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  • Writer's pictureRachel Showstack

From testimonios to dialogue: Conversations about funding for medical interpretation

Updated: Oct 12, 2022

This is the English translation of a post that was originally published in Spanish on Saturday, October 1, 2022.

In the Alce su voz (‘Speak out’) community, we talk a lot about the importance of sharing our testimonios, the stories that we tell that are connected with a sociopolitical context and that often include a declaration of the need for systemic change. The practice of sharing testimonios and listening attentively to other’s stories has nourished the formation of our community and has helped us to identify the topics that we want to address. Furthermore, the dissemination of video-recorded testimonios has personalized the effect of the inconsistence in medical interpretation services so that legislators become interested in changing the system to improve peoples’ lives. Then, as we have observed this process, our members have become motivated to participate more fully in civic life, raising our voices to demand equitable public services.

In addition to speaking out, a significant component of leadership is knowing how to engage in dialogue. Two weeks ago, I met with the CEO of a health clinic that offers services for underserved patients here in Wichita. I started the conversation with my speech about how Alce su voz started and why the system for providing interpretation services in Kansas needs to be improved. My intention was to propose a collaboration with the clinic to be able to investigate the challenges they face and support them in providing qualified interpretation services. However, I made the mistake of sharing my point of view before asking for hers.

After listening to me for at least five minutes, the CEO told me that it was her turn to get on her soapbox. She told me about her firm desire to offer equitable healthcare services for all of her patients and the impossibility of funding such services. A couple of years ago, the clinic administration realized that using family members as interpreters was not working well because the family members were not interpreting the messages with precision.[1] They had recently started using video remote interpreting services, and those services were costing over $11,000 per month. The CEO described the clinic's lack of resources to pay for such services and added that they can’t wait for the insurance company because patients need immediate help. When she finished explaining the situation, she told me that my initial discourse had made her feel a little bit defensive because she felt like I was blaming her. She reminded me about the importance of opening conversations with questions and listening to the experiences of others. The experience of the clinic CEO clearly demonstrates something that I had already suspected: there is a need to fix the system of paying for medical interpreting services.

To meet our objective of health equity, we have to learn to dialogue in a productive way in different contexts and with different interlocutors. Yesterday I met with State Representative Susan Ruiz, two other colleagues, and a student from North High, to discuss a proposed law that would require that all Kansas healthcare institutions that receive federal funds offer qualified interpreters for all patients who need them. The purpose would be to reinforce the federal legislation that already exists but that is not always followed in Kansas. Often when we think about conversations with legislators, we think about testimonies and requests for change. However, in the case of this meeting, a different kind of dialogue was needed. She explained the barriers to passing the legislation, and we listened and asked what we could do to support her in her efforts.

Representative Ruiz explained to us why it is so hard for healthcare institutions to get reimbursed for the interpreting services they offer. A few years ago, the state of Kansas changed its way of providing services to Medicaid recipients. Now it uses three health plans, Aetna, Sunflower Health Plan, and United Healthcare Community Plan. To attain paid interpreting services through these plans, the Medicaid recipients must call in advance to request them before their medical visit. If the services are not scheduled, the hospital has the responsibility of paying for them without being reimbursed. The hospitals cannot directly bill Medicaid, because the private companies are already taking it on. All of this brings us to the fact that there is a need to start negotiations with the managed care organizations (MCOs). At the moment, Representative Ruiz told us, these negotiations are on pause until after the upcoming November gubernatorial elections.

At this point, the dialogue should also address the question: Which gubernatorial candidate is going to support us in the process of making systemic change that brings us closer to our objective of achieving health equity for the Latinx community in Kansas? We need to educate ourselves and participate in dialogues with colleagues in order to be prepared to vote. Kansans who are not eligible to vote can give the message to those who are eligible that the Nov. 8 elections are going to have a major influence in the future of our Latinx community.

Participants in our Oct. 8 health workshop, led by Ana López, learned about voting and the upcoming November elections. We also met members of the League of Women Voters, who are available to provide more information in English or Spanish. If you would like to learn more about what will be on the ballot for the upcoming election, see the latest blog post Las elecciones generales de 2022 y la importancia de votar (‘The 2022 General Elections and the Importance of Voting’), written by WSU undergraduate student Alondra Aguilera.

[1] As many of us know, this happens for various reasons, including not wanting to hurt or startle the ill family member with negative information about their health, the lack of training in medical terminology, and the lack of awareness of the code of ethics of medical interpretation.

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