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With Earth Day right around the corner, climate change and environmentalism are top of mind for us — and probably for you too. While conversations about climate change often center around topics like global warming, loss of biodiversity, and natural disasters, we think there’s another topic that deserves attention in the discourse surrounding climate change: loss of linguistic diversity. Climate change and language are just as closely linked as, say, climate change and biodiversity. Just as experts predict that climate change will have a devastating effect on the planet’s biodiversity (a 2020 study, for instance, projected that climate change could lead to the extinction of one-third of the world’s plant and animal species over the next half a century), it’s likely that climate change will have a negative impact on linguistic diversity as well.  Though estimates vary from source to source, anywhere from 50 to 90% of the world’s 7,000 languages are expected to be lost by the end of this century. As the environment becomes increasingly more hostile for people living in highly linguistically diverse areas — from sea-level rise along the coast to more severe droughts in desert regions — climate change-induced migration could have serious consequences for some of the most at-risk languages spoken today. As we recognize Earth Day this weekend, it’s important to consider how climate change affects not only our planet’s ecosystems but also its linguistic diversity. Read on to learn more about how climate change and language are closely linked, and what you can do to support the planet’s linguistic diversity in the face of the current climate crisis.
While there are many other threats to linguistic diversity, evidence shows that climate change is accelerating language loss. The languages that face the most serious consequences are those spoken in regions that are highly vulnerable to the impacts of climate change — think island nations, coastal regions, and deserts. Minority and Indigenous languages that are only spoken in one or two geographic regions are particularly vulnerable here — as climate change forces Indigenous people to move from their original homes, their language may not be passed onto the next generation. As the climate changes, natural disasters like floods and hurricanes are likely to become more frequent and more severe, causing entire communities to be displaced, leading to the loss of their languages and cultures. This forced migration can be particularly damaging to Indigenous languages, which have historically been vulnerable to the more dominant languages spoken in their vicinity. When members of a community move to another geographical region, their descendants tend to adopt the predominant language in their new community. Sociolinguists note that immigrant communities often pass down their language to the second generation, but it’s rare for third- and fourth-generation family members to speak the language natively. Interestingly, the loss of biodiversity appears to be correlated with the loss of linguistic diversity as well. In 2012, researchers at Arizona State University found that the number of languages spoken in a given region is closely linked with the number of species that can be found in that same area. And this shouldn’t be particularly surprising after all — biodiverse regions tend to be highly hospitable to human life, allowing a wide range of cultures and languages to thrive — in turn, these languages store important knowledge about the plant and animal species around them. As a result, these languages are intrinsically linked to the biodiversity of a given region — if we lose one, we may lose the other as well. Even more, Indigenous people are working hard to protect these regions at higher rates than others. According to the World Wildlife Fund, “Indigenous peoples are fighting to save the planet. Although they comprise less than 5% of the world population, Indigenous peoples protect 80% of the Earth’s biodiversity”
So, what can we do to support linguistic diversity in the face of climate change-induced language loss? While most of the same tips to fight climate change apply here — things like reducing greenhouse gas emissions and recycling — it’s also important to devise an action plan to support the languages that will be most affected. Here are just a few ways we can promote the languages that will need the most care as climate change worsens: This last one is particularly critical — we must encourage and enable people to speak with their most authentic voice in their preferred language. In turn, this means giving them access to the same opportunities and services available to others with language support through translation and interpretation, rather than expecting them to use a more widely spoken language. Language service providers will play an especially important role here, by providing language support for low resource languages. Remote interpreting options are particularly useful in supporting authentic voices, as they enable individuals to speak and be understood without requiring an interpreter to be physically present in the same space. This means that the pool of available interpreters in low resource languages may increase, as you can reach interpreters who are living in different locations. Additionally, relay interpreting — wherein two interpreters work in two different, but overlapping language pairs — can help when there is no interpreter for a specific language pair. For instance, a Quechua-Spanish interpreter and a Spanish-English interpreter might work to help a Quechua speaker be understood by an English-speaking audience. By offering these services, LSPs can make a great difference in allowing individuals from linguistically vulnerable communities to use their authentic voice. 
This Earth Day, we hope you’ll remember the link between climate change and language. Just as we support our planet’s biodiversity on this day, we should also celebrate and support our linguistic diversity, which is an integral part of promoting health communication and knowledge sharing. In short, here are just a few things we encourage you to consider this Earth Day: At Avantpage, we’re proud to support linguistic diversity by offering translation and interpreting services in low-resource languages. If you’re interested in learning more about how you can utilize our services to help protect and preserve the languages most at-risk to climate change, contact us today at contact us at [email protected] or (530) 750-2040.

We talk about language access a lot when it comes to areas like legal assistance, health care, and voting, but the conversation shouldn’t just end there. For many people in our communities, language access — or a lack thereof — has effects that must be faced regularly.  Take emergency situations and disaster relief, for instance. Language access for first responders is a critical consideration that can, quite literally, be a life-or-death situation here. Although many of us take it for granted, the language we speak plays an important role in our ability to communicate with first responders and give them the rundown of the emergency we’re facing. But even dialing up 911 to request a firefighter or ambulance can feel a bit daunting for US residents with limited English proficiency (LEP). Luckily, most 911 centers have access to on-demand over-the-phone interpreting services that can ease communication between the operator and a caller with LEP. But it’s not so simple for the emergency responders that actually arrive on the scene. A study published in JAMA Network Open earlier this year found that language barriers between emergency medical service (EMS) workers and patients with LEP can lead to patient distrust and make it difficult for the responder to determine the actual severity of a given emergency. This — combined with the fact that the population of individuals with LEP is on the rise — means it’s critical that any department employing emergency responders develop a thorough, well-informed language access plan. By creating a language access plan that takes into account the unique needs of people in emergency situations, fire departments, law enforcement agencies, and other institutions providing first responder services can refine and improve their level of emergency preparedness. Read on for important considerations these agencies should make as they devise their language access plan.
