a color scheme for your multicultural audience.

Ultimately, whatever colors you choose the tasks you should be trying to accomplish include evoking the sense of trust, tranquility and knowledge retention.

Put it in practice: Never assume that the color scheme you are using for U.S.-based target audience will work in another country or culture, even if it’s your brand’s colors. Research your target audience and pick the colors that will appeal most to them.

4. Layout & Space

As you create and layout your eLearning content always remember that white space is your friend.

This is especially important once you have the source text translated into other languages. Some languages expand in volume, where others contract. Spanish, for example, will take up about 25% more space than English. That could really impact the look and feel of the design you originally intended to produce.

In other words, it may look great in English, but lose its design quality in Spanish. Working with the same layout and space, you’d either have to scale the font size down to fit the Spanish translation or have it overflow to another frame or slide. It is better to use caution and leave more white space if you’re unsure whether your target language will expand.

Content layout

When organizing your text content around the graphical elements, be mindful of the symmetry and how the graphics are positioned in relation to the text.

Lastly, practice subtractive design. As Connie Malamed points out, “remove, remove until only necessary is left.” Sometimes less is more.

Put it in practice: Think about text expansion and contraction in the languages your eLearning content will be translated into. Plan your design layout and space with the text content in mind. Ask your localization vendor for expansion and contraction charts for your target languages, so you are aware of those factors as you design the source content.

5. Audio & Video

Your eLearning modules may contain audio and video components. You probably won’t be handling the production of A/V content yourself and will outsource it to a professional instead.

Here are some visual design aspects to consider to make your A/V content localization-friendly.

When it comes to video bumpers and superimposed graphics, think in layers as well. Adobe Premiere allows for a video project to be saved with all video and audio assets as separate files. Your localization vendor will ask for these assets to complete the localization process.

Audio recording in a studio

To make the video truly accessible not only for the Deaf and hard of hearing individuals, but also for audience who don’t speak English, make sure to include captions or subtitles.

From a design perspective, keep the things you just learned about in mind. That includes the use of photos, images, graphics, fonts, colors and whitespace. And if you plan to include captions or subtitles, try to keep the bottom third of the screen free of other text so there is room for the captions/subtitles.

Audio is not directly related to visual design, but because it goes hand-in-hand with video content, it could very well be a part of your eLearning content. Learn more about audio localization in this article.

Put it in practice: Localized audio and video content will take your eLearning modules to the next level. Consider integrating A/V in your training modules.

6. Scenarios

The five components I discussed above all play a part in the training scenarios you design.

Make sure that scenarios and real world examples are relatable and relevant. If your audience can’t relate to your training content, they won’t have a good learning experience.

Factory scenario

If your content is centered on safety training for factory workers in Mexico, be sure your translation vendor is aware of this so they can utilize the appropriate terminology. Using technical terminology intended for academic users may not be appropriate for factory workers who would prefer the terminology they encounter on a daily basis.

If the trainees can relate to your scenarios, they are more likely to succeed in training. Retention rates will increase and there will be less on-the-job injuries.

Put it in practice: Have your translation vendor provide an in-country review by a subject-matter expert who can offer his or her opinion. If your budget allows it, conduct a small focus group with a few select trainees to test the scenario as well. This will allow you to fine-tune the scenario content before going live.

Need help translating and localizing your eLearning content?

Let’s discuss your specific needs.

Contact us.

Conclusion

I learned a lot at the Learning Solutions Conference & Expo this year and look forward to many industry events. One of the biggest takeaways for me was how to effectively use visual design.

Hanging with Gene at LS Con

I also hope you learned something new from reading this article.

Now you can take your knowledge of visual design and use the tips I provided to you about eLearning localization and set your trainees up for success.

What is your experience with visual design and eLearning localization?

Share your thoughts in the comments.

How to Accommodate Deaf Students through a Referral Agency

Every quarter or semester, colleges and universities have one trend in common. That trend is student enrollment.

Student enrollment trend

Some of the students who enroll may be Deaf or hard of hearing. In order to communicate with those students, you will need the help of professional sign language interpreters.

