Arizona Deaf and Hard of Hearing Quality Assurance Task Force Report Produced by the Arizona Commission for the Deaf and the Hard of Hearing June 2004 Updated Edition Contact: Marian Kaanon, Planner and Public Relations Coordinator Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 (602) 363-1579 (602) 542-3380 FAX marian.kaanon@acdhh.state.az.us www.acdhh.org Statutory Performance Arizona Revised Statutes §36-1944 empowers the Arizona Commission for the Deaf and the Hard of Hearing to “act as a bureau of information to the deaf and the hard of hearing, state agencies and institutions providing services to the deaf and the hard of hearing, local agencies of government and other public or private community agencies and programs.” Furthermore, Arizona Revised Statutes §36-1944(3) empowers the Commission to “Study issues relating to the deaf and the hard of hearing, review the administration and operation of the various programs for the deaf and the hard of hearing in this state and make recommendations concerning these problems to the several agencies and institutions represented on the commission as it deems necessary.” Report Preparation Sherri Collins, M. Ed. Executive Director Arizona Commission for the Deaf and the Hard of Hearing © 2004 Arizona Commission for the Deaf and the Hard of Hearing 1 Table of Contents I. ACDHH Overview Mission & Vision Statements Letter from the Executive Director Page 3 Page 3 Page 5 II. Report Purpose Structure Categories Methodology Use Page 6 Page 6 Page 6 Page 7 Page 8 Page 10 III. Populations Deaf Hard of Hearing Deaf-Blind Parents Interpreters Page 11 Page 11 Page 12 Page 13 Page 14 Page 14 IV. Executive Summary Page 16 V. Findings and Recommendations—at a Glance Page 17 VI. Findings and Recommendations—In-Depth A. Assistive Technology B. Communication Access C. Community Interaction & Empowerment D. Education & Training E. Public Awareness F. Service Delivery G. Transition Services & Employment Page 27 VII. Acknowledgments Page 86 2 ACDHH Overview The Arizona Commission for the Deaf and the Hard of Hearing (ACDHH) was established in 1977 as a state agency to address the needs and concerns of Arizona’s Deaf and Hard of Hearing population. ACDHH is governed by a 14-member board of directors appointed by the governor for a term of three years. An executive director and a staff of 14 administer all programs and daily operations on an annual budget of approximately $5.7 million, coming from the Telecommunication Fund for the Deaf. Daily operations of ACDHH include information and referral, telecommunication relay service administration, no-cost telecommunications equipment distribution, and interpreter certification and licensure. ACDHH also provides training, houses a resource library, performs statewide outreach, produces a weekly 30-minute TV program, and publishes a wide variety of materials, which include a newsletter, informational brochures, fact sheets, and an annual report. For more information, please visit the ACDHH website at www.acdhh.org or sign up on the ACDHH email list by writing to info@acdhh.state.az.us. Mission Statement The purpose of ACDHH is to ensure, in partnership with the public and private sector, accessibility for the Deaf and Hard of Hearing to improve their quality of life. Vision Statement An energetic and innovative team, ACDHH aspires to be a national leader in the provision of communication access, support services, and community empowerment throughout the Grand Canyon State. 3 The Arizona Deaf and Hard of Hearing Quality Assurance Task Force Report is dedicated to: Dr. Frank Turk For his leadership For his commitment For his vision For his contributions to the entire deaf and hard of hearing community 4 Dear Community Member, On behalf of the Arizona Commission for the Deaf and the Hard of Hearing (ACDHH), I am proud to present the updated Arizona Deaf and Hard of Hearing Quality Assurance Task Force Report. This comprehensive document was born out of an awareness that there are overlapping issues that affect us all – and working together to resolve these common issues increases our ability to succeed as a community. Issues addressed within this document range from education to service delivery and public awarenss. ACDHH will work to update the report annually with our work and progress. This is the second edition (June 2004) of the report. After several years of intensive community research, the report truly encompasses the opinions and worthwhile feedback of Deaf and Hard of Hearing Arizonans, their family members, interpreters, non-profit organizations and service providers. Report highlights range from Deaf senior services to an ongoing need for public awareness – that’s just part of the 54 findings you will find contained within this report! I trust you will find the report of good use to you and/or your organization – the report was written to also serve as a tool that organizations can use in their strategic planning and future needs assessment. To make extra copies of the report in the future, you are welcome to visit us online at www.acdhh.org. Sincerely, Sherri L. Collins Executive Director 5 Report Purpose The Arizona Deaf and Hard of Hearing Quality Assurance Task Force study began in 1998 during a time of change for ACDHH. There was a new executive director, an upcoming sunset review that would expand ACDHH’s stakeholder population to include persons who are Hard of Hearing, an emerging focus on the cochlear implant, increased attention to the needs of persons who were Deaf-Blind, and projections of a population growth that would see Arizona among the fastest growing states in the new millennium. Clearly, the time had arrived for a comprehensive assessment of state-provided programs and services. ACDHH set out to investigate not only the programs and services that were established for persons with hearing loss, but all programs and services funded by the state. Also, ACDHH evaluated state programs and services not only for quality but also for accessibility. Included in the scope of the task force’s review was the effectiveness of public information, the availability of resources in rural areas, the response time to the evolving trends affecting the lives of persons, and aspects basic to the pursuit of happiness—the ability to interact and the sense of empowerment. The end result is this report, the shared voice of both professionals and grassroots community members, which outlines recommendations for the improvement of the quality of life for all Arizonans who are Deaf and Hard of Hearing. Thus, ACDHH has developed a road map for itself and its many partners to guide their actions and collaborations in the years ahead. Structure The findings and recommendations in their in-depth version read like information sheets. Each single-page paper has five parts: • • • • • Finding Population Data Context Recommendations Implementing Agents The Finding heads each page and identifies a problem or an issue. An example finding is: Finding #1: Persons with hearing loss do not connect with the name of the Arizona Council of the Hearing Impaired. Information given under Population Data and Context help to frame the problem and reduces the interpretability of the Finding. An example compelling statistic is: 6 Population Data: • 23 state agencies serving persons with hearing loss in the U.S. renamed themselves in the past 5 years from the Hearing Impaired to the Deaf and the Hard of Hearing. Example contextual information is: Context: • Hearing Impaired is viewed as a negative term among those with hearing loss. Recommendations are proposed measures to respond to or to minimize the problem or issue identified by the Finding. There might be multiple recommendations for a single finding; however many recommendations there are, their numbers always refer to the finding. Two example recommendation are: Recommendation #1.1: Change the name of ACHI to the Arizona Commission for the Deaf and the Hard of Hearing. Recommendation #1.2: Set forth clear definitions for persons who are Deaf and Hard of Hearing. Implementing Agents are those who will effect the recommendations. Example implementing agents are: Implementing Agents: • ACHI • Arizona state legislature Categories The findings and recommendations are organized into broad categories: A. B. C. D. E. F. G. Assistive Technology Communication Access Community Interaction & Empowerment Education & Training Public Awareness Service Delivery Transition Planning & Employment These categories are not neat divisions; rather, common and overlapping elements can be found in a number of findings. The categorizations were made, however, to identify what ACDHH in its consultative power believes to be the main service deficiency. The categories deal with definitions that are made as distinctive as possible: 7 Assistive Technology: Pertains not only to the technologies per se but also to accessibility thereof (costs and availability), vigor in research and development, the availability of resources for training and consultation, and awareness. Communication Access: Pertains to the ease of information receipt from persons who are Deaf and Hard of Hearing with programs and services provided by the state. All findings concern accommodations. Community Interaction & Empowerment: Pertains to opportunities for the participation of persons who are Deaf and Hard of Hearing in community activities, programs, and services. Encompassed here are the inclusion of persons who are Deaf and Hard of Hearing in policy development and the availability of opportunities for identity formation and self-reliance. Education & Training: Pertains to the provision of learning opportunities at all levels for persons who are Deaf and Hard of Hearing of all ages, from youth to adult, from state education to vocational training to self-betterment recreational training. The findings concern quality of instruction, access to information and effective communication, options, and support services. Public Awareness: Pertains to both awareness and understanding on the part of the state legislators and taxpayers of the sub-populations within the Arizona Deaf and Hard of Hearing community and of their specific issues, which can overlap with other categories. Also addressed are awareness of hearing conservation and information access for bilingual populations. Service Delivery: Pertains to the provision of services—as well as their accessibility, availability, and effectiveness—to persons who are Deaf and Hard of Hearing. Quality, consistency, failure and gaps, and appropriateness are addressed. Transition Planning & Employment: Pertains to employment issues and employment preparation opportunities and options. Methodology The study was initiated by ACDHH with the following premises: • • • • • • Access to available programs and services in Arizona is critical to productive citizenship. Resources must be utilized appropriately by service providers for optimal effect. Self-advocacy is an ideal with no equal substitution. Empowerment is achieved through performing leading roles in service design and implementation. Service delivery entails quality participation rather than mere enrollment. Lastly, the Deaf and the Hard of Hearing community brings within itself a diverse set of needs, reflecting the non-uniformity of individual persons with hearing loss. ACDHH focused the study on four distinct populations that comprise the Deaf and Hard of Hearing community: 8 1. 2. 3. 4. Youth Deaf Adult Deaf Hard of Hearing Deaf-Blind Over the course of the study, many findings and recommendations gave emergence to two additional populations: 5. Parents 6. Interpreters During the writing phase, the Deaf Youth and Deaf Adult distinction was ultimately merged in favor of a unified Deaf population, leaving the report with five identifiable populations. Definitions and elaborations on each of these five populations are given in the next section of this report (Populations). From 1998 through 2003, ACDHH coordinated task force meetings and open public sessions for the purpose of collecting expert and legislative counsel along with community input. The task force meetings all focused on a specific population and were comprised of populationappropriate representatives of state agencies, community organizations, service providers, other professionals, and community members. ACDHH also coordinated a number of service areaspecific task forces: Newborn hearing screening, communication access, mental health services, and interpreter rules. All task force meetings were open to public participation. All task force meetings and open public sessions ensured communication accessibility through the provision of sign language interpreting, captioning in real time, and FM systems. All task force meetings and public sessions were recorded with verbatim transcripts and often with minutes. All task force committees submitted formal reports at their conclusion. All these documents served as the collective basis of the synthesized findings and reports given in this report, in Section V and in depth in Section VI. The initial data collection and analysis were performed by Jerry Nelson, a consultant who is Deaf. The process continued with Hands On Communications, a Phoenix-based consultation firm that is Deaf-owned. Lastly, the data collection and analysis were completed by Glenn Lockhart, a contractor who is Deaf. Mr. Lockhart also reorganized the data out of population divisions, created the format as seen in Section VI, and performed the report writing. The draft of the report was reviewed at a Fall 2003 statewide conference co-hosted by the Arizona Association of the Deaf and Connecting Arizona Advocates, Inc., both statewide community-based organizations with grassroots appeal. Public input was solicited from conference attendees. The report was then published in 2004. 9 Findings that have already seen resolution and recommendations that have already seen implementation are not included here, as this report purports to effect positive change. Use As given in the concluding paragraph in Purpose, this report outlines recommendations for the improvement of the quality of life for all Arizonans who are Deaf and Hard of Hearing, giving ACDHH and the Arizona Deaf and Hard of Hearing community a clear direction for action and collaboration in the years ahead. The findings and recommendations can be freely reproduced and are intended to contribute to by: • • • • • • Enabling organizations and agencies to develop a strategic plan Supplementing grant proposals Fostering collaborations at the community and state level Compelling address of internal deficiencies Supporting research activities Creating fact sheets and other informational materials to aid in lobbying efforts Furthermore, state and local government agencies will find this report to be an invaluable tool as they perform strategic planning and services assessment. Community organizations and state agencies are strongly encouraged to seek ACDHH’s expertise and assistance when reviewing and evaluating their programs and services to better serve the state’s 450,000 Deaf and Hard of Hearing residents. 