1. Massachusetts Language Access Coalition Conference
Working with deaf, Deaf & hard of hearing clients: An overview of applicable law, history, and practice tools
Massachusetts Language Access Coalition Conference
June 26, 2015
Caitlin Parton
Disability Law Center

2. The Laws Title III of the Americans with Disabilities Act
Ensures access to places of public accommodation
Section 504 of the Rehabilitation Act of 1973
Program or activity receiving federal financial assistance
Executive agencies are both subject to and enforce the provisions of Section 504
Massachusetts Public Accommodations Laws
Mass. Gen. Laws 272 §§ 98 and 92A
Massachusetts prohibits discrimination based on physical disability in any “place of public accommodation, resort or amusement,” i.e., “any place, whether licensed or unlicensed, which is open to and accepts or solicits the patronage of the general public.”

3. What is a “program or activity”?
A college, university or other post-secondary institution, including public higher education
A local educational agency (school district)
Public Health and welfare agencies
Public housing authorities
Entities that receive federal funding subsidies (does not include private landlords who have Section 8 tenants)
Medicare and Medicaid
Any grant, loan or contract by which a federal agency provides or otherwise makes available assistance

4. Title III of the ADA
“No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.”

5. What is a “public accommodation”?
Any facility or program that provides goods, services or interaction with or to members of the public
Examples:
Doctors’ offices
Lawyers’ offices, Legal Aid, service agencies
Court rooms (Title II of the ADA)
Hotels
Hospitals
Banks
Restaurants
Theaters and movie houses
Museums, libraries, adult education programs

6. Auxiliary aids and services
Under Title III of the ADA, public accommodations are required to provide auxiliary aids and services to ensure effective communication with individuals who have vision, hearing or speech impairments
Examples:
Qualified ASL/CDI/cued speech interpreters
CART services
TTYs, VRS, VP
Assistive listening devices
FM loop systems
Amplified phones and headsets
Note-taking services
Captioning videos and other visual displays
Providing written material
Personal devices not required to be provided (i.e. hearing aids)

7. Who is financially responsible?
The fee the consumer pays the provider for services is NOT the determining factor when it comes to communication access
The lawyer is responsible
The doctor is responsible
The educational entity is responsible

8. Undue Burden Exception
A public accommodation can avoid providing and paying for auxiliary aids and services if they can prove that providing such services would fundamentally alter the service itself or that it would be an undue burden
Undue burden = significant difficulty or expense when considered in light of a variety of factors, including the nature and cost of the auxiliary aid or service, and the overall financial and other resources of the business
Undue burden is NOT measured by the amount of income the business is receiving from a client, patient or customer with a disability – it is measured by the financial impact on the entity as a whole

9. Deaf v. deaf: What’s the difference? Why does it matter?
Photo source: Wikipedia.org
Photo source: Wikipedia.org
Alexander Graham Bell
Thomas Gallaudet
Want to learn more? Check out Richard Winefield, Never the Twain Shall Meet: Bell, Gallaudet, and the Communications Debate, Gallaudet University Press, 1987.

10. What does culturally Deaf mean?
A person who is culturally Deaf has been brought up in an environment where ASL is the dominant and preferred mode of communication
ASL is a real language like any other, not just a form of visually translating English
Clients who identify as culturally Deaf will use ASL and will require ASL interpreters for all communications

11. What does oral deaf mean?
An oral deaf person is someone who was born deaf or became deaf at a young age, and was brought up with the auditory/verbal method of communication
They may use hearing aids, cochlear implants, speechreading, cued speech, oral interpreters, or use sign language
Depending on the individual, and on the success of whatever methodology is chosen, he or she may grow up to not need auxiliary aids

12. What does hard of hearing mean?
Post-lingual onset of hearing loss
Person will usually be auditory/verbal, with few issues reading and writing, but may have difficulty understanding in complex auditory situations and environments
Many hard of hearing individuals benefit from hearing aids to some extent, but hearing will never be fully restored
Situations with significant background noise or multiple speakers can be very difficult even with hearing aids

13. What does late deafened mean?
Total post-lingual hearing loss. Often speak normally but cannot benefit from hearing aids or assistive listening systems alone due to severity of loss
May use a cochlear implant to regain some of their hearing

14. Hearing aids
Hearing aids come in many shapes and sizes and have many features. Perhaps the most important one is the T-switch, also known as Telecoil. This feature allows integration with many assistive listening technologies.