When disasters and emergencies strike, seconds can feel like hours. Though it may not be more than a couple of seconds, the time it takes to get connected to a 911 dispatcher can seem like a lengthy wait. Now, imagine having to wait for an interpreter to come on the line after that. 911 dispatchers and first responders like firefighters, EMS drivers, and police officers are typically the first people on the scene to provide assistance in emergency situations where timeliness is of the essence. Language barriers between these workers and those in need can delay their care and potentially endanger them even further. As a result, language access is essential in emergency management and disaster relief. Here are some things that first responder agencies can keep in mind to ensure that they’re prepared to help anybody who finds themselves in an emergency, regardless of the language they speak. It’s not always possible — or safe — to bring an in-person interpreter to the scene of an emergency. Remote interpretation services like video remote interpreting (VRI) and over-the-phone (OPI) interpreting can allow first responders to communicate with LEP individuals, without the need for an interpreter to be present. VRI allows users to see the patient as well, making this a particularly useful option when providing aid to deaf or hard-of-hearing individuals. Plus, the ability to see visual cues and get a better idea of the context in which the emergency is taking place makes VRI a better option for spoken languages too. First responder agencies should consult and partner with local language service providers to ensure the availability of on-demand VRI or OPI services in emergency situations. Although these services might have slight delays compared to on-scene interpreters or bilingual staff, it’s an important step toward providing adequate language access. It’s also a good idea to prioritize hiring bilingual staff who can communicate with people in different languages. Although bilingual police officers and firefighters aren’t a complete replacement for interpreters in emergency situations, individuals with native proficiency in a second language can be immensely helpful in providing timely care to those in need. Still, agencies must be thoughtful and principled in their approach to seeking out bilingual staff. Consult with local LSPs and conduct your own research to identify languages that are particularly common in your region to identify the most in-demand languages in your region. Hiring bilingual staff and working with an LSP to provide remote interpreting services is a good first step. But you also need to have a way to find out what language an individual speaks. Individuals who don’t speak English as their primary language may not know how to express their primary language to you — that’s where I Speak cards come in handy. These cards provide basic communication phrases in different languages, making it easier to identify an individual’s primary language. Bringing I Speak cards to the site of an emergency can help first responders determine which language a person needs. While human interpreters are undoubtedly a critical part of providing language access in emergency situations, visual aids like signs and pictures can also help bridge the language gap. Now, these are by no means a replacement for actual language services. However, they can help first responders communicate with individuals on the scene if there’s a significant delay in remote interpretation services or the arrival of a bilingual first responder. To provide high-quality care, first responders should also receive comprehensive training in providing culturally and linguistically appropriate services. This can help them better understand cultural differences and provide more effective and sensitive care. Again, since language barriers can cause a sense of distrust in the patient, being sensitive to cultural differences can allow first responders to create and maintain a sense of trust. With the growth of LEP populations throughout the US, language access services are becoming a critical consideration for first responders. Here are some things first responder agencies should keep in mind when developing a language access plan: At Avantpage, we’re proud to provide remote interpretation services to first responders. If you’re interested in learning more about how first responder agencies can develop and improve their language access services, contact us today at [email protected] or (530) 750-2040.

How alternative format services allow providers to offer comprehensive access to healthcare. In order to provide the most comprehensive care possible, healthcare providers and organizations must be sure that all of their communications and services — from informational pamphlets to in-person doctor’s appointments — are as accessible and easy-to-understand as possible. Just as individuals with limited English proficiency need adequate accessibility services like interpreting and translation, so too do those with blindness, low vision, or other disabilities that affect one’s ability to read texts. Alternative format services (AFS) like large print or braille make information more accessible to individuals with blindness, low vision, or certain learning disabilities. For healthcare providers, these are a critical component of developing an accessibility plan. Alternative formats are ways to render written text in a more accessible fashion — think along the lines of braille, large print, and audio recordings. And implementing alternative formats in your official communications and messaging isn’t just the right thing to do — it may also be required by law for certain organizations. Under the Americans with Disabilities Act (ADA), state and federal government agencies — along with businesses and nonprofit organizations that serve the public — are required to offer communications in formats that are accessible to individuals with disabilities. This means healthcare providers ought to be particularly proactive about offering more accessible, alternative means of communication. Here, we’ll explain just what AFS is and why it’s so important for healthcare providers and organizations. Plus, we’ve got a quick primer in the “Summary” section for those of you who simply need a refresher on accessibility services for patients who have low vision or blindness.
Just like efforts to improve culturally and linguistically competent outreach for individuals with limited English proficiency, alternative formats allow people who are unable to read quickly (or at all) to access and easily understand important messaging about their health plans, Medicaid eligibility, healthcare procedures, and more. And that’s not to mention the fact that people with these disabilities also have the legal right to access this information equally under the ADA. This means that documents and other forms of media providing critical information to prospective patients or Medicaid applicants must meet certain accessibility criteria. The bottom line is this: Alternative text formats like large print or audio recordings allow healthcare providers to expand outreach  and help current patients make informed decisions about their healthcare. This ultimately improves health outcomes for individuals who cannot read traditional text media.
Healthcare providers looking to offer AFS for patients should identify a common set of documents and other media that need to be offered in accessible formats. Here are just a few examples of items that you might want to consider updating in alternative formats: To identify these documents and make them accessible in alternative formats, we recommend seeking out the advice of an agency specializing in accessibility services. Many agencies — Avantpage included — offer specialized services to bring your organization up to ADA compliance. While you may choose to create in-house alternative format documents, it may be best to outsource these tasks to a third-party provider who knows the ins and outs of accessibility services.
