ࡱ> q` r2bjbjqPqP .H::)bbb84(%''''''$\hbKK`X%%E j8ߎCbv]Dv0e,&.&&PKKXd bb  Access for Deaf people to health services Comments to the HREOC Forum on Access to Health Services by Karen Lloyd, Manager Australian Association of the Deaf 28 May 2004 Australian Association of the Deaf (AAD) represents people who are Deaf and who use Auslan (Australian Sign Language). These are mainly people who have been deaf from birth or early childhood. To them, deafness is a lifestyle; it is not in itself a health issue. So they are not looking for solutions to a hearing problem. They are looking for ways to live as healthy Deaf people in an environment designed for hearing people. This is an important distinguishing feature of the Deaf community. It is important for health professionals to understand the distinction between a Deaf person and a hard of hearing/hearing impaired person. The approach of these two groups to deafness and health issues tends to be quite different. For hearing impaired people, the ability or inability to hear is usually in itself a health issue in a way that it is not for Deaf people. Deaf people do use hearing aids but very generally speaking, they are not looking for ways to manage their hearing loss or to solve this problem of being unable to hear. They do not see it as a problem that needs to be fixed or managed, it is just an everyday part of who they are. I will be leaving it to my colleague from Deafness Forum to focus on the hearing health issues that are of concern to hearing impaired people. I will be speaking only about Deaf people. For Deaf people, access to health services is largely about how to make those services accessible in their language, Auslan. Since there are very few health care providers who are themselves Deaf and/or fluent in Auslan, access means the provision of Auslan interpreters. Until May 11 this year, Deaf peoples access to private health services was a serious issue because funding was not available to provide Auslan interpreters in these situations. We have been talking to the Commonwealth government about this issue and last year they agreed to do a study into the supply and demand for interpreting. This study clearly showed that interpreting in private health situations is a serious problem. In the budget this year government allocated $18.4m over 4 years to establish a unit to provide Auslan interpreting for specified private health consultations. This is a significant commitment to ensuring that health care becomes more accessible for Deaf people. AAD congratulates the government for recognizing the importance of this aspect of access to health services and for doing something practical to make it happen. However, while equitable access for Deaf people cannot begin to happen without this funding, simply providing the funding is not going to be the magic cure. We now need health care providers to work co-operatively with us to ensure that information about this interpreting service and how and