Houston and Dallas have opened cooling centers across their metropolitan areas for people to escape the heat.
Houston-area cooling centers
With temperatures forecast in the upper 90’s all week, and heat indexes making it feel like it’s in the mid-100’s, the City of Houston has activated its heat emergency plan to provide cool places for people to spend hours or the day.
Most of the locations are libraries. Some run regular business hours, as early as 8 a.m. to around 4, 5, or 6:00 p.m. Others stay open as late as 9 p.m. The cooling centers are open different days, with many being closed on weekends or having certain days open.
If you read Deaf blogs or Deaf organizations’ websites for information about requesting and receiving live sign language interpreters for medical appointments, you probably won’t find recent news about a law revision giving patients who are Deaf many rights.
Revisions to part of the Affordable Care Act bring more rights–including:
the right to choose which accommodations work best for you,
how health care providers need to post notices with information about how to get an interpreter or other accommodations, and
requirements for interpreters your health care provider uses to communicate with you.
The National Association of the Deaf’s website has a “Position Statement on Health Care Access for Deaf Patients” that doesn’t include the most recent information about laws that now give patients who are Deaf the right to choose: the best communication method for them, whether they need a live or remote interpreter, and more.
Deaf Organizations Provided Input for the Law Changes
We’ve examined the most recent law revisions for you. We asked the National Association of the Deaf’s Policy Counsel of the Law and Advocacy Center, Zainab Alkebsi, Esq., why the latest law revisions aren’t on the organization’s website. She said that the National Association of the Deaf, or NAD, gave formal comments to Health and Human Services regarding the revisions to a part of the Affordable Care Act that now gives patients who are Deaf, Hard of Hearing, and Deaf-Blind, the right to choose.
Changes Section 1557 Brings
The part of the law that provides the changes is Section 1557.
Here are changes Section 1557 addresses, when your medical provider:
denies you an interpreter,
tells you to bring your own interpreter,
asks you to use family members or friends as interpreters for your appointment,
or when you are told an interpreter can’t be provided because they are a small practice.
All of the above excuses are now removed by Section 1557 of the Affordable Care Act, which Health and Human Services has revised.
The changes are so broad, this is probably one of the reasons Alkebsi said the NAD is transitioning their website to a new one.
The Biggest Change the Law Brings for the Deaf Community
The language for Section 1557 is complicated. One of the most important revisions for the Deaf community says healthcare providers should give individuals a choice about how they will communicate.
Section 1557 says medical providers should “give primary consideration to the choice of an aid or service requested by the individual with a disability.”
In a time when many health care providers are considering providing remote sign language interpreters, often without asking patients who are Deaf what is most appropriate for them, Health and Human Services reaffirms federal laws to defend the individual’s right of choice to determine what accommodations will help them understand their health care providers best.
Section 1557 revisions are based on Health and Human Services interpretation of the Americans with Disabilities Acts’ Titles II and III.
Title III says that public service providers need to provide accommodations for people with disabilities.
The department’s interpretation of Title II has brought the most changes, because anyone who receives government funding such as Medicare or Medicaid or other financial resources, which includes almost every medical practice and hospital, must follow the law. And the department determined that the law calls for the health care providers to give “primary consideration,” or first choice, to the person with a disability.
Removal of Economic Burden as Reason for Not Providing an Interpreter
Before, smaller health care practices, such as a clinic or dentist’s office, were allowed to give an excuse for not providing interpreters if the costs of the interpreter was a “burden” to the practice.
With the Section 1557 revisions, claiming a financial burden for providing barrier free healthcare with sign language interpreters is removed.
Why Using Family, Friends, or Inexperienced Interpreters May Not be Appropriate
Each individual has a choice about their needs. It’s sometimes difficult to know what’s best, though.
Health and Human Services determined that interpreters should be familiar with medical vocabulary, or “terminology,” as well as how healthcare providers communicate, or “phraseology.”
According to the revisions, “…we added the words ‘terminology’ and ‘phraseology’ in both definitions to align the final rule’s description of the requisite knowledge, skills, and abilities an interpreter must possess with those recognized within the field.”
