Health care providers, take note of the recent enforcement activities of the Department of Justice’s (DOJ’s) Civil Rights Division to resolve violations of the American with Disabilities Act (ADA). In addition to enforcement efforts of the HHS Office of Civil Rights, the DOJ, in a little over a year, has entered into nine settlement agreements with health care providers to resolve issues related to discrimination of individuals with disabilities. The settlement agreements are part of the U.S. Attorney Program for the Enforcement of the ADA and, more specifically, the Barrier-Free Health Care Initiative (Initiative). The nine settlement agreements involved individuals with HIV and hearing impaired individuals.
In July of 2012, the DOJ announced the partnership between U.S. Attorneys’ offices nationwide and the Civil Rights Division to target their enforcement efforts to ensure that people with disabilities, especially those who are deaf or hard of hearing, have access to medical information provided to them. The Initiative is a multi-phase plan that will involve other key issues for people with disabilities, including ensuring physical access to medical buildings. The goal of the initiative is to focus and leverage DOJ’s resources and “echo the collective message that disability discrimination in health care is illegal and unacceptable.”
The ADA requires places of public accommodation such as doctors’ offices, medical clinics, hospitals, and other health care providers, to provide people with disabilities, including those with HIV, equal access to goods, services, and facilities. In general, hospitals are required to provide qualified sign language interpreters and other auxiliary aids, free of charge, to individuals who are deaf, hard of hearing, or have speech disabilities in situations in which the medical services involve important, lengthy or complex oral communications with patients or companions, according to the DOJ. The appropriate auxiliary aid to be provided depends on a variety of factors including the nature, length and importance of the communication; the communication skills and knowledge of the individual who is deaf or hard of hearing; and the individual’s stated need for a particular type of auxiliary aid.
The Settlement Agreements
Settlement agreements arising from the Initiative that the DOJ has entered into on behalf of the United States include:
On February 12, 2013, the DOJ announced a settlement with Woodlawn Family Dentistry (Woodlawn) of Alexandria, Virginia to resolve allegations that Woodlawn violated the ADA by requiring a patient with HIV to schedule all future appointments as the last appointment of the day. The DOJ determined that Woodlawn failed to offer the patient the same options and availability in scheduling future appointments as it offered to other people without a lawful reason for not treating the patient at any time during normal business hours. Under the settlement, Woodlawn must pay the patient $7,000 and $3,000 in civil penalties.
- On February 6, 2013, the DOJ announced that it had entered into a four-year settlement agreement with Castlewood Treatment Center LLC, of St. Louis, Missouri (Castlewood), to resolve allegations that Castlewood violated the ADA by refusing to treat a woman for a serious eating disorder because she has HIV. According to the settlement agreement, Castlewood delayed offering treatment to the woman by up to seven months, had a stated policy of not accepting clients with high-risk communicable diseases, and required that all blood drawn from the woman be done at an outside hospital. In addition to drafting an anti-discrimination policy and training staff on the ADA, and HIV discrimination, Castlewood was required to pay $25,000 in civil penalties and $115,000 to the woman.
On January 31, 2013, the DOJ announced that it had entered into a settlement agreement with the Fayetteville Pain Center to resolve allegations that Fayetteville Pain Center violated the ADA by refusing to treat a woman because she had HIV. A woman with HIV, who was suffering from back pain as a result of a car accident, complained that she was unable to obtain medical treatment because the doctor at the Fayetteville Pain Center refused to treat a person with HIV. Under the settlement, the Fayetteville Pain Center must pay $10,000 to the complainant and $5,000 to the United States in civil penalties, train its staff on the ADA, and develop and implement an anti-discrimination policy.
On June 8, 2012, the United States entered into a three-year settlement agreement with Northshore University Healthsystems to resolve allegations that Skokie Hospital, one of four hospitals owned and operated by Northshore University Healthsystems, refused, on three separate occasions, to provide requested sign language interpretive services to a deaf individual who was the primary caretaker of his elderly mother so that he could communicate with the hospital’s medical personnel about his mother’s condition. The hospital paid $3,000 to the United States and a total of $48,000 to the complainants.
Other health care providers that have entered into settlement agreements with the United States to resolve allegations of ADA violations for failure to provide sign language services to hearing impaired individuals include: (1) Steven Senica, M.D. and Senia Brueau, Ltd. entered into a three-year settlement agreement on June 11, 2012, and paid $3500 to the complainant and $3500 in civil money penalties (CMPs); (2) Richard Noren, M.D., Henry Kurzydlowski, M.D. and Pain Consultant, Inc. entered into a three-year settlement agreement on April 3, 2012, and paid the complainant $5000; (3) Trinity Regional Medical Center and Trinity Health Systems entered into a settlement agreement on March 29, 2012, and paid a total of $198,000 to four aggrieved individuals and a $20,000 CMP; (4) the Henry Ford Health System entered into a two-year settlement agreement on February 1, 2012, and paid $70,000 to family members who were denied effective communication; and (5) Cheshire Medical Center, Keen Health Alliance, and Dartmouth-Hitchcock Clinic d/b/a Dartmouth-Hitcock Keene entered into a three-year consent decree on October 31, 2011, and paid a $25,000 CMP in addition to a separate settlement with the complainants.