Recently, the U.S. Department of Justice and Franciscan St. James Health (St. James), a nonprofit health care system providing comprehensive health care at hospitals in Illinois, settled a lawsuit alleging that St. James violated Title III of the Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12181–12189, and its implementing regulations, 28 C.F.R. Part 36, by failing to provide sign language interpretive services to a patient with a hearing impairment (the complainant). The complainant alleged that during her time as a patient at Chicago Heights Hospital in 2011, she requested on multiple occasions, but was not provided, a sign language interpreter so she could communicate with medical personnel about her condition. 

The Department of Justice investigated the allegations and determined the hospital denied the complainant auxiliary aides and services necessary for effective communication during treatment, in violation of 42 U.S.C. § 12182(b)(2)(A)(iii). This section of the ADA requires “public accommodations,” including many businesses generally open to the public, “to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services, unless the entity can demonstrate that taking such steps would fundamentally alter the nature of the good, service, facility, privilege, advantage, or accommodation being offered or would result in an undue burden.” 

The settlement agreement requires the hospitals to provide “appropriate auxiliary aides and services, including qualified interpreters, where such aids and services are necessary to ensure effective communication with deaf and hard of hearing patients and their companions.” Specifically, St. James must ensure that the hospitals:

• Provide auxiliary aids and services, including sign language interpreters, to people who are deaf or hard of hearing, within prescribed time frames and free of charge
• Designate an ADA Administrator
• Utilize their grievance resolution systems to investigate disputes regarding effective communication with deaf and hard-of-hearing patients
• Post notices of their effective-communication policy
• Train hospital personnel on the effective-communication requirements of the ADA
• File compliance reports with the Department of Justice
• Pay damages in the amount of $70,000 to the complainant in this case

Although the settlement is not a binding precedent, it does reflect the enforcement priorities of the Justice Department’s Barrier-Free Health Care Initiative, a partnership of the Civil Rights Division and U.S. Attorney’s Offices across the nation to ensure that people with disabilities, including those who are deaf or hard of hearing, have equal access to medical services. Health care providers must evaluate their ADA compliance specifically concerning individuals with hearing or sight impairments to confirm that such individuals are receiving services “necessary to ensure effective communication.” Providers who fail to do so risk becoming entangled in serious enforcement proceedings.

Additionally, ADA regulations define “place of public accommodation” to encompass a wide range of commercial and nonprofit facilities, including hotels, student housing, transient lodging facilities, and many other places of lodging. Therefore, government enforcement of ADA effective communication requirements could potentially extend beyond health care providers to include numerous other service providers as well.