10 Populations Deaf Arizona has an estimated Deaf population of 42,000, with the number projected to exceed 60,000 in the year 2020, according to “Arizona Estimated Hard of Hearing/Deaf Population,” a year 2000 report published by the Arizona Department of Economic Security. The State of Arizona (Arizona Administrative Code, R9-26) defines persons who are Deaf as “those persons who cannot understand speech sounds with or without a hearing aid when in optimal listening conditions.” This definition aligns with the special definition used for the purpose of this report, which says persons who are Deaf are those who primarily rely on American Sign Language for communication. This is seen through their use of sign language interpreters for accommodation in public places, a sign language environment for the classroom when it comes to their educational choice, and interacting with near exclusivity with other sign language for community involvement. However, the state definition gives room to classify persons with hearing loss meeting this legal definition as Deaf even if they do not use any form of sign language, for example senior citizens with adult onset hearing loss. It is important to note that those persons and their unique needs are not addressed by the findings and recommendations in this report that reference persons who are Deaf. Causes of Deafness are numerous and occur throughout life. The most common causes are heredity and pre-natal complications, especially rubella for the baby boomer generation. A 2002 report from the Early Hearing Detection and Intervention Coalition which is sponsored by ACDHH states that annually more than 250 babies are born with hearing loss in Arizona. The demographics rise to one in 10 in adulthood due to a whole other host of causes, which include environmental trauma. The odds rise sharply among senior citizens, although, as already explained, this report excludes them in references to the Deaf population. Persons who are Deaf have a varying range of communication options apart from fingerspelling and sign language. They include gestures, lipreading, and oral communication utilizing residual hearing and amplification devices. Because English is not native to persons who are Deaf, their ease and command as demonstrated in writing and reading is below average, or at the same level demonstrated by most speakers of a foreign language. Currently the best known bodies of legislation that encompass the Deaf population are the Individuals with Disabilities Education Act, first enacted in 1986 as the Education of the Handicapped Act, and the Americans with Disabilities Act of 1990. These laws guarantee the least restrictive learning environment for children and equal accessibility and reasonable accommodations at public facilities and programs for everyone, which includes access to the 11 telephone through a state-subsidized relay service. These laws and other federal laws, such as Section 508 which deals with accessible information technology, are slowly being reshaped in the courts throughout the country and their impact on the Deaf Population will ultimately be determined. In this report, the key issue concerning the Deaf population is communication access. Hard of Hearing The Hard of Hearing population in Arizona is approximately 375,000 and is estimated to hit 550,000 in the year 2010, according to “Arizona Estimated Hard of Hearing/Deaf Population”, a year 2000 report published by the Arizona Department of Economic Security. The State of Arizona (Arizona Administrative Code, Title 9, Chapter 26) defines a Hard of Hearing person as “persons who have a degree of hearing loss greater than 40 dB, PTA-2 but less than 85 dB, PTA-2 in the better ear.” For this report’s purpose, persons who are Hard of Hearing but rely wholly on American Sign Language for oral communication are regarded as Deaf. Findings and recommendations that concern sign language users need to be read with this understanding. This report defines persons who are Hard of Hearing as persons with hearing loss whose primary oral communication option is speaking and possibly listens with the aid of devices and/or lipreading. The Better Hearing Institute states in a 1999 publication that 95% of hearing loss is correctable with the use of hearing aids. This illustrates an important difference between persons who are Hard of Hearing and persons who are Deaf; the main issue with the Hard of Hearing community deals with access to assistive technologies rather than communication access. A 2002 report from the Early Hearing Detection and Intervention Coalition which is sponsored by ACDHH states that annually more than 250 babies are born with hearing loss in Arizona, with a great majority of them Hard of Hearing. Thus, early identification and placement in early intervention services are viewed as key in serving youth who are Hard of Hearing. Arizona insurance providers cover hearing aids for children aged 0-18. Other popular assistive technology options include FM systems and the cochlear implant. The rapid pace of technological progress seen from both in the current generation has made them much more viable accommodation measures than ever before. Currently the best known bodies of legislation that encompass the Hard of Hearing population is the Americans with Disabilities Act of 1990, which prohibits discrimination and mandates equal accessibility and reasonable accommodations at public facilities and programs for everyone, which includes access to the telephone through a state-subsidized relay service. A large number of persons who are Hard of Hearing are senior citizens, including those who live in Arizona part of the year and utilize state services. Although there is an infrastructure for 12 serving them, its adequacy will be put to the test when the baby boomers come of senior citizen age. Deaf-Blind Of the 284 million people making up the U.S. population, an estimated 70,000 are Deaf-Blind according to the formula established by the American Deafness and Rehabilitation Association. Based on the 70,000 figure, one in 4,050 in the U.S. is Deaf-Blind. With Arizona’s current population count, a proportionate Arizona Deaf-Blind population is 1,300, though the number is conceivably higher owing to the greater incidence of Deaf-Blindness among the state’s large senior citizen population. The National Deaf-Blind Child Count, a survey performed by Western Oregon University, reported 118 Deaf-Blind children aged 0-21 in Arizona in 1999. The State of Arizona (Arizona Administrative Code, Title 9, Chapter 26) defines someone who is Deaf-Blind as “a person who is either deaf or hard of hearing and: a) has a central visual acuity of 20/200 or less in the better eye with corrective lenses, or b) a field defect where the peripheral diameter of visual field subtends an angular distance no greater than 20 degrees, or 3) a progressive visual loss having a prognosis leading to one or both of the conditions stated in a and b.” The State of Arizona in the same authority defines a Deaf person as “those persons who cannot understand speech sounds with or without a hearing aid when in optimal listening conditions” and a hard of hearing person as “persons who have a degree of hearing loss greater than 40 dB, PTA-2 but less than 85 dB, PTA-2 in the better ear.” It is important to note that for this report’s purpose, the definition formed by the members of the Deaf-Blind community is used rather than the state’s. So, Deaf is taken broadly; persons who are Deaf-Blind aren’t necessarily Deaf, they could be Hard of Hearing. Therefore, the combined range of sensory impairments included in the term Deaf-Blindness is great. Causes of Deaf-Blindness are numerous. The most common causes are at birth, either by heredity or by pre-natal complications. Examples listed by the National Information Clearinghouse on Children who are Deaf-Blind include syndromes (Down’s, Usher’s); multiple birth deficiencies such as CHARGE Association, Hydrocephaly, Microcephaly, or resulting from maternal alcohol or drug abuse during pregnancy; prematurity; and birth complications resulting from Rubella or sexually transmitted diseases such as AIDS, Herpes, and Syphilis. Communication methods are also marked with great diversity. Depending on the extent of vision and hearing, people who are Deaf-Blind may communicate using touch cues, gestures, tactile object or picture symbols, fingerspelling, sign language, Braille writing and reading, large-print writing and reading, lipreading, or through specific methods of speech reading and/or a combination of two or more methods listed above. Currently the best known bodies of legislation that encompass the Deaf-Blind population are the Individuals with Disabilities Education Act, first enacted in 1986 as the Education of the 13 Handicapped Act, and the Americans with Disabilites Act of 1990. These laws guarantee the least restrictive learning environment for children, and equal accessibility and reasonable accommodations at public facilities and programs for everyone. An individualized education plan is required for each school-age Deaf-Blind child, as well as transition services. In this report, the key areas of focus are information access, communication access, mobility, and community interaction. Parents Parents as defined here are persons with parenting roles not unlike any other. There is no special scope given by state law. However, it should be noted that parents referred to herein have distinctions beyond parenthood. This report presents some findings and recommendations that make specific references to parents who are Deaf or Hard of Hearing. To understand these particular findings and recommendations, please consult the appropriate pages in this section for definitions of persons who are Deaf and Hard of Hearing. This report also presents findings and recommendations that concern only parents with normal hearing levels, who are parents of children who are Deaf and Hard of Hearing. Depending on the particular context in the finding or the recommendation, these parents are implied to not be conversant in American Sign Language. The standard definition of a parent is that the child is between 0 and 18 years of age. When the finding concerns parents of school-age children, it is important to note that the state serves students up to the age of 22. When the finding concerns a parent who is also in a caretaker capacity, the parent could be anywhere from young adult age to of senior citizen age. Interpreters Interpreters as defined here are all-inclusive as pertains to communication access providers serving persons who are Deaf and Hard of Hearing, from professional interpreters to educational interpreters to non-certified practitioners. Interpreters here are not taken to mean foreign language speakers who have no professional interaction with persons who are Deaf and Hard of Hearing. This report refers to interpreters as intermediaries who perform translation and transliteration, either in American Sign Language, spoken English, or any other language that serves persons who are Deaf and Hard of Hearing. There are several distinctions amongst interpreters of the Deaf and the Hard of Hearing, two of which are clarified here: State-certified interpreters are defined in Arizona Revised Statutes §12-242 as “a person who has a valid license of competency authorized by the commission for the deaf and the hard of 14 hearing.” R9-26-501(5) of the Arizona Administrative Code defines the criteria used by ACDHH to issue certification and the current criteria require national certification from the Registry of Interpreters for the Deaf. Educational interpreters will see certification requirements in 2005 or the near future and are presently defined by proposed language as “a person trained to translate in sign language for students identified to require such services through an Individualized Education Program (IEP) or a 504 accommodation plan in order to access academic instruction.” Further into the definition there is an elaboration that states that this definition does not restrict the definition as given in R7-2-401(B)(13) of the Arizona Administrative Code , “a person trained to translate orally or in sign language in matters pertaining to special education identification, evaluation, placement, the provision of FAPE, or assurance of procedural safeguards for parents and students who converse in a language other than spoken English. Each student’s IEP team determines the level of interpreter skill necessary for the provision of FAPE [Free and Appropriate Education].” All other interpreters, excluding real-time captionists and telecommunication relay operators, are taken to mean those who simply facilitate communication between persons who are Deaf and Hard of Hearing and other persons. 15 Executive Summary The Arizona Commission for the Deaf and the Hard of Hearing undertook this task force study on its own beginning in 1998, without prompts from the state legislature or from the community which it serves. From the start, the study was a full embracement of ACDHH’s mission and vision statements, the first of which recognizes the value of a dialogue between ACDHH and the community and the second which rightly states the critical importance of communication access, support services, and community empowerment. It is the latter three that underlie all recommendations and show a remarkable interdependence; any two cannot exist without the third. In meeting with the many populations that comprise the Deaf and Hard of Hearing Community and the issues and service gaps they face, ACDHH has come up with 59 findings and 144 recommendations. From these, ACDHH concludes that: • The voices and needs within the Deaf and Hard of Hearing community are diverse. There is no singular identity for the community members to adopt and accordingly there should be no single generalization for the state to make when designing its services for the public. • Persons who are Deaf-Blind are severely underserved in the State of Arizona. If there are not service gaps, the services are likely nonexistent or inaccessible. The inaccessibility stems from both lack of accommodations and lack of awareness. • Communication access is practically a universal theme in all findings. Service delivery, education, employment, and empowerment find much of their shortcomings rooted in ineffective or restricted communication. The need for research and development of and the availability of assistive technologies is also a manifestation of restricted communication. • Information access needs to always be unfettered. When there is no blockage or dilution of information receipt, persons who are Deaf and Hard of Hearing can be expected to be as productive as any other citizens. Consequently, information dissemination through the media—including the Internet—needs to provide complete accessibility to the Deaf and Hard of Hearing public. • There is a statewide shortage of quality interpreters. Recommendations that referred to interpreters were equally divided in sentiment between quality and availability. Because interpreting services is a key accommodation in combating communication inaccessibility, the state needs to expand interpreter resources from all angles. It is important to note that the statewide shortage of quality interpreters identified here is also national in scope. 