when to use it reaches all the people who need to know about it. There are, for example, several issues that health practitioners need to be aware of, including: When should an Auslan interpreter be provided. Most hearing people, including health care providers, are not au fait with the differences between Deaf and hard of hearing/hearing impaired people. But as I mentioned earlier, this knowledge can make a big difference to making health care accessible to these people. One of these differences it that, generally speaking, Deaf people use Auslan and hard of hearing (or hearing impaired) people do not. If a person is deaf this does not automatically mean an Auslan interpreter should be provided. If a person requests an Auslan interpreter, then one should be provided. If you are not sure if an Auslan interpreter is needed, then ask the deaf person. Where do you get an Auslan interpreter. It depends on which state you are in, and what type of health service it is. The easiest way to find out usually is to contact the Deaf Society in your capital city. Who pays for the interpreter. At the moment public health care providers pay for Auslan interpreters. If a Deaf person goes to a public hospital or some other public health facility, then the health facility must arrange and pay for an interpreter. For private health care, the situation varies in different states. In some states the State Deaf Society will provide an interpreter free of charge, but in some states an interpreter is not provided at all unless the Deaf person pays. This will change from January 2005, when the new Commonwealth government funding for private health consultations comes into effect. The importance of using a qualified interpreter. Health care providers do not always recognize the importance of using interpreters who are qualified. Often family members who can sign are asked to interpret for a Deaf person. We even hear of health care providers who ask a staff member who knows some sign language to interpret. This is an inappropriate and dangerous practice. It is important for anyone to have privacy and to understand information about their health, and this principle is no different for Deaf people. It is not acceptable for them to receive some information from someone who knows some sign language. Even if the person who knows some sign language is fluent in Auslan, this does not mean they are capable of accurately and appropriately interpreting from Auslan to English and vice versa. Interpreting from one language into another is a specialized skill that is not automatically acquired just because one knows two languages. Interpreting also requires a specific code of ethics. In addition, health information is specialized information. Family members, unless they themselves are health care providers, will not necessarily understand the information being given to the Deaf person. How then can the health care provider be sure that they are accurately conveying the