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Table of Contents - What Is Trauma-Informed Care? - Why Trauma-Informed Language Services Matter for Healthcare, Legal, and Social Service Providers - General Considerations for Interpreting Settings - Trauma-Informed Care: Special Considerations - 1. Gender Preferences - 2. Age Preferences - 3. Language Preferences - 4. Community Dynamic - 5. Interpreter's Preference - How Avantpage Delivers Trauma-Informed Interpreting - Why Trauma-Informed Care Is Critical to Spoken Communication - Frequently Asked Questions About Trauma-Informed Services - Partner With a Language Service Provider Trained in Trauma-Informed Care Navigate a person-centered care system through trauma-informed language services.
At the surface level, language services like translation and interpreting might seem like fairly straightforward processes: You take content (or speech) in one language, and reproduce the meaning and message in another. But in practice, it’s all a lot more complicated than that. Translators and interpreters have to take all sorts of other considerations into account, from the specific context of the source to the audience who will be receiving the message in the target language. After all, the content you might read in an advertisement is worlds away from the language a medical interpreter has to relay back and forth between a patient and their doctor. And certain settings, such as healthcare, emergency services, and legal services, may require providers of language services to take into account the trauma that a person might have experienced before needing those services. As a result, translation and interpretation become inextricably linked with providing trauma-informed care, and it’s important that language service providers working in these sectors be able to pair non-English-speaking individuals who’ve suffered trauma with interpreters who are well-equipped to provide trauma-informed language services. For language service providers working in these domains, translation and interpreting are far from just matching and pairing languages — it’s also about making sure individuals with limited English proficiency (LEP) get the care they need and are able to advocate for themselves in light of traumatic experiences. Interpreters in particular are likely to work with clients and patients who need trauma-informed services. When working with individuals who have dealt with traumatic experiences — whether it’s violence or serious injury — interpreters need to be knowledgeable about how to effectively provide trauma-informed care. Here, we’ll discuss what trauma-informed care looks like and what interpreters and language service providers in general can do to ensure that they’re providing effective and sensitive trauma-informed language services. Trauma-informed care is a way to provide effective care and services to individuals who may have experienced some form of trauma. It’s a matter of being sensitive to an individual’s traumas and making sure that they’re able to receive adequate care in response to these traumatic events. Revisiting and discussing traumatic events can actively harm somebody’s mental well-being — as a result, it’s important to be sensitive when providing care to people who have faced such trauma. In recent years, providers of both legal and medical services have championed ways to provide trauma-informed services, from reframing the way they talk about traumatic events to avoiding triggering topics altogether. Providing trauma-informed care can be even trickier when there’s a language and/or cultural barrier. As a result, using interpreters who are specialized in providing trauma-informed care can help build bridges for limited English proficient individuals to receive adequate care. In addition, nationally recognized frameworks such as SAMHSA’s Six Principles of Trauma-Informed Care (Safety, Trustworthiness, Peer Support, Collaboration, Empowerment, and Cultural/Historical/Gender Sensitivity) play an important role in shaping how language access providers support LEP individuals. Incorporating these principles helps ensure that communication is not only accurate but also emotionally safe and culturally aligned. For organizations serving vulnerable populations, trauma-informed language access is more than a best practice — it’s a compliance requirement and patient safety issue. Providers must consider: When communication is unclear or emotionally triggering, organizations may see increased safety risks, misdiagnosis, patient dissatisfaction, or legal complications. Effective trauma-informed interpreting helps reduce these risks while supporting a more compassionate, person-centered care approach. Before delving into trauma-informed language services specifically, it’s worthwhile to go over some general considerations that apply to most interpreting settings. These include: The key consideration to keep in mind when providing trauma-informed services is the emotional and physical well-being of the client or patient.   