WSR 97-15-058

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Public Assistance)

[Filed July 15, 1997, 1:36 p.m.]

Date of Adoption: July 15, 1997.

Purpose: To codify into WAC existing policies regarding interpreter services for limited-English speaking, deaf-blind, and deaf/hard of hearing clients.

Statutory Authority for Adoption: RCW 74.08.090, 74.04.025, 74.04.050; 45 CFR Sections 80.1 and 80.3; 45 CFR Section 605.52; 28 CFR Part 35.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

Reasons for this Finding: The budget allocated for interpreter services for MAA has been significantly reduced for the 1997-99 biennium. In order to keep the interpreter services program in existence, MAA must codify its policies in WAC to assure funds for the program do not run out. Lack of interpreter services may endanger the health, safety, and general welfare of its limited-English proficient, deaf, deaf-blind, and hard of hearing clients due to inability to communicate with providers or total denial of services.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 0, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 0, amended 0, repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.

Number of Sections Adopted on the Agency's own Initiative: New 10, amended 0, repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 10, amended 0, repealed 0.

Number of Sections Adopted using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 10, amended 0, repealed 0.

Effective Date of Rule: Immediately.

July 15, 1997

Merry A. Kogut

Rules and Policies Assistance Unit

INTERPRETER SERVICES

NEW SECTION

WAC 388-555-1000 Scope of care. (1) The department shall pay for interpreter services for a person determined eligible for a medical program who is:

(a) Deaf;

(b) Deaf-blind;

(c) Hard of hearing; or

(d) Limited English proficient.

(2) The department shall pay for interpreter services for clients described in subsection (1) of this section when such services:

(a) Are provided during the provision of a necessary medical service; and

(b) The medical service for which interpretation services are needed is covered under a medical assistance program for which the client is eligible. For exceptions, see 388-555-1200, Noncovered services.

[]

NEW SECTION

WAC 388-555-1050 Definitions. For the purposes of this chapter, the following definitions apply:

"Consecutive appointments" - means appointments beginning or scheduled to begin within fifteen minutes of the last completed appointment.

"Family member" - means any person who is related to the client: a spouse, child, grandmother, grandfather, mother, father, sister, brother, cousin, niece, nephew, aunt, uncle, step relations and/or in-laws.

"Independent interpreter" - means any fluent, bilingual/multilingual person, certified by LIST, who provides interpreter services for payment and who is not employed by or a contractor of any interpreter agency enrolled with the medical assistance administration (MAA).

"Interpreter" - means a person who speaks English and another language fluently or signs English or another language fluently. Fluency includes an understanding of nonverbal and cultural patterns necessary to effectively communicate in that language. An interpreter enables clients and medical/health care providers to communicate effectively with each other.

"Interpreter agency" - a business entity which offers, by advertising or otherwise, as one of its main objectives or purposes, to procure interpreter services by employing or contracting with bilingual/multilingual persons on a permanent or part-time basis to provide interpreter services for payment in at least three of the languages required by RCW 74.04.025 or sign language. For purposes of this chapter, interpreter agency shall not include:

(1) Any person, or business entity that employs a person exclusively or regularly to perform other duties, or who performs interpreter services solely in connection with the affairs of that employer; or

(2) Those who are self-employed, and are the only bilingual/multilingual employee contracting for the purpose of providing interpreter services to others.

"Language interpretation services and translation" (LIST) - means the office within the department of social and health services (DSHS) that is responsible for certifying and qualifying spoken language interpreters.

"Limited English proficient (LEP)" - means a limited ability or an inability to speak, read, or write English well enough to understand and communicate effectively in normal daily activities. The client decides whether he/she is limited in his/her ability to speak, read, or write English.

"Primary language" - means the language identified by the client as the language in which he/she wishes to communicate. This is also referred to as the preferred language.

"Qualified interpreter (for spoken languages)" - means an interpreter who has passed DSHS screening tests in languages other than the seven DSHS certificated languages as listed in RCW 74.04.025.

"Qualified interpreter (for American Sign Language)" - means a noncertified interpreter for the deaf, deaf-blind and/or hard of hearing who is determined to be qualified by the consumer to effectively meet their communication needs, both receptively and expressively.

"Unit" - means a billable amount of time for interpreter services equal to fifteen minutes.

[]

NEW SECTION

WAC 388-555-1100 Eligible providers. (1) The department shall pay for interpreter services provided to an eligible client by independent interpreters, and/or interpreter agencies:

(a) Enrolled with the department to provide interpreter services;

(b) Who meet the criteria in this chapter, WAC 388-87-007, Medical provider agreement, and WAC 388-87-010, Conditions of payment--General.

(2) To enroll as an independent interpreter for medical assistance clients, interpreters shall submit the following to the department:

(a) A copy of a current office of language interpretation services and translation (LIST) certificate of proficiency for any LIST-tested languages; or

(b) A copy of a current registry of interpreters for deaf (RID) or Washington state national association of the deaf (NAD) certificate for certified sign language interpreters; and

(c) Verification of Social Security Number;

(d) Verification of unified business identifier number;

(e) A completed contract;

(f) A signed confidentiality pledge;

(g) A completed provider information form; and

(h) Verification of errors and omissions liability insurance at or over one hundred thousand dollars per occurrence.

(3) To enroll as an MAA interpreter agency, the agency shall submit to the department:

(a) Verification of federal tax identification number;

(b) A unified business identifier number;

(c) A completed MAA contract;

(d) Verification of errors and omissions liability insurance at or over one million dollars per occurrence;

(e) A completed provider information form; and

(f) A list of interpreters employed/contracted to provide services to medical assistance clients, including for each interpreter:

(i) A Social Security Number;

(ii) A signed confidentiality pledge; and

(iii) A copy of a current LIST certificate of proficiency for any LIST-tested languages or verification of qualification by LIST in non-LIST-tested languages; or

(iv) A copy of a current RID or NAD certificate for certified sign language interpreters or verification of qualified interpreter status.