information to the Deaf person? The use of family members as interpreters also breaches the Deaf persons right to privacy and confidentiality. For these reasons only qualified interpreters should be used. Auslan interpreters provided by an interpreting agency are qualified interpreters. The agency should match the interpreters skills to the task required. Understanding how to work with an interpreter. People who work with interpreters (both the Deaf person and the health professional) need to understand such things as the ethics involved in working with an interpreter and practical issues such as where to position the interpreter so that the Deaf person can see them but still retain their privacy in medical situations. Respecting the Deaf persons right to choose. If a Deaf person requests a specific interpreter by name, then every effort should be made to provide that interpreter, unless the interpreter is a member of the Deaf persons family. This is especially important for health issues, but in many cases health providers and interpreter providers will not do this because it is too much trouble for their booking system. But there are good reasons to make an extra effort to make this possible. The number of Auslan interpreters is limited and many Deaf people tend to know the interpreters they work with, and to be comfortable with some interpreters but not with others, for various reasons. Health situations can be sensitive and it is important the Deaf person and the interpreter are comfortable with each other. If they are not then the Deaf persons health care can be compromised. It is especially important to match male interpreters with male patients and female interpreters with female patients. Understanding the need for relay interpreters in some situations. In some situations two interpreters are required: a regular Auslan interpreter to interpret Auslan/English, and a Deaf relay interpreter to modify the Auslan to a language level that the Deaf patient can understand. There are some Deaf people who have minimal language skills in both English and Auslan. Reasons for this can be because of decisions made early in their life about language access and a lack of access to education; or because the Deaf person is from a non-English speaking background and has acquired Auslan more recently; or because they have an additional disability. A small number of Deaf people have had training in relay interpreting. It is important to use relay interpreters who have had training and experience and have the skills to do this level of interpreting. Now that the Commonwealth government is committing funds to provide interpreting in private health consultations, the difficulty in making health services accessible to Deaf people who use Auslan lies mainly with ensuring that health care providers are aware of what is available and what is needed. This is where organizations like AAD can work with the health care industry to provide information to all sectors