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DCF HHS Advisory Committee Meeting

9 a.m., November 2, 2011 Embassy Suites, Fort Lauderdale, Florida

DISCLAIMER

This transcript was created in real time by a Certified CART Provider. It has been roughly edited. It is not to be considered a certified legal transcript. It is intended for use by the recipient as notes of the proceedings.

HRI CART

Communication Access Realtime Translation 813.404.2488 (cell/text) www.HRICART.com

P R O C E E D I N G S

>>I am Shana Williams, here for the Center for Hearing and Communication in

Fort Lauderdale. >>I'm Judy Martin from Jacksonville, representing the Hearing Loss Association of

Florida. >>I'm Danielle Porter, a support service provider from Daytona Beach, Florida. >>I'm Susan Herring from Pensacola, Florida. >>I'm Lois Maroney from St. Petersburg. >>Yasmine Gilmore, DCF Human Resources. >>Merlin Raoulac, DCF human resources. >>Carolyn Dudley, DCF Office of Civil Rights. >>Michelle Riske-Morris from the Justice Research & Advocacy Center, Cleveland,

and I'm the independent consultant. >>VALERIE STAFFORD-MALLIS: Valerie Stafford-Mallis from the Florida

Coordinating Council for the Deaf and Hard of Hearing from Bradenton, Florida. And I am wondering if I can move over to Michelle so I can look at your faces.

>>KIM GAUT: I'm Kim Gaut from Charlotte County Deaf SErvice Center. >>RICK KOTTLER: Rick Kottler, Deaf Service Center in Jensen Beach. >>TERRI SCHISLER: Terri Schisler, President of the Florida Registry of

Interpreters for the Deaf, from Pensacola. >>SHANA WILLIAMS: And now our CART provider is Gayl Hardeman, and our

interpreter is Jodi Raffoul. We have one more interpreter on the way. Also, I received e-mails and calls from Debbie, who will be out for personal

reasons; Cindy, who is recovering from surgery and may actually join us by phone later; and Marc is out on appointment. Yasmine?

>>YASMINE GILMORE: I need to go ahead and set up for the conference call. >>SHANA WILLIAMS: Has everybody had a chance to look at the minutes? Are

there any changes? May I have a motion to accept the minutes? Motion by Judy, second by Valerie. Motion carried to accept the minutes.

I'm sorry, we need to vote, thank you. All in favor to accept the minutes? Motion carried now. Rick promised to help me through this. (:-) I spoke with Carolyn earlier and she said this will be the final time to make

corrections on all the Policies and Procedures so that they can meet their deadlines. So as we go through page by page, any comments you want to make, this is the time.

She also felt that perhaps we will be finishing a little earlier than is on the agenda, so if that happen, we will go over the motions that were made last time and we will have Michelle start her presentations too, that way, if we're lucky, we will get out at noon tomorrow.

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>>Voice on the phone: Hello. I'm on the conference. >>SHANA WILLIAMS: Cindy, good morning, are you on the conference call?

Can you hear us? >>(No response. >>SHANA WILLIAMS: Carolyn, do you want to start? >>CAROLYN DUDLEY: Good morning. With the policies, we will start with

Chapter 1 and take it section by section and you give us any added comments as relates to any particular section. We will review those comments. I have two staff persons, Caroline [], Southeast Region Civil Rights Officer, and Roosevelt Johnson, Southern Region Civil Rights Officer, that can help answer any questions that you may have.

So, with that being said, are there any comments in Section 1.1 of Chapter 1? Section 1.2.

>>MICHELLE RISKE-MORRIS: This is Michelle. The only thing I was questioning was --

>>Hello, is anybody there? Okay, go ahead. (Discussion about phone)

>>SHANA WILLIAMS: Cindy, are you able to hear us now? Cindy, we can hear you. Can you hear us?

>>SHANA WILLIAMS: Cindy, can you hear us? >>MERLIN ROUHLAC: Can you hear us, Cindy? >>SHANA WILLIAMS: I have asked Cindy if she can join the chat, but if it's not

working for Cindy, it's probably not working period? All right. So they are going to continue to work on that, and I will try to contact

Cindy. Michelle, I cannot see you from where I am, so if you want to make a comment,

you just need to speak up. Okay? Thank you. All right. So we're going to continue.

Rick has a comment. >>RICK KOTTLER: The definitions are not the same. That's a problem. Look at

Page 1-8 and Page 3-13. And look at the definitions for "deaf" in both situations. One is about two sentences and one's a paragraph.

>>CAROLYN DUDLEY: So which definition? >>RICK KOTTLER: I would think the Chapter 3 definition is clearer. >>SHANA WILLIAMS: Any comments on the Chapter 3 definition? >>RICK KOTTLER: I'm comparing 1-8 with 3-13. Also on 1-8, "effective

communication" should be singular, not plural. >>CAROLYN DUDLEY: The reason 1-8 is different from 3-13 is we are talking

about individuals with hearing loss. We have listed four individual types: Deaf, hard of hearing, late-deafened -- and 3-13 is just definition of "deaf" as it is, but we can go back and just put -- use the one in 3-13.

>>RICK KOTTLER: You can or can't? You can, okay. >>SHANA WILLIAMS: Okay, they will make the definitions consistent on "deaf" and

make the other ones singular. Anyone else? Valerie?

>>VALERIE STAFFORD-MALLIS: Yes, this is Valerie. Going back to the "effective communications" definition on 1.8 and 3.12, in 1.8, it talks about persons who are deaf or hard of hearing, but there's nothing in there about deafblind, and I'm just wondering if it should be there, because someone who's deafblind is going to need different accommodations for effective communication. I'm looking at Page 1.8 or 1-8, and then for effective communication, which is definition S, and then I'm looking at document 3-12; and in that one, effective communication is Item Z.

If we're going to spell out what the sensory disabilities are, then I think it's important that we include deafblind along with persons who are deaf, hard of hearing.

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If we choose not to spell out what the sensory disabilities are, that's fine. But I think it's better to spell it out.

>>SHANA WILLIAMS: Anybody else? Lois? >>LOIS MARONEY: Yes, this is Lois Maroney. One sentence on L-1, it talks

about Registered Professional Reporter: This is the basic level of certification required for court reporting and is the first step in learning the advanced skills necessary to become a CART provider.

I think add to that, "it is not a test of real-time writing," so it is clear it's not for real-time purposes. So I suggest to add, "it is not a test of real-time writing."

>>SHANA WILLIAMS: My comment on that will people reading this know the difference between real-time writing?

>>LOIS MARONEY: Do we want to say "it's not a test of real-time translation"? Because we are talking about that.

>>SHANA WILLIAMS: I think that sounds better. Anybody else? Okay, Carolyn, are we adding the deafblind to the definition that Valerie

recommended on effective communication? >>CAROLYN DUDLEY: We will look at it -- we will let HHS make the decision,

because they indicated to us that when this Settlement Agreement was written it was written for everybody that is in the deaf community, whether it is deafblind or late-deafened. So we will take it and look at it.

>>SHANA WILLIAMS: Okay. Thank you. And on Lois's comment, do we want to add "real-time translation"?

Yes. Okay. Moving on. Rick?

>>RICK KOTTLER: On Page 1-9, the first definition which says "Certified Deaf Interpreter," I think the definition should say, "individuals who are deaf who are certified." Specifically point that out.

Under the definition of Qualified Interpreter, do you want to specifically state in that section right there that this is dealing with a DCF employee? Or not? Because that was the differentiation between Certified and Qualified.

>>Michelle Riske-Morris: That is one of the distinctions, because when I went through the procedures, there is not a separation between Certified and Qualified when I went through the policies. That is my concern there is not a distinction between Certified and Qualified overall. Because these are the policies that staff are going to be using out in the field to help guide them in terms of implementing the Settlement Agreement. So do we want to use the terminology that they're going to feel comfortable with that they're trained on from the DCF training, the use of Certified versus Qualified? And I don't mean just Qualified Interpreter, but Qualified Staff Interpreter, that designation, because I see throughout there's reference to and sometimes Certified, and I do understand that any Certified Interpreter also has to be Qualified, so I think we need to have a general consensus again as to throughout the policy, what do we want to use and make sure then that it's carried through to each of the policies so that staff understand; as well as if that determination is made to use Qualified Staff Interpreters, who does that? The designation of "sufficient." Because if you look at some of the policies right now, it just says, if a determination is made that you have a Qualified Interpreter. Well, a staff reading that, an agency may say, oh yeah, we have a qualified staff. My director made that determination, we're okay. And that doesn't necessarily mean it's in compliance with the agreement.

