The following is a transcript for the first installment in the DSA 2024 Webinar Series, focused on the Older Americans Act (OAA). Open to all interested persons, the webinar was held via Zoom on June 4, 2024 with more than 500 registered participants. The webinar series is provided through the generous support of the Laurence W. Levine Foundation, with technical support by ZP Better Together.
Postscript: We apologize that the recording of our recent Older Americans Act (OAA) webinar is unavailable due to a technical error. We've also taken steps to ensure all future webinar recordings are available.
PHIL AIELLO: Hello, everybody. My name is Phil Aiello. I am the President of Deaf Seniors of America (DSA). Welcome to DSA's first webinar series with today's topic on the Older Americans Act (OAA). In today's webinar, we will learn why this act is critically important for Deaf senior citizens across the nation.
I want to introduce you to our three panel members who will share information regarding the OAA. They are Sherri Collins, Executive Director of the Arizona Commission for the Deaf and Hard of Hearing (ACDHH), AnnMarie Killian, CEO of TDIforAccess (TDI), and Jacob Salem, State Legislation Manager of National Association of the Deaf (NAD). Again, thank you for joining us. Let's go ahead and start with introductions. Thank you.
SHERRI COLLINS: Absolutely. Hello. Good afternoon, everyone. My name is Sherri Collins. I am Executive Director at ACDHH. And I'm also here representing the National Association of State Agencies of the Deaf and the Hard of Hearing (NASADHH). I am an older woman with short, brown hair, black sleeves that come down to my elbows. I have a black background.
JACOB SALEM: Well, I am Jacob Salem. And I am the State Legislation Manager for NAD. I have brown skin and black hair. I am wearing a polo shirt with the NAD logo. I look forward to being with you all today.
ANNMARIE KILLIAN: Hi, good afternoon. I'm thrilled to be here. My name is AnnMarie Killian. I am the CEO of TDIforAccess (TDI). TDI is best known for their distribution of the Blue Book. We have changed our name from Telecommunications for the Deaf and Hard of Hearing to TDIforAccess, but still go by TDI. I’m thrilled to join both Jacob and Sherri. I am a white female wearing brown glasses. I have long, straight, brown hair. I'm wearing a black blouse, hoop earrings and red lipstick. I am seated in front of a gray background. Thank you.
SHERRI COLLINS: Okay. Yes. Let's go ahead and start. If you could move to the next slide, please. There is quite a bit of information about the OAA. So I'm going to share some things that hopefully you want to just keep in mind. And this is going to be quite a broad overview. It's a very important topic, and we've got lots to cover.
As you can see here, there's a map of the United States with statistics next to it. And these statistics reflect what the American population looks like. Of course, we are using the term "older adults." We are not using the term senior citizens. We are not senior citizens. We prefer to be called older adults. You can see on the slide that between 33 and 50% of older adults have some level of hearing loss. And about 2% of adults between the ages of 34 to 54 have what is considered a disabling hearing loss. The rate increase for adults who are 55 to 64 for hearing loss is 8.5%. And then almost 25% of Americans aged 65 to 74, and 50% of those who are 75 or older, have what's considered a disabling hearing loss. Those are some really powerful numbers.
Now that you know some of the statistics, in 20 years, the year 2035, the number of older adults, that's going to be people aged 65 or older will be more than the number of people who are young adults. The number of older adults is steadily climbing in our population. And you'll see a great graph that illustrates this in a moment.
So obviously, anything that is going to affect older adults is going to affect us in the Deaf and hard of hearing community as well. We're getting older too. So it's time for us to make sure that Congress is paying attention to our community. Making sure that we are getting necessary funding and support. And we'll get into that a little bit more later. As you can see, the number of older adults is rising here in the United States. This bar graph that's displayed here on the screen is showing that every decade, the number of older adults is steadily increasing. Those numbers are based on -- are per million. So let me give you an example.
The year that I was born is actually the very last year to be considered a baby boomer. So by the year 2030, that group, baby boomers, will all be 65 or older. That is going to be a huge increase of older adults which also means we're going to have an increase of the demand for services. We're going to have a huge increase for services related to hearing loss. Of course, for things like measles/rubella, all of the different reasons why people from my generation became Deaf are going to be impactful as we're getting older.
By the year 2030, we are going to be a larger population than younger people for the first time in America. And as you can see, as the years progress, that number just goes higher and higher.