of the industry and all levels of staff from health specialists to receptionists. Rather than going into great detail about all the possible issues that can arise in relation to access to health services, at this stage I want to highlight the need for the health care industry to work with organizations like AAD and other peak disability organizations to identify and find ways to address issues. However, there is one other issue that I want to flag today as needing serious attention: access to mental health services. Apart from the provision of interpreters, mental health professionals also need to have a greater understanding of Deaf peoples cultural perspectives, and the life experiences of Deaf people. There are particular issues that are specific to Deaf people and unless mental health professionals are aware of these issues and understand them it is difficult to provide appropriate health care. This is a complicated area and not something that we can examine in detail in this forum. But it does need to be flagged as an issue that needs attention. AAD has for long been aware of the need to work with health care providers to ensure that all areas of health care are accessible to Deaf people. A significant problem for us has always been the difficulty of linking up with the right people in the health care industry who are in a position to work with us in a way that will have positive outcomes for everyone. Todays forum is a wonderful opportunity for all of us to make this connection between advocates for people with disabilities, and the health care industry. AAD sincerely hopes that today will be the start of an ongoing partnership with the industry to work towards achieving equitable access for all.     Australian Association of the Deaf Inc. HREOC Forum on Access to Health Servicespage  PAGE 3 of  NUMPAGES 528 May 2004  -' , 1 8 _ 1 J HJSʹʹssseseeeWh&OJQJ^JmH sH h<dOJQJ^JmH sH hPgMOJQJ^JmH sH hv"OJQJ^JmH sH henOJQJ^JmH sH hl\ OJQJ^JmH sH hXOJQJ^JmH sH  hu5OJQJ\^JmH sH  hX5OJQJ\^JmH sH hXOJQJ^JhX5\mH sH jhX5U\mH sH "-.g^ _ JKSTM & F h88^8gdl\ $a$1q2MN[\BC S"#$%VWst & F h88^8^\}t| #%_c $"T"#W%d%i%z%x**d+++++J,r,,,,,,--I-..A/// 0+0K1L111򛉛֛֛։։hFyOJQJ^JmH sH hXhtFOJQJ^JmH sH  hX6OJQJ]^JmH sH h&OJQJ^JmH sH hh9JOJQJ^JmH sH hv"OJQJ^JmH sH hQOJQJ^JmH sH hXOJQJ^JmH sH 6!" $"%"S"T"##&&V&W&/'0'((q) & F h88^8^gdtF & F h88^8gdtF^q)r)c+d+--@/A/0011111111122<2^2 $$Ifa$$If &dP11111111122A2B2H2I2J2K2O2P2Z2[2\2]2n2p2q2r2hXOJQJ^JmH sH %h&0JCJOJQJ^JmHnHuhu0JCJOJQJ^J#jhu0JCJOJQJU^JhuCJOJQJ^JhuhuCJOJQJ^JmH sH hXjhXU^2_2k2l2m2$Ifnkd$$Ifl09 064 lam2n2o2p2q2r2nkdk$$Ifl09 064 la,1h. A!"#$% Ddx  C TA<AAD Logo with full name speltR3E`g0#;#jDF3E`g0#;#jJFIF,,LEAD Technologies Inc. V1.01  +4%'+>7A@=7<;EMcTEI]J;zœJJ;^jm>ֽJT#OG-2S$ nGӝX]0lIӔa/rp05(ʬݝMuYK;#^:QS,hD4vczYS^cYPlǓ ƼTGdo)(/nO@WF 唛՝g$Ih [1%?|ΊmlW)P0 ( ( ( ( J( ( ( #֝) ( ( (P0A@P0 (P@P0 (P@ ( (A@ (P0A@ (A@P@=P@P@P@(:}O;aGAݏ)Ӕd&-F}JG׫ qlIMv\)u2K?VT[_VuSKiiP0IYy u9K2S$C8Q5Ҧ#Smܵ菩8\[a5jrosl*(W!