American Sign Language (ASL) is the most widely used sign language in the world. While its roots can be traced back to 18th century France, sign languages existed in the Americas well before the arrival of Europeans. Native American tribes relied on Indigenous Sign Language (ISL) to facilitate inter-tribal communication—in addition to communicating with deaf members. Today, most deaf Native Americans and their families use ASL, but a small number still understand ISL, and they’re working to keep these dialects alive.


Here’s a look at three ISL dialects from the past and present.


Plateau Sign Language


Plateau Sign Language was used across the Columbian Plateau in the present-day U.S. states of Washington, Oregon, Idaho, and the Canadian province of British Columbia. Primarily used by the Salish people, the language went extinct in the 18th century.


Inuit Sign Language


Inuit Sign Language is used within Inuit communities in the Canadian Arctic. As of 2000, 47 of the 155 deaf tribe members used the language in the Canadian territory of Nunavut. While the language doesn’t have legal protection under federal law, it has been used alongside ASL in the Nunavut legislature since 2008.


Plains Sign Language


Plains Sign Language (PSL) has the largest number of users on our list. Once the lingua franca of present-day Central Canada, central and western parts of the United States, and Northern Mexico, it had over 110,000 users in 1885. It was used across at least 37 tribes, and remains strong among the Crow, Cheyenne, and Arapaho. Dialects of PSL include: Navajo, Blackfoot, Cree, and Ojibwa.


Also known as Plains Sign Talk, PSL is the most sophisticated indigenous sign language known. It’s recognized in the official courts, education, and legislative assembly of Ontario, Canada.


Preserving Indigenous Sign Languages


Indigenous sign languages, along with many indigenous spoken languages, are endangered. However, activists such as Nikki Sellars of the Xat’sull First Nation have been working to preserve ISL and improve protections under Canadian law. According to activists, integrating ISL into the curriculum at Native American schools for the deaf will be vital for keeping these languages alive.


Language Support and Boostlingo 


Although our Boostlingo Professional Interpreters Network (BPIN) doesn’t include ISL interpreters, we provide support for ASL and spoken languages such as Navajo, Mixteco, and Quechua. Our platform includes video remote interpreting options for ASL users and over-the-phone interpreting for languages of lesser diffusion, such as the ones listed above.


Want to learn more about how Boostlingo can provide the language support you need? Contact us today to start your free trial!


COVID-19 has exposed a long-standing issue within the U.S. healthcare system: lack of access to language services for people with limited English proficiency (LEP). As hospitals struggled to manage rising caseloads, LEP patients risked missing out on life saving care due to language barriers. Yet the shortage of medical interpreters and translators began well before the pandemic.


According to a 2016 survey by the American Hospital Association, only 56% of hospitals offered linguistic and translation services—up from 54% in 2011. To put this into perspective, a 2010 study found that 97% of doctors have non-English speaking patients. That gap between patients’ needs and the availability of language services can prevent them from receiving appropriate treatments or even seeking care at all.


Federal Funding and Title VI of the Civil Rights Act


However, the need for medical interpreters and translators is well known among healthcare professionals. Organizations that receive financial assistance from the Department of Health and Human Services (HHS) must provide access to language services under Title VI of the Civil Rights Act. Recipients of this assistance include:


  • Healthcare providers that participate in CHIP and Medicaid programs
  • Hospitals and nursing homes (recipients under Medicare Part A)
  • Medicare Advantage plans (e.g. HMOs and PPOs)
  • Human or social service agencies
  • Insurers that participate in Marketplaces and receive premium tax credits


So, why do so many healthcare organizations fall short? The answer lies in insurance reimbursement.


Interpreting Services and Healthcare Reimbursement


Despite federal assistance, few insurers directly reimburse for interpreter services. Aside from some Medicaid plans, healthcare providers typically pay the costs—ranging from $30 to $400 per patient. Meanwhile, Medicaid programs pay only $30 to $50 per patient, which means providers often lose money by treating LEP patients. Unsurprisingly, 25% of clinicians considered interpreting costs a barrier to care. And as revenue falls due to COVID-19, more providers may consider cutting interpretation services as a cost-saving measure.


Telehealth and More Affordable Interpreting


Fortunately, the news isn’t all bad. Due to the pandemic, the HHS has expanded access to telehealth to keep patients and healthcare professionals safe. Using a platform like BoostCare Telehealth, healthcare providers can connect with remote medical interpreters who charge lower rates than onsite interpreters.


Our video remote and over-the-phone (OTP) interpreting options give you access to interpreters who speak over 200 languages within minutes—without the travel expenses. You can easily treat patients via telehealth or onsite without waiting for an interpreter to arrive. All you need is internet access and a mobile device or computer with a webcam.


Think BoostCare Telehealth may be right for your practice? Contact us today to start your free trial!


Anthropologist and linguist Edward Sapir wrote in 1929 that, “In the state of California alone, there are greater and more numerous linguistics extremes than can be illustrated in all the length and breadth of Europe.” You could even narrow that down to Northern California—or just San Francisco, where 112 languages are spoken. And while each of these languages has a unique history and culture, let’s take a look at the five most widely spoken ones in NorCal.


