DPSS ePolicy

To revise an existing policy and/or form(s).

 What changed?

1. The CR 6181, Interpreter Services Statement and Confidentiality Agreement (11/2020) replaces the PA 6181, Interpreter Services Statement and Confidentiality Agreement (02/2018).
2. This release provides guidance and instructions to all Department of Public Social Services (DPSS) staff for completing and documenting the CR 6181 form.

The CR 6181, Interpreter Services Statement and Confidentially Agreement (11/2020) is used to:

1. Inform Non-English (NE)/Limited English Proficient (LEP) customers of the risks of using their own interpreter instead of free interpretive services from DPSS, including, potential communication errors and maintaining sensitive and personal information confidential; 
2. Document language services requirements when customers use their own interpreter;
3. Document the customer’s own interpreter confidentiality agreement; and
4. Reaffirm NE/LEP customer’s right to request an interpreter from DPSS.  The customer may, at any time stop using their own interpreter and request a free interpreter.

All County Letter 21-128, Instructions on When to Offer and How to Complete and Document Form CR 6181 Regarding Interpretive Services and Confidentiality Agreement, released the CR 6181, Interpreter Services Statement and Confidentiality Agreement (11/20).  Effective with this release, the CR 6181 replaces the PA 6181, Interpreter Services Statement and Confidentiality Agreement form (02/2018).

The CR 6181 informs the customer of the potential for communication errors when using their own interpreter, that their interpreter may need to interpret sensitive and personal information, and that the County cannot guarantee the interpreter will maintain confidentiality for any information obtained through the interpretation process.  It also restricts the use of minors (under the age 18 years) as interpreters in extenuating circumstances.

Note: Form CR 6181 does not replace the GEN 1365 Notice of Language Services, which informs customers of their right to language interpretation services at no cost to them.

This form must be used when customers choose to use their own interpreter after they have been offered free County provided interpretive services.  Free DPSS language services include:

• Verbal interpretation by County certified bilingual staff;
• Over the phone interpretation by a telephone language service vendor;
• Bilingual Resource Utilization database; and
• American Sign Language (ASL) and Spanish Sign Language (SSL) interpretation by an ASL/SSL certified vendor. 

CR 6181, Interpreter Services Statement and Confidentiality Agreement