9-11 Emergency Response and the Deaf and Hard of Hearing Community

9-11 Emergency Response and the Deaf and Hard of Hearing Community Perceptions, attitudes, and capacity Mychael Dickerson, Jonathan Kinsey, and Paul Negrin

Table of Contents • Cultural Competency • Statement of Problem • Purpose of Report • Methodology and Analysis Techniques • Recommendations • Barriers • Questions

Cultural Competence Services, supports or other assistance that are conducted or provided in a manner that is responsive to the beliefs, interpersonal styles, attitudes, language and behaviors of individuals who are receiving services, and in a manner that has the greatest likelihood of ensuring their maximum participation in the program. - Developmental Disabilities Assistance and Bill of Rights Act Amendments of 1994

Statement of Problem Virginia’s 9-1-1 Emergency Response service is currently administered by local Public Safety Answering Points (PSAPs). With Next Generation 9-1-1, VITA will be helping these centers transition to a new, more advanced system to process communications. One of the populations that effort is designed to help is the deaf and hard of hearing community. However, there has been little research into the current level of service that the community currently receives. Is the current service level adequate? Will the proposed changes improve the current situation?

Purpose of Report Our group, in conjunction with VITA’s Integrated Services Program, PSAPs and local deaf and hard of hearing communities, will attempt to determine the current level of emergency response service provided to the deaf and hard of hearing community. Furthermore, our group will attempt to evaluate whether or not the proposed changes to 9-1-1 emergency response will improve the current level of service to this community.

Methodology and Analysis Techniques Our group has employed a combination of surveys and literature review in order to determine service levels to the deaf and hard of hearing community. These include: • A literature review of government mandates relating to emergency response guidelines • A literature review of NG 9-1-1 • A survey distributed to emergency responders • A survey distributed to individual deaf and hard of hearing communities

Methodology and Analysis Techniques, Cont’d • Analysis of • Code of Federal Regulations • VITA documents • National Emergency Number Association (NENA) Operations Information Document • Focused on • Current and future mandates • Current and future technologies • Recommendations for PSAPs, the community, and communication assistant professionals

Methodology and Analysis Techniques, Cont’d • 28 million Americans are deaf or hard of hearing • 1.2 million Virginians will experience hearing difficultly* • Current technologies available to PSAPs • TTY • Internet Protocol (IP) Relay • Wireless IP Relay • Video Relay • Communication assistants and video interpreters are significant service providers • Any change in service to emergency response needs to be comprehensive *Data estimated using CDC and U.S. Census data

Methodology and Analysis Techniques, Cont’d • Literature Review of Next Generation 9-1-1 Comprehensive Plan • Establishes the foundation for taking the 9-1-1 center to the next level • Pursuing a more comprehensive and technically advanced suite of services in major cities • Establishes 9-1-1 telecommunications as a rewarding career choice

Methodology and Analysis Techniques, Cont’d • Literature review of Next Generation 9-1-1: Findings • System needs to address the needs of specific communities, including deaf and hard of hearing • Technological upgrades need to be made statewide and not just in major metropolitan areas • Training must be available and consistent to all PSAPs

Methodology and Analysis Techniques, Cont’d • Survey for emergency responders • Distribution Method • Created on SurveyMonkey.com • Distributed to Richmond area PSAP • Question Overview • Survey consists of 5 questions • Question types are ordinal and open ended • Created with the intent of determining current level of service

Survey for Responders, Summary & Results • What is your confidence level that 9-1-1 calls from the deaf and hard of hearing community are answered promptly? • What is your level of confidence that 9-1-1 calls from the deaf and hard of hearing community are answered accurately? • What is your confidence level in the technical effectiveness of the 9-1-1 system for handling calls specifically from the deaf and hard of hearing community?

Survey for Responders, Summary & Results 4) How many calls from a deaf and hearing caller do you receive during an average shift? This data is based on yearly totals, as those surveyed responded on differing time spans

Survey for Responders, Summary & Results 5) What changes, if any, do you think should be made to the PSAP that would benefit the deaf and hard of hearing callers? “Receive text messaging” “…text or e-mail would be beneficial” “More outreach to the deaf and hard of hearing callers” “More communication that 9-1-1 can handle TTY” “More training!” “…test calls to every PSAP”

Survey for Responders, Summary & Results • PSAP employees are confident with services being offered, but acknowledge there is a lot of room for technological and training growth and improvement. Does this match the perception from the deaf and hard of hearing community? How should NG 9-1-1 address this gap?

Methodology and Analysis Techniques, Cont’d • Survey to deaf and hard of hearing communities • Distribution method • Created on SurveyMonkey.com • Distributed to the Hearing Loss Association of Central Virginia and the Virginia School for the Deaf and the Blind • Sample size of 38 • Question overview • Survey consists of 10 questions • Question types used are ordinal, nominal, and open-ended • Created with the intent of analyzing current perception of service level and desired service level

Survey for Deaf and Hard of Hearing Communities, Summary and Results 1) Please select your hearing threshold.

