Effective Communication

Jennifer Bowerman

Welcome everyone. I apologize for the delay in today''s session. We have had some technical difficulties that we are still working out in the web site. There is a little lag behind in the captioning on the internet and it is kinda ironic that of all the sessions we have done thus far, this session on "Effective Communication" is the session we have the technology glitch on. Due to the late start, we will be going into 20 minutes of the next hour so that we can have a full hour with you all today. Today''s session features Marc Charmatz, Director of the National Association for the Deaf Law Center. It is hosted by your regional Disability and Business Technical Assistance Center. We''re thrilled to have Marc with us this afternoon. Again he is the Director of the National Association for the Deaf Law Center, where he litigates discrimination complaints under the ADA, the Rehabilitation act and IDEA. He joined the National Association for the Deaf in 1977, after starting out in private practice, and has a law degree from Northwestern University. Marc I''m going to turn it over to you for a second, to tell us a little bit more about NAD.

Marc Charmatz

Thank you very much. I''m an attorney with the the National Association of the Deaf. I have been with NAD for 24 years. At our office, we have three attorneys including Sarah Gear and Mary Vargas. I''m happy to say that we''re going to be adding a fourth attorney in the fall. We have received a Scadden fellowship and a new attorney is going to be starting then. Our office litigates discrimination cases around the country under the Americans with Disabilities Act, the Rehabilitation Act and the IDEA, the Individuals with Disabilities Education Act. We represent deaf and hard of hearing individuals, and a variety of discrimination complaints in employment, in education, in access to health care, public accommodations, and we do that, as I said, providing direct legal representation. Our services are free to our clients. I''m going to give you my e-mail address as well as my phone number, because after today, you may have additional questions, and I''m happy to try to answer them. My e-mail address is charmatz@nad.org and my phone number is (301) 587-7732 (voice/TTY). I''m happy to answer questions today, and I''m also happy to answer questions the day after today and in the future. I look forward to our dialogue. I think it is important that we discuss effective communication, and I''m ready for all the questions.

Jennifer Bowerman

Thanks, Marc. You should have received a session handout that was put together by the Region 3 Disability and Business Technical Assistance Center. Basically the session handout pulls together all of the references to effective communication under Title III of the Americans with Disabilities Act. If you don''t have the session handout right now, you can go back to the Great Lakes Web site and download it later and get it with the session transcript as well. We would like to thank Region 3 for pulling that together for us. I think the first question that we really want to start out with, Marc, is if you could actually talk about what Title III says about effective communication.

Marc Charmatz

Title III applies to public accommodations. There is a laundry list of what public accommodation is. Title III with respect to communication requires just that, effective communication. And it also requires that public accommodations provide auxiliary aids and services, and the law says unless the entity can demonstrate an undue burden or fundamental alteration of a program. I''ve been litigating these cases as I said for 24 years, and I have never, never found a case in which a court has said that providing auxiliary aids and services is some sort of undue burden, undue financial or administrative, in any context. What this means is that in real life, public accommodations like doctors and hospitals and lawyers have to provide auxiliary aids and services to ensure effective communication, because effective communication is a right.

Jennifer Bowerman

Marc, one of the most frequent questions that we get comes in from doctors'' offices, attorneys'' offices and so forth, that the automatic first gut reaction is "oh, my gosh I''ve got to get a sign language interpreter" for this client that might be coming in or the patient that might be coming in. Can you talk about what are some of the factors to determining effective communication?

Marc Charmatz

Let me look at it this way. When you have a public accommodation and you have a deaf person, that person by definition under the statutes an individual with a disability. That person needs to be qualified, that is, to be able to participate in the program or to be eligible to receive services. So in the doctor case, that person is a patient, contacts a doctor and of course requires some medical services. The deaf person is going to pay the same amount of money to the doctor in terms of medical services as anyone else. So the question then becomes "what is necessary for effective communication?" Because both the doctor and patient need to be able to communicate with each other in order for a doctor to understand the patient''s needs and medical issues, and as well for the patient to be able to make sure that he or she is following the doctor''s advice. When you look at effective communication and auxiliary aids and services, for most of my clients, their primary means of communication is in sign language. That is the way they communicate. American Sign Language (ASL) is not Signed English. It is American Sign Language, a completely different language. Doctors oftentimes say, "Well, my medical fee is $50 and the interpreter bill is $50, therefore it is an undue burden." That is a common statement from some of the health care providers. And the answer to that is right in the ADA and the Department of Justice regulations which say that you look at the overall financial resources of a public accommodation. I''m a litigator. I file complaints, and I do that only as a last resort. I don''t file complaints as the first thing to do. I generally contact doctors, if that person calls us up regarding legal representation, and advise the doctors as other public accommodations, about their rights and responsibilities under the ADA. But in those times where it is necessary to file a lawsuit, the first question I''ll ask a doctor who raises undue burden is "Please tell me how much money you make." Because if you can say it is an undue burden, I''m going to have to respond to it. And then I say "Look at the tax consequences that come out in each of these things." So you look at the overall resources of the public accommodation in making any determination on undue burden.