Federal law has already determined that having people under the age of 18 should not interpret for anyone. Why? It can be psychologically damaging to children to interpret for others and feel responsible for their health. If things go poorly, the child may feel responsible for injuries or death. Besides this, some material covered during health care appointments may be too advanced or mature for children.
When selecting whether a friend or family member should interpret for your medical appointment, consider if they will:
understand medical vocabulary,
keep your medical appointment confidential, and
avoid getting emotional.
Required: Notices about How to Request an Interpreter or File a Complaint
Section 1557 also requires providers to have notices with information about how to request an interpreter or other accommodations, as well as information about who to contact if you have a grievance, or complaint.
If your health care provider doesn’t have this notice, they can find examples of what language to use on their notices on the Section 1557 web page, under the Appendix Section.
Those Receiving Government Money Can’t Discriminate
Health and Human Services cited many disability laws, including Section 504 of the Rehabilitation Act, which doesn’t allow for any government contractor–that is, anyone receiving money from the federal government–to discriminate against patients, even if the cost of interpreters is more than the money they make from patients.
Tax Assistance for Health Care Providers
While this could seem unfair to health care providers, if they make less than $1 million a year and have a staff of 30 people or less, they qualify for a tax deduction. This allows them to get their money back.
Even the IRS recommended asking the person who is Deaf, Hard of Hearing, or Deaf-Blind, which accommodation they needed, and not assuming it or basing the decision on the health care provider’s choice.
Health care providers should discuss interpreter costs with their financial professional to determine which tax credits and/or deductions they can take for these expenses.
More Ways for Providers to Save Money
Certified and/or qualified interpreters protect providers from liabilities that may arise from patients who are Deaf, Hard of Hearing, or Deaf-Blind that don’t understand them and whose conditions worsen as a result. Cases like this may result in lawsuits, some of which the U.S. Department of Justice joins.
Lawsuits can be more expensive than personal damages alone, because health care providers may be required to:
provide staff training,
document their processes,
undergo government supervision, and
potentially have to assign or hire staff to manage accommodations requests.
Lawsuits are Rarely the Answer: Education and Advocacy Are
When we at The Capsule Group and Sign Shares, Inc. communicate with the Deaf community as advocates, they often ask about us how to file a lawsuit. While going to court is an option, it’s a choice that involves a lot of time and effort.
Only serious incidences usually end up going to court, such as when not understanding a health care provider resulted in serious health problems or worse.
First, educate your health care professional about your needs. You can also send them to the Section 1557 website at http://1.usa.gov/24j8z7j to learn about the changes and your right to choose an interpreter or the services you need to communicate with them.
Violations of Section 1557 can already be reported to Health and Human Services. These violations are Civil Rights Complaints and can be completed online.
Educating yourself and others about the changes in the law is one of the quickest ways to make sure everyone knows about them understands them.
If you know of anyone needing this information, please share this article or link with them.
The Capsule Group and Sign Shares Inc./International held an event in Galveston, Texas on Friday, June 3, to address Deaf community concerns regarding the use of Video Remote Interpreting, or VRI, in health care settings.
According to the report, Galveston resident Janie Morales, who is Deaf, wants a live interpreter.
“When Janie Morales goes to the hospital, she doesn’t want to speak to a computer screen,” according to the report.
One of Morales’ chief complaints was that VRI was on a small screen and it was difficult to see.
Attendees requested more information about how to request live interpreters and shared their experiences with healthcare interpreting in general.
The group also discussed revisions to healthcare law Section 1557 of the Affordable Care Act, which will now hold the higher standard of giving preference to the individual with a disability’s choice of accommodation. While revisions to Section 1557 go into effect in July, complaints are active now, since preference for consumer choice was already in effect under Title II of the Americans with Disabilities Act.
If you’re concerned about not having a choice about the use of Video Remote Interpreting with your healthcare professional, you can call Video Phone: Deaf / Hard-of-Hearing: VP1: 832-431-3854 or VP2: 832-431-4889 to discuss it with Sign Shares advocates.