>>SHANA WILLIAMS: Carolyn? >>CAROLYN DUDLEY: We will make those changes because HHS has indicated,

as you know, that anybody among our staff must be Certified other than our staff. >>SHANA WILLIAMS: Terri? >>TERRI SCHISLER: I will add to this conversation that a staff person could be

Certified, so if you define a Qualified staff person as being a QA or a Certified Staff Interpreter, you are using the word "Qualified" twice. You can't have a qualified

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Qualified Interpreter meaning a qualified QA Interpreter. A staff person could be Certified. So I think if you define what's "Qualified" and what's "Certified," and then let those two labels be applied equally to staff and contract interpreters, not saying a Qualified Staff Interpreter, but a Qualified Interpreter is this, and then in the document we will talk about tomorrow where it says you can use a Qualified, any non-Certified Interpreter, under these circumstances, and those are only staff persons. So you understand what I am saying? Define "Certified" and "Qualified" without talking about contract or staff. Then you will state after that that any contract interpreter must be certified.

>>SHANA WILLIAMS: I hear what you are sayhing, Terri, but I think it is a good place to clear it up for people who are not in the field. So they are qualified, but they have to be staff. So it is almost part of their definition.

>>TERRI SCHISLER: The problem is, when you tailor these definitions specifically so your staff people understand them, how it operates within DCF then, that doesn't translate to outside of DCF. And when you are contracting with an interpreter with an agency and you use a specific term with a specific definition that doesn't apply outside of DCF, then the agency will misunderstand.

I'm just -- I'm recommending that you establish a definition for "Certified" and "Qualified" that doesn't also include whether they're contract or staff.

>>MICHELLE RISKE-MORRIS: I understand what you're saying. The only difficulties I see in a practical application is that these Policies and Procedures are for DCF staff to implement. And if you change or have two different definitions because the Settlement Agreement and all of the documents relate to qualified staff persons, and it's starting to be ingrained among staff, like when I go out and do site visits, they know that we must have Certified Interpreters; only if we have qualified staff -- but we don't have any yet, because it hasn't -- you know, they are already starting to utilize that jargon.

We have to think of some, though, that is going to keep that distinction between "Certified" and "Qualified."

My only recommendation would be under DCF's definition of "Certified," to put that, you know, like a caveat or something that they must also be Qualified, and then write in there what is meant by "Qualified."

I don't know. It's a difficult issue. Unfortunately, the Settlement Agreement kind of uses that term, and we are kind of stuck with it. But I agree with you that that's a difficult distinction to make.

The only other thing, too, is that these Policies and Procedures, when determining who a contract Certified Interpreter is, are not applicable, because it's my understanding that the contract sections enter into the negotiations with the contract providers. Those contract providers, because they're not employees of DCF, are not bound by these settlement agreements, nor do they use them.

So I don't know -- I agree that there's an issue. I don't have an answer, but we can't just separate Certified and Qualified, because I think for staff -- remember, part of these Policies and Procedures are for the DCF offices. When I go do a site visit, they will go back and discipline employees. They are holding them to these Policies and Procedures, and this is what they have to follow and do on a day-to-day basis. So having these definitions of Qualified and Certified are going to be too confusing and difficult to enforce.

>>TERRI SCHISLER: That's what I am trying to say. We shouldn't have two definitions for "Qualified." But "qualified" is a definition that's broader than issues within DCF. Qualified -- your Certified Interpreters have to also be qualified. And when you're using that term, "Qualified," to talk specifically about a QA level interpreter, that QA level interpreter is not qualified in many situations. So, you know, I understand that the terminology is already used in the Settlement Agreement; we can't change that.

But in -- for instance, in this section where it's just definitions of terms, I think that

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the definition of "Qualified" should be in line with the ADA and the broader definition, and this chapter of policy and procedure should use that definition and give them the rules and regs that they have to follow. But the definition of "Qualified" is a broader term than a QA-level Interpreter.

>>RICK KOTTLER: As a suggestion, add a definition. Add one specifically for Qualified Interpreter, and then add "Qualified Staff Interpreter," and when you're in the Policies and Procedures and you're referring to a Qualified Staff Interpreter, specifically point that out. And then when you're talking about a Qualified Interpreter, there's the definition that says what a Qualified Interpreter is, and I think that resolves all the issues and we're still living by the Settlement Agreement.

>>VALERIE STAFFORD-MALLIS: So, Rick, if in the thing that you're talking about creating it talks about Qualified Staff Interpreter, would that definition include the QA? Because really, that's the only thing that would be a Qualified Staff Interpreter. Right?

>>RICK KOTTLER: But don't -- the staff interpreters that you're going to use have to go through the QA program, so that specifically should be put in what a staff interpreter is, you know, what qualifications they have to have.

>>SHANA WILLIAMS: Terri? >>TERRI SCHISLER: Don't forget, a staff interpreter could potentially be Certified,

so when you define a Qualified Staff Interpreter, that could be either a QA level or Certified Interpreter. Those staff people could eventually become Certified, so by limiting yourself to QA, then you are removing that possibility.

>>SHANA WILLIAMS: We're having trouble with the phone still. Cindy has texted me and said she's on chat, but she cannot hear.

Carolyn, did you want to comment? >>CAROLYN DUDLEY: No. >>SHANA WILLIAMS: Michelle? >>MICHELLE RISKE-MORRIS: I have a general question. When you are

referring to the person must be "qualified," would that be the same for if it was a staff person or a contracted interpreter? So there is a way that we could do something that defines, like you said, "qualified" within the definition, and what it means in that, and then in the Policies and Procedures make a general reference that irregardless of if it's a Certified Interpreter or a staff interpreter, the person must be qualified. Or is that too simplistic?

>>TERRI SCHISLER: That's a true statement. And then this is where I am trying to go with this. A contract interpreter and a staff interpreter must both be qualified, whether they have a credential or not. Because as you said, a Certified Interpreter may or may not be qualified in a certain circumstance, so that is exactly where we're going. "Qualified" defines the services they provide, not the credential they hold. "Certified" or the QA level defines what credential they hold.

>>SHANA WILLIAMS: So if we added a second definition right here, as Rick suggested, that kept the definition true to what you are saying, Terri, and then we added that DCF staff would also be, how does that sound? Can we also do that?

>>CAROLYN DUDLEY: That sounds fine. We just have to understand that DCF staff -- that anybody other than DCF staff will have to be Certified. There is no discussion on that point.

>>TERRI SCHISLER: Okay. >>SHANA WILLIAMS: That's a positive thing, but it's clearer that way. So any

further comments on this section? Rick. >>RICK KOTTLER: I'm sorry, this is Rick. On 1-10, at the top, we talk about

physical impairment. On Page 3-14, we talk about physical disability. Both have the same, exact definition. So do you want to go with one term or the other? I'm just pointing that out.

>>CAROLYN DUDLEY: We will go with "physical impairment," because that's what I believe is coming from the ADA.

>>SHANA WILLIAMS: Judy?

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>>JUDY MARTIN: On 1-8, bottom of the page, point 4, hard of hearing. That's a perfect description of the hard-of-hearing person. The next one, late-deafened, only indicates when it happened, and it should be the same description as a hard-of-hearing, because saying that "late-deafened persons usually have little or no residual hearing and depend upon their eyes to understand" is really painting it with a broad brush. So I don't know if you want to combine those two, but both -- they are both the same. I am late-deafened, and I am hard of hearing, and I have little residual hearing, but many folks I know have quite a bit, and we're all in the same boat.

>>SHANA WILLIAMS: Valerie? >>VALERIE STAFFORD-MALLIS: I think Judy's point is well taken. However, this

is where we run into the difficulty of the terms being cross-applicable to different degrees of hearing loss. They're not medical terms; they're more sociological, self-descriptive terms. And I think as long as we have that, it's going to be really hard to resolve that issue that Judy has raised. Some people will tell you they're hard of hearing when the fact of the matter is they're deaf, but they will still tell you they're hard of hearing. And some people who are late-deafened will tell you they're hard of hearing, and the fact is they're deaf. So I don't think there's any easy way around that.

>>SHANA WILLIAMS: I think that with the "rely upon their eyes to understand," I think what we're trying to do is get that point across that they use visual cues, that they use good lighting, and that they are able to use all of the environmental cues to understand what is happening. But I'm not sure that is coming across so that it fits into the definition of "late-deafened."

>>LOIS MARONEY: Can you tell me what page we're on right now, the definitions?

>>JUDY MARTIN: Number 1-8. I. >>LOIS MARONEY: Thank you. >>VALERIE STAFFORD-MALLIS: This is Valerie. If one wanted to address what

Shana referred to, the last sentence under "late-deafened" says, "Late-Deafened persons usually have little or no residual hearing and depend upon their eyes to understand," if I was going to word-smith that, I would say, "late-deafened persons usually have little or no residual hearing and depend upon visual cues to a greater extent than those with milder degrees of hearing loss."

>>JUDY MARTIN: I still disagree totally with that discussion, that they "usually have little or no residual hearing." Perhaps we can say "sometimes." But I would have to say late-deafened people run the gamut with their hearing loss, with the degree of hearing loss.

When you say "little or no," it means they're practically deaf, as far as I'm concerned.

