Issue Four: Need for Qualified Persons Who are Deaf or Hard of Hearing to Provide Vocational Rehabilitation Services

This chapter presents the responses to this issue from the Vocational Rehabilitation and Services for the Blind Division (DVR), the Hawaii State Coordinating Council on Deafness (HSCCD), the Hawaii Services on Deafness (HSOD), Goodwill Industries of Honolulu, Inc., the Ohana Kokua Ano Kuli (OKAK), and the Aloha State Association of the Deaf (ASAD). Unless otherwise indicated, quoted material is attributed to the respective respondent group.⁽¹⁾ The ASAD explained that it was not possible to answer the set of questions comparing qualified deaf or hard of hearing providers and hearing providers. [See ASAD's response below.]

DVR Response: The DVR clearly stated its overall belief that there is a need for qualified deaf or hard of hearing persons to provide vocational rehabilitation services. It also felt that deaf or hard of hearing clients benefit more from such providers as compared to otherwise equally qualified hearing providers. The DVR was then asked to indicate the degree of its agreement or disagreement with a series of statements on a five-point scale (disagree strongly, disagree somewhat, no opinion, agree somewhat, and agree strongly).

The DVR agreed strongly with a central premise of H.C.R. No. 157, HD1, that is, hearing impairment creates communication difficulties requiring the services of professionals who possess three traits: being knowledgeable specifically about the implications of hearing loss, fluent in American Sign Language (ASL), and sensitive to the specialized needs of deaf or hard of hearing persons. It also strongly felt that services to deaf or hard of hearing clients are ineffective if providers do not possess these three traits. Further buttressing these beliefs, the DVR strongly felt that:

1. These three traits can improve services and are absolutely essential for providers of service to the deaf or hard of hearing;

2. There is a difference in quality of service given by deaf or hard of hearing and hearing providers who are otherwise equally qualified;

Deaf or hard of hearing providers can provide better services to the deaf and hard of hearing than otherwise equally qualified hearing providers;

4. Deaf and hard of hearing clients identify more with and are more receptive to services given by qualified deaf or hard of hearing providers;

Deaf or hard of hearing providers give better services by virtue of their own disability; and

6. It is not only preferable, but absolutely essential, to use deaf or hard of hearing providers -- and not hearing providers -- to provide services to the deaf and hard of hearing.

However, the DVR strongly disagreed that only deaf or hard of hearing providers can possess the three traits mentioned above. The implication is that hearing providers can also be knowledgeable, fluent, and sensitive. In support of this stance, the DVR further disagreed, although to a lesser degree, that hearing providers, on balance, cannot possess or develop the first two of these three traits (being specifically knowledgeable and fluent in ASL). However, it strongly disagreed that hearing providers cannot be as sensitive to the specialized needs of the deaf and hard of hearing. In other words, it appears that the DVR strongly feels that a provider need not be deaf or hard of hearing in order to acquire the three desirable traits although deaf or hard of hearing providers may have an edge.

The DVR also estimated that more than three out of four deaf or hard of hearing clients have expressed a preference for vocational rehabilitation services to be given by providers who are, themselves, deaf or hard of hearing. The problem is that the DVR does not have any such qualified deaf or hard of hearing staff. According to the DVR, no such qualified personnel are available in the State. (This statement appears to be corroborated by the responses of the other groups surveyed.) Compounding the problem is the lack of role models in Hawaii for local deaf or hard of hearing residents to emulate. The DVR suggested that it was important to expose deaf or hard of hearing students in Hawaii to vocational rehabilitation as a career goal.

Training of Current Hearing Providers: The DVR affirmed that the training of current hearing providers is an option. However, that belief was qualified with the proviso that it would "not [be] equivalent to a deaf or hard of hearing provider." In support of this, it disagreed somewhat that hearing providers can be trained to provide services as well as otherwise equally qualified deaf or hard of hearing providers.

Hawaii State Coordinating Council on Deafness Response: The HSCCD agreed that there is a lack of qualified deaf or hard of hearing persons who can provide vocational rehabilitation services. It offers the following as causes for the situation:

• Lack of local opportunities for training;
• Limited opportunities for employment;
• Salaries are often incompatible with the cost of living in Hawaii and are not offset by incentives for qualified persons from the mainland to move, or return, to Hawaii; and
• Paucity of local deaf and hard of hearing role models in the professional fields in Hawaii to inspire emulation by local deaf and hard of hearing clients.

