Dr. Nelva Lee's Key Note Speach at Children's Healthcare of Atlanta Annual Interpreting Symposium

Sep 26, 2023


Dr. Nelva Lee (00:09):

Hello, I'm Dr. Nelly. I'm the CEO and founder of Met. One of the greatest quotes from Gandhi is be the change you wish to see. I believe that leaders from all generations and throughout history have discovered this one truth. And that is, if you want change to happen, you must make it happen yourself. You must be the change that you wish to see in this world. Two of my greatest heroes are Martin Luther King Jr. And Oprah Winfrey. Martin Luther King was actually born Michael King Jr. See, his father was a great fan of the German reformist, his namesake Martin Luther. And when he returned from a trip to Germany, he changed his name and the name of his then five year old son, Martin Luther King Jr. I believe that that inspired within Young Martin, a desire to be like his namesake, a reformist, a mover, and a shaker, and someone whose life transformed that of millions.

Dr. Nelva Lee (01:17):

And we all know what happened. Martin Luther King became the greatest civil rights leader of our time. His I Have a Dream Speech was both inspiring and prophetic. Now, Oprah Winfrey is a billionaire in her own right. She is a true rags to riches story. But did you know that when she was just 14 years old that she was a teenage mother? She not only had a child as a preemie, but he died just two weeks after he was born. And imagine the pain that must have caused young Oprah, the tragedy that she was feeling at the time and that she had to endure. I believe that young Oprah had to take that circumstance and crush it and turn it into fuel to propel her forward. Similarly in my childhood, I had a very rocky childhood. I was both sexually and emotionally abused. And by the time I was 15 years old, I had lived with seven different families and I had attended 13 different schools.

Dr. Nelva Lee (02:29):

But I did not let that experience crush me. I used it for fuel to propel me forward. Thankfully, I had found purpose early in life and it allowed me to complete my bachelor's, my master's, and then my doctorate in healthcare administration and becoming the first in my family to obtain her doctorate. And later I founded a very successful interpreting institute. See, I believe that each and every one of us have within us the ability to take whatever circumstances or obstacles that come our way and transform them into fuel to propel us forward. I believe that you have that ability within you. Now, the industry that I represent, the interpreting industry, it's in a state of flux. Right now we're going through some challenges. Some would say that we have plateaued. Others would say that we have actually regressed. See the three challenges, the three main challenges that we are facing right now are a lack of standardization, a lack of reimbursement, and a lack of proper educational requirements.

Dr. Nelva Lee (03:45):

See the lack of standardization. There was a study done, uh, by health affairs that said that 59% of hospitals are still not using qualified medical interpreters with their limited English proficient patients. They're using ad hoc interpreters, family members, children, and even Google Translate. So they're not requiring their bilingual staff to be trained in the minimum of 40 hours training per civil rights guidelines and class standards and joint commission standards. They're using family members and even children against HIPAA guidelines. Imagine the trauma that is causing these children to have to interpret medical issues for their adult family members. And you have all seen doctors using Google Translate. Google Translate was never intended to be used in a medical setting. A medical setting is a life and death situation are often discussed. Google Translate was not equipped for that. This is what Met is doing about it.

Dr. Nelva Lee (05:00):

So when I was the director of patient advocacy at the Grady Health System, one of the programs in my department was interpreting services. And when I arrived, I realized that we were not following the standards, the class standards or the OCR civil rights standards. So we went about increasing our standardization. The first thing we did was we hired a company to come in to train all of our interpreters with the minimum of 40 hours training. And we also partnered with a testing company to test the languages of all of our bilingual staff, not just our interpreters, but all of our bilingual staff throughout the system. And for our efforts, we were recognized as the flagship health system in the nation. That experience is what allowed me to then develop and found the Meto Institute. And since then I wanted to replicate the successes of great that I had at Grady.

Dr. Nelva Lee (06:05):

And since then, we have partnered with healthcare organizations all across the nation to include WellStar, where we have trained over a hundred of their interpreters and Heartland Alliance where we have trained over 75 of their interpreters. So we have trained them with our accredited interpreting institute and we have also qualified each and every one of these students for the languages that they speak. And we have gone a step further and now we provide interpreting services through video and audio remotely in over 200 languages with our qualified interpreters. And you get connected in as little as 30 seconds or less. That is what me to you is doing about it. Here's what you can do about it. You can go to the CEO or the healthcare administrator of the facility where you work at and educate them on the class standards, on the OCR civil rights standards and have them increase the standardization within their facility, ensuring that they are no longer using ad hoc interpreters, untrained and unqualified bilingual staff, ensuring that they're no longer using family members and children against HIPAA guidelines, ensuring that they're no longer using Google Translate.

Dr. Nelva Lee (07:32):

You can do this as well. You can make sure that you yourself are not interpreting medically for your family members and that those in your sphere of influence are also not doing that as well. I believe that you can do so. Why? Because you can be the change that you wish to see in this world. Now for those organizations that are following class standards and OCR guidelines, what about the reimbursement? Many of them are doing this out of pocket because there's no Medicaid or Medicare reimbursement. Only 14 states actually have Medicaid reimbursement for medical interpreting services. And in order to get Medicare reimbursement, it's like pulling teeth. Now, we were told back in the early two thousands, that's once medical interpreters were certified, that you could have reimbursement because they could match certification and reimbursement together. Well, we became certified back in 2010. I know cuz I was there.