>>VALERIE STAFFORD-MALLIS: And that's why the label is "late-deafened." >>JUDY MARTIN: Yeah. I disagree with that. >>LOIS MARONEY: Okay. This is the definition from the Association of

Late-Deafened Adults, so this is what we use. I'm Past President of the Association, and I look at this, and I feel that that's a really good definition, so I'm fine with this. I feel that it's me to the "T."

>>JUDY MARTIN: That may be the definition of your organization, but I don't think it speaks to what actually is. If you look at all the people in your organization, I'm sure they have many degrees of hearing loss, and I just would like to not think that all the people in your organization have "little or no residual hearing."

>>LOIS MARONEY: It's true, there are many people in our organization that are deaf, that are hard of hearing; and they come, yes. But "late-deafened," for me, means that the person has little or no residual hearing. They still may come to the organization, but they're deaf; they have little residual hearing. But there are many people, yes, that they get a cochlear implant or use hearing aids, et cetera.

>>JUDY MARTIN: Okay, then do they all depend upon their eyes to understand? Do any of the people, late-deafened people, in your organization, have cochlear

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implants or hearing aids? >>LOIS MARONEY: Yes, certainly, yes, they have cochlear implants and then

they might move on to what you might call more hard of hearing. But when you think about late-deafened, they really need their eyes to understand, and it's just so important. It's really important, because just in this meeting right now, I need my eyes to understand. Whereas, other people are hard of hearing and they can follow a conversation and look down. I can't. I get totally lost. I look down and I don't know what's going on. And I think what we want to do is, we want to be sure that we make that distinction so people truly understand the needs of late-deafened people. They're so different from the hard of hearing, and just having this term really makes it understandable. I mean, when you think about it in here, that is exactly what I am saying. I am looking down and people know I am totally lost, and these are the people that we are trying to define.

>>SHANA WILLIAMS: Okay. So what I am getting from Lois and Valerie and Judy, that perhaps between these two, we are really encompassing a wide variety of people and really making the definition clear to people who may not be as familiar with the nuances. Valerie?

>>VALERIE STAFFORD-MALLIS: Yes, Shana, I would say that's an accurate characterization, and I would also say that among the three people you just mentioned, two-thirds of them are comfortable with the way the definitions are laid out, and one-third of them is not.

>>SHANA WILLIAMS: So okay, if it is okay with the committee, we are going go on.

All right, go ahead. >>RICK KOTTLER: Moving right along, on Page 1-11, under "undue burden," if

you look at the definitions for undue burden on 3-15, there's a note added to it on 3-15 that's not here, in Chapter I. Should that note be added?

>>CAROLYN DUDLEY: We will add the note. >>RICK KOTTLER: One other thing on that page. The definition for "video

remote interpreting," number two, where it says, "An interpreter and the person who are deaf are in the same place and the person who is hearing is in another location." How does that qualify as video remote interpreting, when the interpreter and the deaf individual are in the same room? My understanding for video remote interpreting is that the interpreter is on screen. So help me out here.

>>TERRI SCHISLER: Video remote interpreting means that there's two different locations occurring, so the interpreter could be with the deaf person and interpreting for the hearing person who is on the phone, or the interpreter could be with the hearing person and interpreting for a deaf person on the screen.

The distinction between video remote interpreting and VRS is that VRS cannot occur when the two parties are in the same room.

>>RICK KOTTLER: And I understand that. My question is, if the deaf individual is in the room and the interpreter is in the room, and the other person is on the phone, how does this qualify as video interpreting? It doesn't. It may be remote interpreting, but there is no video involved. So I'm just questioning whether that really needs to be included in the definition, this one right here.

>>TERRI SCHISLER: Right, I got your point. >>SHANA WILLIAMS: And, Terri, take it out? >>TERRI SCHISLER: I would say that since I -- I would expect -- I have seen this

definition before, so it's not the first place I've seen it, and I would imagine that the hearing person could still have the video connection, so the deaf person could see the doctor, for instance. So it's conceivable, even though it may not make sense to have the video connection, but for the deaf person to see the interpreter's face while they're talking is very important and would be something that could be -- it could occur that way.

>>SHANA WILLIAMS: So harmless to leave it in?

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>>TERRI SCHISLER: Yes. >>SHANA WILLIAMS: So we leave it. >>SHANA WILLIAMS: Carolyn? >>CAROLYN DUDLEY: Okay. The next section is Section 1-4, policy statement.

1-5. >>SHANA WILLIAMS: Okay, did we go backwards, to 1-5? >>CAROLYN DUDLEY: We finished with the definitions section, which is 1-3.

Now we're looking at -- all right. So Section 1-5, are there any comments?

>>SHANA WILLIAMS: Look the bottom of that page, on Item Number 6, it says, "Human Resources office will notify the job applicant in writing of the action to be taken." Somewhere in this document it says five days. How long do they have to respond?

>>CAROLYN DUDLEY: This section, they have three to five days to respond, but I put a check mark in this section because we are going to be a shared services model. So this -- representing this Human Resources office will be changing prior to -- well, prior to the policies being in effect. So we are going to have to -- all this section will be changed. I have check marks through. So whenever you see the words, "human resource unit," that will change, because we are going to a shared services model, and not sure how we are going to set that model up yet. So we are going to have to revisit how the employee makes that request and who they make that request to.

But to answer your question now (Laughter), it's going to be the five days, three to five days they will have to go in and to determine what that accommodation will be.

>>SHANA WILLIAMS: Okay, so we are reviewing this for the final time until you change it. And then?

>>CAROLYN DUDLEY: What we will change in this as it relates to the Human Resource offices, we will no longer have Human Resource offices, so that phrase will change.

>>SHANA WILLIAMS: So to clarify, the phrase will change, whatever title they come up with, but the procedures and the way this is laid out will transfer to the name change.

>>CAROLYN DUDLEY: Yes. >>SHANA WILLIAMS: All right. >>CAROLYN DUDLEY: 1-6. >>MICHELLE RISKE-MORRIS: In general, I wanted to make a comment for

discussion regarding the complaint process, because I'd asked Carolyn earlier the difference between "internal" and "external." My only concern is the internal process, when it's filed with a DCF office and not with the Office of Civil Rights, and that needs to better be explained if they file a complaint internally but not with the Office of Civil Rights. Externally I understand. It's like another department, Department of Health and Human Services, Department of Justice. But if they file it internally with a direct service provider or internally with a contract provider, I think throughout the policy, wherever you talk about complaint procedure, that needs to be better described as to what happens in those situations.

>>CAROLYN DUDLEY: We can address how we handle the complaints internally. Each contract provider agency may have a different process of handling their internal complaint. When we do our monitoring, we at that time review their complaint process. But with both DCF internal process and the contract provider process, the employee of the client has the opportunity to file externally with the federal agencies during the process of this investigation.

>>MICHELLE RISKE-MORRIS: I would just say that if they're going to file it internally with the direct service provider, which is the DCF office --?

>>CAROLYN DUDLEY: No. The direct service provider is going to be the contracted client service provider, that external agency that is doing the work for DCF. Our direct service facilities, they file those complaints with the Office of Civil Rights

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directly. >>MICHELLE RISKE-MORRIS: Okay. So no direct service provider -- or no

direct service facility, like an Access office which is controlled by DCF, would ever handle a complaint, ever process it.

>>CAROLYN DUDLEY: No. >>MICHELLE RISKE-MORRIS: They all go to -- okay, good, that alleviates my

other concern. >>CAROLYN DUDLEY: They go to DCF. >>SHANA WILLIAMS: So does that clarify it? How would you change the

language, Michelle? >>MICHELLE RISKE-MORRIS: The only thing I would suggest is in your definition

of "internal," that it includes any complaint filed with the Office of Civil Rights or any DCF -- I think the terminology is direct service facility, must be forwarded to the Office of Civil Rights, and then that would clarify that Office of Civil Rights handles all of those complaints. Because I think it's a very good process. Occasionally you have to be careful with potential conflict of interest. If an Access or an office is providing the service, the individual filing the complaint may not feel comfortable filing the complaint with them, or filing the complaint if they feel that that office is going to handle the resolution of that complaint.

So it always is a better procedure, I should say, if you have a -- you know, if your Office of Civil Rights handles the investigation and provides that resolution. And I would do that at each of the chapters that talk about the complaint procedure.

>>CAROLYN DUDLEY: So noted. >>MICHELLE RISKE-MORRIS: Thank you. >>SHANA WILLIAMS: Okay, and then we are going on. >>CAROLYN DUDLEY: That's it on Chapter 1. >>SHANA WILLIAMS: So for right now I want to check in again with the phone

lines. Is anybody on the phone? Cindy, can you hear us? Cindy says her phone is fine, but she is still not hearing us.

>>CINDY SIMON: I hear you now. The reason I put myself on mute is people are coming in and out of my hospital room.

>>SHANA WILLIAMS: This is dedicated! If you have any comments, just speak up and we will put them in. All right? Great.