You already know that you’re required by federal law to provide equal accommodations. The laws are explained in more detail in this article.

It’s possible that your school already employs in-house sign language interpreters, which is great. However, there may be a time where you need to reach out to an interpreter referral agency for assistance.

From my years of experience in working with colleges and universities, I came up with some tips for you to follow.

Here are the tips to accommodate Deaf students through a referral agency.

1. Term Schedule

All schools have class schedules. Those schedules can vary from school to school. Some go by quarter terms, others by semester.

Class Schedule

Regardless of how your classes are spread out over the year, be prepared to provide the following information to the referral agency:

  • Start date and end date of the term
  • Days and times of classes

The referral agency you’re working with will need this information to schedule interpreters.

Why does an agency need to know this information in advance?

So they book a team of interpreters for the entire duration of the term. It helps with consistency and quality of the educational experience.

Interpreters also get booked quickly, so if you can schedule them through the agency for the entire term you will be better off in the long run.

2. Class Names & Types

Is the student taking advanced algebra or a culinary arts class?

This information is helpful to know in advance.

Relay this information to your referral agency so they can pass it on to the interpreters scheduled for the term. Knowing the class names will help interpreters prepare for those sessions in advance.

Student doing algebra

Knowing the class type is also helpful.

For a lecture, a team of two interpreters will almost always be required. For a one hour lab, you may be able to get away with one interpreter.

Here’s why team interpreting is important and necessary.

According to Lydia Callis,

“When interpreting a verbal language into a physical one, ASL interpreters become prone to both physical and mental fatigue. After one hour of interpreting alone, even the best sign language interpreter will be providing a lower quality of service.”

In either case, let the referral agency know so they can accommodate you accordingly.

3. Location

Some schools have only one campus, while others may have multiple campuses in the same city. Be sure you provide the campus address of where you will need interpreter assistance.

Multi-campus college

Go in more detail when it comes to location as well and provide the exact location of the class on campus. For example, the hall name and room number.

It will make it easier for the interpreters to find the student and the classroom.

If you are not specific with the location information, the interpreters may show up late. Or worse, they may not show up at all if they can’t find the location.

4. Student’s Name

There are two important reasons why you should provide the student’s name to your referral agency.

The first reason is that you may have more than one Deaf student at your school. If that’s the case, and you’re arranging interpreters for multiple students, it will be helpful to the referral agency to know each student’s name.

It will make it easier for the referral agency to track and schedule appropriate interpreters for each student.

The second reason is potential conflict of interest. For example, there may be cases where a student doesn’t feel comfortable with a particular interpreter or vice versa.

Conflict of interest

A professional interpreter will always forgo a job if he or she is able to identify a conflict of interest in advance. An example of an interpreter conflict of interest policy can be found here.

5. Degree Type / Program Name

This point relates to the Class Names & Types I explained earlier in the article.

By providing the degree type and program name to the referral agency, the agency can then schedule the most qualified interpreters for the job.

Student with her college degree

It will also help the interpreters to study and ramp up for the course to ensure smooth interpretation.

6. Dress Code

Some classes, for example Psychology 101, may not have a formal dress code. Students can show up being dressed like… students.

A few specialty classes require students to be dressed for the occasion. Specifically, classes that have labs often times require special outfits.

For example, if a Deaf student is taking culinary classes, there might be a lab day where he or she has to prepare food. One must dress like a chef when they are cooking in such environments.

Students in culinary class

This expectation is passed onto the interpreters as well. Communicate this information in advance to the referral agency.

Also, be prepared to provide uniforms for the interpreters at the school’s expense.

7. Parking

Parking is generally not an issue on suburban campuses. However, if your school has a specific parking policy, be sure to communicate that to the referral agency so they can inform the interpreters.

For schools with urban campuses, it gets more complicated. There may not be any school parking on campuses located in downtown areas of a major city.

Provide interpreters with parking instructions

The interpreters will then have to find where to park themselves.

Be prepared to either provide free parking to the interpreters or reimburse them for any parking fees they incur. Such reimbursement can be done through your referral agency.

8. School Access

With the recent increase of violence on college and university campuses, many schools are implementing tighter restrictions for campus access.