*M%q_4,~z!MB<9\wftB-(Ϸ|wiPtӠZ@ ( ( ( ( ԼP0 D|3n=O»i9ݮc*vHeQ< 1pz焴[jtUl ((k:Q 1^յ{9֞)02k g[ ʛ5nұWP@sbb=? X&w]'k>5KC8LJ)=j^VeurbPPsFIXuf8\v1nYmo]h)? mח'VSr=9|^g]kiZ:H 1:5W*j4Э ). 3ZS)2vF8t=>.}7º._I6˰a$ Q)wn <_}J].Ŝ}\F}J]ۮ p-fϹ}J]DZI[ѣ WقAZIҕ5˵E [VJXB@َ1[Ңb%.S4܏l/es)J]z̀L7 sN}K!Ӧ}颕JXjWj_SIX:==kX( }{1/aԟAWNP%vd[h6_񮟩Ϻ25tuQ<ے7PG\)rfjJY(P 0ϋ,Õ.xƻ>>#,%eF$x8?ʹAӗ+4M]* (P@7^$IN'g%tћZn4*Ӽk:Jɕ)+dPP@ er ua5tD(0dW|޸0SMXP@KRխƈ\opUr=:ڝTIw(8ֿTOc{ݲr0A#sM5tXPҀ1*ӳǝJF~7ew\CcҰ%N螠 ( ( (A@ (݂Y@4v@p:֦铑!?tzs)RTdqm<=F_6enxaAYWՖڳ;!F ytlWԎxe/쾿S^*~<圹:jL&-T{_Nֻ>mY`DiӕY~lRPG}y=\\ڽ8EAr唛wf/R!:[ݎ氇6y@( (P@P@P@?s:޿Sc9˕]En˷,{IB<*NN}i%<чP!8<$]kRu#nc~bM.I]lΪrZXP00bH$Á5ۂߡmgJ:^&Q»S~0#xhP0m{F?Z8g{u~ LcoGFqpZަ6)k_{4i*q^%I;"mD:eoˌޝkTKPO[t)-@ do*0A/4(u\ӎ.F,Hbe㑤pP3?MjJ)UjA}h֏o!eGJsp2%GVZ\C+쿯`<'`^qPn/ Vt˨⅝wFslW]nєɢe}/fDebJj8!B Nz9y¸~>݇"6;r̼㴰a#4tvճẮʳշȣ+3?L=bRԱᱷ8'WAt9+*qprW9<Ǖy" TD讌4*P`F=zq]TƢLeQۥB:Ӷ} ԽoԸMۡ܊򎠤@xS[߳!S G=Ձ)55^HfkǫOͣ2W.C (_ h0y^ ZsV$gӊg]Y]C) 29WմgXC9c؜׸+w> F>kpQ\z].Hc(SuP@P@P s:,$~i1nxwa)]Ҳ9*K䷏*7]%J<榹cm%  (NNJzHc͌U9IHRWV3 ڐs mS)i T՚7אo<"w=aRVEes.羼i.{vQzЄ`9IY%.3Ϸz_v;Fͫ5i4=OFKosns^sgz$Hؑ lmZ1m3iאuP0  (  (PGP,cbM{)rF~%Y]ӌE0W&.3]?3ZQ,ӼQw?F#cus/Λ{|$^Wmj~61NdEt!A;3u!:mo²NoLq=9k/FaN*Рa@<2͆?[^6GgSN'te?CnP^= !O׃^fdq;kcYOWprʹ4%7[g[xdCєW΁ P@r^4`՞=9O?SB~#Zb_Ț_WuP5Lm#/+_޷^W18Lu g]8)3:Z{^9 }8 )x^ƻ0|] cHi/#Q랕ڎCk;B (7_Կd#Γ{[Ч'ȉ_P!z\C.i#{_O6[q p1U?SZum%Ė 4LG^$SJ;??x6g漬E/g=6gd%̍J,(<ͳq;_ ykTk1P0 y^^!Cnx$]rL1֎+(2Sր8n1fx\tczzJݜdܬix?N1Ҍ"GXb_2KxO)2_FW!dc#ʫ R듰GS!$񵿄OV\ yGHP@r5K>{?z5FXk&HՃ}6]6ѕ(']I@LGۺzӡYTW*v[_kxWVUf ?>?/JRkoJML:s\zSCݵ8_w~A#ד+Q\P@P@P@Sε+}Op˕w!xooҽC (✮:؋}7p8#QU9KJ*1çqQ~^;EaJQ.Nɳ+7[E3l39?tb┓DSwZjqm-yVP*IקB >fsO'ߕ"%}OcWuh}•-kAq PTˢ]Y3IXzZ%c[YnT_tSqP@ L@ (A@€ (F/uiet?`/ϧ]xZ|{#*1؝OPKqd~:Tss;*PT`8gh)V0Aia%;>gk٣?io+İ)n&/u?\xV|tRՎMB`ˍ2@\:Zp_0֗;NG|'S+/FeOG׊u ~qy݃Q%vu^ ҦO6?7CoW!Pn[3f9ad_Gq]kʖ5#'Q\:ס E9Pq"֎ZWVf"Tz3rœFo!Tc0ߗB* ?Β |yCЊ9AGBwP@r~2v^~5mO'ʴ ;9rcz'noutYew$NFFG5R\Y r\xQ#oq_Ssk1xQafXSMaOZW-˼t*u!Ij%K]ΫF!1+ߌ^}lCkW)P@H`pz|YA1'^Чn%I]Ӽc} r\][E֔tWO!KYGc:T ´n-Sm2e#MȹqZ/S:rqww  cZ@P0&Sӯ{Xk(sIY#^N+Z (Pdk7g潚*q{9W&7tmG:J6 *yZ,#`QM\vk Kw{#*9 >K 1>N\;k Kcj [mݝ KyFRE$ՙw0Kmhqz.dzMY|9h˽M ѿ4 sFsP-a,O^±o_2)[5 '܆*{ittt][avK꟡ҽI]l/5aZ~< wa/GKMK74CX#^F'vFsP@ (P@ 7RG&Ƿz'dXa^"[x#>j}x|ͶvbxGGoyϓ]XH^M3 t I<\i :6"%T'vĒFnfYoSV){Ik"rHdRIwwlbMziYs4 tz?pWs7Nڽ6TԭATr@3k RNIn`]krꟸ\1NF#޻cU޿`3?snV`6܀{0-V迯'Zk[Y . n%qn}ަЧ'!,j|sC1ӽc<..5n6l {>S|v7 :r橦-faH P d啶)f>1ZtD]O]ΕXݤs-O}*9MJzmmd7/qZUG]##z^)P#L '?KsR9! *'uyHP@s^5[>xJ}}ŬRdg;qW]irMB+cot{zΏg~i`wC8TڷiOb'EY2mpD9cA>⤹^ N/~N:tԕp t( Z٭Eg~uׅ.g3B1 q\go|~IߡʭZzQ(^^sTz>,?֗*yøټOʏ;6 jtНH=9»$-lro6٬b^c'?1^v.ζgU9s+=ѿ\F@yd<ڽWxPAЍy8⿑O5 ([?xO=٣4rTǽYd_U?֪/iRiN`H ;ڱ- n@k>/a[K?oMo&꼃&l$C=?]Xj[3*WG#˧ݤFfsN/CgXwz' r##m/I_w^m}ב+;aLW9a@P@ ( ( MŌޒ6Q".Y)+nAlA=f8tz&x|7]Fvn9$vusEٸ$PX=OKZkcj/tiJ퇩5J%)IF)D 'kRD]fEE7jTInO׊n4d&lu+FF:\ $i(JL4;M5619OJƥyTd\)h@ H :mw(㝩8|p;ڍ>ɴs:62$˴Ұ+Iջ;#þbd׶􉢧Ա.csi/6ѱv)#6ȱȪykӋ2<9,0m#HXm 2+ 8=WT1JOf8ꌹ#i HzzMI_#ccF&p^3{ǽsu_*tgD+( (P#~2_ʽ /F*24M8zF_b`v?t֫~TΤxoK=yYQ.{ooabsMh^{(v,g Uug_Ɨ{ȷnLQW} oV\{sOXW:R_^a ٍCN8g_0~jDN<ǟF) W5+[CS 0g3tqGUHػ`*w~59zi6 ~7=[s^-YjP0$zSRױ,9Ϸ8%71$PAªUs/yH?