Trauma-informed language services acknowledge the potential vulnerability, distress, or triggers that individuals may experience in sensitive or traumatic situations. By implementing trauma-informed practices and considerations, language service providers can create a safe and supportive environment for effective communication and healing. Here are some additional considerations language service providers should take into account when working with patients who have experienced some form of trauma.  Traumatic experiences can lead individuals to feel more comfortable or safe when communicating with an interpreter of a specific gender. Respecting this preference can create an environment that’s conducive to open communication and trust. Similarly, some individuals may find it easier to connect and share their experiences with interpreters within a specific age range. Victims of violence may prefer to avoid interpreters of the same age as their attacker, but broadly speaking, an age preference can also be influenced by cultural factors, life experiences, or personal comfort. Speakers of English as a second language (ESL) may prefer to work with an interpreter even if they don’t have LEP. Generally speaking, it’s easier to convey subtle nuances and express yourself in your native language — it’s hard enough to gather your thoughts after a traumatic experience, so it’s important to respect ESL speakers’ desire to work with an interpreter if they request one. Additionally, speaking through an interpreter from the same linguistic background can help build trust. Some clients may prefer to avoid working with interpreters who they know personally — others may feel safer with somebody they do know. This is particularly important to consider in small communities where an interpreter is more likely to know many members of their linguistic community, but in any setting, it’s important to consider the degree of anonymity a client or patient would like when receiving language access services. Certain words and phrases (particularly body parts and expletives) can be triggering to both the client and the interpreter. It’s important for language service providers to know what a certain interpreter may or may not be comfortable with interpreting. Assigning an interpreter who’s uncomfortable with certain phrases and topics could have a negative impact on the overall integrity of their interpretation, so it’s important to make sure your interpreter’s boundaries. It’s also important to note that these considerations go beyond trauma-informed services as well — even if a client hasn’t experienced severe trauma that you know of. While especially so in particular settings, being sensitive to a client or patient’s needs and triggers is critical to providing effective language services. To support organizations that serve vulnerable or high-risk populations, Avantpage has built specialized processes, training, and quality controls designed specifically for trauma-informed communication. These include: These safeguards help healthcare providers, legal entities, and social service organizations deliver care that is compassionate, culturally aligned, and clinically accurate, even in the most sensitive contexts. A trauma-informed approach to language access services is absolutely crucial, especially when it comes to interpreting for patients and clients in need of mental health, medical, or legal services. By considering an individual’s needs, experiences, and preferences, language service providers can deliver more effective and supportive services. Here are just a few things you should keep in mind when providing interpreting services in a sensitive or trauma-informed setting: A specialized form of interpreting that incorporates emotional safety, cultural sensitivity, and best practices designed to avoid retraumatization. Absolutely! Video remote interpreting (VRI) is often preferred for trauma-informed settings because it allows for visual cues while preserving privacy if anonymity is needed. Look for providers that include trauma-informed training, follow CLAS Standards, comply with Title VI, and demonstrate experience in clinical and legal settings — all areas where Avantpage excels. It minimizes the chance of miscommunication, supports emotional well-being, and helps providers maintain compliance with federal language access requirements. If your organization supports vulnerable communities, trauma survivors, or individuals navigating complex legal or medical systems, choosing the right language access partner is essential. Avantpage provides trauma-informed interpreting, professional translation, and culturally aligned communication services designed to protect safety, dignity, and trust. Ready to strengthen your approach to trauma-informed care? Contact us online or call (530) 750-2040 to speak with our team about building a tailored interpreting solution.