The following presents the HSCCD's responses to the set of questions comparing deaf or hard of hearing and hearing service providers. First, the HSCCD paralleled the DVR in strongly agreeing that both deaf and hard of hearing clients would benefit more from deaf or hard of hearing providers as compared to otherwise equally qualified hearing providers. Like the DVR, it also strongly agreed that:

1. Hearing impairment creates communication difficulties requiring the services of professionals who are knowledgeable specifically about the implications of hearing loss, fluent in ASL, and sensitive to the specialized needs of deaf or hard of hearing clients; and

2. Services to deaf or hard of hearing clients are less effective if providers do not possess these three characteristics.

In other words, the HSCCD and the DVR agree on two general principles: that the deaf and hard of hearing have special needs and that services given by deaf or hard of hearing providers are better.

The HSCCD's views begin to diverge from those of the DVR on specifics. For example, the HSCCD disagreed somewhat (the DVR disagreed strongly) that only deaf or hard of hearing providers can be knowledgeable, fluent, and sensitive. That is, compared to the HSCCD, the DVR seems to give hearing providers more of the benefit of the doubt. On the other hand, the HSCCD disagreed strongly that hearing providers, on balance, cannot be as knowledgeable, fluent, and sensitive as deaf or hard of hearing providers. (In partial concordance, the DVR disagreed strongly about their being as sensitive, but disagreed only somewhat about the first two traits.) In this case, it is the HSCCD that appears to give hearing providers more of the benefit of the doubt.

The HSCCD disagreed somewhat that it is essential, not just preferable, to use qualified deaf or hard of hearing providers as opposed to qualified hearing providers. This is in strong contrast to the DVR's view that such use is absolutely essential. Again, in strong contrast to the DVR, the HSCCD agreed somewhat that there is no difference in quality of service given by the two types of otherwise equally qualified providers. (The DVR disagreed strongly that there is no difference.) The HSCCD also agreed, but to a lesser extent than the DVR, that deaf or hard of hearing providers give better services by virtue of their disability and that deaf and hard of hearing clients identify more with deaf or hard of hearing providers. The HSCCD agreed somewhat that hearing providers can be trained to provide services equally as well as deaf or hard of hearing providers. Finally, like the DVR, the HSCCD indicated that both deaf and hard of hearing clients have expressed a preference for deaf or hard of hearing providers over otherwise equally qualified hearing providers.

In response to identifying specific obstacles preventing the hiring of deaf or hard of hearing service providers, the HSCCD feels that, in general, the state hiring process is time-consuming and cumbersome. As a result, potential applicants may lose interest and seek employment in other fields here or in another state. The HSCCD further contends that cuts in the state budget and hiring freezes frustrate new hiring by interrupting or permanently halting the hiring process.

To overcome this, the HSCCD suggests that specialized vocational rehabilitation positions be exempted from hiring freezes to facilitate recruitment. In addition, it recommends that the recruitment and hiring process be simplified by either instituting measures to streamline hiring within the Department of Human Resources Development or by delegating hiring directly to the Department of Human Services. Furthermore, the search for qualified personnel should not be limited to Hawaii.

Locally, the HSCCD urged the DVR to:

". . . be more aggressive in providing services to potential clients who could become DVR counselors or service-related providers. DVR should be more willing to cover costs of both undergraduate college and graduate school (local and mainland) for those who meet academic requirements. DVR should also be more aggressive in encouraging recruitment of Deaf and Hard-of-Hearing professionals in the local community."

Training of Current Hearing Providers: The HSCCD believes that training of existing vocational rehabilitation providers who are hearing is a viable option to a certain extent. In general, it feels that were such training to be given, it ". . . should be more extensive and intensive than just once-at-a-time workshops" or a session lasting a few weeks at a college. In particular, it stressed the importance of sign language training that is "much more extensive/intensive than currently offered" -- especially for counselors and staff on the neighbor islands. General counselors, particularly on the neighbor islands, need this specialized staff development in order to serve those who are deaf and hard of hearing within their general client population.

Hawaii Services on Deafness Response: The HSOD submitted two sets of surveys.⁽²⁾ The two responses reflect a distinct ambivalence towards this issue. The first response agreed that deaf clients benefit more from deaf or hard of hearing providers compared to otherwise equally qualified hearing providers. The second qualified its agreement by saying it depends heavily on whether or not the person is deaf-sensitive, e.g., a hearing child of deaf parents. Neither offered an opinion for hard of hearing clients. However, both agreed strongly that:

1. Hearing impairment creates communication difficulties requiring the services of professionals who are knowledgeable specifically about the implications of hearing loss, fluent in ASL, and sensitive to the specialized needs of deaf or hard of hearing clients; and

2. Services to deaf or hard of hearing clients are less effective if providers do not possess these three characteristics.

