Feds steps up enforcement of the ADA to protect rights of people with hearing loss

David Kirkwood
April 17, 2013

WASHINGTON, DC—The U.S. Department of Justice (DoJ) has reached settlements with eight health care facilities around the country that it found to be in violation of Americans with Disabilities Act (ADA) requirements for communicating with people who are deaf or hard of hearing. Most of the cases stemmed from the reported failure of the eight hospitals, medical clinics, nursing homes, and other medical facilities to provide sign language interpreters for patients and family members with hearing loss.

According to a statement issued by the DoJ on April 4, the settlements, which were reached over the course of the past year, were the product of its Barrier-Free Health Care Initiative, which was launched in July 2012. The initiative, a partnership of the department’s Civil Rights Division and U.S. Attorney’s offices nationwide, focuses enforcement efforts on an area of critical importance for persons with hearing loss.

In agreeing to settle with the Justice Department, the facilities promised to comply with Title III of the ADA, which requires health care providers to make appropriate accommodations to ensure that they communicate as effectively with people with hearing disabilities as they do with people without such disabilities. To meet this obligation, health care facilities are required, like other public accommodations, to provide auxiliary aids and services unless doing so would place an undue burden on them or would fundamentally alter the service being provided.

Under the ADA, in the case of complex health care-related communications, a provider may be required to provide a qualified sign language interpreter or other auxiliary aid at no cost to the person with the hearing loss.



The Justice Department reported that at each of the eight facilities with which it subsequently reached a settlement someone who was deaf or hard of hearing sought access to health care services and was denied a sign language interpreter. That, it said, constituted discrimination on the basis of disability. By failing to provide an interpreter or otherwise accommodate the communication needs of people with hearing loss, the DoJ said that the facilities and the doctors were compromising the overall health of their patients.

In one of the cases cited by the DoJ, the complainant went to the emergency department at Monadnock Community Hospital, in Peterborough, NH, for treatment for an allergic reaction that made it difficult for her to breathe. Upon entering the hospital she requested a sign language interpreter by presenting an Emergency Interpreter Referral Card. Despite her request, hospital staff attempted to use the patient’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, but although she was provided with discharge paperwork, she alleged that she had no understanding of what was done to her or of the discharge document.

In a case involving Northshore University HealthSystem in the Chicago area, a deaf man who was the primary caretaker for his 80-year-old mother said that on three separate occasions—one emergency room visit and two hospitalizations–he and his mother requested a sign language interpreter so the son could communicate with the hospital’s medical personnel about his mother’s condition. He was told that the hospital does not provide interpreters to family members of patients who can hear.

In all the settlements with the Justice Department, the health care providers agreed to change their policies so as 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. Four of the settlements required the providers to pay monetary damages to the complainants. In two cases, providers paid a civil penalty to the government.

The physicians and medical facilities that signed agreements with the government over the past year are: Richard Noren, MD, Henry Kurzydlowski, MD, and Pain Care Consultants, Inc., in Illinois; Steven Senica, MD, and Senica Bruneau, MD, in Illinois; Northshore University HealthSystem in Illinois; Paul S. Biedenbach, MD, and Northern Ohio Medical Specialists Healthcare in Ohio; the Center for Orthopaedic and Sports Medicine in Virginia; Manassas Health and Rehabilitation Center and Gainesville Health and Rehabilitation Center, both in Virginia; and Monadnock Community Hospital in New Hampshire.

“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, across the country–need to provide equal access to people with disabilities, including people who are deaf.”

The DoJ has a number of publications available to help health care facilities (including hearing care clinics) comply with the ADA in serving people with hearing loss. For more on the ADA, visit its web site.



The Justice Department is not alone in trying to root out violations of the American with Disabilities Act. Last month, the Office for Civil Rights at the Department of Health and Human Services reached a settlement with Genesis HealthCare, one of the nation’s largest providers of senior care. Genesis, which has more than 400 senior facilities, agreed to provide sign language interpreters and other means of effective communication to people who are deaf or hard of hearing.



Finally, in a case of alleged employment discrimination, the U.S Equal Employment Opportunity Commission has (EEOC) filed suit against Toys “R” Us, Inc., one of the world’s largest retailers of toys and juvenile products. The commission charged that the company violated the ADA when it first refused to provide an interpreter for a deaf applicant for a job and then failed to hire her. The suit was announced March 19.

The EEOC claimed that Shakirra Thomas, who is deaf, applied for a team member position at a Toys “R” Us, store in Columbia, MD, in October 2011. Thomas communicates by using American Sign Language, reading lips and, through the written word. When Toys “R” Us contacted her to attend a group interview, Thomas’s mother advised it that her daughter was deaf and she asked the company to provide an interpreter for the interview. The EEOC alleges that the retailer refused and said that if Thomas wished to attend a group interview, she would have to provide her own interpreter.

The applicant’s mother interpreted for her during a group interview, but the company refused to hire Thomas despite her qualifications for and ability to perform the team member position, with or without a reasonable accommodation, the EEOC said in its lawsuit.

The alleged conduct, said the EEOC, violates the Americans with Disabilities Act (ADA), which requires employers to provide reasonable accommodations to employees and applicants with disabilities unless doing so would cause an undue hardship.

  1. Thanks for this good summary article. We know how important it is for the FCC, DOJ, and others writing about equal access for health matters to mention CART also – real time captioning for medical visits and hospital communications. Much of the public reading these important rulings continue to assume that most people who are “deaf” use sign language, when in reality, only about 5% of about 48 million Americans (in the USA) with hearing loss actually are fluent in signing.

    Requesting CART (real time captioning’s acronym in the USA) is equally important if one needs it. For some, “other means” or “auxiliary aids” may help as well, and of course ASL is crucially important for people who sign.

    People who need CART have been slower to ask for it, or discouraged by medical providers also (anecdotal), so that fewer legal challenges have transpired. For more information, see this resource, http://ccacaptioning.org/cart-captioning-healthcare/.

    We hope these good actions lead to equal communication access for all, using the resource they require and choose.

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