Jennifer Bowerman

Marc, let me ask you this. If I am going to go and just run into my doctor''s office and maybe drop off an insurance form or something like that, as opposed to having a consultation with the doctor, and I might be an individual that is hard of hearing or an individual that is deaf, are those two circumstances looked at differently as far as the provision of effective communication or the auxiliary aids?

Marc Charmatz

In each of these instances with each of the patients, there is give and take. What I usually advice deaf patients as well as the health care providers is: on that first visit, make sure you have the most effective communication possible. Then discuss later on for further visits what has going to be necessary. So that the first time someone comes in for high blood pressure, their blood pressure is high, they need medication, they have to be alerted to the consequences of medication, they have to be alerted about taking other medicines and not having them counteract each other. The doctor might say "Well, come in once a month for your blood pressure check. If it is 120 over 80, fine, we don''t need to meet. We just need to monitor it." In that instance, interpreter services may not be necessary because the deaf person as a patient knows what is going to happen for future visits. It is a monitor. The deaf person walks in a month later and blood pressure is still way high. Well, that requires an office visit or consultation, so set up another visit so that we have effective communication. But for a number of instances it may not be necessary. As long as you get off on the right foot, that is, you have that excellent communication to begin with, both sides will feel comfortable and then there will be some discussions about what needs to be done in the future.

Jennifer Bowerman

Great. Let me ask you this, too, Marc. Can a public accommodation have a policy that an auxiliary aid be provided, like X number of hours in advance as opposed to somebody just showing up?

Marc Charmatz

Well, in real life, someone shows up at the door, you try to accommodate that person. In hospital situations of course emergency room situations, you don''t know the next moment whether or not a deaf person is going to show up. So good hospital policy would have the list of professional sign language interpreter agencies available so that in the emergency room situation, the hospital can call. It is preferable to make inquiries in advance. I mean doctors like that you make your appointment for a week or two weeks in advance. That gives the health care provider the opportunity to contact a professional agency to secure services. But in the emergency room, those things have to be in place already. As I said, the hospital never knows when the deaf person is going to be in for an emergency room treatment. So good preparation does the trick. I counsel a lot of independent living centers, state associations of the deaf, even private individuals. Check with your local hospital about their policy. Try to get these problems resolved in advance. It is many times too late when the person is already in the hospital and things are going quickly. It is far better when you''re feeling well and you''re up to it to check with the local hospitals, health care providers, lawyers, banks, whoever might be on the definition of public accommodation, and check in advance and say "well, what is your policy?" What are you going to do in this situation? And get the TTY number for the hospital. Say "Do you have any TTYs?" "Do you have a dedicated line?" "What happens if I have to come in to the hospital?" "Do you have these services available?" "Do you have captioning on your television?" The more you can do these things in advance, the better it is. People really don''t want to come to our office because that means they have discrimination complaints. I find that deaf individuals can be the best advocates, and they do that by doing things in advance and getting issues on the table before the emergency, before the doctor visit.

Jennifer Bowerman

Marc, you talked a little bit about hospital policy and procedure, and you''ve been involved in a number of complaints and cases. Can you pick out a couple of those cases and highlight what was lacking and what the settlement ended up being?

