ODP Deaf Services for Provider Administrators/Agencies Transcript · 2016-03-11 · ODP Deaf...

ODP Deaf Services for Provider Administrators/Agencies 1

Course Number: 018-03-01

ODP Deaf Services for Provider Administrators/Agencies Transcript

Transcript Title Slide (music playing) Webcast Tips This webcast includes spoken narration. At the bottom of the viewing pane are the play and pause buttons as well as buttons to go back and forth. There are also buttons to adjust the volume and view the closed captioning. On the left is a table of contents that can be used to navigate to a specific area of the webcast. There are also times when buttons may appear on the screen. They will typically appear at the bottom. The webcast may pause until you click the button. To continue, click the Continue button that appears in the lower right hand corner. Certificates of Achievement will be available to Administrative Entity staff, Providers, Supports Coordinators, and SC Supervisors after completing all course requirements. Please view and then save or print your certificate in order to receive credit for this course. For SCs and SC Supervisors, course requirements include successful completion of a pre-test and post-test. Welcome Hello. Welcome to the course “ODP Deaf Services Overview.” This course is required for all provider agencies and staff who are serving waiver participants who are deaf. My name is Patty McCool. I am the Director of the Bureau of Supports for People with Intellectual Disabilities and I’ll be your presenter for the first part of this webcast. Next, you’ll hear from Romy Spitz, an expert on supporting people who have an intellectual disability and are deaf from the state of Maine. Romy will discuss Deaf Culture and the unique needs of people with intellectual disabilities who are deaf. The last part of the presentation will be provided by a representative from the ODP Consulting System who will share information about ODP’s expectation of providers, documenting the signing skills of staff, and contacting the Deaf Services Coordinator. Settlement Overview (no narration) In August 2013, DPW entered into a settlement agreement in the case of Harry M. versus DPW. This case focused on communication access for people who are deaf and served through the Consolidated Waiver. This training is one part of what is required by the settlement agreement. We’re going to spend a little time giving you an overview of the various activities and timelines in the settlement at the beginning of this webcast. If you’d like to review the entire agreement or a summary of the settlement, you can access them using the link on this slide.



Transcript Some of the requirements that ODP has implemented as a result of the settlement include the following.

• New data fields have been created in HCSIS to identify hearing status, primary language, and communication skills. More information about these fields is included later in this presentation and can also be found through HCSIS Job Aids and Captivate trainings on the Learning Management System or LMS.

• A Statewide Deaf Services Coordinator has been hired. You’ll hear more about when and how to contact her in a little bit.

• ODP has worked to identify individuals who are deaf who are served through the Consolidated Waiver or on the Emergency Waiting List and staff who are skilled in supporting people who are deaf.

• ODP is also required to provide interpreters and communication assistance during meetings.

Individuals who are deaf will be provided options to choose Supports Coordinators and Providers who are skilled in working with people who are deaf. Individuals will also be supported to live with other individuals who are deaf if they’d like to do this. As of April 2014, ODP is refining the process for providers to use when requesting additional funds relating to increased staff costs due to employing and retaining staff who are skilled in sign language. In this case, the term sign language includes American Sign Language, Sign Language from other countries, such as Spanish Sign Language; Signed Exact English; and a mixture of ASL and signed English; tactile sign; and visual-gestural communication. ODP is also required to establish a standardized communication assessment process for use with all individuals who are deaf and who are served through Pennsylvania’s Consolidated Waiver. The assessment is currently being piloted with a small group of volunteers. After the assessment pilot is completed and the assessment tools and procedures are finalized, ODP will be completing a communication assessment of all individuals who are deaf and served through the Consolidated Waiver. The communication assessor will make recommendations including whether a separate assistive technology evaluation is necessary. Pennsylvania’s Initiative on Assistive Technology, part of the Institute on Disabilities at Temple University, is a good resource for more information on assistive technology. While individuals who are enrolled in the Person/Family Directed Support Waiver are not currently eligible to receive the standardized communication assessment, they may receive an assessment from a speech-language pathologist. There are training requirements in the settlement for Supports Coordinators, Providers, investigators, licensing inspectors, and monitors. The Communication Assessors will also receive training before they complete communication assessments. The settlement specifies what topic will be provided for each audience. The training content includes Deaf Culture, the needs of Waiver participants who are deaf, and the role of the Deaf Services Coordinator.



Transcript As specified in the Harry M. settlement agreement, the topics that will be covered in today’s training are:

• Deaf Culture • Unique needs of Waiver Participants who are deaf • ODP’s expectation of providers with respect to the provision of effective communication • How to document the signing skills of staff and/or other components of a service related

to effective communication identified in a class member’s ISP • And, when and how to contact the Deaf Services Coordinator.

I’ll now turn the presentation over to Romy Spitz who will talk about deaf culture and the unique needs of people with intellectual disabilities who are deaf. Deaf Culture (no narration) Hello, my name is Dr. Romy Spitz and I will be covering information about working with deaf adults with intellectual disability and autism. As Patty McCool said, I am from Maine where I am the consultant on deafness and communication for Maine’s Office of Aging and Disability Services in the Department of Health and Human Services. Within Maine Developmental Services, I am responsible for ensuring that deaf and hard of hearing people with intellectual disabilities and autism receive the services and supports they need to access all department services and contracted programs, including residential services, day habilitation services, and work supports and employment. I’ve been in this position for almost 14 years as well as being a communication assessor for people who use sign language or gestural communication and teaching neurolinguistics, how your brain makes language happen, at the University of Southern Maine. I’m happy that Pennsylvania is creating this webcast, there is a lot to learn. So welcome to the module working with deaf adults with intellectual disability and autism. This module is intended for Provider Agencies and Administrators who will supervise staff working with individuals who are deaf and also for those agencies and administrators who will be hiring deaf staff for the first time. The purpose of the module is to acquaint you with a fuller concept of deafness and how it impacts the services your agency provides to deaf individuals with intellectual disability. This module is intended to give you the background information you will need in order to understand and comply with the Office of Developmental Programs’ or ODP’s new requirements around serving individuals who are deaf with intellectual disability. It is important that you understand these new requirements and know where to seek clarification when needed.



Transcript There are three topics covered in this module.

• The first topic is deafness itself and the concepts related to deaf people. What do the concepts of Deaf Community and Deaf Culture mean both for staff and individuals with intellectual disability who are deaf?

• The second topic asks, What are the unique characteristics of people who are deaf with an intellectual disability? How are people who are deaf and have intellectual disability different from any other person who is deaf? How are they different from each other? And how are they different from other hearing persons with intellectual disability?

• And third, what does ODP expect of you as a provider agency or administrator? What are the staff requirements, the training requirements, and the service requirements you are required to meet?

But before we begin, let’s take a minute to talk about People First Language and how it intersects with the topic of deafness. During the portion of this webcast that I’ll be presenting, I may say deaf person rather than a person who is deaf. I may say a hard of hearing person rather than a person with hearing loss or a person who is hard of hearing. I do this because deaf people and many hard of hearing people prefer this way of referring to themselves. They prefer it to the way that those who use “people-first” policies refer to them. Person-first policies emphasize that you should put the person first and the disability or the difference second. For example, saying a person who is deaf. They do this in order to emphasize the person and de-emphasize the disability. The American and International Association of Deaf and Hard of Hearing adults have endorsed using “deaf” or “hard of hearing” first before the person. Why? Because both groups feel that by not de-emphasizing their deafness, by bringing it to the forefront, it emphasizes the importance of the need for effective communication and in some cases, it marks cultural identity. People who are deaf don’t consider deafness to be a disability and, therefore, feel no need to de-emphasize it. It is best to always use People First Language, such as an individual with deafness or a parent with a hearing difference, the first time you meet the individual or family. As part of your conversation with the individual and family, ask them how they would like you to refer to people who are deaf and then use this language moving forward. We recognize that language can be a very individual experience and we need to be respectful of the individual’s preference.



Transcript For many of you, this may be your first foray into the world of deafness. Take a minute to think; when you hear the words “deaf” or “deafness,” what picture do you see in your mind? Is it the picture on the screen? A picture of a person with ears that are broken? Do you see a picture of a person who cannot speak? That is what we would call the medical view of deafness; a viewpoint that looks only at the physical characteristics of the person and sees them as “broken,” “disabled,” or “dysfunctional." The medical viewpoint seeks to fix the person by curing them of their deafness through amplification and other technology. And if you don’t know deaf people, that is very much a typical way to view them. There is nothing wrong with that viewpoint. But that is not the picture that many deaf people have of themselves. And it is not the picture that people who are supporters, employers, or allies of deaf people should have of them. They don’t see themselves as broken. Your agency will be interacting with deaf adults both in terms of those you support and in terms of those you employ. It is important that you understand the concept of deafness from their perspective. At times, employees who can hear, let’s call them hearing staff, will face challenges as they communicate with deaf staff or deaf individuals with intellectual disability. Knowing how deaf people view themselves as part of a wider culture, will help your agency understand the aspects of those deaf-hearing challenges that are due to culture, not individual personalities. This knowledge will help you assist all parties to work effectively as a team. Remember when I said that if you ask deaf people what they want to be called, they say “Deaf,”as in “I’m a deaf person." Deaf people are proud of the title Deaf. When they see the word D-E-A-F as you see in this screen which shows the words spelled out in American Sign Language fingerspelling, they see the word with pride and with a sense of celebration. Deaf is a positive image. It’s who they are. Deaf people who have sign language as their primary language think of themselves as a culture, as a cohesive group of people living within a special community. They think of themselves with a sense of deafhood, a special sense of belonging, the same way as brothers think of themselves as a brotherhood, or as especially close neighbors think of themselves as a neighborhood. They see themselves as a Deaf Culture the same way you would see any other ethnic or sociolinguistic culture, American culture or Italian culture. You might ask: how can deafness be a culture? Well, the answer to that lies in the concept of culture. What does the term “culture” actually mean? Culture can be defined as the behaviors and beliefs characteristic of a particular social, ethnic, or age group. It’s those behaviors and beliefs that they value and hold in common.