The other statistic to pay attention to is that near 2060, for those who are a little bit younger, go ahead and do your math, how old will you be in the year 2060? Because as you can see projections estimate that there will be 94.7 million people who are older adults by that time. It's definitely something to consider. Next slide.
Can you see this quote here on the screen? People with severe hearing loss are five times more likely to also develop dementia and Alzheimer's compared to people with, quote, unquote, normal hearing. Next slide.
This is part of our Arizona fact sheet that we made specifically for older adults here in the State of Arizona. There are some really powerful numbers, stats, and information on this fact sheet. And this is the perfect example of something that you may want to consider presenting to your legislature, to your Governor, because they are voters. They pay taxes. We have a right to have equal services along with the other Americans who are getting older. So here on these slides, you'll see references to a website that we have developed just to give you some examples. Just to give you some examples of what you could do in your state. Next slide.
This was an important quote that is on our fact sheet. The quote says, "I had to become a caregiver for my husband because there were no caregiving resources specifically for Deaf people with dementia.." There was no communication access. This is a reality for us. Next slide.
I'm going to spend a little bit of time here on this slide with this infographic. Since I've become involved with the OAA and researching what it means, many people have -- this is obviously impactful for Arizona because many people move to Arizona as a retirement state. And as director of ACDHH and my colleagues at NASADHH, we are all hearing the same thing.
Many of the state service providers think that people with a disability often talk of people with a disability in a broad sense, but we are narrowing down that conversation to specifically our communities that we serve. We want to change the mindset of the providers who offer the services that we need. We have to remember that disability can mean cognitive. It can mean mobility. And those groups are what service providers often focus on. But there are so many other disability groups that are left out of the discussion.
A perfect example is that I proposed a workshop in response to a call for papers from a national aging convention. And that is a general population, you know, hearing convention. Not necessarily for Deaf people. I wanted to raise awareness about the communities that we serve, about our communities because it is such an important topic. My paper was turned down. When I looked at that aging conference, at the schedule, I put in a word search for their list of workshops that were being offered. When I put in the word "Deaf," and got zero hits. When I put in the word "communication" and “disability," there are also zero hits. When I put in the word "disability," there were several hits. But, of course, they focused on mobility. They focused on transportation. They focused on cognitive issues. That was it.
And that is the national view. None of those groups think about hearing loss as a disability that needs to be addressed. They don't think about Deaf ASL users. When they think about Deaf people and those who use ASL, they think, oh, all you need is an interpreter? Great. We'll get an interpreter for you. Oh, you need captions? Sure, we'll turn the captions on. But you and I both know that every day, as a Deaf person, all day, every day is when we need communication access. Not just for an hour when an interpreter is hired. We don't want to wait for our medical care while they are setting up interpreting services. We need communication access every day. And I think that's one of the most understood and overlooked points about our community. That we, essentially, have become marginalized and disenfranchised. That makes us into more of a vulnerable population.
Every day, can you imagine if I was in a nursing home with a group of hearing people all day, my quality of life would be in silence. I would just be in silence. While hearing people, they can socialize. They can be with each other and choose whether they want to communicate or not. The point is this is my best example of what I mean by inclusivity and full access. Direct communication with service providers. We have the right to work with service providers that can communicate with us directly. How amazing would it be if any time an older adult who uses ASL was automatically paired up with a service provider that could also communicate in our native language? Communication access, caregivers that can sign. Or caregivers that understand how to work with people who use hearing aids and have hearing loss issues. People who understand how to use the assistive technology that we will undoubtedly need as we get older. I think it's important for us to have a service coordinator that understands these issues as well. And, of course, with technology, we've seen all of the news about artificial intelligence. Think about how that's going to impact us as a population. Think about how much effort and struggle it is to get the communication access that we need or request the interpreters that we need from all the appointments that we have.
That's why we need to look at the OAA because we need to make sure that all of those specialized services are going to be reimbursed. That way organizations and facilities can hire people with those specialized skills like knowing ASL and get reimbursed through the OAA. Facilities need to be accessible. I can’t even begin to tell you the examples that we have heard in our state of inaccessible facilities. Of course, the theme of aging in place, that is a very popular focus, a popular term that you'll see quite a bit when talking about older adults. That means as we get older, we have the right to get services in our own home. And not force us to be placed into a facility if that's not necessary. But, of course, we as Deaf people need complete access, need full communication access for the services that are in our home as well.
