A group of concerned state lawmakers has called together advocates for people with disabilities to increase public awareness of the services health care providers are obligated to provide patients who are deaf, hard of hearing, or deaf and blind.
Patients with hearing challenges routinely experience bureaucratic red tape, added stress in emergency rooms, and are refused as new patients or denied interpreters — all of which is illegal according to state civil rights law and the federal Americans with Disabilities Act.
"This is not a rare occurrence or a rare need," Sen. Josh Green said Wednesday during a news conference at the Capitol. "This is a commonplace need that has to be addressed … and so I really hope that people take to heart how serious this is."
Green, a Hawaii island emergency room physician; Rep. Richard Creagan, also a Hawaii island doctor; and Rep. James Tokioka of Kauai, whose son, Pono, is deaf, called the news conference to unveil public education materials they hope will better inform patients and the health care community of the rights of deaf, hard of hearing, or deaf and blind people.
"All too often I can’t deliver as good care for them because I can’t communicate as well with them, and it hurts sometimes when I have to rely on other people, family members, to try to explain what that individual is suffering with," Green said of his emergency room experiences with people who are deaf.
According to Tokioka (D, Wailua-Hanamaulu-Lihue), 1 to 2 percent of people in Hawaii, or about 16,000 people, are deaf, hard of hearing, or deaf and blind.
"Government is set up to help people who cannot help themselves, and clearly the deaf community is a community that does not choose to be deaf," he said during the meeting. "But they have issues when they go to the doctors, and we need to make sure that doesn’t happen."
The lawmakers’ communication initiative has strong support from the Hawaii Civil Rights Commission and state Disability and Communication Access Board.
Bill Hoshijo, executive director of the Hawaii Civil Rights Commission, emphasized repeatedly the need to treat deaf patients fairly.
"Health care providers are required to provide auxiliary aids and services for patients who are deaf, including qualified sign language interpreters, when required for effective communication," he said. "That’s why we’re here. Hospitals, health clinics and doctors’ offices must be aware of the obligation to provide sign language interpreters when required for effective communication at no cost to the patient who is deaf. Failure to do so is a violation of state and federal law and denies equal treatment for patients who are deaf."
Several members of the deaf community attended the news conference and expressed frustration with how they are treated by health care professionals, both in emergency room settings and private doctors’ offices. They signed through an interpreter to tell their stories.
"I’m so happy to be here today because for 45 years I have suffered with trying to get health care without an interpreter," Linda Yuen Lambrecht signed, explaining that she went through serious complications with pregnancies and even got diagnosed with pneumonia without effective communication.
Lambrecht, whose husband also is deaf, added that it’s not fair to require children to interpret for their parents, because health care often involves private or sensitive information.
"I went to a doctor for pneumonia, and I was there for four hours with no interpreter," she signed. "Finally a call was made to a doctor, and they finally said I had pneumonia. I didn’t understand what that meant, and they said, ‘Well, you’re going to be in the hospital for three weeks.’ And this is trying to communicate through my child, through my daughter."
The Disability and Communication Access Board, which was created to function as a public advocate of persons with disabilities, receives many calls from individuals inquiring about ADA requirements and state law regarding what’s referred to as "effective communication," Executive Director Francine Wai said.
"By far the most significant number of requests are about health care providers, so we know that that is a serious problem," Wai said.
Wai, whose sister can hear but cannot communicate verbally, added that providing easy access to interpreters doesn’t just benefit people who are deaf.
"The health care provider essentially needs that interpreter so that they can do a good job, they can fulfill all their responsibilities," she said.
Kristine Pagano, a communications access specialist with the disability board who helped create the education materials, pointed out through an interpreter that it’s also important to consider how deaf parents feel when doctors try to communicate through a child about the child’s health care.
"The parents, who are responsible for their children, oftentimes … are very frustrated about not having an interpreter at these important appointments," she signed. "And it’s not fair and not right that the child should have to be able to relay this information to their parents."
Green (D, Naalehu-Kailua-Kona) said he plans to get the word out in the physician community that denying patients’ requests for effective communication is not only unethical, but illegal. He suggested one way to move forward might be to have independent physician associations pool resources to staff an on-call interpreter that individual practices might not be able to provide.
In the meantime, Green encouraged advocates to continue to speak out for the rights of people with hearing challenges.
"Make a big stir if you’re not getting the services you want, because that’s the only way that we can show people, ‘Hey, we’re not going to tolerate not treating everyone as an equal and giving them equal access to health care,’" he said. "I think as your stories are told, it will be much easier to just convince people that it’s mainstream medicine that we’re talking about; this is not a special request."