Transcript Cultures can include external features such as distinctive clothing, special foods, traditions, or holidays. Those are things that we can see and observe and take part in. They can include internal features that we cannot see or take part in, such as a sense of identity, internalized values, or cherished beliefs about how someone should behave. And they can include social features that we may or may not be aware of such as having a distinct language, having greeting customs, artistic expression, and jokes. While deaf people do not have some of these characteristics, such as special clothing or foods, they do show many of the other characteristics such as a distinct language, identity, values, and traditions. Deaf Culture, like any other culture, revolves around an identity based on commonalities. What are these commonalities? The first commonality includes communication in American Sign Language or ASL. In Deaf Culture, everyone signs ASL and your skill in that language is valued. They include social protocols such as long introductions when we first meet and extended rituals for goodbyes. In Deaf Culture there is no such thing as a quick “hi, nice to meet you.” Instead, introductions are long and they include a lot of background information. Where did you grow up? Where did you go to school as a child, to college as an adult? Who do you hang out with? Given that information, both people immediately try to find deaf people they may know in each other’s home towns or deaf people that they might have in common. This information is exchanged with the goal of establishing relationships, to establish a common bond of deafhood and a sense of bonded community. For those of you hiring deaf staff, your hearing staff may feel the deaf person is being a little too personal, a little too nosy. Help them understand this as a cultural trait, not as a personality trait of the individual. Establishing common friends and common attitudes is very much part of Deaf Culture. When individuals who are deaf and have an intellectual disability meet, they too may try to forge links toward a relationship. Did you go to WPD, Western Pennsylvania School for the Deaf? Did you go to Scranton School for the Deaf? Which dorm? Which classroom? Which teacher? Who did you hang out with? Establishing common friends, common attitudes, is very much part of Deaf Culture. Help your staff understand the importance of this time and how to provide communication assistance if needed so that cultural links can be forged and maintained.



Transcript And then there is the famous “Deaf Goodbye.” Saying good bye is also a long process for historical reasons. In Deaf Culture, people start to say goodbye, give hugs and begin to leave, only to come back to tell you one more thing, ask one more question, bump into one more friend that they have not seen in a long time or find one more person to say goodbye to. It may be an hour or more before they actually get out the door. All of these are part of the culture which has a rich history where deaf people rarely had the opportunity to come together for an event. And once the event ended, they might not see each other again for months or years until the next event. Remember, cultures are a part of our past that we carry with us to the future, and in times past, deaf people couldn’t simply make a phone call to talk to someone, or text them to set up a last minute lunch date. Those features of Deaf Culture are set in history, but continue today as part of the culture. You will find these same cultural traits in many of the deaf adults with intellectual disability that your agency serves. When planning for support needs for a person, the plan may need to include additional time to leave program or to leave a deaf event, because for them, it may seem like an eternity before they see their signing friends again. Your staff will need to anticipate that extended ritual as part of the person’s culture and provide that extra time with encouragement, not with impatience. And signing staff who are considered part of the deaf world may need to practice how to handle “cultural breaches” such as when they need to shorten their goodbyes at events or leave abruptly based on the needs of the person they are supporting. Anticipating and practicing for these events can help both deaf consumers and deaf staff navigate more easily within deaf culture. Other commonalities are shared recreational events and social groups where everybody signs, and in the telling of familiar deaf experiences, such as being in the deaf dorm at school, participating in regional challenges such as basketball games. The stories also capture the shared experience of not hearing. And of course, like every other culture, there are jokes or other entertainment that you simply will never quite get unless you are connected to Deaf Culture. Let me give you an example of how jokes can tell you a lot about someone’s cultural identity. So here’s joke one: The Motel Joke. A deaf couple checks into a motel and goes to bed early. The wife wakes her husband in the middle of the night complaining of a headache. She asks him to go to the car and get some aspirin from the glove compartment. Groggy with sleep, he struggles to get up, puts on a robe and slippers and leaves his room to go to the car. He finds the aspirin, and with the bottle in his hand he turns toward the motel. But he cannot remember which room is his. After thinking a moment, he returns to the car, places his hand on the horn, holds it down and waits. Very quickly the motel rooms begin to light up…all but one. It’s his deaf wife’s room of course. He locks up his car and heads toward the only room without a light on.



Transcript So here’s joke two. It’s called the Hot Mamma Joke. A 92 year old man who was hard of hearing went to the doctor to get a physical. A few days later, the doctor saw the man walking down the street with a gorgeous young lady on his arm. A couple of weeks later, the doctor talked to the man and said, “You’re really doing great, aren’t you?” The man replied, “Just doing what you said doctor, get a hot mamma and be cheerful.” The doctor said, “Wait, I didn’t say that. I said you got a heart murmur, be careful.” Now chances are that you found one joke funnier than the other joke and which joke you find funny depends on your culture. If you are from Deaf Culture, joke one is humorous both for its deaf solution to a vexing problem, but also for its dig at those hearing people who were bothered by the honking horn. If you are from hearing culture, which most of you are, the second joke is humorous because the message was “misheard” in a funny way, a fact that would be lost on a deaf person who does not have access to the sounds of words such as heart murmur or hot momma. To understand Deaf Culture, you need to understand that the heart of Deaf Culture lies in its use of sign language. In the U.S. and parts of Canada, that culture revolves around American Sign Language or ASL. But Deaf Culture does not exist in a vacuum. It forms a core within a wider community called the Deaf Community. The Deaf Community includes the core of deaf people who grew up with ASL as a primary language, who have a self-identity as a “Deaf” person and who primarily associate with others who sign ASL, but it also includes signing allies. These allies may be family members who sign, interpreters or other people who sign ASL and deaf people who came to learn about ASL and Deaf Culture later in life. They form a big circle surrounding the core culture. Each ally in the Deaf Community has a place either closer to the core Deaf Culture or farther from the core culture based on a variety of factors, but the biggest factor is how well you sign and whether you are seen as having a “deaf heart.” People closer to the core culture are those who share the same deaf values. Allies who do not sign well enough to converse, but who nevertheless are attached to deafness can also be part of the community, but at a distance. Their lack of fluency in ASL will always leave them in the perimeter of the community. Put another way, any person that knows sign language can be a member of the Deaf Community, but the core culture only belongs to deaf people who have grown up surrounded by ASL, and surrounded by people who share that language plus a common history, story, and values. But what about deaf people who did not grow up at schools for the deaf and who use primarily spoken communication, or use amplification from hearing aids or cochlear implants as tools for understanding speech? Yes they are deaf, but they are not automatically part of the Deaf Community and obviously they are not of Deaf Culture. Remember, Deaf Culture is about Deaf Identity, but it’s really about sign language.



Transcript So what would a culturally deaf person look like to us? What clues would tell us that someone is culturally deaf? The obvious clue is that someone who is culturally deaf is also audiologically deaf, that is to say they cannot hear. But not all deaf people are from Deaf Culture. Other clues need to be present. Someone who is culturally deaf likely went to a residential school for the deaf or culturally affirming college where ASL is valued, deaf history is valued, and a positive sense of self-identity as deaf is fostered. Deaf people spend hours rehashing their experiences at deaf residential schools and feel an instant bond with anyone who attended a deaf school even if it was in a different country. Someone who is Culturally Deaf uses sign language as their primary language and they identify with others who also use ASL and who also share their values of being deaf as a cherished thing. More importantly, people who are culturally deaf see themselves as part of a linguistic minority; someone who uses another language other than English. They do not see themselves as a person who has a disability. They do not wish to be cured of their deafness any more than you would like to be cured of your American-ness or African American-ness or a French person who moves to the U.S. wants to be “cured” of his French language. They define themselves by their language. Being deaf is just part of their culture and self-identity. It is important to understand that deaf individuals and deaf staff have a different first language than you do. Their primary language is American Sign Language and it forms the beating heart of Deaf Culture and the Deaf Community. Your staff that can hear may have many misconceptions about ASL. Perhaps they might say “ASL is not a language, it’s just gestures” or “deaf people don’t have a language because they can’t talk” or “ASL is English on the hands." Nothing could be farther from the truth. ASL is a true natural language developed spontaneously by deaf people. ASL emerged from situations where many deaf children and adults were brought together and created a language. ASL bears little resemblance to English. It has its own grammar and syntax, its own rules for making sentences that are different from the rules of English. It is often surprising for people to learn that in many cases, the grammar of ASL is not seen in the signs or words made by the hands, but on subtle signals of facial expression, eye gaze and mouth movements. Raised eyebrows can indicate a yes/no question, they can indicate the topic of a sentence. Furrowed brows can indicate a question such as a where or what question. Subtle lip movements provide adverb information such as whether an action was done naturally or normally, hastily or sloppily. The differences between ASL and English exist even at the level of word meanings. In English, we use the word “ran” to mean many things; he ran to the store, she ran for office, they ran a printing press. In ASL, each of those examples would use a different sign, he physically ran by foot to the store or he drove to the store, she competed for office, they operated a printing press. Let’s look at the sign for these. (no narration) (no narration) (no narration) (no narration) There is nothing that you can say in any other language that you cannot say in ASL. It just happens to be a different language, expressed by the hands, body, and face rather than the mouth and vocal tract.