Other than this, however, the two responses consistently differed. While the first agreed strongly that only deaf or hard of hearing providers can be:

• Knowledgeable specifically about the implications of hearing loss;
• Fluent in ASL; and
• Sensitive to the specialized needs of deaf or hard of hearing clients;

the second indicated the exact opposite by strongly disagreeing with the above statement.

On the one hand, the first HSOD response strongly agreed that, compared to qualified deaf or hard of hearing providers, qualified hearing providers, on balance, cannot be as:

• Knowledgeable specifically about the implications of hearing loss;
• Fluent in ASL; and
• Sensitive to the specialized needs of deaf or hard of hearing clients.

On the other hand, the second HSOD response indicated almost a polar opposite opinion by strongly disagreeing that hearing providers cannot be as knowledgeable or fluent, and by disagreeing somewhat that they cannot be as sensitive.

The conflict between the two HSOD survey responses extends to whether hearing providers, compared to deaf providers, can be as knowledgeable or ASL-fluent. The first response disagreed somewhat while the second response agreed strongly. The first response disagreed strongly that they can be as sensitive; the second agreed strongly.

Similarly, the first HSOD response agreed strongly that, in providing services to deaf and hard of hearing clients, it is not just preferable, but essential, to use qualified deaf or hard of hearing providers, and not qualified hearing providers. The second HSOD response disagreed strongly.

Furthermore, the first HSOD response disagreed strongly that there is no difference in quality of service given by deaf or hard of hearing providers and equally qualified hearing providers. The second response agreed somewhat.

Finally, the first HSOD response indicated that from one-half to three-quarters of both deaf and hard of hearing clients have expressed a preference for deaf or hard of hearing providers over otherwise equally qualified hearing providers. The second HSOD response indicated that it "depends on the deaf and hearing involved" and that the HSOD was unable to give reasonable estimates with current statistical information.

The two sets of responses from the HSOD were not as clearly divergent on the following:

• The first HSOD response reported a "no opinion" on whether hearing providers can be trained to provide services equally well as qualified deaf providers. The second agreed somewhat that they can be so trained;
• The first HSOD response agreed strongly that deaf of hard of hearing providers give better services than hearing providers, by virtue of their being deaf or hard of hearing, assuming that they are otherwise equally qualified; the second agreed somewhat; and
• The first HSOD response agreed strongly that deaf and hard of hearing clients identify more with and are more receptive to services given by qualified providers who are deaf or hard of hearing, as compared to hearing providers; the second response agreed somewhat.

Only the second HSOD response indicated that training of current hearing providers is a viable option. The HSOD also said that increasing deaf awareness and sensitivity among hearing providers would enhance their effectiveness.

Goodwill Industries of Honolulu, Inc. Response: Goodwill notes that there is a need for qualified deaf or hard of hearing persons to provide vocational rehabilitation services to deaf and hard of hearing persons in Hawaii and that the need is unmet. According to Goodwill:

"Education is the key to making more Deaf and hard of hearing service providers available to the community. Education must take place in the disciplines of fluency in the primary language of the recipients of service (ASL) and in counseling techniques, case management[,] and strategies to discourage dependence and [to] foster independence. . . . This condition [need for and lack of qualified deaf or hard of hearing providers] is the result of an educational system that does not graduate enough Deaf or hard of hearing persons who are also educated in human service delivery systems and techniques for effective counseling and teaching independent living skills. This is complicated by an attitude that seems to emphasize the differences between qualified Deaf service providers and qualified hearing service providers." In contrast to the responses of the other groups surveyed, Goodwill feels that deaf and hard of hearing clients do not benefit more from deaf or hard of hearing service providers as compared to otherwise equally qualified hearing providers. It also strongly disagreed that it is essential, not just preferable, to use deaf or hard of hearing providers to provide services to deaf and hard of hearing clients. However, it did strongly agree that:

1. Hearing impairment creates communication difficulties requiring the services of professionals who possess three traits: being knowledgeable specifically about the implications of hearing loss, fluent in American Sign Language (ASL), and sensitive to the specialized needs of deaf or hard of hearing clients;

2. Services to deaf or hard of hearing clients are less effective if providers do not possess these three traits; and

3. Deaf and hard of hearing clients identify more with and are more receptive to services given by qualified providers who are deaf or hard of hearing, as compared to hearing providers.

Goodwill also disagreed somewhat that there is no difference in quality of service given by deaf or hard of hearing providers, as compared to otherwise equally qualified hearing providers. Thus, it acknowledges that there may be some difference in quality of service, presumably favoring deaf or hard of hearing providers.

