Including clients who are deaf, hard of
hearing, deaf-blind, blind, visually impaired
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Define the ADA
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Roles and Responsibilities
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Communication with clients who are deaf or hard of hearing
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Terms and Definitions
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Services
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Interpretation vs. CART
How to access on-line VRI
How to schedule In-person Interpretation and CART
How to access on-line CART services
Phone calls
Accommodations for individuals who are blind or visually impaired
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Americans with Disability Act
◦ The purpose of the ADA ... is to provide a clear and
comprehensive national mandate to end discrimination
against individuals with disabilities and to bring those
individuals into the economic and social mainstream of
American life."
◦ Physical or Mental Impairment are purposefully not
exactly defined to avoid limiting definition and to allow
room for future growth in recognition of disabilities
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Auxiliary Aids and services 28 CFR 36.303
Requires public accommodations provide auxiliary
aids and services to the disabled to allow them to
participate. Applies particularly to communication
with disabled and includes:
◦ a. aids for hearing impaired like interpreters, amplifiers for
telephones, TDD's, open and closed captioning
◦ b. aids for visually impaired like readers, taped texts, braille
materials, large print
◦ c. use of the most advanced equipment is not required so
long as effective communication is ensured
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Employees
ADA Representatives are the location “experts”.
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Complete Forms for each service usage.
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On-Line Services will be accessed through computers
(laptops or desktops) which have been previously set
up by IT. For each program identified as having a
need, one computer at reception and at least one
computer in another location for use during
confidential discussions will be allocated.
Refer to the person first
and the disability second.

There is a young man who is
deaf waiting for assistance.
The deaf man over there wants an
interpreter.
Human Resources – ADA Coordinator
 Training - It is the responsibility of the ADA
Representatives to train all receptionists and
individuals who engage with the public as part of their
regular duties.

On-Site Services and Remote CART Service should
be booked through the ADA Coordinator, Gina
Mallory. At least 4 business days’ notice is needed to
process the request. Expedited services are available
but at an additional cost. If you do not have the
amount of time needed, please call the ADA
Coordinator directly to discuss the circumstances.

The following suggestions will help you
accommodate the individual who is deaf or
hard of hearing.
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Speak in a normal tone of voice. Shouting
makes many words hard to understand.
Don’t slow your speech. Speak at a pace that
allows words to be clearly distinguished from
one another, but not so slowly that you lose
the natural rhythm.
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Before you begin to speak, be sure the
listener knows you want to communicate.
If they are not facing you, wait for them to
look in your direction or tap them gently on
the shoulder.
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When speaking to someone with hearing loss,
make sure they can clearly see your mouth –
especially in noisy environments. Most people
have a natural ability to lip read.
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Maintain eye contact while speaking.
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Keep your hands away from your face.
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Make sure you have good lighting. Light
should be on your face and not behind you.
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Distance makes hearing harder.
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Stay within 4-6 feet of your listener.
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If the listener can hear better on one side, try
to stay on that side.
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We communicate a lot more than we realize
through facial expressions, gestures and tone
of voice.
You can use natural hand gestures to relay
direction or to help identify what you are
trying to relay.
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If you need to repeat a sentence, try using
different words that may be easier to
understand.
If someone with a hearing loss walks in
during the middle of a conversation, bring
him/her up to speed on the subject.
Patience is key.
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Reduce background noise as much as
possible before starting a conversation. TVs,
radios, air conditioners and even other people
talking can greatly affect a listener’s
understanding.
Close the door before you begin to have a
conversation.
Move to a small enclosed room, if possible.
 Yes
 No
 Help
 Bathroom
ASL
 Able
to Sign Language
 American Singing League
 American Sign Language
Answer – American Sign Language
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What you use to take your groceries to the
checkout counter.
Computer And Real Talking
Computer Assisted Real-Time Translation
ANSWER – Computer Assisted Real-Time
Translation
 Very
Real Interpretation
 Video Remote Interpretation
 Vonderful Real Inspiration
ANSWER – Video Remote Interpretation
Also known as VRS or Video Relay…
Services
Captioning
Sign
Language
Services
Sign
Language
Captioning
In person
or
Computer
VRI – Video Relay Interpretation
 Interpreter on your computer
On-Site Interpretation
 Live in person service which must be scheduled
ahead of time (at least 4 business days)
Did you know?
Variations of visual communication/interpretation include:
ASL, Pidgin, Signed Exact English I and II, Tactile, Cued speech,
Oral
Remote CART
 Computer Assisted Real-Time Translation
 Closed Captioning on your Computer
 Used for one-on-one communication
 Must be scheduled ahead of time
On-site CART
 In person Closed Captioning
 Used for planned meetings or events involving
multiple participants
 Must be scheduled ahead of time

A young lady comes into your office accompanied by a
young man and he begins to communicate with you
regarding her needs. He explains that she is deaf.