Survey for Deaf and Hard of Hearing Communities, Summary and Results 2) In the event of an emergency, who would you contact first for assistance? 3) If you answered “Other” to question 2, please describe your first contact. All respondents skipped this question

Survey for Deaf and Hard of Hearing Communities, Summary and Results 4) How confident are you that 9-1-1 Emergency Response would be able to provide assistance that you require in the case of an emergency? 5) How confident are you that 9-1-1 Emergency Response would be able to provide the necessary service to you in a prompt manner in the case of an emergency?

Survey for Deaf and Hard of Hearing Communities, Summary and Results 6) Please list the types of communication that 9-11 Emergency Response is able to receive that you are aware of (e.g. telephone call). • Some incorrect assumptions by community • Videophones • Texting

Survey for Deaf and Hard of Hearing Communities, Summary and Results 7) Please list any additional types of communication that you believe 9-11 Emergency Response should be equipped to receive. • Text-messaging was most common response • Video-phone also appeared

Survey for Deaf and Hard of Hearing Communities, Summary and Results 8) What would be your preferred type of contact with emergency response if all the options were available to you? 9) If you chose “Other” in Question 8, please enter your preferred method. All Respondents skipped this question.

Survey for Deaf and Hard of Hearing Communities, Summary and Results 10) Please provide any additional suggestions or comments for Virginia’s Emergency Response Systems • “Attend a workshop on emergency response for the Deaf and Hard of Hearing” • “Train dispatchers to use TTY machines and Videophones”

Survey for Deaf and Hard of Hearing Communities, Summary and Results • Some perceptions of the current state of 9-1-1 indicate a significant disconnect in information • Suggestions for the future align with national recommendations; not all of these align with Next Generation 9-1-1’s plans • Effectiveness of TTY is just as important as implementation of new technologies

Comparison of Survey Results • Chart comparing perceptions of responders and DHH community on call response

Recommendations • Include improvement of services for the deaf and hard of hearing community as a specific part of the strategic goals and a stand-alone initiative in the Virginia Statewide Comprehensive Plan • The deaf and hard of hearing are a unique culture in respect to 9-1-1 • Cultures like this and ESL must be paid special attention in an established format

Recommendations • Identify, implement and update latest technology and best practices, in PSAPs across the state, to directly receive communication from the deaf and hard of hearing community (to include texting, video conferencing, etc.) • Best practices can come from individual PSAPs, other states, and the communities in question (deaf and hard of hearing)

Recommendations • Consult the deaf and hard of hearing community for future recommendations and changes to emergency services, such as the “Expectations of the Deaf and Hard-of-Hearing Communities for Comprehensive Federal Action to Accelerate Emergency 911 Access” by Gallaudet University • Advances in technology will only be embraced by communities that are ready to accept them • Communities like DHH may have recommendations that are inexpensive and easy to implement

Recommendations • Disseminate information to the deaf and hard of hearing community regarding which types of communications are currently available for emergency response services • There are misconceptions regarding what services and technologies Virginia 9-1-1 is equipped to receive • These misconceptions may be shared by other communities

Recommendations • Provide monthly training for PSAP employees across the commonwealth. This training should include specific training for cultural competency (American Sign Language) as well as technology training for devices like TTY • More training was recommended by both responders and the DHH community • Understanding more about TTY and other technologies from the user’s end may help the responder to serve them

Recommendations • Train and prepare responders for the transition to Next Generation 9-1-1 and stagger the introduction of the new technologies to ensure adequate preparation • When numerous technologies are introduced at once, staff may have a hard time adjusting • Staggering technologies may unveil problems that can fixed quickly

Recommendations • Direct telephone relay services to make 9-1-1 calls a top priority • Research into priorities of relay services proved to be complicated • The promptness of 9-1-1 response was called into question by the DHH survey

Recommendations • Make technological and personnel reforms comprehensive and community based • Commonwealth of Virginia, PSAPs, and communities must all understand the implications of large changes in infrastructure • Everyone is a stakeholder in emergency response

Barriers • Next Generation 9-1-1 • Infrastructural gap in rural areas to handle the latest technology and best practices • More technology may make it more difficult for PSAPs to perform their job well • Video relay services depend on bandwidth of both parties, thus increasing the likelihood of delay and jitter • Communication • The deaf and hard of hearing community is not centralized • Buy-in from PSAP staff may be difficult for what may seem like preferential treatment

Barriers • Cost/Burden • Translation during emergency and stress will be more difficult than in training • The rush to implement technologies may cause service to suffer for all customers • The amount of communications from deaf and hard of hearing individuals to PSAPs is small, making the cost to implement technology high, relative to its use

Conclusion • The future of Virginia 9-1-1 • Questions?

9-11 Emergency Response and the Deaf and Hard of Hearing Community