Transcript As provider agencies working with deaf staff and deaf individuals, you will face some considerable challenges around communication. Deaf people who primarily use ASL as their first language do not typically have good English skills. English is a language that is based on phonemes which are the sounds of language. When we teach children to read, we tell them to “sound out” those phonemes. But a deaf person has likely never heard the sounds of English, and as a result, their reading skills often remain around a fourth grade level. This changes how we handle communication between agencies and deaf employees. Our usual text-based solutions to communication, such as writing notes, sending emails and memos about changes in the organization’s policies and procedures, may not be enough. It also means that for most deaf staff, training has to be handled differently. Using captions to make speech-based trainings such as this webcast accessible, is often an inadequate solution. If you checked the sentences I am using here, they actually require a high school reading level. The better training method is through direct training from one signer to another or through hiring an interpreter to interpret the spoken portion of the training into ASL. In a mixed setting with deaf and hearing staff or deaf and hearing individuals, we need to ensure that deaf people have equal access to all communications. This can be quite a dance as people who can hear carry many misconceptions about deaf people, such as the fact that they all lip-read. We will address some of those misconceptions in the following sections. The fact that ASL may be the primary language also changes how communication is handled between DSPs, Supports Coordinators, and deaf individuals with intellectual disability. Your staff working with deaf signing individuals should be able to communicate directly in ASL or in a visual gestural form of communication if that is what is needed for direct communication. So, if deaf people have Deaf Culture, how do they refer to the culture of those who do not sign ASL? Well, anyone who is not deaf and not of Deaf Culture is referred to as hearing or being from Hearing Culture. That is all of you listening to this webcast. You are all hearing people from Hearing Culture. Hearing Culture actually refers to a few things, the most obvious is that you hear and speak.

As a matter of fact, let’s look at the sign for hearing. (video of the sign for hearing - no sound) Notice that it has nothing to do with hearing or the ear at all. It is all to do with the ability to speak. So Hearing Culture means that you are a speech user. But it also captures the wealth of privileges you have as a hearing, speaking person.



Transcript What are some of these “hearing privileges?” They are the things that you don’t ever have to think about. Things such as being able to communicate easily with most other people because they too are hearing. Being able to get information easily, being able to hear announcements, environmental noises such as sirens or elevator bells that signal events around you, and of course being able to easily navigate your way through everyday activities such as shopping, banking, and listening to the television without the struggle that deaf people face. Being hearing or of Hearing Culture encompasses all of these things. And it marks a divide between the deaf and the hearing world. This divide is often a theme in Deaf Art. This screen shows artwork by Darleen Hutchins, a deaf artist, which portrays some of the tensions between Deaf Culture and Hearing Culture. Here we see signing hands and seeing eyes united against hearing ears and speaking mouths. Yet both sides are seen seeking a universal way of communicating with each other. A way of communicating that for deaf eyes and hands can only happen through ASL. This picture both highlights the sense of common bond seen in Deaf Culture, but also the sense of separation and tension that deaf people feel as people living within a larger world of Hearing Culture. There is a sense in the Deaf Community, that the hearing majority act in an oppressive fashion to the culture and the language. This is called Audism. Audism exists not because hearing people are intentionally oppressive or mean, but because they are unaware of their privilege as hearing people and cannot see the beauty of sign language. So what are some of the differences between Deaf and Hearing Culture? The biggest difference you will notice is that Deaf Culture is consensus-driven. It values the group and strives to ensure that all persons in the group are in agreement with any decision or solution to a problem. That is very different from Hearing Culture which is very much focused on the individual and what the individual wants or needs. This difference of consensus seeking versus individuality can be misunderstood by hearing people who may feel that a deaf person simply does not want to “step up” to a leadership position. Or they may feel that the deaf person is unwilling to argue for a particular viewpoint or is unwilling to argue against a decision that they do not agree with. For deaf people with an intellectual disability, it may be seen as being overly agreeable, not being willing to say “No, I want to do something else.” It is important for a DSP to understand that consensus seeking or over-agreeableness is a cultural feature of deaf people. If you truly want to know what a deaf individual or deaf staff thinks, sometimes it is better to ask the deaf individual or deaf staff member for their opinions before the consensus of hearing staff or hearing individuals have had the opportunity to voice their opinions.



Transcript A second feature that you might notice is that Deaf people have what is called a “flat network.” This means they share information freely with everyone and strive to ensure that everyone is on an equal playing field when it comes to new information. This is very different from Hearing Culture which works off a hierarchical network where information may be shared on a “need to know” basis or be shared with small social networks of friends or co-workers. For deaf people, a flat network is part of the need for consensus. We all need to share information to come to a common decision. And we expect you as a hearing person to be sharing that information freely as well. This can cause misunderstandings because hearing people do not tend to share personal information with co-workers, they do not necessarily feel obligated to tell the deaf person what they heard the program manager say in the hallway. They may not tell a deaf person with intellectual disability what was said about another individual or where another individual is going. For deaf adults with an intellectual disability, this can cause tension because they will want to know why a housemate is angry or what staff are saying in the kitchen or the fact that their friend at work has a physical illness. And sometimes, that information is not ours to share. For hearing co-workers this “deaf” interaction style may be seen as an interaction style that is too personal and too direct.

Even in exchanges of factual information, deaf people tend to state the facts directly with little embellishment or shading for nuance, and they offer more background information and more detail than would be typical for hearing people. They do this so we can reach consensus about the factual information and then move on to a decision or a discussion. But to a hearing ear and a hearing eye, it feels like TMI, too much information. Hearing people approach interactions in an indirect way. We start with the background and come to the point of our request. We are careful not to be too personal in our comments and we don’t generally comment about visually obvious facts such as weight gain, hair style, changes in relationship that are considered fair game in deaf interactions. If a deaf person, with or without intellectual disability, is providing too much personal information or asking “nosy” questions, you need to consider that as part of their culture, not as a negative or challenging behavior.

And finally, there is a difference in seemingly small features such as eye gaze and body language. Deaf people expect direct eye gaze during all communications. It’s part of their culture and their visual world. This can cause both confusion and tension, because hearing eyes tend to wander. As a result, the deaf person may feel that you are hiding something. And the hearing person may feel that they are being stared at or feel intimidated. Deaf people are also used to “reading” the body language of others, which means the unconscious signals about our feelings and attitudes that we give off without knowing about it. If they see you are angry, even though you say you are not, they will comment on it, which can make for uncomfortable interactions. The bottom line is that knowing about cultural differences and being aware of how they impact communication and interaction styles will prevent many miscommunications and allow you to better serve deaf individuals with an intellectual disability.



Transcript We have been talking about Deaf Culture and the valued role of American Sign Language in that culture, but that leaves a question. Where do deaf adults with intellectual disability fit in? Are they also of Deaf Culture? Or are they seen as part of Hearing Culture? Or are they left out of a culture altogether? It’s a great question and one that is not quickly or easily answered. Within the general Deaf Culture, deaf adults with intellectual disability who sign and who attended deaf schools and socialize within the Deaf Community are considered part of the culture. But much as we see hearing people with ID live and socialize on the fringes of hearing society, deaf people with ID tend to be on the fringes of Deaf Culture and can be marginalized within that culture. Depending on their ASL skills and functional skills, they may be considered closer to the core Deaf Culture or closer to signing allies. Or they may be on the fringe of that community with those allies that do not sign well enough to converse, but who still have a connection to deafness. Those who do not sign or understand sign are still seen as deaf, but not really as a member of the community. There is a unique relationship between the Deaf Community and deaf people with intellectual disability. There is a sense of “us-ness” or inclusion into the deaf sphere even though many deaf people with intellectual disability do not have fluent signing skills. This feeling is expressed in the artwork by Darleen Hutchins showing the linkages of friendship, communication, and support between the two groups. In this picture, members of the deaf community are shown by signing grey hands and deaf people with intellectual disability are shown by signing colorful hands. There are clear messages of solidarity, respect, and communication in this artwork. Similarly, in the larger Deaf Community and Culture, there is a sense that all deaf people are linked by hidden bonds of deafness. That we know what the other person needs—they are just like us. That when it comes to a deaf adult with intellectual disability, there is a feeling that a hearing non-signing person could not possibly serve this person, communicate with this person, and understand this person’s world the way a deaf person can. If your program serves deaf individuals with intellectual disability, you will experience Deaf Community members, including deaf staff and interpreters, express frustration with staff who cannot sign or will not sign, express frustration with homes where the deaf person is isolated, and with Individual Support Plans which do not include any time for this person to be socializing with other deaf people in the community that understands them best. Deaf people with intellectual disability may be more toward the fringes of Deaf Culture, but the Deaf Community still strongly believes that deaf individuals with intellectual disability are “deaf first.”



Transcript Deaf people with intellectual disabilities understand that they are accepted by the larger Deaf Community, they feel that same sense of belonging when they go to deaf dinners and socials, and when they convene at a deaf camp. At the same time, they seem to have their own “Deaf ID Culture” which accepts people from the larger Deaf Culture, but accepts many others who are willing to communicate with them as well. We will refer to this as the Deaf ID Community, since they are deaf first and ID second. At the center of this community is, of course, those adults who are “like me,” those deaf people I went to school with, attended signing camp with, work with and see often. Those I communicate with the most. That is the heart of the Deaf ID Community. What do they value? A communication rich environment where information is shared freely with others, where new skills can be learned from others, and where happy events and sad events are felt as “family events.” One of the things that makes this community uniquely different from the general Deaf Community and Deaf Culture, is that this sense of belonging, of brotherhood, is not restricted to deaf people, signing people, or people with an intellectual disability. The Culture and Community embraces anyone who communicates visually or even tries to communicate visually. Membership is not restrictive as in the larger deaf culture and community, it’s inclusive. This inclusiveness allows the community to embrace deaf people with ID who come from very different walks of life. Some attended deaf schools, some attended public schools with no signing supports or interpreters, some speak, some use a combination of speech and signs. Some were encouraged to communicate, some were discouraged from communicating. Some have additional issues such as cerebral palsy which limits their motor skills and causes additional barriers to easy communication, or autism which limits their social communication skills. It also allows them to embrace people with ID who hear, but who communicate through signs and gestures. They are all different, but all are accepted as “deaf like me” in the Deaf ID Community. We will talk more about the unique characteristics of this population next. Unique Needs In this section, we will focus more specifically on people who are both deaf and have intellectual disability.

The combined impact of hearing loss and a cognitive disability presents a unique and complex challenge to service providers. We are talking about people who not only face the same struggle to learn and to function independently that we see for all people with an intellectual disability. But also people who have had one of the best tools for learning information and for navigating everyday challenges taken away—their ability to hear and to speak.