If you require all campus visitors to have a pass, be sure to clarify this in advance. Don’t put the interpreters in an awkward spot by not providing them with this information ahead of time.

College campus security

Last thing we all want is for interpreters not following the proper visitor protocol and being detained by campus security.

Some schools may also have key card access to certain areas of the campus, such as the restrooms. Be sure to provide interpreters access to those key cards.

9. Special Instructions

Each interpreter request situation will be unique. Generally, the more details you can provide to your referral agency the better.

This includes any special instructions you may have for the interpreters to follow.

Provide all necessary instructions

Special instructions may include some of the points I’ve already mentioned, such as the dress code, school access policy and parking procedures.

Here’s an example:

Please ask the interpreters to park in Zone A and check in with security. After they receive their visitor badges, they can proceed to Culinary Hall, Room 123 and check in with the instructor.

We also request that the interpreters arrive a few minutes early. If they arrive after the class begins, they may not be able to enter the classroom.

10. Other Considerations

You’ve done your best in putting together all of the information above for your referral agency and are now ready to place your request.

The chances are good that you may have missed something.

Here are a few other considerations I suggest you communicate to your referral agency.

  • What is your school/class policy on service animals? It’s rare, but possible, that an interpreter may have a service dog. We’ve had a case like that before.
Service dog
  • Is any of the class content potentially offensive? All people have their own beliefs. It’s better to clarify any sensitivity in advance, especially those around religion.
Need assistance accommodating Deaf students?

Let’s discuss your specific needs. Contact us.

Conclusion

You already know that you’re required by law to provide equal accommodations to all students. You work with sign language interpreters to accommodate your Deaf students.

On occasion, you may need to work with an interpreter referral agency to meet those accommodations.

You now know the information you need to provide to your referral agency to successfully accommodate your Deaf students.

Please share your thoughts on working with interpreter referral agencies and any questions you may have.

7 Documents All Health Care Providers Should Have Translated

As a health care provider, you already know that you may be required by law to provide language access to your patients. The cost of providing interpreters is already part of your budget, right?

You might as well leverage it to provide a better patient experience and reduce your risk exposure.

A good way to do this is to have certain documents translated into the languages spoken by your patients. I will share my experience with you in helping hospitals and clinics provide translated content for their patients.

You will also be able to download several templates that were translated into Spanish for use in your practice. Read on to find out more!

For those of you in a hurry, download the templates now by clicking here and comeback when you have time to read the article.

Narrow down the languages

Before you hire a company or a translator to translate your health care documents, figure out your most frequently requested languages. I bet Spanish is probably your top language other than English.

According to Pew Research, by 2020 there will be 41 million Hispanic Spanish speakers in the United States, and not all of them speak English.

Hispanic Spanish Speakers in the U.S.

Translation can get expensive as you add more documents and languages. If you are going to have your documents translated into just one language, I’d recommend you choose Spanish.

Here is more on how translation pricing works.

Gather your documents

As you get ready to have your documents translated, you should first gather them all together. The last thing you want to do is take a paper copy of a document, scan it in and send it off to your translation vendor.

That scanned copy is most definitely going to be low quality and will need to be retyped.

Avoid scanning documents when possible

And retyping leads to additional costs.

What you should do is provide your translation vendor with the documents in an editable format such as MS Word. Editable files are much easier to work with.

Editable files such as MS Word are the way to go

Working with editable files also helps maintain quality and consistency, and reduce overall cost.

Contact your translation vendor

Since you have the editable files, you can simply email them to your translation vendor. In your email, specify what language you want them translated into and your turnaround time requirements. Your vendor will provide you with a cost and time estimate to complete the project.

Email Request for Translation

Once the translation has been completed, the translated documents will be emailed back to you. You can then start using them in your health care organization.

Recommended list of documents for translation

I’ve worked with dozens of health care clients in the past decade and helped them translate hundreds of documents. As a result, I am providing you with a narrowed down list of most popular ones.

Here are the documents all health care providers should have translated.

1. Patient Information Form

This is one of the most essential forms you should use in your practice. It captures all basic health information about the patient that you can then input into the electronic health record (EHR).