There are several types of AFS that healthcare providers should consider. Here’s a breakdown of the most common alternative text formats used for individuals with low vision and blindness. As the name suggests, this format features an enlarged font to make it easier for individuals with low vision or other reading difficulties like dyslexia to access written information. Large print typically consists of text written with 18- to 20-point font. Other non-text assets like images or logos may be enlarged as well, to improve readability. Additionally, when producing large print formats, it’s preferable to use sans serif fonts like Helvetica or Arial — these are generally considered more readable. Braille is a system that allows individuals who are blind or otherwise visually impaired to read text. While traditional writing is two-dimensional, braille is a tactile writing system that consists of a series of raised dots. Each configuration of dots corresponds to an individual letter of the alphabet, enabling people to read with their fingertips. This format has historically been printed, but with the advent of computer technology, there are now also digital braille formats. Readers can connect braille display devices to their computer, making it much easier to access braille. Unlike braille and large print, audio and data CDs convert the written text to audio. These CDs feature an audio recording of the original text, and can either consist of recordings made by a voice actor or text-to-speech software. Audio CDs allow users to pop them into a CD player just like they would with, say, an album or audiobook. On the other hand, data CDs include a digital file, acting more like a storage device such as a USB flash drive. Additionally, some computers and smartphones may be equipped with audio readers, which play a similar function. These employ text-to-speech software that reads a given text to a listener, without having to fuss around with an actual disk.
Just as you might translate a flyer on Medicaid eligibility into Spanish, it’s important to make sure that information is available in alternative formats for individuals with disabilities as well. Here are some key things to keep in mind as you’re looking into alternative text formats: Aside from being the right thing to do, offering AFS is also required by law for many organizations and businesses. Whether you’re looking to start offering accessibility services in English or if you’d like to expand your AFS to include other languages spoken in your community, Avantpage has you covered. Our accessibility experts know the ADA inside and out, so don’t hesitate to contact us at [email protected] or (530) 750-2040

Although language access — that is, enacting policies that ensure an individual’s access to important communications in their preferred language — is an important component of providing legal services to individuals with limited English proficiency (LEP), it’s just a starting point. Organizations must also center language justice in order to truly provide equitable services. Though they’re highly related topics, language justice takes things up a notch, promoting linguistic diversity and emphasizing an individual’s inherent right to access services in their own language. The American Bar Association defines language justice as “an evolving framework based on the notion of respecting every individual’s fundamental language rights—to be able to communicate, understand, and be understood in the language in which they prefer and feel most articulate and powerful.”  Although language access attempts to work around language barriers, language justice attempts to break these barriers, allowing people to seamlessly communicate in their own language. While language access is a good starting point, language justice goes a step further by guaranteeing equity for people who have limited English proficiency. In the field of legal services, that means ensuring individuals with LEP are aware of their rights to a certified court interpreter and other relevant language services, without imposing English upon them. Nearly 10% of the country — that is, 26 million people — has LEP, making it critical that providers of legal services have a plan in place to practice language justice. Indeed, the National Center for State Courts has acknowledged the importance of advertising court services to residents in multiple languages, to ensure that individuals with LEP are aware of their right to access those services. Providers of legal services and state justice departments can and should take several actionable steps to move toward a framework of language justice. In order to push themselves past language access and into the realm of language justice, organizations and agencies working in the legal field can adopt the following practices — if you don’t have time to go through everything in-depth, we’ve summed it all at the bottom of this page.
It might sound like a no-brainer, but one of the key steps in achieving language justice is developing a practical written plan. Under Executive Order 13166, federal agencies must have a language access plan in place already. But by developing a separate language justice plan in addition to an already existing plan for language access, organizations go above and beyond what’s required by federal law, truly demonstrating a commitment to supporting linguistic diversity. This plan should consist of actionable steps to enable your organization to achieve language justice. This plan should also be informed by local data — different cities and zip codes have different linguistic demographics that need to be taken into account in any effective language justice plan.  It’s also important to stay accountable — appointing a language coordinator or working group is a good first step to ensuring that members of an organization uphold the key steps and tenets of the language justice plan. It’s also a good idea to update the plan on a yearly basis, as a sort of yearly check-in to gauge progress toward fulfilling language justice and also identify any obstacles in the process of implementing the plan effectively. Here are just a few of the steps that legal organizations and agencies should include in their plan to bring your language access plan up a notch and emphasize language justice.
By having staff members who are fluent in multiple languages, legal organizations and agencies can better serve clients who speak languages other than the dominant language. Additionally, individuals who are familiar with another language are also likely to have strong cultural knowledge of the community that speaks that language. This cultural competence can improve communication between staff members and clients, which may ultimately lead to better understanding and more effective representation.
This is important because it ensures that all members of the community have access to information about the services offered by the organization or agency. Adopting a new outreach strategy that emphasizes language inclusion may seem daunting but working with a trusted language service provider can help smooth things over. Key aspects of a linguistically inclusive outreach strategy include translated informational materials, multilingual hotlines, as well as advertising and community meetings tailored to specific language communities. By proactively reaching out to different language communities, legal organizations and agencies can increase accessibility and promote equitable access to justice for communities with low levels of English proficiency.
Training your staff on the importance of language justice is a crucial part of ensuring that an organization is not only committed to providing language justice, but also to actively promoting it. This can include presentations on cultural competency, and best practices for working with clients from diverse language backgrounds. Holding these training sessions can provide staff members with the tools and information that they might need to effectively and respectfully communicate with and represent clients.
