The US Department of Health and Human Services (HHS), Office for Civil Rights (OCR) resolved two separate investigations under federal disability rights laws stemming from complaints alleging the denial of effective communication for deaf patients.
OCR enforces Section 504 of the Rehabilitation Act and Section 1557 of the Patient Protection and Affordable Care Act. Both laws require regulated entities to ensure effective communication with individuals with disabilities. This requirement may include providing qualified sign language interpreters or other auxiliary aids and services when needed. It applies across all healthcare settings, including mental, behavioral, and maternal healthcare.
The resolutions secure a major psychiatric hospital’s and a regional health system’s compliance with federal civil rights requirements to ensure effective communication with individuals with disabilities.
OCR’s agreement with a psychiatric hospital in Puerto Rico settles disputed claims following negotiations that began in 2024. OCR had issued a notice of violation and a proposed settlement agreement, finding that the hospital violated federal disability rights laws by failing to provide a qualified sign language interpreter for a court-ordered psychiatric evaluation. The hospital provides rehabilitation, inpatient, and outpatient services to patients with addiction and mental health conditions.
OCR’s agreement with a regional health system resolves an investigation based on a complaint from a deaf woman who uses American Sign Language to communicate. The complainant alleged that the health system asked her to bring an interpreter to her prenatal appointment, relied on inadequate video remote interpreting (VRI) technology during an ultrasound, and failed to provide a qualified interpreter during labor and delivery. The health system is a Minnesota company that owns and operates healthcare facilities in Minnesota and North Dakota.
Under the agreements, the hospital and health system will implement system-wide changes to meet their obligations under federal disability rights laws.
Each provider also agreed to:
- Assess communication needs for individuals with disabilities and document those assessments for future visits.
- Modify policies and procedures to comply with federal effective communication requirements.
- Provide auxiliary aids and services, such as qualified interpreters, in a timely manner and free of charge.
- Use reliable video remote interpreting services that deliver real-time, high-quality audio and video without delays or interruptions.
- Designate a civil rights coordinator to support compliance efforts.
- Train staff on communication requirements and the proper use of video remote interpreting technology.
Notify OCR of any related complaints or legal actions and how they are resolved.
OCR will monitor the hospital’s compliance for two years and the health system’s compliance for one year.
Compliance Perspective
Issue
Federal disability rights laws require covered healthcare entities to ensure effective communication with individuals who have communication disabilities. This includes providing appropriate auxiliary aids and services, such as qualified interpreters, when necessary to ensure communication is as effective as it is with individuals without disabilities. Compliance requires more than simply making aids and services available; it also requires clear processes for identifying communication needs, timely provision of supports, and consistent implementation across all care settings. Failure to establish and follow effective communication practices may result in unequal access to care, civil rights violations, and regulatory enforcement actions.
Discussion Points
- Review and update policies and procedures related to effective communication with patients, residents, and companions who have hearing, vision, or speech disabilities. Policies should clearly outline how communication needs are identified, how auxiliary aids and services are requested and provided, and how compliance with non-discrimination requirements is monitored, including expectations for timely access to qualified interpreters and appropriate use of video remote interpreting systems where applicable. Facilities may also benefit from engaging an external healthcare compliance consultant to assist with policy review, gap analysis, and alignment with regulatory requirements and survey readiness standards.
- Provide regular education and training for staff on effective communication requirements and techniques for interacting with individuals with communication disabilities. Training should address the appropriate use of auxiliary aids and services, staff responsibilities in identifying communication needs, and procedures for accessing interpreter services and other supports in a timely manner to ensure consistent and effective communication across care settings. Med-Net Academy offers the course Caring for Residents with Sensory Impairments, which reviews common hearing and visual conditions, CMS and ADA requirements, communication technologies, and practical strategies for supporting residents with sensory impairments and related communication challenges.
- Implement ongoing monitoring processes to assess compliance with effective communication requirements, including audits of documentation, staff response to communication needs, and the timeliness and effectiveness of auxiliary aid and service provision. Monitoring should also evaluate video remote interpreting systems and staff competency in their use. Periodic internal audits or focused compliance reviews conducted with the support of an external consultant can help identify system gaps, validate corrective actions, and strengthen preparedness for regulatory surveys and complaint investigations. Contact Med-Net Healthcare Consulting or info@mednetconcepts.com for more information.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*