interpreter responses 1 of 2
nathan keepers
Description
Collection
Title:
interpreter responses 1 of 2
Creator:
nathan keepers
Date:
1/23/2004
Text:
Here is a sampling of the many responses I received following my original
post (most are only part of the responses). The first response was actually
made to the list by NAAOP, but reprinted here. It appears to be the most
authoratative answer I received. I did not get a chance to check into it on
my own, but will take that response as good advice.
The patient will be returning in a few months for new shoes and/or follow
up. Between now and then, my plan is to write a letter to the patient
herself stating something to the effect of: Do you personally feel that an
interpreter is necessary for your appointments? I had been under the
impression that we had communicated effectively using a pen and paper. When
your daughter was here previously, she indicated to me that you need a paid
interpreter since it was too difficult for her to listen to the conversation
and to interpret at the same time. Additionally, we will need your
permission in writing for your daughter to be included in conversations
regarding your private personal health information. If you feel it is
necessary to have an interpreter, it would be appreciated if you know
someone who would be willing to do this for us. It is my understanding that
this service can be fairly costly. Please respond in writing, a stamped
return envelope is provided.
This will hopefully get the response that writing is O.K. or she has someone
that could do it for us, if not, my next most preferred response would be
that it gets to the daughter and she gets disgruntled to the point she won't
be back with her mother and they find a new provider. If the patient
returns a letter indicating she needs a paid interpreter, and she signs it,
I will do this. The daughter already indicated they quit one podiatrist that
refused to provide an interpreter as they had been burned many times before
with other patients that never showed when the interpreter had, and they
still had to pay the interpreter.
This may sound callous, but it baffles me that I am financially responsible
for someone else's hearing impairment. Normally I choose the charities I
send my money to. It would seem like this is a donation to a charity cause
that I am required to make, regardless of my opinion on the recipient. My
issue here is not about the money, it's the principle of it being forced on
me (and I really didn't like the daughter's attitude)
Nathan Keepers, CPO
I previously wrote:
I saw a patient today who is deaf. Her daughter indicates that it is my
responsibility to line up an interpreter for her and that I am financially
responsible for the service as well. I indicated that I was not sure if I
could bill insurance for that service or not. She indicated that If I
could
not be reimbursed for it by insurance that I would have to eat it. On
diabetic shoes and inserts, this service would likely be greater than the
profit margin. She brought up that according to ADA, she is supposed to be
provided an interpreter. Is this true? I have no problem arranging the
service for her, but fail to see how it is my responsibility to pay for a
service she requires.
(As a sidebar, I have seen the patient in the past and had no problem
communicating with her back and forth in writing, additionally, the
daughter
can translate, but it is too difficult for her to listen while she
translates, (seemed to go fine today, with no money out of anyone's
pocket))
Any help would be appreciated,
I have received numerous responses and am still getting them. I will print
responses after a few days as there is a lot of interest. Won't print names.
First I will try and follow a few leads on legal advice, and may consult
with an attorney. As some have said, I don't want to set a precedent or I'm
stuck providing this service at a loss. One additional note of interest in
this case. The daughter's profession is interpreting for the hearing
impaired. Makes me think she's looking to pad a co-workers pocket at my
expense.
Nathan Keepers, CPO
replies
In a response to the message sent on the listserve regarding an O&P
facility's obligations to provide interpreters to deaf or hard of hearing
patients, the following describes an O&P facility's rights and
responsibilities under the Americans with Disabilities Act of 1990 (ADA).
O&P facilities are considered public accommodations under Title III of the
ADA, regardless of the size of the business or number of employees. As a
public accommodation, an O&P facility has a responsibility to provide
effective communication through its policies and procedures with the
public, including patients. Effective communication does not require the
provision of an interpreter for every patient who requests it or who is deaf
or hard of hearing. In many instances, note taking and the use of other
auxiliary aids and services to achieve effective communication are perfectly
acceptable. However the complexity of the communication is largely what
determines what form of communication would be considered effective. For
a routine patient encounter, an interpreter is not required absent
extenuating circumstances. However, if the patient encounter involves a
more complex set of communications and consideration of more complicated
issues, an interpreter may well be required by the ADA.