It might not be feasible or even possible to hire a full-time interpreter for your organization. But at the same time, you may find that you need one on relatively short notice — having a working relationship with a provider of remote interpreting services is a good way to ensure that you’re able to provide for new clients who might need an interpreter. Remote interpreting allows for real-time translation during legal proceedings and consultations, which can improve understanding and communication between clients and staff. This can also promote equal access to justice for clients who do not speak the dominant language. Encouraging staff to use remote interpreting services can ensure that all clients have access to the same level of service, regardless of their language background.  Avantpage is committed to language justice — we also have a noted track record of working with legal organizations and government agencies to help individuals with LEP access critical services. If your organization is looking to develop or implement a language justice plan, we’re here to help — contact us at [email protected] or (530) 750-2040.

Public transit is a major component of urban life. On any given weekday in the United States, city dwellers will board buses, light rails, subways, and other forms of public transportation around 34 million times, according to data from the American Public Transportation Association. These services allow millions of US residents to travel to and from their jobs, schools, hospitals, and anywhere else they need to go about their day-to-day lives. At the same time, public transit systems have also historically failed to serve all members of their communities equally, leaving some groups — for example, people with limited English proficiency (LEP) and disabilities — with limited access to these vital resources. As a result, conversations surrounding diversity and equity in public transit are becoming an increasingly more important part of social justice efforts. The population of individuals with LEP in the US has increased significantly in recent decades. Although this growth is particularly evident in regions with strong public transportation networks like the New York City metropolitan area and greater Chicago, cities without robust public transportation networks are seeing significant growth as well. Plus, research from the Washington Metropolitan Area Transit Authority found that individuals with LEP are about three times as likely to rely on the bus than individuals who speak English fluently. Likewise, New Yorkers with disabilities have been found to be more likely to use the bus than their counterparts (and they were less likely to use the city’s famous subway system — probably due to the fact that less than a third of the city’s subway systems are wheelchair accessible). Just as other sectors must evolve to provide for the growing population of individuals with LEP, so too must public transit — factoring populations with LEP into this evolution should be at the forefront of any effort to improve diversity, equity, and inclusion in public transit. To create a truly equitable and diverse approach to developing and maintaining public transportation systems, it is essential that communities with LEP and people with disabilities are meaningfully engaged in the planning, design, and operation of these systems.
Public involvement is an essential component of transportation planning and decision-making. In developing a strategy for public transportation accessibility, it’s particularly important to center diverse voices, to ensure that you’re serving all members of the community. Engaging members of the public provides a way for communities to have a say in public transit projects. This in turn enables these efforts to have a meaningful and positive impact on their lives — it also ensures that the needs and concerns of all stakeholders are taken into account. Language barriers can make it difficult for LEP individuals to access information or participate in meetings, while physical barriers such as inaccessible meeting locations or a lack of accommodations for people with sensory impairments can prevent people with disabilities from participating fully. Equitable access to public involvement opportunities is particularly important for people who come from low-income backgrounds, people of color and people with LEP, as these people tend to be more reliant on public transit than their counterparts. As a result, it’s especially important to communicate with these folks and hear their opinions on any efforts to improve public transit accessibility. There are a number of best practices that can help transportation agencies effectively engage with LEP and people with disabilities. These include: For example, in 2021, when New York City’s subway system began offering free rides to passengers who frequently used contactless payment methods, the city translated its messaging on this initiative into Haitian Creole, Spanish, Russian, and a handful of other languages spoken widely. Such efforts can go a long way toward engaging LEP communities, especially when done in conjunction with the other practices above.
Effective community engagement requires an understanding of the cultural context in which it takes place. This is particularly important when working with communities that have LEP or disabilities, as these groups may have unique barriers to participation that need to be addressed. To engage individuals with LEP, it is critical that any outreach strategy focuses on culturally competent messaging that speaks to them in their language and reflects their cultural values. Likewise, efforts to engage people with disabilities should also use messaging that empathizes with them and makes them feel both welcome and safe on public transit. While linguistic considerations are certainly important for individuals with LEP, it’s also important to work with community-based organizations that can help transportation agencies communicate effectively with communities that have lower levels of English proficiency. Messaging shouldn’t be a word-for-word translation of English documents, but it should also take cultural contexts into consideration — this is the best way to ensure authentic community engagement.
Advancing diversity and equity in public transit requires meaningful public involvement, particularly for communities with LEP and disabilities. By prioritizing the needs and concerns of these communities, we can create more inclusive and equitable public transit systems that benefit everyone. Avantpage has worked closely with state departments of transportation, transportation commissions, and several other organizations at the forefront of innovative transportation. We are proud to offer translation, interpreting, and other cultural mediation services for projects to improve diversity, equity, and inclusion in public transit — for more information about our services, contact us at [email protected] or (530) 750-2040

There have been a handful of significant developments to improve the accessibility of low- or no-cost health insurance over the last 15 years or so. However, many qualifying individuals with limited English proficiency (LEP) aren’t aware that they can receive these benefits. Studies have shown that individuals with LEP have not taken advantage of improvements to Medicaid accessibility as much as their English-speaking counterparts have. This is where culturally competent outreach can make a difference. Culturally competent outreach refers to any sort of outreach strategy that accounts for the cultural context of its target demographic. For individuals with LEP, this doesn’t just mean speaking to them in their language, but also understanding and remaining sensitive to their cultural background. By emphasizing cultural competence, state-based health plans can connect with LEP individuals and inform them about whether they qualify for Medicaid. It’s an essential part of ensuring that LEP individuals have proper access to the health services they need to thrive. Although individuals with LEP make up a comparatively large proportion of Medicaid recipients, there are still thousands of individuals with LEP who are paying more than they need to for their healthcare — or worse, going uninsured. As state-based health providers continue to work toward reducing coverage gaps for eligible individuals with LEP, it’s clear that culturally and linguistically appropriate outreach is key to making healthcare more accessible. Here’s what state-based health plans can do to develop a culturally competent outreach strategy for individuals with limited English proficiency to help close coverage gaps. Of course, one of the most important aspects of any outreach strategy is making sure that you’re communicating with people in the language they speak. This is doubly important when targeting individuals who have LEP. Developing a culturally competent outreach strategy for these populations should start with research on which non-English languages are spoken widely among individuals with LEP in the state. This information will help guide efforts to connect with and engage communities where English isn’t the primary language. Most US residents with LEP speak Spanish as their primary language, according to research from the Brookings Institute. The most prominent languages