Staff that have been trained to support individuals verbally will need to be trained to provide that same support visually. Provider agencies and administrators should always strive to ensure that programs and staff accomplish two very important goals. One, to ensure that deaf people with intellectual disabilities receive equal access to services and information. And two, that staff are trained with the necessary communication skills to ensure that individuals can communicate their thoughts and desires and participate as fully as possible in their communities.



Transcript So what does a deaf person hear? It depends on their level of hearing loss. Most of the people we are talking about will have a hearing loss in the severe to profound range. Let’s take a look at what that means for the person. In this slide, you see a chart called an audiogram which allows us to see what sounds a person can just barely detect. Remember those hearing tests you had in school? The point of listening to all those beeps is to make an audiogram like this one. On the audiogram you see pictures corresponding to various sounds that most people hear every day. Sounds that are soft are located near the top. Sounds that are loud are located near the bottom. Sounds that have a high pitch are located to the right and those with a low pitch are located to the left. The letters on the page symbolize different sounds used in English and, as you can see, they cluster in the middle of the audiogram. Most people have normal hearing and can hear all the sounds pictured on this chart. The bottom lines on this audiogram indicate the highest level of hearing for one deaf person. She can only hear the sounds BELOW the bottom lines. Take a moment and look at all the sounds that she is missing. Each one of those sounds is information from the world that she will never know about without your assistance. That information includes spoken language, environmental sounds softer than a motorcycle, telephone ringers and telephone conversations, music and television soundtracks. And understand that a big part of your job as a DSP is to “catch her up” on all that missed information. It’s a big job!

Hearing aids can help some people hear more sounds by making the sounds louder, but even the best hearing aid cannot make the sounds of speech clearer. Cochlear implants can allow the person to hear sounds by bypassing parts of the hearing system that are broken. Hearing aids and cochlear implants will not be effective for every deaf person and many people will find them bothersome and decide not to wear hearing aids or use their implant. People have the right to choose whether they use hearing aids and cochlear implants or not. So if the person cannot hear us, how should we get their attention so that we can communicate with them? Provider agencies need to ensure that they and their staff are aware of the appropriate ways to obtain a deaf person’s attention in order for the person to feel safe and well-supported. The most important thing to remember is that distant communication is not effective communication. Train staff to come within the individual’s “communication bubble” which is typically within 2 to 4 feet of the person. The less hearing the person has, the smaller their communication bubble will be. If the individual also has vision loss, the communication bubble can shrink to the dimensions of their usable vision, the small range of places where they can see you. To get their attention, tap lightly on a shoulder, wave a hand to get their attention, or move where they can see you. Please don’t tap on them from behind or move too closely within their physical space. They have no way to know who is behind them or what you plan to do. It can be very startling and even scary for someone to approach that closely, that quickly, or from a position where they can’t see you. Remember, if you want to communicate, get their attention first, then communicate.



Transcript While all persons with intellectual disability are unique individuals, agencies need a strong awareness of the ways that people who are deaf and have intellectual disability can be very different from each other. They may have become deaf at different ages. Some were born deaf and some lost their hearing in early childhood or adulthood. The age at which you became deaf has a big impact on how you communicate, such as signing or speaking, or using a little of each. It also impacts how well you communicate. Communication can vary widely and it can take many forms. People who are deaf and have an intellectual disability can be very different from each other. They can vary widely in terms of their level of ability and disability. Often they may be classified as being more cognitively disabled than their hearing peers because they don’t speak and they are more difficult to test. This has led to more restrictive environments and fewer opportunities for learning new skills. Older deaf people with intellectual disability may behave in ways that seem very disabled, but this is not necessarily due to their actual cognitive abilities. It is because in the past, they have been considered as less able to be educated. Rather than providing needed therapies and educational supports, they were shunted aside and ignored. But even now, you will see big differences in deaf adults with intellectual disability depending on how they were educated and whether that education fostered communication, learning and independence or instead provided them with little communication and learning…leading to dependence. The educational backgrounds of the deaf adult you support can vary greatly. Some people received Early Intervention supports and adequate education within signing environments that specialize in working with deaf students. These students were able to learn and to reach their potential as adults. Other people have been in and out of specialized program for deaf students or they may have spent most of their school time in special education classrooms with children and teachers who hear and speak. Often there was no one around who signed fluently. These people missed valuable opportunities for learning. They spent their days without access to instruction or information. They became very dependent on teachers and aides and lost valued skills such as problem solving and making informed choices about what they would like to do or not do. These dependency traits have followed them into the world of adult services. Our job is to ensure that we can directly communicate with individuals in order to support learning. All of these differences add up to very individualized plans for supports and services and require agencies to be flexible and creative in establishing service plans for individuals so that they can change from being dependent to living productive, independent, and self-determined lives.



Transcript People who were born deaf or became deaf before they entered school may have had early access to sign language in preschool programs. Such early intervention programs are common now, but were not common even 10 to 12 years ago. For many of the deaf individuals we serve, their first exposure to true accessible communication may have come when they entered school at age 5 or even later when they transferred to a signing program in their teens. For some individuals, signing was not a primary concern and they have grown up struggling to express their basic desires through single spoken words, such as eat, drink, bathroom, movie or have developed their own gestural signs and words to communicate. They can learn to communicate more effectively if Individual Support Plans include the need for signing staff and sign-based therapies to provide them with the supports they need.

For those deaf adults who did have hearing in childhood and who learned to speak English before becoming deaf, communication skills can still vary widely. Some people keep their verbal skills and can speak whatever they need to say, but often there are changes in the way their words sound because they cannot hear themselves. And these changes make it difficult for us to understand their speech. They may need to learn to say some words more clearly or learn to supplement their speech with signs and gestures. Some people will lose much of their speech once they can no longer hear themselves speak out loud and may communicate in other ways such as learning signs or gestures or using electronic devices to communicate with hearing people. But even if a deaf person can speak, remember, they are still deaf and they can no longer understand you when you speak unless your staff provide additional visual cues. It is very important that individuals who are deaf are able to understand what is happening around them. What are people saying? What is happening in the kitchen or in other places that are not immediately visible? What plans are being made? A deaf individual, even one with great hearing aids, cannot hear all the sounds of speech. They may be able to catch a key word here or there if the lighting is good and the person is facing them. They may be able to use contextual cues to what we are talking about, such as the car keys that are in our hand when we ask if they are ready to leave for program. But they can’t hear you well enough to understand sentences. To get a sense of their experience, click on the [Hearing Loss] button on the screen and select hearing loss. Try the different scenes to see what someone with a severe hearing loss hears. For a more light-hearted approach, click on the second button to experience the Flintstones with hearing loss. Notice how little information is left when hearing loss is severe. Once you have viewed these simulations, click [Continue].



Transcript The people we are talking about today hear at a level even LOWER than those shown in these simulations. They cannot access information through hearing speech. They rely on visual information. Some of that visual information is informal, such as when we point to what we are talking about. But primarily deaf individuals will rely on more formal communication methods. It is important that you are able to communicate directly to the individual using THEIR best receptive mode or language. They can’t adapt to your speech, you need to adapt to their need for visual modes of communication. And often the best mode for understanding, even for those who can speak, is through the use of good signing skills. People working with deaf individuals with an intellectual disability should be able to sign well enough to convey all the information that an individual is missing. Do not rely on methods such as speech-reading or lip-reading. Deaf adults with intellectual disability seldom have good speech-reading skills. In fact, very few deaf adults without cognitive challenges have the speech-reading skills needed to follow a conversation. That is because less than half of the sounds of English are distinguishable by lip and tongue movements. The words, “I love you” and “olive juice” look the same on the mouth as do the words “daughter” and “tortoise.” Shoot, shoes, juice, chews, June and Jews all look the same on the mouth. Take a moment to take Charlie’s Lip-reading Test by clicking on the [Lip-reading Test] button on the screen. When you are ready to go to the next slide, click [Continue]. If lip-reading is that hard for you, who have no cognitive disability and have heard English all your life, imagine how much more difficult it would be for someone who has never heard English and had cognitive challenges. We can’t rely on speech-reading in order to communicate with individuals. 56 It is also important to recognize that individuals who are deaf can have other disabilities which impact communication. And often those secondary disabilities will not be diagnosed. This often happens with autism. Deaf people with autism or who do not have the diagnosis but show the features of autism have a special challenge when it comes to sign language. Sign language is a visual language, you have to look at the person you are communicating with in order to understand what they are saying. People with autism often do not like direct gaze and often do not look at your face for extended periods of time. How can you communicate with them if they won’t look at you? There are some strategies that you can try. If the person prefers to look indirectly at you, for example they look more at your ear or your shoulder or your mouth than your face and your eyes, move your signs to their peripheral vision and don’t look straight at them. Sometimes rather than standing right across from them face-to-face where our eye gaze and direct regard can cause discomfort, we stand next to them or caddy corner from them and sign. And sometimes, for some individuals, standing side by side and signing into a mirror can help, or signing from another room using Skype or FaceTime. Just because they don’t look at you, and just because they don’t respond to your signing, does not mean that they are not listening to you or taking in the information.



