The United States has reached an agreement, under the Americans with Disabilities Act (ADA), with Jack F. Ditty, MD, PSC, a dermatology practice in Ashland, Kentucky, addressing effective communication with deaf and hard of hearing patients. The settlement resolves a complaint filed by a patient who alleged that she was not provided an American Sign Language (ASL) interpreter during an initial appointment. Through an investigation, the United States determined that the dermatology practice failed to take necessary steps to ensure effective communication with deaf or hard of hearing patients, by not providing interpreters or other auxiliary aids and services to patients, who staff knew were deaf or hard of hearing, and encouraging those patients to bring someone with them to facilitate communication.