among communities with LEP can vary significantly from zip code to zip code, so it’s important to do thorough research and identify all of the languages that are prominent in a given area. The Department of Health and Human Services recommends that providers translate vital written documents into any language spoken by 1,000 (or 5%, depending on the size of a given population) or more individuals with LEP in a certain population. This is also a good outreach strategy for state-based health plans. Upon identifying these target languages, more research into local language access plans and mandates is also an important step. While federal mandates like the Civil Rights Act and Section 1557 of the Affordable Care Act include language access provisions for state Medicaid agencies, it’s important to know what’s also required in each state. Some states — like New York, for example — have their own language access policies that state agencies must adhere to. After conducting a thorough review of the language access plans and policies is to commission translations of written documents and texts into the target language (or languages). Documents that will need translation include — but are not limited to — the following: These written documents will likely be an individual’s first impression of the health plan, making it crucial that individuals with LEP can understand them easily. And, in the case that they qualify, it’s also important that they understand how to actually enroll in the plan and exactly what that plan covers. While written documents are an integral component of any outreach strategy, some folks may prefer to talk to a human being, rather than scroll through a website or flip through an informational pamphlet. Or there might be information they just can’t find in writing as easily as they could by chatting with somebody. As such, it’s important to staff phone hotlines and offices with highly qualified bilingual workers who can communicate with individuals who prefer to speak in a language other than English. Offering separate phone lines for different languages is one way to improve accessibility for those who don’t speak English. Interpreters are also key here — they serve as a sort of medium between the insurance provider and the patient, seamlessly switching between each party’s preferred language. Over-the-phone, video remote, and in-person interpreting services are an important part of connecting with individuals who have LEP. State agencies must also be sure to closely research interpreting agencies to make sure they offer services in the most in-demand languages. While the right language is a crucial part of reaching out to and offering culturally competent care to individuals with LEP, it’s also important to make sure your efforts are sensitive to their cultural background. Translation and interpreting ensure that prospective Medicaid insureds can understand the information, but they must also be presented in a way that resonates with an individual’s cultural values. Moreover, as intertwined as culture and language are, they’re still two distinct entities. For instance, a monolingual French speaker from Quebec may be more responsive to different strategies than one from Senegal, and vice versa. Taking into account the communication strategies and acceptable topics that vary from culture to culture is an important part of achieving true cultural competence. Consult with experts on the target culture. Partnering with community organizations and utilizing local resources can be an effective way to reach LEP individuals and provide them with information about Medicaid eligibility and enrollment. These organizations may have connections and relationships with LEP communities that can be leveraged to facilitate outreach and communication. Engaging outreach campaigns have been shown to boost Medicaid enrollment and improve health outcomes for those most in need. By developing outreach strategies that emphasize cultural competence, state-based health plans can help close Medicaid coverage gaps among individuals with LEP. Avantpage strongly emphasizes accessibility in our website localization, content translation, and interpreting services. If you need help getting started, contact us at [email protected] or (530) 750-2040.

To improve equity, one step your organization can take is to provide or expand language access for limited English proficient (LEP) individuals and communities. Language access may present itself in many ways: translated website or content, interpreters at healthcare appointments, language assistance during election time, and more. We’ve provided six essential ways to improve equity through language access for organizations looking to provide or expand on their language access services. Start by figuring out a process to identify, track, and report on Limited English Proficient (LEP) audiences across your organization. Having robust and accurate data will enable you to inform language access queries, leading to support for the LEP community. It’s important to track this data at micro-local and/or at the program level, because languages might be more prominent in specific areas than what’s prominent at state or even county levels. Some ways to collect LEP audience information include: LEP audience data helps organizations plan for language access support and implement initiatives, leading to a better understanding and response to changing demographics and needs. Language access shouldn’t be an afterthought—it’s much easier, more efficient, and less costly to plan ahead. Suppose you’re considering localizing your website into other languages. In this case, you’ll want to make sure that your website is reviewed for internationalization, meaning that it can handle language nuances (e.g., Chinese characters require double-byte codes). Identifying and fixing language requirements before you’re ready to localize your website will save money and time in development costs and prevent delays in launching localized sites. In addition, numerous tools can help improve equity while saving time and money on translation costs for content. For example, preparing a terminology database with technology like AvantMemory before content is translated provides content consistency, reduces costs, and decreases time-to-market. In addition, creating content using plain language can benefit both the audience by making content easier to understand and an organization by reducing translation costs. While you can still use these tools after content is developed, you get the most out of them early on in the process. Consider proactively integrating funds, resources, and planning for language access into all organizational programs early on. A language access plan is a policy describing how an organization will provide language services to support LEP individuals and improve equity. The content of a language access plan varies since there’s not a standard template; however, it generally includes topics such as data about the LEP population, services offered, policies and procedures, training, budgets, and more. Federal regulations require a language access plan for schools and government agencies. Even if a plan isn’t required, it can help an organization focus and put a policy around language services to ensure you’re providing the best possible services. An LSP who works with government agencies and educational institutions should be quite familiar with language access plans and be able to provide some guidance. An LSP may also know the area, what other organizations are doing, and what’s working. Reach out to your LSP to see how they can help. Establish accountability measures that include equity indicators across all levels, both for the LEP community and internally, to ensure that you can provide adequate staff to support your language initiatives. These measures can be built into a language access plan. Here are some examples of the kinds of measures you can put in place: Be resourceful, and learn more about other organizations to gain insights, information, and ideas for strategies. Create community hubs, partner with interagency groups for ideas and resources, and use overarching bodies that already have language access in implementation. For example, digital.gov has a multilingual community as well as multiple resources around translations. In addition, many grants are available—look for ones that promote equity in Social Determinants of Health (SDOH). Also, contact your local government to see what resources may be available. Finally, your LSP should be a great resource, given that they see many organizations and have ideas about where to go for help. Like community hubs, partner organizations that work with LEP individuals and communities are key to high quality and responsiveness language access. Organizations should find and partner with local communities, non-profits, and organizations to target LEP communities in their outreach. These organizations have cultural and linguistic skills and the connections to ensure leveraged outreach. Expanding language access helps improve equity for LEP individuals and communities. Organizations can improve through services using the tips in this blog post. We localize websites, translate content, provide interpreter services, and more. If you need help getting started, contact us at [email protected] or (530) 750-2040.