I better keep moving along. I could talk about this forever. Let's go on to the next slide. So now this is the OAA system. Kind of a flowchart of how the money funnels to people in various states. So we start with the OAA. And that money gets filtered down to the Administration for Community Living (ACL). The ACL is the organization that oversees the spending and the budgetary requirements for the money from the OAA. They are the ones who transition those funds to the state level. Once at the state level, that money gets sent to the various providers.
Now here on this slide, you can see the various regulations and services that are included in the OAA. The last time this act was updated was in 1988. That's what? 36 years ago. Finally, finally we have the opportunity now to update and change this act. There are some positive changes that have already been in effect, but we'll talk about some things that are somewhat concerning. For example, the terminology that's used in these rules. What is commonly referred to in this law is the greatest social need. You'll see that in the law, if you take a look. The term "greatest social need." The impact for the greatest social need. It's great that it is being considered. But these rules, and these decisions are based on who they are deciding is the priority for the greatest social need. States get to determine what that means. So it's important that each individual state is held to task on making sure that we are part of that conversation. We have to contact the people in our states who are responsible for making these kind of determinations. Get with your legislators. Get with your representatives. Ask them, how are you prioritizing Deaf and Hard of Hearing people for this, quote, unquote, greatest social need for the OAA? That is the perfect opportunity to segue over to Jacob. I wanted to give you some basic information about the OAA, and Jacob will take it from here.
JACOB SALEM: Okay, great. Thank you all for your patience with us. My name is Jacob Salem. I am the NAD state legislation manager. And my role here is any state that has a law that needs to be passed, I step in and support them. We talk about strategies. We build relationships with the legislature. If we see a bill that's not so great, and we don't want it to pass, I will step in and support efforts to kill that bill. So I support all 50 states throughout the U.S. I step in and NAD supports that. And that's what my role is like here at NAD. Also, I have various priorities. Aging adults as well and serving that community. So that is a priority for NAD. The NAD does have a relationship with DSA. So we have different representatives from various states from throughout the U.S. with aging adults. That's 55 and above. So I'm going to go ahead and start my presentation now.
As you all know, throughout the U.S., there are different service providers, right? And there's different services being provided. And knowing the quality of service is good, but where are those gaps? So we have realized that there are some very big gaps with service for aging adults. So we do have a group within NAD and DSA and also ACDHH as well. We have the commissions and TDI. We have all come together as a group and had discussions about how we can make some improvements. And really it goes back to the language. Back in the 90s, OAA became law. And the same language has been there ever since. Does that still meet our needs? I don't believe it does. We do need some changes. As time has changed, technology has changed over the years. There are many more things that we need in our language. So after analyzing that, we went through a process called reauthorization. And that reauthorization happens at the federal level. That act is passed. And later down the line, we all come together and start evaluating what was written. And we realized it really is outdated information. To the point that the services we are receiving, honestly, are no longer needed.
So after looking through the language, some of the examples, I'm going to try my best. I'm not going to be able to go through all of this due to time, I'll review a few of these with you. So as you can see, past information that Sherri was talking about and the varying services that are listed, that is what Congress sees. And they don't know who it's for. And it's really not identified. We want to focus on -- right now, it's focused on physical and mental at this point. So where do we as Deaf people and our community fit in? We need to include communication disabilities. That's what we need. That will include all of us. It's not just Deaf, Hard of Hearing, DeafBlind, we want to include everyone. We want to include people who can hear but use sign language to communicate. Maybe speech limitations. And there’s people who are Deaf signers. We want to include everyone within this. It is really critical that we change this language and identify that so when Congress reviews this act, they are able to take that information and then states -- remember, this is a minimum here, what federal sets in place. Then the states can take that information and make it even stronger and more powerful within their state. So we want to change that definition and add communication. So you've noticed varying services. And we need to know how to identify those services that are needed. So we would have varying models. The models we currently have are quite limited. It's just limited to cognitive and then also physical. Like wheelchairs and things like that. But what about communication? Communication is key. So we need to include that and make it more inclusive and make that a priority so it’s a model for our aging adults, for Deaf, Hard of Hearing, DeafBlind, Late-Deafened, and also speech limitations.
So you know, every year, the federal government passes out the rates. And oftentimes, there are increases to rates and specific rates related to our needs. Do they actually match? There are gaps there because there's no definition as far as criteria related to exactly what we need and the services we need. Is it being considered? We are considered actually one of the biggest demands for communication needs.