Although it’s illegal for rental agencies and mortgage lenders to discriminate against individuals on the basis of their English proficiency, we would be remiss not to acknowledge a clear reality: Individuals with limited English proficiency (LEP) tend to face greater housing instability than their English-speaking counterparts. This makes immigrant housing assistance absolutely critical to ensuring that individuals with LEP have a fair chance at securing housing and remaining housed. When it comes to home ownership, areas with high concentrations of LEP have been found to have a rate of home ownership that’s 5% lower than those with lower populations of individuals with LEP. Meanwhile, some rental agencies still refuse to rent to individuals with LEP — one in New York even caught the attention of the US Department of Justice after being accused of refusing to work with LEP individuals even after they offered to pay for their own interpreting services. Communities with LEP comprise a diverse group of people — immigrants, refugees, asylum seekers, and other displaced individuals, just to name a few. Among individuals with LEP, refugees and asylum seekers face unique challenges, as they often lack the resources to prepare for immigration or establish themselves in the country after leaving politically unstable regions. As refugees and asylum seekers arrive in the country, one of their most pressing needs is finding and securing housing accommodations. These individuals tend to be some of the most vulnerable to housing instability, as they may not be immediately ready to navigate the complex housing market upon arrival, especially if they don’t have a strong grasp of English or an established network within the country. Organizations like housing counseling agencies (HCAs) and the Department of Housing and Urban Development (HUD) provide immigrant housing assistance resources and services to equip these folks with the aid that they need. However, it’s crucial to provide these services alongside adequate language access services; otherwise, immigrants and refugees with LEP may not be able to take full advantage of housing assistance. In this blog post, we’ll explore the intersection of language access and immigrant housing assistance, highlighting the importance of equitable language access to support immigrant populations in their pursuit of suitable housing.
To effectively assist immigrant populations with their housing needs, it’s important that housing assistance — whether that’s emergency shelter needs or helping members of a family avoid eviction from their rental unit — be provided in a language that individuals can readily understand. There are a lot of key elements that go into making sure that individuals with LEP are able to find and access housing assistance services — here are just a few tips for housing organizations to enhance outreach and support for individuals with LEP: While it’s clearly important for agencies to provide services to individuals with LEP in a language they can understand, it’s equally important for said agencies to reach those individuals in the first place. After all, if individuals struggling with housing are not aware of or do not fully understand the available assistance, they may not be able to access the help they need. Because of this, it’s important that HCAs and other organizations providing housing assistance to immigrants make an effort to connect with individuals in their advertising and outreach materials — for example, translating (or even transcreating) informational pamphlets into languages that are in high demand within the local community, or directing social media and advertising campaigns toward non-English-speaking communities that are most in need. Partnering with CBOs that have established connections with immigrant communities can significantly improve language access in housing assistance. These organizations can provide valuable insight and cultural expertise to ensure effective communication and service delivery. Not only can they help you with your outreach plans, but they can also help give you an idea of the languages that are most in demand, and also provide consulting as you develop a language access plan. Although English is the most common language on the internet, it’s clear that people prefer accessing websites in their native language. Individuals with LEP will almost certainly be using the internet in a language other than English — so if your website is English-only, people in need may not easily find your website on search engines. That makes it absolutely essential for housing organization websites to localize their websites to cater to diverse linguistic communities. For tips on localization practices, visit our recent blog post on localization mistakes to avoid.  A robust language access plan is an absolute must-have for any organization providing immigrant housing assistance. A good language access plan will guide the ways in which your organization interacts with individuals who have LEP, including (but not limited to) the following actions:
These are just a few important considerations when establishing a language access plan — for more information on creating an effective language access plan, click here. Developing an online portal specifically designed for immigrant housing assistance, translated into multiple languages, can help streamline things for individuals with LEP. This portal can help connect clients with housing counselors who speak their preferred language and can also allow individuals to easily access translated vital documents. Individuals can also use the portal to schedule counseling sessions and communicate whether or not they’ll need an interpreter before their session begins, so the agency can be well-prepared ahead of time.
One’s level of English proficiency should never impact their ability to secure or remain in suitable housing. By recognizing the intersection of language access services and immigrant housing assistance, HCAs and other organizations providing housing assistance can serve their clients with LEP effectively and efficiently. Here are five tips to get you started: Avantpage is proud to help housing organizations provide effective and inclusive language services for some of the most vulnerable individuals. If your housing agency is looking to develop a language access plan or simply needs translation, localization, or interpreting services, we’re here to help — contact us today at [email protected] or (530) 750-2040 to learn more about our services. 