This Tuesday, 12 Deaf lawyers were sworn into the U.S. Supreme Court bar.
According to an Upworthy report, the first Deaf lawyer argued in front of the Supreme Court in 1982. Now, U.S. Chief Justice John Roberts communicated in American Sign Language from the Supreme Court bench.
“Some deaf or hard-of-hearing lawyers doubt that they can actually practice law,” Howard Rosenblum, one of the lawyers who was sworn in that day, told the Washington Post. “But the real practice is based on intellect and deaf people have that in spades,” according to the report.
Upworthy also took a stand on Deaf issues: “Deaf people, like anyone else, are capable of amazing things. But if we’re going to make them find their way in the hearing world, the least we can do is talk to them on their terms.”
If you’re currently enrolled in an undergraduate or graduate program at college, this internship opportunity provides training in disability advocacy and laws, and an opportunity to travel to the nation’s capital to attend a national conference regarding disability issues.
According to a recent announcement from the Independent Living Research Utilization program, the internship includes a $2,160 to $3,600 stipend and will last six to ten weeks during the time frame of June 6 to August 12, 2016.
According to the announcement, interns will attend the annual conference of the National Council on Independent Living in Washington, D.C., where they will gain additional exposure to disability issues, policy and the disability movement.
Interns will also assist in conducting town hall meetings regarding centers for independent living, learn from disability leaders, and visit federal agencies and meet federal officials in the disability network.
Applicants should submit:
a cover letter indicating their interest and availability,
Vox and Curbedcreated a video and article to demonstrate how DeafSpace differs from spaces created for people who hear.
The close captioned video begins with the open captioned words: “We live in a world built for people who hear.”
Curbed houses the article, “How Gallaudet University’s Architects Are Redefining Deaf Space.”
Gallaudet University is America’s only liberal arts college for people who are Deaf or Hard of Hearing.
According to the article, “Deaf (with a capital D) is a cultural identity that stems from pride in signed language and what Deaf Studies professors call ‘Deaf ways of being,’ or shared sensory experiences and cultural traditions.”
“DeafSpace is an approach to architecture and design that is primarily informed by the unique ways in which Deaf people perceive and inhabit space,” according to the video.
The video explores some of the five basic principles of DeafSpace.
Space and Proximity
According to the article, “Facial expressions are important in ASL. So are body movements; to be able to sign comfortably, a person needs adequate space—more than is typically required for someone engaged in spoken conversation.”
The video shows wide hallways that accommodate two people signing and using full body language while having more space to sign and maintain eye contact.
The principle refers to “how Deaf people use their senses to read the environment,” according to the article. DeafSpace would extend the person’s sensory reach, by allowing him or her to view between rooms and have low-glare reflective surfaces so people would see shadows indicating someone is outside the room.
In the video, they show transparent elevators and some offices have opaque glass walls, while some public rooms have clear glass walls.
Mobility and Proximity
“DeafSpace design calls for ramps and wide, gently sloping stairs; ‘soft’ intersections to prevent pedestrian collisions…” according to the article.
In the video, instead of stairs, which hinder the free-flow of communication, ramps allow greater access and would accommodate other disabilities that might need white canes or wheelchairs.
The video also shows classrooms in a U-shape that allows for signers to view one another.
Light and Color
“Certain colors, especially muted blues and greens, contrast well with a variety of skin tones, making them easy on signers’ eyes,” according to the article. “Lighting should be soft and diffuse, and avoid dimness, backlighting, glare, and abrupt changes in illumination levels.”
In the video, Derrick Behm, from Gallaudet’s Office of Campus Design and Planning, signs in natural lighting that is restive to the eyes.
According to the article, “In general, acoustically quiet spaces are the goal. Hearing aids and cochlear implants amplify sounds, and for their users, the hum of air conditioning or loud echoes can prove extremely distracting.”
DeafSpace is part of an architectural movement similar to Universal Design, where architectural design considers how to complement all abilities, not just mainstream ones.