Dr. Nelva Lee (08:41):

I was a part of the I M I A work group that developed a written exam. I was a subject matter expert for the early stages of the certification process where we developed the oral exam and made sure that the, the exam was rigorous and ensured that it meant industry standards. And for my efforts, I was elected the first chair of the National Board of Certification for Medical Interpreters. Now, that was back in 2010 and since then, thousands of interpreters have become certified all across the nation. Kudos to them. Now. This is what Met has done to move the profession forward. Here's what you can do. I encourage you to lobby your state representative and your state senators to include Medicaid reimbursement of medical interpreting services in their next budget. I also encourage you to lobby your congressman and your state, your senator on the federal level to include Medicare reimbursement of medical interpreting services in their next budget.

Dr. Nelva Lee (09:49):

Also, lobby your healthcare administrator and CEO of the facility that you work at, ensuring that they have certification as a minimum requirement for entry level medical interpreters. And lastly, make sure that you, yourself and those in your sphere of influence are all getting certified as well. I believe that you can do that. Why? Because you can be the change that you wish to see in this world. Now the last issue that we're facing in this industry is that of improper educational standards. So medical interpreters are an allied health professional, just like certified nurses assistants, respiratory technicians, medical billers. But what those allied professionals have in common is that their educational requirements are much higher than medical interpreters. So medical interpreters are only required to have 40 hours of training. Certified nurses assistants are required 160 hours of training to include a practicum and they must complete a certification before they can actually work on the floor.

Dr. Nelva Lee (11:02):

Similarly, respiratory technicians, medical billers, they must also complete a minimum usually of associate's degree and a certification before they can work on the floor. In Europe, they're required a hundred hours. Interpreters are required a hundred hours of training before they can work as medical interpreters. But here in the US we're only requiring 40. So this is what METTO has done about it. We no longer offer the 40 hour training. We offer a 60 hour training in keeping with our I my A accreditation. And we only offer this training to those that have three years or more of healthcare experience. Why? Because that healthcare experience gives them exposure to medical terminology. It gives them exposure to healthcare law. So when they layer on medical interpreting standards of practice and protocol, it's not a daunting task. Now for those that don't have that experience, they must take our 160 hour diploma program.

Dr. Nelva Lee (12:09):

Our hundred 60 hour diploma program is very rigorous. It includes medical terminology, healthcare law. It includes medical interpreting standards of practice protocols. It includes 24 hours of live practice sessions to include six hours of an internship. So when students complete our program, our diploma program, they are confident in their abilities. They know that they can work on day one and have the knowledge that they need to be successful as a medical interpreters. They know that they'll be able to pass the certification exam. So this is what MiTio is doing for the industry. Here's what you can do. First of all, I want you to lobby the CCH I and the cmi. These are the certification bodies for medical interpreters. I want you to ask them to raise their minimum standards from 40 hours to 160 hours of educational requirements. For those that are going to sit for the certification exam, go back to that CEO and healthcare administrator and have them increase the certification, uh, requirements, the entry level requirements for their medical interpreters upon higher to 160 hours.

Dr. Nelva Lee (13:32):

And make sure that you, yourself and those in your sphere of influence are doing the same. Increasing your educational requirements. You can do this because you can be the change that you wish to see in this world. See, one of my favorite quotes is that obstacles are nothing but opportunities brilliantly disguised as insurmountable barriers. I truly believe that whatever obstacle we face, whatever trauma or trouble that's in our way, that we can take it, crush it and use it as fuel to propel us forward. Each and every one of us has within us the ability to do this. It's all about a change in our perspective. See, I talked earlier about the abuse and instability that I face as a child. Well, I took that sexual abuse and allowed it to teach me true forgiveness. The emotional abuse. It allowed me to discern between truth and lies and that instability that I talked about that I had as a child.

Dr. Nelva Lee (14:42):

Well it's made me a very resilient person. It's allowed me to be able to pivot very quickly when a situation arises. It's made me the person that I am today. See, I'm going to tell you a story. So we were, when I was at Grady, I was on an elevator and on pops up in the VP of it. And uh, I was bragging of a little bit about the successes of our interpreting services department. And he asked me this question. He said, Why don't these people just learn English? Why, uh, do we have to offer them medical interpreting services? They live here in the us. Why don't they just learn English? And I remember thinking, that is such an ignorant question to ask. So I went straight to the CEO and told him about it. And I can assure you that that was the last time that question was uttered.

Dr. Nelva Lee (15:40):

And I tell you this story because I believe that each and every one of us, if we are truly passionate about something, we're not going to let anything, any obstacles stand in our way in order to accomplish the goal that we set before us. You have the ability to do that. Every single one of us has that. Cindy wrote, who is a leader in the medical interpreting community challenges just last year at a conference. And she said, What is one thing that you can do today to advance the profession forward, to move the profession forward? Well, I have given you several things that you can do today. The first lobby, your state representative and your senator on the state level to include Medicaid reimbursement for medical interpreting services. Second lobby, your congressman and the your senator at the federal government level to include Medicare reimbursement for medical interpreting services in their next budget.

Dr. Nelva Lee (16:45):

I want you to also lobby your CEO or your healthcare administrator or the owner of the healthcare facility that you're currently working at, and ensure that they are including minimum standards for their hires. Okay? Make sure that they're no longer using ad hoc interpreters or family members or children or Google translate to interpret, but that they're in fact hiring people with 40 hours of training and that are qualified for the languages that they're speaking, that they're interpreting in. I also want you to lobby cch, h i and CMI to increase the educational requirements for the certification. For those sitting. For certification. It's 160 hours versus the 40 hours. And lastly, I want you and your friends to do the same. I want you to increase your educational standards, obtain certification, and no longer interpret for your family and friends. I believe that you can do that. Why? Because you can be the change that you wish to see in this world. I believe in you. Thank you.

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