AUG 28, 1992

The Honorable Larry Pressler
United State Senate
133 Hart Senate Office Building
Washington, D.C. 20510-6125
Dear Senator Pressler:

        This letter is in response to your inquiry on behalf of your
constituent, Dr. Robert Johnson. Dr. Johnson has asked whether
he is required by the Americans with Disabilities Act to provide
interpreters to his patients with hearing impairments.

        The Americans with Disabilities Act authorizes the
Department of Justice to provide technical assistance to
individuals and entities having rights or obligations under the
Act. This letter provides informal guidance to assist your
constituent in understanding the Act's requirements. It does
not, however, constitute a legal interpretation, and it is not
binding on the Department.

        The ADA requires physicians to furnish appropriate auxiliary
aids and services where necessary to ensure effective
communication with individuals with disabilities. A physician
may not impose a surcharge on any particular individual with a
disability to cover the costs of measures, such as providing
auxiliary aids, that are required by the ADA. These provisions
appear in sections 36.301(c) and 36.303 of the enclosed title III
regulation, at pages 35596 and 35597, respectively. Also
enclosed is the Department's Title III Technical Assistance
Manual, which may provide further assistance to your constituent.
Pertinent discussion may be found at pages 22 (surcharges) and
25-28 (auxiliary aids).

cc: Records, Chrono, Wodatch, MillerC,-McDowney, FOIA, Library
    :udd:millerc:pressler.cong
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        Under section 36.301(c) of the regulation, the cost of an
interpreter must be absorbed by the doctor in the limited
circumstances when an interpreter is necessary. However, as
provided in section 36.303(f), a doctor is not required to
provide any auxiliary aid that would result in an undue burden.
The flexibility of the auxiliary aids requirement, the undue
burden limitation, and the ability to spread costs over all
patients should minimize any burden on the medical profession.

        What constitutes an effective auxiliary aid or service will
depend upon the unique facts of each situation, including the
length and complexity of the communication involved. Generally,
a doctor may satisfy the auxiliary aid or service requirement by
using a note pad and written materials where a deaf patient is
making a routine office visit. By contrast, a discussion of
whether to undergo major surgery may require the provision of a
sign language interpreter. Further discussion of this point may
be found on page 35567 of the enclosed regulation.

        I hope this information will be helpful to you in responding
to your constituent.

                                        Sincerely,

                                        James P. Turner
                                Acting Assistant Attorney General
                                        Civil Rights Division
Enclosures (2)

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