In 2004, there were 50 million non-English speakers in the United States and an additional 22 million who had marginal English proficiency. Many had no health insurance or access to low-cost, affordable health care. This case describes the dilemma faced in 2004 by Jim Zimmerman, the executive director of the Illinois-based HealthReach clinic, which served the area's uninsured poor, in deciding what initiatives to continue funding. One of these was Healthcare Access by Language Advocacy (HABLA), a medical interpretation program developed in 2001 to bridge the language gap between the volunteer medical staff and their Hispanic patients, many of whom spoke little or no English. This had proved an invaluable program, but Zimmerman's funds were tight.