Transcript People who are deaf and have an intellectual disability face a real disadvantage in that they cannot overhear conversations. As children, they could not overhear television shows or conversations between mom and dad to learn new information. As adults, they cannot overhear conversations that would warn them of dangers or lead to new experiences. For example, a hearing housemate overhears a staff member talking about a trip to Great Wolf Lodge Waterpark and speaks up “I want to go to Great Wolf Lodge and ride the Hydro Plunge.” Immediately there are conversations about what she thinks would be involved so that an outcome can be made. What steps would need to be added to her Individual Support Plan, or ISP, to accomplish this task? We discuss with her which parts of the park she would like to go to and what parts of the plan she is ready to do now. What parts of the plan does she think she can do with minimal support? What agility skills would she need for some of the obstacle courses or to go across the rope line on the water? Staff might offer that Great Wolf has DVDs that they will send you if you ask, and a plan is made for the roommate to write a letter or call on the telephone. For her deaf housemate, none of this can happen unless the staff are communicating in a way that is visible and accessible to the person. If it is a spoken conversation, the deaf person will never hear of Great Wolf, will never make a plan and problem solve so she can go, and will never experience the growth in independence such events can provide. Deaf adults with an intellectual disability need to rely on others to provide even basic information about the choices available in their daily lives, to know of new opportunities which may arise, to be aware of events that are happening around them and even environmental signals such as the microwave dinging, the fire alarm going off, the fire truck that just went by. They depend on the staff that you hire and train and on the commitment to communication that each agency makes. When we first meet a new individual, whether deaf or hearing, one of the first questions we ask is “how does he communicate?” meaning how should I communicate so that he understands me and how will he communicate so that I can understand him. And the answer for deaf adults with intellectual disabilities is often, it varies. On the following slides you will see some videos of people with intellectual disability who sign and use gestures to communicate so you can see the differences between them. This is Sandra. She’s deaf. She’s always been deaf and she grew up in isolation from other deaf people. So her whole life she’s had to communicate using a few made up gestures and signs she’s learned from any source that was available. In this video, we’re asking Sandra to show us her sign for light bulb, but Sandra has another idea. She wants to tell us that the light bulb way up there in the ceiling is burned out. What is she doing that tells us that the light bulb is burned out? What gestures is she using? What pointing is she using? And, what facial expressions and body language is she using to tell the other person that the light bulb is burned out? Think about this as you watch this video. (video playing - no narration) In this video, Jamie’s talking about his vacation. See if you can tell what he’s saying. (video playing - no narration)



Transcript So what did Jamie do on his vacation this year? He went to see some trains at a train museum. It was great because he got to bring his engineer hat and sleep in a tent. Jamie really likes trains. What else did he do? He went to camp. And what happened at camp? Well there was a camp fire. He got to sleep in a tent again. He got to drink root beer. He got to go swimming and he got to eat corn on the cob in front of a fire. If you’d like to watch Jamie’s video again click [Jamie’s Video], otherwise click [Continue]. This is Butch. He grew up at the local school for the deaf. In this video he’s talking about what he does for work everyday. Can you figure out what he does for work?

(video playing - no narration) So what does Butch do for work? He works in a nursery where he raises plants and when the plants get really, really big, he sells them and gets money for it. It’s clear from watching Butch talk about his job how much he loves what he does for work and how proud he is that he makes money doing it. If you’d like to watch Butch’s video again click [Butch’s Video], otherwise click [Continue].

Deaf people with intellectual disability use a variety of communication modes from formal sign language such as ASL, to using spoken words, to using short combinations of signs, to using modified signs that are barely traceable to their ASL origins, to using gestures that they have created or all of these at the same time. Because they deal with many different staff who have varying levels of skill and comfort with these communication modes, they may also may use pictures or a speech output device such as an iPad that can convey messages in spoken English. There is no one way that this group communicates and often you will find that they combine multiple ways of communicating in order to get their message across. Provider agencies need to train their personnel to develop a very broad communication toolbox so that they and the individual can communicate effectively and plan outcomes which can be carried out successfully. The individual should not have to adapt to meet the limited communication skills of your staff. Staff hiring needs to reflect the individual’s communication needs.



Transcript We often tell providers that when two people cannot effectively communicate through a shared language, for example in order to engage in activities such as planning meetings, that the agencies need to include the services of an interpreter. Interpreters are professionals trained to move comfortably between English and ASL in order for two parties to communicate who do not speak the same language. Sometimes a regular interpreter will be sufficient for an individual who is deaf and has intellectual disability. If a regular interpreter is sufficient, it should say so in the Communication section of the person’s ISP. More often, something more than a regular interpreter is required. Many deaf adults with intellectual disability do not understand or use standard ASL. They may have limited expressive signs or be able to understand sentences when the grammar is brought to a lower level. They may use their own gestures to communicate. In such situations, it is best to bring in a Deaf-Hearing Interpreter team consisting of a regular interpreter paired with a specially trained deaf interpreter who has specific skills in communicating with people who use non-standard forms of signing. The person’s communication assessment report and/or the Communication section of their ISP will tell which kind of interpreter is needed. It is important to understand the difference between a dependence on someone and the use of a tool to overcome the communication barriers that come with deafness. Deaf people who have ASL as a first language, whether they have intellectual disability or not, will require a working relationship with interpreters in some settings. This should not be seen as a “dependence” on the interpreter, but instead as the independent use of a tool, in this case a person, to achieve some goal. This is true of deaf adults with an intellectual disability as well. Teaching them to use an interpreter properly is not increasing their dependence, it is increasing their independence. Similarly, deaf individuals with intellectual disability will need to rely on their staff to help bridge the communication gap between themselves and others in the community. This again should not be seen as a “dependence” to be overcome, but as a resourceful use of tools to solve a communication problem. In no case, should a signing individual be forced to use speech output devices in order to “speak for themselves." When we first meet a deaf adult with an intellectual disability, we quickly form an idea of who this person is and what this person might be able do based on their functional skills, what they can do independently. Yet when a deaf adult first enters our services, we often find that their ability to communicate with others is a lot less sophisticated than we would expect based on their functional skills. Sometimes this is because they did not have exposure to fluently signing peers or because they attended programs where signed communication was not valued. Sometimes the communication limitation is because of missed opportunities or a lack of opportunity for improvement through therapy. Children with speech issues go to a speech therapist, children with signing issues have no therapist. But sometimes the limitation is not in childhood, it only develops once they enter adult services. It is in their environment. We often find situations where the individual had signing skills that flourished in one environment, but declined in another environment.



Transcript Here is one person’s story. Daniel is both a person who is deaf and has intellectual disability with autism. He grew up in a deaf school and used signing to express his thoughts and desires. He graduated that June, and like many individuals with intellectual disability, he was placed in a residential program that was near to his family’s home. There were no fluent signers there, but the staff were told that they would need to learn to sign. By the end of five months, when I visited Daniel, he had stopped signing beyond basic words such as yes, no, bathroom, drink, eat, and television. By the end of eight months, even those signs were disappearing. At his yearly planning meeting, he was reported as being “non-verbal, non-signing” due to autism. At the request of his family, he moved to a residence with two other signing individuals and was provided with a sign language “tutor” to regain his former skills. Now three years later, he is back to communicating and conversing in sign language. He attends a peer support group with other deaf individuals and is considered a leader and a decider. It only took five months to lose his signs, and it took more than two years to get his skills back. This is a common story and it highlights the importance of both a communication-rich and accessible environment, and communication therapy that is relevant to the individual’s way of communicating, in this case signing. More importantly, it highlights a key fact - the limited communication skills we see in deaf adults with intellectual disability are often due to a lack of opportunity, not a lack of ability. When given the opportunity, they often show gains in communication that exceed our expectations. They can show growth that we would never expect to see in a hearing individual. The communication therapy and support you provide may be the first communication therapy and support this person has ever had. This section of the webcast was designed to help you understand deafness and the unique communication and cultural characteristics of deaf adults with intellectual disability, It was also designed to help you supervise and interact effectively with deaf employees you may hire. Deaf Pennsylvanians with intellectual disability have been waiting for communication their entire lives. Your agency’s commitment to ensuring that communication happens is the key to promoting successful, independent, and productive, lives. ODP’s Expectations (no narration) Deaf people with intellectual disability may have been waiting for communication their entire lives. The Pennsylvania Office of Developmental Programs is committed to ensuring that the deaf people it serves can have equal access to supports and services.

And that commitment begins with you.



Transcript Pennsylvania’s ODP has a number of expectations for provider agencies and administrators supporting people who are deaf. These include being able to deliver services directly to the individual in the language of the individual. Being able to provide agency staff with the training needed for them to support individual rights including their right to achieve personal goals and outcomes. Being knowledgeable about needed accommodations such as interpreters or assistive technology and how to obtain those for the individuals they serve. Being able to identify and obtain environmental alerts to notify the individual of a fire, a person at their door such as a first responder, a person entering their private spaces. And, being able to provide the individual with a home environment that promotes participation and reduces isolation through the use of visual environments that are friendly to visual communicators. Administrators and provider agencies must ensure that they and their staff can communicate directly with the individuals that they serve. In order to do this, they must first identify the individual’s receptive and expressive communication modes to establish the set of skills needed for staffing and other service decisions. This information should be gathered directly from a communication assessment report for the individual. Pennsylvania has established a clear process for assessing each deaf individual’s strengths and skills in a variety of communication modes including speech, signing, writing, visual-gestural communication, and the use of communication technology. This process will be discussed shortly as well as how to get a current assessment for an individual if no report is present or a re-evaluation needs to be done. Provider agencies and administrators should understand that individuals may use the same mode for understanding communication and expressing communication, or they can use very different modes. When making staffing decisions, the individual’s receptive needs should be considered paramount. Staff who can “sign a little” or “sign some” cannot adequately inform a deaf person about all the information he or she may be missing. The fact that he or she does not sign fluently or expresses with some words and some signs should not be the factor that determines what information she receives. Finally, agencies should ensure to the best extent possible that staff are hired who comprise a “best fit” model for expressive communication. A “best fit model” is one that attempts to meet the primary and secondary preferred expressive modes of the individual. The preferred expressive mode may not be the one that the individual is best at or the one that is expected. Information about the individual’s primary and secondary expressive modes is available from the communication assessment report. In order to meet the set of expectations we just discussed, agencies will need to ensure that their workforce development policies and procedures are written such that they can ensure the hiring of staff with the requisite skills. Almost all agencies have applications and interview procedures that can act as “soft discrimination” by making the process more onerous, more difficult for deaf and signing applicants. Sometimes the answer is as simple as reducing the reading level required to fill out the application, putting a checkbox for “I would prefer an interpreter at interview” so that deaf applicants know that yours is deaf savvy and deaf welcoming workplace, and ensuring that interview questions are either known in advance if the deaf or hard of hearing applicant is choosing to go without an interpreter or provided to the interpreter prior to the interview.



