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

Rehabilitation Act

Applies to places of public

accommodation
Right to eective
communication
Available remedies (solutions)

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

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.