Key Questions to Consider in Setting Up a Navigator Program

2. How can navigators provide culturally and linguistically appropriate services?

National surveys have found that the people who are expected to enroll in exchange coverage will have significant language assistance needs, as approximately one in four of these consumers will speak a language other than English at home.²¹ In some states, this percentage will be much higher.

Exchanges are required to provide oral interpretation and written translations of web and print materials at no cost. They’re also required to inform consumers about the availability of these services through the use of tag lines in the most common languages spoken by the exchange-eligible population.²² However, there is still uncertainly about how many languages these resources will be translated into, and about how many languages the taglines will be provided in to inform consumers that oral translation assistance is available. While these basic language services are essential to providing accessible consumer information and assistance in exchanges, these tools alone will not be sufficient to conduct outreach to diverse communities or to meet their consumer assistance needs.

Navigators will be a key component in ensuring that exchange outreach and enrollment assistance is accessible to culturally and linguistically diverse populations. Navigator and assister programs should build language assistance services into program operations by developing policies and procedures for identifying, assessing, and meeting language needs, and by budgeting for language access resources. Regardless of the populations they serve, all navigators and assisters should receive training on how to obtain interpreter services, how to work with in-person and telephone interpreters, and how to respond to calls and written communications and conduct in-person meetings with individuals who have limited English proficiency.²³

Conducting community-based outreach and enrollment using trusted local organizations that can provide culturally appropriate, in-person assistance in multiple languages, including languages that are less commonly spoken, will also be critical in making new coverage options accessible to diverse populations. Beyond leveraging these relationships, it will be important for navigator training in general to make sure that navigators and assisters have or develop the ability to provide assistance in ways that are culturally and linguistically appropriate. It will also be important for individual programs to develop the values, policies, knowledge, and skills necessary to foster effective cross-cultural communication.²⁴ 

SHIP Tips: Providing Culturally and Linguistically Appropriate Services

• Build relationships with community groups, cultural institutions, and business communities that may not be well-positioned to provide services themselves but that have strong ties to target communities and can serve as valuable partners in outreach and public education.²⁵
• Translate print and online materials, as well as materials that are used for outreach, using a certified translator.²⁶ Provide counselors with both the English version and the translation to allow those who are working with an interpreter to follow along and help individuals who speak some English to feel more comfortable and confident if they need to communicate in English.²⁷
• Hire trained and competent bilingual staff or staff interpreters, including some who are certified translators. To do this, conduct a rigorous interview process that includes written and oral testing and observation of interactions with consumers.²⁸
• Provide resources and some level of training in the language the counselor will be using when assisting clients. For example, give counselors a translated glossary of key terms to promote consistent use of terminology.
• Be aware that using family and friends as interpreters may not be appropriate, for example, because of privacy concerns or because of the complexity of the information being provided. Ensure that other options to receive oral assistance are available. Also be aware that telephone language interpreters may not be familiar with health care terminology and may provide literal translations that do not accurately convey complex concepts. When working with contracted translators, make sure that they receive training on the information and topics that will be relevant to providing enrollment assistance.

[Back: Key Question #1] [Next: Key Question #3]