1. Improving Access to Healthcare for the Deaf and Hard of Hearing Kris Balfanz-Vertiz Sinai Health System Chicago, IL July 16, 2009

2. Overview Deaf and Hard of Hearing Population Deaf and Hard of Hearing Population Nationwide: 28 million Nationwide: 28 million Deaf Population Deaf Population Deaf with a capital “D” refers to a unique linguistic and cultural group that self-identity as such Deaf with a capital “D” refers to a unique linguistic and cultural group that self-identity as such Nationwide: 1 million Nationwide: 1 million Metro Chicago: 37,000-59,000 Metro Chicago: 37,000-59,000

3. American Sign Language  About 50% of deaf and nearly all culturally Deaf adults rely on American Sign Language(ASL) as their primary mode of communication.  Being fluent in ASL does not translate into being fluent in written and spoken English.  Average Deaf adult reads at a 4 th grade level

4. HEALTH KNOWLEDGE Deaf are at increased risk for deficits in health knowledge and healthy living Exercise Nutrition Weight Status Cancer Screening Medical Terminology Cholesterol Blood Pressure Cardiovascular Disease Alcohol/Drugs Smoking HIV/AIDS Mental Health Medication Use

5. Even with effective communication… Deaf individuals literate in English may not have basic health knowledge Deaf individuals literate in English may not have basic health knowledge Cholesterol Cholesterol Stroke Stroke Shared expressions with different connotation Shared expressions with different connotation HIV positive HIV positive

6. Barriers to Care  Accessing quality health and health information.  Communicating with health care providers.

7. DEAF ACCESS PROGRAM

8. Comprehensive medical and mental health services for patients who are deaf and hard of hearing. Comprehensive medical and mental health services for patients who are deaf and hard of hearing. Approximately 1,300 deaf and hard of hearing patients in our system. Approximately 1,300 deaf and hard of hearing patients in our system.

10. Program Overview Medical Services Medical Services Mental Health Services Mental Health Services Interpreting Services Interpreting Services Case Management Case Management Health Education Health Education Accessibility Accommodations Accessibility Accommodations Manager of DAP, who is Deaf and culturally/linguistically competent Medical Director, Dept Director, Mgr of Evaluation and Research Culturally Competent hospital staff

11. Medical Services Acute care hospital Acute care hospital Outpatient Clinics Outpatient Clinics Specialty Services Specialty Services Rehab Hospital Rehab Hospital Private Ins, Medicare and Medicaid Private Ins, Medicare and Medicaid 3 Doctors that sign 3 Doctors that sign Adult and Pediatrics Adult and Pediatrics

12. Mental Health Services 3 Mental Health Counselors that are Deaf or are fluent in ASL 3 Mental Health Counselors that are Deaf or are fluent in ASL Adults and Children Adults and Children Accept all insurances including Medicaid Accept all insurances including Medicaid

13. ASL Interpreters on site ASL Interpreters on site 5 Certified ASL Interpreters (2.5 FTE) 5 Certified ASL Interpreters (2.5 FTE) IL Licensure Law Jan 2009 IL Licensure Law Jan 2009 Advanced or Masters level Advanced or Masters level 2 -10 hour days- qualify for benefits 2 -10 hour days- qualify for benefits Interpreting Services

14. Staff interpreters Staff interpreters Monday-Friday Monday-Friday 8:00am-7:00pm 8:00am-7:00pm Contracted interpreting services Contracted interpreting services via on call pager via on call pager Evenings Evenings 7:00pm-8:00am 7:00pm-8:00am Weekends/Holidays Weekends/Holidays

15. IVIN Illinois Video Interpreting Network

16. Shortage of ASL Interpreters that have medical experience Training ground for student and experienced interpreters to gain skills in medical and mental health settings Training ground for student and experienced interpreters to gain skills in medical and mental health settings ASL Interpreter conferences on medical issues and terminology ASL Interpreter conferences on medical issues and terminology Mentorship opportunities in a medical setting Mentorship opportunities in a medical setting

17. Case Management Basic assistance Basic assistance Social Security Social Security Medicaid Medicaid Transportation Applications Transportation Applications Energy Assistance Programs Energy Assistance Programs SW students from Gallaudet SW students from Gallaudet

18. Health Education HIV, CVD and Depression Curriculum development Classes Grant Funded

19.  Through classes and 1:1 teach people to become better patients and take the lead in their health care  Make hospitals more accessible to people that are Deaf  Funded by Michael Reese Health Trust

20. Emergency Preparedness To ensure people with disabilities are included in emergency preparedness planning and responses at all levels of our society. To ensure people with disabilities are included in emergency preparedness planning and responses at all levels of our society.

21. Accessibility Accommodations TTY machines TTY machines Video relay services (VRS) Video relay services (VRS) 2 VRS Booths- acute and rehab hospitals 2 VRS Booths- acute and rehab hospitals Green stickers- Pt is deaf on the chart Green stickers- Pt is deaf on the chart “I am Deaf” “please call for sign language interpreter” sign in pt room “I am Deaf” “please call for sign language interpreter” sign in pt room

22. “I am Deaf” cards “I am Deaf” cards Communication book Communication book

23. Deaf Access Replications Iowa Iowa Ohio Ohio

24. QUESTIONS ?