The Justice Department announced today that, as part of its Barrier-Free Health Care Initiative, over the past year it has reached seven settlements with eight health care providers from across the United States to ensure that they are providing effective communication to people who are deaf or have hearing disabilities. These settlements address the requirements of the Americans with Disabilities Act (ADA) for health care providers, such as hospitals, medical clinics, nursing homes and doctor’s offices, to provide effective communication to people who are deaf or have hearing disabilities in the provision of medical services.
The Department of Justice’s Barrier-Free Health Care Initiative is a partnership of the Civil Rights Division and U.S. Attorney’s offices across the nation, to target enforcement efforts on a critical area for individuals with disabilities. The initiative, launched on the 22nd anniversary of the ADA in July 2012, includes the participation of more than 40 U.S. Attorney’s offices. Six of the seven settlements were obtained by the U.S. Attorney’s Offices. The settlement obtained by the department’s Civil Rights Division covers two facilities.
The seven settlements from the past year are:
“Disability-based discrimination in health care is illegal under the Americans with Disabilities Act and will not be tolerated,” said Eve L. Hill, Senior Counselor to the Assistant Attorney General for the Civil Rights Division. “All types of health care providers – from hospitals to nursing homes, from surgeons to general practitioners – all across the country – need to provide equal access to people with disabilities, including people who are deaf. More than 20 years after passage of the ADA, the time for compliance is now.”
In addition to the department’s settlements, in early March, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) reached a settlement agreement with Genesis HealthCare, one of the nation’s largest providers of senior care with over 400 facilities, to provide sign language interpreters and other means of effective communication to individuals who are deaf or hard of hearing.
OCR Director Leon Rodriguez noted “My office continues its enforcement activities and work with providers, particularly large health care systems like Genesis, to make certain that compliance with nondiscrimination laws is a system wide obligation.”
Title III of the ADA requires health care providers to ensure that their communications with people with hearing disabilities are as effective as their communications with people without disabilities. To meet this obligation, health care providers, as well as other public accommodations, must provide auxiliary aids and services unless doing so would cause an undue burden to the facility or fundamentally alter the service being provided. Although handwritten notes or typed text can be an appropriate auxiliary aid for simple communications, in complex health care-related communications, a qualified sign language interpreter may be required. The individual with a disability cannot be charged extra for the cost of an interpreter or other auxiliary aid.
The Justice Department found that at each of the eight facilities, a person who is deaf sought to access health care services and was denied a needed sign language interpreter, resulting in discrimination on the basis of disability. By not providing a sign language interpreter or otherwise communicating effectively with the individuals who are deaf, the facilities and doctors were compromising the overall health of their patients.
In the Monadnock Community Hospital settlement, the complainant went to the emergency department at the hospital for treatment for an allergic reaction that caused her to have difficulty breathing. Upon entering the hospital she requested a sign language interpreter by presenting an Emergency Interpreter Referral Card. Despite this request, hospital staff attempted to use the complainant’s 11-year-old daughter as an interpreter. The complainant repeatedly asked for an interpreter during her time in the ER, where she was administered medical procedures. She was eventually discharged, and although she was provided with discharge paperwork, she alleged she had no understanding of what was done to her, and had no understanding of the discharge document.
In the Center for Orthopaedic and Sports Medicine settlement, the patient, who is deaf, repeatedly requested an interpreter for multiple medical and physical therapy appointments related to a back injury. The orthopedic practice told the patient it was her responsibility to provide an interpreter and did not provide her with an interpreter at any of her appointments. Similarly, in the Northern Ohio Medical Specialists matter, the complainant, who is deaf and communicates using American Sign Language (ASL), sought medical care and requested an interpreter, but Northern Ohio Medical Specialists refused to provide an interpreter for her at her appointment, citing company policy.
In the Northshore University HealthSystem matter, R.A., who is deaf, was the primary caretaker of his 80-year-old mother S.A. On three separate occasions, for an emergency room visit and two hospitalizations, R.A. and S.A. requested a sign language interpreter so R.A. could communicate with the hospital’s medical personnel about his mother’s condition. R.A. was told that the hospital does not provide interpreters to family members of patients who are not hearing impaired.
Under each settlement agreement, the health care provider agreed to change their policies to provide effective communication, including sign language interpreters, free of charge, and to train all staff on their new policies and procedures and the effective communication requirements of the ADA. Under the terms of the agreements with Monadnock Community Hospital, the Center for Orthopaedic and Sports Medicine, the Northshore University Health Specialists, Senica Bruneau and Noren, monetary damages were paid to the complainants. In the Northshore University HealthSystem and the Northern Ohio Medical Specialists settlements, the health care providers agreed to pay a civil penalty to the United States. Under the ADA a civil penalty of up to $55,000 may be assessed against a healthcare provider or other entity that violates the ADA.
The Barrier-Free Health Care Initiative addresses access to health care for people with hearing disabilities and for people with HIV, as well as physical access to health care facilities. Earlier this year the Civil Rights Division and U.S. Attorney’s offices reached four settlement agreements regarding access to medical care for people with HIV in just five weeks.
The department has a number of publications available to assist entities to comply with the ADA, including a Business Brief on Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings, www.ada.gov/hospcombr.htm, and publications specific to health care providers, HIV discrimination, and effective communication with people with hearing and vision disabilities, as well as publications about tax credits available for providing access. For more information on the ADA and to access these publications, visit www.ada.gov. The seven Barrier-Free Health Care Initiative settlements may be found at www.ada.gov/settlemt.htm. For more information on the Barrier Free Health Care Initiative visit www.ada.gov/usao-agreements.htm. Those interested in finding out more about these settlements or the obligations of public accommodations under the ADA may call the Justice Department’s toll-free ADA information line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website at www.ada.gov. ADA complaints may be filed by email to email@example.com.