Marc Charmatz

Public accommodations under Title III of the ADA allows for injunctive and declaratory relief. Under the Rehabilitation Act, compensatory damages are available against a recipient of federal financial assistance. Most of the clients who come our way want to say "I''ve been discriminated against, and I want to make sure what happens to me doesn''t happen to somebody else." "I''ve been hurt or injured by the discrimination." The person will go into the emergency room and may be admitted to a hospital with no services. That means not having the ability to call family through TTY, laying in the bed not having captioned television, or the doctor comes in not having effective communication. Some of these cases have resolved in damage awards, others have included injunctive relief-that is, a policy to ensure that what happens in one time doesn''t happen again. The best example of hospital policies is a case called DeVinney v. Maine Medical Center (consent decree: http://www.usdoj.gov/crt/ada/devin.htm) Our client went into the hospital. She did not receive any services. She was referred to counseling. There were no services. And after she left the hospital, she filed a complaint. To the hospital''s credit, the hospital wanted to resolve this problem so that it would not take place again. The United States Department of Justice intervened in the complaint. There is a comprehensive consent decree about the responsibilities of health care providers to provide auxiliary aids and services for deaf patients and family members as well. The best part of that lengthy consent decree is the one page form that the deaf person would receive, where there is a simple question, "Do you want an interpreter: yes or no?" That type of document is put in the patient''s records so that automatically the doctor will know that interpreter services are necessary when communicating with the patient. Deaf people have encountered discrimination by health care providers. That is our number one priority and topic. Almost every day it seems to me that someone is contacting our office. People who have had surgery in the hospital, people who have had family members who have been in the hospital. In one case we had a deaf minor whose hearing mother took the minor to the hospital and the hospital tried to have the parent interpret. Well, the parent was not in her role as parent and comforting the child. The parent was in a way the bad medical person who was doing all these medical procedures on the child. That is not the role of the parent. At the same time we had a hearing child whose parents had to take the child to the hospital on numerous occasions. One of the reasons that they did so was because the hospital personnel never explained to the parents about the hearing patient''s problems. The ADA Title III and 504 of the Rehabilitation Act cover parents, whether they be hearing or deaf, to make sure that they have effective communication with hospital personnel as well.

Jennifer Bowerman

You just started to touch on a sensitive issue there, too. There is a lot of concern about the subject matter and the sensitivity of the subject matter and what type of confidentiality can the individual or the public accommodations expect when it comes to maybe meeting one on one and having an interpreter there.

Marc Charmatz

All the more reason to use professional people. Interpreters have a code of ethics, interpreters have a responsibility to maintain confidentiality. In this day and age interpreters are used in the jury room when there is a deaf person who is a juror. They are used in a variety of situations to ensure effective communication. Using family members in very sensitive medical situations is certainly, I think, prohibited-even when the family member could be a certified interpreter. We recognize that the interpreter has to be able to interpret expressively, impartially and effectively. That takes a professional. When you have those professionals available, you ensure that confidentiality. It works in the jury room, in jury deliberations. It works in the criminal procedures, when someone is arrested and it works in the medical situations as well.

Jennifer Bowerman

Actually, you just brought up a really good topic that I was going to ask you about next and that is the instance whenever you would be working the police, whether or not you would be a victim of crime or potentially a person that has committed a crime, what types of expectations could you expect if you were being brought into a police department or something like that to be questioned?

Marc Charmatz

That is a good question. Back in 1980s, the Department of Justice issued 504 regulations which applied to correctional agencies, police departments and courts. The Justice Department advised police officers and court administrators and prison officials that they needed to ensure effective communication. And in fact, had a notice requirement saying "if you need interpreter services, we''re telling you that we will provide one if you want one." That is very important. The notice is extremely critical. I believe the ADA requires the same thing. Sure, you''re not going to see the police officer running down the street trying to catch a criminal saying first "Do you want an interpreter?" But when you have that person who is in custody, whether it be police, corrections or in court, you can ask once that person if they want interpreter services "yes" or "no"? I believe it is a requirement that notice be given in many other state laws as well. In real life, police officers and district attorneys don''t want to lose convictions. In real life, if they''re prosecuting someone, they believe that person is guilty and don''t want to get involved in whether Miranda rights were read or not read, whether confession is voluntary or not. I think it is good police procedure to have effective communication, because that is going to make the police officer job easier. It is going to make it done in a better way. It is going to result in for what the police and prosecutors want, it is going to protect them from the case where if you didn''t provide effective communication, things are thrown out. So in real life it makes good sense to provide effective communication. Now, having said that, the court system has for many, many years in many places been a place where interpreter services or auxiliary aids are not provided. In my time here, we have filed complaints against states and judges in Pennsylvania, Indiana, Louisiana, Mary land, New Jersey, and a few other places. In one place, a judge said "We will conduct the trial by writing rather than provide signing."