Website accessibility is a way to promote access on your website for those with disabilities. Improving a website’s accessibility benefits everyone—a better structure and experience means greater satisfaction and connection to your brand. You can implement coding, design, and content items to make your website accessible. In 2008, the World Wide Web Consortium (W3C) created Web Content Accessibility Guidelines (WCAG) to share common standards for website accessibility. The guidelines are organized around these four principles: perceive, operate, understand, and interact with the web.  Numerous online tools (software programs or online services) are available to test out your website to see how it meets accessibility guidelines. W3C has an extensive list of online tools that you can filter to find one that meets your needs. Using one of these tools is a good starting point to get an idea of the current state of your website’s accessibility. In this blog, we’ll look at ways that you can make your website accessible by making it more understandable through plain language, functional with webpage accessibility, and more accessible to everyone by professional translations. To learn more about ways to make your website more accessible via perception, operable or robust, read how a California health plan provider achieved linguistic and accessibility compliance. Plain language is defined by the Plain Writing Act of 2010 as: Writing that is clear, concise, well-organized, and follows other best practices appropriate to the subject or field and intended audience. The government developed plain language as a guide to help save federal agencies time and money while better serving Americans. Plain language benefits both the audience (makes content easier to understand and navigate through) and the writers (shorter authoring time and enables people to take action more quickly). In addition, the concise, active tense style of writing for plain language can help facilitate an easier start for translations. Here are some recommendations for writing in plain language: For more information, the plainlanguage.gov website provides many resources, including guidelines, training, and more.  The WCAG guidelines include many items related to the technical aspects of accessibility, such as making the site navigable by keyboards, elements readable by screen readers, and much more. In regards to language accessibility and understanding, you can make changes to the content and the content’s structure to help the user with website access.  Here are some recommendations for improving the user experience and structure: When it comes time to translating your website content, there’s no substitute for a professional translation company. Professional linguists understand the language’s culture and will choose words that are the best fit given the context. Linguists also have experience, certifications, and knowledge of translation tools. Here are some recommendations for making your website accessible for translated content: Making a website accessible benefits everyone—not just those with disabilities or limited English proficiency. For example, all visitors can benefit by having an easily navigable website with concise, easy-to-read content. At Avantpage, we help our clients make their content accessible and provide language services for LEP individuals. We offer an accessibility service that reports our findings for our clients to implement or we can provide a full service of reporting and implementation. We also localization website content into over 150 languages. For more information, email us at [email protected] or (530) 750-2040.

Telehealth services have become a convenient way for patients and healthcare providers to address health issues. And while telehealth and telemedicine are excellent ways to receive care for many people, research shows that telehealth services aren’t always accessible for individuals with disabilities. This includes not just the telehealth appointment itself but also the steps of the patient journey leading up to the appointment (e.g., finding a doctor, filling out forms, etc.) and the post-appointment (e.g., getting a prescription, scheduling follow-up tests, reading materials, etc.). While many different types of disabilities exist (e.g., hearing, visual, cognitive, motor and dexterity, and speech), we’ll focus on hearing and visual disabilities for this blog. A survey by the American Foundation for the Blind (AFB) found that 70% of 488 adults in the U.S. who are blind, have low vision or are deafblind tried to use telemedicine, but 57% had problems accessing the platform. In addition, a research report by the AFB showed that most of the material provided by healthcare providers is not accessible to them. This results in difficulties with prescription labels, pre-surgery instructions, and other types of materials. “We need accessible healthcare mobile apps and websites. We need technology to represent graphical information in a format we can understand.” —Congenitally VI White male, aged 45 to 54 years, with no additional disabilities (p.55 Flatten Accessibility Report) Yet healthcare providers can take steps to make their services more accessible for individuals. We’ll look at what should be reviewed and made accessible along the patient journey. Finding a physician and initiating an appointment are the first few steps in the patient journey. In general, people turn online to do this research. Think about all the steps a patient must take do before a telehealth visit. How can you make those steps more accessible? For example: The telehealth visit should be viewed from the patients’ perspective and also from an internal technical perspective. How can your organization make its telehealth services more accessible during the appointment? The patient needs to receive accessible log-in instructions, troubleshooting information, contact information for technical help, and information on how to cancel or reschedule. Your organization’s IT team should implement the following technical features to ensure the telehealth visit is accessible for users who are blind, have low vision, are deaf, or are hard-of-hearing. This will ensure the patient is able to connect into their telehealth appointment. If you would like help assessing these areas, Avantpage is happy to find a solution to match your budget and timeline. Request a quote today. The patient experience doesn’t end with the telehealth appointment. There might be instructions, follow-up appointments to schedule, tests to schedule, care instructions, updates in patient portals, and more. While the post-visit process varies for each individual, the same concepts that we mentioned earlier also apply here. Healthcare providers can greatly improve the patient journey by providing accessible materials and online experience. These materials should provide the best accessibility and user experience. We provide a full range of services for healthcare providers to accommodate those with disabilities. We can review your current client-facing content for accessibility and work together with you to make changes to websites, digital content, and other types of content along the patient journey. Visit our website to learn more about how we can help healthcare providers accommodate their patients with disabilities and improve their patient journeys, and contact us at [email protected] or (530) 750-2040.

