A woman’s hands coming from a person out of shot on the left, signing doctor into the male hands of a person on the right.
Americans with Disabilities Act

The Americans with Disabilities Act or ADA outlines the responsibilities in providing access to communication for disabled persons. It repeatedly states, “reasonable accommodations” and “qualified” interpreter. How can reasonable accommodations be determined? This is a conversation that must be had with the Deaf person. They will have needs and preferences that are unique to them and should be part of the accommodation selection. How does one determine qualification? An evaluation from a bilingual user and or certification are the only ways to determine an interpreter’s qualification. Different states have different laws that must be followed but ultimately the responsibility of vetting an interpreter falls on the person/entity who employs the interpreting services. For more information visit https://www.ada.gov/ and search “interpreter”.

Why do I need an interpreter?

Deaf, Hard of Hearing, and Deaf/Blind individuals communicate in various ways, depending on their degree of deafness, the age they lost their hearing, and their educational and environmental background.

Common Misconceptions are:

  • All sign language users can read lips
  • All sign language users can read and write in English
  • All sign language users who can speak can also understand what you say

Please remember that your ability to understand someone who uses sign language does not mean they can understand you. They may have questions to ask even if you do not. Communication must work both ways and everyone has the right to have access to information. Miscommunication can result in information not being received and serious needs going unmet.

Writing notes is not always an option for someone who uses sign language. English may not be their first language or they may be monolingual and are only fluent in American Sign Language (ASL).

How do I know if I need to provide an interpreter for my client? For my employee?

Identify what is a REASONABLE ACCOMODATION. There are times when simple and brief communication occurs and writing back and forth or use of email is acceptable. For other events, accommodations must be made in order to provide equal access to all participants.

Examples of this would be:

  • Job interview
  • Intake information
  • Training, presentations, and workshops
  • Group meetings
  • Disciplinary actions
When do I need to call for an interpreter for my patient?

Anytime a Deaf, Hard of Hearing, or Deaf/Blind patient is under your care, it is very important for you to be able to communicate with the patient and them with you.  It is inappropriate and not in compliance with HIPAA or state and federal laws to rely on family or friends to act as interpreters. A family member or friend may not have the fluency to interpret or may have difficulty in remaining unbiased. If someone knows sign language that does not make that person an interpreter. In order to make sure that communication is clear and unbiased a professional interpreter should be used.

A patient using sign language has all the same fears and anxieties as a hearing patient. However, these fears are greatly compounded when they can’t make their needs known or understand what is being done to or for them.

Most importantly, miscommunication can result in needs going unmet, wrong medication given, delays in correct diagnosis and treatment, and serious harm to the patient. Finally, it is important that you are familiar with your responsibilities in regard to the Americans with Disabilities Act (ADA). The responsibility in making sure that a patient receives and understands all the information that is given falls on the health care provider.

Areas where an interpreter may be needed:

  • Admission and orientation
  • Medical procedures
  • Patient/family conference with physician(s)
  • Explanation of medical condition, diagnosis, or treatment
  • Signing of any consent forms
  • Discharge instructions
  • Any time the patient or family member needs to communicate with you or you with them
What is a Certified Deaf Interpreter (CDI)?

A Certified Deaf Interpreter or CDI, is a Deaf person who is certified to interpret. They receive national certification, state certification, or both, and must also follow the industries Code of Professional Conduct (CPC) and abide by HIPAA medical standards. In a wide variety of settings, CDIs are an essential part of the communication process. They are native users of ASL and can communicate at a level that a second language user will never have the innate ability to do.

Examples where a CDI may be needed:

  • Medical settings
  • Mental health evaluations
  • Legal settings
  • Encounters involving complex language needs
  • Encounters involving a minor
What is Video Remote Interpreting (VRI)?

