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	<title>News for ASL Interpreters&#187; ADA</title>
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	<description>presented by Accessible Communication for the Deaf</description>
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		<title>Could VRI Piggyback on Telemedicine</title>
		<link>http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/</link>
		<comments>http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/#comments</comments>
		<pubDate>Wed, 02 Jun 2010 13:07:56 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[ADA]]></category>
		<category><![CDATA[American Sign Language]]></category>
		<category><![CDATA[Legal]]></category>
		<category><![CDATA[Medical Interpreting]]></category>
		<category><![CDATA[Technology Innovations]]></category>
		<category><![CDATA[Telemedicine]]></category>
		<category><![CDATA[VRI]]></category>
		<category><![CDATA[hard of hearing]]></category>
		<category><![CDATA[hearing aids]]></category>
		<category><![CDATA[hearing impaired]]></category>
		<category><![CDATA[mainstreaming]]></category>
		<category><![CDATA[ASL]]></category>
		<category><![CDATA[sign language interpreter]]></category>
		<category><![CDATA[video phone for deaf]]></category>

		<guid isPermaLink="false">http://www.chazl.com/acd/?p=1509</guid>
		<description><![CDATA[jQuery(document).ready(function($) { window.setTimeout('loadFBShareMe_1509()',5000); }); function loadFBShareMe_1509(){ jQuery(document).ready(function($) { $('.dd-fbshareme-1509').remove();$('.DD_FBSHAREME_AJAX_1509').attr('width','53');$('.DD_FBSHAREME_AJAX_1509').attr('height','69');$('.DD_FBSHAREME_AJAX_1509').attr('src','http://widgets.fbshare.me/files/fbshare.php?url=http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/&#038;size=large'); }); }&#8220;Spurred by health care trends and technological advances, telemedicine is growing into a mainstream industry. A fifth of Americans live in places where primary care physicians are scarce, according to government statistics. That need is converging with advances that include lower costs for video-conferencing equipment, [...]]]></description>
			<content:encoded><![CDATA[<div class="KonaBody"><script type="text/javascript">jQuery(document).ready(function($) { window.setTimeout('loadFBShareMe_1509()',5000); });</script><script type="text/javascript"> function loadFBShareMe_1509(){ jQuery(document).ready(function($) { $('.dd-fbshareme-1509').remove();$('.DD_FBSHAREME_AJAX_1509').attr('width','53');$('.DD_FBSHAREME_AJAX_1509').attr('height','69');$('.DD_FBSHAREME_AJAX_1509').attr('src','http://widgets.fbshare.me/files/fbshare.php?url=http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/&size=large');  }); }</script><p>&#8220;Spurred by health care trends and technological advances, telemedicine is growing into a mainstream industry. A fifth of Americans live in places where primary care physicians are scarce, according to government statistics. That need is converging with advances that include lower costs for video-conferencing equipment, more high-speed communications links by satellite, and greater ability to work securely and dependably over the Internet.&#8221;</p>
<p>~ <a href="http://www.lewrockwell.com/spl2/doctor-will-see-you-online.html">http://www.lewrockwell.com/spl2/doctor-will-see-you-online.html</a></p>
<p>Our thoughts:</p>
<ol>
<li>equipment purchased for telemedicine use will meet all technical standards for VRI</li>
<li>no problems with bandwidth &#8211; less needed for VRI</li>
<li>HIPAA compliant</li>
<li>if a doctor uses telemedicine, there is no additional cost to treat a deaf patient in his office except for interpreting fees</li>
<li>videoconferencing equipment and interpreting services are considered accommodations under the ADA and could provide tax credits to the medical office for what is dual use equipment</li>
</ol>
<p>Telemedicine may be the vehicle for smaller medical offices to accommodate deaf patients without it costing them a fortune in unreimbursed interpreting fees.</p><div class='dd_post_share'><div class='dd_buttons'><div class='dd_button'><script src='http://widgets.digg.com/buttons.js' type='text/javascript'></script><a class='DiggThisButton DiggMedium' href='http://digg.com/submit?url=http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/&amp;title=Could+VRI+Piggyback+on+Telemedicine'></a></div><div class='dd_button'><a href="http://twitter.com/share" class="twitter-share-button" data-url="http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/" data-count="vertical" data-text="Could VRI Piggyback on Telemedicine" data-via="chazradical" >Tweet</a><script type="text/javascript" src="http://platform.twitter.com/widgets.js"></script></div><div class='dd_button'><a title='Post on Google Buzz' class='google-buzz-button' href='http://www.google.com/buzz/post' data-button-style='normal-count' data-url='http://www.chazl.com/acd/could-vri-piggyback-on-telemedicine/'></a><script type='text/javascript' src='http://www.google.com/buzz/api/button.js'></script></div></div></div><div style='clear:both'></div><!-- Social Buttons Shared Counts Generated by Digg Digg plugin v4.2.2.2, 