If the patient requests an interpreter, the practitioner should engage in a
dialogue with the patient and/or his/her representative or family members to
arrive at the method of communication that suits the particular needs of the
patient and the circumstances of the patient visit.
If an interpreter is determined to be required, the O&P facility is
obligated to pay for the interpreter entirely and may not impose a surcharge
on the patient, even if the reimbursement for the patient service is less
than the cost of the interpreter needed for that patient visit. The cost of
interpreter services are measured against the revenues of the entire
operation, not against the individual requiring the interpreter. In other
words, the provision of interpreters or other auxiliary aids and services to
deaf and hard of hearing patients is a cost of doing business with the
public.
This response is provided to the O&P community as a service of the National
Association for the Advancement of Orthotics and Prosthetics (NAAOP).
Although drafted by NAAOP's General Counsel, Peter W. Thomas, it does not
constitute legal advice.
Visit our web site at www.oandp.com/naaop
Come share YOUR view! Government Relations is what WE do!
If you have an interpreter school in your area, students must have so many
hours of experience as a part of their schooling. If they're not limited to
non profit organizations, you may be able to have a student come in. Call
the school. They will be able to direct you to other resources if they
can't help you directly.
If you want to talk directly to your patient rather than going through the
daughter, assuming that the patient has a TDD, there are many non profit
call centers which you call and they relay your speech into a TDD. Call the
mother through this service and let the mother know what the problem is.
She may have a friend who is willing to interpret for her. It may even be
possible to talk to the patient on the phone through a call center if she
brings her TDD in with her.
They are expensive 50-60 bucks and hour in Birmingham Alabama and
you have to pay them even if the patient doesn't show up.
This is text from a series of informational pamphlets about the
Americans with Disabilities Act. One of the pamphlets is ACCESS
EQUALS OPPORTUNITY: OUTPATIENT MEDICAL AND HEALTH CARE FACILITIES
(The Council of Better Business Bureaus' Foundation and the
DisabilityRights Education and Defense Fund (DREDF) have joined together in
a
national partnership for compliance. The U.S. Department of Justice
provided the initial funding and technical support for this series of
nine guides. )
Q. How do health care facilities communicate with patients or clients
who have hearing or speech impairments? Must they provide sign
language interpreters to communicate with individuals who are deaf?
A. For communications that are short and straightforward, such as
whena patient is having a simple blood test, using a pen and note pad or
taking turns at a computer terminal are adequate ways to communicate
effectively with a patient or client who is deaf or hard of hearing.
Sign language interpreters are required in situations when they are
necessary for a doctor or other health care provider to communicate
effectively with a patient or client and when providing an
interpreterwould not pose an undue burden. For example, when a doctor needs
to
discuss with a deaf patient a complex matter like treatment options
for cancer and that patient is someone who communicates through sign
language, a physician who can locate a qualified sign language
interpreter and absorb the fee in his or her overhead without undue
burden is required to provide interpreter service for communicating
with that patient.It is also important for medical and health care
facilities to
communicate effectively with patients with speech impairments.
Allowing sufficient time for a person with such a disability to
express himself or herself or to spell out a message on his or her
word board are examples of methods to achieve effective
communication.
I find no resources pertaining to billing for this service either.
I am a PT supervisor for a rehabilitation unit. we are obligated to provide
interpreters for any patient who speaks a foreign language or sign language.
While the interpreters are not there 24 hours/day, we are also able to
access the AT&T language line which provides a bilingual operator. Also,
because of patient confidentiality, we cannot legally use a family member to
interpret without written consent from the patient.
If her daughter is not even willing to help her mother out, why do you feel
obligated? I sure wouldn't. It seems like she is just looking to make a
statement for some reason.