16 • This report needs to be viewed as a living document. The work here is not complete, and should not be viewed as a finite document. Findings cited here and their corresponding recommendations should be routinely reviewed as trends change and they are expected to be revised or inspire additional findings and recommendations. A followup report will be essential in providing ACDHH and the Deaf and Hard of Hearing community with clearly defined challenges and in clear direction of their goals. It is on the last note that the acknowledged weaknesses and omissions of this report concern the cochlear implant, consumer information, computer education and Internet access, legal issues and the justice system, and voter participation. Issues and trends emerge continuously and ACDHH will turn its attention to these areas in upcoming reviews. This report can only be as effective as the dedication of all involved, from state and community service providers and organizations to the members of the Deaf and Hard of Hearing community. The continuing support of the State of Arizona Legislature will be a critical factor to this report’s success. 17 A. Assistive Technology Finding #1: Hearing aids and other assistive listening devices for persons who are Hard of Hearing are costly. Recommendation #1.1: Lobby for legislation creation. Recommendation #1.2: Secure funding sources for community-based services to provide low-cost or loaner equipment. Recommendation #1.3: Advocate for coverage of hearing aids and other assistive listening devices by insurance carriers. Finding #2: Assistive technologies for persons who are Deaf-Blind are too costly for personal purchase. Recommendation #2.1: Secure funding to provide persons of all ages who are Deaf-Blind with scalable assistive technologies. Recommendation #2.2: Secure funding for training on and support for assistive technology available to persons who are Deaf-Blind. Finding #3: Persons who are Hard of Hearing are often unaware of or untrained on available telecommunication technologies. Recommendation #3.1: Expand the staff of the Arizona Telecommunication Equipment Distribution Program. Recommendation #3.2: Establish telecommunication equipment demonstration sites throughout the state. Finding #4: State resources on cochlear implants are limited. Recommendation #4.1: Create an information packet on the cochlear implant. Recommendation #4.2: Develop a referral directory of resources on the cochlear implant. Finding #5: State agencies and businesses are unaware of available accommodations. Recommendation #5.1: Promote awareness of Arizona Relay Service and Arizona Telecommunication Equipment Demonstration Program to state agencies and businesses. Recommendation #5.2: Promote awareness of available communication accommodations for public facilities through demonstrations, to include public TTY machines, hotel room kits, and open captioning at theatres. Recommendation #5.3: Develop a resource guide on available accommodations. 17 B. Communication Access Finding #6: Persons who are Deaf encounter numerous communication barriers. Recommendation #6.1: Increase the pool of certified interpreters in the state (See Finding #8). Recommendation #6.2: Make emergency communication and notifications available to persons who are Deaf and Hard of Hearing (see Finding #9). Recommendation #6.3: Ensure a least restrictive environment for students who are Deaf through the passage of a Students with Hearing Loss Bill of Rights. Recommendation #6.4: Advocate for early exposure to sign language for children who are Deaf. Recommendation #6.5: Promote the use of sign language at home by parents of children who are Deaf. Finding #7: Quality interpreting services are scarce. Recommendation #7.1: Increase the quality of current interpreters by including consumers in their continuing education and mentoring. Recommendation #7.2: Standardize curricula at interpreter training programs, to meet or exceed national standards. Recommendation #7.3: Establish minimum standards for American Sign Language instructors teaching interpreting students. Recommendation #7.4: Require mentoring and internships from interpreting students. Recommendation #7.5: Implement a four-year interpreter training program that confers bachelor degrees. Finding #8: Emergency measures and information are not always accessible to persons who are Deaf and Hard of Hearing. Recommendation #8.1: Establish a coalition consisting of emergency response personnel to periodically review readiness and communication procedures. Recommendation #8.2: Ensure roadside TTY access and at all other public facilities. Recommendation #8.3: Send out constant reminders of the FCC Rule of Order on emergency broadcasting to TV networks. Finding #9: Spanish-speaking persons who are Hard of Hearing have no access to public information on hearing loss resources. Recommendation #9.1: Coordinate an annual media campaign targeted at Spanish-speaking persons who are Hard of Hearing. Finding #10: Persons who are Deaf-Blind face severe communication barriers. Recommendation #10.1: Advocate for enhancements of current technologies such as two-way communication devices with Braille/digital text/large print/voice output capabilities, alerting devices, magnification devices, and tactile-based caller ID. Recommendation #10.2: Enforce minimum accessibility requirements to the Internet. 18 Finding #11: Ineffective communication frequently occurs in medical settings for persons who are Deaf-Blind. Recommendation #11.1: Provide all medical reports and information in large print or Braille. Recommendation #11.2: Provide sensitivity training to medical students and health care professionals on Deaf-Blindness. Recommendation #11.3: Have health care providers develop ear- and eye-related information materials for persons who are Deaf-Blind. Recommendation #11.4: Develop a checklist for hospitals and health service providers on working with persons who are Deaf-Blind. C. Community Interaction & Empowerment Finding #12: When performing internal quality assurance, state and community health agencies seldom solicit feedback from persons who are Deaf or Hard of Hearing. Recommendation #12.1: Undertake a joint in-depth review between ACDHH, the Department of Health Services, and the Behavioral Health Service bureaus which includes community members who are Deaf and Hard of Hearing. Finding #13: There are limited recreation options for youth who are Deaf and Hard of Hearing. Recommendation #13.1: Establish summer camps and programs at community centers in Arizona. Recommendation #13.2: Promote inter-scholastic activities among schools with programs serving students with hearing loss. Recommendation #13.3: Offer opportunities for leadership development through the establishment of a statewide youth organization. Recommendation #13.4: Implement an adult-youth mentorship program for persons who are Hard of Hearing. Finding #14: Youth who are Deaf have little or no understanding of the Deaf Community and American Sign Language. Recommendation #14.1: Incorporate Deaf Culture and Deaf History into their school’s curriculum. Finding #15: Youth who are Deaf often are unaware of how to use sign language interpreters after school graduation. Recommendation #15.1: Provide workshops on interpreter usage. Finding #16: Public facilities are not always visually or aurally accessible to persons who are Deaf-Blind. Recommendation #16.1: Work with legislators and community and aging organizations to provide low vision and audio options. 19 Recommendation #16.2: Enlarge signage and include Braille on all signage at public places. Recommendation #16.3: Investigate technologies that can convert visual information into audio or tactile formats and audio information into visual or tactile formats. Finding #17: Persons who are Deaf-Blind do not receive sufficient pertinent environmental, safety, consumer, travel, and public accommodation information. Recommendation #17.1: Increase the numbers of available Support Service Providers for tactile/aural reception of information on immediate surroundings and developments. D. Education & Training Finding #18: Many teachers of the Deaf are inadequately qualified. Recommendation #18.1: Require state licensure for teachers of the Deaf. Recommendation #18.2: Implement a performance assessment system for teachers of the Deaf. Recommendation #18.3: Evaluate for American Sign Language competency among teachers of the Deaf. Finding #19: There is a shortage of quality interpreting services K-12. Recommendation #19.1: Require state licensure for educational interpreters. Recommendation #19.2: Provide ongoing professional development opportunities to teachers & educational interpreters. Finding #20: School materials are not always accessible to students who are Deaf or Hard of Hearing. Recommendation #20.1: Ensure accessibility of technologies in the classroom. Recommendation #20.2: Ensure accessibility of learning materials, including the captioning of all audio information. Finding #21: Adult basic education programs do not provide adequate or appropriate interpreting services to adults who are Deaf. Recommendation #21.1: Advocate for minimum standards for interpreters. Recommendation #21.2: Encourage the utilization of Deaf intermediaries for the education of non-native American Sign Language users. Finding #22: Learning options for basic education are limited for adults who are Deaf. Recommendation #22.1: Expand opportunities to include the subject areas of computer literacy, English as a second language, GED, self-advocacy, and leadership. Finding #23: Students who are Hard of Hearing receive inadequate support services and hearing loss education at school. Recommendation #23.1: Increase accessibility to audiological evaluations. 20 Recommendation #23.2: Collaborate with school systems in providing FM systems. Recommendation #23.3: Coordinate a poster child & public awareness campaign at public schools. Finding #24: Parents of children with hearing loss are often unaware of assistive technology options appropriate for use at schools. Recommendation #24.1: Develop informational materials for parents on oral interpreting, FM systems, captioning, and CART. E. Public Awareness Finding #25: Public understanding of American Sign Language is low. Recommendation #25.1: Promote greater awareness of ASL as a bona fide language. Recommendation #25.2: Recognize ASL as a foreign language subject in schools. Finding #26: Public awareness of hearing loss issues is low in Arizona. Recommendation #26.1: Develop an online hearing aid resource site. Recommendation #26.2: Conduct statewide awareness campaigns during Better Hearing and Speech Month, Deaf Awareness Week, and International Deaf Awareness Day. Recommendation #26.3: Establish a toll-free hotline. Recommendation #26.4: Develop public service announcements for broadcast. Recommendation #26.5: Create a forum on hearing loss issues for audiologists, doctors, speech-language pathologists, and consumers with hearing loss. Finding #27: Public awareness of hearing loss issues is even lower among Native Americans and Spanish-speaking persons. Recommendation #27.1: Ensure translations of all informational materials. Recommendation #27.2: Coordinate outreach activities at reservations. Recommendation #27.3: Foster collaborations between agencies and organizations serving persons with hearing loss and serving persons who are Native American or Spanish-speaking. Finding #28: Late-deafened adults and winter residents are often unaware of available state resources. Recommendation #28.1: Develop video material for and provide awareness training to police, hospitals and medical service providers, and the American Medical Association. Finding #29: There is insufficient public understanding of hearing conservation. Recommendation #29.1: Create an information kit. Recommendation #29.2: Host a hearing conservation month. 21 Recommendation #29.3: Collaborate with Tinnitus organizations in implementing noise prevention measures at schools and residential facilities for the aging. Finding #30: Ignorance on Deaf-Blind issues is still widespread. Recommendation #30.1: Produce and broadcast public service announcements on Deaf-Blindness and low vision. Recommendation #30.2: Disseminate articles discussing Deaf-Blind issues. Recommendation #30.3: Promote Deaf-Blind Awareness Week, occurring yearly during the last week of June. Finding #31: Community resources and options are not always known to medical professionals who work with parents of children who are Deaf or Hard of Hearing. Recommendation #31.1: Develop an information packet on community resources for parents of children who are Deaf or Hard of Hearing and the medical professionals who work with them. Recommendation #31.2: Encourage and offer continuing education training to medical professionals who work with parents of children who are Deaf or Hard of Hearing. Finding #32: Family and caregivers of persons who are Deaf-Blind are often unaware of adult service options. Recommendation #32.1: Train family members and caregivers on a one-onebasis regarding issues and aspects of Deaf-Blindness. Recommendation #32.2: Educate parents, family members, caretakers, and teachers on the need for transition and development of appropriate individual transition program goals. F. Service Delivery Finding #33: Hearing screening of babies do not see statewide consistency. Recommendation #33.1: Pass legislation mandating minimum standards for statewide newborn hearing screening. Recommendation #33.2: Implement a statewide newborn hearing screening service to perform data tracking and ensure statewide compliance. Finding #34: Students who are Deaf or Hard of Hearing and with additional disabilities do not always receive early intervention services. Recommendation #34.1: Develop better diagnostic assessment tools to identify additional disabilities in students who are Deaf and Hard of Hearing. Finding #35: Access to quality mental health services is limited for persons who are Deaf and Hard of Hearing. Recommendation #35.1: Increase the pool of mental health professionals who know sign language. 