Guidelines for Medical Services to Deaf and HOH Adults
- Part 1
Editor: An organization called the Delmarva Foundation for Medical
Care Inc recently led an effort to establish guidelines for health care
standards for people with hearing loss. Here are the results of that
effort. Please direct your comments and questions to Dr. David Boan at
dboan@dfmc.org
~~~~~~~~~~~~~~~~~~~
Guidelines for Services to Deaf and HOH Adults as Modified by the
Conference on Standards of Care for Deaf and HOH, March 31, 2000
A project of the Delmarva Foundation for Medical Care, Inc.,
Gallaudet University, and the Health Care Financing Administration.
Introduction
This document reflects the consensus of a set of standards,
guidelines and recommendations proposed by a virtual panel of experts
and revised by a second panel. These standards assume that there is a
gap in the quality of care received by deaf and hard of hearing adults
(Deaf /HOH) as compared to the general population. Further, that there
is a crisis in health care services for Deaf/HOH that raises the issue
of whether we as a society will guarantee that all Americans have a
right to a minimum level of health care. The following guidelines and
standards also assume that equity in the quality of health care is a
civil right for all people. The following guidelines and standards are
proposed as the conditions that must be met if a Deaf/HOH adult is to
receive the same quality care as a patient who is free from hearing loss
or impairment.
You will see that the standards and guidelines do not focus upon
providers. They were proposed from one simple question: What conditions
must exist to eliminate the gap in quality between Deaf/HOH and the
general population.
Further, these are not all strictly standards. Some are standards and
their inclusion here is expected to lead to further work to adopt them
as regulations. Other statements are better seen as recommendations,
program guidelines, and policy statements rather than standards of care.
The goal was not to develop standards to address the gap in care, which
is a more comprehensive goal.
Comments or questions may be mailed to:
Dr. David Boan
Delmarva Foundation for Medical Care
9240 Centreville Road
Easton, MD 21601
dboan@dfmc.org
410.822.0697
Revised May 3, 2000
1. Equal Access
1.1 It is the responsibility of the provider and/or health care
organization to insure that communication does not create a barrier to
the equal access to services. This must include;
- assessing the communication needs and preferences of the Deaf/HOH
patient and
- assurance that all systems of access in that setting can
accommodate the patient's communication needs.
1.2 Determination of communication needs must be done by individual
assessment of the patient's needs and preferences. While existing law
allows for a variety of means to accomplish effective communication, the
patient's needs and preferences should be paramount in determining the
most appropriate method.
1.3 Advocacy services are basic to insuring equal access to treatment
and quality of service, and therefore special attention is needed to
insure the needs of Deaf/Hard of Hearing adults are adequately addressed
by the existing advocacy services that are available in a timely manner.
2. Identification:
2.1 Three dimensions need to be addressed in identifying the
communication and access needs of Deaf/HOH adults:
functional hearing status and preference (does the patient rely on
visual or auditory communication, or both),
language use (American Sign Language, English, Foreign Language,
etc),
and communication skills.
2.2 Standards and guidelines should address the needs of the
following groups:
Hard of Hearing
Deaf
Late Deafened
Deaf and Blind
Hearing Children of Deaf Parents
Deaf and Minimal Language Skills
2.3 People should always be asked their preferred mode of
communication. Check lists should be made available to standardize this
process.
2.4 When developing regulations, guidelines, or any printed
materials, the following terms should be avoided due to their negative
connotation:
deaf-mute
deaf-mutism
deaf-dumb
hearing impaired
Part 2