>>CINDY SIMON: Great. >>SHANA WILLIAMS: Carolyn? >>CAROLYN DUDLEY: Chapter 3. Section 3.1. 3-2.

Terri, okay? 3-3. 3-4.

>>SHANA WILLIAMS: Just a second. On 3-2, under "Accountability," there is Certified CART. I saw other places where it didn't say "Certified CART," so I'm not sure that that's consistent. So you might want to go through the document again to make sure that it says, "And Certified CART."

>>CAROLYN DUDLEY: On 3-2? >>SHANA WILLIAMS: 3-6a, I'm sorry. >>CAROLYN DUDLEY: We're on Section 3-2. >>SHANA WILLIAMS: I'm sorry. >>CAROLYN DUDLEY: 3-5, the definitions.

3-6. >>SHANA WILLIAMS: Okay, so that's where the CART, Certified CART is under.

First paragraph on 3-6. >>CAROLYN DUDLEY: Okay. >>SHANA WILLIAMS: Lois, do you have a question, comment? >>LOIS MARONEY: On 3-5, at the very bottom of the page, 3-14, a,b, my point is

on b. I think I threw out the documents --

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>>SHANA WILLIAMS: I did the same thing, Lois. We are not quite on that page yet. We are still on 3-2, in Section 3.6 and 3.7.

Carolyn, tell us where you are. [LAUGHTER]

>>CAROLYN DUDLEY: I'm at Section 3 dash 6, Accountability. >>VALERIE STAFFORD-MALLIS: I'm sorry, I'm not moving as fast as Carolyn, but

going back to the -- I think it's 3-3, where they're talking about interpreters -- I just lost my place. There was a place where it meant to say "foreign language interpreters," and it just said "foreign language." And now I have to ask you to give me a minute to find that spot exactly.

It's the section where they are talking about Limited English Proficiency. >>SHANA WILLIAMS: Valerie, I found it. It's on a different page. It's on Page

3-3. >>VALERIE STAFFORD-MALLIS: It's point f on Page 3-3 where it says, "The use

of auxiliary aids and services, Certified Sign Language Interpreters, Certified CART Providers, Translators, or Foreign Language ... will be at no cost to the customers." So I think who they wanted to say was "Foreign Language Interpreters."

>>CAROLYN DUDLEY: Okay, we will make that change. >>RICK KOTTLER: Can I ask a question?

Same question, using the term, "Foreign Language Interpreters," are they interpreters? Or are they translators? I always -- you know, when you put "interpreters" with Sign Language and "translators" going from English to Spanish or whatever, so I don't know what the proper terminology is.

>>TERRI SCHISLER: A translator, are you specifically talking about written text or frozen text, where you have time to use resources to help you in your translation? So foreign language, from Spanish to English, is still an interpreter, and Sign Language interpreters are rarely translators, because we don't work with frozen text, unless it's a videotape.

>>SHANA WILLIAMS: All right. Anybody else? Carolyn? >>CAROLYN DUDLEY: Is there any other discussion on Section 3-6,

Accountability? >>VALERIE STAFFORD-MALLIS: Going back to Page 3-4, Section 3-11 where we

are talking about time intensity of -- >>SHANA WILLIAMS: Valerie, not yet. >>VALERIE STAFFORD-MALLIS: Oh, we are not there yet? I thought I heard

Carolyn say 3-6. >>CAROLYN DUDLEY: No. >>VALERIE STAFFORD-MALLIS: Okay. >>CAROLYN DUDLEY: Section 3 dash 7? >>SHANA WILLIAMS: Okay, 3 dash 7 is Dissemination. >>CAROLYN DUDLEY: I will just say the topics. >>SHANA WILLIAMS: That will work.

Okay. Anybody? 3 dash 8, Revisions. 3 dash 9, Insuring Effective Communication.

>>SHANA WILLIAMS: Michelle? >>MICHELLE RISKE-MORRIS: I would just add, throughout the policies, you

speak a lot to the customer, but rarely do you see the reference to the companion. And when a companion requests, they get the same services. And so, I don't know if you want to make it a general statement that when referring to the customer, it also references that it is equally applicable to the companion, something to that effect. Because especially when you're talking about ensuring effective communication, denials, anything like that, it's just referencing the client or the customer, an employee reviewing this may say, oh, well, it's a companion, so it doesn't apply to them, and we want to make sure that it applies to them as well.

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If we're still on 3.9, I have a couple more. On 3.9, on the next page, which is Page 3-3, just a couple references with, there's no discussion of them completing the Request for Services form. They talk about completing the communications assessment form, but we also have to make sure they complete the Request for Services form, which is actually completed by the customer or companion.

And also, when they talk about, if it's non-aid-essential, Paragraph 2 at the top of Page 3-3, there needs to be reference to providing alternatives and giving them the opportunity for requesting alternative auxiliary aids and service, so that if there is a denial, it's not just you don't get anything. I know there's a statement that "if an alternative is provided," but you need to put in there that "if it's denied, then the employee has to offer them an alternative," and then documenting if there is an alternative. It's just somewhat confusing, that if you deny it, then you have to offer them an alternative. You can't just deny it. The employee has to provide an alternative or suggest alternative aids.

And who has the authority to do the denial? I think DCF is pretty clear on who can make that determination. So that should be included, that only the director or the designee can make that determination.

>>CAROLYN DUDLEY: Okay. We will add -- because it's on the form. It says the only person that can deny is the Human -- the Regional Manager or his or her designee.

>>MICHELLE RISKE-MORRIS: Another one is that in the Settlement Agreement it talks about Communication Assessment Form and also a Service Record Form. DCF combined those two and did one document, so in the Policies and Procedures on Page 3-3, Paragraph 4 -- I'm sorry, Section E, Paragraph E, you state that the customer -- you only have to fill it out once. Actually, unless there's a communication plan, they have to fill that communication assessment each time, because that's your documentation of the services being provided. Since you combined that, you have to do it each time. So it needs to read that it actually has to be done each time, unless there's a communication plan, and also, if you need to revise it for reassessment.

>>CAROLYN DUDLEY: Any other discussions or questions? >>CAROLYN DUDLEY: Section 3-10, Translation of Written Materials. >>SHANA WILLIAMS: Lois, when your question comes up . . . >>LOIS MARONEY: One more page. >>TERRI SCHISLER: I would just like to back up one paragraph. On the section

F, Paragraph 4, that says "non-employee Sign Language Interpreters must be Certified," if we could choose a different term to use there. They must be "evaluated" or we can't choose a different term, because every time you say that the interpreter must be Certified, it references that they're nationally Certified.

>>CAROLYN DUDLEY: Yes. >>TERRI SCHISLER: So you are saying that? >>CAROLYN DUDLEY: Yes. >>TERRI SCHISLER: "Non-employee interpreters must be nationally Certified"? >>CAROLYN DUDLEY: Yes. >>TERRI SCHISLER: Okay. >>SHANA WILLIAMS: That was the whole discussion that there may not be

enough of them to meet this requirement. >>TERRI SCHISLER: I read this wrong. Then just to be clear, could we put

"nationally Certified" there? They must be nationally Certified? >>MICHELLE RISKE-MORRIS: The only thing that I would suggest on that is, we

have the glossary definitions of Certified, and that will reference nationally Certified, and throughout the training and common sense references when employees are doing it, when they are undergoing this process of determining, they are kind of using the term "Certified." That's what we talked about before. When employees are being trained, they are being trained that they have to be Certified or they have to be a qualified staff person designated by DCF.

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Even employees, they are actually -- when we were at the Florida State Hospital, they actually have a staff person who is Certified, and they actually refer to that person as a Certified Interpreter. They don't even refer to them as a "qualified DCF employee." They say, we have a Certified Interpreter on staff.

>>TERRI SCHISLER: That's fine. My concern is, using this term, whether in my -- and my English grammar is not all that great, as a verb or as a noun, we are not using it as a verb here, but it could be misunderstood as they must be certified instead of the noun, nationally Certified. When you put "nationally" in front of it, it becomes a noun and not a verb.

>>MICHELLE RISKE-MORRIS: Or we could put "Certified as defined in these policies."

>>TERRI SCHISLER: It still could be a verb, "must be certified." "Must be evaluated." If you can take the word "certified" out and put "evaluate" in there and it makes the same sense, it is a verb.

>>MICHELLE RISKE-MORRIS: They can't, just because of the Settlement Agreement. Non-employees have to be Certified.

>>TERRI SCHISLER: I'm not concerned about the -- we're clear on the policy. It's the language of that sentence and whether the term could be construed as the verb "to certify" instead of the term "nationally Certified." Because if it could be misconstrued to say, oh, they have to be evaluated, they have to be certified, then there's a misunderstanding that could occur.

