September 29, 2008
Hospital Settles With Deaf Patients on Communication ; It Will Be Required to Provide Interpreters
By SHIRA SCHOENBERG
Concord Hospital will pay $100,000 in a settlement with six deaf people who say the hospital did not provide them with the services they needed to communicate with hospital staff, the U.S. Attorney's Office said.
The hospital will also establish a new program to provide more effective communication for people who are deaf or hard of hearing. Although the U.S. attorney determined that the hospital violated the Americans with Disabilities Act, the hospital did not admit to any liability as part of the settlement.
In a written statement, Concord Hospital CEO and President Michael Green acknowledged that the hospital needed to improve its services for the deaf and hard of hearing. "Concord Hospital is very sorry that we failed to meet the needs of the deaf and hard-of- hearing population," Green said. "We take this settlement agreement very seriously and understand that although those involved received excellent care, sub-optimal communication creates stress and anxiety for patients and their families."
The complainants in the case are William Case, Joan Case, Christopher Emerson, Glenys Crane-Emerson, Gerald Girouard and Pamela Goguen. The Cases and the Emersons are married couples. Crane- Emerson is listed on the website of Northeast Deaf and Hard of Hearing Services as the organization's New Hampshire telecommunication equipment distribution program coordinator. All of the complainants are deaf and communicate through American Sign Language. Joan Case and Goguen are also visually impaired.
According to the settlement agreement, each of the complainants claimed that the hospital discriminated against him or her by not providing services that would have allowed them to communicate with hospital personnel when they, or someone they were with, received medical treatment. They say they were not provided with sign language interpreters, and were required to use inadequate or inappropriate auxiliary aids, which hospital personnel did not know how to operate. In some cases, they had to rely on family members to help them communicate their medical concerns.
Assistant U.S. Attorney John Farley said that an initial complaint was submitted to the Department of Justice, and while investigating, Farley found other people who had similar experiences. Farley said the hospital cooperated with the investigation. "They expressed willingness to enter a settlement so we wouldn't have to enter litigation," Farley said.
None of the complainants could be reached for this story. But Joan Case's case may have stemmed from a 2005 incident that was reported by the Associated Press. According to the AP, Joan Case was hospitalized with high fever and body aches. She asked for an interpreter but said no one showed up. Her husband gave an emergency medical technician a card with a toll-free number for an interpreter program, but records showed that no call was ever made.
Joan Case said that as a result, the emergency room doctor misunderstood her symptoms, leading to three days of unnecessary tests. Even after she had been admitted and treated for a leg infection, she said she did not learn of her diagnosis until two days later.
According to the terms of the settlement, the hospital will pay $50,000 to the Cases, $20,000 to the Emersons, $20,000 to Girouard and $10,000 to Goguen.
The settlement also lays out a detailed plan that Concord Hospital has agreed to implement. The hospital will need to create new positions for program administrators. These are people who will be available around the clock to answer questions and provide assistance to those who need it. The hospital will need to determine what assistance is required as soon as the patient comes into contact with the hospital. It will need to keep records of which patients need services, in order to provide the services on each visit.
The hospital will be required to provide qualified sign language, oral or tactile interpreters to patients and companions who need them, for things such as determining a patient's medical history, receiving permission for treatment, explaining a diagnosis or treatment, explaining medication or test results, understanding billing or insurance issues, or a variety of other circumstances.
Within 30 days, the hospital will need to enter into a contract with an interpreter or an agency that can provide interpreters within the hour for at least 80 percent of the incidents. The hospital will also be required to maintain a list of all known freelance interpreters within 15 miles of the hospital who can be called in an emergency. The hospital will be required to meet certain guidelines ensuring quick response times for interpreters. It must also document every request for an interpreter and the response to that request.
In addition to personnel, access to technical equipment will also be improved. The hospital will be required to have high-quality video interpreting services available. It will also need to provide TTY devices, which allow those who are deaf to talk on the phone, wherever there are public phones. Portable TTYs will need to be available to patients in their rooms.
The hospital is forbidden to require a family member or companion to interpret.
The hospital will also need to do outreach to both staff and the public, posting signs about the availability of services, advertising its services and making information such as hospital polices and procedures available on video in American Sign Language. Physicians and emergency department personnel will receive mandatory training regarding how to assist patients with special needs.
The hospital will report to the U.S. Attorney's Office regarding compliance with the settlement.
The hospital says it has already appointed a deaf and hard of hearing program coordinator, who will be an advocate for patients and companions. It has expanded the availability of devices and services, established a hospital-wide education program and modified its medical forms to ensure compliance.
Originally published by SHIRA SCHOENBERG Monitor staff.
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