&v(\xrwm}Hx}n#Gƽ<Nj<,1CU'ڴ w(P kƟv һ_kc[dc{#_MA5Ոi|gy^9- 9i]Ŀק^Z*xUν-$=Rt*Sw"Z@Gq2[Jp\HMBﮤs}WqNWw6t %͔sK,M D9k)N1W6Kُx>2`c7XϪ\e]xFtآᅴ{ye 2Ƀ`v֎+\ZsetacwD?q]U g8C99I05.-wԀPI.OJ JDžOHa8gЍy⳶z4 @w#[Z}+٣8#6COOk6+(~a,')^݄vj#EAgb3oһjUTasOW?5bɟE @tL?Ət=Ǹ{!(D}?}e%9$a*{U )Ǚ8'u?>ݬl~,W.+]NRGC\F@Y Htg`(mN#t؟2hl+:9Oi&'7s:?ν-noqjLtsA(ujV h3"8nf; q?gl>i9A@€ (P@P}3Wd_Nw7q?Jp9JxY̜1Fs`}b(ʥ;hn+)Jᣓ5N ;?J Ju]7(O0ϩ[ʦL/H5k|TPǢ㏩uzPWf>LѤjl᳧F1?UH+9ݍ,H/Fͅr)BuӿOa^"<0\P~ GOtP<>JޅOg?"'dqcyn[[ )^v;4w]$rue+=kȫ ;a.erdPPNC27q?uQ:~T^E,vU<N>7Qj Rc( DLc#=iNn2<xg:?N⽘d6Ϋºm>+4c{~]?*T%̶gM)+js,TȖ h!G I۞ކeL ԕn>i}0:/q[W 3fwa@PkV-jOqc?{Teiu8'c[`6-O _ǯ\.mF}ךnL Wfp=V>Mח'ߞta7y-KSVL=Hnz_=J}CMHaW(XjvNOe F[x2v-¦xjqv8Ugk^Q(/2r<Ӝ׵F:t9'3wDkO:}+Mh'G\QZIq)Pg䢄ݕ緗癁yNNO=W$qI;? iaӃiA~_μM^yۢ:ǕhP@>,ӍŢxUu R}Ljl+-3" NdZC{yPP]HC+=N\K1 bc^7q< !`smhwѿ#^F+J,(P@ (P  (+|moa4Zԇ=4J&tWR3PZ@q$K>Ͻz4k{Ma8[M V6䰀%֊y[_'mךnP@P@P0A@ (P@Fz@N(  (P ѣVi]EP1EY Ha@P0A@P0A@P@jj`0)jZ@P@!AbHa@ !'Uv*0էG3H?9\Z*(paD)ȉxQ֎iw,{P4hOPjb]H9k*+HnmOL0o E \nN$T(Q[Alg^ ;nf]CUϒIdnz߭^+KTvWnR֔8S^kj,ᛷ&c#a遁x=lT|ocnD)Lc6p$tN_iwsNK=YP,mgetM㎠擋{sZX#1{w֍ .Ѫ駉4-dQ橌U):ኃC@FG#֩4Ta֩W1/lqm+k7Ty)JVZ&ǜgJMZg6E 5iz+]D]ƒ/.E\dvܮ4s+|!W3pX]F=qPe$FP@^*\#;] .7z=q]Yj2|9qjF9n 7akuКo_3<ܥ4 z,&YW^6p+_?s:fEkLy9a= r$Z^"FPKI 1P='k.W֠$2W2nt[W9[IO21zT*uo\Z#ӵ. lyf,x?(J3_aV_Xjۑq^uJneК,Vc ( (3UOAM&ݐ&|F^%m y7v 8JR\KX"?$#=ǜ$&a@"CI#Ef=nSQLHeF1g6z)Mufk6$CB5gՓk6׌ + 1| Y7fw&?/g1Iֺ95$D⮌=?[RKeiUv]u(Pm#(Ti^QPKVF&b ƵJU6j*nYy)"8\u?1һN#=\nwU PZDՓWlOAA&Ad==y¾{WѓQ d!?+9a=~i_ ?B-F_c#iXOGF"+Vt" ^c,I幐.ҺpЌi"&cts:}9E 'L,_gpC~_ ǚ9;3`8W]"j#.8+ԧ(&֧esbMB (: h#}QRRUS)k#0¡hpVjW`#Q,)l6"p~e}r7`!Bjo:ዋLf9@hTi*\h?)?Ƈs 4H}*ƔnX2yly04d|ҼڸKHhխMqGqo-r Td4#h_߿2ICGֽ:OusTZ(i:mם̧Ezҭ%Qr>WtwL0du ڼEٝI$WSN{9 =kJ.T'^K{pf-{WN`qɹnj~7%uV0p\z~o;Nڽק]G=v :t=f0&g1'MƯ\VW-@sx_WF ##^9_ǥF08:t vPC (Dq,uis˙Gt{5$;`z3wU ̗:_e|}Ez7{R.:O:k X(h6.4-,WnP@ǜym8WC  9׵c_^E]h'MyX;!nUcOV0=ai1: o$gfʪ9,Oyk0O^!ٖ` 4 h+/h'ʮps33IORǵz$8t Ĩ?YA?pžooN`PObxVW8%լW/ •GOQ؏oQFڱ-y{o^f"w]9#^M8 pݜ7*qo71grNܙxrc$h7˩P@P"9)?w F;XfDi%r,3 4M׎E&9t3n4rv?G)<5HtR6tnGAFcvM^hHfHQBmTNOSn 㸏|LwSOcЄ5xjϧ=Mv(hS:Hُ̡>ҳ9٭ux{̪U T0 cn{;ζO(&N.hKL (1#`O *,W^/-¥;ꌝ'R:u7y,3 #7 ںjM α]C! dkic_~ n|bD ]t+[f3T;;ld$ ]sfhtn RHr+ϩJTFjMKAIKi;{8=V/i_<>C4~x .k%tdVKC5@blS 8=>q;kƛkK,3|þ;չଘ8&˳܉a٠!;'~&IYlvFWEĠ 6/ni۱՝"ܲW㾱XYuȪ [yGPP@Gqw<2maU8AI&8#o;D.Pku8d{}ɗNNa{3^n.6κRn:+|ar7c!hsw9jg6ijpDЗq؁~xm^~ 3fWvP@fxgBy ]p=z^w9/L8^- dҤY\==_P{2WJ G u14wQ迀s^n& 8r?lf>ݰ*uזم/dp>-֔:*ǝ۸mn׳Ҳዓs&2ʜЊqϲϨ넹sչ1<^G]xO|'#cy[&1 _M٣5+BѨLc1dkrmVms-Oc6<0ק(jqw;:=B'ysʞ׏R.Vv&,c8 d]=O"+ke#w_t2p$W&6V6~[3p  (G3w+Irۃn'rNj9M˩%srj[C8yVżyJ~d1Tг$׉D_ή5:uVItHXb7t)8sLӉ qKop9]3HApzi隀8?#|g$Ӻ<G 4K" ;d3q9zKVx~E:j-P@PF[Y# {+n_v[_HDENvOV*k'=+t_9ͶD#?0lv]tkrc8uG= nގ2v)oS$_NI_-Œu8ܾ\Dd&jW 0pӣ_GLͱMo5,h;q㬘:]-?_JיDQ]'}Or?ӹj[Ft"F 2+h͇Ra@9j~}$'/ro^,yS;^˷.V*|!W|c^aOܥl+*p9#գgR4d8s }k\E/i 7Dҗ,܊NiPsp'$_Fx4%߄洕o̿]qK+4ϙ+ߎ+XTYNԮCA! ?:5f9#u8u;s$+Fz Rt)+bPP;.>!Va ?Zӭ: "PRY(Wl1HTZL+;Vѿ_uq]Zw4t\id妃?ụCXUFjFi . %#..D yukz}O})LS223?rcS_ p (5FV}3c{UR23"ezٝ5pO[2?5l#IT՘ *1?t-{ygHP@PgFt+ Sgu^z]NxGp(vKѥG NU3<7aA!]n3y'X|[c[s9r_νL-NxrsUq>{y!ϧOUgѱֲui=1 E.1VXRw,xh f"{k= 'J$&JmY(< 0=WZ]^4Z?l+O¼M.Ilr扱\@d{zS vıC8QsױBnTgT- ȧ*НFX/Uv"(!