Video Remote Interpreting (VRI) is a supplemental technology enabling businesses to communicate with their Deaf clients using an off-site interpreter. With VRI, the interpreter and the business must have a laptop or tablet, a high speed internet connection, video-conferencing technology, and a web cam.
The interpreter and the business connect with each other via the videoconferencing program when the Deaf client arrives. The computer is directed toward the Deaf person so they can see the interpreter on the screen and the interpreter can clearly see the Deaf consumer. The interpreter voices the message which is heard via the computer speaker in your office. The rate is charged by the minute and with a 30 minute minimum. For more information on VRI, click here.
Interpreters charge the 2hr minimum to cover an hour of their time with you and your client/patient and an hour for their travel time to and from assignments. The travel time helps them maintain reliable transportation and cover the cost of fuel. They provide an hour of service because they are hired and needed for the entire appointment process, not just the 15 minutes you are scheduled to see them. The interpreter will arrive on time, if not early, help the Deaf person check in, clarify any questions prior to seeing the professional, wait with them in the waiting room, go back to the exam/meeting room, interpret for the other staff, wait for the professional to arrive in the room and interpret, then follow them back up to the front for check out. If other tests or labs need to be done in office, we’ll stay for that too. So, in the big picture, it’s really not just 15 minutes we are needed, it’s the entire process. The 2hr minimum is an industry standard strictly adhered to by professional interpreters.
No, unfortunately, you cannot bill the Deaf patient for the interpreting services – that would be illegal. You can, however, set up a general cancellation policy in your office that applies to all of your patients. This means you can charge a cancellation fee or no-show fee to ALL your patients that do just that. If you enforce it, it will help off-set the cost of the interpreter. To enforce this only with your Deaf clients/patients would be considered discriminatory.
I would also discuss this policy with the patient next time you have an interpreter. I find if the staff actually explain that it’s imperative the patient calls 24 business hours before (weekends do not count) the appointment time to cancel or reschedule, they’ll remember to do so. If you have a Deaf patient that frequently cancels or doesn’t show, then there are other options we can offer to help prevent the cancellation fee by the interpreters.
Keep in mind that most other interpreting agencies demand a 48-72 hour window to cancel without being billed. Our 24 hour cancellation policy is one of the many reasons our customers prefer CbH. The interpreters strictly enforce this 24hr cancellation/no-show policy. It is an industry standard that Communication by Hand must honor to retain the best certified interpreters possible.
Think about it… would you have your minor child accompany you to an appointment and put them in the critical position of making sure you understand what’s going on? They are not certified interpreters and do exactly what we are taught NOT to do – edit the message or give personal opinions! (Embarrassing topic? Content too difficult to keep up with? Don’t like the way the hearing professional is treating their parent? HIPAA violation?) Professional and certified interpreters do not edit; they keep their opinions out of it and are bound by a Code of Professional Conduct (CPC). Our job is to make sure effective communication is happening. In fact, the revised regulations of the ADA forbid the use of a minor as an interpreter unless it is an absolute emergency (life or death).
Your client is either Deaf or Hard of Hearing. The Deaf community has taught me that they hate the term “hearing impaired” because they feel you are telling them that there is something inherently wrong with them because they cannot hear. Furthermore – “Deaf” is proper for the person in front of you, and “deaf” is proper describing that they cannot hear. (D = culturally Deaf.) The NAD (National Association for the Deaf) has a great article on this very topic.
It may be necessary to use an interpreter to ensure both you and your client/patient have a clear means of communication and that nothing of importance gets misunderstood. Title III of the Americans with Disabilities Act (ADA) directs places of public access to make their programs and services accessible to individuals who have a disability. Accommodations for a person who is Deaf may require the use of sign language interpreters to achieve effective communication. When determining which accommodation to utilize, the provider should take the following into consideration: the Deaf individual’s possible limited English language skills, their primary mode of communication and complexity of the specific appointment. Please see this link for some additional information.*
When using an interpreter, the ADA requires that the interpreter is QUALIFIED and defines such as an individual who can interpret accurately, effectively and impartially, both receptively and expressively, using any necessary specialized vocabulary. Other methods of communication, such as writing notes or lip-reading, may not be effective for some clients/patients, since medical and legal situations are typically more complex and are sometimes lengthy. Also consider the ethical reasons to ensure you are communicating effectively. A lack of clear communication can have serious consequences for both the business and the patient/client. Family members and friends cannot be expected to be neutral and sign everything they hear. They may be emotionally or personally involved and this may affect their interpreting. Using them as interpreters can also cause problems in maintaining confidentiality with your patient/client.
An entity may avoid provision of an auxiliary aid only if it can demonstrate that provision of such would fundamentally alter the nature of the service or would constitute an undue burden. If the entity is able to demonstrate a fundamental alteration or an undue burden in the provision of a particular auxiliary aid it must, however, be prepared to provide an alternative auxiliary aid 28 C.F.R.Section 36.303(f).
*This information was provided by Doug Dittfurth formerly with DARS DHHS – thank you, Doug, for your sharing your knowledge with us.
The Department of Justice (DOJ) considers all the resources of the business as a whole and usually treats the cost of interpreters as a cost of doing business and not an undue burden. In other words, comparing how much you charge your Deaf patient/client/customer and the cost of hiring an interpreter for equal access to your office is not permitted. Legitimate hardships to business for providing an accommodation would need to be determined by the DOJ. There are tax credits available that allows businesses to recover up to 50% of expenses paid for accommodations with persons who have a disability that includes effective communication. Please visit this link for more information. Keep in mind the ADA does not allow for businesses to pass on the cost of an accommodation to the individual with a disability.
For more information about your rights and responsibilities in regards to the ADA and serving persons who are Deaf or hard-of-hearing please contact your local resource provided by Texas’ Office for Deaf and Hard-of-hearing Services.
ASL is a useful and rewarding 2nd language to learn. Here are some places to take classes:
Austin Community College
Austin Sign Language School – Deaf instructors are a plus!
San Antonio College
Texas Institute of Sign Language – Deaf owned, small classes taught by a Deaf instructor
Gallaudet University online courses
Many High Schools offer their students ASL classes. Check with your local school district for more information.
Communication by Hand offers Delia’s “Connecting Workshops”, which are Deaf Sensitivity Seminars including ADA compliance education. It’s a safe place for “hearies” to learn about Deaf culture and ask questions without feeling like they have to be politically correct. Invite us to your next “brown bag” lunch! It’s free of charge and takes about an hour. Consider us your Deaf culture and community resource.