Transcript Consider how you will provide training in advance. Will you be training a signing staff member as a trainer who can provide required trainings in ASL? And if so, do they have both the required ASL skills and the required training experience? Are they aware of areas of information where deaf trainees are likely to have information gaps? Will you be providing training using a mixed deaf-hearing class and relying on interpreters to provide the language and cultural bridging needed for deaf members to gain critical information and skills? If so, have you adequately factored the cost for two interpreters per hour into your training budget? Why two interpreters? Because interpreters tend to work in teams and trade off interpreting in 20 minute intervals. It can be a considerable expense. And it often does not provide the best outcome. Interpreters can only interpret what is said. They are not responsible for filling in any information gaps that the deaf trainees have. Direct instruction is always better. That is why ODP encourages your agency to make contact with other agencies that also have deaf staff. By combining deaf trainees from multiple agencies, there is a better chance that there will be someone capable of training directly in ASL. And if there is not someone, sharing the cost of the interpreting services across multiple agencies softens the blow to each agency’s budget. Training is not the only time you will need to budget for interpreting costs. Budgeting interpreting costs for staff meetings is also important. Deaf staff are an important part of the team for individuals who are deaf. If hearing staff are expected to attend staff meetings, then deaf staff should also be attending the meeting with interpretation so that they can participate equally. Training expectations for your workforce is not limited to the required training for all direct support providers. If your agency is hiring staff that will be working with deaf individuals, additional training is expected of you. Some of these trainings are obvious. If the staff is not fluent, there needs to be training on ASL with a focus on using ASL to inform the individual. Providing information to the person and being able to support them in learning new skills is paramount in ensuring equal access to your services. Even for staff who are sign fluent, training in visual gestural communication is often necessary. While signing staff may be able to communicate to the individual using a non-linguistic form of ASL or in gestures, understanding what the person is saying is an entirely different matter. Earlier in this video, you saw videos of individuals using ASL and visual-gestural communication. You saw Sandra letting a staff person know that a light bulb was broken, Jamie talking about his vacation, and Butch talking about his job at the nursery. When you watched these videos for the first time, could you tell what Sandra, Jamie, and Butch were saying? If you show these same clips to deaf staff, they also will be unable to tell you the message the person is expressing, even though this individual is being very clear and very understandable. But, if you can understand the individual’s visual-gestural communication, or VG, then you know what they were saying. There are buttons on the screen that you can use if you’d like to watch any of these videos again. When you are finished revisiting these videos, click [Continue].



Transcript Staff will also need training on Deaf Culture and Deaf Community, and it is helpful for them also to learn about the community of people who are deaf and have intellectual disability. You received a slice of that information earlier in this webcast. How much of that information would you have known before this training?

Staff and other personnel may also find themselves in the position of being with an individual and not knowing whether the individual’s hearing technology is functioning. Individuals who wear hearing aids should have staff capable of doing daily hearing aids checks to ensure the battery is strong, the sound is clear, and that part of the aid that goes into the ear is clear of obstructions. More and more individuals will be using additional technology such as digital or FM systems at work or in specific situations where sound needs to be brought closer or using cochlear implants. Each of these systems can have breakdowns and many of those breakdowns can either be avoided with maintenance or repaired with some basic training.

Most important, all staff will need specific training in the learning styles of deaf adults with intellectual disability. Remember, we discussed how their educational experience and intervention history has been different from both hearing people with intellectual disability and those who are deaf without intellectual disability. We also touched on teaching methods that are most effective for deaf adults who are visual learners. As providers and administrators, you will be involved in support planning for deaf individuals. ODP expects that individual support planning will be accomplished in a manner that ensures that the individual has equal opportunity to participate in the pre-planning, meeting, and service determination process. ODP understands that pre-planning takes more time with deaf individuals, even when the individual and the provider or staff member can communicate directly. Individuals may not have experience with the concepts of self-determination, personal choice and few have the language skills to understand the concept of futures planning or incremental goals to attain a personal goal, and many will not have the communication fluency required to express these concepts through an interpreter. Providing substantially more time in pre-planning will allow staff to use person-centered planning tools to better fit the individualized needs of individuals. It also allows staff to support the individual in gaining needed vocabulary or identifying needed accommodations prior to the actual meeting. Taking the time to do proper pre-planning is the key to a successful ISP and to setting and achieving personal goals and outcomes.



Transcript As professionals who provide staffing, support planning, and/or service provision to deaf adults with intellectual disability, ODP expects that you will be able to identify accommodations that will allow deaf individuals to have equal access to services and equal participation in service events. Part of that process is the identification of needed accommodations. Some of this information is available from the ISP and from the communication assessment report. But each individual, whether their difference is deafness or other disabilities, should have a form that is easily accessible in their file that stipulates what accommodations are needed and the circumstances or events those accommodations are needed.

Interpreter needs should be prominently displayed in individual’s files and there should be an indication of which interpreters have been successful with this individual, or have not been successful. If there is a need for visual agendas at planning meetings or a need for picture supports to guide the person in what they wish to say, this should be listed in the Know and Do area. And finally, any technology or accommodations needed to use the technology should be listed. For example, technology accommodations would include the need for a digital or FM system for better auditory access at the meeting. Accommodations needed for technology would include prior charging of an iPad or other tablet technology needed for participation or ensuring that an electric outlet is available for use in order to prevent battery drain.

When a need for communication assistance is identified, the provider must provide an opportunity for individuals to request the type of communication assistance of their choice. Primary consideration must be given to the choice expressed by the individual unless a different communication assistance is recommended in the deaf individual’s most current communication assessment. According to ODP Bulletin 00-14-04, Accessibility of Intellectual Disability Services for Individuals Who Are Deaf, each provider must have written protocols in place for staff to request and obtain the necessary communication assistance. In most significant meetings, you will be responsible for ensuring that an interpreter is present if either an individual or staff who are deaf are involved. In some cases, such as medical or legal meetings, interpreters are required. ODP expects you to be able to determine what kind of interpreting service will be needed in order to ensure the individual’s right to informed consent and equal participation are protected. The communication assessment report will specify whether a regular ASL interpreter is required or whether an additional service, called a Deaf Interpreter, is required in order to ensure that individuals with limited communication skills have the additional information they need to understand and have a say. It will also specify when an interpreter is required for each individual.

We’ll be talking more about coordinating with interpreters and payment for interpretation services later in the presentation.

In order to be maximally effective in assisting communication between deaf and hearing participants in a meeting, the interpreters will need information for preparation. These can include agendas, meeting goals, lists of key terms or acronyms, or minutes from past meetings. In regard to confidentiality, certified interpreters abide by a code of ethics and are required to maintain confidentiality.

The information should be sent at least a week prior to the meeting in order to give interpreters sufficient time to prepare.



Transcript Provider agencies and administrators should have a working knowledge about interpreters and interpretation services. Interpreters in Pennsylvania must be registered with the state. Interpreters are professionals trained to assist deaf and hearing parties to understand and communicate with each other in each person’s first language. They are neutral parties which mean they cannot advocate on behalf of the deaf person. They cannot interject themselves or their opinions or thoughts. It is for this reason that interpreters should not be friends or family members of either party. And in no case, should children be used to interpret. An interpreter provides a confidential service and cannot talk about what transpired at a meeting. Within the field of interpreting, there are various specialties that providers should be aware of. The first specialty, that of deaf interpreter, is a role we have already talked about. A second specialty is a Certified Legal Interpreter, which ensures that the interpreter has specialized training for interpreting in legal situations or in court. If the situation is a legal issue or may become a legal issue, it is best to request a certified legal interpreter. Other interpreters specialize in medical situations. Information about hiring and paying for interpreters will be covered later in this presentation. The following are some guidelines that will make working with interpreters happen more smoothly. Understandably most people are uncomfortable the first few times they work with interpreters. The process is new and different. The interpreter and the other party are communicating in a language you cannot understand. There can be long pauses where you will not know what is happening and misunderstandings happen and need to be clarified.

One of the harder aspects for people to become used to is to remember to speak to the other party, not the interpreter. This is made more difficult by the fact that the voice you hear is the interpreter’s voice. But the words he or she is saying are the other person’s words. When he or she says “I” they don’t mean themselves, they mean the deaf person. And when you are talking and they sign to the deaf person and use “I” they don’t mean themselves, they mean you.

When using interpreters, be careful to speak directly to the person you are addressing. Do not say “tell him” meaning the deaf person. The two of you are in conversation, the interpreter is just a bridge. Be sure to allow time for the other person to process what you have said and formulate a response. While the time between when you asked the question and when the interpretation has ended may seem long, it hasn’t been that long for the other party who has been patiently waiting for the question to be completely interpreted. They will need a moment to consider their response. You can make the conversation happen more quickly and efficiently by keeping your part of the conversation clear and direct. Do not go on and on before inviting the other party to respond.

When speaking, speak slightly slower and pause more often. Understand that the interpreters are doing just that, interpreting your comments into another language and not doing a word for word translation. There will be times when one of the parties requires clarification of something you said or the interpreter said or signed. This causes a pause that can be quite uncomfortable for hearing people, but understand the time taken to clarify the interpretation is the mark of a good interpreter who strives to ensure that both parties understand what is being communicated. And finally, when using interpreters, spend some time checking for understanding, checking to see that the other party has the information that you intended to communicate. Don’t wait until the end of the meeting to find out that a step was misunderstood or an important piece of information was missed.



