RE: Interpreter

[Guest guest]

Thank you very much to all who commented on this subject. You input was

very instrumental in helping us formulate an action plan.

Comments like these reinforce how valuable a tool this listserve has become.

Regards,

Ken Muller

Director of Outpatient Rehab

Stuart FL

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Beckley

Sent: Monday, November 24, 2008 9:03 PM

To: PTManager

Subject: RE: Interpreter

Dr. Muller

If you are a Medicare certified facility (hospital, SNF, rehab agency, CORF

etc) the facility would have completed a " Civil Rights package " (required by

Medicare for Survey and Certification). The Package from OCR contains the

requirements for Medicare facilities, as well as model policies that can be

adopted. A resource page on their website is very helpful:

http://www.hhs. <http://www.hhs.gov/ocr/crclearance.html>

gov/ocr/crclearance.html (The OCR is also the enforcers for

HIPAA).

In your facility's " Assurance of Compliance' filings they would have been

required to have the following information (from your policies and

procedures) attached with respect to the hard of hearing:

" Procedures used to communicate effectively with individuals who are deaf,

hard of hearing, blind, have low vision, or who have other impaired sensory,

manual or speaking skills, including (see example):

a) Process to identify individuals who need sign language interpreters or

other assistive services;

Procedures to provide interpreters and other auxiliary aids and

services. Include the name(s) and telephone number(s) of your interpreter(s)

and/or interpreter service(s);

c) Procedures used to communicate with deaf or hard of hearing persons over

the telephone, including

the telephone number of your TTY/TDD or State Relay System;

d) A list of available auxiliary aids and services;

e) Methods to inform persons that interpreter or other assistive services

are available at no cost to the person being served;

f) Appropriate restrictions on the use of family and friends as sign

language interpreters. "

The Department of Justice is responsible for administering the Americans

With Disabilities Act (ADA). Their ADA website: http://www.ada.

<http://www.ada.gov/> gov/ The

ADA requires a " Qualified Interpreter " and that definition from the ADA is

(Title III) " an interpreter who is able to interpret effectively,

accurately and impartially both receptively and expressively, using any

necessary specialized vocabulary. " While there is a certification process

for interpreters, certification is not curently required by the ADA. This

is a source of confusion. Keep in mind that certain states may also have

additional requirements in the civil rights arena, particularly with respect

to health care facilities.

Both the DOJ and the OCR can, and do, act with the " long arm of the law " .

It is best to not have a complaint filed against your facility, so it is

best to act with legal compliance in mind. Both of these agencies have

technical assitance hot lines, that you should avail yourself of (take good

note of who you spoke to, and what you were advised). There are exceptions

for small providers, and for those where compliance would be a hardship.

Below I have copied the OCR Model Policy for working with the hearing

impaired:

Example of a Policy and Procedure for Providing Auxiliary Aids for Persons

with Disabilities

AUXILIARY AIDS AND SERVICES FOR PERSONS WITH DISABILITIES

POLICY:

(Insert name of your facility) will take appropriate steps to ensure that

persons with disabilities, including persons who are deaf, hard of hearing,

or blind, or who have other sensory or manual impairments, have an equal

opportunity to participate in our services, activities, programs and other

benefits. The procedures outlined below are intended to ensure effective

communication with patients/clients involving their medical conditions,

treatment, services and benefits. The procedures also apply to, among other

types of communication, communication of information contained in important

documents, including waivers of rights, consent to treatment forms,

financial and insurance benefits forms, etc. (include those documents

applicable to your facility). All necessary auxiliary aids and services

shall be provided without cost to the person being served.

All staff will be provided written notice of this policy and procedure, and

staff that may have direct contact with individuals with disabilities will

be trained in effective communication techniques, including the effective

use of interpreters.

PROCEDURES:

1. Identification and assessment of need:

(Name of facility) provides notice of the availability of and procedure for

requesting auxiliary aids and services through notices in our (brochures,

handbooks, letters, print/radio /televison advertisements, etc.) and through

notices posted (in waiting rooms, lobbies, etc.). When an individual

self-identifies as a person with a disability that affects the ability to

communicate or to access or manipulate written materials or requests an

auxiliary aid or service, staff will consult with the individual to

determine what aids or services are necessary to provide effective

communication in particular situations.