Jennifer Bowerman

Did his hands get tired?

Marc Charmatz

That is what the judge said. When I found that out, I had our client file a lawsuit against the judge and State of Indiana because we thought that was discriminatory. We''re not going to see a trial by writing. Even today, those issues still come up. We have cases today in a number of states against court systems for failing to provide auxiliary aids and services.

Jennifer Bowerman

I think it is important to note that you mentioned a number of cases that DOJ has intervened and said the settlements have really become kind of modeled for other states to look at. What we''ll do for the session transcript is we''ll go highlight some of those listed on the DOJ web site so that people can link from the transcript to some of those model settlement. I think that at this point I would like to open it up to question and answer.

Caller

You mentioned the consent decree, DeVinney v. Maine Medical Center. How can I get a copy of that?

Jennifer Bowerman

It is it is on the DOJ Web site and we''ll go ahead and post that in the transcript.

Caller

My name is Francine and I would like to ask a question. Once a lawyer tries to get (in audible)

Marc Charmatz

The question was what if a lawyer charges a deaf client $150 for an interpreter. I look at case and is try to look at them again in the same way. The deaf person is an individual with a disability under the ADA. The deaf person has paid an attorney for legal services so that person is a client, qualified under the ADA. Both the lawyer and the doctor have recognized that interpreter services are necessary because interpreter services were provided. Putting the cost of the auxiliary aid onto the client I believe is prohibited under the ADA. So I don''t think that the lawyer can charge the client $150 for interpreter costs.

Jennifer Bowerman

Marc let me ask you this, because I''m sure that this question is out there. What about when the person that needs an auxiliary aid does not show up for the appointment?

Marc Charmatz

Well, unfortunately, that happens in everyday life for all people. People do have the flat tire on the way to work, people miss a class. It is discouraging in all instances, but it happens. The public accommodation absorbs the cost of that auxiliary aid and service when it happens because it is very rare. Of course if a public accommodation said to a hearing person "if you don''t show up for an appointment, we charge you $25." If that is what is done for all individuals, well then deaf individuals will pay that $25 in the same way that all individuals that have the responsibility. But you don''t pass on the cost of auxiliary aids and services onto the deaf person.

Jennifer Bowerman

That kind of follows into a question that we had come up in the last couple of weeks here at the DBTAC. We had a call from an interpreting service that had a client that was making appointments here and there around town and they were becoming notorious for not showing up. And so being, the interpreting service really wanted to keep a positive relationship with the doctor''s offices, insurance agents and so forth that were contacting them. So the question from the interpreting service was whether or not they could refuse, after X number of times of not showing up, but also not calling to cancel or giving advanced notice of that, if they could have a policy not to provide services for that person.

Marc Charmatz

I think as a lawyer and a person that schedules appointments all the time, if a person made an appointment with me and failed to show up three, four, five times, I would not want to represent that person. Not because the person is deaf, but because the person I felt was unreliable. I would assume that would be the same case for most other public accommodations. If someone doesn''t play by the rules, that is, show up, I don''t feel very comfortable representing them. I wouldn''t want to have them as a client. Again, not because of deafness, not because of disability, but because they have known the rules and the rules were to show up on time.

Jennifer Bowerman

Great. Thanks for commenting on that. Do we have another question?

Caller

Hello. I was checking if a state law requires a certified interpreter, which is more stringent under the state law or the ADA?

Marc Charmatz

The ADA talks in terms of "qualified" interpreters and has a definition for qualified interpreters. The ADA also says that if there are any state laws that afford greater protections, then those state laws need to be followed. So in those instances in which state laws use "certified" interpreters, generally from the Registry of Interpreters for the Deaf (www.rid.org) or the National Association of the Deaf (www.nad.org), those state laws need to be followed, because they provide greater protection than the ADA, which uses a term "qualified" interpreter

Caller

What if the individual has a preference so that it is not a certified interpreter?