Transcript ODP expects all Providers to provide services that comply with all Pennsylvania regulations. They also expect that you will modify or arrange your services to be safe for persons who are deaf and hard of hearing. One part of that expectation is ensuring that agencies install environmental alerts that allow someone who cannot hear environmental sounds such as a fire and CO2 alarms, doorbells, telephone ringers, and knocks on their door, to nevertheless know that those signals are happening. Where you launched this webcast is a list of appropriate services and resources for various environmental alerts and we encourage you to utilize this list. One important alarm, the fire alarm, may require you to know a little more specific information about the individual’s hearing loss. Those people with profound high frequency losses will not be able to hear the fire alarm for the deaf because while the sound it emits is very loud at 90 decibels, it is also a very high frequency tone. There are alarms that emit low frequency sound and those should be sought out as some individuals may not rouse to the flashing signal of the fire alarm during the day or if they are heavy sleepers at night. There is more to a home than safety. In order to appropriately serve deaf people within residences, we need to ensure that those residences facilitate communication and information sharing. Deaf people are visual people. Kitchen tables or tables in gathering places should be round or oblong in order to and for participants to see each other to communicate. Open floor plans prevents corners and walls from blocking communication and seeing what others are doing in the same residence. This promotes peer to peer learning of skills. Being able to see others and being informed about events in the home reduces the amount of time and energy staff need to expend in providing information to the deaf house members. Providing a visual home also means installing or using equipment that ensures that deaf house members have access to telephones and to television. Visual people, whether signing or signing plus speaking, need visual forms of telephones. For most people that will be a videophone, a web-based or internet face-to-face communication system that allows two parties to see each other, either alone or combined with an audio system that allows them to speak or hear the other party. It also means ensuring the television is large enough to show captions which are sufficiently large or show signers and signing that is sufficiently large to be clearly seen, especially by older eyes or those that tend not to wear their glasses.

Even if you are not a provider of residential services, these concepts are still important. All service providers should think about how the environment can best support the individual and his or her communication needs. Most importantly, ODP expects provider agencies and administrators to develop a communication policy for each service location where an individual who is deaf receives services that clearly states how communication will happen. This policy should include the expectations for current staff as well as expectations for new staff and how new staff will learn about the individual’s communication style and how to effectively communicate with the individual.

Ultimately, the policy should require that all staff sign at all times in the individuals’ presence so that the individual’s right to equal access to information is protected. Less clearly stated policies, such as staff will use sign or use the language of the individual, result in homes where communication is less effective. It is not sufficient to have staff typically communicate with speech when it is inaccessible to the residents and just throw a few signs in. And once developed, ODP expects agencies to provide the oversight necessary to ensure that this policy is followed by all staff on all shifts. The requirements for safe homes and visual homes are not limited to residences. They must also be implemented in day services and workplaces where individuals who are deaf participate.



Transcript Communication Supports (no narration) The Americans with Disabilities Act, or ADA, ensures the provision of equal access for all individuals with disabilities. This law requires that “reasonable accommodation” be made to allow individuals with disabilities to participate fully in and receive all of the services and benefits available to those without disabilities. In certain instances, it is necessary for individuals who are deaf to have communication assistance in order to receive services and benefits. Communication assistance services can take a variety of forms depending on the needs and ability of the individual who is deaf.

Communication assistance for people who are deaf includes the following types of activities: • Certified Deaf Interpreters, • Staff or interpreters proficient in sign language, • Video Remote Interpreting, • Assistive Technology, such as adapted telephones like captioned telephones and

telecommunication devices for deaf persons or TTYs, • Communication Access Real-time Translation known as CART or real-time captioning, • Access to video phone equipment, • Visual supports such as checklists, schedules and materials, • Open and closed captioning on TV, and • Exchange of written notes.

An individual’s need for communication assistance can be determined in various ways which include, but are not limited to: an assessment completed by a speech-language pathologist, a formal communication assessment selected by ODP for individuals who meet the criteria for such an assessment, or a determination by the Individual Support Plan team of the individual’s needs for communication assistance to be provided on an interim basis pending the completion of an assessment. Assessments are very important for determining the long-term needs of participants. The need for an assessment, however, should not delay the provision of communication assistance such as an interpreter for a meeting. For this reason, the service can be authorized in the Individual Support Plan and provided on an interim basis pending the completion of an assessment when the Individual Support Plan team determines that communication assistance is necessary.



Transcript Individuals have the right to participate in and contribute to things related to themselves and their lives. If the individual or a family member uses an interpreter or staff that is able to interpret to communicate, it’s important to have an interpreter or interpreting staff present so that the individual is able to fully participate in the discussion. Providers are required to provide communication assistance when supporting an individual who is deaf. If you aware that an individual for whom you provide support needs interpreting staff, don’t wait for a Communication Assessment to provide staff who are able to appropriately support the individual and his or her communication needs. Other interpreters may be called upon if needed, but ODP expects that providers employ staff that can interpret for an individual whenever services are being provided.

When we’re talking about providing an interpreter, we’re talking about providing a Qualified Sign Language Interpreter, an individual who is state-registered under the Sign Language Interpreter and Transliterator State Registration Act and who engages in sign language interpretation or transliteration. When available, ODP expects providers to at least have staff that are able to interpret for the individual or individuals that are being served. For the purposes of this definition, interpreting is the process of conveying English in grammatically correct American Sign Language and the process of conveying American Sign Language in English.

As specified in ODP Bulletin 00-14-04 “Accessibility of Intellectual Disability Services for Individuals Who Are Deaf”, in general it is not recommended that family members or friends be utilized as Sign Language Interpreters, so that these people can focus on their roles as team members and supporters for the individual. Some situations in which it may be appropriate for family members or friends to interpret include when the individual requests that family or friends interpret, when the individual does not use a recognized sign language and no other interpreter is available who understand the individual’s communication, and informal situations, not meetings, in the home or community. For more information about situations in which it may be acceptable to use a family or friend as a Sign Language Interpreter, please see Bulletin 00-14-04. Another resource comes from the Office for the Deaf and Hard of Hearing, the state office that provides advocacy, information, and referrals for Pennsylvanians who are deaf, hard-of-hearing or deaf blind, and their families and caregivers. On the Office’s website, there is a Sign Language Interpreter Search that can be used to help locate interpreters in your area of the state. Please note that the drop-down box will include all interpreters willing to work in a particular county, not just interpreters who live in that county. A link to the search website is on this slide. You can also search online for “PA ODHH Interpreter” to find this webpage.

Scheduling an interpreter should be completed well in advance of the meeting date. It is best practice to begin scheduling for an interpreter about three to four weeks in advance of the meeting date and to give the interpreter or interpreter service multiple dates and times to choose from.



Transcript As you are coordinating and working with interpreters, here are some helpful hints.

Interpreters usually charge for a 2-hour minimum of their services. This timeframe is “door-to-door” and includes travel time.

Develop a list of certified interpreters and certified deaf interpreters who live in each county where you provide services. Use this list to find an interpreter in the county needed or a neighboring county.

If an interpreter is needed on short notice, be prepared to make yourself available around their schedule. Ask the interpreter if he or she has any other time available which might meet your needs. If an interpreter is needed on short notice, you may need to utilize an interpreter several hours away. To help reduce costs, plan early, one to two months in advance if possible, to avoid needing to use an interpreter from a distance. We also wanted to share some resource information with you related to interpreters for Medical Assistance services.

When scheduling an appointment for Medical Assistance non-waiver services, individuals or staff who assist the individuals should ask the Medical Assistance provider for an interpreter. If there is difficulty getting an interpreter, individuals or staff should ask for further assistance in obtaining an interpreter. To ensure that an interpreter has been secured for an appointment, provider staff should contact the physician’s office and ask for the name of the interpreter. If the staff is unable to provide this information, the appointment should be changed to a time when an interpreter can be provided.

If the individual receives physical or behavioral health services through fee-for-service such as ACCESS, the individual or staff should either send an e-mail to [email protected], or call the Office of Medical Assistance, Bureau of Fee-for-Service Programs at 1-866-872-8969, choose Option #7, and leave a message.

If the individual uses a Medicaid Managed Care Organization, or MCO, for physical or behavioral health, the MCO should be contacted for assistance. In the case of physical health, contact the Special Needs unit of the MCO.

If these contacts do not resolve the problem, the individual or staff should contact the ODP Deaf Services Coordinator. As a provider of ID services, you are responsible to provide communication assistance to individuals who are deaf at all times during the provision of the service. For example, if you are providing home and communication habilitation to an individual and you plan to go to the grocery store, you are responsible to provide staff that have the skills to “translate” for the individual while at the grocery store. Also, you are responsible to ensure that all staff working with the individual have the communication skills necessary to understand the individual and translate for them when needed. In other words, the staff should be able to have a back and forth communication with the individual and also relay what the individual is saying to other people.

In conclusion, you must ensure that the individual can communicate with others during the provision of the service and ensure staff have the skills to translate for the individual when needed.

mailto:[email protected]



Transcript Communication Assessment (no narration) As we talked about earlier in this webcast, all individuals who are deaf and enrolled in the Consolidated Waiver or in the intent to enroll status for the Consolidated Waiver will have a standardized communication assessment completed within the next year.

The assessment will evaluate language skills including the individual’s:

• Ability to sign, speak, read, write, speech read, use technology, and gesture • Ability to learn how to sign, speak, read, write, speech read, use technology, and gesture • Currently preferred method of communication, and • Most promising method to learn.

The assessment will also generate recommendations concerning:

• Staff skills, such as level of ASL fluency, visual-gestural training or other skills that are needed for effective communication now

• Staff skills needed to improve communication ability • Specialized services, environment, or equipment needed to improve communication ability • Needed communication assistance at meetings and appointments • The timing of the communication reassessment • Whether a separate assistive technology evaluation is necessary, and • Any other matter the assessor deems relevant

After the assessment is completed for the individual, the Deaf Services Coordinator or DSC will send the assessment report and recommendations to the Supports Coordinator. The Supports Coordinator will share this assessment information with the team and will work with the team to incorporate the information with specificity in the Communication section of the ISP and other appropriate areas of the individual’s support plan.



Transcript We wanted to provide you with some examples of the kinds of recommendations you may see from the Communication Assessment. Remember, these recommendations must be included in the Communication section of the ISP.