We need states to get out there and apply and go ahead and participate. When they do so, they receive that funding. When you have grants, a certain percentage will go to the people within that community. That’s some of the language we need to change. Of course, with administration, across the entire United States, it's really important to have a state agency in place to kind of mediate that. Make sure everything kind of runs smoothly. So that we have accountability for the aging adults. We want to escalate that. We want that to be more enhanced. We want people to be involved. Being on the committees. Represent our communities and the like. We want to make sure that everything is represented, and we are a part of that. And then the providers, we want to make sure that we have accessible providers that have those linguistic skills. They may say that they provide services to Deaf, but do they have people in place, resources? Do they have guidelines? Do they have affiliations with the appropriate people? Do they have CDIs? Do they have interpreters in place? Do they have all of that? Is it Deaf-centric? Do they have the funds available? Some states, you know, in rural areas rely on the Internet as the VRI, the video remote interpreting system available? Is it accessible for our entire community?
After you've seen all of this, of course, when you get services, you know we want to receive services for people who understand us and know us, right? You don't want it to take a long period of time. We want to have direct services from those who are a part of our community. We want that to be available. So it's really important that it's very inclusive and the providers have cultural and linguistic abilities to serve our community. That will address our needs.
And the next thing would be, you know, oftentimes committees will come together and look into data, analyze those statistics. And where's the research on our community? We need to find the funding to invest into that research and make sure that we can have some success within the States. We have that data and that research to allow us to address those needs that we know that we have. We need an increase in funding for that to happen. We need caregiving that is available. We need to make sure that it is successful for our communities.
Recently Gallaudet released some training to become a certified caregiver. They're pushing for that, but we need that. We need more of that. So that funding needs to become a priority. Next slide.
Education. During the recent presentation, we know education is important. We need to provide quality services. And we can't do that without education. We need to have a good foundation, a good understanding of what our needs are, and then build on that. We need to provide grants to our states and legislatures and our providers and commissions throughout the United States. We need to have that available to them.
All right. So I showed you various examples. You'll see on the one side, it's the current language. And then we have the proposed language. We are having analysts and lawmakers look into this to make sure that we have the correct language. This is the start. This is where we're going. We have the framework. There are various elements to see what will work within a bill. What they'll do is they'll utilize and improve upon it. So with that being said, I'm going to turn it over to AnnMarie now.
ANNMARIE KILLIAN: Thank you, Jacob. I really appreciate that information. When you opened up, you shared what my role is at TDI. I actually collaborate with different consumer organizations such as the NAD, the Hearing Loss Association of America, the American Council of the Blind, the American Foundation for the Blind, and other disability organizations who support access to information, especially information communication technology (ICT).
I'm thrilled to be here to talk about the impact that technology has on the Older Americans Act (OAA). Next slide, please.
Many of us watching this webinar have noticed that technology has changed and evolved rapidly, especially in the last 10 years. These changes significantly impact various communities of people with disabilities, particularly in the realm of technology. Once upon a time, we used TTYs, and then Video Relay Services emerged. But it doesn't stop there—new technologies are constantly being developed, even in captioning. Previously, a human being had to speak into the captioning, but now we have artificial intelligence (AI) or automated speech recognition (ASR) providing captioning.
A lot of changes have occurred across different parts of the community—Deaf, DeafBlind, DeafDisabled, Late-Deafened, Hard of Hearing. These subgroups have diverse needs, requiring different technologies. Within the OAA, there is a need to address all these aspects, as Sherri mentioned. Currently, the language only addresses three specific areas unrelated to communication. Sensory loss includes Deaf, DeafDisabled, DeafBlind, and Hard of Hearing individuals. This session aims to help us understand what we need to do to bring accessibility and inclusion to the forefront for older Americans. Next slide.
As humans, we rely on three very important things: First, to be independent and gain our own agency; secondly, to be safe and secure; and thirdly, to have social connectivity, whether in-person or virtually. There is a lot of technology available, as you can see from our list: Video Relay Services, caption telephones, real-time captioning, speech recognition, hearing aids, cochlear implants, and screen readers. These are all excellent technologies, but do they meet all our needs?
