NH hospital settles lawsuit, launches vast program to enhance communications with deaf, hard-of hearing patients

From Seacoastonline:

PORTSMOUTH, N.H. - Managers at Portsmouth Regional Hospital are launching a vast program to enhance communications with deaf and hard-of hearing patients as a result of an out-of-court agreement to settle a lawsuit filed by the U.S. Attorney's office.

The federal suit, filed Nov. 23, 2010, claimed the hospital discriminated against deaf patients on multiple occasions. Through a negotiated consent decree, the hospital agreed to pay one deaf patient $35,000, to pay her husband $15,000, and to pay a second deaf patient $10,000. The hospital also agreed to pay a $20,000 civil penalty and to adhere to the terms of a 37-page consent decree outlining changes in the way the hospital interacts with deaf and hard-of-hearing patients.

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Terms call for PRH to offer sign language interpreters free of charge, to modify medical intake forms, to designate an Americans With Disabilities Act coordinator and compile a list of sign language interpreters living within 45 miles of the hospital. Modified telephones for the deaf must be available and hospital staff must be trained to interact with deaf and hard-of-hearing patients within 60 days of the agreement signed Dec. 16, 2010.

Donna Fitts, vice president of quality and risk for PRH, said she and a nursing coordinator are serving as the hospital's ADA coordinators. She said changes are "well under way," while reminding that patients are rushed to the hospital and arrive with needs that are "completely unexpected." There have been times, she said, when there was absolutely no translator available.

The hospital now has access to Web-based translations with live translators working in real time, she said. The service offers sign and spoken language translations through laptop computers that can be brought to patients, she said.

Also according to the consent decree, the hospital is required to advertise at least twice in a newspaper its services for deaf and hard-of-hearing patients. On Monday, an advocacy organization for the deaf provided PRH staff with a seminar demonstrating what it's like to be a deaf hospital patient, said Fitts.

"That was very enriching for people," she said. "We pride ourselves in being a hospital that tries to serve the community and we're meeting their needs in the best way possible."

Fitts said the agreement with the U.S. AG's office has resulted in a collaboration with the other N. H. hospitals that faced similar suits and resolutions.

"There is now a network of hospitals across the state providing services to the deaf community," she said.

The federal suit was brought by Assistant US Attorney John Farley, chief of the AG's disability rights division. In it, Farley claimed HCA Health Services, doing business as Portsmouth Regional Hospital, violated the Americans With Disabilities Act by discriminating against two deaf patients and the husband of one of them.

PRH "repeatedly failed to ensure individuals who are deaf or hard of hearing are offered opportunities to participate in or benefit from PRH's services and facilities," he wrote. "The US Attorney General has reasonable cause to believe PRH engaged in a practice of discrimination."

Specifically, Farley alleged, a deaf woman who uses sign language to communicate was transported to PRH in July of 2005 with a heart attack, spent four days in the hospital and was never provided a sign interpreter. Farley told the U.S. District Court that records show PRH staff was aware the woman was "a deaf mute," that she underwent multiple serious cardiac procedures, but didn't understand what was happening because of a lack of interpreter.

PRH policy states that interpreters will be made available to patients in need and at no cost, but in spite of that, the woman's husband was asked to translate, Farley alleged. Further, Farley wrote, the deaf patient's husband is hard-of-hearing and in one instance, was trying to translate what a physician said through a face mask.

During two subsequent stays at PRH, the woman's husband asked for an interpreter and once they were provided with a note pad to write on, but no interpreter, said Farley. On another occasion, the couple was provided a pregnant interpreter who was unable to assist during a medical procedure because of radiation, according to the suit.

A second deaf patient arrived at the hospital in June of 2007 with a hand injury, was given no notice of availability of an interpreter and was not offered an interpreter, Farley alleged. He was given paper and a pen to communicate and forced to write with his right hand, while being left-handed with a left-hand injury, Farley alleged. PRH documented that the patient was right-handed, Farley told the federal court.

That same deaf patient later went to the hospital for a follow-up visit and a year later for chest pains and was not provided a sign interpreter either time, the U.S. AG's office alleged.

Farley told the Herald the consent decree was reached with PRH attorneys and requires record-keeping and reporting that will ensure the terms of the agreement are met. He said he doesn't believe hospitals are "mean-spirited," just in need of education.

"We need to ensure communication is effective," he said.