A hidden barrier to reinforcing a health policy for non-English speaking populations in the U.S. : A community-initiated medical interpreter program

Title VI of the Civil Rights Act stipulates that any agency receiving federal funding needs to provide interpreters for persons with limited English proficiency. A series of community surveys and focus groups conducted by the Korean Resource Center (KRC), in collaboration with the Johns Hopkins University Korean American Health Research Initiative, revealed a strong and urgent need for adequate interpretive services for Korean Americans (KA) in Maryland. In response to this significant problem, the KRC-Hopkins team developed a program to train indigent bilingual speakers to function as medical interpreters. A total of 12 volunteers underwent our two-day training sessions. Training topics included: 1) code of ethics, 2) principles of medical interpretation, 3) medical terminology, and 4) cultural competency. This unprecedented program was publicized to mainstream care providers as well as to the KA community. Overall evaluation of this on-going program can be summarized as a limited success. While five mainstream healthcare agencies have sporadically utilized the service to meet the needs of their KA patients, most agencies still rely on traditional approaches of translation using untrained Korean staff or KA family members. Focus group interviews with health providers revealed that the major barrier to implementing this policy is no financial incentives given to the provider who utilizes trained medical interpreters. Rapidly rising medical cost in the U.S. along with complicated medical reimbursement system hinges the implementation of this policy which can result in inadequate healthcare utilization among non-English speaking minority populations.