Sherri said it beautifully: It's great that we have these technologies, but we need to be on an even playing field with the services required. There is a misconception that our community's needs are already met with provisions like interpreters or captions. However, we constantly have to educate others. For example, an hour of interpreting service isn't sufficient. We have the same needs as ‘abled’ older Americans and need these services to be available 24/7. Resources are available, but they are not a cure-all, as older Americans have diverse life experiences that must be addressed. Next slide.
Let me let you read this question for a moment: In today's rapidly changing technological era, how well do our current accessibility and technology solutions meet these essential needs? Do they currently? I would say no. Next slide.
Sherri mentioned AI, artificial intelligence. Many people are now reaching out, saying AI is this new technology they see everywhere. The truth is, it's not new; it has been around since the 1950s, experiencing periods of ebb and flow. What we see happening now is a significant rise in the use of AI.
There is an organization called #DeafSafeAI that led research conducted last fall on identifying safeguards and ethical standards for automated interpreting by artificial intelligence. They held webinars and sought feedback on readiness to use AI because companies and service providers are exploring automated interpreting by artificial intelligence (AIxAI). This concept makes sense but carries the assumption that AI would replace human interpreters, which is not the case.This first example I'm going to share with you highlights some key statistics and resources available. We will share additional resources at the end of this session.
Back in 2021, 43.3% of adults aged 65 or older were utilizing telehealth services. These services are widely used across the country, particularly in urban areas rather than rural ones. Several factors contribute to this disparity. One organization, NASRA (National Association of State Relay Administrators) developed a white paper addressing the accessibility of broadband in rural areas. Despite some individuals still using TTYs—an obsolete technology relying on landlines—the transition away from landlines is inevitable. We need to proactively identify ways for those who rely on TTYs to maintain their access. Economically, the situation is challenging. The Affordability Connectivity Program (ACP) has run out of funding, impacting millions who depend on these funds for access needs in rural areas. This is one of the significant challenges in technology and telehealth.
Often, telehealth platforms do not support three-party conversations, which are essential for communication facilitation between the doctor, the patient, and the interpreter. When an interpreter cannot be part of the platform, we have to rely on captioning, if available, which is not my preferred method of communication with my doctor. This can lead to misunderstandings, as providers often assume that a Deaf individual can lip-read. Requests for an interpreter are frequently met with the offer of VRI (Video Remote Interpreting), which is not always accessible due to challenges with high-speed internet.
Human interpreters cannot be replaced for numerous reasons. Nevertheless, companies are already planning to create not just an avatar but an artificial intelligence interpreter. This development is also impacting captioning.
Recently, I discussed with some key people that captions are increasingly driven by ASR (automatic speech recognition) with no communication assistance involved. We need to require the FCC to mandate that any provider certified to provide caption services has a backup plan involving communication assistants—a live person who can work with the system. As technology progresses, this requirement is crucial.
In telehealth, the demand for accessible services is growing. All parties involved must be able to join the platform, although I haven't seen this fully implemented yet. Technology is advancing, but ensuring doctors can include interpreters in telehealth appointments and having CDIs available for DeafBlind patients who need remote consultations remains essential. The technology is not always 100% reliable, highlighting the need for focus in this area.
Providers must understand their legal obligation to ensure communication access for all individuals with disabilities. This includes CART writers and interpreters to support people with different communication needs. Whether each entity will have this capability is a significant question.
What are we going to do within the OAA to truly support this? We want to push the OAA to recognize the diversity of the communities they serve, especially those who are disabled. It's not just about individuals with developmental, cognitive or mobile disabilities but the entire range of life experiences of people with disabilities. They need access to resources and services that meet all their needs.
We are still advocating today about the digital age and its impact. Therefore, we need to support relevant policies. Organizations like ACDHH, TDI, NAD, and DSA are collaborating on this effort, but we also need your support, audience members, for #OAA4DEAF. Thank you. With that, I will turn the floor back over to Jacob.
JACOB SALEM: Thank you, all. This has been some great information. Information overload. We do have some questions coming up soon. Here's some information I want you to take advantage of some of these details that we do have. Here’s a question: In California, the organization is called GLAAD. And they have been successful building a Hard of Hearing apartment complex. So other state agencies should get involved and take action in the same idea. Does anyone have any comments related to that question?
SHERRI COLLINS: Okay. Yes, I can speak on that. In Arizona, we have a Deaf housing facility. And they worked very closely with HUD. Of course, that's the federal level. As well as the State Department of housing here in Arizona. Depending on where that facility would be located, which city it's in, the city government may be involved as well. For example, our facility is in the City of Tempe, one of the cities that makes up the Phoenix metro area. It causes a bit more complication with all of those government entities, but that's what worked for us.
