VRI ADVOCACY

Debra Patkin, NAD Attorney Zainab Alkebsi, NAD Policy Counsel

Holly Ketchum, NAD VRI Task Force Chair

Your Speakers

Debra Patkin, Attorney Zainab Alkebsi, Policy Counsel Holly Ketchum, VRI Task Force Chair National Association of the Deaf

Law and Advocacy Center 8630 Fenton St., Ste. 820 Silver Spring MD 20910

301.587.1788 [VP] 301.328.1443 [VP] 301.587.1789 [TTY] 301.587.1791 [FAX] nad.info@nad.org [email] www.nad.org [website]

Roadmap

VRS v. VRI Know Your Rights NAD Litigation Strategy What You Can Do NAD VRI Task Force Questions

VRS V. VRI

VRS v. VRI

How many of you have used VRS? Opinion?

How many of you have used VRI? Opinion?

Dierences?

Proper Use of VRI vs Improper Use of VRI

Proper: Temporary use, e.g. intake or while waiting for on-site interpreter to

arrive. Adequate high-speed Internet available and VRI equipment available

in dierent locations in the hospital. D/HOH user is able to understand the VRI interpreter and vice versa,

and the use of VRI relays eective communication about the medical visit.

Proper Use of VRI vs Improper Use of VRI

Improper: VRI interpreters are randomly assigned, not necessarily specialized in

medical interpreting or consistent relationship D/HOH user is lying down (2D vs 3D) VRI equipment cant physically follow patient through testing,

transfers, etc. Technical diculties Improper screen size Speed of answer Insucient training of or turnover among hospital sta D/HOH patient has vision loss or other additional disability

DOJ Regulations

DOJ published revised final regulations for ADAAA. Recognized that VRI will not be eective in all circumstances

(such as the scenarios from last slide) and in those conditions, on-site interpreters may be required.

If VRI is chosen, ALL performance standards must be met: High-quality video images without lags, choppy, blurry, or grainy

images, or irregular pauses in communication Image large enough to display the face, arms, hands, and fingers of

both the interpreter and the patient. Clear, audible transmission of voices; and Adequate sta training to ensure quick set-up and proper operation

KNOW YOUR RIGHTS

Hearing Myths about ADA/Rehab. Act

The ADA doesnt apply to us because . . . If interpreters/CART is expensive, we dont have to provide it. Writing notes and lipreading = eective communication. VRI machines always work. Deaf people can bring their own interpreters. If a hearing person has a deaf family member or took ASL I,

they can interpret! Accepting relay calls creates a security risk (for banks,

hospitals, etc.).

Deaf Myths about ADA/Rehab. Act

Eective Communication = Interpreters? Interpreters & CART all the time! Certified Interpreters Required! Interpreters work for us, the Deaf! Violate ADA, Sue for $100,000,000,000! My lawyer will fix everything by tomorrow! All lawyers know all laws! Deaf lawyers are rich and should help free! Only a Deaf lawyer can understand my case!

Deaf Rights!

Americans with Disabilities Act (ADA) Rehabilitation Act of 1973 Individuals with Disabilities Education Act (IDEA) Communications and Video Accessibility Act (CVAA) Telecommunications Act Television Decoder Circuitry Act Air Carrier Access Act Fair Housing Amendments Act State and local laws

Laws Applying to Hospitals

Americans with Disabilities Act (ADA) Title II (State hospitals) Title III (Private hospitals)

Rehabilitation Act of 1973

Title III v. Rehabilitation Act

Title III Applies to places of public

accommodation Right to eective

communication Available remedies (solutions)

Change of policy Reimbursement Attorney fees

Rehabilitation Act Applies to recipients of federal

financial assistance ( 504) Right to equal opportunity to

benefit from the service Available remedies (solutions)

Change of policy Reimbursement Attorney fees Money for emotional distress (if

discrimination intentional)

Application

Title II covers all public hospitals Title III covers all private hospitals Rehabilitation Act covers all hospitals that receive Medicaid

or Medicare

Rights

Eective communication and equal opportunity Focus on the communication that happened What the patient did/didnt understand.

Compare to hearing patients experience

Remedies

Change of policy Require ADA compliance in future MUST show deaf will go back

Reimbursement (if you pay for own interpreter) Attorney fees

Defendant pays, not the deaf person. Lets NAD keep doing this work!

Compensatory damages Only if defendant intentionally discriminated

What We Need to Show

Communication was not eective Hospital sta knew it was not eective Deaf will go back to that hospital

How to Show Communication Ineective

Deaf does not read or write well enough to communicate in writing.

Hospitals interpreter does not know ASL. NOTE: uncertified interpreter not enough.

Deaf can explain the information that he/she missed. Hospital did wrong procedure.

How to Show Hospital Knew Communication was Ineective

Deaf wrote I dont understand. Deaf wrote I need an interpreter. Deaf wrote I cannot use the VRI. Family member said I cant serve as the interpreter. Deaf/family complained.

How to Show Deaf Will Go Back to That Hospital

You live near by. You have a chronic condition that requires regular

hospitalizations. Your primary care doctor is there (and doesnt provide

interpreters) Your specialist is there (and doesnt provide interpreters) Pregnancy or other optional situations

NAD LITIGATION STRATEGY

Ask Howard Anything

http://nad.org/news/2015/4/aha-april-2015

How We Pick Cases

Focus on system change Suing one hospital not enough Suing hospital system better

Focus on clear-cut wins Communication clearly ineective Hospital clearly knew

VRI Litigation Ours and Theirs

Review of NADs VRI Cases Review of Others VRI Cases

WHAT YOU CAN DO

Before your Appointment

Request it in advance (two weeks or more) Specify what you need: interpreter (what kind), CART, FM

Loop, other assistive listening devices, etc. I require a qualified interpreter I require a qualified CART captionist

Find out who is the best person to contact: Front desk? ADA coordinator? Nurse?

Ask that person! ALMOST NEVER bring your own accommodation!

At the Hospital

Write out what you need (interpreter) Write out that you dont understand.

Keep the note or take a picture of it Ask/tell everybody you can. Ask to meet with an administrator. Keep a record of what you do!

What to do if Communication Access is Denied

Keep calm and explain the law. Keep records of everything!!! Write down:

The name and position of the person you contacted The day and time you communicate with them

Exactly what they said If you wrote notes to each other, keep them Use email or letters to communicate and keep them

Contact an advocate

VRI TASK FORCE

NAD/DSA VRI Task Force

NAD and DSA in partnership

Mission

Develop VRI Guidelines By Consumers perspectives Medical Settings

For Who?

Manufactures VRI operators Network Technicians Related Personnel Interpreters

Issues

a. Situa?ons Intakes Opera?ng rooms Mobility of equipment Mobility of pa?ents b. Specica?ons Broadband Firewall Space Set ups

Training

Con?nuity 24/7 Technical support

Interpreters

Qualica?ons Familiarity of local signs Broadband 24/7

We Want your Stories

Learn what hospitals do. Get stories from many of you. Decide next steps.