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March 2018

March 2018 Issue

Education + Advocacy = Action

The last CCDHH newsletter addressed how to self-advocate for access to medical service providers; e.g., clinics, hospitals, etc. This article will address the use of Video Remote Interpreting, because VRI is often used in hospital settings.

A hospital or doctor may opt to provide a Video Remote Interpreter. This involves the use of a live ASL interpreter who is located at another location and who interprets through an Internet connection using a portable screen and camera. According to the Eleventh Circuit Court of Appeals, “If effective communication under the circumstances is achievable with something less than an on-site interpreter, then the hospital is well within its [Americans with Disabilities Act] obligations to rely on other alternatives. Indeed, the implementing regulations clarify that as an ADA Title III entity ‘the ultimate decision as to what actions would provide effective access to communication is up to the hospital.”

The Department of Justice allows the use of VRI, but the Department of Justice Regulations, has the following requirements to use a VRI:

(f) Video remote interpreting (VRI) services. A public accommodation that chooses to provide qualified interpreters via VRI service shall ensure that it provides –

(1) Real-time, full-motion video and audio over a dedicated high-speed, wide-bandwidth video connection or wireless connection that delivers high-quality video images that do not produce lags, choppy, blurry, or grainy images, or irregular pauses in communication;

(2) A sharply delineated image that is large enough to display the interpreter´s face, arms, hands, and fingers, and the participating individual´s face, arms, hands, and fingers, regardless of his or her body position;

(3) A clear, audible transmission of voices; and

(4) Adequate training to users of the technology and other involved individuals so that they may quickly and efficiently set up and operate the VRI.

The Department of Justice does not accept blurry pictures, frequent disconnects, or a pictures that pixelates or staff who struggle with setting up and using the VRI as effective communication. In addition, there are times when VRI does not provide effective communication. For example, it is not appropriate to use VRI with patients who:

  • have low vision or are blind.
  • are injured or who must undergo a procedure that makes it difficult to see the screen.
  • are unable to put their signs in the view of the interpreter; e.g., broken arm.
  • will have numerous medical personnel in the area talking which could make it difficult for the interpreter to know who is talking.
  • will be physically active due to physical or occupational therapy.
  • are emotional, medicated or intoxicated.
  • need to discuss sensitive or emotional concerns.

If the VRI is working and the deaf patient does not want to use the VRI, then the deaf patient may consider using the VRI to their advantage.  For example, use the VRI only to explain to the doctor why the patient feels the VRI is not effective for communication during treatment or service.

If the doctor or hospital continues to refuse to provide an onsite interpreter and the patient decides to file a complaint, the doctor or hospital cannot refuse to have the deaf patient use their services. Amy F. Robertson, Civil Rights Education and Enforcement Center (CRECC) will challenge accessibility barriers on behalf of deaf and hard of hearing people, by first educating and mediating. Then if unsuccessful, may litigate against the doctor or hospital. Ms. Robertson may be contacted at the Colorado CREEC office, 400 Broadway, Suite 400, Denver, CO. Call and make an appointment at (303) 757 – 7901. Ms. Robertson provides interpreters upon request.

For our subscribers who prefers to download a .doc format of this issue and read at their convenience, use the link below:

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The Colorado Daylight Partnership (CDP)

The Colorado Daylight Partnership (CDP), a collaborative effort lead by the Mental Health Center of Denver and the Colorado Commission for the Deaf and Hard of Hearing, is designed to provide assistance to Colorado community mental health centers and publicly funded substance abuse providers who want to advance access to behavioral health services to Coloradans who are deaf and hard of hearing.  CDP promotes best practices by taking a multi-level systems approach to training and technical assistance. CDP values the right of consumers to choose their communication preference. This includes services provided in American Sign Language (ASL), ASL via TeleBehavioral Health, through an interpreter or using hearing assistive technology.

CDP began in the fall of 2009 and continued through June 2011 with an initial grant from the Statewide Strategic Use Fund.  CDP began with seven areas of focus:

  • Assessment of Training and Technology Needs
  • Consumer & Family Leadership
  • Implementing & Supporting Use of Technology
  • Training and Technical Assistance to Behavioral Health Providers
  • Development and Adoption of Standards of Care
  • Planning for Sustainability
  • Evaluating Project Implementation

CDP has continued since 2011 with maintenance funding from the Office of Behavioral Health. CDP’s focus is on sustaining the CDP Learning Collaborative through on- going training & technical assistance.

CDP-Integrated Care Initiative:  A project of the CDP is its Integrated Care Initiative that is focused on the integration of behavioral health (mental health and substance use) services within primary care physical health practices.  The definition of integrated health care comes from the State Innovation Model efforts to integrated physical healthcare and behavioral healthcare at https://www.colorado.gov/pacific/healthinnovation/levels-integrated-care

Building upon the foundational work of the CDP, this initiative seeks to expand access to behavioral healthcare through integration with physical healthcare for people who are deaf or hard of hearing.  The first phase of the project is the research and plan development phase that will inform the implementation phase where two pilot sites within the Denver Metro area will implement a model intervention for serving the behavioral health needs of patients within a primary health care setting who are deaf, deafblind, and hard of hearing.

For more information about the Colorado Daylight Partnership visit  www.mhcd.org/cdp

Emergency Alert Notification on Your Mobile Device. 

When applying for a mobile phone, such as a smartphone or flip phone, through the Telecommunications Equipment Distribution Program (TEDP), orders that are approved always receive the Serene CA-CX and BS-100.

This ringer/flasher/bed shaker notification system can detect Wireless Emergency Alert (WEA) signals.  Upon detection, the CA-CX activates a unique flasher and an audio alert when specific emergency notifications are transmitted.

As long as your cell phone can receive the WEA and your cell phone service provider can transmit WEA (almost all providers have this capability), then the CA-CX will alert you with a unique ring and flash. You must have the cell phone on the CA-CX or plugged into the CA-CX.  The BS-100 (bed shaker) must also be plugged into the back of the CA-CX in order for the bed shaker device to work.

If you’re interested in applying to the wireless program that provides unlocked iPhones for most service provider, WIFI-only iPads, Jitterbug flip and smartphones, as well as Sprint-contracted iPhones and Androids, please contact JoAnne Hirsch at joanne.hirsch@state.co.us or go to http://ccdhh.com/index.php/tedprogram/ for an application

Deafblind Services Update

Since its inception in May 2017, DeafBlind Services has been building steadily and is now serving 25 deafblind consumers with Support Service Providers (SSP), totaling 1,255 hours.  
 
In the first month of this program, only 61 hours were provided, and in Feb. 2018, 195 hours of SSP Services were authorized by CCDHH.  
 
DeafBlind Services is now focusing on the expansion of its pool of Orientation and Mobility (O&M) specialists.  Orientation is the ability to recognize one’s position in relation to the environment, whereas mobility is the ability to move around safely and efficiently.  O&M specialists provide assessments, develop instructional programs and provide basic instruction on orientation and mobility and assist people in learning how to navigate public transportation systems.    
 
If you are interested in becoming a vendor; e.g. O&M specialist, or a SSP please contact Ryan Hawkins, CCDHH DeafBlind Services Coordinator, at ryan.hawkins@state.co.us or 720-399-4227.
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