TRENTON
– Attorney General Peter C. Harvey
announced today a major new initiative,
launched in conjunction with the New Jersey
Hospital Association (NJHA), that will
result in improved communication between
hospital care providers and patients who
are deaf or hard of hearing at more than
100 hospitals throughout the state.
According to Harvey, the key to the new
initiative is a commitment from 112 NJHA
member hospitals to comply with the New
Jersey Law Against Discrimination (LAD)
and other state and federal laws by providing
sign-language interpreters, assistive
listening devices and other “reasonable
accommodations” to ensure that persons
with hearing loss can communicate effectively
with hospital staff.
“Adults
and children who are deaf or hard of hearing
must be able to effectively communicate
with doctors and nurses to explain their
illness or injury,” said the Attorney
General. “This is as much a public
safety issue as one of health care. Certainly,
communication cannot be the barrier between
life and death. I credit New Jersey’s
hospital community for recognizing that
a disparity has existed, that it can do
a better job of serving the needs of deaf
and hard of hearing persons, and for its
willingness to work cooperatively with
us to improve the situation.”
Reasons
for the Hospital Deaf/Hard of Hearing
Initiative
There are an estimated 720,000 deaf or
hard of hearing persons in New Jersey
alone. Advocates agree the number could
be substantially higher because it is
often difficult to identify those with
hearing loss. Absent the services of a
sign language interpreter, assistive listening
device or other accommodation, deaf and
hard of hearing persons often experience
difficulty in conveying vital information
about their symptoms and medical histories.
In addition, said Attorney General Harvey,
patients with hearing loss have complained
about being placed in the awkward –
and potentially harmful – position
of relating sensitive medical or personal
information through friends and relatives,
including small children.
Joining Attorney General Harvey for today’s
announcement were J. Frank Vespa-Papaleo,
Director of the Division on Civil Rights,
representatives of the NJHA, representatives
of the state Division of the Deaf and
Hard of Hearing in the Department of Human
Services and Albert Gutierrez, Chief Executive
Officer of Shore Memorial Hospital in
Somers Point, who chaired an NJHA task
force on hospital communication with the
deaf.
By virtue of the New Jersey LAD and the
federal Americans with Disabilities Act
(ADA), hospitals are required to provide
deaf and hard of hearing patients –
as well as third parties with a legal
right to health care information and/or
authority to make health care decisions
– with an effective means of communicating
with hospital staff. The means of communication
must be provided with minimal delay, and
at no cost to the patient or third party
needing the service. Attorney General
Harvey noted that, while the law does
not require hospitals to provide every
service requested by a person with hearing
loss, it does require an accommodation
that is “reasonable” under
the specific circumstances. For example,
Harvey explained, it may be reasonable
under certain circumstances for hospital
staff and a person with hearing loss to
communicate by using simple hand gestures,
a nod of the head, or by writing basic
questions and answers on a sheet of note
paper.
However, the Attorney General noted, more
complex interactions – the discussion
of symptoms, personal history, medical
diagnosis, treatment options, etc. –
are likely to require a certified sign
language interpreter, assistive listening
device or other accommodation to ensure
that vital information is communicated
accurately, and in keeping with “informed
consent” and patient confidentiality
requirements.
Division on Civil Rights Director Vespa-Papaleo
noted that the State and the NJHA are
in agreement that -- save for a genuine
medical emergency, or a situation in which
the patient has refused the services of
an interpreter or assisted listening device
-- using family members, companions and
friends as interpreters is not to be considered
a reasonable accommodation.
“This
is not only a matter of protecting the
individual rights provided for by law.
It is also a matter of patient well-being,”
said Vespa-Papaleo. “Persons with
hearing loss should be advised up front,
in clear terms, that they have a right
to an interpreter or assisted listening
device provided by the hospital at no
cost to them. The individual with hearing
loss should also be consulted as to his
or her preferred method of communication.
It is important to remember that different
people within the deaf and hard of hearing
community experience different degrees
of hearing loss. A one-size-fits-all approach
to enhancing communication will not suffice.”
Attorney General Harvey acknowledged that,
based on input from the advocacy community,
it appears there is a shortage of qualified
sign-language interpreters serving New
Jersey, particularly after hours. He agreed
that developing a larger pool of qualified
interpreters is a priority issue, and
one that will not be resolved overnight.
However, the Attorney General said, other
factors have also contributed to a lack
of accommodation for the deaf among New
Jersey hospitals including a failure to
consistently commit needed financial resources.
(Hospitals contend that, where this has
occurred, it is directly related to inadequate
reimbursement from insurers for services
to the deaf.)
