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For Immediate Release:  
For Further Information Contact:
December 5, 2005

Office of The Attorney General
- Peter C. Harvey, Attorney General


Lee Moore
or Ron Czajkowski


AG Harvey, NJHA Announce Initiative to Improve Communication
for Deaf, Hard of Hearing

TRENTON – Attorney General Peter C. Harvey announced today a major new initiative, launched in conjunction with the New Jersey Hospital Association (NJHA), that will result in improved communication between hospital care providers and patients who are deaf or hard of hearing at more than 100 hospitals throughout the state.

According to Harvey, the key to the new initiative is a commitment from 112 NJHA member hospitals to comply with the New Jersey Law Against Discrimination (LAD) and other state and federal laws by providing sign-language interpreters, assistive listening devices and other “reasonable accommodations” to ensure that persons with hearing loss can communicate effectively with hospital staff.

“Adults and children who are deaf or hard of hearing must be able to effectively communicate with doctors and nurses to explain their illness or injury,” said the Attorney General. “This is as much a public safety issue as one of health care. Certainly, communication cannot be the barrier between life and death. I credit New Jersey’s hospital community for recognizing that a disparity has existed, that it can do a better job of serving the needs of deaf and hard of hearing persons, and for its willingness to work cooperatively with us to improve the situation.”

Reasons for the Hospital Deaf/Hard of Hearing Initiative

There are an estimated 720,000 deaf or hard of hearing persons in New Jersey alone. Advocates agree the number could be substantially higher because it is often difficult to identify those with hearing loss. Absent the services of a sign language interpreter, assistive listening device or other accommodation, deaf and hard of hearing persons often experience difficulty in conveying vital information about their symptoms and medical histories. In addition, said Attorney General Harvey, patients with hearing loss have complained about being placed in the awkward – and potentially harmful – position of relating sensitive medical or personal information through friends and relatives, including small children.

Joining Attorney General Harvey for today’s announcement were J. Frank Vespa-Papaleo, Director of the Division on Civil Rights, representatives of the NJHA, representatives of the state Division of the Deaf and Hard of Hearing in the Department of Human Services and Albert Gutierrez, Chief Executive Officer of Shore Memorial Hospital in Somers Point, who chaired an NJHA task force on hospital communication with the deaf.

By virtue of the New Jersey LAD and the federal Americans with Disabilities Act (ADA), hospitals are required to provide deaf and hard of hearing patients – as well as third parties with a legal right to health care information and/or authority to make health care decisions – with an effective means of communicating with hospital staff. The means of communication must be provided with minimal delay, and at no cost to the patient or third party needing the service. Attorney General Harvey noted that, while the law does not require hospitals to provide every service requested by a person with hearing loss, it does require an accommodation that is “reasonable” under the specific circumstances. For example, Harvey explained, it may be reasonable under certain circumstances for hospital staff and a person with hearing loss to communicate by using simple hand gestures, a nod of the head, or by writing basic questions and answers on a sheet of note paper.

However, the Attorney General noted, more complex interactions – the discussion of symptoms, personal history, medical diagnosis, treatment options, etc. – are likely to require a certified sign language interpreter, assistive listening device or other accommodation to ensure that vital information is communicated accurately, and in keeping with “informed consent” and patient confidentiality requirements.

Division on Civil Rights Director Vespa-Papaleo noted that the State and the NJHA are in agreement that -- save for a genuine medical emergency, or a situation in which the patient has refused the services of an interpreter or assisted listening device -- using family members, companions and friends as interpreters is not to be considered a reasonable accommodation.

“This is not only a matter of protecting the individual rights provided for by law. It is also a matter of patient well-being,” said Vespa-Papaleo. “Persons with hearing loss should be advised up front, in clear terms, that they have a right to an interpreter or assisted listening device provided by the hospital at no cost to them. The individual with hearing loss should also be consulted as to his or her preferred method of communication. It is important to remember that different people within the deaf and hard of hearing community experience different degrees of hearing loss. A one-size-fits-all approach to enhancing communication will not suffice.”

Attorney General Harvey acknowledged that, based on input from the advocacy community, it appears there is a shortage of qualified sign-language interpreters serving New Jersey, particularly after hours. He agreed that developing a larger pool of qualified interpreters is a priority issue, and one that will not be resolved overnight.

However, the Attorney General said, other factors have also contributed to a lack of accommodation for the deaf among New Jersey hospitals including a failure to consistently commit needed financial resources. (Hospitals contend that, where this has occurred, it is directly related to inadequate reimbursement from insurers for services to the deaf.)