You probably don’t need us to remind you that in 2020, the United States declared the COVID-19 pandemic to be a public health emergency (PHE) — but now it’s looking like we’re finally in the clear, after three years of masking, social distancing, and working from home.  That’s not to say the pandemic’s over or that we no longer need to worry about COVID-19 — just that the state of emergency is over. Last month, the United States officially ended the PHE that was put in place more than three years ago. Among other aspects of daily life, the PHE had a profound impact on healthcare and how we access it — as such, the PHE ending is also likely to have an equally profound impact on telehealth. “[The Department of Health and Human Services] and the leadership across the Department remain focused on protecting the health and well-being of all Americans, particularly those at highest at risk, including seniors and immunocompromised people, making sure we don’t leave the uninsured behind, and monitoring the latest subvariants so we’re prepared and ready to manage the risks of the virus moving forward,” secretary of health and human services Xavier Becerra said in a statement on May 11, when the PHE officially ended. In response to the PHE, doctors and other healthcare providers adopted several telehealth measures and practices to allow patients and healthcare workers to stay safe in the face of COVID-19. The US Department of Health and Human Services first declared a PHE in response to COVID-19 in late January 2020. But it wasn’t until about a month and a half later that things began to hit the fan. In mid-March of that year the number of people diagnosed with COVID started rising fast — in response, businesses began to close their doors, students attended class on their laptops, and the video communications platform known as Zoom became a household name. During the PHE, virtual doctor’s appointments and other forms of telehealth became more prominent — this was possible because the PHE relaxed certain HIPAA requirements and allowed patients to file insurance claims for more telehealth services. And in the language services domain, remote interpreting became an even more important method of delivering services than before. The shift to telehealth meant healthcare providers had to rely on remote interpreting technology more than ever before.  It certainly stands to reason that this change should have had a positive impact on patients with limited English proficiency (LEP). Instead, it seems that telehealth was often less accessible to patients with LEP than those without. From problems with digital literacy to inaccessible user journeys, many patients with LEP struggled to receive the care they needed during the PHE. As we transition into this post-PHE era, here’s what healthcare providers — telehealth or otherwise — should know about accessing language services and providing equitable care to patients with LEP.
Throughout the COVID-19 pandemic, language barriers have posed challenges to effective healthcare delivery for individuals with LEP. Even before the pandemic, healthcare providers have had to take measures to break language barriers for patients with LEP.  But the pandemic and the shift to telehealth under the PHE made things even tougher. Insufficient digital literacy, lack of access to digital requirements like broadband internet among certain populations with LEP, and occasionally erroneous or misleading translations of important public health information made it harder for patients with LEP to access telehealth. And as a result, research suggests that populations with LEP were more likely to suffer adverse consequences from COVID-19 than other groups. These disparities shed some much-needed light on the importance of language access in healthcare. Ultimately, the PHE created a motive for healthcare providers to develop programs and innovative solutions to address language access barriers and ensure equitable healthcare for all. 
With the end of the PHE last month, many healthcare providers will be less likely to rely upon certain telehealth practices. And some things that were allowed under the PHE — for example, a relaxation of HIPAA that let providers who were covered by Medicare to use WhatsApp and FaceTime — will no longer be allowed. Likewise, the end of the PHE also means that doctors are no longer able to prescribe controlled substances to patients via telehealth alone. Patients will be required to come in for an in-person visit with the doctor before any such prescriptions can be written or filled. While video doctors’ appointments will certainly stick around, they’ll likely become less common than they were during the pandemic — especially since fewer telehealth visits will be covered by insurance, requiring many patients to default to onsite visits to the doctor. This means patients with LEP could potentially have to travel longer distances to meet with a doctor who speaks their language. Healthcare providers will still be able to use remote interpreting technology to get connected with an interpreter, in the event that a patient needs an interpreter. Demand for in-person interpreting may increase, however, as doctors begin to shift away from telehealth appointments and technologies.  Additionally, healthcare providers may need to reevaluate their language access practices to ensure that they meet the needs of patients who are coming into the office or hospital. In-person appointments introduce additional layers — for example, interacting with the receptionist at the front desk — that could cause friction if language access isn’t adequately considered.