Attorney General Harvey also observed
that there has been a lack of consistent
training and education among care providers
and other staff at hospitals throughout
the state. He noted that the NJHA has
agreed, as part of the joint initiative,
to take a lead role in coordinating information,
education and staff training efforts at
member hospitals, and has committed to
serving as a general catalyst for change.
“To
be certain, there are complex issues that
need to be addressed on a continuing basis,
but a commitment from the New Jersey Hospital
Association to improve training and education
at its member hospitals – and to
act as a catalyst in making this a priority
issue at those hospitals -- is an important
part of the overall solution,” said
Harvey.
Hospital
Signs
As part of the joint initiative, NJHA
hospitals have agreed to post signs throughout
their facilities – including the
admissions, registration and emergency
care areas – informing persons who
are deaf or hard of hearing that the hospital
provides reasonable accommodations to
individuals who suffer from hearing loss.
In addition, the hospitals have agreed
to assess the individual needs of those
who request an accommodation, and provide
him or her with written materials describing
the types of services available, as well
as reminding that the services are free.
Fact
Sheet
In addition, the Attorney General’s
Office and the Division on Civil Rights
have created a-
two-page
fact sheet (108k)
plugin -that
explains what NJHA member hospitals will
be doing to improve communication between
care-providers and patients with hearing
loss. The Fact Sheet also contains answers
to frequently asked questions, and provides
information on what recourse is available
to a deaf or hard of hearing person who
believes he or she has been denied a reasonable
accommodation. The Fact Sheet will be
provided to NJHA member hospitals for
posting within their facilities and/or
distribution to patients and visitors.
It will also be posted on the New Jersey
Division on Civil Rights Web site at www.NJCivilRights.org,
as well as on the Web site of the Division
of the Deaf and Hard of Hearing at www.nj.gov/humanservices/ddhh
and the New Jersey Hospital Association
Web site at www.NJHA.com
.
Training
Manual
The NJHA has also developed an extensive
manual to be circulated among its member
hospitals entitled “Interpreter
Services for the Deaf & Hard of Hearing:
a Resource for Hospitals.”
Brian Shomo, Director of the Division
of the Deaf and Hard of Hearing, welcomed
NJHA’s development of a resource
manual, and its readiness to serve as
an industry clearinghouse for training
and education on accommodating persons
with hearing loss. Shomo said the NJHA
“is demonstrating a genuine commitment
to achieving optimum health service for
people with hearing loss by way of giving
health care organizations and front-line
professionals the freedom and support
they need to work more effectively.”
Attorney General’s Focus
on Deaf and Hard of Hearing Community
Attorney General Harvey made improving
hospital communication for persons with
hearing loss a top priority in the wake
of two public forums on issues of concern
to the deaf and hard of hearing in 2004.
Sponsored by Director Vespa-Papaleo and
the Division on Civil Rights, the forums
– one at Camden County College in
Blackwood, one at Montclair State University
in Montclair – brought together
representatives of government, persons
with hearing loss, their loved ones, and
advocates for the deaf and hard of hearing.
First Phase –
Movie Theater Initiative
During the same public forums held in
March 2004, many persons with hearing
loss related tales of having been unable
to fully experience first-run Hollywood
movies in a theater setting due to a lack
of adequate captioning. Some spoke of
their sadness at seeing their deaf or
hard of hearing children miss the thrill
of experiencing a popular new movie, as
their hearing friends had, or of not being
able to share the experience with their
children.
In the aftermath, the Attorney General’s
Office spearheaded a legal initiative
that helped ensure that persons with disabilities
would have the same opportunity to enjoy
first-run movies as everyone else. Through
settlement agreements with four major
movie chains operating in New Jersey –
American Multi-Cinema (AMC), Loews Cineplex
Theaters, Clearview Cinemas, and National
Amusements – the State brought cutting
edge deaf captioning technology to multiplex
theater screens across the state. ( In
addition, AMC, Clearview and National
Amusements agreed to install technology
that enables the blind and visually impaired
to better follow the action of a movie
through special narration provided via
audio headset. The technology is known
as DVS or Descriptive Video Service.)
As a result of the captioning agreements,
New Jersey went from three to 38 movie
screens that provide new captioning technology
for the deaf and hard of hearing –
more than any other state. In each case,
the four participating theater chains
chose a form of closed captioning known
as Rear Window Captioning. However, the
Attorney General’s Office made plain
that it viewed either Rear Window Captioning
or another approach, known as Open Caption
Projection, as “reasonable”
accommodations for the deaf and hard of
hearing, and had no preference. One theater
chain refused to install technology to
assist the deaf and hard of hearing view
movies – Regal Cinemas. As a result,
the Attorney General’s Office filed
suit in 2004 against the Tennessee-based
Regal, the largest multiplex operator
in New Jersey. The complaint, which alleges
violation of the New Jersey LAD by Regal,
remains in litigation.