٠w#~`CW K$*Jpv2{G_vF$2O^f1.t_ \f&PKd˂ó?Z09{Qo,lL6?Zק!eijw2TvvH _b70{ZҦJ\瞷y&ᖬ|1f֚BA^F*|=j5k6cҵOi'dy8ڝ^cN߇,G_=3xTvhӮrOs%^C]5ϑo>jB[?C 9#;De X`N,pvvf2Fq^ >gHrH|?Xbߏ֌YÏWM-)Ƨm.A,bF_t5nP@P@Zv6r .c*1*W57\#aU=)#ZUSmğM%P}W?7Ev ')$1I}J~84%֚VV:卑.}u!iz7p? 6pJj$]+BK}L, A/#`4r#Eݱu&`?4~'`养yQ3l~4y5Ol(a@I4q'$zR{ qL9 M5K wNzjbZuvHmy%TxcGŘ"T"`HqwE&IR2dTS=7t&MP0 ( (a@8__nԈCaO_KrT3н;̙ldy0?XY("3y@(obbW$a$Oʽ W#Km6+Qu/ MT%@DWCXdWND7B[7yk3®9);+6,&]//d.-0ժ+wdB-|wEi $D.%uq%;i>bsۧ^bQ)6SLxgR 9^v*~t҃Z#c;XՆ䖇kk}mb'>'lᚩҳҰ'TܭX2?,<6 A1饄uNh#Yَ\ǩ1zytԅsO[ERw[Џ*~(+fu7P{WNn28mSJLlr|{?zUcIArƓ 9|tp̨kNAmm>aݑqK Qme9T7#1Qz?kĤ[F0$dVI'b]eG1_}/p#]+EJN[bOub9}iN#0 kȌ=NM'~ș۪ozp?urTӺ(څΟ6ixnYHokR*i$(MDt+s6ܿ2\35𻛪˩֜b[ΰt*.HbIgu|wBQEu!V$d'+0 rJ0ro`Dݑ\ƆgH}xWFΧ2GL׮W=0tVnoEL<WOνL->H=sU7ºp7.z3_ʌUNXJwgg^YP@4cRLvnG V}jי&tEe?Xmuz,M9r#=: B6Ut5'*:u=3qcxlAt>JVwCFsPv  jsZ^f<\&8W?^! V'܍µUwDN yi%Ar1 {W cQqҼM%opje-c5nCa8]D=u*#5U"# NOd=Y[q'8 Ϲ?50š.V/33*3kЧN4բa)F4&.VcOXk{Ⱥt;ΐ _Uك'ʷrv\_ێr ,\^^B+t#{ӛ(+ 弖Wr[npGf2Rq4I3pJĹ$}jJ6Dju^ $\qڼn pP@PN;[>8ymLQPzţU-tzV"  L1SчV?t깻ӗ[Dw#+PsM4:Of:€ 3#sG$Jsח/u9=nR,jn%3 QVQqj@ 7;tJ_|s]G͸CÎm"#W_I`_qB[pPq?*%R)|?Up0ddvE&608(i|?u*? ] Bı']GGb;/uv/-[j2/w`9:^՜'_~)R#W1  (P0A@€ -qk$+#D]v^Qm\RM /CK? ekV5INLV&P@<)q *GR=ETdsO$;Ev}u)%lFmP$`\f.do1Z=۶>3)C?S"톳ұ?ű,ٲ28Tܳݴ<y .>eqU+ jMZF\ơ@#&BoJtc_J86#3o!Fx3_\f'F~_ȳrsqxH#\s9Uʆ͍?Hӹo +iѽ  a@€$i,e$Etn 4qwB1|+g+n#S_&fsFr#WkeTgš̀q?MbL$'j?u9¡D%Foֱ,lXsrGӵsRjײ7%w4( ˽2۟åtR:og:j^F\Nm ~"1}bv/U]?0SB ߞ ۯ5^E/2Z_Es-ʓT^cYT)A-˅)&#ٵ-0F|`bhI4ZG>a2y85ر]eJ}"+[vU>pqR\9D9$uvgS`mvG.zV+V-e ( ^Ko'ݑqOCnRBˏϟoC9O/iz|v.ɟۭqVe>hMF̹YGsX"ICmqWyw:M.m`̃s\f7$tA5j,( ivq ewp:}kURٝH+#&װJ@sWLPZo(P" {輻AؑjT3 *2m.J+8lw3Φh$H1Xo줺@6=ˮV4 tص$Þ%k'P25|5ejw AkxChR՛jPvc6`!pcƷR4yQ9F÷WP z:WdT{Fk:€ ״a­ŹNBZ_ٻ=Aha +tه2}2eٺG6cLj5n5( ( Eqkmz~4REi#2mԓ/R3+An-."΍Xr?JsNH|HcQME$ 0&?VQu'~i?-%VoKt>f'^ӰO\WsMOO#dqTzA@ ˳6#; 8#<zCVg)-;?=<ǖ tiΧ+|Ģi`brOyIsDIR0$)"9r:RhM\̞ѡ尥ztj_df_% ,7| YA裿|R7+_##r (P a@P  ( (P  (P@P@P a@ ( ( ( ( ( (P  ( ( ( P@ ( P@P@P%EZ( ( G%2}("T-ӭ ϐ"}5XZwY T)4|EGd: ᑈHH{W/mO OִSmo'EIٰY}ڢU)E+2R"qsJ- jWX{U[553}=z~_9+3x{%ۏ_j^ɕ} :qy'X*(8Tl{+zK_挑H=7t]{`ո>2g3̖䲵<}Gj樭#H2  (A@  (P0A@P@€ ( ( ( (P0A@P@]`P DgV|rFkk)4d]O.u"N}[?_%Hx.c^$]eGfRǪ-Co1 mc,0j7zs23p (( 7b5㎦x}˒qchaWbyNkAYl^,[>Y8(&rVӪ; (P" ۡi7p֓vZU#=MMr}q)k88=vRG5 (ԅ8lT9*b\%b1,@J%Wa/oVH8?_a_q-eH`nnw4璍G`P@P@ $: ( ( ( ( ( ( (A@G4{dOUF.NM\ʚyX T￧j8}F|ъ,79ۛh:ֹ=nKK/p[8'#{t՗np@$'$'㷥r[sS<M+݄ЏJɐ j콿'Um(Zk}A^0X 10?=vSV[2W/iM+'t翩=~"j(( (P@P@ ( (P@P@P@ ( (q`Γ ӗU8` AyXNi>5}Vb.?4 {~,Mݳ嗌:,xJom )m>fӦ-[S RgI2i- ۊE0rN)+P,s۵fx/{uI#ǒGzF r?ٖ5.ߋ.xivX:dž9Ƌ!M;@P@ n>( <\I,;8YOaˠEƚ&u\a|)cJKRy'ܫ=@a@ 29ڡF#ZCpWs+Go8l5M7"-XUdt5%beY><ƕ}VompѡtdTpbp ( "Fxc Z(@j( ( ( ( ( (:A:QvFDnH%P:ںezm_bH3( (0F:/zΤ쬿#Q/Ìcs?q&H԰!<#E8sj˓!;3Yv^nLضɁSIXlqBnc'9iHWhnWRT]; ̿"8#vцYq=WM89;N39+(+8;m֝Yr?Pi)P@€  ( (xln,OD]?:SˢζֵdxbqY좷RRF3xZFbԎ;֡b̮u [C v2þִtV*SOQY< } pT˕-Veo BEq,h"Sr;Jp9ɧd-fXcjeVE 3#)V\rTDOڧ5/oC ;?He89)F2NJ&ֆ#iA.:l*rT25 OO e,Y0FxJ Uc˞.͚FEys~?