Marc Charmatz

That is a tough question on the preference. I''m the public accommodation, and I have a contract with a professional reputable agency. Then the client or the patient who wants to come in, says "I want so and so." Generally, I would side with the public accommodation on that, assuming that the interpreter is qualified to do the job. That is not always the case. In many instances, and I think interpreters would say the same thing, no matter how certified, no matter how qualified, there are certain people who may have homemade signs who are difficult to communicate with. Professionals in those instances bow out. The same way as a lawyer. I think I''m knowledgeable about the ADA, but sometimes people come to me with questions on subjects that I don''t feel comfortable answering. I don''t know, for example, the statute of limitations in every state. So I bow out on some instances because I don''t feel comfortable doing it. But generally, when an public accommodation has a contract with an agency, they''re entitled to use that agency, assuming that the interpreter is qualified.

Jennifer Bowerman

Thanks, Marc.

Caller

Hello. My name is Karen Marcer.. I am familiar with the ADA law in regards to accessibility for banks, lawyers, etc. that they must provide interpreters. My question is, since the law itself is vague, I do remember reading the law that it really depends on the number of employees working at that business. And also if a doctor office in private practice, depends on the number of employees. I was wondering if you could clarify that for me.

Marc Charmatz

Certainly. In preparation for the conference today, I have my copy of the ADA. It is probably about 30-40 pages long. I have my copy of the Department of Justice regulations to Title II and Title III of the ADA, which are very long. I have my EEOC regulations for Title I of the ADA. I have the old Department of Education regulations to Section 504 and the justice department regulations. And I always hear about how these statutes and regulations are difficult to understand. I kind of think I understand them, and I think that they have a lot of information in them. The entity you questioned, for employment purposes under Title I of the ADA, is covered with 15 or more employees. There is a definition of what an employee is. But generally, 15 or more employees. If you have a complaint against an employer under Title I of the ADA, there must be 15 or more employees. However, it could be less than 15 employees if the place may receive federal funding, and so you would have a complaint under Section 504 of the Rehabilitation Act. Or you may have a complaint under state law. Employment Title I, 15 employees. Less than 15 employees look to 504 of the Rehabilitation Act, because that doesn''t have an employee number limit, but it requires federal funding. In terms of public accommodation, it is irrelevant how many employees there are. It could be one, it could be two. A public accommodation is not subject to different things depending on the number of employees they have.

Caller

Yes, hello. I''m an interpreter in this area, and I would like to know if a deaf client or I had a question about a problem or individual complaint, what would you do if we called you? Would you actually contact the service provider, say if a health service provider declined an interpreter service? Would you actually contact them and would you need the point of contact number, fax number? What would you need in order to marshal your services? As an example, a hospital in our area has on contract an interpreter who is a Level 2 English and a Level 1 ASL, which is obviously not adequate for emergency room situations. So if we contacted you, what would you do about a situation like that?

Marc Charmatz

Thanks for the question. We receive a lot of technical assistance calls. The first thing we try to do is provide the people who call us with the information they need because we feel that those individuals can be the best advocate. We supply the information and the education. Hopefully we empower those individuals to solve their own problems. And I must say in many, many instances, that works. It educates the deaf consumer, then using that information, helps somebody else, a public accommodation to become accessible. Of course there are going to be those instances where that doesn''t work. So after trying that as a first resort, if it is necessary we send letters to public accommodations. We certainly respond to their requests, and we try to give them the information that they need to know what the law is. In many instances, it is the ignorance of the law more than "I don''t want to comply with it" or the lack of knowledge. I was looking at our NAD web site, which is always a work in progress. But it has a number of our memorandum on there on a variety of topics. So someone could go to NAD web site and find some of our memos on a variety of these topics, copy them out and distribute them to the public accommodations in the area. As I said before, it is really important to put people on that notice, to ask in advance rather than wait before it is too late, but always better to do it as early as possible. Whenever I give a speech or a go to make a presentation, I always say, "You have homework to do." Your homework is to learn, to read, to prepare, and then to go out in the community to make sure that the public accommodations that you will have access to as well as state or local government entities, to go to them and say, "Here is what I have. We want to make sure you''re in compliance." I think most hospitals, and all public accommodations and public entities would benefit from that and would prefer it.

