National Certification for Healthcare Interpreters   

Guiding Principles in the development of national certification

NCIHC Key Milestones on the Path to National Certification

    2002-2003  2004  2005  2006-2007  2007  2008  2009

What is certification?

Does a national certification program exist now for healthcare interpreters?

How will certification benefit healthcare interpreters?

When will certification be available?

What can I do to prepare myself while waiting for national certification?

Background

In the midst of the attention recently given to national certification of healthcare interpreters, it should be noted that many groups and individuals have been working toward this goal for many years.  At the “Working Group” meetings held over 16 years ago – before the NCIHC officially existed – there was discussion about how to develop certification and the implications of its existence.  The NCIHC began the national movement with the development of a national consensus on the role of the healthcare interpreter (2001), the establishment of a National Code of Ethics (2004), followed by National Standards of Practice for Interpreters in Healthcare (2005).  The NCIHC has deliberately chosen this measured path to reflect the belief that a certification process cannot be created in a vacuum. First, the field must agree on the scope of its work, how practitioners are expected to do that work, what constitutes acceptable practice, and how that acceptable practice can be best taught and tested.  Accordingly, the Council is currently working to develop national standards for healthcare interpreter training.

As the NCIHC continues to progress on its path toward national certification, it does so under the following principles:

Guiding Principles in the development of national certification

The following principles outline the spirit in which all the work of the NCIHC, including discussions around certification, has and should be grounded. They ensure that such discussions and any resulting certification will be conducted in a fair, equitable, inclusive, and transparent manner. 

• Certification as a complex undertaking. The NCIHC believes that the development of a national certification process goes beyond the creation of a test. We believe that certification is a complex process in any field but especially so in a field in which the content is steeped in difficult linguistic and cultural issues. While we wholeheartedly agree to the need for scientifically rigorous assessment methodologies, we still have much to learn about creating an equitable and fair process that will allow all competent interpreters, regardless of background, to be able to demonstrate the knowledge and skills they possess as interpreters, and that will not result in high numbers of good interpreters failing simply because of a certification tool’s inability to adequately assess knowledge and skills across cultural and linguistic differences.
• Inclusiveness and consensus-building. The NCIHC believes that any effort to develop national standards or assessment must be a collaborative, consensus-driven process in which all stakeholders have the opportunity to participate. In order to address the complexities of certification in a respectful manner and to ensure the transparency of the development process, we will need to find a variety of ways to include the voices of as many stakeholders as possible, especially those who do not have the opportunity to participate in large national meetings
• Neutral leadership. The emerging healthcare interpreting field incorporates many stakeholders: patients, interpreters, healthcare institutions, advocates, interpreter associations, language companies, non-profits and for-profits. It is imperative that the national dialogue be led by a neutral party whose primary interest is the well-being of those in need of interpreting services. Each entity involved must make known the nature of its interest in certification, including potential conflicts of interest and/or benefits that it may accrue as a result of the work. In order for a national certification process to be credible, care must be taken to avoid even the appearance that any vested interest has unduly influenced the development process.

NCIHC Key Milestones on the Path to National Certification

2002-2003

The NCIHC initiated a collaboration with the Massachusetts Medical Interpreters Association (MMIA; now the International Medical Interpreters Association - IMIA) and the California Healthcare Interpreters Association (CHIA; now the California Healthcare Interpreting Association) to pilot a certification process for Spanish interpreters in healthcare.  The MMIA had already developed a prototype and had undertaken a small pre-pilot which had been completed, although with insufficient numbers to establish reliability.  CHIA had recently published Standards of Practice and was interested in gaining experience in testing and contributing to the body of work that MMIA had developed.  All three organizations met in Boston in 2002; NCIHC secured funding from the federal Office of Minority Health (OMH) for the project; a revised version of the MMIA prototype was administered in mid-2003 to 37 participants in Massachusetts and 46 in California; and the final report was published in 2003.

2004

The NCIHC published the National Code of Ethics for Interpreters in Healthcare.  In this document, the NCIHC identified three steps that needed to occur at the national level in order to standardize expectations and raise the quality of healthcare interpreting.  These steps were: 1) to create and build support for a national code of ethics; 2) to develop nationally accepted standards of practice; and 3) to create a national certification process.

2005

After extensive public input from stakeholders around the country, the National Standards of Practice for Interpreters in Health Care were published. These documents have been endorsed or supported by 162 stakeholder groups so far, including interpreter associations, governmental agencies, language companies, accreditation organizations, professional medical associations, and healthcare institutions.

As the NCIHC engaged in the development of the National Code of Ethics and Standards of Practice, it became evident that in order to create a level playing field for national certification the quality of interpreter training and education had to be addressed.  Consequently, the NCIHC added an additional step prior to national certification – the development of national standards for healthcare interpreter training.

Acknowledging the increasing pressure at the state and national level for certification, the NCIHC began to seek funding to simultaneously address the development of standards for interpreter training, and certification.

