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Press Release

DOJ Reaches Settlement with Washington Health Care Authority to Improve Services to Patients Who are Deaf or Hard of Hearing

For Immediate Release
U.S. Attorney's Office, Western District of Washington
WA State Agency Administered ‘Apple Health’ in a Manner that Discriminated Against Patients Who Rely on Sign Language Interpreters

          The U.S. Department of Justice, working through the U.S. Attorney’s Office, and the Washington Health Care Authority (HCA) today entered into a settlement designed to improve important interpreter services for low income patients with hearing disabilities, announced U.S. Attorney Annette L. Hayes.  The settlement calls for HCA to vastly increase the number of sign language interpreters it has available to attend Apple Health Plan (Medicaid) medical appointments and interpret for patients who are hearing impaired and/or their companions.   Under the terms of the settlement, the number of interpreters under contract statewide will be increased from fewer than ten to more than 100.

            “The ability of people with hearing disabilities to fully understand and thus participate in their medical care is a fundamental right protected by federal law,” said U.S. Attorney Annette L. Hayes.  “Healthcare providers, and state agencies involved in healthcare, must ensure that their services are provided in a manner that does not exclude people with disabilities.”

          An investigation by the U.S. Department of Justice, led by the U.S. Attorney’s Office for the Western District of Washington, revealed that since 2012, HCA’s Interpreter Services Program has contracted with CTS LanguageLink to provide interpreter services for medical appointments.  However, during the term of that five year contract, CTS LanguageLink only had between zero and eight sign language interpreters available for Apple Health appointments state-wide, with no sign language interpreters available in most counties. This resulted in fewer than 30% of all requests for interpreter services being fulfilled.  As a result, appointments with medical professionals were often cancelled or rescheduled when no interpreter was available.  In some instances the appointments went forward with inferior means of communicating with the patient or their caregiver.  The investigation concluded that HCA was violating the Americans with Disabilities Act because it failed to ensure that the Medicaid benefits of the Apple Health program were being provided equally to qualified individuals with disabilities.

          Under the terms of the settlement, by July 1, 2018, HCA will contract with an interpreter service provider that has at least 100 sign language interpreters statewide.  By April 2019, HCA will need to show an appointment fulfillment rate of at least 90 percent.  If any region of the state falls short of that requirement, the settlement calls for HCA to take specific steps to recruit additional sign language interpreters. 

          The settlement also calls for immediate relief for the interpreter shortfalls by requiring HCA to permit healthcare providers to immediately obtain their own ASL interpreter for healthcare appointments outside of the HCA system and receive reimbursement by HCA for those services. The settlement also calls for HCA to use the Apple Health website and other communications tools to inform patients of their rights to interpreter services along with a grievance procedure if they believe their rights have been violated.

            The agreement will be in force for three years and during that time the HCA will collect data on requests and fulfillment for sign language interpreting.  The data will be provided to the U.S. Attorney’s Office, Western District of Washington on a quarterly basis so that the Department of Justice can ensure services are being provided as required.

            Assistant United States Attorney Christina Fogg led the investigation and negotiated the settlement. 



Press contact for the U.S. Attorney’s Office is Public Affairs officer Emily Langlie at (206) 553-4110 or

Updated August 10, 2021

Civil Rights
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