Caller

The question here is if you have a child that is hearing and the parents are deaf, what are the responsibilities concerning interpreters? Is there any case law to back us up? Because apparently we''ve had problems in this area. We''ve had problems where a deaf adult needs services for a hearing child, and in order to be an effective parent, it is important for an interpreter to be there, say in a medical situation or a mental health situation, and the service provider refuses to have an interpreter for the parents.

Marc Charmatz

That issue comes up often. Many years ago, we litigated a case called Rothchild v Grotthanler. It was a case where deaf parents had hearing kids in the public school. It was "back to school" night, it was "meet the teacher" night, it was "drug awareness" night. One of the kids was in high school. The school district said that the Rehabilitation Act only applied if the kids were deaf, not if the parents were deaf. We filed a complaint in court and we were successful. The school district reimbursed the parents for the cost of any interpreter services that they paid for. But it set a precedent that deaf parents in the educational setting were entitled to go to back to school night and the school play and all of the variety of evening programs that were available to hearing parents. Well, that same issue came up in a medical setting. I mentioned it before, where a deaf parent had a hearing child who was hospitalized. Quite frankly, she was hospitalized I think seven times. And in each of those instances, the hospital personnel did not communicate effectively with the deaf parents. I think that may have led to the further hospitalizations. We filed a lawsuit in that case. The result of the lawsuit was another hospital policy modeled after the DiVinney Maine Medical Center policy and a damage award which is confidential. But no doubt you''ve raised an important point, that deaf parents have rights when their hearing children are in educational settings or in hospital settings. Now, of course it gets more difficult if the child is an adult. Then you have other issues. When I say children, certainly under 18, deaf parents need to know what is going on. The other example that came up is a deaf father whose hearing child got a traffic ticket at age 16. The child had to go to court because he had a traffic ticket. Well, the parent wanted to be there. All right. And I believe that parent had a right to be there and a right to understand what was going on and hear what the police officer had to say and hear what the child had to say and assume that the good responsibilities of a parent.

Caller

This is Dr. Bob Siegelman in Sacramento. This is a two-part question. Every state now provides a TTY relay and an outreach program to go with that. As of March 20001, each state will also be required to provide speech to speech, which is an analogous relay for people with speech disabilities. Is each state required to spend same per capita on speech to speech outreach as on TTY relay outreach? If so, what is the enforcement mechanism? I ask this question because the speech disabled community does not have the resources to advocate their state to set up the outreach program the same as the deaf community has. So we never get our piece of pie, or almost never.

Jennifer Bowerman

I think that in this situation, because it is kind of a unique new requirement with speech to speech, the Federal Communication Commission (FCC) which oversees the relay requirement has a new Office of Disability Rights (www.fcc.gov/dtf). They used to have a Task Force on Disability Issues, but now they have a Disability Rights Office and you can actually ask that question through their website. We have an online question here, Marc, and hopefully I can phrase it how they did. This is from independent living center in Maryland. For the second year in a row there is legislation that would require insurance carriers to pay for interpreting services when needed in medical situations. The insurance industry has opposed this legislation, saying that it would conflict with the ADA. Do you have any thoughts on that?

Marc Charmatz

That is an interesting question. I believe that under the ADA health care providers have to provide auxiliary aids and services. To the extent that insurance companies take over that responsibility or have dual or equal responsibilities, in many ways as long as a deaf person is not paying, not complaining. On the other hand with insurance companies there are always deductibles and there are always things that you have to be careful of. I would hate to see that the insurance companies say "Well, we''ll pay the cost of interpreter after the first $200 and at this point, the responsibilities are on the health care providers." Having said that, it may be that there is a good way of working something out between insurance companies and health care providers, because the goal of this is to ensure effective communication in the easiest way possible. I''m aware of that proposed legislation. I''m also aware that it hasn''t gone very far.

Caller

Hi. The question comes from James Newsome from the State of Michigan Family Independence Agency. We have a situation where we have workers what we call child protection workers. They go out and investigate child abuse. Many times they go out and they may find that the parents of the children are deaf. We don''t go back and say we''re going to get an interpreter once we''re dealing with the safety of the child as an issue versus the need to provide effective communication. Would you consider us to be liable in how we handle that situation?