Refuse service?
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Help them as usual?
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Ask him if she would like to communicate directly via Sign
Language?
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Point to the sign in the window explaining services
available?
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Access video relay interpretation?
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NO
Webcams/laptops have been set up with
special software in order to access the
services on-line.
One at reception.
One in a location where a confidential
conversation can take place.
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Login
Click on the icon –
Enter the Username – DHMH
Enter the password – bisvri
Under ClearSea Server
◦ Enter – call.clickvri.com
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Arrow over the green dot.
Choices will show on the right,
Click on CALL.
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Harford County Health Department
Walk-In VRI SERVICE USAGE FORM
1. Fill out the form and
have your ADA rep. sign
it.
2. Make a copy.
3. Send to Gina.
This form must be completed for billing purposes. Keep a copy for
your records, but return the original form to: Gina Mallory, ADA
Coordinator.
Date - ________________ Time of Service - _________________________
Division/Program - _______________________________________________
PCA # - ___________________________________________________________
Company Used – Check One
***NOTE: It is critical that the first vendor listed in bold be used.
Documentation is required if the highest-ranked vendor is unable to
provide services.
For Video Remote Interpretation
Birnbaum Interpreting Services – Video Remote Interpretation
Purple Language Services Co. – *Explain below why you were
unable to use Birnbaum Interpreting Services.
*Explanation if first vendor in the list was not used ____________________________________________________________________
____________________________________________________________________
Name of person completing form___________________________________
Phone number of person completing form___________________________
Program ADA Representative Signature - ___________________________
Division Director Signature - _______________________________________
ADA Coordinator - _________________________________________________
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Go to:
www.karasch.com
Click on the User
Login button at
the top right of
the screen
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Enter username:
DHMH
Enter password:
Harford
 Click on
Join
Session
next to
Remote
CART
Meeting.
 Internet Explorer -
you may see this
message:
Click ALLOW.
------------ If you see this
screen, Click on
Always run on
this site.
A pop-up box will appear asking you to join
the audio conference.
•Click yes

Just click on the X to close this box.
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Click on X to close the volume box.
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For CART services
and On-site
services, you must
complete a form
and send to the
ADA Coordinator.
Once, services are
scheduled, you will
receive a form to
complete on the day
services are
rendered.
To reach someone through Maryland Relay,
dial 9-7-1-1
1. Press 1 for Voice Relay
2. Press 1 to place a call
-or1. Press 2 for instructions
2. Enter the phone number on your phone
keypad
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VISION – there’s more than meets the eye
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Respond to your client’s requests and needs.
Never assume what functional effects the
client’s visual acuity may have.
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Introduce yourself by name and function.
Address the client by name when speaking
to him/her.
“Hi, Mr. Smith. I’m Gina Mallory and I’m
going to take you to the exam room.”
Upon request, staff should provide
assistance.
OPTIONS
 Large print
 Reading documents aloud
 Forms on tape/pre-recorded on the
computer.
 Braille
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A piece of cardboard, a plastic ruler or metal
signature template can be used to indicate
where a signature is required.
Place the cardboard edge horizontally below a
signature line or orient the opening of
signature template where signature is
required.
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Staff should NOT touch or remove mobility canes (such as
the long white cane) unless requested to do so and should
not interfere with dog guides.
Identify yourself and offer guide assistance if it appears to
be needed. If assistance is accepted, offer your arm to the
client. The client will lightly hold your arm directly above
the elbow. Don't pull or push the client or hold his or her
arm. Relax and walk at a comfortable, normal pace. Allow
the client to walk a step or two behind you, and indicate
changes in terrain.
If it is necessary to take an individual's cane, tell the
person you are removing it and where it can be retrieved.
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Must allow dog guides into the building
unless there is a direct threat to health or
safety must be determined by competent
staff, based upon medical or other evidence.
Owner is responsible for care and supervision
of the dog.
Do not pet, feed or otherwise distract the
animal.
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Tactile interpretation or printing in the
person’s palm for communication.
May have some residual sight and could use
large print.
X drawn on his/her back is the universal sign
for EMERGENCY.

ADA stands for
◦ Americans with Disability Act

VRI stands for
◦ Video Relay Interpretation
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CART stands for
◦ Computer Assisted Real-time Translation
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ASL stands for
◦ American Sign Language
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Always describe the person first and the
disability second.
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Offer assistance, never assume.
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Access VRI Service and complete a form.


For scheduled service (including on-site
interpretation and CART services), complete
request and send to Gina Mallory.
ADA Coordinator – GINA MALLORY
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Walk-in
◦ VRI – Sign Language
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Schedule
◦ Sign Language Interpreter (in-person)
◦ CART (in-person)
◦ CART (on-line)