2006-2007 

The NCIHC conducted 10 forums around the country to initiate a dialogue on the complexities of a national certification process.  Are We Ready for National Certification of Health Care Interpreters?  A Summary of NCIHC Open Forums was published in 2007.

2007

In October 2007, NCIHC received a grant from The California Endowment, part of which was to develop an “inclusive national certification process”. 

The NCIHC convened a meeting in December 2007 to discuss the formation of a coalition to move the healthcare interpreter certification process forward.  Representatives of ATA, CHIA, IMIA, and NCIHC were present for this and subsequent meetings.  This group became the National Coalition on Health Care Interpreter Certification (NCC).

2008

In May 2008, the NCC announced the organizations who joined with the NCC Founding Members to form the full NCC.  The new members represented a broad range of stakeholder organizations who were committed to working on national certification.  The inaugural meeting of the full NCC took place on May 29-30 in Chicago.

In September 2008, the NCC held its second in-person meeting on September 20-21 in Minneapolis.  The focus of the meeting was to create governance structures which would allow the NCC to operate more efficiently and effectively.  Three important outcomes of the meeting were: 1. the transformation of the Coordinating Committee into a Steering Committee; 2. the changing of the purpose statement of the National Coalition; 3. and the branding of the NCC.

2009

On January 22-23, 2009, the NCC held its third in-person meeting in Los Angeles where the group stepped up its work on certification by reaffirming its purpose and laying out concrete next steps including the submission by all members of proprietary tests and materials for the group’s consideration. 

On May 1, 2009, NCIHC held an Open Call on the work of the NCC to present a “preliminary report from the front line”. 

Throughout the spring and summer of 2009, the NCC attempted to address internal organizational issues that were presenting themselves as barriers to further progress.   It became apparent that the existing structure would not be tenable as a means of moving national certification forward.

On September 15, 2009, the Certification Commission for Healthcare Interpreters (CCHI) was launched.  CCHI is the first certification commission created by interpreters for interpreters and the public good. CCHI was incorporated as an independent certification agency and 501(c)(6) organization in compliance with requirements of the IRS for certification commissions.  All but two of the NCC organizational members are part of CCHI, and the NCIHC is proud to say that 3 current board members are also involved.  CCHI is the first to step forward with a total structure and vendor-neutral business plan to serve the current and future needs of healthcare interpreters and the stakeholders (healthcare providers and institutions, language agencies, government agencies, customers) to provide a trained, qualified, certified and competency-based population of healthcare interpreters.  CCHI will create a national, valid, credible vendor-neutral certification program for healthcare interpreters. Its goal is to ensure the competency of interpreters through an accredited, professional certification program so that communication barriers do not affect access to, and quality of, care.

What is certification?

The Institute for Credentialing Excellence (formerly NOCA), established by Congress to develop standards for quality certification in the allied health fields, says, “The certification of specialized skill-sets affirms a knowledge and experience base for practitioners in a particular field, their employers, and the public at large.  Certification represents a declaration of a particular individual’s professional competence.” Certification is a process by which a governmental, academic or professional organization attests to or guarantees that an individual is qualified to provide a particular service. Certification calls for formal assessment, using an instrument that has been tested for validity and reliability, so that the certifying body can be confident that the individuals it certifies have the knowledge and skills needed to do the job.

Does a national certification program exist now for healthcare interpreters?

There is no current national certification specifically for healthcare interpreters.  However, in September 2009 the Certification Commission for Healthcare Interpreters  was formed to meet the need for providing certification of professional competence that meets national standards of knowledge, skills and performance for healthcare interpreters. Visit the CCHI website for more information on the current status of healthcare interpreter certification.

How will certification benefit healthcare interpreters?

National certification brings with it a number of benefits for interpreters as well as other stakeholders in the healthcare arena.  With national certification, the quality of interpreting would increase and be ensured. There would be consistency of quality across state lines, and quality control could be ensured through compliance to a uniform set of standards. For interpreters, national certification would provide greater credibility, legitimacy, and recognition to the profession thereby advancing the field and making it a more attractive career path on a par with other allied health professions. It would provide a greater incentive for interpreters to pursue continuing education credits which, in turn, are connected to the potential for enhanced job security.  Fundamentally, certification offers healthcare interpreters the recognition and respect they deserve.

When will certification be available?

For more information on the availability of certification, please visit the CCHI website. 

What can I do to prepare myself while waiting for national certification?

• Take advantage of formal training and continuous education opportunities.
• Attend local, state and national conferences.
• Consider each opportunity you have to interpret in healthcare as part of your training and experience requirements for the upcoming certification examination.
• Join professional associations and attend workshops.
• Keep abreast of professional developments in your field.
• Self-assess your on-the-job performance and evaluate ways you could enhance your professionalism.
• Visit the CCHI Website to view regular updates on certification planning and sign up for our ongoing alerts to be notified when it is time for you to complete the application form.