Recommendations may include:

• What communication methods lead to effective communication with the individual • What communication methods are not effective and should not be used with the individual • Services for the individual to enhance his or her communication effectiveness • Communication skills such as level of fluency and type that are needed by staff working with the

specific Waiver Participant who is deaf • Accommodation recommendations for the individual for interactions with staff and other

providers who are not proficient in communication methods identified in the individual’s Communication Assessment

• Housing recommendations for the individual, including if the individual may benefit from living with others who are deaf

• Other deaf-specific resources that can be useful to the Waiver Participant who is deaf or those supporting the individual

• In-context communication training for staff specific to the communication needs of the individual

• Recommendations for assistive technology, and • Recommendations for opportunities for the Waiver Participants who are deaf and their family

and support staff to socialize locally with other individuals who are deaf and communicate like the individual.

The timing for a re-assessment will be recommended by the first Communication Assessment. SCs should record the recommended timing for re-assessment with the other recommendations in the Communication section of the ISP. The DSC will be tracking re-assessment timing as she is responsible for coordinating the scheduling of assessments and re-assessments. She will also be monitoring assessment timing to ensure that assessments and re-assessments are completed within the required timeframes.

If a re-assessment is needed sooner than the timing recommended by the first assessment due to changing needs related to communication, the ISP team can request a re-assessment. An example of when a re-assessment may be needed is if an individual has a sudden change in health, such as a stroke. This health change may result in changing needs, including those related to communication. In this situation, the individual and the people who support this individual may need to learn new ways to communicate, and the assessment may help them figure out how to best do this. A re-assessment may also be needed if the individual is learning faster or slower than expected.



Transcript Once the assessment process has been finalized, ODP will communicate the exact steps that need to be taken. As a provider, you have the ability request a Communication Assessment for anyone you serve who is deaf. A Communication Assessment can be completed by a speech and language pathologist for individuals who are not in the Consolidated Waiver.

Once an assessment is completed, the DSC will review all documentation and provide the results to both the individual's SC and the authorized Administrative Entity. If the results of the assessment result in the need for a critical revision to the ISP, the SC will hold a team meeting. With the information that is received through the assessment, the Communication section of the individual’s ISP will be updated. To demonstrate that you are able to support the individual, you may be requested to supply additional documentation. Documentation Requirements (no narration) In this section of the presentation, we’re going to talk about documentation roles and the responsibilities for provider agencies. We’ll be talking about how to document the signing skills of staff and other components of service related to effective communication identified in a class member’s ISP. We’ll also be sharing information about the enhanced rate that is available and how this rate is documented in HCSIS. Let’s start by sharing information about the enhanced rate and the rate exception process. Until the Communication Assessment process has been implemented, ODP has a responsibility to provide providers the opportunity to apply for a rate Exception or an Enhanced rate. This process will allow a provider to apply for additional funding associated with the recruitment or retention of staff that have skills to work with an individual who is deaf.

If you currently have staff or need to recruit staff that have skills to work with individuals who are deaf, you should contact the ODP Deaf Services mailbox at [email protected]. ODP will then provide you with the documentation requirements and next steps. Your Regional Fiscal Officer or RFO will supply you with a list of required documentation related to the rate. The RFO will need information such as the type of service for which you need the additional funding, the individuals you are serving at the locations at which the services are being delivered, and the frequency of service.

Once the request is received, the regional program representative will review the individual’s ISP. They will be looking for indications of the individual’s hearing status, the way they communicate, and the services they are currently receiving. All documentation to support the recruitment and retention of staff, including staff skills, and any individual communication assessments that have been completed, needs to be sent to the Deaf Services Coordinator. The Deaf Services Coordinator will review the documentation for completeness and may contact you if additional information needs submitted. They will also be reviewing the qualification of staff to ensure they have the skills needed to support the individuals and their current hearing status.

This rate exception is effective for any individual who is deaf and receiving support through the Consolidated Waiver. Once approval or disapproval is determined, you will be notified. The rate exception process should take no longer than 30 days. If your request for a rate exception is approved, you will be provided instructions on what you will need to do in HCSIS and in PROMISe™ to receive the enhanced rate.



Transcript As part of the Harry M. settlement, DPW agreed to add mandatory data fields to the Home and Community-Based Services Information System, or HCSIS, to allow Harry M. class members to be identified and tracked through the system. The system is also able to identify and track individuals eligible for Enhanced Communication Services, or ECS, as well as add and bill for those Enhanced Communication Services. To facilitate this change, Enhanced Communication Service indicators have been added to HCSIS, and changes have been made to the fee schedule and residential rates.

Let’s talk a little more about ECS. Enhanced Communication Services are a subset of the Consolidated Waiver services that have been updated with a U1 modifier in HCSIS. These services allow providers who have staff who meet specific qualifications to obtain a higher rate than providers who do not. This higher rate was created to both encourage and support providers in both the recruitment and retention of staff who are needed to support these individuals. The qualification of staff can vary depending on the individual’s needs. ODP is currently working on a policy to not only match the skills of the individual and the staff, but improve the skills of both.

Individuals will qualify for the service if they meet the following qualifications:

One, they are deaf as defined in the Harry M. settlement agreement.

Two, they have received the standardized Deaf Services Assessment and the assessment results have found that they need staff to support their current communication needs; and/or

Three, they are able to reach higher levels of communication.

Once an Enhanced Communication Service is added to an Individual Support Plan, the services area of the ISP will be updated. While reviewing the services section of the ISP, you will be able to see the services which have the U1 modifier or ECS at the end. As we just reviewed, an individual who is Eligible for Enhanced Communication Services must have a completed Deaf Services Assessment and be found to be “In Need of Enhanced Communication Services.” Once the standardized communication assessment is completed for an individual, this assessment should be documented in the Other Non-Medical Evaluation screen of the ISP. Remember that the standardized communication assessment will be completed for all individuals who are deaf and in the Consolidated Waiver or in intent to enroll for the Consolidated Waiver.



Transcript Individuals who use sign language as their primary mode of communication will also need staff that communicate in the same way. One way to evaluate a staff person’s skills in communicating by sign language or American Sign Language is through a proficiency interview. The Sign Language Proficiency Interview, abbreviated as SLPI, or the American Sign Language Proficiency Interview, abbreviated as ASPLI, are two nationally recognized tools to determine a staff’s level of proficiency. Both the SLPI and ASLPI involve a rater communicating with the staff member in sign language or American Sign Language either face-to-face or via video. Once the interview is over, the rater gives the participant a document indicating their current level of sign language proficiency. The range of SLPI starts at Novice and ends at Superior Plus.

The results from a proficiency interview should be sent to the ODP Deaf Services Coordinator to support a provider’s request for an enhanced rate, rate exception, or qualification for the Enhanced Communication Services.

Unfortunately at this time, there is no nationally recognized evaluation tool for staff who are experts in visual-gestural communication. In order to determine if a staff is qualified to support an individual who communicates through visual-gestural communication, providers will need to send in documentation. This documentation should indicate the staff’s name, any training they have received, training dates, and, if this is an ongoing training plan, the estimated date of completion. It will be the provider’s responsibility to ensure that the ODP DSC has most up-to-date information and progress notes for this staff person. If you are interested in scheduling an SLPI assessment for a member of your staff, here are some resources for you. Both the Western PA School for the Deaf and Gallaudet University provide these evaluations. Click [Continue] when you are ready to go to the next slide. Another resource is the Rochester Institute of Technology. You can learn more by clicking the button on the slide. Contacting the DSC (no narration) At this point in the presentation, we’d like to introduce you to Maureen Veety, the Deaf Services Coordinator, or DSC, for ODP. As part of the Harry M. settlement agreement, ODP hired Maureen to provide a specific set of roles and responsibilities related to supporting people who are deaf and the SCs, providers, and others who support them. Maureen has been in this role since February 3, 2014.

Next, you will see Maureen introducing herself, giving her name and her title as Deaf Services Coordinator, using American Sign Language. If you’d like to read along while Maureen signs, the English translation will be in the notes pane on the right side of your screen. (video playing – no narration) Before becoming the Deaf Services Coordinator, Maureen worked for both the Bureau of Human Services Licensing and ODP as the licensing administrator for the Northeast Region. Before her time with DPW, she worked as a social worker at the Scranton School for the Deaf for 20 years. The Deaf Services Coordinator’s focus is on supporting Harry M. class members – those individuals who are deaf and in the Consolidated Waiver. She is also available as a resource for all individuals who are deaf and supported by the ID system.



Transcript The Deaf Services Coordinator position was created in the settlement agreement to provide stakeholders of the Office of Developmental Programs with a resource to assist in supporting individuals who are deaf and served in the ID system. As a provider administrator, you have the ability to contact the DSC directly on issues that affect your organization. One of the first ways she can be contacted is for technical assistance with physical environment adaptations. Physical environment adaptations can range from bed rockers to three-way light switches. Another area of assistance is matching deaf individuals with providers who have expertise in supporting people who are deaf. If you are a provider and you currently serve individuals who are deaf, you could be added to a list so that SCs and others are aware of the services that you provide. Provider agency administrators can also contact the DSC to find out how to post vacancies if you are a provider with specialized expertise in working with individuals who are deaf. The posting will assist you in finding staff that are qualified to work with individuals and also support individuals who are deaf in knowing what types of services are available. If you are in a situation where an individual would like to have an SC who has specialized expertise in working with individuals who are deaf, the DSC can be contacted to find the most up-to-date list. Lastly, the DSC can be contacted to assist with locating and informing provider agencies about assistive technology resources. Here is the contact information for Maureen. Please note, Maureen is hard of hearing and, therefore, has difficulty hearing voicemail messages clearly. It is best to contact Maureen by email if possible. If you call her and are not able to get in touch with her directly by phone, please send her an email with a short description of your concern and your contact information so that she can make sure to get back to you. This webcast has been developed and produced by the Office of Developmental Programs Consulting System on behalf of the Pennsylvania Department of Public Welfare, Office of Developmental Programs.

ODP Deaf Services for Provider Administrators/Agencies Transcript · 2016-03-11 · ODP Deaf...

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Transcript of ODP Deaf Services for Provider Administrators/Agencies Transcript · 2016-03-11 · ODP Deaf...