(Tz=LoDᱳ N:ZtnEcH)/p-e 2 cfDsnV9$"v1ֽ M8*w997ךtr:yq2:6<}½zqC]v扊f]wGK]?G/|{-oh,{QW=yӕ #N s=>+LfTʟ1: Fc'28q(X^@#rQ::B ;yO[$긍T6gT{ J^-=S+wq4ZViWM %v/`>inͷ g`P0C]4, &IazҳgRnr6tQkl;|iX-: bܴBei4qxeZ+GT+Tj:sтZP0GۤstTKsq*6ؙ=BQfg dx/98f_݀#lƕ~֧v]'K$g#i*gNsi;€ (ĚՅHK6Ty=(N-Ƥv54-琂F 1sՊFصY.Cip@l==B6Rq7Hq6zb|gyVb}aSh3\*shlC{y6c$#O>]:v_E)t+̓Ao0 |}J+<&hE$u=OVjg^$GƷMw33Bl=kIIE_$b4 >>5Jê@(a@ P@M4&h밉d#c-׭/gM函3 FVdSG?[З-E2WFd惢Is?+k:7&ds &,/j6(9w*6@SɴXرle#U.A1~JU6( U! T潌+%u9*gp*N+gZ]ǬݾFUpCcFG2FEz)Õ-NxN8Jr\Uo"i#Fy|6G$V9s W~'M~hƗwUFW8n3/W3^mߴ-qm۴gƺ4;rR6ljqL3\Uk"_:݋&q1c8J-4EST|;u{b ҡL7GSZP@cks"t'jj75̢i1/WskF 򛂿wU/GѪ;B sڐ݅C+,%cNZ4A@€ (G+#|u?]z8OUz:%B+d_J8K4K$2Ӱ`Gױ?vqryY^?&&L{?CQE;=oe+:[xX4n2 yqgBwWGinJ?G<3$3ױZFv'o;=0<-Ey4ΛCt-UWcF<טt ( ( ( ( ( ( qX z5:w_'L +gzZ4Φ=<2i]W"n#c)- d yv]=)N]oX Hv,ycVVe=4̷-PxMjmC%L3T=\7nP@€#A HyAhnu&#y^yYh7m[p$*%MϏ5G %5̵$e? .ߋ1fqz@G?SAi fxTQIe[ Ῡkp+ʟ\PqS$Β)XD9VBJiIl:qTowCA.?(ׂ_TwP@x +,и,Jő>J83V6 iʕt^RkMV%m\Vco\ғ4Jĵ# P@(P@P@[GTA^EޕyRc9R1ҵ0R+'Ha@¨+Rr|st*Fs>#/o-[ 9~8Bf!&:XVFF "qMZ ( A_Kx.0^ Ѝ49BNWHZ@GpU%wI s~ү-5$x4F2q߈ Bf4%-NpGBoeْ4,K8ʑNjrg=8NuyAA-Α4P&+|]ڹœmi I*,(P"c"ƥw鴌O=Rْ-yR=hً+ [#hUtGQf5XQ? {hlI?3(SV%(P@Z\;!j,ҩu mvBTvbo:yStaU0]9Ӱ{:%\^9'=(tWs&m՞P3/U}!Uyy$GX.<ɑ' 0M krpe5kGP@`iv(ݐU=Дe Q=J1Mhos$(PglR2`${UzsusF_22B1ک881|ƅ3( (c(qm$)"z6T1DjQGbd3b6*'oרҢhm^AcItKOV#{3*nrV ~GU<jܗ#9&Ee! zkM v(9TЧֱGY1)?jCc>LR~ײ6t,k$#ָB0kuNKM>iUg@ 2:J sQa&u{BH#USp(z[(BSȄ-ѷ\f@P@P@P@P@[Iʺ*7Z[4` iΣرYU|}7|qjYY^D8O 1% Iݔ!kH]˴`eb}J9%k P0 (  (P0 (P0A@P@P@P@P@€ (P0 ( P@ ( ( ( ( ( (A@€ (P0 (P@€ ( ( ( ( ( (P@€ (A@€ ( ( ( (A@€ (P0A@€  (A@P@P0 ( ( ( P@P@(P@PP@ @ @ @%P@P a@P@P@P@P@P@P@P@P@P a@P@P@P@P@P P a@(P a@P@ P@P@P@P@P@P@-%-P@P@-%P@P@P@P@P@P@P@P@P@P@P@P@(a@P@P@P@P@P@P a@(P@P@P@P@P@P@P@( ZJ(h(h Z(( ( ( ( ( (h ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ZJZJ( ( ( ( ( ( ( (م$$If!vh55#v:V l0654$$If!vh55#v:V l0654@@@ NormalCJ_HaJmH sH tH L@L Heading 1$$@&a$5CJ\mH sH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List XC@X Body Text Indent ^OJQJ^JmH sH 4@4 Header  9r 4 @4 Footer  9r .)@!. Page Numberr*H-.g^_J K S T   M N [ \ BC S"#$%VWst!"$%STVW/0 q!r!c#d#%%@'A'(()))))))))**<*^*_*k*l*m*n*o*p*s*0000000000000000000000000 00000000 00000 0000000000 000000000000 0000 000000 0000000000000000I00I00I00I00I00I00I00I00@0I00@0 @0 @0 @0@0 @0 @0 @0I00I00D 551r2!Mq)^2m2r2 "#q2cjlq|~!))))))))))))p*s*giux# ? SU ))))))))))))p*s*3333333 ))))))))))))<*A*K*O*]*n*p*s*))))))))))))p*s*Qy"Ӗhh^h`o(.88^8`.L^`L.  ^ `.  ^ `.xLx^x`L.HH^H`.^`.L^`L.Qy          enFyl\ tFh9JPgMwO<dv",&uXQ)*<*^*_*l*m*n*s*@Lr*@UnknownGz Times New Roman5Symbol3& z Arial"1hڅۅڅ3?#K?#K!4))2QHX?l\ 2 Karen LloydAndrew Wiltshire Oh+'0  < H T `lt|  Karen LloydNormalAndrew Wiltshire4Microsoft Office Word@@ C@𖜇C@}C?#՜.+,0 hp  Aust. Assoc. of the DeafK)  Title  !"#$&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnoqrstuvwxyz{|}~Root Entry FpFߎCData %1Tablep6WordDocument.HSummaryInformation(DocumentSummaryInformation8CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89qRoot Entry F.ÏCData %1Tablep6WordDocument.HSummaryInformation(DocumentSummaryInformation8xCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q՜.+,D՜.+,D hp  Aust. Assoc. of the DeafK)  Title4 $,