WHY ARE QUALIFIED INTERPRETERS NECESSARY?

Sign Language interpreters are highly experienced professionals that have specialized expertise and training. While proficiency in English and in Sign Language is necessary, language skills alone are not sufficient for an individual to work as a professional interpreter. Becoming an interpreter is a complex process that requires a high degree of linguistic and technical skills. According to ADA Regulations, a qualified interpreter is required to be able to interpret accurately, both expressively and receptively using any specialized vocabulary needed for the communication. While professional certification is not required under the law, an important measure of an interpreter’s proven ability is professional credentials by an accrediting organization such as Registry of Interpreters for the Deaf, Inc. (RID).

There are some persons in the Deaf community who have limited fluency in ASL and may require a Certified Deaf Interpreter, who is a deaf individual certified to interpret with a certified sign language interpreter to facilitate understanding with the patient.

What is the law for providing Sign Language Interpreters for the Deaf?
Under the ADA, the definition of discrimination includes: (iii) a failure to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services, unless the entity can demonstrate that taking such steps would fundamentally alter the nature of the good, service, facility, privilege, advantage, or accommodation being offered or would result in an undue burden.

The Department of Justice is the governmental entity that enforces the ADA, and to interpret the ADA, it created regulations. One of which is the need to provide effective communication.

To assist hospitals and medical professionals to comply with the requirements of effective communication, the Department of Justice issued guidance to hospitals when interpreters should be used.

However, the problem was that “effective communication” was not defined, for advocates, effective communication was communication necessary so a Deaf person is not “excluded, denied services, segregated or otherwise treated differently than “hearing persons because of a lack of an interpreter; for some medical providers, the duty of effective communication only gave the Deaf patient a basic understanding of the medical procedure or hospital stay.

However, the problem was that “effective communication” was not defined, for advocates, effective communication was communication necessary so a Deaf person is not “excluded, denied services, segregated or otherwise treated differently than “hearing persons because of a lack of an interpreter; for some medical providers, the duty of effective communication only gave the Deaf patient a basic understanding of the medical procedure or hospital stay.

WHAT IS “EFFECTIVE COMMUNICATION?

The meaning of “effective communication” was clarified through several decisions in the appellate courts. “Effective communication” is defined as having an equal opportunity to participate in healthcare services and be able to communicate (both expressively and receptively) medically relevant information.

For many persons in the Deaf population, English is not their primary language; American Sign Language is. Also, the majority of English speech sounds emanates from the tongue, throat, breath, so they are invisible on the lips. Approximately 70% of speech reading involves guesswork because only about 30% of English speech sounds appear on the lips. During a discussion about medical information, where the patient is usually nervous and anxious, this type of guesswork leads to misunderstandings and may place the patient in serious danger. Written notes may be acceptable for short and simple conversations, such as asking a question in a store, but not when the information is long, important, or complex.

DOES THE LAW REQUIRE DOCTORS TO PROVIDE INTERPRETERS?

Doctors’ offices are public accommodations and are required to provide auxiliary aids and services, such as an interpreter for the appointments. It also requires that the doctor provide an interpreter to a companion of a patient that the doctor would normally communicate with during the appointment. Unlike hospitals, small doctor’s offices may claim that providing interpreters are an undue burden for them to provide an interpreter. If a doctor’s office is inside a hospital or a medical building with doctor’s office owned by the hospital, both the hospital and the doctor’s office are both responsible for providing the interpreter.

Besides the basic benefit that doctors are able to communicate with their patient and be compassionate and understanding to the Deaf patient’s needs, the Internal Revenue Service provides a Disabled Access Tax Credit for 50% of all amounts spent on services for the Deaf. After the first $250.00, this amount is in addition to the 50% deduction for the business expense. So if you have several Deaf patients, the tax benefit pays for the price of the interpreter.

Where the information conveyed is short, simple and not important. If the visit is to provide a flu shot, with not much discussion or conversation, then passing notes may be acceptable. However, if the patient has a pre-existing condition that would cause a side effect, an interpreter may be required. 

When providing an interpreter is an undue burden, meaning that providing a interpreter would have a substantial material effect on the overall resources of the doctor’s office. This may be the case if the doctor’s office has a very few patients and can hardly make ends meet. When a doctor has an active medical practice, it does not matter whether the cost of the interpreter exceeds the amount of the appointment. 

REFERENCE LINK

If the doctor leases space from a medical building that is owned by a hospital, call the hospital’s interpreter services and ask them to provide an interpreter for the doctor’s office. Under the ADA, the person who owns the space where the medical office is located may also be responsible for the accommodation. This is the case where the building owner focuses on having all doctors and medical offices in its building.

Call up the insurance company. Most insurance companies receive and administer Medicare policies, especially those that are a part of the Affordable Care Act (Obamacare), and if they do, they are not allowed to discriminate in their programs and services under a law called Section 504 of the Rehabilitation Act. Tell them that the doctor on their plan refused to provide an interpreter and you want to see a doctor that will provide an interpreter.