22 Recommendation #35.2: Create training materials for professionals at regional behavioral health associations and curriculum materials for colleges offering degrees in counseling. Recommendation #35.3: Offer training opportunities to interpreters who work in mental health settings. Recommendation #35.4: Establish a speaker bureau of professionals— audiologists, speech-language pathologists, and educators—to educate counselors on hearing loss issues. Recommendation #35.5: Establish a state-funded position charged with oversight of state programs offering mental health services to persons who are Deaf. Finding #36: Senior citizens who are Deaf do not receive appropriate services at residential facilities for the aging. Recommendation #36.1: Establish a residential facility for senior citizens who are Deaf. Finding #37: Senior citizens who are Deaf face communication barriers to community services and public information. Recommendation #37.1: Establish a centralized community resource for senior citizens who are Deaf. Recommendation #37.2: Provide consumer training specially suited to senior citizens who are Deaf. Finding #38: Statewide services for persons who are Hard of Hearing are inconsistent throughout the state. Recommendation #38.1: Establish linkages between metropolitan and rural area hospitals. Recommendation #38.2: Create a unique category in the telephone directory listing hearing loss resources. Recommendation #38.3: Produce inserts listing hearing loss resources for inclusion in community information and referral directories. Finding #39: Persons with adult onset hearing loss living at facilities for the aging have no awareness of or access to information on hearing aids. Recommendation #39.1: Distribute hearing aid information packets to residential facilities for the aging. Recommendation #39.2: Train residential staff on hearing loss awareness and assistive technology. Recommendation #39.3: Have assistive technology demonstrations at residential facilities for the aging. Finding #40: Persons who are Deaf or Hard of Hearing and living in rural areas receive no local services. Recommendation #40.1: Establish a toll-free hotline. Recommendation #40.2: Create a statewide resource directory that is available on the Internet and for mail out. 23 Recommendation #40.3: Maintain a calendar of regional special and recurring events. Finding #41: Support services and programs available to Deaf-Blind persons are severely limited to nonexistent. Recommendation #41.1: Seek funding to hire and train Support Service Providers, especially in rural and urban areas. Recommendation #41.2: Lobby for funding for services to Deaf-Blind adults, providing for staffing and an infrastructure. Recommendation #41.3: Encourage community groups to write grants that specify their target population as Deaf-Blind, not Deaf or Blind. Recommendation #41.4: Lobby for funding for support services and educational opportunities for persons who are Deaf-Blind, caretakers, and families. Finding #42: Arizona has no permanent training program for Support Service Providers. Recommendation #42.1: Establish a centralized state resource to coordinate and train Support Service Providers. Recommendation #42.2: Develop an assessment tool to evaluate the competency of Support Service Providers. Finding #43: Persons who are Deaf-Blind are often unsure of the exact role of the Support Services Provider. Recommendation #43.1: Provide ongoing orientation to persons who are DeafBlind on the usage and roles of Support Service Providers. Finding #44: Parents have few options for professional care of infants and children with hearing loss. Recommendation #44.1: Implement programs at schools for tots who are deaf and Hard of Hearing. Recommendation #44.2: Offer learning opportunities to kindergarten and preschool personnel for basic sign language and awareness. Finding #45: Spanish-speaking parents of children who are Deaf and Hard of Hearing have no access to parental services. Recommendation #45.1: Create a database of Spanish-speaking parents of children who are Deaf and Hard of Hearing. Recommendation #45.2: Establish support groups of their own. Finding #46: There are few specialized resources for parents of Deaf children. Recommendation #46.1: Establish an information network for Deaf parents of hearing children. Recommendation #46.2: Provide mentorship to parents of children with hearing loss. Finding #47: American Sign Language instructors are not always qualified. 24 Recommendation #47.1: Establish minimum standards for American Sign Language instructors. Recommendation #47.2: Provide continuing education opportunities to American Sign Language instructors. G. Transition Planning & Employment Finding #48: Employment preparation performed at schools is inadequate. Recommendation #48.1: Require students who are Deaf to enroll in career education classes that provide basic transition training. Recommendation #48.2: Establish a career day at schools with programs that serve students with a hearing loss. Finding #49: Public ignorance of services provided by the Office of Vocational Rehabilitation is high. Recommendation #49.1: Promote awareness of the Office of Vocational Rehabilitation among rural & mainstreamed students and their parents. Recommendation #49.2: Provide in-service training to special education personnel on services provided by the Office of Vocational Rehabilitation. Recommendation #49.3: Establish satellite vocational rehabilitation offices on the campus of schools and programs serving students who are Deaf and Hard of Hearing. Finding #50: Persons with hearing loss face restrictive work environments. Recommendation #50.1: Increase awareness among human resource personnel of training on deafness and the Americans with Disabilities Act of 1990. Recommendation #50.2: Promote awareness of available workplace accommodations. Recommendation #50.3: Utilize Support Service Providers in the workplace instead of job coaches for persons who are Deaf-Blind. Finding #51: Persons with hearing loss have difficulty finding employment. Recommendation #51.2: Promote awareness of tax credit for hiring persons who are Deaf and Hard of Hearing. Recommendation #51.3: Educate employers on the relative low cost of workplace accommodations. Recommendation #51.4: Increase accessibility of internship programs for college students who are Deaf and Hard of Hearing. Recommendation #51.5: Expand the role of Arizona Job Services in providing services to persons who are Deaf-Blind. Finding #52: Barriers to effective communication often exist in the workplace. Recommendation #52.1: Provide in-service on sensitivity, assistive technology, and communication strategies. 25 Recommendation #52.2: Provide awareness training on assistive technology and communication strategies to employment seekers receiving services from the Office of Vocational Rehabilitation. Finding #53: Transition services often do not incorporate employment options for persons who are Deaf-Blind into their individualized transition plans. Recommendation #53.1: Require employment goals from students who are DeafBlind up to post-school work placement. Recommendation #53.2: Provide job coaching to students who are Deaf-Blind to help them attain their employment goals as outlined in their Individualized Transition Plan. 26 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 A-1. Assistive Technology Finding #1: Hearing aids and other assistive listening devices for persons who are Hard of Hearing are costly. Population Data: • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. • One out of three senior citizens has moderate to severe hearing loss. Context: • Hearing aids can correct hearing loss in approximately 95% of cases, according to a 1999 report from the Better Hearing Institute. • Digital models cost between $1,700 and $4,500. • Six out of seven hard of hearing persons do not use a hearing aid, according to an estimate by the National Council on Aging. • Only hearing aids are not covered by Arizona’s assistive technology lemon law. • Arizona Medicaid prohibits hearing aid coverage for adults. Recommendation #1.1: Lobby for legislation creation. Recommendation #1.2: Secure funding sources for community-based services to provide low-cost or loaner equipment. Recommendation #1.3: Advocate for coverage of hearing aids and other assistive listening devices by insurance carriers. Action Steps Taken or Planned: • ACDHH secured grant from the Arizona Community Foundation to study issues related to hearing aids. Coalition set up and consultant hired to draft a model for the state provision of hearing aids to adults living with hearing loss. • The Arizona Loans for Assistive Technology (AzLAT) program provides alternative financing options to persons with hearing loss for the purchase of hearing aids. 27 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 A-2. Assistive Technology Finding #2: Assistive technologies for persons who are Deaf-Blind are too costly for personal purchase. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • In 2002, a basic telephone handset costs approximately $10; a basic TTY $249; and a Braille-capable TTY $5,840. • Comparison shopping is rarely possible as assistive technology devices are not mass-produced. • IDEA requires school districts in Arizona to provide assistive technology devices and services to individuals who are Deaf-Blind in accordance with a written IEP. • The Assistive Technology Lemon Law was enacted only in 1998, after approximately 30 other states passed similar legislation. • When availability of assistive technology is not the issue, funding often is. Recommendation #2.1: Secure funding to provide persons of all ages who are DeafBlind with scalable assistive technologies. Recommendation #2.2: Secure funding for training on and support for assistive technology available to persons who are Deaf-Blind. Action Steps Taken or Planned: • Arizona Telecommunications Equipment Distribution Program (AzTEDP) provides most popular telecommunications devices specifically tailored for DeafBlind consumers. • ACDHH is preparing a presentation on lack of services, to the Department of Economic Security. • Arizona Technology Access Program (AzTAP) offers a loan program to people with disabilities for the purcase of assistive technology. 28 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 A-3. Assistive Technology. Finding #3: Persons who are Hard of Hearing are often unaware of or untrained on available telecommunication technologies. Population Data: • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. • One out of three senior citizens has moderate to severe hearing loss. Context: • Current telecommunication options are more extensive than those of 10 years ago. • Telecommunication technologies can create solutions to communication barriers that affect issues at home, in the workplace, and between relationships. • The Arizona Telecommunication Equipment Distribution Program is a statewide program that offers free devices to persons with hearing loss. • The Arizona Relay Service is an around-the-clock state-funded service that relay calls for persons who are Deaf, Hard of Hearing, Speech-Impaired, and Hearing. Recommendation #3.1: Expand the staff of the Arizona Telecommunication Equipment Distribution Program. Recommendation #3.2: Establish telecommunication equipment demonstration sites throughout the state. Action Steps Taken or Planned: • The Arizona Telecommunications Equipment Distribution Program (AzTEDP) added a staff member to assist with voucher applications and other process-related issues. • AzTEDP partnered with Northern Arizona University and contraced with several demonstrations states around the state for greater ease-of-access to consumers in rural areas. • Listing of AZTEDP demo sites can now be found online at www.acdhh.org. 29 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 A-4. Assistive Technology. Finding #4: State resources on cochlear implants are limited. Population Data: • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. Context: • The majority of information on the cochlear implant is from medical providers, not community service providers. • There are no activity groups for children with a cochlear implant. • Cochlear implants costs as much as $40,000 each. • Schools and community organizations do not have support services specially for persons with a cochlear implant. Recommendation #4.1: Create an information packet on the cochlear implant. Recommendation #4.2: Develop a referral directory of resources on the cochlear implant. Action Steps Taken or Planned: • The ACDHH Hard of Hearing Specialist created informational packets and a video about cochlear implants. Package was distributed to audiologists and other healthcare professionals around the state. Packet includes a referral directory of resources on cochlear implants as well. 30 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 A-5. Assistive Technology Finding #5: The public is still largely ignorant of existing accommodations. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. Context: • The Arizona Telecommunication Equipment Distribution Program, around since 1986, is a statewide program that offers free devices to persons with hearing loss. • The Arizona Relay Service was established in 1987 and offers an around-theclock state-funded service that relay calls for persons who are Deaf, Hard of Hearing, Speech-Impaired, and Hearing. • Training and informational materials are often not captioned. • Transportation hubs and businesses such as hotels are not always accessible as mandated by the Americans with Disabilities Act of 1990. Recommendation #5.1: Promote awareness of Arizona Relay Service and Arizona Telecommunication Equipment Distribution Program to state agencies and businesses. Recommendation #5.2: Promote awareness of available communication accommodations for public facilities through demonstrations, to include public TTY machines, hotel room kits, and open captioning at theatres. Recommendation #5.3: Develop a resource guide on available accommodations. Action Steps Taken or Planned: • ACDHH promotes the agency's services and programs through a number of booths and presentations statewide. • ACDHH contracts with Community Outreach Program for the Deaf (COPD) in Tucson for southern outreach services. Counties covered include Cochise, Bisbee, Douglas, Sierra Vista, Gila, Graham, Greenlee, Pima, Oro Valley, Santa Cruz and Yuma. • ACDHH compiles and distributes a "Communications Accessibility Directory" to hospitals, nursing homes, assisted living centers, and medical offices. • Information is also provided by ACDHH to police departments, among other public entities. 31 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-1. Community Interaction & Empowerment Finding #12: When performing internal quality assurance, state and community health agencies seldom solicit feedback from persons who are Deaf or Hard of Hearing. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • Services for persons who are Deaf and Hard of Hearing encompass programs dealing with education, domestic issues, mental illness, substance abuse, residential facilities, and employment. • Persons who are Deaf often require services that take in account language and cultural implications. • Many services and programs in Arizona that specially target persons who are Deaf or Hard of Hearing do not have advisory positions for them. Recommendation #12.1: Undertake a joint in-depth review between ACDHH, the Department of Health Services, and the Behavioral Health Service bureaus which includes community members who are Deaf and Hard of Hearing. Action Steps Taken or Planned: • The ACDHH Mental Health Roundtable recently paved the way for ACDHH to partner with the Arizona Department of Health Services (Behavioral Health Division) to put together a workgroup that will prepare an action plan related to mental health for people for hearing loss. • The ACDHH weekly television show, "Community View" aired shows on a number of health topics in 2004, including stories related to HIV, the new Medicare prescription plan, and elderly health. 39 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-2. Community Interaction & Empowerment Finding #13: There are limited recreation options for youth who are Deaf and Hard of Hearing. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • In some instances, schools have only one or two students who are Deaf. • There are no recreational summer camps for in Arizona. • No community organizations in Arizona offer programs exclusively to youth who are Deaf or Hard of Hearing. Recommendation #13.1: Establish summer camps and programs at community centers in Arizona. Recommendation #13.2: Promote inter-scholastic activities among schools with programs serving students with hearing loss. Recommendation #13.3: Offer opportunities for leadership development through the establishment of a statewide youth organization. Recommendation #13.4: Implement an adult-youth mentorship program for persons who are Hard of Hearing. Action Steps Taken or Planned: • ACDHH is seeking grant opportunities for summer camp and leadership development opportunities for Deaf and Hard of Hearing youth. 