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2	Challenges of Funding Resident salary+benefits: $61,000-$70,000/yr Interpreters: ~$90,000/yr Resident compensation-6 yrs: ~$400,000 Interpreters: ~$540,000 ~$940,000 Cost of Entire Program: $5,400,000/yr (without interpreters): $16,000,000+/3 yrs
3	Challenges of Funding What are the sources of funding? Medicare: Direct and Indirect Graduate Medical Education (GME) Funding Children’s Hospital GME State Legislature (Utah Medical Education Council) Patient Care Revenues
4	Challenges of Funding Does the ADA of 1990 guide us? The Americans with Disabilities Act (ADA) requires an employer with 15 or more employees to provide reasonable accommodation for individuals with disabilities, unless it would cause undue hardship.
5	Challenges of Funding Does the ADA of 1990 guide us? Every request for reasonable accommodation should be evaluated separately to determine if it would impose an undue hardship, taking into account: the nature and cost of the accommodation needed To the extent that a portion of the cost of an accommodation causes undue hardship, the employer should ask the individual with a disability if s/he will pay the difference
6	Challenges of “Standards” Technical Standards Policies “These standards describe the essential functions that residents and fellows must demonstrate in the requirements of post-graduate medical education, and thus, are pre-requisites to entrance, continuation, and completion of training in the Adult Neurology, Pediatric Neurology, and Neurophysiology Programs. ”
7	Challenges of “Standards” Technical Standards Policies “Possess sufficient hearing for required diagnostic functions (e.g., use of stethoscope to assess breath sounds, bruits, heart murmurs, heart sounds, etc.) and precise localization of lesions in the neuraxis (e.g., dysarthria, dysphonia)”
8	Challenges of “Standards” Technical Standards Policies “In emergency situations, understand and convey information for the safe and effective care of patients in a clear, unambiguous, and rapid fashion, including receiving and understanding input from multiple sources simultaneously or in rapid-fire sequence”
9	Challenges of “Standards” Technical Standards Policies “Communication: Candidates and students must be able to communicate verbally with patients and colleagues. They should be able to hear the history of a patient and respond to the patient verbally. “
10	Challenges of “Standards” Technical Standards Policies “Provide general care and emergency medical care such as airway management, placement of intravenous catheters, cardiopulmonary resuscitation, assisting in transport of patients, use of reflex hammer, palpation of muscle bulk, performing range of motion analysis, and application of pressure to control bleeding”
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