About a month into this new chapter, it’s critical that healthcare providers consider ways in which the end of the PHE might impact the accessibility of telehealth services. Here are some things for healthcare providers to keep in mind during this critical junction: As we transition into this new phase of the pandemic, Avantpage is proud to provide consulting, translation, and interpreting services to healthcare providers all across the country. If you need to work on revising your language access plan for the post-PHE era, don’t hesitate to contact us at [email protected] or (530) 750-2040 for more information about our services.

Are you developing a language access plan? Here’s how you can get started with community and language assessments A language access plan is a must-have for many organizations: healthcare providers, public agencies, legal firms, the list goes on and on.  In recent years, lawmakers and the general public alike have grown increasingly aware about the importance of language access. The turn of the 21st century also marked an important turn in advocacy for language access: Executive Order 13166, signed in August 2000, required federal agencies to develop a plan to ensure that individuals with limited English proficiency (LEP) could receive “meaningful access” to their services. Since then, language access bills and advocacy efforts have sprung up all across the nation. Take for instance the recently launched Office of Language Access in the state of New York, which is overseeing the enforcement of the state’s new language access policy. Meanwhile, a similar bill passed the New Jersey state senate in March 2023.  Given our nation’s status as one of the most linguistically diverse countries in the world, it’s no surprise that language access has become an important part of our cultural dialogue. Of course, talking about language access isn’t enough — in order to take meaningful action toward progress, it’s important for agencies to take a thoughtful, principled approach to devising a language access plan. There’s no one-size-fits-all approach to language access — as such, each organization will need to take different steps toward providing adequate language access services. And that’s where the language access plan comes in. By taking the time to research your community’s linguistic needs and examine your organization’s services, you can create an actionable language access plan. If you’re looking to build an effective and equitable language access plan, this blog post can serve as a launching point for you to begin creating that plan. Here, we’ll explore how to get started with developing a language access plan and highlight some of the essential steps you need to take.
One of the first steps toward creating a meaningful language access plan is identifying the languages that are particularly prevalent in your community. Pre-assessment research allows you to determine which languages have the most demand — that is, what languages are most frequently spoken among populations with LEP? You can begin conducting research by looking through data from the U.S. Census Bureau, such as the annual American Community Survey. Not only does this data allow you to identify widely spoken languages in your community, but it also allows you to identify which languages are most widely spoken among groups that tend to have low levels of English proficiency.  By doing this research, you’ll have a better understanding of the linguistic diversity of the community and the types of services that individuals with LEP need.
Once you’ve identified a set of languages that are in high demand, it’s important to critically analyze your organization’s services and pain points that individuals with LEP might face when attempting to access these services. While some of this work can be done internally, it’s important to seek out the perspective of the community you’re serving, to get an external point-of-view. One option for identifying community needs is to conduct this community research in-house, hosting surveys, focus groups, and doing other data analysis. Many federal and state programs offer funding for such community research, so a good first step is to look for grants that your organization is eligible for and apply for them. Another step is to work with community-based organizations or consulting firms. In many cases, seeking out help from these organizations may be a more straightforward approach to sussing out the community’s needs.  Community-based organizations are likely to be quite tuned in to the needs of your consumers, while consultative organizations that specialize in language access or diversity equity and inclusion (DEI) can provide particularly helpful guidance on developing effective plans. Additionally, language service providers can also provide valuable insights and support in developing a comprehensive language access plan.
In addition to getting to know your community, it’s also essential to consider how members of the community interact with your organization and use your services.  It’s a good first step to identify all of your organization’s vital documents. You’ll likely need to commission translations of these documents into the languages you identified in the previous steps, so having a running list of these documents is a good first step. Next, it’s important to think critically about how people in your community use your services. Moreover, ask your team how frequently do individuals with LEP interact with your agency or organization — government agencies in particular will also want to consider how many individuals with LEP are eligible for their services. In conjunction with the information gathered and analyzed in the previous steps, this step will allow you to prioritize certain aspects and goals in your language access plan. For example, an agency that frequently works face-to-face with LEP individuals will want to prioritize hiring bilingual staff and contracting interpreters, while organizations that do not have many walk-in clients might focus more on written communications first.
