And How Akorbi's Telehealth Solution Can Help
Employee vs Independent Contractor
There are many reasons why workers seek full-time employment. Just a few of the many perks include comfortable hourly wages, salaried positions, healthcare benefits, unemployment insurance, financial security, and advancement opportunities. However, there are those who prefer to remain independent contractors (ICs). “Why,” you might ask, “when there’s no job security?” Well, for starters, being your own boss and making a name for yourself can be very rewarding to many professionals despite the risks involved. ICs also have the freedom to negotiate their own wages. They have the ability to work remotely and to engage with multiple clients, and the flexible hours that freelancers enjoy might be just what they need to accommodate their personal responsibilities outside of work.
For decades, a number of industries have run smoothly with this client-contractor relationship. The construction world might immediately come to mind but that is just one of many. The personal care and childcare sectors, maintenance, transportation, arts and design, entertainment, as well as the legal and medical professions have all had a longstanding relationship with ICs. In fact, the US Bureau of Labor Statistics (BLS) estimates that by 2026, there will be approximately 10.3 million self-employed workers within the United States, up from 9.6 million in 2016.
Assembly Bill 5 (AB5)
Introduced by California assemblywoman, Lorena Gonzalez, and endorsed by Governor Gavin Newsom, AB5 went into law January 1st, 2020 and essentially codifies the state’s ABC test, a three-part assessment to determine whether or not workers are appropriately classified. The test states that, in order to maintain an IC classification:
- The worker must be “free from the control and direction of the hiring entity”
- The service must be outside the “usual course” of business of the hiring entity
- The worker must be “customarily engaged in an independently established trade, occupation, profession, or business of the same nature as that involved in the service performed”
The general presumption of AB5 is that most ICs have been misclassified and should, in fact, be reclassified as employees. And while this might be true for many workers within the gig economy, when it comes to the language services industry, it becomes a little more complicated to unpack.
AB5's Impact on Healthcare Interpreting
According to Professor Barry Slaughter Olsen, Associate Professor of Translation and Interpretation at the Middlebury Institute of International Studies at Monterey (MISS), roughly 75 percent of interpreters work as ICs. But, over the years, government regulations have challenged this classification and have caused widespread panic within the language services industry on more than one occasion – AB5 is just the latest challenge.
Within the healthcare sector, AB5 poses a particular concern. Under current federal law, all healthcare facilities within the United States must provide a qualified interpreter for their limited-English proficient (LEP) patients regardless of the language. In order to remain compliant, many healthcare providers have chosen to partner with LSPs that can streamline the process and schedule their contracted interpreters as needed. But the implementation of AB5 has just thrown a proverbial wrench into that well-oiled process.
The LSP Challenge
Thanks in large part to their partnership with ICs, many LSPs are able to offer healthcare interpreting services in hundreds of languages. But LSPs receive interpreting requests for rare languages much less frequently than requests for the more commonly-spoken non-English languages. To expect California-based LSPs to hire employees for each of these rare languages – even on a part-time basis – is simply not reasonable and can potentially force companies to lose business. The employer would be spending thousands of dollars on employee health insurance, retirement savings plans, worker’s compensation, unemployment insurance, and more which would ultimately result in a negative return on investment (ROI).
The Professional Linguist Challenge
Many translators and interpreters work remotely and offer their professional services to several LSPs and medical facilities. AB5 threatens to disrupt their way of life that they’ve worked so hard to build and maintain. And while one workaround might be to establish a limited liability company (LLC), ICs will be responsible for paying an additional annual franchise tax. Complicating matters even further, some LSPs have now decided to only work with ICs in California who can establish themselves as corporations.
The Healthcare Provider Challenge
And what about the healthcare providers themselves that have come to rely heavily on effective partnerships with California-based LSPs? What should they do now if their LSP partner can no longer provide enough medically-trained interpreters to meet the demand for in-person and over-the-phone interpreting? It would not be economically justifiable nor reasonable to assume that the majority of healthcare facilities can instantly hire and manage a team of medically-trained, qualified, in-house interpreters overnight.