Your front desk staff will give this form to the patient to fill out before the appointment is scheduled to start. If the patient speaks Spanish, it will just make it that much easier for him or her to fill out the form.

Patient Information Form

The patient information form may include the following elements: patient’s contact info, medical history and changes since their last visit with a doctor. You can get as detailed as you need, but I’d recommend keeping this form limited to two pages.

2. Patient Rights & Responsibilities

This should also be a fairly short document. It includes the rights your patients have when visiting your practice as well as their responsibilities to you.

Remember that one of those rights is having an interpreter available at no cost to the patient.

Language access in Spanish

I’ve included a sign for your convenience that you can print and place near your reception area that will make it easier for the patient to know that interpreter services are available.

You can download it with the rest of the templates.

3. Consent and Assent Forms

Your patients have the right to consent to treatment. They also have the right to refuse treatment. In many cases, you may be required by law or corporate policy to have such decisions documented.

Signing an informed consent

Some of the common consent and assent forms include:

  • Release of Information
  • Consent to Treat
  • Consent to Procedure
  • Consent to Immunization

If your patients don’t understand what they are consenting to, it does not do you any good having consent forms to begin with.

Have your consent and assent forms translated to keep your patients informed.

4. Patient Instructions

Your patients will need instructions that they should follow after they visit with you and perhaps even before their next visit.

For some procedures, such as a colonoscopy, one has to prepare. He or she does that by following your instructions.

Patient Instructions

In physical therapy, you may have just treated someone for a sports–related injury. That patient now needs instructions for what to do and what to avoid in order for his or her treatment to be effective.

Translate those patient instructions and give them to your patients.

5. History Questionnaires and Progress Notes

This is something that you may or may not need translated. For history questionnaires, you can write down the answers provided to you by the patient with the help of an interpreter.

As you interview the patient, the interpreter will relay the information between you and the patient in English and your patient’s language. Your task is to write down the information in English.

Things get a bit tricky with progress notes. Let’s say your patient presents you with progress notes from Mexico.

Those progress notes are handwritten in Spanish. There could be critical health information in those notes and you should have them translated from Spanish into English.

Handwritten progress notes are hard to read

Handwritten text is difficult enough to read. Handwriting done by a doctor or nurse in Spanish is even more difficult.

Scan those progress notes into a PDF and send them off to your translation vendor to have them translated (this is the only time it’s appropriate to scan your documents).

Your vendor will provide you with a translation in an easy-to-read, typed-up document.

6. Missed Appointment Policy

Everyone hates untimely cancellations and no-shows. It’s a huge waste of time for everyone, including the staff at your practice. In this case, time also equals money.

If your patient doesn’t show up for an appointment, you lose money. Additionally, the interpreter will expect to be compensated in such occurrences.

Medical appointment schedule

To mitigate patients missing their appointments, many health care providers implement a missed appointment policy. According to the American Medical Association, it is ethical for health care providers to charge patients for missed appointments.

However, your patients must know of this policy in advance.

Have your missed appointment policy translated and provide it to your patients so they understand the consequences of missing appointments without providing you with sufficient notice.

7. Patient Financial Responsibility Waiver

All citizens and legal residents of the United States are now required to have health insurance, or face a penalty. I bet most of your patients are insured, with the exception of those few that prefer to pay cash.

Having the ability to bill your patient’s insurance for your services is great. Of course, until the claim is denied and you’re in an awkward spot having to contact your patient with the bad news.

Medical bills

Clear this up in advance by having your patients sign off on a financial waiver. This will cover you in the event insurance doesn’t cover a certain medical procedure or refuses to pay for your services for one reason or another.

By communicating this information to your patients in advance and having them sign a financial waiver protects you. You now have an ability try and collect from your patients directly.

Free Templates to Get You Started

The American College of Physicians has many great patient care and office forms you can download here. With the permission of the ACP, NWI Global went ahead and translated some of these forms into Spanish.

This is great news for you since you can start utilizing these forms without any additional overhead cost for translation.