15. Cochlear implants
Cochlear Implants are tools for individuals who, even with hearing aids, do not benefit from sound amplification. Implanted electrodes stimulate the auditory nerve to replicate function of damaged nerve cells.

16. Reality check – what does hearing loss sound like?
Massachusetts Population years and older
Estimated # of deaf/ hard of hearing people
Percent of Population
6,349,097
546,022
8.6%
Description
Estimated number
% of Population
Deaf, both ears
11,428
.18%
Cannot hear and understand any speech
14,603
.23%
At best, can hear and understand words shouted in the better ear
31,111
.49%
Source:

17. Other facts on d/Deafness
90% of d/Deaf people have hearing parents
ASL is used in Canada and the U.S.
Facial expression, head movements, and eye gaze in ASL is primarily grammatical
In Deaf Culture, when you arrive late to a meeting it is expected that you stop and explain why you were late
How would you get a Deaf person’s attention? Simply wave to the person or touch the person
What would you do if you need to pass between two people signing? It is socially appropriate to walk between the signers. As you are doing so slightly bow your head and sign “excuse me.” If it is a group of people signing it is best to go around the group

18. Best practices for Deaf clients
Arrange for an ASL interpreter; if client requests, arrange for a CDI, as well
Be aware: will need to arrange an interpreter at least a month in advance; if it is an emergency situation, try freelance list
Meet in quiet, private area, with enough space for interpreter; interpreter will be seated next to you, allowing client to look at both you and the interpreter at the same time
Speak directly to the client – NOT the interpreter
Ask the client if s/he is okay with you taking notes; explain why you need to take notes
With non-Deaf clients, we may be more accustomed to having more control over the pacing of the interview, going through a list of questions; this comes across as rude and rushed to Deaf people. Allow them to tell their story first (it may include many asides or deviations), and then ask follow up questions. Plan for at least one hour when meeting with a Deaf client
Explain the purpose of the interview and why you need to ask questions. Give the client a road map of how the conversation will go:
1) tell me your story 2) follow up questions 3) client has opportunity to ask questions

19. Video Remote Interpreting
When an onsite ASL interpreter cannot be obtained, VRI can be used as a backup. You are responsible for payment of VRI services.
VRI may employ interpreters from other parts of the region and country, which may result in unfamiliarity with regional/local signs or pronunciation.
Technical problems and accessibility issues of VRI
In person ASL interpretation is always best

20. Best practices for deaf & hard of hearing clients
Meet in a quiet room/noise-free environment
Ask them if they have a seating preference
Speak clearly, enunciate well, and with appropriate volume – as if you were giving a presentation to an audience
Tell client you are happy to repeat anything as needed for clarity or to rephrase as necessary
Give a roadmap for the conversation
DO NOT: speak extra slowly; mumble; cover your mouth; talk while looking down at your notes
CART (Computer Assisted Realtime Translation)
Remote CART – can only work if all speech is heard by the remote provider

21. Best phone practices for Deaf, deaf and hard of hearing clients
No one uses a TTY/TTD anymore! VP
VRS
VRS is funded by the Federal Communications Commission. There are many different providers; usually a Deaf individual will have a preference for a specific service. Most VRS providers offer multiple platform mobile apps
VRS utilizes certified interpreters to interpret between a Deaf person on a videophone and a hearing person using a telephone
communication
Captioned telephones and web CapTel
And… meeting in person is the best practice

22. Resources
To request an interpreter: MCDHH – request an ASL interpreter, CDI, and/or CART provider (
Freelance interpreters (see handout)
Disability Law Center ( )
MCDHH resources: assistive technology, ASL classes, substance abuse programs for d/D/hh, accessible religious services, and more
Massachusetts Equipment Distribution Program
Flashing fire alarms, amplified telephones

23. Questions?