  1. Spanish


It should come as no surprise that Spanish takes the number one spot. With over 10.6 million speakers state-wide[i], 28.5% of the Golden State’s population communicates in Spanish. In Northern California, the agricultural countries of the San Joaquin Valley and the San Fernando Valley are home to the majority[ii].


  1. Chinese (Including Cantonese and Mandarin)


Chinese speakers make up 2.8% of the state’s population, with over 1.2 million speakers state-wide.1 Most Chinese speaking NorCal residents live in the Bay area—primarily in San Francisco, Alameda, San Mateo, and Santa Clara counties.2


  1. Tagalog


An estimated 2.2% of California residents speak Tagalog, a language native to the Philippines. The majority of the roughly 796,000 speakers live in Southern California, but the San Francisco Bay area also boasts a thriving community.2


  1. Vietnamese


Did you know San Jose is home to the largest percentage of Vietnamese speakers outside of Vietnam? With around 559,000 residents, Vietnamese speakers make up 1.43% of California’s population, most of whom live in Northern California.2


  1. Korean


Korean rounds out the top 5 languages with around 368,000 speakers state-wide. Korean speakers make up about 1.08% of California’s population. The largest communities are in Orange and Los Angeles counties, but about 1.3% of San Jose residents and 1.1% of San Francisco residents identify as Korean.[iii]


Honorable Mention


Persian, Japanese, Russian, and Armenian round out the top 10 most commonly spoken languages (along with English) in NorCal. The first three are primarily spoken in the Bay area, while Fresno is home to a large Armenian community.


A Note on Native American Languages

Although the state’s pre-colonial indigenous communities spoke over 80 different languages, the vast majority are now either extinct or severely endangered. Languages such as Karuk, Hupa, and Yurok, which were once common in Northern California, now only have about a dozen speakers.[iv] Chukchansi and Luiseño are also native to the region, and languages from larger groupings such as Athabascan, Algic, and Uto-Aztecan are spoken in small numbers. The San Francisco area has a small number of Navajo speakers as well.


Yet despite the shrinking number of speakers, organizations such as Advocates for Indigenous California Language Survival are working to keep these languages alive through education and community building.


Language Support from Boostlingo


As you can see, Northern California’s linguistic diversity spans across urban, suburban, and rural areas of the region. While each of these communities add to the state’s unique culture, language differences can also pose barriers to communication.


Fortunately, Boostlingo makes it easy to access interpreters for over 200 languages. Our interpretation platform let’s you schedule an onsite interpreter or connect with an over-the-phone or video remote interpreter in minutes.


Want to learn more about how Boostlingo works? Start your free trial today!








If you or a loved one has ever had a medical emergency, your first reaction was likely to dial 911. Now imagine you didn’t speak English. What would happen then? Ideally, the operator would quickly connect you with a 911 interpreter.


These specialized medical interpreters must remain calm in even the most stressful situations. In this blog post, we shine the spotlight on these sometimes-forgotten interpreters and the vital work they do.


What It Takes to Become a Boostlingo 911 Interpreter


First things first. Medical interpreters who join the Boostlingo Professional Interpreters Network (BPIN) are not employees, but are independent contractors. Yet that doesn’t mean we don’t require them to meet strict requirements before accepting emergency assignments.


Below is a partial list of our medical interpreter requirements:


  • A minimum of 60 hours of medical interpreter training.
  • A minimum of 3 years of medical interpreting experience.
  • Completion of required CEUs.
  • Evidence of current HIPAA compliance (must be updated every 2 years).


Given the sensitive nature of emergency calls, we also ask our interpreters to follow a strict code of ethics for the calling environment. It must comply with HIPAA regulations for security and privacy, i.e. no answering calls in public places or in a room where others are present.


How 911 Interpreting Works


When someone places an emergency call, it’s routed to the requested language and type. An interpreter will answer the call with the greeting, “Hello, my name is NAME and my ID number is NUMBER and I am your language interpreter. How may I help you?”


All interpreters who accept these calls are prepared to take them.


Meet Our BPIN Interpreters


The 911 interpreters who join our network have varied backgrounds, but all of them are well trained and meet requirements above. Here’s a brief introduction for just two of them:


Andrea Lane, a Portuguese-English interpreter based in San Diego has a degree in nutrition and previously worked in a hospital. Now, she not only interpreters 911 calls, but provides legal interpreting for government agencies and immigration.


Andres Wallace, a Spanish-English interpreter based in Costa Rica, studied translation before becoming a medical interpreter. Throughout his seven years of experience, he’s taken 911 calls due to domestic violence, stabbings, shootings, and motor vehicle accidents.



During our interview, he recalled a harrowing incident that involved a collision with a heavy motor vehicle. A passenger had fallen unconscious, and Andres had to walk the driver through removing the passenger, ensuring they were still breathing, and interpreting for the EMTs.


Both interpreters emphasized the importance of remaining calm and adhering to the code of ethics they’ve sworn to follow, regardless of the scenario.


Partnering with Boostlingo


As you can see, our 911 interpreters undergo a rigorous training process, and must sometimes interpret during life or death situations. Because of this, our BPIN interpreters are some of the best in the industry.


Want to learn more about how Boostlingo can assist your emergency call center? Contact us today!