On June 4, 2024, the US Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a settlement with a New Jersey medical practice to ensure effective communication and access to services for individuals who are deaf or hard of hearing. The practice provides otolaryngology services, including the medical and surgical management of problems related to the ear, nose, and throat, for adults and adolescents in New Jersey. The settlement was the result of OCR’s investigation of the practice regarding allegations that it discriminated against people who are deaf and utilize American Sign Language as their primary means of communication.
The complainants alleged that the practice denied their requests to provide an auxiliary aid (sign language interpreter) and schedule an appointment; thereby denying them an equal opportunity to participate in or benefit from the practice’s programs and services.
Federal civil rights laws prevent discrimination against people with disabilities, including for sign language interpretation and when a person requests a companion to aid in a visit. Under the terms of the settlement, the practice agrees to take several actions that ensure equal treatment of patients who are deaf or hard of hearing.
OCR entered into the agreement under Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act, which prohibit discrimination on the basis of disability. These laws specifically require healthcare providers to provide appropriate auxiliary aids and services to ensure that their communication with individuals with disabilities is as effective as their communication with others.
Under the terms of the agreement, OCR will monitor the practice for at least two years to ensure that it comes into compliance with the law. Among other actions, the practice specifically agrees that it will:
- Furnish appropriate auxiliary aids and services free of charge to ensure effective communication for those individuals who request them;
- Revise its non-discrimination policies and procedures to clarify how individuals can obtain services;
- Provide training to personnel and staff on federal civil rights laws and update training materials so that staff are aware of patients’ rights and the hospital’s obligation to provide appropriate services;
- Display notification to the public, patients, and personnel of the rights and protections civil rights laws afford regarding nondiscrimination in healthcare and human services; and
- Report progress of compliance with the settlement agreement to OCR through a series of compliance reports.
“Individuals who are deaf or hard of hearing should be able to schedule medical appointments and be seen by medical professionals just as easily as any other patient,” said OCR Director Melanie Fontes Rainer. “The law promises deaf and hard of hearing patients that they should receive care, free from discrimination, and have access to effective communication in appointments with their providers. [June 4th’s] agreement puts other health care providers and facilities on notice to prioritize the communication needs of their patients and follow the law.”
Compliance Perspective
Issue
Failure to provide effective communication for individuals who are deaf or hard of hearing violates Section 504 of the Rehabilitation Act of 1973 and Section 1557 of the Affordable Care Act of 2010, and retaliation is prohibited under each of the civil rights laws that OCR enforces. Healthcare facilities that receive federal funding must provide aids and services when needed to communicate effectively with people who have hearing, sight, or speech disabilities. For people who are deaf, have hearing loss, or are deaf-blind, this includes providing a qualified notetaker; a qualified sign language interpreter, oral interpreter, cued-speech interpreter, or tactile interpreter; real-time captioning; written materials; or a printed script of a stock speech. A “qualified” interpreter means someone who is able to interpret effectively, accurately, and impartially, both receptively (i.e., understanding what the person with the disability is saying) and expressively (i.e., having the skill needed to convey information back to that person) using any necessary specialized vocabulary.
Discussion Points
- Review your policies and procedures for communicating effectively with residents who are hearing, sight, or speech impaired. Also review your policies and procedures for the prevention of discrimination and retaliation. Update as needed.
- Provide training for staff on effective communication techniques for all residents, including those with hearing, sight, or speech disabilities. Document that these trainings occurred and file each signed document in the employee’s individual education file.
- Periodically survey staff to ensure that they are aware of resources that are available at the facility for residents who are hard of hearing or deaf, or who have sight or speech disabilities. In addition, ensure that staff are aware of how to report any concerns of discrimination or retaliation.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