>>SHANA WILLIAMS: Valerie? >>VALERIE STAFFORD-MALLIS: If you are concerned about that, instead of

saying they must be certified, you say they must possess national certification. >>TERRI SCHISLER: That's a good point. >>MICHELLE RISKE-MORRIS: That will make it clearer, because we can't use

"evaluated" because "evaluated" is used under the assessment process. >>TERRI SCHISLER: Right, but that's what I am saying, use the term "nationally

certified," because then it is not misunderstood as a verb. >>CAROLYN DUDLEY: 3-10, Translation of Written Materials.

3-11, Competency of interpreters and translators. >>SHANA WILLIAMS: We have a translation of written materials in 3-10. Were

we going to add a place where we had translation of read material into signed? We spent some time talking about that, but there's not really a clear description of what that would be like.

I looked at the actual video on your Web site. Gorgeous. Really, really nice job. I felt it was excellent. But I would like this to say that we are going to do more of those.

>>CAROLYN DUDLEY: We'll make the adjustments. Section 3-11. Are there any comments on that before we move to Section 3-12?

>>VALERIE STAFFORD-MALLIS: This is Valerie. I am thinking that to the other definitions where we're defining Certified and Qualified, and then, in this section, we're talking about competency, and when we talk about qualified interpretation, we're talking about the ability to accurately interpret both receptively and expressively, I'm wondering if it might not be better to somehow weave that language into this section where we're talking about competency, because in my mind we are talking about the same thing, but we're calling it two different labels. I don't know if we have that latitude because of the language of the Settlement Agreement.

>>MICHELLE RISKE-MORRIS: Would it be possible to then leave the definitions more analogous to the Settlement Agreement in how we talk about Certified Interpreters for nationally Certified, qualified staff employees who meet that assessment -- that is, the assessment performed by DCF -- and then have the section about competency referencing more about the individual must be qualified, thereby reduce the number of definitions, but yet still get at the requirement that regardless of whether you are a certified contract provider or a Qualified Staff Interpreter, you must

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be qualified for that particular situation. Would that work? >>TERRI SCHISLER: I'm not sure. >>MICHELLE RISKE-MORRIS: Instead of different definitions such as Certified

Interpreter, qualified staff, qualified in general, we just have definitions under Policies and Procedures to say, DCF will either use a Certified contract provider who is nationally Certified, or a qualified DCF staff employee, and those are analogous to the definitions provided in the Settlement Agreement. We use those definitions.

Then, in a section -- and this section will have to be repeated throughout the various policies -- regarding the individual, regardless of if they're contracted out or a staff person, they must be qualified, or in this case there's reference to they must be competent. Combine the two. As Valerie said, combine the two into one section to talk about those requirements to make it easier for employees to understand what is meant.

>>SHANA WILLIAMS: Terri, before you answer that, I am reading this and seeing a process of discriminating between a foreign language person who does not have to be certified and the responsibility. Who does that fall on to make sure that the competencies are being met? This feels much more procedural than definition to me. So I think if we are repeating the definition yet again here, we are missing what the intent was of this section. Terri?

>>TERRI SCHISLER: I would say that when I read this section, because it starts off with "certification of foreign language interpreters is not required, however, their competency is proven based on these factors." So this section said to me this is really talking more about foreign language interpreters than Sign Language Interpreters and talking about their qualifications, because you don't have an outside factor determining whether they are qualified or not.

So I read this as really more relating to the foreign language interpreters than to Sign Language. So if you want it to relate to all of your interpreters including foreign language, then I would move that statement down to some other place, because having that first and foremost, I kind of glossed over this section.

>>VALERIE STAFFORD-MALLIS: I hear what Terri is saying, but then on Point C in that same section it starts talking about an employee's ASL skills and communicating with a person. So it's jumbled. So what you are saying is, break it out into two separate things, one for foreign language interpreters and one for Sign Language?

>>TERRI SCHISLER: I think that, you know, this section is good and valid, but that statement about foreign language interpreters needs to be moved down to its own point rather than leading off with that statement. And then there could be some modifications to the numbers 1, 2, 3, 4.

Whether those are comprehensive and accurate, I would have to give that more thought. Whether that definition of the competency criteria -- I would have to give that more thought.

>>CAROLYN DUDLEY: We will just make a section that says competency for interpreters and competency for foreign language interpreters. That way they are separated.

>>MICHELLE RISKE-MORRIS: That is what I was going to suggest. Because again, we don't want individuals reviewing these policies thinking they can make that determination of who is the qualified staff employee. It really needs to be brought out specifically who makes that determination so that it doesn't become an issue when the staff are just using someone, an employee at the agency who say, oh, I know Sign Language.

>>TERRI SCHISLER: Exactly. So your competency of Sign Language Interpreters has already been determined, because they must be Certified or QA Qualified. So that is why I was skimming over that section, because you don't have any determination to be made.

>>SHANA WILLIAMS: All right, going forward. >>CAROLYN DUDLEY: Section 3-12, Provision of Interpreters in a Timely

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Manner. 3-13, Identifying Language Needs. 3-14.

>>SHANA WILLIAMS: Lois! >>LOIS MARONEY: This is Lois. Okay, on 3-14, when you have A, when I was

working with the CART providers, we had made a suggestion for facilities used for meetings conferences and seminars will be reviewed for accessiblities, and then we added in, including the use of a loop system, Internet and P.A. system. So we're just clarifying because of all the accessibilities, people are only thinking about floor raised, things like that. So if you want to add that in.

Then down this section in, throughout all the documents, (D), I noticed in here, they have auxiliary aids or interpreters, so I'm wondering if it could be auxiliary aids or service providers, just so that is clear it could be a CART provider.

>>SHANA WILLIAMS: I think "service provider" might confuse them because DCF uses service providers as other people outside of their own agency staff. But I hear your point. So let's think of a way that we can say that without that specific term.

>>LOIS MARONEY: Well, if we could say auxiliary aids -- we have to be careful. Interpreters or CART Providers? I think there was another section where we listed a whole bunch of service providers. Maybe take that language and move it over there.

>>MICHELLE RISKE-MORRIS: (Nodding head.) >>LOIS MARONEY: She'll add a comment over here, then I might want to add

one more thing. >>MICHELLE RISKE-MORRIS: I was just agreeing with Lois that in Section C on

Page 3.6 -- or Paragraph C, Section 1, it talks about interpreters, or possibly telephones, but maybe use more of the other language that provides about different types of auxiliary aids and services that could be utilized, such as the ALDs, or CART provider, put that under the definition. And I think that would help better clarify that it's not just for meetings -- it's not just interpreters that are used, you may use other types of auxiliary aids and services. That was going to -- I was just agreeing.

>>SHANA WILLIAMS: So, Lois, if you put that there, the different descriptions of the auxiliary aids and services, that will clear it up for you?

>>LOIS MARONEY: Yes. Will you tell me how (D) is going to read? >>MICHELLE RISKE-MORRIS: I have to find it in the policy. But there is another

definition in the policy that talks about auxiliary aids and services that can be utilized, and it's almost the -- I think it is the ADA definition that was used that talks about some of those. Taking that definition, and I can find it later on, and put it back in there. But it references ALDs, CART Providers, interpreters, sometimes you have written materials that are utilized during a conference -- all of those in there.

>>VALERIE STAFFORD-MALLIS: I support that, because in a meeting, CART is so essential that it's worthwhile to be redundant, to make certain that DCF employees know that if they are scheduling a meeting and there are going to be persons who are hard of hearing or deaf who communicate in English, they need CART.

>>TERRI SCHISLER: I would just note that on that same page, C, Item 1, it talks about TDDs or TTYs. Anytime that the TDD is referenced, I would feel like a videophone should also be referenced. If we're talking about a person in a treatment facility, then they would need to be provided with a videophone, not just a TTY, according to their preference.

>>SHANA WILLIAMS: Carolyn, you are making notes. Was that a yes? >>CAROLYN DUDLEY: Yes. >>SHANA WILLIAMS: All right. Lois? >>LOIS MARONEY: I have a note, "sometimes it is not just preference." Also if

they are calling a family member and the family member only use as videophone and a TTY is provided at the facility, they cannot talk to the family member. So it's just not preferences. It will inhibit them from making telephone calls.

>>VALERIE STAFFORD-MALLIS: And just for the DCF people's information, it

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has to do with functional equivalency, and the Florida Public Service Commission recently tried to support a move to get rid of videophones and video relay service because it went above and beyond functional equivalency, and that was absolutely not supported and upheld. So absolutely, TTYs, TDDs, my point is, are not functionally equivalent for a person who communicates in Sign Language, because they are not communicating in English.

>>SHANA WILLIAMS: Thank you. Lois? >>LOIS MARONEY: Okay. I'd like to know if there was a section for CART and

certification in the requirements? I didn't see that at all. But we are talking about competency of interpreters and translators. I think we do mention the different levels, but does it ever -- is there any section at all that talks about using Certified CART Providers and the rules for that?