ANNMARIE KILLIAN: It's an excellent question because it reflects that there's a need for this conversation. It is significant advocacy that needs to happen. And we need to document all the things that are happening with the different organizations.
JACOB SALEM: Great. Thank you. Let's move on to the next question. This is an anonymous person. They're asking if NAD should recognize ASL as an official language, making that effort for the Federal Government to actually recognize that language. That's for me, and I'll go ahead and take the answer for that. Of course, our ultimate goal is for ASL to be recognized at a federal level. The process is a bit different than states. So just to let you know, it's a lot easier to pass things at a state level. But currently, at the federal level, it takes a really long time. It's a very long process. But at the State level, currently, like next year's legislative session, it's really important. You want to go ahead and reach out to them and say you want that support for the federal level. We want to get those bills passed and recognized at a state level because the majority of the States recognize it, it makes sense. and then the federal level starts recognizing it. So I definitely agree with that comment.
JACOB SALEM: Let me go ahead and look at the questions. We have several here. All right. Let's see. This is a question for AnnMarie. Suzanne has a question for you. So why are states so slow to process E911? I don't know what the strategy might be or do you have comments related to that?
ANNMARIE KILLIAN: Suzanne, correct? I want to make sure I spell your name correctly. Thank you for that question. One of the main challenges identified is the ability to contact E911, especially in a disaster. This is particularly true for individuals who are traveling. For example, let's say I am in the mountains hiking, and I take a fall and need help. I pick up my iPhone, click on my VRS provider's app, and call E911. Once I connect with E911, the number they see is not my text number, but my VRS number, which is associated with my home address. The immediate assumption is that I am calling from my home; but I am actually calling from the mountains—a different location. I have to explain that I am not home, I am in the mountains. When hearing people call E911, they are able to immediately identify the geolocation of the individuals.Also, the Public Safety Answering Points (PSAPs) that handle emergency calls are not regulated by the FCC, but by the Department of Justice (DOJ). We are advocating for PSAPs to be fully accessible, and currently, they still have TTYs which, while important, do not address the needs of individuals who rely on video relay. We are pushing for the DOJ to mandate that PSAPs can identify the location of individuals who call through VRS. We are seeing progress, but as Jacob has mentioned, progress is slow at the federal level. We will continue to advocate, which requires collaboration with industry stakeholders, policymakers, and advocacy groups.
JACOB SALEM: Thank you, AnnMarie. Another question is: I'm guilty, sometimes I've caught myself signing senior citizens. But what is the change from senior citizens to aging adults?
SHERRI COLLINS: When we're talking about the law itself, it references older Americans. And we are transitioning that to older adults. It's as simple as that.
JACOB SALEM: Okay, great. Another question. Does anyone know where all the grants are coming from? Is there any person that works at the State or maybe a consultant who happened to be able to utilize the grants? Or thousand expand your services? Where do we reach out for that type of information?
ANNMARIE KILLIAN: When talking about grants, specifically related to technology, there are quite a few available. Recently, the National Telecommunications and Information Administration (NTIA), a federal program, announced a capacity-building grant. This grant includes multiple areas where collaboration can occur between local, state, and federal entities to pool resources and elevate digital equity. That’s just one example.There are numerous resources depending on your ultimate goal. If it’s telehealth or technology-specific initiatives, you can reach out to organizations like the National Association of the Deaf (NAD) or your state commissions for Deaf and Hard of Hearing to find out what grants are available in different areas. Unfortunately, these grants can be challenging to find, so thorough research is necessary at this time. There are organizations working to gather and organize these resources, such as the National Digital Inclusion Alliance. You might also find some federal-level support from agencies like the US Access Board and the Center for Democracy and Technology.
JACOB SALEM: I do want to add to that. At the State level, just to let you know, state agencies can apply for grants. Absolutely can. Currently, the challenge is, it really depends on what department you're under. So there are different levels of determination within that process. If you're under the governor or if you're under another agency, state agency. So it's really important. I encourage everyone to look at what's already been provided. Partner with them. Find those affiliates. See if there's any other grants that are available to address the needs. So research that. Utilize those funders who we already have relationships with. For example, like the Governor's office. Partnering with them at a state level. Letting them know about the concerns and the gaps in accessibility for aging adults. Then, they start utilizing that information. Noticing the need that it's out there. And then later, they will find the money, and then you can definitely apply for those grants. There are various funds, and there's a state level and a federal level. So the state level is, of course, internal. Federal level is official paperwork that has to be sent in. So it would be really great to have a familiarized grant writer to support you in that.