40 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-3. Community Interaction & Empowerment Finding #14: Youth who are Deaf have little or no understanding of the Deaf Community and American Sign Language. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. Context: • The Council on Education of the Deaf, a national professional organization that recommends best educational practices, endorses cultural awareness in curricula. • Persons who are Deaf often are unaware of historical events and figures that have influenced the development of the American and international Deaf Community. • Having historical role models can be significant in a youth’s character development. Recommendation #14.1: Incorporate Deaf Culture and Deaf History into schools’ curriculum. Action Steps Taken or Planned: • ACDHH and the Arizona Relay Service (AZRS) has partnered with the University of Arizona to bring the travelling exhibit "History Through Deaf Eyes" to Tucson. The six week exhibition, put together by Gallaudet University, will incorporate numerous historical artifacts from Deaf culture and provide a learning opportunity for Deaf youth. 41 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-4. Community Interaction & Empowerment Finding #15: Youth who are Deaf often are unaware of how to use sign language interpreters after school graduation. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. Context: • Students who attend public schools do not realize that the role of the educational interpreter differs from that of interpreters who work in other settings. • Students who are Deaf and attend one of the Arizona State Schools for the Deaf never encounter interpreters until after graduation. • Adults who are Deaf rely on interpreters for communication access when interviewing for employment, receiving medical and social services, and visiting police stations and courts. Recommendation #15.1: Provide workshops on interpreter usage. Action Steps Taken or Planned: • The ACDHH interpreter summit will provide numerous opportunities for Deaf youth to learn more about utilizing interpreters. 42 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-5. Community Interaction & Empowerment Finding #16: Public facilities are not always visually or aurally accessible to persons who are Deaf-Blind. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Voice announcements or posted notices are often not received by individuals who are Deaf-Blind. • The Americans with Disabilities Act of 1990 mandates comprehensive accessibility at all public facilities. • Support Services Providers facilitate communication and provide environmental cues for individuals who are Deaf-Blind but are in short supply. • People around individuals who are Deaf-Blind often do not know how to relay information tactually to the Deaf-Blind individual. Recommendation #16.1: Work with legislators and community and aging organizations to provide low vision and audio options. Recommendation #16.2: Enlarge signage and include Braille on all signage at public places. Recommendation #16.3: Investigate technologies that can convert visual information into audio or tactile formats and audio information into visual or tactile formats. Action Steps Taken or Planned: • The DeafBlind task force is working to address accessibility issues. 43 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 C-6. Community Interaction & Empowerment Finding #17: Persons who are Deaf-Blind do not receive sufficient pertinent environmental, safety, consumer, travel, and public accommodation information. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Emergency broadcasts are often not received by persons who are Deaf-Blind. • Simple announcements or alerts, such as a sign announcing that another door is to be used or the floor is wet, may not be received. • Support Services Providers (SSPs) facilitate communication and provide environmental cues for individuals who are Deaf-Blind but are in short supply. • People around the Deaf-Blind often do not know how to relay information tactually to the Deaf-Blind individual. Recommendation #17.1: Increase the numbers of available Support Service Providers for tactile/aural reception of information on immediate surroundings and developments. Action Steps Taken or Planned: • House Bill 2495 specifically addressed and provided funding for the training of Support Service Providers for the DeafBlind. ACDHH will work with colleges and universities to set up training programs. 44 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-1. Communication Access Finding #6: Persons who are Deaf encounter numerous communication barriers. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • Communication at home, schools, and medical offices are often compromised. • One in four houses in Arizona are Spanish-Speaking and a language divide is common between parents who speak Spanish and children who use sign language. • Research has shown benefits of an immersive sign language environment at home and at school for children who are Deaf. • The shortage of qualified interpreters in Arizona is also a nationwide problem. Recommendation #6.1: Increase the pool of certified interpreters in the state (See Finding #8). Recommendation #6.2: Make emergency communication and notifications available to persons who are Deaf and Hard of Hearing (see Finding #9). Recommendation #6.3: Ensure a least restrictive environment for students who are Deaf through the passage of a Students with Hearing Loss Bill of Rights. Recommendation #6.4: Advocate for early exposure to sign language for children who are Deaf. Recommendation #6.5: Promote the use of sign language at home by parents of children who are Deaf. Action Steps Taken or Planned: • House Bill 2495 was signed by the Governor in 2004, mandating that ACDHH partner with colleges and universities to ensure quality training programs for interpreters and support service providers for the DeafBlind. • ACDHH was the premier sponsor of the National Association of the Deaf (NAD) – Registry of Interpreters for the Deaf (RID) new national test for interpreters. The new written test was made available in June 2004, and the performance test will be coming in the summer of 2005. Due to ACDHH leadership on this new nationwide test, up to 500 Arizona interpreters will take the test at no charge. 33 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-2. Communication Access Finding #7: Quality interpreting services are scarce. Population Data: • As of 2003, less than 90 interpreters in Arizona have state certification, or approximately one certified interpreter for every 4,600. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. • One out of three senior citizens has moderate to severe hearing loss. Context: • The shortage of qualified interpreters in Arizona is also a nationwide problem. • Persons who are Deaf depend on interpreters for communication facilitation in the workplace, when receiving medical services, and when receiving social services. • Less than 20 interpreters in Arizona are qualified to work in legal settings such as courtrooms and police stations. • The current ratio of certified interpreters to consumers who are Deaf or Hard of Hearing in Arizona is approximately 1: 4,600. Recommendation #7.1: Increase the quality of current interpreters by including consumers in their continuing education and mentoring. Recommendation #7.2: Standardize curricula at interpreter training programs, to meet or exceed national standards. Recommendation #7.3: Establish minimum standards for American Sign Language instructors teaching interpreting students. Recommendation #7.4: Require mentoring and internships from interpreting students. Recommendation #7.5: Implement a four-year interpreter training program that confers bachelor degrees. Action Steps Taken or Planned: • In support of HB 2495, ACDHH prepared the "Arizona Interpreter Development Plan" which outlines training and development to increase the number and quality of interpreters. The draft is available for public review and feedback on www.acdhh.org. • ACDHH is planning a statewide "Interpreter Summit" in August 2004 to bring together professionals for training and the exchange of ideas and best practices. 34 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-3. Communication Access Finding #8: Emergency measures and information are not always accessible to persons who are Deaf and Hard of Hearing. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • Emergency broadcasts and live reports are often not captioned. • Persons who are Deaf and Hard of Hearing cannot receive notifications through the radio or public announcement systems and rely on alternative media and friends, co-workers, and neighbors. • An absence of information or misinformation creates dependence from persons who are Deaf and Hard of Hearing on emergency response personnel. Recommendation #8.1: Establish a coalition consisting of emergency response personnel to periodically review readiness and communication procedures. Recommendation #8.2: Ensure roadside TTY access and at all other public facilities. Recommendation #8.3: Send out constant reminders of the FCC Rule of Order on emergency broadcasting to TV networks. Action Steps Taken or Planned: • ACDHH is a member of the 9-1-1 advisory group that assists the statewide 9-1-1 administrator with ensuring that the needs of deaf and hard of hearing Arizonans is not compromised in emergency situations. • ACDHH made recommendations to the Department of Emergency Management on the type of emergency communication necessary for broadcasters to comply with. • ACDHH, through its partnership with the Statewide Independent Living Council (SILC), advises the state emergency planning committee on issues related to the deaf and hard of hearing. 35 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-4. Communication Access Finding #9: Spanish-speaking persons who are Hard of Hearing have no access to public information on hearing loss resources. Population Data: • The 2000 U.S. Census estimated one out of five Arizona households is Spanishspeaking. • Latinos make up a quarter of Arizona’s total population, or 1¼ million. • The incidence of hearing loss is the same among the Latino community as with Arizonans in general. Context: • Informational materials on hearing loss are often available only in English. • There is a language divide among Latinos who are Deaf and Hard of Hearing; Latinos who are Deaf use American Sign Language while Latinos who are Hard of Hearing speak in Spanish. • The Latino population is underrepresented in membership organizations organized by persons who are Deaf and Hard of Hearing. • There are no programs that are designed specifically for Spanish-language speaking persons who are Hard of Hearing. Recommendation #9.1: Coordinate an annual media campaign targeted at Spanishspeaking persons who are Hard of Hearing. Responsible Agents: • ACDHH coordinated and distributed Spanish-language Public Service Announcements (PSAs) to Hispanic broadcasters statewide. • ACDHH is preparing translation of its current public materials. 36 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-5. Communication Access Finding #10: Persons who are Deaf-Blind face severe communication barriers. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Those not born Deaf-Blind rely on technology to continue using their preferred communication avenues. • Those born Deaf-Blind or progress into Deaf-Blindness usually have difficulty finding adaptive technologies that allow them to stay current with developments. • Support Services Providers facilitate communication and provide environmental cues for individuals who are Deaf-Blind but are in short supply. • Sign language interpreters familiar with Deaf-Blindness terminology are few. Recommendation #10.1: Advocate for enhancements of current technologies such as two-way communication devices with Braille/digital text/large print/voice output capabilities, alerting devices, magnification devices, and tactile-based caller ID. Recommendation #10.2: Enforce minimum accessibility requirements to the Internet. Recommendation #10.3: Encourage social events to arrange for DeafBlind accessibility, including Support Service Providers and transporation. Action Steps Taken or Planned: • The DeafBlind task force meets on a regular basis to discuss issues related to DeafBlind consumers. • In 2004, ACDHH supported HB 2495, which provides training dollars for Support Service Providers for the DeafBlind. The draft "Arizona Interpreter Development Plan" includes recommendations for training Support Service Providers, and the plan can be found online at www.acdhh.org. 37 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 B-6. Communication Access Finding #11: Ineffective communication frequently occurs in medical settings for persons who are DeafBlind. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Individuals who are Deaf-Blind frequently seek medical consultation.* • A high rate of health care providers are unfamiliar with Deaf-Blindness. • Few interpreters are familiar with medical or Deaf-Blindness terminology. • Personnel at doctor’s offices and hospital are unfamiliar with interpreting services, from providing for an appointment to throughout a visit. Recommendation #11.1: Provide all medical reports and information in large print or Braille. Recommendation #11.2: Provide sensitivity training to medical students and health care professionals. Recommendation #11.3: Have health care providers develop ear- and eye-related information materials for persons who are Deaf-Blind. Recommendation #11.4: Develop a checklist for hospitals and health service providers on working with persons who are Deaf-Blind. Action Steps Taken or Planned: • ACDHH plans to contact University of Arizona among other healthcare schools to provide training to students and raise awareness of issues related to DeafBlind. • The ACDHH "Communications Accessibility Directory" is sent to hospitals and medical offices statewide. * Western Oregon University reported in their 1999 National Deaf-Blind Child Count Summary that in the preceding three years, 67 out of 82 Deaf-Blind Arizonans received ophthalmological assessment and 73 out of 84 received audiological assessment 38 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-1. Education & Training Finding #18: Many teachers of the Deaf are inadequately qualified. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • There is an assessment tool known as the Sign Communication Proficiency Interview but it is not administered to applicants for teaching positions. • Some teachers of the Deaf lack basic proficiency in expressing and receiving information in American Sign Language. • Effective teaching of students who are Deaf requires fluency in American Sign Language. • American Sign Language has received recognition as an official language by linguists. Recommendation #18.1: Require state licensure for teachers of the Deaf. Recommendation #18.2: Implement a performance assessment system for teachers of the Deaf. Recommendation #18.3: Evaluate for American Sign Language competency among teachers of the Deaf. Action Steps Taken or Planned: • ACDHH is researching the feasibility of obtaining and providing "Signed Communication Proficiency Interview" (SCPI) testing to other state agencies. This would allow state agencies to measure the signing aptitude and develop a baseline for employees who are assigned to communicate with deaf consumers but do not necessarily possess an interpreting certificate. 