Attorney General Harvey also observed that there has been a lack of consistent training and education among care providers and other staff at hospitals throughout the state. He noted that the NJHA has agreed, as part of the joint initiative, to take a lead role in coordinating information, education and staff training efforts at member hospitals, and has committed to serving as a general catalyst for change.

“To be certain, there are complex issues that need to be addressed on a continuing basis, but a commitment from the New Jersey Hospital Association to improve training and education at its member hospitals – and to act as a catalyst in making this a priority issue at those hospitals -- is an important part of the overall solution,” said Harvey.

Hospital Signs

As part of the joint initiative, NJHA hospitals have agreed to post signs throughout their facilities – including the admissions, registration and emergency care areas – informing persons who are deaf or hard of hearing that the hospital provides reasonable accommodations to individuals who suffer from hearing loss. In addition, the hospitals have agreed to assess the individual needs of those who request an accommodation, and provide him or her with written materials describing the types of services available, as well as reminding that the services are free.

Fact Sheet

In addition, the Attorney General’s Office and the Division on Civil Rights have created a- two-page fact sheet (108k) plugin
-that explains what NJHA member hospitals will be doing to improve communication between care-providers and patients with hearing loss. The Fact Sheet also contains answers to frequently asked questions, and provides information on what recourse is available to a deaf or hard of hearing person who believes he or she has been denied a reasonable accommodation. The Fact Sheet will be provided to NJHA member hospitals for posting within their facilities and/or distribution to patients and visitors. It will also be posted on the New Jersey Division on Civil Rights Web site at, as well as on the Web site of the Division of the Deaf and Hard of Hearing at and the New Jersey Hospital Association Web site at .

Training Manual

The NJHA has also developed an extensive manual to be circulated among its member hospitals entitled “Interpreter Services for the Deaf & Hard of Hearing: a Resource for Hospitals.”

Brian Shomo, Director of the Division of the Deaf and Hard of Hearing, welcomed NJHA’s development of a resource manual, and its readiness to serve as an industry clearinghouse for training and education on accommodating persons with hearing loss. Shomo said the NJHA “is demonstrating a genuine commitment to achieving optimum health service for people with hearing loss by way of giving health care organizations and front-line professionals the freedom and support they need to work more effectively.”

Attorney General’s Focus on Deaf and Hard of Hearing Community

Attorney General Harvey made improving hospital communication for persons with hearing loss a top priority in the wake of two public forums on issues of concern to the deaf and hard of hearing in 2004. Sponsored by Director Vespa-Papaleo and the Division on Civil Rights, the forums – one at Camden County College in Blackwood, one at Montclair State University in Montclair – brought together representatives of government, persons with hearing loss, their loved ones, and advocates for the deaf and hard of hearing.

First Phase – Movie Theater Initiative

During the same public forums held in March 2004, many persons with hearing loss related tales of having been unable to fully experience first-run Hollywood movies in a theater setting due to a lack of adequate captioning. Some spoke of their sadness at seeing their deaf or hard of hearing children miss the thrill of experiencing a popular new movie, as their hearing friends had, or of not being able to share the experience with their children.

In the aftermath, the Attorney General’s Office spearheaded a legal initiative that helped ensure that persons with disabilities would have the same opportunity to enjoy first-run movies as everyone else. Through settlement agreements with four major movie chains operating in New Jersey – American Multi-Cinema (AMC), Loews Cineplex Theaters, Clearview Cinemas, and National Amusements – the State brought cutting edge deaf captioning technology to multiplex theater screens across the state. ( In addition, AMC, Clearview and National Amusements agreed to install technology that enables the blind and visually impaired to better follow the action of a movie through special narration provided via audio headset. The technology is known as DVS or Descriptive Video Service.)

As a result of the captioning agreements, New Jersey went from three to 38 movie screens that provide new captioning technology for the deaf and hard of hearing – more than any other state. In each case, the four participating theater chains chose a form of closed captioning known as Rear Window Captioning. However, the Attorney General’s Office made plain that it viewed either Rear Window Captioning or another approach, known as Open Caption Projection, as “reasonable” accommodations for the deaf and hard of hearing, and had no preference. One theater chain refused to install technology to assist the deaf and hard of hearing view movies – Regal Cinemas. As a result, the Attorney General’s Office filed suit in 2004 against the Tennessee-based Regal, the largest multiplex operator in New Jersey. The complaint, which alleges violation of the New Jersey LAD by Regal, remains in litigation.

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