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		<title>Doctor Liable</title>
		<link>http://www.chazl.com/acd/doctor-liable/</link>
		<comments>http://www.chazl.com/acd/doctor-liable/#comments</comments>
		<pubDate>Wed, 19 May 2010 19:36:40 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[ADA]]></category>
		<category><![CDATA[Legal]]></category>
		<category><![CDATA[doctor]]></category>
		<category><![CDATA[liability]]></category>

		<guid isPermaLink="false">http://www.chazl.com/acd/?p=954</guid>
		<description><![CDATA[jQuery(document).ready(function($) { window.setTimeout('loadFBShareMe_954()',5000); }); function loadFBShareMe_954(){ jQuery(document).ready(function($) { $('.dd-fbshareme-954').remove();$('.DD_FBSHAREME_AJAX_954').attr('width','53');$('.DD_FBSHAREME_AJAX_954').attr('height','69');$('.DD_FBSHAREME_AJAX_954').attr('src','http://widgets.fbshare.me/files/fbshare.php?url=http://www.chazl.com/acd/doctor-liable/&#038;size=large'); }); }Doctor liable for not providing sign language interpreterTweet]]></description>
			<content:encoded><![CDATA[<div class="KonaBody"><script type="text/javascript">jQuery(document).ready(function($) { window.setTimeout('loadFBShareMe_954()',5000); });</script><script type="text/javascript"> function loadFBShareMe_954(){ jQuery(document).ready(function($) { $('.dd-fbshareme-954').remove();$('.DD_FBSHAREME_AJAX_954').attr('width','53');$('.DD_FBSHAREME_AJAX_954').attr('height','69');$('.DD_FBSHAREME_AJAX_954').attr('src','http://widgets.fbshare.me/files/fbshare.php?url=http://www.chazl.com/acd/doctor-liable/&size=large');  }); }</script><p><a href="http://www.ama-assn.org/amednews/2009/01/05/prca0105.htm">Doctor liable for not providing sign language interpreter</a></p><div class='dd_post_share'><div class='dd_buttons'><div class='dd_button'><script src='http://widgets.digg.com/buttons.js' type='text/javascript'></script><a class='DiggThisButton DiggMedium' href='http://digg.com/submit?url=http://www.chazl.com/acd/doctor-liable/&amp;title=Doctor+Liable'></a></div><div class='dd_button'><a href="http://twitter.com/share" class="twitter-share-button" data-url="http://www.chazl.com/acd/doctor-liable/" data-count="vertical" data-text="Doctor Liable" data-via="chazradical" >Tweet</a><script type="text/javascript" src="http://platform.twitter.com/widgets.js"></script></div><div class='dd_button'><a title='Post on Google Buzz' class='google-buzz-button' href='http://www.google.com/buzz/post' data-button-style='normal-count' data-url='http://www.chazl.com/acd/doctor-liable/'></a><script type='text/javascript' src='http://www.google.com/buzz/api/button.js'></script></div></div></div><div style='clear:both'></div><!-- Social Buttons Shared Counts Generated by Digg Digg plugin v4.2.2.2, 
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		<item>
		<title>Personal Opinion &#8211; Reforming VRS</title>
		<link>http://www.chazl.com/acd/personal-opinion-reforming-vrs/</link>
		<comments>http://www.chazl.com/acd/personal-opinion-reforming-vrs/#comments</comments>
		<pubDate>Thu, 13 May 2010 17:24:15 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[ADA]]></category>
		<category><![CDATA[ASL]]></category>
		<category><![CDATA[FCC]]></category>
		<category><![CDATA[NAD]]></category>
		<category><![CDATA[NECA]]></category>
		<category><![CDATA[RID]]></category>
		<category><![CDATA[Sign Language]]></category>
		<category><![CDATA[TRS]]></category>
		<category><![CDATA[Technology Innovations]]></category>
		<category><![CDATA[VRS]]></category>
		<category><![CDATA[hearing impaired]]></category>
		<category><![CDATA[Communication Assistant]]></category>
		<category><![CDATA[sign language interpreter]]></category>
		<category><![CDATA[sorensonvrs]]></category>

		<guid isPermaLink="false">http://www.chazl.com/acd/?p=619</guid>
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			<content:encoded><![CDATA[<div class="KonaBody"><script type="text/javascript">jQuery(document).ready(function($) { window.setTimeout('loadFBShareMe_619()',5000); });</script><script type="text/javascript"> function loadFBShareMe_619(){ jQuery(document).ready(function($) { $('.dd-fbshareme-619').remove();$('.DD_FBSHAREME_AJAX_619').attr('width','53');$('.DD_FBSHAREME_AJAX_619').attr('height','69');$('.DD_FBSHAREME_AJAX_619').attr('src','http://widgets.fbshare.me/files/fbshare.php?url=http://www.chazl.com/acd/personal-opinion-reforming-vrs/&size=large');  }); }</script><div id="article_body">
<p><strong>Video Relay Service (VRS) </strong>enables  persons who use American Sign Language (ASL) to 				communicate with  voice telephone users through video equipment, 				rather than through  typed text (like the old TTY). Videoconferencing equipment, videophone,  or computer and webcam links the VRS 				user with an  interpreter/operator &#8211; called a &#8220;Communications Assistant&#8221; 				(CA) &#8211; so  that the deaf user and the CA can communicate 				with each other in  sign language and by voice to the hearing party. VRS has become an  enormously popular.</p>
<p>Unfortunately, high rates (over $6 per minute)  for VRS interpreting led to massive fraud and arrests in 2009.</p>