(4) An interpreter agency shall have the capacity to provide interpretation in no fewer than three of the required languages in RCW 74.04.025.

(5) Interpreter agencies shall assume full legal and financial liability for interpreter services provided by employees and contractors.

[]

NEW SECTION

WAC 388-555-1150 Provider requirements. (1) An interpreter shall not determine the need for interpreter services, nor shall the interpreter market interpreter services to medical assistance clients. See WAC 388-555-1250, Coordination of services.

(2) An interpreter shall not require a medical assistance client to obtain interpreter services exclusive of other interpreters or interpreter agencies.

(3) Interpreters shall adhere to department policies and procedures regarding confidentiality of client records as stated in WAC 388-501-0150.

(4) An independent interpreter shall enroll with the department as provided in WAC 388-555-1100 and obtain a current medical assistance provider number.

(5) The department shall schedule and give providers of interpreter services an orientation within their first year of contracting with the department. The department may terminate contracts with any provider who does not participate in the orientation. The orientation shall include:

(a) Codes of professional conduct and confidentiality for interpreters;

(b) Legal requirements;

(c) The interpreter's role when working with medical assistance clients;

(d) Issues specific to medical assistance client interpretation services;

(e) An overview of the billing process; and

(f) Record keeping requirements.

[]

NEW SECTION

WAC 388-555-1200 Noncovered services. (1) The department shall not pay for interpretation services related to:

(a) Inpatient hospital services;

(b) Nursing facility services;

(c) Community mental health center services;

(d) The provision of any noncovered service; or

(e) Interpretation funded or paid for by any other source.

(2) The department shall not pay for the following:

(a) Interpretation services provided to the interpreter's family members;

(b) Any person other than an eligible medical assistance client;

(c) Medical Assistance client no-shows;

(d) The interpreter's transportation costs or travel time;

(e) Waiting time before the scheduled appointment; or

(f) Any block of time when services are not required by the medical provider to communicate with a medical assistance client.

[]

NEW SECTION

WAC 388-555-1250 Coordination of services. An interpreter shall:

(1) Facilitate coordination of the appointment dates and times with the medical provider and the client as requested by the medical provider;

(2) Provide interpretation for medically necessary services; and

(3) Notify the medical provider of any changes to scheduled appointments at least twenty-four hours in advance.

[]

NEW SECTION

WAC 388-555-1300 Payment. (1) The department shall pay for interpretation services for limited English proficient (LEP), deaf, deaf-blind and/or hard of hearing medical assistance clients when the interpreter is enrolled with the department as provided in WAC 388-555-1100; and requirements of chapter 388-87 WAC and the following conditions are met:

(a) The medical assistance client or the medical provider determines that an interpreter is necessary in order for the client to appropriately access necessary medical and health care services covered by the client's medical assistance program;

(b) The medical provider has informed the client that interpreter services are available at no cost to the client; and

(c) The interpreter presents a current identification card with his/her name, such as a driver's license, prior to all interpretation services.

(2) Interpreters shall provide written justification to the department for any interpretation service at or exceeding eight units.

(3) The department may reimburse an interpreter for up to twenty-four units per client per day.

(4) To the extent permitted under federal law, the department may provide federal financial participation to match public funds expended by public agencies for interpreter services.

[]

NEW SECTION

WAC 388-555-1350 Payment methodology. The department shall base its payment for interpreter services on:

(1) Funds legislatively provided for interpreter services;

(2) Department allocation of vendor rate increases appropriated by the legislature; and

(3) Billable units of time, where a unit equals fifteen minutes.

[]

NEW SECTION

WAC 388-555-1400 Billing requirements. (1) An interpreter may bill a minimum of four units per encounter, except as provided in subsection (2).

(2) An interpreter shall charge the actual time spent interpreting for a client encounter with a medical provider when the appointments are consecutive and:

(a) The interpreter interprets for more than one client in the same medical provider's office on the same day;

(b) The interpreter interprets for one client for multiple medical providers in the same medical facility on the same day; or

(c) The interpreter interprets for more than one client for multiple medical providers in the same medical facility on the same day.

(3) Interpreters shall bill claims to the department according to the department's billing instructions. The department shall publish and provide its billing instructions to all eligible interpreters.

(4) The following shall be included on the claim submitted to the department for payment:

(a) The interpreter's name;

(b) The medical provider's name;

(c) The medical condition for which the client required interpreter services; and

(d) The client's language interpreted during the units being billed.

(5) When the interpreter interprets for eight units or more for the same client, the interpreter shall include the following on the department's claim:

(a) An explanation justifying the need for eight or more units of interpretation services;

(b) Waiting time exceeding one unit between medical services; and

(c) Waiting time between separate medical services that are provided during a single appointment and the interpreter was requested to wait between services.

(6) See 388-87-015, Billing limitations, for time frames for submitting claims to the department.

[]

NEW SECTION

WAC 388-555-1450 Audits. (1) Providers shall maintain legible, accurate, and complete records in order to support and justify interpretation services provided to medical assistance clients.

(2) Providers shall maintain interpretation service records by date of service and interpreter.

(3) Interpreter records shall be legible, written in English, and shall include at a minimum:

(a) The client's name;

(b) The client's patient identification code;

(c) The client's assistance unit number;

(d) The name of the interpreter who provided the service;

(e) The language used;

(f) The date of the service;

(g) The name of the medical provider for whom interpretation assistance was provided;

(h) The specific reason for the appointments;

(i) The start and end time of each interpretation service for a client;

(j) Place of service; and

(k) Patient's address.