Translation and language services drive communication and business in the global marketplace and business world. The translation services industry was valued at over 39 billion in 2020 and is projected to reach over 46 billion by 2028. Despite the industry’s importance, you may have some preconceived notions about it if you haven’t done any or very little work with translations before. This leaves clients with knowledge gaps, leading to misunderstandings and uncertainty. The language service provider (LSP) should ensure everything is clear, and the client feels comfortable asking any questions they might have. In this blog, we’ll address 10 common misconceptions about translation. Here are basic definitions: Learn more about the differences between translators and interpreters. As we just described, a translator is about written communication, whereas an interpreter is about verbal communication. These two styles are very different, just as they are for all of us. Also, every individual has expertise, so a Spanish interpreter in the healthcare industry may not have the expertise to interpret in a legal setting. And marketing content requires a different type of translator than a technical manual. So many specializations exist, and a language expert can’t do everything.
Just because someone is a native speaker of a language doesn’t mean that they have the skills to be a linguist. Linguists are specially trained professionals with acutely developed skills. This comes by way of certifications, continuing education credits, professional development, learning, formal education, and professional memberships to hold everyone accountable to high levels of professional standards and code of ethics. Having a bilingual employee do translation work is not a sufficient way to deliver translation projects since: Learn more about the hidden costs of using bilingual employees for translation. “I need a sign language interpreter” is too vague to provide any meaning. A sign language interpreter is not just one type of interpreter. Between 138 and 300 different sign languages are used worldwide. In the US, the most common types are American Sign Language (ASL), Signed Exact, and Tactile. While many people who are deaf do know sign language, there are also many who know different varieties or home signs, or who have different levels of proficiency in a sign language.   In order to provide meaningful access, certain questions need to be asked to find the best suited interpreter match. Learn more about deaf or hard-of-hearing interpreter requirements. You may get a directive to “translate this into Spanish.” Yet Spanish isn’t a universal language; it’s the same idea as “needing a sign language interpreter.” So while the target language may sound simple—Spanish, French, Portuguese, Arabic or Chinese—many languages are regionally targeted. Some translations, especially in the US, need to use Universal Spanish to target multiple varieties and most common Spanish understandings. For regional language varieties, such as smaller, established communities, a Community reviewer might be necessary. A Community reviewer can help with these specialized language variations. Another misconception about languages is if a child is willing to interpret for a parent or guardian, and the adult says it’s OK, then it’s OK. This isn’t a good idea for several reasons: Using an experienced interpreter is the best way to go—not have a child do the work. If you received multiple bids on an RFP, know that the lowest bid charges aren’t necessarily the only charges you may incur. Hidden fees may pop up or the quality is poor, which results in more time to manage the project, re-do the work or worst case—errors go unnoticed and turn into a liability or lawsuit. In addition, over time, these costs and more might actually add up to a higher price than the best-value bids. Some agencies that appear to cost more outright might have technologies for built-in cost savings (e.g., re-using already translated terms, project management tools) that enable you to save money over time. While the most obvious thing that an LSP does is provide translation and interpreting, they do so much more, such as: Depending on the type of organization, you may be eligible for additional funding for language services. Sometimes grants are available that help fund language services. Find them and apply to grow your language access programs. For example, grants that promote equity in Social Determinants of Health among immigrant populations, improve student learning, and others are available. Having misconceptions about the translation industry is understandable, especially if you’re new to working with it. We’re here to help answer any of your questions. For more information, contact us at [email protected] or (530) 750-2040. Let us help you provide the best language services.

For this year’s Hispanic Heritage Month we wanted to celebrate the contributions and achievements of those who play such a large part in our U.S. identity. We decided to talk with Avantpage CEO & founder, Luis Miguel, a bit about Hispanic Heritage Month, his own background, and a few of the many ways these individuals have and continue to play such a big part of the U.S. In some ways I am a typical immigrant to the US, coming from Mexico attracted by the American Dream and looking for opportunity and a better life.  Yet my ancestors on both sides emigrated to Mexico from Lebanon in the 1920s, again looking for opportunity and a better life. And once in Mexico in the 1930s, both my paternal and maternal grandparents migrated from Teziutlan, Puebla, a small town to the grand metropolis, Mexico City.  So, I come from a family of immigrants with middle eastern roots, born and raised in Mexico, a country with a complex mixture of indigenous and Spanish peoples creating a pluralistic and rich culture.  The United States also has a rich and complex history and Spain, the Viceroyalty of New Spain and Mexico have prominent parts in that history. A huge part of the South and Western U.S. belonged to the Viceroyalty of New Spain, a Spanish colony, until 1821 when Mexico won its independence from Spain and became an internationally recognized new country. At that time, Mexico included modern day California, New Mexico, Utah, Nevada, Arizona, Colorado and Texas among others.  Over the next 50 years the U.S. annexed about 50% of Mexico’s territory, in the process leaving millions of Mexican citizens as U.S. citizens. In addition, the border between both countries has always been very porous, with millions of people moving back and forth to this day.  Hispanic heritage month reminds me of this rich cultural, economic and ethnic mix of both countries, something that the dominant European immigrant groups suppressed for many years until very recently. Spanish is the second most spoken language in the U.S., and several of the old Mexico states, like California and Texas, will soon have more Hispanics than any other ethnic group.  As I mentioned before, I was born and raised in Mexico. It is where most of my family still resides, and I have a deep love and respect for the country.  Since English to Spanish is about 50% of our translation work at Avantpage and we were getting most translations from Argentina [based linguists], in 2008 I decided to open an office in Mexico City to do our Spanish translation work. The translation industry in Mexico at the time was 100% focused on the internal market and had low levels of technology and modern business practices.  