_________________________________________________________________
Get a FREE online virus check for your PC here, from McAfee.
<URL Redacted>
post (most are only part of the responses). The first response was actually
made to the list by NAAOP, but reprinted here. It appears to be the most
authoratative answer I received. I did not get a chance to check into it on
my own, but will take that response as good advice.
The patient will be returning in a few months for new shoes and/or follow
up. Between now and then, my plan is to write a letter to the patient
herself stating something to the effect of: Do you personally feel that an
interpreter is necessary for your appointments? I had been under the
impression that we had communicated effectively using a pen and paper. When
your daughter was here previously, she indicated to me that you need a paid
interpreter since it was too difficult for her to listen to the conversation
and to interpret at the same time. Additionally, we will need your
permission in writing for your daughter to be included in conversations
regarding your private personal health information. If you feel it is
necessary to have an interpreter, it would be appreciated if you know
someone who would be willing to do this for us. It is my understanding that
this service can be fairly costly. Please respond in writing, a stamped
return envelope is provided.
This will hopefully get the response that writing is O.K. or she has someone
that could do it for us, if not, my next most preferred response would be
that it gets to the daughter and she gets disgruntled to the point she won't
be back with her mother and they find a new provider. If the patient
returns a letter indicating she needs a paid interpreter, and she signs it,
I will do this. The daughter already indicated they quit one podiatrist that
refused to provide an interpreter as they had been burned many times before
with other patients that never showed when the interpreter had, and they
still had to pay the interpreter.
This may sound callous, but it baffles me that I am financially responsible
for someone else's hearing impairment. Normally I choose the charities I
send my money to. It would seem like this is a donation to a charity cause
that I am required to make, regardless of my opinion on the recipient. My
issue here is not about the money, it's the principle of it being forced on
me (and I really didn't like the daughter's attitude)
Nathan Keepers, CPO
I previously wrote:
I saw a patient today who is deaf. Her daughter indicates that it is my
responsibility to line up an interpreter for her and that I am financially
responsible for the service as well. I indicated that I was not sure if I
could bill insurance for that service or not. She indicated that If I
could
not be reimbursed for it by insurance that I would have to eat it. On
diabetic shoes and inserts, this service would likely be greater than the
profit margin. She brought up that according to ADA, she is supposed to be
provided an interpreter. Is this true? I have no problem arranging the
service for her, but fail to see how it is my responsibility to pay for a
service she requires.
(As a sidebar, I have seen the patient in the past and had no problem
communicating with her back and forth in writing, additionally, the
daughter
can translate, but it is too difficult for her to listen while she
translates, (seemed to go fine today, with no money out of anyone's
pocket))
Any help would be appreciated,
I have received numerous responses and am still getting them. I will print
responses after a few days as there is a lot of interest. Won't print names.
First I will try and follow a few leads on legal advice, and may consult
with an attorney. As some have said, I don't want to set a precedent or I'm
stuck providing this service at a loss. One additional note of interest in
this case. The daughter's profession is interpreting for the hearing
impaired. Makes me think she's looking to pad a co-workers pocket at my
expense.
Nathan Keepers, CPO
replies
In a response to the message sent on the listserve regarding an O&P
facility's obligations to provide interpreters to deaf or hard of hearing
patients, the following describes an O&P facility's rights and
responsibilities under the Americans with Disabilities Act of 1990 (ADA).
O&P facilities are considered public accommodations under Title III of the
ADA, regardless of the size of the business or number of employees. As a
public accommodation, an O&P facility has a responsibility to provide
effective communication through its policies and procedures with the
public, including patients. Effective communication does not require the
provision of an interpreter for every patient who requests it or who is deaf
or hard of hearing. In many instances, note taking and the use of other
auxiliary aids and services to achieve effective communication are perfectly
acceptable. However the complexity of the communication is largely what
determines what form of communication would be considered effective. For
a routine patient encounter, an interpreter is not required absent
extenuating circumstances. However, if the patient encounter involves a
more complex set of communications and consideration of more complicated
issues, an interpreter may well be required by the ADA.