Nonetheless, Goodwill strongly disagreed that only deaf or hard of hearing providers can be sensitive to the specialized needs of the deaf and hard of hearing. That is, it feels that hearing providers can also be sensitive to clients' needs. Goodwill disagreed to a lesser extent that only deaf or hard of hearing providers can be knowledgeable specifically about the implications of hearing loss. Goodwill did agree, although not strongly, that only deaf or hard of hearing providers can be fluent in ASL. The implication here is that, more often than not, one can expect deaf persons to be more fluent in ASL than hearing persons who learn ASL but who do not totally depend on it to communicate.

Comparing equally qualified deaf or hard of hearing and hearing providers, Goodwill agreed somewhat that hearing providers cannot be as fluent but disagreed somewhat that they cannot be as knowledgeable or as sensitive. This position is generally consistent with its response in the preceding paragraph. This may mean that knowledge and sensitivity are not the exclusive province of the deaf or hard of hearing but that hearing providers, on balance, may not be able to acquire these two traits to the same degree or with the same ease.

Overall, it appears to be Goodwill's position that vocational rehabilitation service providers, whether hearing or not, need to possess certain traits and that these traits enhance services delivered. However, deaf or hard of hearing providers do not seem to have a monopoly on these traits although they may have an advantage over hearing providers in acquiring some of them to a greater degree. Worthy of note is Goodwill's belief that deaf or hard of hearing persons have a clear advantage in becoming fluent in ASL. Despite this, Goodwill does not believe that it is essential to use deaf or hard of hearing providers in place of hearing providers. Furthermore, unlike the other respondent groups, Goodwill indicated that, to its knowledge, neither deaf nor hard of hearing clients have expressed a preference for obtaining services from deaf or hard of hearing providers over otherwise equally qualified hearing providers.

Training of Current Hearing Providers: In support of this position, Goodwill strongly believes that hearing providers can be trained to provide services equally well, compared to otherwise equally qualified deaf or hard of hearing providers. Goodwill believes that:

"Yes, there is a need to train current hearing providers who can provide a different perspective and have a differing set of expertise to provide [services to] the Deaf population. The need is for effective transition and inclusion which results in the blending of the Deaf and hearing cultures, as such[,] there is a need for trained professional service providers representing both cultures."

Ohana Kokua Ano Kuli Response: The OKAK agreed that there is a lack of deaf or hard of hearing providers who are qualified to provide vocational rehabilitation services to deaf or hard of hearing clients. It believes that deaf or hard of hearing individuals ". . . are often most sensitive, understanding, and enthusiastic concerning the needs of other deaf and/or hard of hearing individuals." However, the OKAK believes that services still need to be delivered regardless of the availability of qualified deaf or hard of hearing providers. That is, given the current lack of qualified deaf or hard of hearing providers, services should not cease to be delivered even if only hearing providers are available to deliver them.

The OKAK indicated its belief that both deaf and hard of hearing clients benefit more from qualified deaf or hard of hearing providers, as compared to otherwise equally qualified hearing providers. Consistent with its other responses, the OKAK strongly agreed that:

1. Hearing impairment creates communication difficulties requiring the services of professionals who possess three traits: being knowledgeable specifically about the implications of hearing loss, fluent in American Sign Language (ASL), and sensitive to the specialized needs of deaf or hard of hearing clients; and

2. Services to deaf or hard of hearing clients are less effective if providers do not possess these three traits.

The OKAK disagreed somewhat that only deaf or hard of hearing providers can be knowledgeable about the implication of hearing loss but disagreed strongly that only they can be fluent in ASL. It agreed somewhat that only the deaf or hard of hearing can be sensitive to the special needs of deaf and hard of hearing clients. These responses seem to give hearing providers the benefit of the doubt. However, responses to subsequent questions were somewhat inconsistent with its previous views. It agreed somewhat that hearing providers cannot learn ASL as well nor be equally sensitive to the needs of deaf or hard of hearing clients. It did disagree somewhat that they cannot be as knowledgeable. In an ensuing set of questions, the OKAK agreed somewhat that hearing providers can learn ASL equally well, be as sensitive to the needs of deaf and hard of hearing clients, and be as knowledgeable as deaf or hard of hearing providers.