Marc Charmatz

Certainly a social service agency, if it is a part of a state or local government, is covered under Title II. Private social service agencies would of course be covered under Title III. When you come to an emergency situation, it is one thing. However, just like hospitals who have emergency rooms, I assume social service agencies also have emergency situations and need to be prepared in advance to when they encounter something that they weren''t expecting. So for those times, if they have emergency situations, they''re going to need to deal with them the same as a hospital needs to deal with them. Now, the interpreters are on call in many places 24 hours a day. Certainly you have obligations under your own state law and you want to ensure health, safety, etc. But when you encounter that situation with a deaf parent, I think the obligation is to ensure effective communication, and in that sense the social service agency looks a lot like the hospital emergency room. It is not going to be instantaneous, but it is going to be something that needs to be done.

Jennifer Bowerman

Marc, let me ask you, are you seeing any higher frequency in requests for different types of technologies as auxiliary aids, like the realtime captioning or the cart service or something like that?

Marc Charmatz

Yes, we are. That is individuals, as I say, symptoms come in all shapes and sizes. Some primary means of communications is in sign language. For others, sign language is not their primary means of communication. It is a very important issue that there are all sorts of new technologies out there, far probably much more than I''m aware of and one size doesn''t fit all. That brings up the point that I think I would like to stress that it is really important to ask deaf individuals what means do they prefer for effective communication? That is really what you want to do as a service provider, as a public accommodation, as a public entity. Establishing that good dialogue with a deaf person, that is really the key. You''ll find that it could be cart, it could be a variety of other means through computers, Internet, TTY, etc. Once you get that good communication established, then life is going to be much easier. In preparation for this session last w

Jennifer Bowerman

I think this is an important point, too. If we look back at what is our homework for public accommodations? It is to really look at "what is your policy?" "what is your procedure?" "Do you know who your resources are in your communities?" "Do you know where to look to get a sign language interpreter or to find a realtime captioner?" Marc and I were talking about how I remember when I was a first time program coordinator and I got my very first request for sign language interpreter or realtime captioning, and I freaked out. I had no idea where to look. I think that is an important aspect too that we really want to leave people with-so know what your policy is. Identify your policy, where might we need to make adjustments in our policy or procedure, and to identify your resources in advance, like you pointed out. And if you don''t know where your local center for independent living is or where your nearest interpreter service is, that is when I would encourage people to contact their regional Disability and Business Technical Assistance Center so that they can assist you in identifying those resources and you can do that by calling (800) 949-4232. Marc, I''m just going to kind of throw it back to you. We have a ton of questions but we are coming up on our time constraint, and I appreciate everyone that has stuck with us due to our late start. But I''m going to throw it back to you again if you have some final closing thoughts that you would like to leave people with.

Marc Charmatz

As I said before, I''m delighted that I have this opportunity to discuss this very, very important issue. Again, my e-mail address is charmatz@nad.org (301) 587-7732 (voice or TTY). I counsel people who have discrimination complaints. For many of my clients, that is the last thing they want to do. They want to get services. They want to have equal access. They want to have effective communication. And to do that, we do our homework. We prepare. We review the law, regulations, case law. Our office sends that information out to people in the community. And people in the community, the people on this line today, are the best advocates. They are the ones that know the local situations. They know the problems. So people like me need to feed the information to people like you all out in the community so you can solve the problems. In those instances where you cannot, I am happy to be of assistance. I think that the ADA is lengthy but in many areas it is clear. There is no case that I know of that says providing an auxiliary aid is an undue burden. So we have an obligation to educate public accommodations, public entities to look at the state laws and get out in the communities. I like that because it may mean less work for me at some point. And then we will have that best of all world, full compliance. That is still a long way off but I think we are getting there.

Jennifer Bowerman

Thank you Marc. We appreciate you taking time out of your day to spend time with us on this issue. We have a ton more questions coming in and unfortunately we don''t have enough time. For those of you that still have questions, please consider contacting your regional Disability and Business Technical Assistance Center. Marc, thank you again. I hope we can have you back again.

Marc Charmatz

Thank you. It was my pleasure.

Jennifer Bowerman

To highlight some of our upcoming sessions. Next month attorney Chris Bell will talk about the interplay between worker''s compensation and the ADA. In May, John Salmen will talk about the principles of universal design and highlight some of the things to look forward to from the International Conference on Universal Design in June. We are looking at filling up the calendar from September to December. So if you are interested in the schedule, you can visit your regional DBTAC website or www.adagreatlakes.org Thank you for joining us today. We look forward to your future participation.