2. Provision of Auxiliary Aids and Services:

(Insert name of your facility) shall provide the following services or aids

to achieve effective communication with persons with disabilities:

A.

For Persons Who Are Deaf or Hard of Hearing

(i) For persons who are deaf/hard of hearing and who use sign

language as their primary means of communication, the (identify responsible

staff person or position with a telephone number) is responsible for

providing effective interpretation or arranging for a qualified interpreter

when needed.

In the event that an interpreter is needed, the (identify

responsible staff person) is responsible for:

Maintaining a list of qualified interpreters on staff showing their

names, phone numbers, qualifications and hours of availability (provide the

list);

Contacting the appropriate interpreter on staff to interpret, if one

is available and qualified to interpret; or

Obtaining an outside interpreter if a qualified interpreter on staff

is not available. (Identify the agency(s) name with whom you have contracted

or made arrangements) has agreed to provide interpreter services. The

agency's/agencies' telephone number(s) is/are (insert number(s) and the

hours of availability).

[Note: If video interpreter services are provided via computer, the

procedures for accessing the service must be included.]

(ii) Communicating by Telephone with Persons Who Are Deaf or Hard of

Hearing

[Listed below are three methods for communicating over the telephone

with persons who are deaf/hard of hearing. Select the method(s) to

incorporate in your policy that best applies/apply to your facility.]

(Insert name of facility) utilizes a Telecommunication Device for

the Deaf (TDD) for external communication. The telephone number for the TDD

is (insert number). The TDD and instructions on how to operate it are

located (insert location) in the facility; OR

(Insert name of provider) has made arrangements to share a TDD. When

it is determined by staff that a TDD is needed, we contact (identify the

entity e.g., library, school or university, provide address and telephone

numbers); OR

(Insert name of facility) utilizes relay services for external

telephone with TTY users. We accept and make calls through a relay service.

The state relay service number is (insert telephone for your State Relay).

(iii) For the following auxiliary aids and services, staff will

contact (responsible staff person or position and telephone number), who is

responsible to provide the aids and services in a timely manner:

Note-takers; computer-aided transcription services; telephone

handset amplifiers; written copies of oral announcements; assistive

listening devices; assistive listening systems; telephones compatible with

hearing aids; closed caption decoders; open and closed captioning;

telecommunications devices for deaf persons (TDDs); videotext displays; or

other effective methods that help make aurally delivered materials available

to individuals who are deaf or hard of hearing.

(iv) Some persons who are deaf or hard of hearing may prefer or

request to use a family member or friend as an interpreter. However, family

members or friends of the person will not be used as interpreters unless

specifically requested by that individual and after an offer of an

interpreter at no charge to the person has been made by the facility. Such

an offer and the response will be documented in the person's file. If the

person chooses to use a family member or friend as an interpreter, issues of

competency of interpretation, confidentiality, privacy and conflict of

interest will be considered. If the family member or friend is not competent

or appropriate for any of these reasons, competent interpreter services will

be provided.

NOTE: Children and other residents will not be used to interpret, in order

to ensure confidentiality of information and accurate communication.

Beckley, MS, MBA, CHC

Certified Healthcare Compliance

Bloomingdale Consulting Group, Inc

<http://www.blooming <http://www.bloomingdaleconsulting.com/>

daleconsulting.com/> www.BloomingdaleConsulting.com

( (direct)

* <mailto:*@Bloomingdale <mailto:%2A%40BloomingdaleConsulting.com>

Consulting.com>

@BloomingdaleC <mailto:%40BloomingdaleConsulting.com>

onsulting.com

_____

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com] On

Behalf

Of Muller

Sent: Friday, November 21, 2008 12:13 PM

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: Interpreter

Question to the group:

A potential medicare patient who happens to be deaf is telling our

facility we are compelled to provide an interpreter for them.

Upon examining our corporate policy, it does state that we are

compelled to provide (and pay for) an interpreter upon patient

request. One of our Speech therapists has a BS degree in deaf

education and is proficient in signing so we would use her.

The potential patient has informed us that the interpreter must be

certified and want us to use their interpreter (this person charges $40

per hour with a 2 hour minimum).

Does anyone know of an ADA or Medicare regulation which states the

interpreter must be certified?

Thanks,

Muller, PT, PhD

Director of Outpatient Rehab

Stuart, FL