If the patient requests an interpreter, the practitioner should engage in a
dialogue with the patient and/or his/her representative or family members to
arrive at the method of communication that suits the particular needs of the
patient and the circumstances of the patient visit.
If an interpreter is determined to be required, the O&P facility is
obligated to pay for the interpreter entirely and may not impose a surcharge
on the patient, even if the reimbursement for the patient service is less
than the cost of the interpreter needed for that patient visit. The cost of
interpreter services are measured against the revenues of the entire
operation, not against the individual requiring the interpreter. In other
words, the provision of interpreters or other auxiliary aids and services to
deaf and hard of hearing patients is a cost of doing business with the
public.
This response is provided to the O&P community as a service of the National
Association for the Advancement of Orthotics and Prosthetics (NAAOP).
Although drafted by NAAOP's General Counsel, Peter W. Thomas, it does not
constitute legal advice.
Visit our web site at www.oandp.com/naaop
Come share YOUR view! Government Relations is what WE do!
If you have an interpreter school in your area, students must have so many
hours of experience as a part of their schooling. If they're not limited to
non profit organizations, you may be able to have a student come in. Call
the school. They will be able to direct you to other resources if they
can't help you directly.
If you want to talk directly to your patient rather than going through the
daughter, assuming that the patient has a TDD, there are many non profit
call centers which you call and they relay your speech into a TDD. Call the
mother through this service and let the mother know what the problem is.
She may have a friend who is willing to interpret for her. It may even be
possible to talk to the patient on the phone through a call center if she
brings her TDD in with her.
They are expensive 50-60 bucks and hour in Birmingham Alabama and
you have to pay them even if the patient doesn't show up.
This is text from a series of informational pamphlets about the
Americans with Disabilities Act. One of the pamphlets is ACCESS
EQUALS OPPORTUNITY: OUTPATIENT MEDICAL AND HEALTH CARE FACILITIES
(The Council of Better Business Bureaus' Foundation and the
DisabilityRights Education and Defense Fund (DREDF) have joined together in
a
national partnership for compliance. The U.S. Department of Justice
provided the initial funding and technical support for this series of
nine guides. )
Q. How do health care facilities communicate with patients or clients
who have hearing or speech impairments? Must they provide sign
language interpreters to communicate with individuals who are deaf?
A. For communications that are short and straightforward, such as
whena patient is having a simple blood test, using a pen and note pad or
taking turns at a computer terminal are adequate ways to communicate
effectively with a patient or client who is deaf or hard of hearing.
Sign language interpreters are required in situations when they are
necessary for a doctor or other health care provider to communicate
effectively with a patient or client and when providing an
interpreterwould not pose an undue burden. For example, when a doctor needs
to
discuss with a deaf patient a complex matter like treatment options
for cancer and that patient is someone who communicates through sign
language, a physician who can locate a qualified sign language
interpreter and absorb the fee in his or her overhead without undue
burden is required to provide interpreter service for communicating
with that patient.It is also important for medical and health care
facilities to
communicate effectively with patients with speech impairments.
Allowing sufficient time for a person with such a disability to
express himself or herself or to spell out a message on his or her
word board are examples of methods to achieve effective
communication.
I find no resources pertaining to billing for this service either.
I am a PT supervisor for a rehabilitation unit. we are obligated to provide
interpreters for any patient who speaks a foreign language or sign language.
While the interpreters are not there 24 hours/day, we are also able to
access the AT&T language line which provides a bilingual operator. Also,
because of patient confidentiality, we cannot legally use a family member to
interpret without written consent from the patient.
If her daughter is not even willing to help her mother out, why do you feel
obligated? I sure wouldn't. It seems like she is just looking to make a
statement for some reason.
_________________________________________________________________
Get a FREE online virus check for your PC here, from McAfee.
<URL Redacted>
Citation
nathan keepers, “interpreter responses 1 of 2,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/222325.
