Slide 0: Advocates: Caring Partners. Creative Solutions. Better Lives.
What is Accessible Healthcare to Deaf People?  
2023
Slide 1: What is Access?
Note: This slide contains 6 images. 
Image 1: A person in a wheelchair. 
Image 2: Three animated people with open heads. The first person has red, pink, and blue triangles floating out of their “brain.” The second person has pink, yellow, and orange swirls floating out of their “brain.” The third person has red, blue, and orange stars floating out of their “brain.”
Image 3: An image of the interpreter logo in ASL.
Image 4: A pair of black eyeglasses on a table. 
Image 5: The “Closed Captioning” symbol. 
Image 6: A microphone. 

Note: this and all slides going forward contain the Advocates website “www.Advocates.org” as a footnote.
Slide 2: Problem Statement
•	Current plan information and website designs are not universally designed for access. This creates barriers to healthcare access, enrollment, and early intervention to care for the Deaf community. 
Slide 3: Addressing the Problem Requires…
•	Designing Accessible Websites
•	Direct Communication and Language Justice
•	Cultural Competency 

Note: This slide contains three images. 
Image 1: A blue rectangle with the phrase “Web Accessibility” surrounded by small icons relating to computers and the internet. 
Image 2: A woman on a video call on the computer with a man. 
Image 3: A man and a child communicating with a doctor in sign language. 
Slide 4: Inaccessible Information/Website
Note: this slide contains a screenshot of the “How to enroll in One Care” page from the Mass.gov website.

Missing features
•	Visual Information
•	Language Options
•	Method to Request Interpreters 
•	Culturally competent information
•	Screen/Braille reader accessible?
•	Videophone number
•	TTY is outdated technology
Slide 5: Access Action #1 - Accessible Websites
Features Included:
•	Font size, color scheme for low vision and color-blindness
•	Audio descriptions
•	Screen and braille reader accessible
•	Language options 
•	Embedded vlogs in ASL – direct language access
•	The interpreter symbol to signal commitment to provide access 

Note: this slide contains a screenshot of a page from the Disability Law Center website regarding “Civil Legal Aid for Persons with Disabilities Who are Victims of Crime”. This slide also contains an image of the interpreter logo in ASL.
Slide 6: Access Action #2 – Direct Communication / Language Justice 
•	Develop Vlogs for welcome info and plan descriptions
•	Videophone number in addition to TTY
•	If you hire a Deaf employee, they can have direct access to members
•	VRI is a deterrent for many Deaf people
o	Often used in crisis
o	iPad screen/connectivity issues
o	Privacy/HIPAA issues in ER

Note: This slide contains two images. 
Image 1: Two people conversing in American Sign Language on a blue background.
Image 2: A person sitting in front of a laptop signing "help" in ASL.
Slide 7: Requirement #3 – Lead with Cultural Competency to draw in Deaf Community

•	Competency means having an employee who is a member of that community which means a person in the Deaf community
•	Deaf to Deaf direct communication
•	Culturally competent care reduces delays in seeking preventative care. It also reduces unnecessary and expensive exams and tests
•	Invest in training designated employees in ASL classes and Deaf Culture 101
•	Partner with MCDHH to enhance cultural knowledge

Note: this slide contains an image of a painting by Nancy Rourke called Deaf Connect. Image of a globe with six hands signing "Connect"
Slide 8: The Solution - Deaf Care Coordinators
•	Provide access to care through language justice and cultural competence – easier and more cost effective to hire and train one Deaf employee
•	Direct explanation of information versus interpretation
•	Collectivist cultural values are shared by the community – a Deaf Care Coordinator will attract many Deaf community members and the community will spread the word
•	Reduces need for interpreters and therefore interpreter scarcity, VRI ineffectiveness and scheduling challenges will be partially alleviated

Note: This slide contains two images. 
Image 1: A yellow hand and red hand on blue background with the words "Listening to the Deaf Community" in white letters.
Image 2: One person smiling signing "help" in American Sign Language to another person who is responding with "okay"
Slide 9: Support and Educate Providers
•	Providers need to be educated on working with Deaf people
•	Video Remote Interpreting (VRI) isn’t the answer
•	On-site Interpreters are a reasonable accommodation. Shortage of interpreters is not a viable reason to refuse providing.
•	Hire Interpreters x hours a week/month
•	If hired a Deaf professional, they could guide the providers. 

Note: this slide contains a black and white icon of a doctor. 
Slide 10: Alternative but less viable options
•	Train non-Deaf case coordinator in Deaf culture and ASL.
•	Acquire interpreting contract for minimum of x hours per year.
•	Downsides
o	Not as successful as Deaf community member
o	Interpreter scarcity 
o	Increased financial burden
o	Less likely to attract Deaf Community 
o	Significant increase in administrative coordination

Note: this slide contains a Chuck Baird painting X-ray image of chest area with Red heart outline and hands  making the ASL sign "Heart"
Slide 11: Resources
•	Disability Policy Consortium 
•	Disability Law Center
•	Mass Commission for the Deaf and Hard of Hearing
•	Communication Access Training and Technology Services
•	Deaf and Hard of Hearing Independent Living Services (DHILS)
o	Center for Living and Working  
o	Deaf Inc.  
•	Sharon Hirt Director of Communication Access at Advocates Smaclea@advocates.org