JACOB SALEM: Next question. How do we improve the quality of full communication access for Deaf, immigrant aging adults? What about CDIs? And in the Court systems? And for medical appointments as well? As far as my experience goes, my background is, I worked at the State level prior. And within that experience, oftentimes, within the Deaf community, within the state, we rely on the State and nonprofit organizations who already get funds for immigrant services. So I definitely understand there's a gap there. Receiving complete access within those services. If a state happens to have a Deaf commission or if they have an office, a Deaf office under the government, I encourage those connections to be made, educate each other, educate those organizations. And then those nonprofit organizations become aware. And then start to provide that communication access that's needed. I know, there's a shortage of CDIs. There's no question to that. We are all facing that shortage. And VRI is not the solution for everyone. It's a challenge. It is an option when we're looking into that for the time being. But it does vary. It varies on the needs of every individual. So, you know, if it's a court process, it's legal. So we want to make sure that they're getting a CDI and providing complete access. State agencies, offices, and the like, we need to see that partnership. Sherri, would you like to add anything to that?
SHERRI COLLINS: Yeah, just to add to that really quickly. Jacob, I agree with you wholeheartedly. Some states have licensure requirements as well. For example, Arizona, my state, requires licensing for ASL interpreters. And of course, those interpreters would need to pass a national certification test as well. So as far as the question of demand, it really is going to vary. Of course, the communities are not going to be monolithic. Yeah. It's a challenge.
JACOB SALEM: Thank you. The next question is: What about medical alert devices that are obviously not Deaf friendly? What happened about those? And what might we do with those.
ANNMARIE KILLIAN: That is an excellent question. DSA is working with AARP as this is a significant issue. These medical devices are auditory-based which do not support individuals with hearing loss or who rely on ASL. I applaud DSA for addressing the needs of their specific community as this availability is vital. I want to acknowledge that AARP is participating in this webinar. Welcome, AARP, and thank you for being here! Your role in this discussion is crucial because it impacts all the audience members, particularly for older Americans. As the statistics show, we are an integral part of the American community, and this issue needs to be addressed
JACOB SALEM: Great. Thank you. Next one. In Nebraska, most senior citizens in nursing homes and assisted living are spread throughout the State. So how can we provide and show the State that they need safe and secure spaces and bringing them all together in a safe and secure space, what might we do regarding that?
SHERRI COLLINS: Yes, thank you for that question. There are, of course, several challenges. Now, I can only speak for Arizona. Because we did do a robust research study with older adults all over the State of Arizona. We asked them if they would be open to going into a nursing home, and the majority said, no. The other issue that I've seen here in Arizona is that people don't want to live on the other side of the city, far from their family, far from their support systems. They would rather be close to where they were living prior. Here in this state, we do have Medicare. And Medicaid. Some older adults have other disability issues as well. And they need some type of assistance or support and rely on government services. We do have one facility here that is somewhat centralized. And many of those individuals are accepted there to live with the other residents. Really it's an individual basis. Most older adults would prefer to stay at home. And it becomes a challenge. So the key here really is that person is getting the services, if those services are not available in their home, of course, they're going to have to go into a facility. If we're dealing with dementia or Alzheimer's diagnosis, then a facility might be necessary. That’s why we are really emphasizing and pushing for that direct communication and communication access with adult Americans. It's a huge issue.
JACOB SALEM: Next question from a Deaf advocate and they're seeing an increase in cases with Deaf senior citizens. Like financial crimes, negligence, various things. So is that going to become part of the plan and part of that action? Some type of law enforcement education as well?
SHERRI COLLINS: Quite a few issues that are sometimes a local police issue. But of course, if the victim is an older adult, that's when adult protective services gets involved. That is required by the Older Americans Act. In each state. There's a new rule that is changing things for adult protective services. The rules and regulations. That I mentioned that are changing, one of the biggest changes is an improvement related to adult protective services. I do have a few questions related to those recent changes. Specifically with adult protective services. I'm seeing a question about how we can call, how we can call in to make a report? How can we communicate with people from that agency? I'm actually scheduled to meet with my state division of aging who oversee the OAA here in the State of Arizona. I'll be meeting with them in about two weeks. And we plan to discuss adult protective services and how our community is vulnerable to issues with finances and lack of communication. So this is a huge concern. It's a big issue. Absolutely.
