On December 5, 2005, Attorney General Peter C. Harvey announced a major new initiative, launched in conjunction with the New Jersey Hospital Association (NJHA), that will result in improved communication between hospital care providers and patients who are deaf or hard of hearing at more than 100 hospitals throughout the state.

According to Harvey, the key to the new initiative is a commitment from 112 NJHA member hospitals to comply with the New Jersey Law Against Discrimination (LAD) and other state and federal laws by providing sign-language interpreters, assistive listening devices and other “reasonable accommodations” to ensure that persons with hearing loss can communicate effectively with hospital staff.

“Adults and children who are deaf or hard of hearing must be able to effectively communicate with doctors and nurses to explain their illness or injury,” said the Attorney General. “This is as much a public safety issue as one of health care. Certainly, communication cannot be the barrier between life and death. I credit New Jersey's hospital community for recognizing that a disparity has existed, that it can do a better job of serving the needs of deaf and hard of hearing persons, and for its willingness to work cooperatively with us to improve the situation.”

Reasons for the Hospital Deaf/Hard of Hearing Initiative

There are an estimated 720,000 deaf or hard of hearing persons in New Jersey alone. Advocates agree the number could be substantially higher because it is often difficult to identify those with hearing loss. Absent the services of a sign language interpreter, assistive listening device or other accommodation, deaf and hard of hearing persons often experience difficulty in conveying vital information about their symptoms and medical histories. In addition, said Attorney General Harvey, patients with hearing loss have complained about being placed in the awkward – and potentially harmful – position of relating sensitive medical or personal information through friends and relatives, including small children.

Joining Attorney General Harvey for the announcement were J. Frank Vespa-Papaleo, Director of the Division on Civil Rights, representatives of the NJHA, representatives of the state Division of the Deaf and Hard of Hearing in the Department of Human Services and Albert Gutierrez, Chief Executive Officer of Shore Memorial Hospital in Somers Point, who chaired an NJHA task force on hospital communication with the deaf.

By virtue of the New Jersey LAD and the federal Americans with Disabilities Act (ADA), hospitals are required to provide deaf and hard of hearing patients – as well as third parties with a legal right to health care information and/or authority to make health care decisions – with an effective means of communicating with hospital staff. The means of communication must be provided with minimal delay, and at no cost to the patient or third party needing the service. Attorney General Harvey noted that, while the law does not require hospitals to provide every service requested by a person with hearing loss, it does require an accommodation that is “reasonable” under the specific circumstances. For example, Harvey explained, it may be reasonable under certain circumstances for hospital staff and a person with hearing loss to communicate by using simple hand gestures, a nod of the head, or by writing basic questions and answers on a sheet of note paper.

However, the Attorney General noted, more complex interactions – the discussion of symptoms, personal history, medical diagnosis, treatment options, etc. – are likely to require a certified sign language interpreter, assistive listening device or other accommodation to ensure that vital information is communicated accurately, and in keeping with “informed consent” and patient confidentiality requirements.

The State and the NJHA are in agreement that -- save for a genuine medical emergency, or a situation in which the patient has refused the services of an interpreter or assisted listening device -- using family members, companions and friends as interpreters is not to be considered a reasonable accommodation.

“This is not only a matter of protecting the individual rights provided for by law. It is also a matter of patient well-being,” said Vespa-Papaleo. “Persons with hearing loss should be advised up front, in clear terms, that they have a right to an interpreter or assisted listening device provided by the hospital at no cost to them. The individual with hearing loss should also be consulted as to his or her preferred method of communication. It is important to remember that different people within the deaf and hard of hearing community experience different degrees of hearing loss. A one-size-fits-all approach to enhancing communication will not suffice.”

Attorney General Harvey acknowledged that, based on input from the advocacy community, it appears there is a shortage of qualified sign-language interpreters serving New Jersey, particularly after hours. He agreed that developing a larger pool of qualified interpreters is a priority issue, and one that will not be resolved overnight.

However, the Attorney General said, other factors have also contributed to a lack of accommodation for the deaf among New Jersey hospitals including a failure to consistently commit needed financial resources. (Hospitals contend that, where this has occurred, it is directly related to inadequate reimbursement from insurers for services to the deaf.)

Attorney General Harvey also observed that there has been a lack of consistent training and education among care providers and other staff at hospitals throughout the state. He noted that the NJHA has agreed, as part of the joint initiative, to take a lead role in coordinating information, education and staff training efforts at member hospitals, and has committed to serving as a general catalyst for change.

“To be certain, there are complex issues that need to be addressed on a continuing basis, but a commitment from the New Jersey Hospital Association to improve training and education at its member hospitals – and to act as a catalyst in making this a priority issue at those hospitals -- is an important part of the overall solution,” said Harvey.

Hospital Signs

As part of the joint initiative, NJHA hospitals have agreed to post signs throughout their facilities – including the admissions, registration and emergency care areas – informing persons who are deaf or hard of hearing that the hospital provides reasonable accommodations to individuals who suffer from hearing loss. In addition, the hospitals have agreed to assess the individual needs of those who request an accommodation, and provide him or her with written materials describing the types of services available, as well as reminding that the services are free.

Fact Sheet

In addition, the Attorney General's Office and the Division on Civil Rights have created a - two-page fact sheet (108k) plugin - that explains what NJHA member hospitals will be doing to improve communication between care-providers and patients with hearing loss. The Fact Sheet also contains answers to frequently asked questions, and provides information on what recourse is available to a deaf or hard of hearing person who believes he or she has been denied a reasonable accommodation. The Fact Sheet will be provided to NJHA member hospitals for posting within their facilities and/or distribution to patients and visitors. It will also be posted on the New Jersey Division on Civil Rights Web site at www.NJCivilRights.org , as well as on the Web site of the Division of the Deaf and Hard of Hearing at www.nj.gov/humanservices/ddhh and the New Jersey Hospital Association Web site at www.NJHA.com .

Training Manual

The NJHA has also developed an extensive manual to be circulated among its member hospitals entitled “Interpreter Services for the Deaf & Hard of Hearing: a Resource for Hospitals.”

Related Links:
	News Release
	Ensuring Open and Effective Communication In Hospitals - For Persons Who are Deaf or Hard of Hearing >> Fact Sheet (108k) pdf plugin