48 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-2. Education & Training Finding #19: There is a shortage of quality interpreting services K-12. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • Educational interpreters are the only category of the interpreting profession for which certification in Arizona is exempt. • The certification rate among educational interpreters working in Arizona is low. • An evaluation tool known as the Educational Interpreter Proficiency Assessment is available but the minimum passing score is waived if there are no qualified applicants. • Educational interpreters, either working for the Arizona State Schools for the Deaf and the Blind or not, are not paid competitively in comparison to interpreters who work in other settings. • The shortage of qualified interpreters in Arizona is also a nationwide problem. Recommendation #19.1: Require state licensure for educational interpreters. Recommendation #19.2: Provide ongoing professional development opportunities to teachers & educational interpreters. Action Steps Taken or Planned: • The Arizona Department of Education is responsible for educational interpreters. The Department of Education rulemaking (R7-2-620) was approved on May 21st, 2004, which establishes optional standards for educational interpreters. 49 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-3. Education & Training Finding #20: School materials are not always accessible to students who are Deaf or Hard of Hearing. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • The Individuals with Disabilities Education Act (IDEA) requires the consideration of assistive technology be part of each Deaf and Hard of Hearing student’s individualized education plan but does not ensure their accessibility. • Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 both prohibit discrimination in school on the basis of hearing loss, meaning accommodation is required. • Section 508 of the Rehabilitation Act of 1973 is an accessible information technology bill and deals only with the federal government but could serve as a baseline for Arizona. Recommendation #20.1: Ensure accessibility of technologies in the classroom. Recommendation #20.2: Ensure accessibility of learning materials, including the captioning of all audio information. Action Steps Taken or Planned: • ACDHH will be attending the 2004 Transition Conference hosted by the Department of Education to assess what is currently being done for students who are deaf or hard of hearing. 50 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-4. Education & Training Finding #21: Adult basic education programs do not provide adequate or appropriate interpreting services to adults who are Deaf. Population Data: • As of 2003, less than 90 interpreters in Arizona have state certification, or approximately one certified interpreter for every 4,600. • Arizona’s current Deaf and Hard of Hearing population is estimated at 415,000. • One out of three senior citizens has moderate to severe hearing loss. Context: • Adults and senior citizens who are Deaf often have no access to computer training and Internet usage, financial planning, and nutrition information. • Adults and senior citizens who are Deaf have no access to trainings and workshops that could keep them abreast of current trends. • Interpreters at adult basic education programs sometimes are non-certified. • The shortage of qualified interpreters in Arizona is also a nationwide problem. Recommendation #21.1: Advocate for minimum standards for interpreters. Recommendation #21.2: Encourage the utilization of Deaf intermediaries for the education of non-native American Sign Language users. Action Steps Taken or Planned: • ACDHH is mandated by 2007 to license all general interpreters in the State of Arizona. • House Bill 2495 allows ACDHH to partner with colleges and universities to better train interpreters. • The 2004 Interpreter Summit will allow for sharing of best practices among the professional interpreting community. 51 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-5. Education & Training Finding #22: Learning options for basic education are limited for adults who are Deaf. Population Data: • Arizona’s current Deaf and Hard of Hearing population is estimated at 415,000. • One out of three senior citizens has moderate to severe hearing loss. Context: • Interpreter availability is a vital component of adult basic education for persons who are Deaf. • Approximately two-thirds of the disabled do not participate in the labor force. • Only one in five of those with a disability who work, work full-time. Recommendation #22.1: Expand opportunities to include the subject areas of computer literacy, English as a second language, GED, self-advocacy, and leadership. Action Steps Taken or Planned: • Tucson-based Community Outreach Program for the Deaf (COPD) and Valley Center for the Deaf (VCD) currently provide some direct services for the deaf and hard of hearing. • The Office of Vocational Rehabilitation, through the Department of Economic Security, provides for training and other adult education opportunities. 52 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-6. Education & Training Finding #23: Students who are Hard of Hearing receive inadequate support services and hearing loss education at school. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. Context: • Some schools do not have loaner FM systems and assistive technologies. • Some schools do not have classrooms outfitted with surround-sound systems. • The Individuals with Disabilities Education Act requires that each student receive transition services starting at age 14. • Educational interpreters who provide oral interpreting often are not certified. • State curricula does not incorporate hearing conservation and schools often do not observe Better Hearing and Speech Week. Recommendation #23.1: Increase accessibility to audiological evaluations. Recommendation #23.2: Collaborate with school systems in providing FM systems. Recommendation #23.3: Coordinate a poster child & public awareness campaign at public schools. Action Steps Taken or Planned: • ACDHH worked with other organizations to provide free hearing screenings during "Better Hearing and Speech Month" in May 2004. • During "Better Hearing and Speech Month" educational posters on hearing loss conservation were sent to schools statewide. 53 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 D-7. Education & Training Finding #24: Parents of children with hearing loss are often unaware of assistive technology options appropriate for use at schools. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • Some schools and districts have loaner equipment available to students. • Not all persons with hearing loss require the same accommodations. • Maladaptive behavior and fatigue are symptomatic of hearing loss in students. • Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 both prohibit discrimination in school on the basis of hearing loss, meaning accommodation is required. Recommendation #24.1: Develop informational materials for parents on oral interpreting, FM systems, captioning, and real-time transcribing. Action Steps Taken or Planned: • Phoenix Day School for the Deaf, along with Arizona Schools for the Deaf and Blind, provide parents with some trainings on assistive technology. • The Arizona Telecommunications Equipment Distribution Program (AZTEDP) through ACDHH, provides some trainings at school districts statewide. 54 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-1. Public Awareness Finding #25: Public understanding of American Sign Language is low. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • American Sign Language has received recognition as an official language by linguists. • ASL is taught in select schools throughout the state as a foreign language. • Indigenous forms of sign language have received constitutional recognition in Denmark, Ecuador, England, Finland, Portugal, Thailand, Uganda, Uruguay, and Venezuela. Recommendation #25.1: Promote greater awareness of ASL as a bona fide language. Recommendation #25.2: Recognize ASL as a foreign language subject in schools. Action Steps Taken or Planned: • ACDHH has undertaken a media relations campaign to raise awareness of ASL as a vibrant language utilized by the Deaf community. • Deaf Awareness Week activities provide an opportunity to emphasize/recognize the existance and use of American Sign Language. • ACDHH has asked the Governor to proclaim November as "American Sign Language Celebration Month" to commemerate a travelling exhibition supported by ACDHH and Arizona Relay Service (AZRS) being held at the University of Arizona in November 2004. 55 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-2. Public Awareness Finding #26: Public awareness of hearing loss issues is low in Arizona. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. Context: • The Better Hearing and Speech Month occurs annually in May. • The National Deaf Awareness Week takes place the last week of every September. • The International Deaf Awareness Day falls on the fourth Sunday of September. Recommendation #26.1: Develop an online hearing aid resource site. Recommendation #26.2: Conduct statewide awareness campaigns during Better Hearing and Speech Month, Deaf Awareness Week, and International Deaf Awareness Day. Recommendation #26.3: Establish a toll-free hotline. Recommendation #26.4: Develop public service announcements for broadcast. Recommendation #26.5: Create a forum on hearing loss issues for audiologists, doctors, speech-language pathologists, and consumers with hearing loss. Action Steps Taken or Planned: • A comprehensive public awareness campaign was launched for Better Hearing and Speech month in May, and included educational posters distributed to schools statewide, along with free hearing screenings. • Public Service Announcements regarding Arizona Relay Service (AZRS) were prepared in English and Spanish and distributed to broadcasters. • ACDHH will research feasibility of hosting a quarterly panel of speakers, creating a speaker series to address current issues in the deaf and hard of hearing community. 56 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-3. Public Awareness Finding #27: Public awareness of hearing loss issues is even lower among Native Americans and Spanish-speaking persons. Population Data: • Latinos make up a quarter of Arizona’s total population, or 1¼ million. • Native Americans make up 5% of Arizona’s total population, or 250,000. • The incidence of hearing loss is the same among both Native Americans and the Latino community as with Arizonans in general. Context: • A majority of rural area residents are Native Americans and Spanish-speaking persons. • Announcements on activities during Better Hearing and Speech Month and Deaf Awareness Week usually are advertised in English. • There is a language divide among Latinos who are Deaf and Hard of Hearing; Latinos who are Deaf use American Sign Language while Latinos who are Hard of Hearing speak in Spanish. Recommendation #27.1: Ensure translations of all informational materials. Recommendation #27.2: Coordinate outreach activities at reservations. Recommendation #27.3: Foster collaborations between agencies and organizations serving persons with hearing loss and serving persons who are Native American or Spanish-speaking. Action Steps Taken or Planned: • ACDHH has translated past brochures and materials into Spanish and will continue to do so. • Arizona Relay Service has focused on the Hispanic community and hosted a number of booths at various Hispanic events statewide. 57 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-4. Public Awareness Finding #28: Late-deafened adults and winter residents are often unaware of available state resources. Population Data: • As of 2000, more than 650,000 Arizonans or 17% of the state residents were 60 years of age or above. • One out of three senior citizens has moderate to severe hearing loss. • Senior Citizens grew 38% in number from 1990 to 2000 but the greatest increase is expected to occur from 2010 to 2020 with the Baby Boomer generation. Context: • Persons who do not reside year-round in Arizona are still eligible for equipment from the Arizona Telecommunication Equipment Distribution Program. • Senior citizens often do not acknowledge their hearing loss; six of seven persons who could benefit from hearing aids do not wear them. • Public awareness of issues facing persons who are Hard of Hearing is low among service providers. Recommendation #28.1: Develop video material for and provide awareness training to police, hospitals and medical service providers, and the American Medical Association. Action Steps Taken or Planned: • ACDHH presents at a number of assisted living centers, nursing homes, activity centers and other locations geared towards late-deafened adults and seniors. • Arizona Relay Services hosts a booth on their services at numerous senior fairs. • ACDHH contributes a regular column on hearing loss for a senior magazine. 58 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-5. Public Awareness Finding #29: There is insufficient public understanding of hearing conservation. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • One out of three senior citizens has moderate to severe hearing loss. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. Context: • Trauma to the ears is among a leading cause of adult onset hearing loss. • The Baby Boomer generation is expected to bring an unprecedented increase to the Arizona Hard of Hearing population. • There is no period of observation set aside for hearing conservation. Recommendation #29.1: Create an information kit. Recommendation #29.2: Host a hearing conservation month. Recommendation #29.3: Collaborate with Tinnitus organizations in implementing noise prevention measures at schools and residential facilities for the aging. Action Steps Taken or Planned: • ACDHH has created a number of media materials and brochures on Tinnitus and distributed statewide. • For Better Hearing and Speech Month, a poster on hearing conservation was drafted and distributed to schools statewide. 59 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-6. Public Awareness Finding #30: Ignorance on Deaf-Blind issues is still widespread. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Helen Keller is frequently the extent of public awareness on Deaf-Blindness • ACDHH has no office dedicated to Deaf-Blindness. • Only in late 2001 was the World Federation of the Deaf-Blind formed, linking national organizations together. • Deaf-Blind individuals themselves may not know of community resources, assistive technologies, or alternative techniques. • There is virtually no mention of the Deaf-Blind in both publications of the Deaf and of the Blind. Recommendation #30.1: Produce and broadcast public service announcements on DeafBlindness and low vision. Recommendation #30.2: Disseminate articles discussing Deaf-Blind issues. Recommendation #30.3: Promote Deaf-Blind Awareness Week, occurring yearly during the last week of June. Action Steps Taken or Planned: • The DeafBlind task force meets regularly to discuss issues related to DeafBlind individuals. • The ACDHH show "Community View" hosted a guest to discuss assistive technologies available to the DeafBlind. 