What do healthcare facilities do now in order to remain compliant? How do the most vulnerable patients continue to receive the language access they so desperately need? Luckily, multilingual telehealth provides an immediate solution.
For healthcare providers, LSPs, healthcare interpreters, and patients, telehealth has literally revolutionized the healthcare industry. Thanks to these technological advances, healthcare specialists have been able to further their patient reach, offering healthcare consultations, diagnoses, and treatment options to virtually any patient with access to the internet.Telehealth has also decreased emergency room visits and has reduced healthcare costs for patients who no longer need to take time off of work, travel long distances, or find childcare ahead of time. This in turn, has increased overall patient satisfaction.
In less than a decade, telehealth services have grown exponentially. By 2017, 76 percent of US hospitals were connecting with patients “and consulting with practitioners at a distance through the use of video and other technology.”2 But what about the nation’s growing LEP population who has traditionally experienced disparities in healthcare access? That’s where multilingual telehealth services come into play.
Multilingual Telehealth – A Viable Solution to AB5
In order to improve LEP patient outreach, many healthcare facilities and LSPs are now turning to multilingual telehealth services. With video remote interpreting (VRI), multilingual telehealth services connect LEP patients with medically-trained interpreters during each telehealth call. Since these services are offered online, LSPs and healthcare providers now have access to thousands of medically-certified and qualified interpreters who reside throughout the United States and abroad. In other words, as long as the ICs are not in California, AB5 doesn’t apply.
And while it is true that the nation’s most populous state has a history of setting national trends, multilingual telehealth will act as an immediate lifeline to LSPs and healthcare facilities alike whose services have been negatively impacted by AB5.
Akorbi's Multilingual Telehealth Solutions
As state and federal laws continue to change, many industries find themselves in a perpetual state of flux. This is certainly true of the healthcare and language services industries, and it is for this very reason that companies need to do more than just keep abreast of these changes – they need to be prepared in advance. Although the future is uncertain as to whether or not language services professionals will be AB5 exempt, Akorbi has you covered.
By partnering with Akorbi, you’ll have access to some of the most advanced multilingual telehealth technologies the industry has to offer, not to mention access to medical interpreters in over 150 languages. Akorbi’s multilingual telehealth solutions also provides EMR integration, remote patient monitoring, and medsitter patient sitting.
Akorbi prides itself for being at the forefront of change within the language services and healthcare industries. We not only keep our fingers on the pulse, but we consider ourselves industry trailblazers. Don’t let AB5 slow down your business or deny language access to your most vulnerable patients. Talk to Akorbi today.
Updated With New Information on May 5, 2020
1. “Small-Business Options: Occupational Outlook for Self-Employed Workers : Career Outlook.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, www.bls.gov/careeroutlook/2018/article/self-employment.htm#high-concentration.
2. “Fact Sheet: Telehealth.” American Hospital Association, Feb. 2019, www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf.
In addition to:
“Bill Text.” Bill Text – AB-5 Worker Status: Employees and Independent Contractors., leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB5.
“Small-Business Options: Occupational Outlook for Self-Employed Workers : Career Outlook.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, www.bls.gov/careeroutlook/2018/article/self-employment.htm#high-concentration.
Features · by Eden Estopace On May 11, et al. “Breaking the System? The SOSi Interpreter Ruling and Its Implications.” Slator, 10 July 2019, slator.com/features/breaking-the-system-the-sosi-interpreter-ruling-and-its-implications/.
Industry News · by Seyma Albarino On January 15, et al. “California’s Translators and Interpreters Scramble to Contain Damage Caused by AB5.” Slator, 23 Jan. 2020, slator.com/industry-news/californias-translators-and-interpreters-scramble-to-contain-damage-caused-by-ab5/.