So I saw the opportunity to create a new translation agency niche in Mexico, modeled after the agencies in Argentina, that served the Spanish needs of the U.S. market. This provided new opportunities for work to both project managers and translators in Mexico.  So much substance and complexity! Not only do we have people from many Mexico regions, but also from many other former Spanish colonies including Venezuela, Argentina, El Salvador, Brazil, etc. So the ethnic, cultural and linguistic diversity within the hispanic population is enormous and very rich. The Cuban and Puerto Rican immigrants in Florida and New York have different dialects and cultures from the Mexican immigrants in Texas.  The linguistic scope of Spanish has steadily increased over the years, as the Hispanic populations continue to grow, integrate and become more varied.  In many locations you have Spanish immersion programs in public schools, websites, signage and notices in Spanish, and even ES/EN bilingual people serving the public.  I have no doubt that the penetration and influence of Spanish will continue to grow in the U.S. given the higher birth rates among the Hispanic population, and the continuing renewal through our porous Southern border. Luis Miguel, CEO of Avantpage Translations, joins SlatorPod to talk about the LSP’s mission over the past 25 years of helping immigrants and other limited-English-proficient (LEP) populations. Check out this list of resources from National Council of Hispanic Employment Program Managers National Park Service’s Telling All Americans’ Stories: Introduction to American Latino Heritage

Language barriers can come in many forms, and reducing language barriers in healthcare needs to be innovative and detailed. Immigrants and limited English proficient (LEP) individuals have historically been marginalized and discriminated against due to accents or language capabilities, despite being integral members of our society.   Healthcare is one of the many areas where LEP individuals face communication challenges, sometimes resulting in negative experiences, care, and outcomes. These types of experiences may lead to avoiding care as a whole, resulting in more severe impacts on health when faced with things like:  Not providing full and meaningful language access creates uncertainty and complexity for the patient. To work towards an equity-based healthcare system that reduces health disparities, it’s important to make strides that create the opposite environment, working to eliminate harsh histories of discrimination. Healthcare organizations can do this by focusing on innovative ways to support and encourage the LEP voice in healthcare experiences.   To work towards a healthcare system that promotes equity for all, we need to actively work to reduce longstanding disparities in innovative ways. After all, improving access to care benefits LEP and underrepresented communities, and it improves the healthcare organization as a whole.   Organizations can start by creating a framework to advocate for and advance health equity. To create a culture of health equity, language should be written into internal procedures and processes, and training should be provided for staff. In addition, the messaging should be written into any content that involves patient quality and safety, and have a plan with measurable goals for improving care.   Here are some of the benefits that organizations can see.  If language preference isn’t addressed during a clinical encounter, the patient may receive lower quality and costlier care. LEP patients have an increased chance of readmission, risk of surgical delays, and longer hospital stays if an interpreter wasn’t available during admission and/or discharge.   In looking at readmissions, a study showed that over a 3-year period, readmissions were significantly fewer when telephone interpreters were available. Per the report, “language access represents an important service that all medical centers should provide to achieve equitable, high quality health care.”  One study found that only nine percent of people understand their health insurance. And that’s for people who speak English. For LEP patients, the complexity rises. However, when members understand their plan, it results in taking more action and receiving better care. Healthcare companies can help make their content easier for LEP members by translating their content, providing language access during the enrollment assistance program, and creating an outreach program to educate LEP communities.   When members understand their health insurance, financial incentives to seek higher quality doctors and hospitals can work. As a result, plan members can receive better care and plan performance can improve.  Improving patient satisfaction is a win-win for individuals and organizations alike. For patients, a better experience is directly tied to the process and providers of the care they receive, leading to better health outcomes.   On the business side, better patient experiences are tied to services provider loyalty, greater employee satisfaction and reduced turnover, financial incentives, and lower medical malpractice risks.   Staff can do a lot for LEP patients and their families if the environment is supportive and has the necessary resources for reducing language barriers in healthcare.  Organizations can support and encourage their staff to provide meaningful language access by using interpreters and sharing translated materials. Having a strategic and cohesive language access plan including training can help staff be better prepared and ready to help patients.  Patient handoffs are one of the most dangerous times of a patient’s care. And adding a language difference on top of that makes a situation even more complex. To minimize the difficulties during these times, standardize the process of language access during handoffs. For example, have an interpreter available during handoffs.  A study by JAMA Pediatrics found that children and their parents who face language barriers are two times less likely to say they’re unafraid of “asking questions when something does not seem right” and five times less likely to say they “feel free to question the decisions or actions of health care providers.  Providers should do more to make patients feel safe to speak up and ask questions. One way to help with this is to train staff to talk to LEP patients and their families about their care. Consider how questions are phrased. Simple yes or no questions are less encouraging for speaking up about questions or doubts. Providers can use questioning-tactics like asking the family to repeat their understanding, or what they can help further clarify are a few ways to encourage question-asking in a safe environment.   Even if patients speak some English, encourage them and their families to use an interpreter. Federal law requires that hospitals provide interpreters free of charge to those with LEP, so it’s their right to ask for this service. While a family member can pitch in if there isn’t another option, this can risk an increase of misunderstandings and create unnecessary complications. Therefore, it’s best to have a professional medical interpreter help with LEP patients.  Breaking through language barriers benefits LEP patients, their families, and healthcare organizations. Good care results in trust in providers, positive patient experiences, and better health outcomes.   We provide interpreter services for healthcare organizations, and we translate member and marketing materials. We want to help healthcare organizations reduce health inequities. For more information about our healthcare services, contact us at [email protected] or (530) 750-2040.