Video Remote Interpreting or VRI, is the use of technology to remotely provide interpreting services. The interpreter is in another location and is being accessed through a screen. It can be useful in encounters where logistic and communication needs are a match. However, it cannot always replace the need for an on-site interpreter. VRI has limitations that must be considered and the Deaf person/s preferences should always be addressed. If a Deaf person is frustrated using VRI or they do not feel like they are understanding or being understood, then the use of VRI needs to be reconsidered. The responsibility of the message being accurately received and the Deaf individuals’ needs being met falls on the person/entity who is paying for the VRI service.

When do I need to schedule an interpreter?

An interpreter needs to be requested as soon as you know you will need to communicate with an American Sign Language (ASL) user. The more time you give our agency to schedule an interpreter, the better the opportunity for us to arrange the interpreter best matched for your request.

Due to high demand for interpreting services, we ask for a 3-5 business day notice for scheduled appointments. If we are unable to provide an interpreter, we will refer you to a trusted business partner who may be able to assist.

Plays, concerts, and conferences should be requested at least 2-3 weeks in advance. This is important so that your times and dates can be secured and a team or teams of interpreters can be selected and can start preparing for the event.

What if I need to request an interpreter afterhours?

Hired Hands provides interpreters twenty-four hours a day, seven days a week. You can always call last minute for an interpreter on an EMERGENCY basis.  Our agency has an Emergency/Afterhours phone that is answered by an interpreting staff member who will be able to assist you. However, it is always best to inform Hired Hands as soon as you know of a scheduled doctor visit, family conference, procedure, etc.  We recommend calling at least 3-5 business days in advance so we can provide the interpreter most qualified to meet your needs. Emergency/Afterhours number is (817) 880-3242.

Why do I need two interpreters/an interpreter team?

Sign language interpreting is not only a mental task but a physical one. Anytime an interpreter is continually interpreting for over one and half hours a team of two interpreters may be needed. Anything over two hours will more than likely require a team of two. This is to ensure that the communication remains accurate and does not become subject to the interpreters mental or physical exhaustion and for the health of the interpreter. Other situations that may warrant a team are not always time based. Other examples where a team of two interpreters may be needed would be:

  • Complexity of the communication
  • Multiple participants with continuous interaction
  • Logistics

Hired Hands will always contact you to discuss if there is a need for a team and why before placing interpreters.

Who is responsible for paying for interpreting services?

The cost for interpreting services is the responsibility of the business or organization to where the Deaf person is trying to get access and is something that should be built into annual budgets and planning. According to the Americans with Disabilities Act (ADA), the cost for providing accessibility accommodations cannot be charged to a person with a disability. For more information visit https://www.ada.gov/

Why do I have to pay travel/prep time and minimums?

Interpreters work in a multitude of communication encounters from schools and business to medical appointments and courtrooms. For each request the interpreter must prepare for the type communication that will occur, the kind of vocabulary that will be used, and the logistics of where they will be. Each assignment requires that the interpreter do prep work before the assignment and that the interpreter be able to travel wherever they are needed. Set travel/prep times and minimums are the fairest and simplest way to create standardization for the interpreters and consumers.

Why does Hired Hands charge for less than 24-business hour cancellations?

Once the services of an interpreter/s has been arranged the interpreters’ time is purchased. They are committed to your request and their previous and following assignments are based on their time scheduled with you. If you cancel the interpreter within 24-business hours, they do not have the ability to replace that scheduled time with something else. Right now, the interpreting industry is trending to require 48-72-hour cancellation policies. Because Hired Hands has a staff of interpreters vs. independent contractors, we can often move things around to take care of our interpreters and our consumers while honoring a 24-business hour cancellation policy.


Reasonable and fair rates must reflect the standards of the industry and the quality of the service. Hired Hands takes great strides in staying abreast to market trends and making sure that you are being charged fairly and receive quality service. Please contact our office for our current rate information.

What is ASL?