The OKAK agreed somewhat that deaf clients identify more with and are more receptive to deaf providers and that deaf providers give better service by virtue of their disability. The OKAK also strongly disagreed that there is no difference in quality of service given by deaf or hard of hearing and hearing providers who are equally qualified. However, it strongly disagreed that the use of deaf or hard of hearing providers is essential. In summary, it appears that although the OKAK acknowledges the value of deaf or hard of hearing providers, it is somewhat ambivalent when it comes to comparing their abilities to those of hearing providers. In clarification of its responses, the OKAK submitted the following additional comments:

"In providing services for individual with hearing losses, it should be clear that the needs of the deaf and hard of hearing are often very different. Service providers need to be knowledgeable and sensitive to the needs of various individuals with various hearing losses. This includes the ability to communicate with their clients.

In addition, while it is indeed preferable to have service providers who are deaf or hard of hearing themselves, it would be discriminating to hire only such individuals [by] virtue of their hearing loss. That is, it would be discriminating to hearing individuals who are qualified and able to provide such services. Again, whereas it is preferable to have deaf/hard of hearing service providers, there are other qualities that make the service provider 'qualified' -- qualities such as sensitivity and knowledge of deaf/hard of hearing issues, ability to communicate with clients clearly, etc."

Less than 25% of the OKAK's own sub-population of hard of hearing persons have expressed a preference for deaf or hard of hearing providers. It did not provide information concerning deaf clients' preferences.

Training of Current Hearing Providers: The OKAK strongly agreed that, under the assumption that deaf or hard of hearing providers provide better services than hearing providers, the latter can be trained to provide services equally well. However, the OKAK warned that this was only viable as an interim measure and that ". . . aggressive recruitment of deaf/hard of hearing trainees is a must!" It recommended that training programs be instituted and that trainees be supported with stipends during training, and that particular efforts be made to recruit deaf and hard of hearing individuals as trainees.

Aloha State Association of the Deaf Response: The ASAD did not agree that deaf or hard of hearing clients benefit more from deaf or hard of hearing providers who are equally qualified as comparable hearing providers ("Not really, as the qualifications of hearing staff knowing sign language and fundamentals can do it too."). However, its clarification reveals some ambivalence:

"We [the DVR and the State's vocational rehabilitation system] don't have deaf staff at present, but it may be possible to have one or two in the future if a Deaf Service Branch is set up. Without a doubt, it will work better for our Deaf clients. . . . Yes, [there is a need for or a lack of qualified persons who are deaf or hard o hearing to provide services] it would be very helpful to have a qualified deaf or hard of hearing person for bilingual clients. On the other hand, it is the qualification of that person that is required for ability and knowledge of vocational services."

The ASAD explained that it was "rather hard" to answer the set of questions comparing equally qualified deaf or hard of hearing providers with hearing providers "because of a diversity among those qualified and unqualified persons or clients. . . . Even with Number 12, [a question asking what proportion of deaf and hard of hearing clients have expressed a preference for deaf or hard of hearing providers over otherwise equally qualified hearing providers] it is impossible [t]o rate the percentage due to the diversity again."

The ASAD suggested that the high cost of living in Hawaii is an obstacle to hiring qualified deaf or hard of hearing vocational rehabilitation staff. The level of required professional experience is also an obstacle especially for recent deaf or hard of hearing graduates or those who have insufficient credentials but who are interested in this career path. According to the ASAD, the hiring of interns would be ideal. However, it feels that such interns never remain to serve in Hawaii upon their graduation. Presumably, the high cost of living is a contributing factor. It suggests the solution lies in formulating a suitable recruitment strategy that both capitalizes on recruits' interest in a vocational rehabilitation career and addresses the cost of living obstacle.

Training of Current Hearing Providers: The ASAD believes that training of current hearing providers a viable option "if necessary due to no qualified deaf persons at this time." It approves of additional training about deafness for current hearing providers on Oahu and the neighbor islands such as the current practice of having them attend courses at "Monmouth College for a month or so."

1. An initial response from the Hawaii Services on Deafness was received on August 29, 1996. That initial response provided background information on the HSOD and dealt with issues two and three relating to services for high school students and briefly touched on the need for adjustment services (issue seven). It had been intended that the HSOD board of directors, which includes several deaf and hard of hearing persons, would provide an institutional response to the remaining issues at its board meeting on September 7, 1996. However, because of the absence of a board member at that meeting, it was decided that an unspecified number of the board's deaf or hard of hearing members would meet with Bureau staff at a later date, using an interpreter. Despite repeated attempts, that meeting was never scheduled. As a result, in order to have its input included in this study, the Bureau requested the HSOD to return the Bureau's survey instead, part of which was received on September 30, 1996.

2. The first survey response was received on September 30, 1996 unsigned; the second was signed and was received on October 7, 1996.

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