These three steps don’t make a language access plan all on their own — but they do provide you with a strong foundation for one. By researching the linguistic demographics of the community that you serve and analyzing your organization’s services, you’ll be well-prepared to begin developing a methodical and thoughtful language access plan. In short, here are some steps to conducting the research that underlies a successful language access plan: Building a language access plan can be a challenging process, but it’s essential for any organization that serves diverse communities. If you need help getting started with your language access plan, Avantpage is happy to help provide consulting, translation, and interpreting services to agencies and organizations across the country. Feel free to reach out to us at [email protected] or (530) 750-2040 for more information about our services.

Avantpage Translations, a language service provider specializing in translation services for government, elections, and healthcare, recently announced the latest company expansion after experiencing a record year of growth. The company moves to having an in-house Spanish linguistic team. This change will be pivotal to improving overall client satisfaction through faster turnaround times, higher quality translations, and lowered costs.   2022 featured numerous core company achievements like ISO 9001 and 17100 certifications and a spot in the top 30 LSPs in North America. It became apparent that growth in services and increased in-house capacity would be crucial in continued success to ensuring our clients see improvements in our services. “By having an in-house group of proven and experienced Spanish [linguists], we will be able to deliver better, customized Spanish translations faster and at lower cost,” said CEO Luis Miguel.   Dominika Villafuerte-Woszczyk, Director of Operations and Quality, and long term Avantpage employee with 10 years of industry experience, expressed the potential impact of these changes. “Our internal dedicated Spanish team opens up a new door of opportunities for our clients. We are increasing our in-house linguists, so our processes will be more straightforward and effective,” explained Dominika. She went on to share that by having this dedicated, in-house team, there will also be more internal control of these projects, leading to higher quality services, faster turnaround times, and better opportunities for quality control in specialized areas like machine translation post-editing (MTPE) and remote interpreting.  “All of us at Avantpage are very excited to bring in-house the Spanish linguistic function. We expect that it will be transparent to our clients who will only see that our services keep improving in quality and speed while remaining price competitive.” Luis hinted that Avantpage will be a company to watch over the coming years due to many different investments for improved client satisfaction, such as the launch of Avantpage Life Sciences division in Europe, and enhancements to proprietary client tools like AvantPortal and AvantData with new technology to supplement the company’s remote interpreting. “We are excited about Avantpage’s future and will continue to bring to the market services designed to support immigrants in the USA and Life Sciences companies in Europe!”  About Avantpage Translations  For over 25 years, Avantpage has partnered with both public and private sector organizations to help their diverse and limited English proficient audiences gain more equitable access. We translate, interpret, and localize in more than 150 languages, and we believe in showing Empathy Beyond Words through the humanistic qualities of your audiences. Our goal at Avantpage is simple: to help our clients create a linguistic bridge that connects people, cultures, and communities through mutual understanding. For more information visit www.avantpage.com. 