>>MICHELLE RISKE-MORRIS: That's one thing that I have in my notes to talk with DCF about, about incorporating some type of provision. The Settlement Agreement does not really talk about other auxiliary aids and services when it talks about time frames or providing of it. It references them, but there's no specific provisions on them. And I would suggest to DCF that they have just a general section that talks about "other auxiliary aids and services," so that individuals know that if you're not using an interpreter, you know, there are other auxiliary aids and services. So a general statement about that, and just reiterate that there are other things out there.

Because when you interview staff, a lot of times staff kind of focus on interpreters or PockeTalkers, and if you ask them "what if communication is not effective," well, if I am using a Pocketalker® I will just go to an interpreter -- which they don't understand that that would not necessarily mean if the person does not know Sign Language that it would work. So a reference to other aids and services that might be used.

But it will have to be fleshed out as to how that will be written out. But I agree with Lois to have something in there that talks about other types of auxiliary aids and services that can be used by staff.

>>SHANA WILLIAMS: Then that also has to be put into the competencies areas, when we are talking about language interpreters, ASL interpreters, foreign language translators, and CART Providers for competency.

>>MICHELLE RISKE-MORRIS: And that's not something that is in the Settlement Agreement regarding that you have to use Certified CART Providers. That I don't know -- has DCF made that determination that we are only using Certified?

>>RICK KOTTLER: If you look at back where we are talking about competency, the first thing it says is, certification of foreign language translators or interpreters is not required. You could start off the same way with CART, saying that certification is not required. However, these are areas of competency that you should be aware of, you know?

>>LOIS MARONEY: But I would have a real difficult time if we were not using a Certified CART reporter. I have attended meetings sometimes where they have had CART reporters that -- I couldn't understand it. It was gibberish. So I was saying that we don't want the CART -- are we saying that we don't want the CART reporters to be certified? It's the same thing, if a deaf person is using an interpreter, it's the same, they can't understand with CART. If the person is not good with typing and they haven't passed the skills, because somebody who is a very fast speaker, and if they don't have the certificate that matches how many words per minute they can type, then you can't understand.

>>SHANA WILLIAMS: Michelle, do you want to talk about that? >>MICHELLE RISKE-MORRIS: That is something that, as the independent

consultant, the only thing I can say is that the Settlement Agreement does not require Certified CART. It does require, though, Certified Interpreters. That is something that DCF will have to make a determination and use the advice of the committee members as to what they recommend. If it's a change to certify, then that would have to be

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something that would then have to be taken back to the Office of Civil Rights, Gail Hoffman; because, again, unfortunately, it's not required in the Settlement Agreement.

>>SHANA WILLIAMS: So are we saying that we are going to fall back on "effective communication" and say if it is not effective, then we have -- the consumer is going to complain? Or are we making a motion to go back to change the language? Valerie?

>>VALERIE STAFFORD-MALLIS: I think what we want to say, if the service provider is not able to facilitate effective communication, then we must find something else that will. If the auxiliary aid or service is not able to facilitate effective communication -- that language comes from the ADA -- then another alternative must be found.

>>LOIS MARONEY: Just for the record, I would like to say that I would like us to go back and change it and have it be "Certified." But if that's not what the majority here says ... but just for the record, that is what I would like. It makes a big difference for me, and being able to understand that a CART reporter is Certified. Also, it's probably -- I will just leave it at that: Certified.

>>JUDY MARTIN: I have to agree with Lois on this. I think we should go back and get a determination from the DCF.

>>SHANA WILLIAMS: Lois, would you like to make that motion? >>LOIS MARONEY: Okay, I would like to make a motion, okay? I would like to

make a motion that we ask for clarification on CART service providers, if they are Certified, or we would like to request Certified CART Providers. I need help.

>>JUDY MARTIN: I just wanted to help her with that. Perhaps we would like a determination that CART Providers be Certified. Period. If that's ...

>>LOIS MARONEY: Thank you. >>SHANA WILLIAMS: Okay, a second? >>JUDY MARTIN: I second it. >>SHANA WILLIAMS: So the motion is made by Lois, seconded by Judy.

Discussion? All in favor that this go back and be re -- >>RICK KOTTLER: Hold the discussion. Yes, there's a question. I think what

we're trying to do is ask you to think about it, talk to Gail about it, see if in some way we can put it in, that these need to be Certified. And then, if you would come back next time and tell us all those wonderful things we want to hear.

>>CAROLYN DUDLEY: We will do that. Judy? >>JUDY MARTIN: Yes, I think that's what we said, Rick.

(LAUGHTER.) >>SHANA WILLIAMS: The eloquence award goes to -- and the vote? All in

favor? Motion carried. [Motion carried.]

>>CAROLYN DUDLEY: Section 3-15. Notification. >>SHANA WILLIAMS: Valerie has a comment. >>VALERIE STAFFORD-MALLIS: Back to the section on meetings. I just wanted

to let y'all know that the Deaf Research Foundation in the fall of 2011 magazine has a wonderful, three-page article on planning accessible meetings for persons who are deaf or hard of hearing. And I will be happy to send that to staff, and that might be a resource that will be helpful for that section, and to resource.

>>JUDY MARTIN: When we refer to them by sections, can we refer to them by numbers so we can find out what page we're on? Thank you.

>>CAROLYN DUDLEY: Okay. >>SHANA WILLIAMS: Carolyn, we have a few more minutes before break, so

would you like to do the next section? >>CAROLYN DUDLEY: Yes, I would like to do that. It is only three pages for this.

Section 3-15, Notification. 3-16, Training.

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>>MICHELLE RISKE-MORRIS: You have to train staff on the complaint procedure, so you just have to add in Chapter 6.

>>CAROLYN DUDLEY: 3-17, Documentation. Record and Retention. >>MICHELLE RISKE-MORRIS: The only thing is that, again, you have to include

that Request for Services form. That is part of the record retention. And secondly, the Customer Feedback Form, it says that when you are provided an auxiliary aid or service, I would put that as, whenever an assessment is done, the client should receive a Customer Feedback Form. Because they may say they don't want an auxiliary aid or service, so they check the box to say I don't want one; but it could be a misunderstanding. They may not understand it. And I would just be more open-ended and say, any time you are doing a communication assessment and the client comes in who is deaf or hard of hearing, give them a Customer Feedback Form.

>>CAROLYN DUDLEY: Any other comments? >>SHANA WILLIAMS: Lois? >>LOIS MARONEY: Yes. If we could just go back, still on Page 3.8, but maybe it

was already, Limited English Proficiency, or do you say Limited English Proficient? >>MICHELLE RISKE-MORRIS: You are changing it to "Proficiency"? >>VALERIE STAFFORD-MALLIS: It is "Limited English Proficiency." >>SHANA WILLIAMS: Thank you.

Sorry, one more thing from Valerie. >>VALERIE STAFFORD-MALLIS: 3-8, the sentence says, "All staff will be trained

on how to attain assistive devices or aids or other reasonable accommodation." Then throughout the document we talk about auxiliary aids and services. Are we really talking about the same thing again but we're using two different labels? I am wondering if we want to be consistent with that so that staff has no doubt in their mind, you know, that we're talking about auxiliary aids and services.

>>SHANA WILLIAMS: Carolyn, you look perplexed. (:-)

>>CAROLYN DUDLEY: For the record. >>SHANA WILLIAMS: How can Valerie clear that up for you? >>CAROLYN DUDLEY: We will make a change. >>VALERIE STAFFORD-MALLIS: I believe in the definitions section when we talk

about auxiliary aids and services, we spell out what all that stuff is, I hope. >>CAROLYN DUDLEY: Okay. Anything else upon 3-8? Page 3-8? Sorry.

Section 3-18, Compliance Monitoring. Section 3-19, Compliance Reviews.

>>SHANA WILLIAMS: Okay, very good. So that brings us to the first break, and almost the end of Chapter 3. So let's break until 10:45 and reconvene on time, please.

>>(Recess taken at 10:33 a.m.) >>SHANA WILLIAMS: Is everyone ready to go back on the record? Let's get

started. Are we ready for Chapter 4?

>>VALERIE STAFFORD-MALLIS: I just wanted to go back to this glossary of terms that we were working on in Chapter 3, and I'm at the bottom of Page 3-10, Item Number I, auxiliary aids or services, where we define that, and there's a shopping list of different kinds of auxiliary aids and services, and I was wondering if we might want to add some of the items that we discussed this morning, such as videophones, loop systems, TTY, TDD, and VRI capability. Just to kind of update that list so that it reflects things that are currently in use. It already has CART and assistive listening devices and that type of thing, but I did notice that these items we discussed this morning weren't on there. I am thinking we might insert them.

>>SHANA WILLIAMS: Thank you. >>CAROLYN DUDLEY: Chapter 4, Section 4-1, Purpose. 4-2, Scope. >>LOIS MARONEY: Are we going over the glossary of terms and the attachments

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for Chapter 3? >>SHANA WILLIAMS: We did the glossary of terms. We have an attachment,

though. Maybe we should back up and do that attachment. Michelle? >>MICHELLE RISKE-MORRIS: We can do that now, and it's also on the agenda

for later. >>SHANA WILLIAMS: Let's do it later then, Lois. >>LOIS MARONEY: On the glossary of terms, I'm on Page 3-10, C, and it says,

and "services for customers, clients"? Something needs to be put in there. Glossary of terms, C, and services for customers, clients. What do you do, "customers and clients"? Do you see where?