<p>Recent  proposals to lower the rates significantly have generated protests from  the largest VRS service providers.</p>
<p><strong><em>Modest  proposal for reforming Video Relay Services (VRS):</em></strong></p>
<p><strong>1.  Separate the telecommunications/technical/bandwidth side of VRS from  the sign language interpreters.</strong></p>
<p>As it stands now, for a  VRS service provider to become licensed by the FCC, they must combine a  telco with a sign language interpreting agency. The types of businesses  have nothing in common and should be licensed and paid separately.</p>
<p>Major  telcos (ATT, Sprint, Verizon) should be able to bid on providing the  telecommunications portion of VRS calls without worrying about hiring  ASL interpreters.</p>
<p><strong>2. Have the FCC assign a 10 digit  geographical phone number to each deaf consumer &#8211; not providers.</strong></p>
<p>As  it stands now, 10 digit numbers are assigned by the default VRS service  provider who originally signed up a deaf individual for VRS service.  Unless the deaf caller has the technical savvy to modify his equipment,  any calls he or she makes is handled by the default provider.</p>
<p>By  giving away free, simple videoconferencing equipment, SorensonVRS has  captured about 70% of all VRS calls. Switching providers is possible but  cumbersome.</p>
<p>Emergency calls &#8211; e911 &#8211; are now the responsibility  of the individual VRS service providers. I would pass this to a central  authority or to the telco who wins the technical bid for VRS.</p>
<p>10  digit numbers allowed fraudulent VRS calls to be routed to a particular  agency.</p>
<p><strong>3. Let sign language interpreting agencies bid on  providing just ASL interpreters.</strong></p>
<p>Communication Assistants  (CAs) are the sign language interpreters who use video to communicate  with deaf callers and who voice to hearing callers over standard  telephone lines.</p>
<p>In late 2009, fraud among interpreter  subcontractors for VRS service providers nearly destroyed Video Relay  Services for the deaf. The FBI arrested a number of interpreters in 9  states who were inflating VRS minutes and cheating the TRS fund out of  millions of dollars.</p>
<p><strong>4. Least cost routing.</strong></p>
<p>Instead  of having calls routed to the default provider, I would have all calls  to 10 digit numbers registered to the deaf routed through a central  switch.</p>
<p>Sign language interpreting agencies would then submit bids  to the FCC for providing CAs. Calls would be routed to the agency with  the lowest bid who had an interpreter available to take a call.</p>
<p>At  this time, VRS service providers are compensated per minute of  interpreting. Proposals for new, lower rates have brought claims that  the new rates will drive providers into bankruptcy.</p>
<p>By having the  service providers bid on what it costs them to handle VRS calls &#8211; at a  rate and with a profit they can accept &#8211; the fight over rates  disappears.</p>
<p><strong>5. NAD/RID Certification for CAs.</strong></p>
<p>As  it stands now, the FCC allows VRS providers to determine the  qualifications of their interpreters. This allowed criminal agencies to  hire unqualified interpreters to process &#8220;run calls&#8221; and bilk the  government.</p>
<p>Everyone would be better served if each CA met some  minimal level of competence in ASL, and had something to lose if they  engaged in fraud.</p>
<p>The National Association for the Deaf (NAD) and  the Registry of Interpreters for the Deaf (RID) have certification  programs in place. CA certification could be easily added.</p>
<p>Each CA  could be identified by a number. Complaints or fraud could then be  tracked to the specific person responsible. Poor interpreters could be  weeded out of the system</p>
<p>Pass legislation to allow the FCC  watchdogs to monitor random calls, much like wiretapping regulations for  police.</p>
<p>Privacy is a serious concern. Care would have to be taken  not to record legitimate conversations. Monitoring could be limited to  30 or 60 seconds unless suspicious activity is present.</p>
<p>However,  fraud is hard to catch or prevent if calls cannot be checked at random.<strong> </strong></p>
<p><strong> </strong></p>
<p><strong>Conclusion:</strong></p>
<p>Market  forces via least cost routing provide a viable method to reduce the  cost of VRS calls to the government, maximize efficiency in the sign  language agencies, and keep the rates at a level that allows VRS service  providers to survive.</p>
<p>=====</p>
<p>I want to emphasize that these proposals are my own personal  opinion. I consult for a sign  language interpreting agency, but not for  any VRS providers.</p>
<p>Charles Lamm is a retired  attorney now serving as a legal/technical consultant for Accessible  Communication for the Deaf <a href="http://acdvri.com/" target="_new">(ACD)</a> in Sunrise, Florida &#8211; <a href="http://acdterps.com/" target="_new">http://acdterps.com</a></p>
<p><a href="http://ezinearticles.com/?expert=Chaz_Lamm"><br />
</a></p>
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