Telehealth and its 4 subsets might not have been on your radar until the COVID-19 pandemic brought it into the spotlight back in the spring of 2020. But even as the pandemic’s eased up, telehealth doesn’t appear to be going anywhere any time soon.  It’s become a particularly important tool in providing healthcare to individuals who would otherwise face significant barriers to healthcare services, such as people who live in highly rural locations or those with limited English proficiency (LEP). Simply put, telehealth is a way for healthcare providers to digitally work with patients and interact with the public — though it’s often viewed as synonymous with live video appointments, this is just one aspect of telehealth. There are four subsets of telehealth, ranging from more intimate one-on-one video sessions with a patient and a doctor, to more wide-reaching public health campaigns. The four subsets of telehealth are as follows: For individuals with LEP, telehealth can break language barriers in several different ways. Live video appointments can connect patients with doctors who speak their language but are located far away, while mobile health campaigns can be translated into different languages to ensure LEP individuals are informed about public health issues and other important medical information. Despite all of this, the COVID-19 pandemic highlighted significant disparities in the health outcomes of patients with LEP. Throughout the early days of the pandemic, populations with significant proportions of individuals with LEP often faced the toughest outcomes when compared to their English-speaking counterparts. From insufficiently accessible (and in turn, discouraging) user journeys on telehealth portals to problems with digital literacy, the rise of telehealth made healthcare less accessible for individuals with LEP.  As telehealth became more prominent, so too did awareness of the disparities between patients with LEP and those without. Here, we’ll examine the four subsets of telehealth and how they can impact the care that patients with LEP receive. From remote patient monitoring to store and forward, we’ll discuss ways in which providers can be thoughtful and purposeful in the way they interact with and treat their patients who do not speak English proficiently.
There are a handful of different types of technology that healthcare providers can use when offering telehealth — each one is unique, serving different outcomes and leading to different outcomes.
This is the form of telehealth that you’re probably most familiar with — live video telehealth utilizes video conferencing tools like Zoom to connect patients with their healthcare providers. This allows patients to receive care from the comfort of their homes, and healthcare providers can assess a patient’s health status in real-time. With live video, a doctor’s geographical proximity becomes less important — this allows patients with LEP to more easily connect with doctors and interpreters who speak their language without having to travel long distances. However, video visits may also require interpreting services to ensure effective communication between the patient and the provider. Telehealth providers should always be prepared to offer virtual remote interpreting services for video visits in case a patient is and provide instructions and training materials in the patient’s preferred language.
Mobile telehealth includes any sort of public health messaging or medical education delivered to patients via mobile devices like smartphones or tablets. This might include a series of mass text messages sent out to alert a community about a disease outbreak in their area or more general campaigns that simply aim to promote healthy behavior. Although these types of campaigns may not be as palpable as a one-on-one appointment with a doctor, they do play an important role in engaging individuals with LEP. By working with language service providers to translate these messages into a linguistically and culturally appropriate format, telehealth providers can ensure that these messages are as accessible and meaningful as possible. When mobile health campaigns aren’t linguistically appropriate, prospective patients might feel alienated or discouraged from pursuing healthcare services — or worse, left in the dark about important public health information like local disease outbreaks.
Remote patient monitoring involves the use of electronic devices to monitor a patient’s health status from the comfort of their own home. These devices monitor things like a patient’s blood pressure, heart rate, weight, and other vital signs — this data can then be sent to healthcare providers to monitor and assess a patient’s health status. Healthcare providers typically use these devices after discharging a patient, in an effort to lower the likelihood of hospital readmission. For patients with LEP, language access is critical in ensuring that they understand how to use remote patient monitoring devices properly and that healthcare providers can understand and interpret the data correctly. Providers should offer instructions and training materials in the patient’s preferred language, and offer interpreter services when necessary. Store and forward is a form of asynchronous telehealth that allows doctors to assess a patient’s status without ever having to schedule a real-time appointment (over video or otherwise). With store and forward, patients and healthcare providers can send photos, videos, and other health records to other specialists for analysis — for example, a patient might send photos of a skin lesion to their primary care physician, who then passes the photo off to a dermatologist for further analysis. To ensure that LEP individuals benefit from store and forward, healthcare providers can work with language service providers to translate and interpret information about store and forward practices, so that they understand the benefit of this type of telehealth.  Telehealth can be an undoubtedly powerful tool for improving health equity among patients with LEP. Within the realm of telehealth, there are four subsets that must be applied in different situations. For each type of telehealth service, providers must keep in mind unique considerations for patients with LEP. To recap, here are the four subsets of telehealth and how they work: At Avantpage, we’re proud to help telehealth providers improve their approach to language access and unlock telehealth’s potential to break language barriers for patients with LEP. If you’re looking to make your telehealth services more accessible to individuals with LEP, contact us at [email protected] or (530) 750-2040.

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.