60 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-7. Public Awareness Finding #31: Community resources and options are not always known to medical professionals who work with parents of children who are Deaf or Hard of Hearing. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • Family and caregivers often are unaware of available community resources Recommendation #31.1: Develop an information packet on community resources for parents of children who are Deaf or Hard of Hearing and the medical professionals who work with them. Recommendation #31.2: Encourage and offer continuing education training to medical professionals who work with parents of children who are Deaf or Hard of Hearing. Action Steps Taken or Planned: • ACDHH has developed and distributed a "Communications Accessibility Directory" to hospitals and medical offices statewide that explains ADA law, provides an intepreter directory and contains other information specific to the medical setting. 61 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 E-8. Public Awareness Finding #32: Family and caregivers of persons who are Deaf-Blind are often unaware of adult service options. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Family and caregivers often are unaware of available community resources. • Family and caregivers may not realize that IDEA requires a transition plan for Deaf-Blind children beginning at age 14. • Role models for the Deaf-Blind are not plentiful. • Family and caregivers may be unaware of the Americans with Disabilities Act of 1990, which ensures reasonable accommodations in the workplace. • A range of assistive technologies for the workplace is available, but is not known or is not financially feasible to individuals, family members, and caregivers. • 66.7% of students with disabilities complete high school, compared to 82.4% without; for college, the comparison is 9.6% with disabilities to 22.9% without.* Recommendation #32.1: Train family members and caregivers on a one-one-basis regarding issues and aspects of Deaf-Blindness. Recommendation #32.2: Educate parents, family members, caretakers, and teachers on the need for transition and development of appropriate individual transition program goals. Action Steps Taken or Planned: • The DeafBlind task force meets on a regular basis to discuss issues pertaining to DeafBlind consumers. * LaPlante, M.P., Kennedy, J., Kaye, H.S. & Wegner, B.L. (1996, January). Disability and Employment. Disability Statistics Abstracts, No.11. Washington, D.C.: National Institute on Disability and Rehabilitation Research, U.S. Department of Education. (ERIC Document Reproduction Service No. ED 427 472). 62 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-1. Service Delivery Finding #33: Hearing screening of babies do not see statewide consistency. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • A reliable hearing screen costs as little as $35. • Unlike 38 other states, Arizona has no mandate for newborn hearing screening. • Children misdiagnosed with a developmental disability might actually only have moderate hearing loss. • ACDHH is mandated by ARS §36-1944(8) to “make recommendations to the legislature regarding statutory changes needed to implement a statewide newborn child hearing loss screening program.” Recommendation #33.1: Pass legislation mandating minimum standards for statewide newborn hearing screening. Recommendation #33.2: Implement a statewide newborn hearing screening service to perform data tracking and ensure statewide compliance. Action Steps Taken or Planned: • ACDHH is working with the Arizona Department of Health Services and other organizational partners to seek a legislative mandate for statewide newborn hearing screening, tracking and follow-up systems to be centralized under the auspices of ADHS. 64 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-2. Service Delivery Finding #34: Students who are Deaf or Hard of Hearing and with additional disabilities do not always receive early intervention services. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • The Arizona Early Intervention Program—made up of five state agencies and guided by the statute in the Individuals with Disabilities Education Act, Part C, CFR 303—serves only kids aged 0-3. • Children misdiagnosed as having a developmental disability might actually only have moderate hearing loss. • Parents, caretakers, educators, and diagnosticians often do not know sign language, making it difficult to detect age-appropriate communication. Recommendation #34.1: Develop better diagnostic assessment tools to identify additional disabilities in students who are Deaf and Hard of Hearing. Action Steps Taken or Planned: • ACDHH is a member of the Arizona Early Hearing Detection and Intervention (EHDI) workgroup, and serves as a consultant to the members of this group, on a number of hearing loss-related issues. 65 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-3. Service Delivery Finding #35: Access to quality mental health services is limited for persons who are Deaf and Hard of Hearing. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. Context: • Arizona is bound by federal laws—including the Americans with Disabilities Act of 1990, the Rehabilitation Act of 1973, and the Civil Rights Act of 1964—to compel accessibility of its mental health systems. • Two-way communication between mental health professionals and clients who are deaf is usually dependent on an interpreter. • Group and residential therapies present communication barriers for individuals who are Deaf. • The Better Hearing Institute reported in 1999 that as many as 15 million individuals refuse help because of stigmatization and embarrassment. Recommendation #35.1: Identify mental health professionals who know sign language. Recommendation #35.2: Create training materials for professionals at regional behavioral health associations and curriculum materials for colleges offering degrees in counseling. Recommendation #35.3: Offer training opportunities to interpreters who work in mental health settings. Recommendation #35.4: Establish a speaker bureau of professionals—audiologists, speech-language pathologists, and educators—to educate counselors on hearing loss issues. Recommendation #35.5: Establish a state-funded position charged with oversight of state programs offering mental health services to persons who are Deaf. Action Steps Taken or Planned: • Based on the findings of the Mental Health Roundtable, ACDHH has created a workgroup with Arizona Department of Health Services to review and prepare materials related to the mental health issues of deaf and hard of hearing Arizonans. 66 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-4. Service Delivery. Finding #36: Senior citizens who are Deaf do not receive appropriate services at residential facilities for the aging. Population Data: • As of 2000, more than 650,000 Arizonans or 17% of the state residents were 60 years of age or above. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • There is no housing facility in Arizona for senior citizens who are Deaf and communicates primarily in sign language. • No senior citizen housing facility in Arizona has a full staff fluent in sign language. • Senior citizens who uses sign language and live at retirement homes are unable to communicate with other residents, placing them at greater risk for depression. Recommendation #36.1: Establish a residential facility for senior citizens who are Deaf. Action Steps Taken or Planned: • ACDHH has created a Deaf and Hard of Hearing Seniors Task Force. • ACDHH is a member of the Governor's "Healthy Aging 2010" initiative and workgroup, and advises the group on issues related to hearing loss. • ACDHH has attended several meetings with the Deaf Senior Citizens group to discuss the possibility of a home for Deaf seniors. 67 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-5. Service Delivery. Finding #37: Senior citizens who are Deaf face communication barriers to community services and public information. Population Data: • As of 2000, more than 650,000 Arizonans or 17% of the state residents were 60 years of age or above. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • The Deaf population of Arizona is projected to exceed 50,000 in 2010 and 61,000 in 2020. Context: • Senior citizens often rely on public services such as transportation, Medicaid, and social security. • Senior citizens who are Deaf often have no access to computer training and Internet usage, financial planning, and nutrition information. • Adults and senior citizens who are Deaf have no access to trainings and workshops that could keep them abreast of current trends. • There is a statewide shortage of qualified sign language interpreters. Recommendation #37.1: Establish a centralized community resource for senior citizens who are Deaf. Recommendation #37.2: Provide consumer training specially suited to senior citizens who are Deaf. Action Steps Taken or Planned: • ACDHH and Arizona Relay Service (AZRS) supports numerous events organized by the Phoenix Association for the Deaf (PAD). • The ACDHH Deaf and Hard of Hearing Seniors Task Force will address issues of concern to seniors. 68 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-6. Service Delivery Finding #38: Statewide services for persons who are Hard of Hearing are inconsistent throughout the state. Population Data: • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • The Hard of Hearing population of Arizona is projected to exceed 550,000 in 2010. Context: • Rural area residents are generally underserved and with reduced state resources. • The majority of community programs and support services available to persons who are Hard of Hearing are located in Phoenix and Tucson. • The cost of contracting with oral interpreters and captionists are prohibitive in rural areas because of travel surcharges. Recommendation #38.1: Establish linkages between metropolitan and rural area hospitals. Recommendation #38.2: Create a unique category in the telephone directory listing hearing loss resources. Recommendation #38.3: Produce inserts listing hearing loss resources for inclusion in community information and referral directories. Action Steps Taken or Planned: • ACDHH is creating a "Rural Resource Directory" that will provide information on rural services available to the deaf and hard of hearing. The directory will provide information on education, health services, community services, housing assistance grants and other public programs. 69 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-7. Service Delivery Finding #39: Persons with adult onset hearing loss living at facilities for the aging have no awareness of or access to information on hearing aids. Population Data: • As of 2000, more than 650,000 Arizonans or 17% of the state residents were 60 years of age or above. • One out of three senior citizens has moderate to severe hearing loss. • Senior Citizens grew 38% in number from 1990 to 2000 but the greatest increase is expected to occur from 2010 to 2020 with the Baby Boomer generation. Context: • Hearing loss ranks third among serious health issues facing the elderly, behind arthritis and hypertension. • The two leading reasons for rejection of hearing aids are price and denial. • Attempted correction of maladaptive behavior stemming from hearing loss anxiety is usually done with medication, not hearing aids. • Research states that hearing loss contributes to elderly individuals’ feelings of loneliness and isolation, and in severe cases, depression and paranoia. Recommendation #39.1: Distribute hearing aid information packets to residential facilities for the aging. Recommendation #39.2: Train residential staff on hearing loss awareness and assistive technology. Recommendation #39.3: Have assistive technology demonstrations at residential facilities for the aging. Action Steps Taken or Planned: • ACDHH provides numerous in-service trainings regarding hearing loss issues at residential facilities for the aging. • The Arizona Telecommunciations Equipment Distribution Program (AzTEPD) hosts numerous demonstrations to residential staff on telecommunications equipment available through the state. 70 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-8. Service Delivery Finding #40: Persons who are Deaf or Hard of Hearing and living in rural areas receive no local services. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. Context: • Rural area residents are generally underserved and with reduced state resources. • The majority of community programs and support services available to persons who are Deaf and Hard of Hearing are located in Phoenix and Tucson. • The cost of contracting with interpreters and captionists are prohibitive in rural areas because of travel surcharges. Recommendation #40.1: Establish a toll-free hotline. Recommendation #40.2: Create a statewide resource directory that is available on the Internet and for mail out. Recommendation #40.3: Maintain a calendar of regional special and recurring events. Action Steps Taken or Planned: • ACDHH is creating a "Rural Resource Directory" that will provide information on rural services available to the deaf and hard of hearing. The directory will provide information on education, health services, community services, housing assistance grants and other public programs. 71 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-9. Service Delivery Finding #41: Support services and programs available to Deaf-Blind persons are severely limited to nonexistent. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • Funding dedicated to individuals who are Deaf-Blind is scarce. • Federal Law 371.11 mandates program funding for Deaf-Blind children but is little-known. • Services available are usually tailored for either the Deaf or the Blind, not both • State funding is available in intervention and technical assistance for school-age Deaf-Blind children, but not older. • The Arizona School for the Deaf and the Blind is not appropriated to create programs that focus exclusively on Deaf-Blind students. • Only in late 2001 was the World Federation of the Deaf-Blind formed, linking national organizations together. Recommendation #41.1: Seek funding to hire and train Support Service Providers, especially in rural and urban areas. Recommendation #41.2: Lobby for funding for services to Deaf-Blind adults, providing for staffing and an infrastructure. Recommendation #41.3: Encourage community groups to write grants that specify their target population as Deaf-Blind, not Deaf or Blind. Recommendation #41.4: Lobby for funding for support services and educational opportunities for persons who are Deaf-Blind, caretakers, and families. Action Steps Taken or Planned: • The DeafBlind task force discusses barriers that exist, preventing equal access for the DeafBlind, and the task force will make recommendations to appropriate agencies and organizations for improvement on accessibility-related issues. 72 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-10. Service Delivery Finding #42: Arizona has no permanent training program for Support Service Providers. