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The SHHH Californian - WINTER 2001 / Page 6

KAISER PERMANENTE, PART TWO
THANK YOU, DISABILITY RIGHTS ADVOCATES
THANK YOU, KAISER PERMANENTE HMO

Sid Wolinsky, Litigation Director of Disability Rights Advocates, the Oakland group that brought the lawsuit against Kaiser Permanente (KP), said that the article I wrote in the Fall issue of The SHHH Californian was badly mistaken, that KP will give access to all disabled people including hard of hearing people and asked me to print a retraction. Sid Wolinsky says, "Both the complaint and the settlement in Kaiser do each cover all disabilities, including hard of hearing, late deafened and deaf persons. Since its inception, Disability Rights Advocates has made a particular commitment to advancing the rights of people with hearing disabilities." So I apologize. I retract my statement. I am happy to say that I was wrong.

KP has just published a Training Manual, Listening Closely, A Better Way to Communicate with the Hard of Hearing. Fred Smith, Ronda Bonati and Margaret Azcona, representing SHHH, are acknowledged in it for their invaluable support and contributions to its development. Congratulations!

In an effort to eliminate communication barriers between the hard of hearing (hoh) patient and health care providers/staff, KP has developed this Training Manual, designed for multidisciplinary health care professionals. The key objective of the manual is to give health care providers/staff the basic concepts and skills necessary to work effectively with the hoh patient and to better understand the concerns and health implications of this population. Approximately 80 to 100 department heads at the KP San Francisco Medical Center have completed a train-the-trainer program on these materials and training has been provided to several departments in the Medical Center to date.

The contents of the Training Manual are excellent, very complete and a good foundation on which to build. Following are a few highlights:

Two populations--deaf and hard of hearing. The manual describes in depth the difference between deaf and hard of hearing people, acknowledging that it is important to make the distinction between a person who is deaf and a person who is hard of hearing in order to accommodate to their specific needs. This is an idea long put forth by SHHH.

Identifying a patient with hearing loss and guidelines. The manual describes the signs and symptoms of hearing loss, components of hearing loss and how to identify a patient with a hearing loss. Guidelines for communicating with hoh people are given, covering conversational etiquette, communication clarity and environmental conditions.

International Hearing Loss Symbol. The manual suggests placing the international hearing loss symbol on the KP membership card and on a wrist band when the hoh person is in the hospital.

Federal Legislation. The legislative protections that hoh people have with Section 504 of the Rehabilitation Act and Title III of the ADA are discussed, saying that failing to comply with these federal laws may be discrimination on the basis of disability and may result in medical malpractice.

Hospital Information Kit. The description and use of the Hospital Information Kit that SHHH members have worked on for so long is included in its entirety.

Assistive Technology. This section tells how to use a TTY and the California Relay Service. This is the section that needs to be greatly expanded. For instance, the only mention of FM and Infrared assistive listening devices is in the glossary. FM is the assistive listening device of choice for hoh people. Fifteen years ago I was deaf. Today, because of technology, I am hearing. The technology that helped me needs to be described in this section
Here are some further areas of concern. Except for Item 1, KP has not yet dealt with the following:

1. Hospital personnel need to learn how to communicate with a hospitalized hard of hearing person. This has been covered completely and very well in the just published Training Manual.

2. The Health Education classes are inaccessible to hard of hearing people. They need to be made accessible by using assistive listening devices and providing the necessary signage.

3. Hard of hearing people cannot understand Healthphone information.. This information should be made available by email, fax or on the internet and the necessary signage provided

4. Office visits. Doctor-patient communication. I use my FM assistive listening device when I go to see the doctor and they are very interested in it. Doctors are having trouble communicating with their hard of hearing patients.

5. The ADA mandates signage. To meet the signage requirement, publish articles in your quarterly pamphlets educating members about the use and availability of assistive listening devices in your Health Education classes. Tell them that the Health phone messages are also available by email, fax or on the internet.

   Hard of hearing people don't ask for assistive listening devices because they have never heard of them. And hard of hearing people don't sign up for Health Education classes or use the Healthphone, because they know they won't be able to hear very well.

   An open-captioned video could be made and shown in the various waiting rooms, telling KP members how to use and obtain assistive listening devices.

6. Hard of hearing people cannot understand videos. All videos need to be open or closed captioned.

7. KP and the medical profession ignore hearing loss as a serious disability. The Healthwise Handbook needs to talk about hearing loss. For instance, if you are stressed, tired, anxious, depressed, have high blood pressure, etc., your hearing should be checked. I went through the handbook and wrote up changes several years ago. I would be glad to help edit the latest version.

8. KP puts out an excellent quarterly pamphlet, Senior Outlook. One issue could be devoted entirely to Hearing and Hearing Loss. One quarter to one third of people over the age of 60 are hard of hearing. Educating members about hearing loss follows Kaiser's philosophy of preventive medicine through education.

KP is the largest HMO in California and in the U.S. This is a major breakthrough. We are finally being listened to. Change won't happen overnight, but when these ideas are fully implemented, they will ripple throughout the medical community of the United States. Heaven would be living in a world that was set up like the SHHH National Conventions, where you can hear easily in every situation. Maybe we'll get there yet.

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