American Sign Language is the language that is most readily used by the Deaf population in the United States and is the third largest language used in the country. ASL is a language that has its own lexicon, syntax, and grammar. It is not English on your hands nor is it a form of signed English. ASL is not universal. Consider that just as every spoken language is unique, so is true of the variations of signed languages used all over the world.

What is Deaf Culture?

Just like any culture or sub-culture, Deaf Culture is a group of individuals who share knowledge, values, art, customs, and behaviors that are derived from a shared language, history, and commonality. Within Deaf Culture the word “deaf” is often recorded in writing and sign with a capital D and is referred to as “big D deaf”. People who identify with being Deaf do not consider their lack of hearing to be a “loss” or an “impairment”.  They are proud of their language, their community, and their culture.

Deaf vs. Hearing Impaired

Big D deaf “Deaf” is the term preferred by the Deaf community. It represents cultural awareness and shows respect to those whose native language is American Sign Language (ASL). “Hearing Impaired” is a medical label that implies an impairment or something that needs to be fixed and is not a preferred term used in the Deaf community or among American Sign Language (ASL) users.

Why do I need a certified interpreter?

Certification is proof that the practicing professional has satisfied all of the education and testing requirements to practice. Certification is a protection to all parties involved in the communication process and ensures that the interpreter has the skills and training that are necessary to facilitate communication. It also requires that the interpreter is following the code of conduct that relates to their certification/s and ensures confidentiality and ethical practices. Would you use a doctor who was not licensed to practice? Would you hire a lawyer who could not pass the bar exam? Would you allow your children to be in a classroom with a teacher who did not have the credentials to teach? Then why should Deaf people be expected to access any of those services though a person not certified to interpret?

What certifications exist?

An interpreter can be nationally certified, state certified, or both. There are levels of certification and certification types that better qualify an interpreter to be placed. Other considerations are the interpreter’s education and experience. Hired Hands employs interpreters who range from Basic all the way to Master. We are experts in our field and will assess your request and place interpreters who are the best match based on their certification, education, experience, and skills.

What kind of education does an interpreter receive?

Interpreting degrees are earned at associate, bachelor, and master levels. Many interpreters also obtain degrees in related fields such as: Linguistics, English, Communication, or Deaf Studies. As of 2008, a person testing to become state certified must have a minimum of an associate degree or equivalent and as of 2012, a person testing to become nationally certified must have a minimum of a bachelor degree or equivalent.

What is a practicum student?

A practicum student is a college student who is pursuing a degree in sign language interpreting and is satisfying their degree requirements by accompanying a working professional for practical experience. Hired Hands will always get permission before allowing a student to join an interpreter on an assignment. Students do not make up an interpreting team and do not replace the need for an interpreter. You will never be charged for allowing a student to participate in your request. They are only there to learn.

Health Insurance Portability and Accountability Act

Health Insurance Portability and Accountability Act or HIPAA has language that includes the use of interpreters and allows health care providers who act as a “covered entity” to utilize their services. HIPAA also provides guidance on the use of interpreters. A “covered entity” may also be required to comply with the Americans with Disabilities Act (ADA). For more information visit https://www.hhs.gov/hipaa and search “interpreter”.

Spoken Language Agencies

Spoken language agencies that provide translating and interpreting services for multiple languages have started adding American Sign Language (ASL) to their list of options. Due to the complexity of ASL and the unique culture and community that is formed through this language, it is important to ensure that the language agencies are considering the layered needs in placing a sign language interpreter. The act of placement for a sign language interpreter has more demands then a spoken language and the interpreter must be properly vetted. It is important that the language agency you choose places interpreters considering all aspects of an encounter. For more detailed information about how to choose and agency see About interpreting.

What is Tactile Interpreting?

Tactile signing is a way that Deaf-Blind people communicate.  This is accomplished by the Deaf-Blind person placing their hands on the hands of another person and feeling the sign language. During this type of encounter, the interpreter is not only responsible for communicating the conversation but also describing what they are seeing.