>>JUDY MARTIN: What number? >>LOIS MARONEY: On Page 3-10, glossary of terms, C, ADA-Section 504

coordinators, ensuring the provision of auxiliary aids and services for customers, clients. Just needs a little something in there. Okay?

>>SHANA WILLIAMS: So you want the slash? And what about "companion"? Okay, she has it.

Thank you. >>LOIS MARONEY: Again, on 3-16, Attachment 2 -- >>SHANA WILLIAMS: Lois -- >>LOIS MARONEY: Very bottom of that page, well, three up from the bottom, it

says "interpreters service status," do you want to put "CART provider" in there also? On some of these forms where it might ask for the interpreter's signature --

>>SHANA WILLIAMS: We have a lot of comments that are going to go on those forms. All the attachments. So I think we are going to do all of the forms and attachments --

>>LOIS MARONEY: That would be at a whole section? Oh, I thought because it was on here, to get it in now. But we'll do that later?

>>SHANA WILLIAMS: Yes. Is that all right? >>LOIS MARONEY: Sure. >>SHANA WILLIAMS: All right, Carolyn? >>CAROLYN DUDLEY: 4-2, Scope.

4-3, References. 4-4, General. 4-5, Definitions. 4-6, Roles and Responsibilities of ADA/Section 504 Coordinators and Single

Points of Contact. 4-7, Policy.

>>SHANA WILLIAMS: Terri? >>TERRI SCHISLER: I have a question. In Paragraph 5 on Page 4-4, between

the time an interpreter is requested, is the paragraph. And it uses the term on the second line from the bottom, "Sign language pictographs." Can you clarify what that is?

>>CAROLYN DUDLEY: In the institutions we saw during our recent visits, there are pictures that give the -- helps the client understand what's going on, what they need, if they can identify this is what they are looking for, do they want an interpreter, or do they need a videophone, whatever they need. They have pictures. I don't have an example with me. I don't know if Michelle has any with her or not.

>>MICHELLE RISKE-MORRIS: They also use things like if they want something to eat, they have pictures on the wall, so if you have an individual who is there 24/7, they have pictures that, they can point to somebody or point to the wall and point at what they want. Or if it is time for medicine, if they want other types of things, letting them know it is time to go eat, time to go to class, they use pictures.

>>TERRI SCHISLER: I think in the hospital setting, I have often seen those types of communication tools. I'm not -- without seeing the actual one they are using, though, I am not sure if they are just sign language pictographs or just simply

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pictographs. >>MICHELLE RISKE-MORRIS: I don't know. And they do have, at some of the

Access facilities they use flash cards. Carolyn is not here, because they also use them -- I think they are Sign Language flash cards, though, that they do use at the facilities that, while they're waiting, trying to assist the client or companion, they will pull those out in case they are requesting like food stamps, trying to figure out what type of aid the person wants.

>>SHANA WILLIAMS: I have seen both apex, that is a communication system, pictures or labels for everything, that works and they usually keep them on a key ring and they can flip them, or put them on the wall. And there are the Sign Language cards you are talking about. I have actually seen the patient Bill of Rights done with those pictures, so on, so on. So I think it is an intermediate way; but when you read this, does that come across that that is what they are talking about? Or do we need to add some words here to make the Sign Language pictures or text communication system distinguished? Terri?

>>TERRI SCHISLER: You might want to clarify, they could be Sign Language pictographs or Sign Language materials, and also other kind of pictorial system to use. I just didn't quite understand what we were referring to and wanted to make sure. That would be an intermediary tool for when the interpreter is not there, and you just want to know, are they hungry, do they need medication, is something bothering. Yeah, I am very familiar with those. I just wanted to clarify the terminology on that.

>>MICHELLE RISKE-MORRIS: I would suggest any type of thing that an employee is going to understand. So if they are reading this, that is just made so they understand what they are referring to.

>>SHANA WILLIAMS: Sign Language or other pictures of communication. >>SHANA WILLIAMS: Lois? >>LOIS MARONEY: Can I apologize for this, Page 4-1, the very first paragraph

4-1, purpose. At the end, auxiliary aids and or qualified interpreters, we have to do something in there. So auxiliary aids, or service providers at no cost, or auxiliary aids and/or qualified interpreters, CART Providers, at no cost. But just to put that in there.

>>CAROLYN DUDLEY: We will review it. >>CAROLYN DUDLEY: 4-8, Communication Assessment Criteria. 4-9 -- >>MICHELLE RISKE-MORRIS: Oh, I don't understand under 4-8, which is on

Page 4-4, why, when they are determining whether or not it is aid-essential, the type of auxiliary aid or service requested is relevant. And I thought that was going to be taken out, because --

>>VALERIE STAFFORD-MALLIS: Oh, yeah. >>CAROLYN DUDLEY: All right, we will remove it. >>VALERIE STAFFORD-MALLIS: Absolutely, because otherwise you could say

you were discriminating based on the accommodation they were requesting. >>SHANA WILLIAMS: Thank you. >>MICHELLE RISKE-MORRIS: And back on Section 4-7, the policy section, I

think that you have an example, an attachment of examples of aid-essential communication. I think we should reference that. As an attachment to the chapter, so that staff have an idea, and it's based on the Settlement Agreement.

>>CAROLYN DUDLEY: 4-9, Completing the Communication Assessment Using 7-61 DCF Available Forms.

>>SHANA WILLIAMS: Lois? >>LOIS MARONEY: Are we on 4-9, Page 4-5? >>SHANA WILLIAMS: Yes. >>LOIS MARONEY: All right, thank you. D. 1. Staff will utilize the ... auxiliary

aids plan as appropriate to ensure interpreters are available to assist individuals who are deaf. You know what's coming. CART Providers.

>>CAROLYN DUDLEY: Anybody else at 4-9? 4-10. Provision of ongoing and subsequent auxiliary aids or services without

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additional customer requests. 4-11. Medical concerns. 4-12. Determination not to provide requested auxiliary ... for non-aid-essential

communication situations. 4-13. Notice of available appropriate auxiliary aids and services to individuals

who do not request such aids. >>VALERIE STAFFORD-MALLIS: Going back to Section 4-12, where we were

talking about turning down the requested auxiliary aid or service, I remember earlier in the morning we talked about the fact that that was incomplete, and needed to have a sentence inserted that something has to be offered in addition to the turn-down.

>>MICHELLE RISKE-MORRIS: Again, I'll write this up as well, but that additional, and also who has the authority to deny that service. But in 4-13, I think there needs to be additional information about when you provide them, because I do notice on the Request for Services form, there's a section that says, you may not want an interpreter provided, but we may provide an interpreter, such as during an abuse investigation. So I think that similar language should be added about the notice of available auxiliary aids when you do not request such. So you need to let staff know that even in situations where you deny aids or service you may have to provide an interpreter.

>>SHANA WILLIAMS: I also ask on 14 just to clarify, basically when I read this, it just said that if you didn't provide something and you still think something is needed that you are going to tell them it's free. It doesn't really talk about, okay, what is your next step.

>>CAROLYN DUDLEY: 4-14, requesting feedback from customers and/or companions?

>>SHANA WILLIAMS: On that, we are planning to do these on video. Right? We should probably add that. Terri?

>>TERRI SCHISLER: In 4-14, Paragraph C, it talks about getting that feedback form sand it says including additional interpreter services where necessary. I oh know we talked about the fact that -- how that feedback form is going to be completed. If the interpreter who's on site during that incident or that meeting is then also provided to help the client to fill out the feedback form, the feedback may be about the interpreter who's there with them.

It's probably going to be important that that feedback be provided in a different place or time, or with a different interpreter, or somehow. I don't know how you could make that work, but you can't use the interpreter who you are giving feedback on to give -- to fill out the feedback form.

>>CAROLYN DUDLEY: Michelle is going to be discussing the feedback form now because the form we have now is going to be revised so wait until her presentation.

>>MICHELLE RISKE-MORRIS: I am suggesting that we really revise it so we can talk about that.

>>TERRI SCHISLER: Then in section -- no, I'll hold it until the next section. >>LOIS MARONEY: Are we on 34-14, page 4-6? >>SHANA WILLIAMS: Go ahead. >>LOIS MARONEY: This is just general, or I am just going to keep saying it again

and again and again. But if you could, I know that with auxiliary aids and we add service and I think we went through everything and fixed that up. Now I would like to make that request are where it says "interpreter," that you also put in, "or other service provider, or CART Provider."