Click Here to Download the ACP Patient Care and Office Forms in Spanish

These are just general templates, so if you need to customize them, make sure you work with your translation vendor to do that. You can also reach out to us for assistance.

Conclusion

Providing interpreters for your patients isn’t enough. You should also provide them with written content that’s been translated into their languages. You now have a good starting point and a list of recommended documents to have translated.

By doing this, you are going to improve patient satisfaction. You will also reduce your risk of not being in compliance with Title VI and other regulations.

It’s true that translating documents will cost you, but in the long run the payoff will be immeasurable.

What other documents can you think of that need to be translated for your practice?

Share your thoughts in the comments.

Are Hospitals Required to Provide Language Access Services?

You are reading this article because you are not sure that you may have to provide language access services for your patients, right?

You are not the only one, as this is very important topic that is often clouded in confusion. To provide an expert answer, I reached out to the National Health Law Program (NHeLP) for assistance.

The staff at NHeLP did a great job clarifying the requirements for us in very simple terms.

Language access services are generally provided with the help of professional interpreters and translators.

For the purpose of this article, I will assume that you are a health care provider fitting one of the following four categories:

  1. You provide language access services for your patients, but are unsure if you are required to do so.
  2. You don’t provide language access services for your patients, but understand you may be required to do so.
  3. You didn’t provide language access services for a patient and are being threatened with legal action.
  4. A law suit has been filed against your practice for failure to provide language access services by, or on behalf, of the patient.

Regardless of which category fits you, the information below should help clarify your responsibility to provide language access services for your patients.

Unless of course you fall into category 4. If that’s the case, contact your attorney as soon as possible.

Are hospitals required to provide language access services?

Yes.

Here is why.

Under Title VI of the Civil Rights Act of 1964, discrimination on the basis of race, color or national origin is prohibited.

Therefore, health care providers, including hospitals, that receive federal funding, including Medicare, Medicaid and SCHIP, are required to provide language access services for their patients.

What if health care providers opt out of federal funding?

When federal funds are not in question, health care providers may not be subject to Title VI requirements. However, there may be state laws that require you to provide language access services.

Can health care providers bill the patient for language access services?

No.

If you are receiving federal funding, you are required to cover interpreter costs for all your limited English proficient (LEP) patients, including those with private insurance and no insurance.

State laws may also prohibit you from billing your patients for language access services.

What health care entities are covered under Title VI?

The entities covered by Title VI include hospitals, doctor’s offices, nursing homes, managed care organizations, state Medicaid agencies, home health agencies, health service providers and social service organizations.

How can health care organizations provide language access services to patients?

Health care providers may choose to hire staff interpreters as employees to interpret the most frequently requested languages. Many health care providers typically contract with language service companies to provide language access services.

A language services company can greatly streamline the process by providing scheduling, quality assurance, billing and project management.

What types of language access services should health care providers have readily available to patients?

At a minimum, it is recommended that all health care providers be able to provide on-site interpretation, over-the-phone interpretation and document translation services.

Can health providers use family members, friends or bi-lingual staff to interpret for patients?

It is strongly advised against using family members, friends or bi-lingual staff members to interpret for patients. You could risk malpractice, the cost of which would far outweigh any money you might save by asking friends or family members to help.

In fact, your legal fees in dealing with just one malpractice lawsuit could potentially cover your language access services budget for several years to come.

What about written translation services for patient communication?

According to U.S. Department of Health and Human Services Office for Civil Rights, various types of documents may require translation from English into other languages. Some of the documents include patient forms, discharge instructions and information about the availability of interpreter services.

Learn about the 7 most common document types all health care providers should have translated.

I’d like more information on developing a Language Access Plan for our health care organization.

For more information, check out these publications:

Like this article?

Download it now in PDF format.

Need assistance with language access services in health care settings?

Let’s discuss your specific needs. Contact us.

Conclusion

Dozens of law suits are filed every year against health care facilities for failing to provide language access services.

My advice to you is to set aside a budget for language access services and deliver the best patient experience you can. It will cost you less in the long run.

Share your questions, thoughts and experiences in the comments.

This article was originally published on July 8, 2011 and has been updated on February 8, 2016.