Deaf residents report frequent problems with sign language interpretation in Connecticut hospitals and healthcare facilities, which hinders their ability to fully understand medical care.
And although remote video interpretation services are widely available in Connecticut hospitals, patients have reported mixed experiences with the technology.
The problems persist more than 30 years after the passage of the Americans with Disabilities Act, which requires interpretation for patients and family members under the “effective communication” section of the law. Over the past three years, the U.S. Attorney’s Office has negotiated four settlements with medical facilities in Connecticut for complaints related to communicating with deaf patients.
“At one point, ADA and accessibility seemed to be very good,” said Marissa Rivera, an attorney at Connecticut Disability Rights. “And now, in 2022, it’s completely collapsed.”
The reasons are many and complex, but often attributed to an ongoing shortage of interpreters, which makes it difficult to consistently obtain in-person interpretation, especially during unscheduled emergency room visits.
About 5% of adults in the state have a hearing disability, a rate that jumps to nearly 9% among people over 60. according to US Census figures. There are currently 497 registered interpreters in the state, but not all of them have the certifications required to work in a medical setting.
Connecticut hospitals and state lawmakers met with advocates through a Legislature Social Services Committee Task Forcewho proposed a bill to accept additional interpreter certifications and better organize public services for the deaf.
“I would say this is a universal problem, meaning statewide, that we are trying to solve,” said social services committee chairwoman Rep. Catherine Abercrombie, who serves Meriden and Berlin.
Deaf residents may file complaints with a hospital or through state and federal agencies, so it is difficult to get a complete picture of the number of complaints filed. But the DRCT receives weekly calls related to medical interpretation issues, Rivera said.
The DRCT helped Mary Pat Donovan, 60, of Vernon, file a federal lawsuit after a mental health emergency in 2016 led to a three-day stay at the Institute of Living at Hartford Hospital. Donovan was not provided with an interpreter and therefore was unable to participate in group therapy sessions or understand his care, according to his complaint, which was recently settled.
Donovan said the lack of communication during her stay made an already difficult situation more difficult and caused her to take the wrong medication.
“I felt like my self-esteem was kind of crushed,” Donovan said through an interpreter. “I couldn’t say what I wanted to say. I couldn’t express myself. »
Assistant U.S. Attorney William Brown, the civil rights coordinator for Connecticut whose office is investigating the complaints, said, “We want to work collaboratively with the hospitals. I would say most of the time they are reactive and want to do the right thing.
“Ultimately, the goal is to ensure that the deaf community can communicate with their health care providers like anyone else,” Brown said.
Although remote video interpretation systems are increasingly common and often touted for their quick access, they can leave patients stranded if technology issues arise.
“It comes down to life and death sometimes,” Rivera said. “We’ve had cases like this, where on someone’s deathbed, the VRI didn’t work. It’s awful.”
Sometimes it can be difficult to understand an interpreter through a screen in a medical situation, said Connecticut Deaf Association President Luisa Gasco-Soboleski.
“If I’m in pain or on deep medication, there’s no way the video will work for me,” Gasco-Soboleski said through an interpreter. “It depends on the severity.”
Still, remote services may be the only option in some cases.
“On the one hand, people are saying that we shouldn’t use VRI in the hospital because of the technical issues. But on the other hand, without VRI, sometimes we don’t have anyone,” said Doreen Simons, American Sign Language (ASL) teacher at UConn. “I’d rather have VRI than no interpreter.”
Simons saw the problems from both sides: as a deaf patient and as a certified deaf interpreter helping other patients understand their care.
Simons of Farmington underwent emergency heart surgery at UConn Health Center in 2015. His interpreter for the ER visit had difficulty hearing and could not properly explain to him what was going on. When she woke up after quintuple bypass surgery, only her sister was available to interpret.
“It was not appropriate at all,” Simons said through an interpreter. “They have to provide a certified interpreter. They shouldn’t put my family members in this situation.
Her two adult children ended up acting out many of the follow-up conversations with the doctors after her surgery, emotionally processing the information while also playing the official role of informing their mother.
Although Connecticut is known as a leader in supporting deaf residents, advocates say services have declined over the past 10 years, contributing to problems in medical settings.
The state launched the Commission for the Deaf and Hard of Hearing in 1974, the first of its kind in the country. But in 2011, the commission was transformed into an advisory council.
Amid budget cuts in 2016, the Department of Rehabilitation Services reduced its sign language interpreting service. That same year, the state’s Office of Disability Advocacy and Welfare was abolished and duties were reassigned to Disability Rights Connecticut and the Department of Aging and Disability Services.
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“We were first in the country and our services were great,” Gasco-Soboleski said. “And right now, we have zero. And I see more problems arising, more problems arising because there is no training.
A 1998 Department of Justice Consent Order, which required hospitals to provide an interpreter within one hour of notification for at least 80% of requests, has expired. As part of the agreement, the Connecticut Hospital Association hired sign language interpreters on behalf of all of the hospitals. Without the executive order in place, advocates say compliance is lapsed.
A Connecticut Hospital Association spokesperson declined to be interviewed or answer specific questions via email, but released a statement highlighting the hospitals’ dedication to patient care and working with advocates to address concerns. .
Several hospitals, proactively or following complaints, are working on service improvement plans.
Stamford Hospital, for example, recently launched long-term staff training on cultural considerations, working with interpreters and basic sign language. The hospital has 30 remote video interpretation machines and a contract for 24-hour translation services in over 200 languages, including ASL. He also has an in-person interpretation contract and relies on 211 if an interpreter is not available when needed.
“Our standard has always been to provide appropriate interpreting services to patients,” said Liz Longmore, senior vice president of ambulatory services and patient experience at Stamford Hospital. “It got harder over time.”
This story was reported in partnership with the Connecticut Health I-Team (c-hit.org), a nonprofit news organization dedicated to health reporting.