Because if you take a look on 4-14 Page 4-6 and the performance of the interpreter, same thing as the performance of the CART person. If they are not able to understand, you get feedback from them. Because the typing wasn't good? They didn't have the terminology for like medicine, things like that? So throughout all of these documents, unless the section is specifically talking about interpreting, just go through and add in, "CART provider or other service provider."

>>MICHELLE RISKE-MORRIS: They have "interpreter or other appropriate

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auxiliary aid or service." I think that's what they were trying to capture, anything else that's utilized besides the interpreter.

>>LOIS MARONEY: Okay. This says specifically the performance of the interpreter. I appreciate what you are saying, Michelle; it is in there through this. But I'm just trying to have it be known and clear that it can also be a CART provider, and I think we don't want them to just be thinking of interpreters. Do you see where this is?

>>MICHELLE RISKE-MORRIS: Sorry, I see where you are saying. I was looking at the wrong place. Thank you.

>>CAROLYN DUDLEY: Any other questions on 4-14? 4-15. Notice to community. 4- -- whoops. Sorry, Terri.

>>TERRI SCHISLER: I don't know if this needs to be explicitly stated here, but my recommendation on the Web site for all of the videos, and I haven't seen the recent video, so I don't know if there's been recent changes, but it would help the deaf and hard-of-hearing consumers, especially those who have limited English proficiency, if the information that is strictly for them as a customer or companion information is on a single Web page or separate Web page from all of the legal documents and the minutes and all of those required postings of public information, so that the deaf person doesn't have to sort through 100 links and documents; that that information for the customer's companions is on a different page or set of pages and is easily accessible without having to figure out what all those individual links mean and where they can find the information.

>>SHANA WILLIAMS: I have to agree. Also, we bounced back and forth some logos and designs for accessibility and

for notice to the public that these services are available. Did we decide on a logo that DCF is going to use that depicts the different auxiliary aids?

All right. So we need to revisit what that's going to look like so we can get a visual cue for consumers who understand that when they see that, that means they can have any of those -- I think there's an interpreter, augmentative devices, a bunch of things on that logo.

>>MICHELLE RISKE-MORRIS: And you are saying when DCF sends out notices for like a meeting, that they have those logos.

>>TERRI SCHISLER: Correct. >>MICHELLE RISKE-MORRIS: All right. >>CAROLYN DUDLEY: 4-16, Sign Language and Oral Interpreters. >>RICK KOTTLER: This concern comes in this portion, but it is overall. We talk

about Number 3 and Section D, video remote interpreting services. Staff has to ensure that those interpreters are certified. And I don't think that that's specifically pointed out anywhere in this document. It may be here, it may need to be someplace else, but you can't use any video interpreting service. If you go online and punch in those services, 50,000 of them will come up and try sending them an e-mail and asking if they are certified and you will never hear back from them. (:-)

>>SHANA WILLIAMS: Anything else on 4-16? Terri? >>TERRI SCHISLER: Starting at the top. B. The terminology that's used in

here, and it's used other places, also says, have rudimentary familiarity with Sign Language or fingerspelling to communicate. I'm reading the whole paragraph. Because, is this paragraph saying that any person who has rudimentary familiarity with Sign Language and has been evaluated could be considered qualified? Facilities may use staff who have rudimentary familiarity with Sign Language.

>>SHANA WILLIAMS: Go ahead, Michelle. >>MICHELLE RISKE-MORRIS: This was, again, a reference to earlier, I'm going

to request it again of DCF to say that, when they talk about staff, that they refer more so to the Settlement Agreement that states, we have this process to determine who qualified staff are, and then put that in there, not in language.

In I think emergent -- the Settlement Agreement provides that in emerging situations until such time as that interpreter can be there, they may use, you know,

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somebody to assist just to let the person know what's going on. They are not a qualified, but just to help until they can get that interpreter there. So that should be really the only two sections that are put in.

So my suggestion is, this is rewritten to mirror DCF's process to evaluate and designate an employee as Qualified Staff Interpreter.

>>SHANA WILLIAMS: Okay, I think that that's going to be very useful. My comment is that this doesn't delineate between the person who walks up and says hi, good morning, in sign, and gives you a brochure, and that level is so different than filling out an admissions form.

>>TERRI SCHISLER: The list of items that they can be qualified to do such as filling out admissions form is not acceptable when the person has what we call survival signs -- they can say hello, where's the bathroom. So I definitely had concerns there.

The next paragraph, all contract interpreters must be certified, reviewing the credentials. Again, that use of the term "Certified," can be a verb. So are we asking that they can be evaluated to determine? Or that they must be nationally Certified?

>>CAROLYN DUDLEY: It will be rephrased to indicate that all contract interpreters have to be Certified. We cannot accept -- nationally Certified. We cannot accept anybody who is not Certified.

>>TERRI SCHISLER: It's the same wording that we talked about earlier, where we said a person who possesses certification, rather than "must be Certified."

>>VALERIE STAFFORD-MALLIS: Yes, you could say all contract interpreters must possess national certifications, determined by reviewing the credentials of individual contractors. So they possess the national certification as determined by a review of their credentials.

>>TERRI SCHISLER: Exactly. >>SHANA WILLIAMS: Anything else, Terri? >>CAROLYN DUDLEY: Any other discussion on 4-16? >>TERRI SCHISLER: Yes. In the next paragraph, D, the paragraph talks about

when a customer or companion requests a Sign Language Interpreter or an oral interpreter for an aid-essential communication situation, and then in number two it lists qualified DCF staff. But a qualified staff person is only for non-aid essential according to the policy.

>>CAROLYN DUDLEY: No. The qualified staff can also do aid-essential situations.

>>TERRI SCHISLER: I haven't seen that in the policy. >>MICHELLE RISKE-MORRIS: In the Settlement Agreement, it does reference

that DCF can have qualified staff who can interpret an aid-essential. Unfortunately, however, DCF has not found anybody to have that designation. The only time that really they can use anybody else for any type of communication is just in that short interim period before they get an interpreter, or if someone comes in and requests like to use the facilities or something like that, rudimentary Sign Language. But generally speaking, only on aid-essential use, such as qualified staff facilities in an Access facility. So if someone is coming in and filling out application for benefits, they can assist someone with that.

>>TERRI SCHISLER: Then I need to go back and review the documents and see where that language is, and that would come up again tomorrow when we look at the form that I created, because as we stated before, if I go through all of these documents and I try to understand what the Settlement Agreement requires, and then what exactly is DCF's policy, because you've upped the qualifications stating that all contractors must be Certified, which is not what the Settlement Agreement says -- you have raised the bar there. So if I try to determine exactly what is the policy on use of interpreters, then I have missed it again, because I had heard that only qualified DCF staff were to be used in non-aid-essential so I am missing where that is somewhere else.

>>CAROLYN DUDLEY: Okay, if you look at the Settlement Agreement, it's on Page 26, Section H-2. DCF direct services facility shall utilize Certified Interpreters on

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a contracted basis and DCF personnel who are qualified to interpret for deaf and hard-of-hearing customers or companions when requested by a customer or companion in aid-essential situation or as necessary for effective communications.

>>TERRI SCHISLER: I definitely see what is being said in that paragraph and it talks about those able to be used in non-aid-essential. I would want to go back and look through some of these documents to verify that that's clear in other places as well.

>>MICHELLE RISKE-MORRIS: And that's one of the things that I brought it up earlier, but that I am working with DCF, because I have it throughout the document, it's circled everywhere they talk about qualified, qualified, or certified. Because I can't stress enough to DCF and to everybody that if you are going to use terminology that staff are going to understand, they're being trained right now to know certified, and qualified staff. It's got to mirror in this policy. That's why I want to focus as much on just those two definitions, but then have another provision that does talk about qualified, competent interpreters, but to minimize the confusion. Because these are for the employees. And DCF is going to use this to enforce their policies, because now that they are putting those policies in place, and staff are being trained, if staff aren't following them, DCF has to follow up with those staff members, which could lead to employee discipline. And so making these policies as clear as possible, that is going to be something that there's going to have to be a substantial revision of these terms, so that it's clear that if it is a DCF -- non-DCF staff, it has to be a Certified Interpreter, even if it is with a contract provider, if it's with any DCF direct service facility or administrative office; if it's a non-employer, it must be certified.

With DCF facilities for employees, they have to be qualified through that assessment process or they can -- you can also have a certified employee, because there are some employees who have the national certification, and so that's the one little tricky situation, but, you know, I think you will start seeing more of that.

>>TERRI SCHISLER: Right. In the next item, D, 3, video remote interpreting services, I'm going to go back to

see what we're talking about here. I think in that section we are talking about what are the appropriate services for

aid-essential situations, and you list video remote interpreting, and, of course, we do want to make sure we are getting a Certified Interpreter through those services. But if you are going to list that, you also need to list video relay services. Because video relay service could be initiated by the client calling you on the phone through VRS, whether you actively use it or not. T client is going to call you through the video relay service is so you are going to be providing aid-essential through VRS as well.

>>VALER