Different states have different standards for interpreters. Some states, such as Oregon, have a “statewide” certification. In New York, there is only a state certification for the court system, and certification is only available in a select number of languages. Medical interpreter certification is available through the International Medical Interpreters Association (IMIA) and the Certification Commission for Healthcare Interpreters (CCHI). CCHI offers a credential for medical interpreters of all languages. This is not a “certification,” but a professional accreditation. University degree programs are also available for interpretation in a select number of languages and will accommodate other languages. For a certification to exist, there must be a written and spoken component that can be graded by qualified professionals. This is the reason why certification does not exist for most languages and is especially more difficult for languages of limited diffusion.