On November 13, the U.S. Attorney’s Office for the Eastern District of Michigan announced a far-reaching settlement agreement with Beaumont Health—the largest health care system in Michigan. This settlement agreement resolves allegations that Beaumont Health had violated the Americans with Disabilities Act for failing to provide effective communication services to deaf or hard-of-hearing individuals.

As a part of the announcement, the Civil Rights Unit of the U.S. Attorney’s Office specifically noted that its investigation revealed that Beaumont Health’s systems were not adequate to ensure that deaf and hard of hearing patients were provided auxiliary aids to guarantee effective communication during their treatment. A link to the U.S. Attorney’s Office press release may be found here.

The settlement agreement entered into by Beaumont Health is extensive. It covers three Beaumont hospitals and approximately 30 off-campus outpatient locations and medical centers for a term of 15 months. As a part of the settlement agreement, Beaumont Health has agreed to:

• Review and revise its policies on providing effective communication to patients and companions;
• Develop and implement a program to provide appropriate auxiliary aids and services;
• Designate and train personnel to be available to answer questions and provide appropriate assistance regarding immediate access to, and the proper use of, auxiliary aids and services;
• Submit all revisions of policies and procedures concerning effective communication to DOJ for review;
• Use a designated assessment tool in consultation with a patient or companion, to evaluate the type of appropriate auxiliary aid and service that will be provided, including its timing, duration, and frequency;
• Make its determinations concerning auxiliary aids within certain time periods while maintaining a comprehensive log of all such determinations;
• Ensure that its use of Video-Remote Interpreting (VRI) services are effective by providing a dedicated high-speed connection that delivers high-quality video and audio;
• Notify individuals in advance if Beaumont Health wishes to use VRI instead of an on-site interpreter;
• Collect data on its interpreter response times;
• Conduct comprehensive training for designated “ADA Personnel” and its larger workforce; and
• Provide written reports of compliance to DOJ, including the number of complaints received by Beaumont Health concerning effective communication.

In light of this investigation and settlement, health systems should consider reviewing their policies and procedures concerning the provision of auxiliary aids and services to deaf or hard-of-hearing individuals to ensure that sufficient resources are being dedicated to providing equal access to healthcare to this population. Though Beaumont Health was not required to pay compensatory damages as a part of this settlement, such damages and attorney’s fees may be authorized where it is shown that a health system acted with deliberate indifference to the rights of deaf or hard-of-hearing individuals. See, e.g., Michelle Puerner v. Hudson Spine and Pain Medicine P.C., 2018 WL 4103491 (S.D.N.Y. Aug. 28, 2018).

It also bears emphasis that a plaintiff alleging ineffective communication under the ADA need not show “actual deficient treatment,” rather, it may be sufficient for a patient to show that the failure to offer an appropriate auxiliary aid “impaired the patient’s ability to exchange medically relevant information” with staff. See, e.g., Silva v. Baptist Health S. Fla., Inc., 856 F.3d 824, 829 (11th Cir. 2017).