JACOB SALEM: So another question is: How can we advocate for people who are retired and in a care community but don't use sign language? How do we advocate for that population?
ANNMARIE KILLIAN: As I was saying, we collaborate very closely with the Hearing Loss Association of America (HLAA). They are quite active in working with us, as well as with the National Association of the Deaf (NAD), to shape accessibility for people who are hard of hearing and do not sign. We encourage you to reach out to us at TDI, NAD, or HLAA because we are here to advocate for you as equally valuable partners in the community.
SHERRI COLLINS: Yes, I feel obligated to respond because, yes, my state -- we are the State agency that serves the Deaf and the Hard of Hearing. And I don't know if the State that you're in has a similar office. But you can always reach out to NASADHH.org. They have a wonderful board that would be able to respond and maybe give you resources for your specific state. You can reach out to your local level and get that support that you need.
JACOB SALEM: Great. Two more. And then we'll go ahead and wrap things up. So if the State receives federal funding and grants, how do Deaf people in the community request a caregiver with access for home care? How do they get that information?
SHERRI COLLINS: Yes. Thank you. It's an excellent question. If you recall, in my presentation, I did speak about the OAA and that funding being filtered down to the State level at individual states. It's important to ask your state Division on Aging or whatever your local agency is called in the State that manages that funding. Mine is called the Division on Aging. Now, I do want to emphasize that the funding that gets appropriated to each state is different for every state. It is based on a formula on the number of people in your state. So the funding amount is not going to be uniform for all of the States. It depends on your state's legislature. It depends on your population.So the first step is to check at the local level at who is in charge of that funding.
JACOB SALEM: Okay. The very last question. Very important as well. Related to the DeafBlind community. What if or if there's any national movement that involves communication facilitators. From what we see now, during COVID, we have seen some things grow. Is there any comments as far as service for the DeafBlind community? There may be resources for the senior community, but of course, we're looking for one-on-one services that have the skills that we do need. Does anyone have a response to that?
ANNMARIE KILLIAN: Thank you for raising such an important question. It's an interesting time. Just about a month ago, a group of consumer organizations, including the NAD and TDI, drafted a message to the FCC. They emphasized the need to seriously consider expanding the availability of resources, such as Communication Assistants (CAs) and Certified Deaf Interpreters (CDIs), who can provide in-home assistance to individuals who are DeafBlind.These supports are necessary and essential communication access tools. There is ongoing discussion and activity around this issue. It is crucial to acknowledge it as a priority in the overall discussion. The FCC is now considering adding these services specifically for DeafBlind individuals, including community facilitators who can provide telehealth appointments and other services in their homes. The need is recognized. Please send your comments to the FCC. There are resources available, including an ASL line that you can connect to and share your thoughts about this kind of service.
JACOB SALEM: We are done. I see that there are so many questions that haven't been answered. But that might mean we need a second meeting here. So I'm going to turn it over to Phil.
PHIL AIELLO: Hello, again, everyone. Wow, such impressive information on the OAA. Like we mentioned before, this webinar will be posted online, on the DSA website with the FAQs. We will make sure that all the information is posted with questions. And we have been working with this, with AARP for two years, and we have not given up. We are trying very hard to make a breakthrough here to make changes that will work for the Deaf and Hard of Hearing community.
All of us are working together in partnership toward our common goal in getting communication access added to the OAA. DSA plans to meet with AARP to go over this with their legislative group. And we are asking them for their support with this to encourage Congress to add any and all additional language for communication access. Please know that this is our goal to work with them and get their support going forward.
Those of you who are not members of DSA, the recording will be accessible for everyone. However, I do encourage all of you that are not members to please join and become members of DSA. The more members we have, the stronger we become as an organization and a community.
I also want to share with all of you that our next DSA Conference will be held in Kansas City, Missouri, next year, August 1-7, 2025. You can check out information on our website at deafseniors.us. And you will be able to read all about the conference and information. We appreciate your joining us for today’s webinar. We will have many more webinars going forward. We appreciate the generous support of Laurence W. Levine Foundation and technical support of ZP Better Together. Thank you, and have a nice day.