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • A national curriculum for interpreters and support services providers has recently been developed by Northwestern Connecticut Community College and the U.S. Department of Education. • As of 2002, there is a short-term, grant-funded program for SSPs in Tucson. • There are no minimum qualifications for SSPs. • SSP services provided vary from person to person. • The SSP is ultimately responsible for assisting individuals who are Deaf-Blind with communication, interaction, and mobility. • State funding is available in intervention and technical assistance for school-age children, but not older. Recommendation #42.1: Establish a centralized state resource to coordinate and train Support Service Providers. Recommendation #42.2: Develop an assessment tool to evaluate the competency of Support Service Providers. Action Steps Taken or Planned: • House Bill 2495 specifically addressed and provided funding for the training of Support Service Providers for the DeafBlind. ACDHH will work with colleges and universities to set up training programs. 73 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-11. Service Delivery Finding #43: Persons who are Deaf-Blind are often unsure of the exact role of the Support Services Provider. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • SSP services vary from person to person. • There is no established certificate program for SSPs in Arizona. • A national curriculum for interpreters and support services providers has only recently been developed by Northwestern Connecticut Community College and the U.S. Department of Education. • As sight or hearing deteriorates, the Deaf-Blind individual may not realize that the SSP can adapt job performance to provide compensatory support services. Recommendation #43.1: Provide ongoing orientation to persons who are Deaf-Blind on the usage and roles of Support Service Providers. Action Steps Taken or Planned: • House Bill 2495 specifically addressed and provided funding for the training of Support Service Providers (SSPs) for the DeafBlind. ACDHH will work with colleges and universities to set up training programs. In coordination with these training programs, DeafBlind individuals will be provided an opportunity to assist with the real-time training of SSPs. 74 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-12. Service Delivery Finding #44: Parents have few options for professional care of infants and children with hearing loss. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • Kindergarten and pre-school programs are not always inclusive. • Language acquisition is optimal during the formative years of age 0-3. • Research has shown benefits of sign language communication with tots. Recommendation #44.1: Implement programs at schools for tots who are deaf and Hard of Hearing. Recommendation #44.2: Offer learning opportunities to kindergarten and preschool personnel for basic sign language and awareness. Action Steps Taken or Planned: • ACDHH is a member of the Arizona Early Hearing, Detection and Intervention (EHDI) workgroup and serves as a consultant to the agencies and groups represented on this task force. 75 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-13. Service Delivery Finding #45: Spanish-speaking parents of children who are Deaf and Hard of Hearing have no access to parental services. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • The 2000 U.S. Census estimated one out of five Arizona households is Spanishspeaking. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • One in four houses in Arizona are Spanish-Speaking and a language divide is common between parents who speak Spanish and children who use sign language. • The Arizona Early Intervention Program is an one-size-fits-all program. • There are no programs that are designed specifically for Spanish-language speaking parents of children who are Deaf and Hard of Hearing. Recommendation #45.1: Create a database of Spanish-speaking parents of children who are Deaf and Hard of Hearing. Recommendation #45.2: Establish support groups of their own. Action Steps Taken or Planned: 76 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-14. Service Delivery Finding #46: There are few specialized resources for parents of Deaf children. Population Data: • In Arizona, approximately 250 babies are identified with hearing loss annually. • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. Context: • Most programs available to parents of children who are Deaf or Hard of Hearing brings them together with parents of children with other disabilities. • The Arizona Early Intervention Program—made up of five state agencies and guided by the statute in the Individuals with Disabilities Education Act, Part C, CFR 303—serves only kids aged 0-3. • The Parent Information Network, under the state Department of Education, in 2003 finally established a program for Hearing parents of children who are Deaf. Recommendation #46.1: Establish an information network for Deaf parents of hearing children. Recommendation #46.2: Provide mentorship to parents of children with hearing loss. Action Steps Taken or Planned: • Phoenix Day School for the Deaf (PDSD) also houses the "Center for Hearing Impaired Children" which provides independent resources and information to parents of children with hearing loss. 77 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 F-15. Service Delivery Finding #47: American Sign Language instructors are not always qualified. Population Data: • As of 2003, less than 90 interpreters in Arizona have state certification, or approximately one certified interpreter for every 4,600; All interpreter students take sign language courses. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000; Some try to learn sign language. • In Arizona, approximately 250 babies are identified with hearing loss annually; Many parents enroll in sign language classes. Context: • Language has been proposed for rulemaking on ASL instructor certification, expected to see implementation in 2005. • American Sign Language instruction is an essential component of interpreter training programs. • Arizona has a state member chapter of the ASL Teachers Association, a national professional organization. • Currently, ASL instructors in Kindergarten through grade 12 classrooms are required to meet state certification requirements, while minimum requirements for college ASL instructors vary. Recommendation #47.1: Establish minimum standards for American Sign Language instructors. Recommendation #47.2: Provide continuing education opportunities to American Sign Language instructors. Action Steps Taken or Planned: • The 2007 mandate for licensure includes ASL instructors, which will be licensed and certified by ACDHH. 78 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-1. Transition Planning & Employment Finding #48: Employment preparation performed at schools is inadequate. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona’s Deaf and Hard of Hearing population is projected at 600,000 in 2010. Context: • The Individuals with Disabilities Education Act requires that each student receive transition services starting at age 14. • The Arizona State Schools for the Deaf and the Blind serves students aged 0-22 and currently has over 2,000 students enrolled. • Arizonans of adult age qualify for services from the Office of Vocational Rehabilitation under the Department of Economic Security, but not if they are still enrolled in school. • Youth who are deaf may not receive meaningful paraprofessional job opportunities, leaving them with fewer desirable skills and little or no experience. • Approximately two-thirds of the disabled do not participate in the labor force. • Only one in five of those with a disability who work, work full-time. Recommendation #48.1: Require students who are Deaf to enroll in career education classes that provide basic transition training. Recommendation #48.2: Establish a career day at schools with programs that serve students with a hearing loss. Action Steps Taken or Planned: • The Office of Vocational Rehabilitation, through the Department of Economic Security, provides transition planning support services in conjunction with Arizona Schools for the Deaf and Blind. 80 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-2. Transition Planning & Employment Finding #49: Public ignorance of services provided by the Office of Vocational Rehabilitation is high. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • Services other than placement provided by the Office of Vocational Rehabilitation include employment preparation, financial aid for education, and voter assistance. • The Office of Vocational Rehabilitation is under the Department of Economic Security and coordinates its services with all other sister agencies, which include children services, family services, Medicaid, and health services. • Families and caretakers of persons who are Deaf and Hard of Hearing are often unaware of available resources. Recommendation #49.1: Promote awareness of the Office of Vocational Rehabilitation among rural & mainstreamed students and their parents. Recommendation #49.2: Provide in-service training to special education personnel on services provided by the Office of Vocational Rehabilitation. Recommendation #49.3: Establish satellite vocational rehabilitation offices on the campus of schools and programs serving students who are Deaf and Hard of Hearing. Action Steps Taken or Planned: • ACDHH is working with the Department of Economic Security (DES), division of Rehabilitation Services Administration, to possibly implement an agreement on various services that will impact Deaf, Hard of Hearing, and DeafBlind Arizonans. 81 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-3. Transition Planning & Employment Finding #50: Persons with hearing loss face restrictive work environments. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • Employers are often unaware of incentives for hiring individuals who are deaf. • Youth who are deaf may not receive meaningful paraprofessional job opportunities, leaving them with fewer desirable skills and little or no experience. • Employers might be incapable of assessing the skills of Deaf candidates. • Employers’ attitudes toward individuals who are Deaf may be a barrier. • Approximately two-thirds of the disabled do not participate in the labor force. • Only one in five of those with a disability who work, work full-time. Recommendation #50.1: Increase awareness among human resource personnel of training on deafness and the Americans with Disabilities Act of 1990. Recommendation #50.2: Promote awareness of available workplace accommodations. Recommendation #50.3: Utilize Support Service Providers in the workplace instead of job coaches for persons who are Deaf-Blind. Action Steps Taken or Planned: • The Arizona Relay Service (AZRS) is coordinating a Business Relay Partner kit which will be utilized to train employers and their employees about using the 7-11 Relay number. • ACDHH coordinates a number of in-service trainings for companies statewide. 82 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-4. Transition Planning & Employment Finding #51: Persons with hearing loss have difficulty finding employment. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • Job developers no know how to work with them. • Persons with hearing loss may not receive meaningful paraprofessional job opportunities, leaving them with fewer desirable skills and little or no experience. • The Americans with Disabilities Act of 1990 mandates reasonable accommodations in the workplace and accessibility at all public facilities. • Approximately two-thirds of the disabled do not participate in the labor force. • Only one in five of those with a disability who work, work full-time. Recommendation #51.2: Promote awareness of tax credit for hiring persons who are Deaf and Hard of Hearing. Recommendation #51.3: Educate employers on the relative low cost of workplace accommodations. Recommendation #51.4: Increase accessibility of internship programs for college students who are Deaf and Hard of Hearing. Recommendation #51.5: Expand the role of Arizona Job Services in providing services to persons who are Deaf-Blind. Action Steps Taken or Planned: • ACDHH is working with the Department of Economic Security (DES), division of Rehabilitation Services Administration, to possibly implement an agreement on various services that will impact Deaf, Hard of Hearing, and DeafBlind Arizonans. 83 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-5. Transition Planning & Employment Finding #52: Barriers to effective communication often exist in the workplace. Population Data: • An estimated 0.9% of Arizona’s population is Deaf, or 42,000. • An estimated 8.4% of Arizonans are Hard of Hearing, or 375,000. • Arizona has approximately 1,300 Deaf-Blind residents. Context: • The majority of accommodations are low-cost. • The Arizona Commission for the Deaf and the Hard of Hearing and several community organizations offer training on communication strategies. • The Americans with Disabilities Act of 1990 prohibits discrimination in the workplace. Recommendation #52.1: Provide in-service on sensitivity, assistive technology, and communication strategies. Recommendation #52.2: Provide awareness training on assistive technology and communication strategies to employment seekers receiving services from the Office of Vocational Rehabilitation. Action Steps Taken or Planned: • The Deaf Specialist and Hard of Hearing Specialist continue to represent employees with hearing loss in the workplace and provide a number of trainings to employers annually. 84 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007 Arizona Commission for the Deaf and the Hard of Hearing Quality Assurance Task Force Report 2004 G-6. Transition Planning & Employment Finding #53: Individualized Transition Plans for persons who are Deaf-Blind do not always include employment goals. Population Data: • An estimated 70,000 Americans are Deaf-Blind. • Arizona has approximately 1,300 Deaf-Blind residents. • A 1999 study reported 118 Deaf-Blind children in Arizona. Context: • The Individuals with Disabilities Education Act requires a transition plan for Deaf-Blind children by the time they are 14. • Job coaches who function as support services providers is provided for up to 9 months by the Department of Vocational Rehabilitation; as soon as the DeafBlind individual is employed, this service stops even though there still may be an occasional or ongoing need. • Approximately two-thirds of the disabled do not participate in the labor force. • Only one in five of those with a disability who work, work full-time. • Deaf-Blind persons may not receive meaningful paraprofessional job opportunities, leaving them with fewer desirable skills and little or no experience. Recommendation #53.1: Require employment goals from students who are Deaf-Blind up to post-school work placement. Recommendation #53.2: Provide job coaching to students who are Deaf-Blind to help them attain their employment goals as outlined in their Individualized Transition Plan. Action Steps Taken or Planned: • ACDHH is working with the Department of Economic Security (DES), division of Rehabilitation Services Administration, to possibly implement an agreement on various services that will impact Deaf, Hard of Hearing, and DeafBlind Arizonans. 85 Arizona Commission for the Deaf and the Hard of Hearing 1400 West Washington #126 Phoenix, AZ 85007