SETTLEMENT AGREEMENT
BETWEEN THE UNITED STATES OF AMERICA AND
DR. PETER CHANG-SING, M.D. , F.A.C.C.

U.S. ATTORNEYS OFFICE # 2013V00225

PARTIES

1. The parties to this Settlement Agreement are the United States of America and Peter Chang-Sing, M.D. , F.A.C.C. (hereinafter, "Dr. Chang-Sing").
2. The United States Department of Justice ("United States") is the federal agency responsible for enforcing Title III of the Americans with Disabilities Act of 1990, as amended ("ADA"), 42 U.S.C. § 12181 et seq.

   BACKGROUND

3. This matter was initiated by a complaint sent to the United States against Dr. Chang-Sing, alleging violations of Title III of the ADA, 42 U.S.C. §§ 12181-12189, and its implementing regulation, 28 C.F.R. Part 36. Specifically, Gregory Allison (“Complainant”), who is deaf, alleged that in September 2012, Dr. Chang-Sing failed to provide a sign language interpreter when requested. Complainant alleges a sign language interpreter was needed to allow for effective communication and to afford Complainant the opportunity to derive the same benefits from the appointment as other individuals without a hearing impairment.

4. This Agreement is neither an admission of liability by Dr. Chang-Sing nor a concession by the United States that its claims are not well founded. By entering into this Agreement, Dr. Chang-Sing is not admitting that any action taken with respect to Complainant was wrongful, unlawful or in violation of any local, state or federal act or statute.

5. Complainant is deaf and relies upon American Sign Language as his primary means of communication. Complainant is an individual with a disability within the meaning of the ADA. 42 U.S.C. § 12102; 28 C.F.R. § 36.104.
6. The Attorney General of the United States is authorized to investigate alleged violations of Title III of the ADA, and to bring a civil action in federal court if the United States is unable to secure voluntary compliance in any case that involves a pattern or practice of discrimination or that raises issues of general public importance. 42 U.S.C. § 12188(b).
7. Dr. Chang-Sing owns and operates a professional medical office at 500 Doyle Park Drive, Suite 302, Santa Rosa, CA 95405. The office is a place of public accommodation covered by Title III of the ADA. 42 USC § 1218 (7)(F); 28 C.F.R. § 36.104. Accordingly, Dr. Chang-Sing is obligated to comply with the requirements of Title III of the ADA. 42 U.S.C. § 12182(a).
8. The ADA prohibits public accommodations from discriminating against an individual on the basis of disability in the full and equal enjoyment of its goods, services, privileges, advantages, or accommodations, and requires public accommodations to provide auxiliary aids and services when necessary to ensure effective communication. 42 U.S.C. §§ 12182(a), 12182(b)(1)(A)(ii), 12182(b)(2)(A)(iii); 28 C.F.R. §§ 36.201(a), 36.202, 36.303.
9. Dr. Chang-Sing cooperated with the United States’ investigation. After learning of the United States’ investigation, Dr. Chang-Sing implemented a policy regarding the provision of sign language interpreters; that policy will be bolstered and improved pursuant to this Agreement.

   FINDINGS

10. As a result of its investigation, the United States found that, by denying Complainant’s request for a sign language interpreter, failing to consult with Complainant in making this determination, and not informing Complainant in advance that this request had been rejected, Dr. Chang-Sing denied the Complainant a full and equal opportunity to participate in and benefit from the goods, services, facilities, privileges, advantages, or accommodations of Dr. Chang-Sing’s medical practice within the meaning of 42 U.S.C. §§ 12182(a), 12182(b)(1)(A)(ii), 12182(b)(2)(A)(iii) and 28 C.F.R. §§ 36.202;36.303.
11. The United States and Dr. Chang-Sing have determined that the complaint sent to the United States can be resolved without litigation and accordingly have agreed to the terms of this Agreement.

12. In consideration of the terms of this Agreement, the United States agrees to refrain from undertaking further investigation or filing of a civil suit in this matter regarding the areas covered under the Remedial Action or Compensatory Damages sections of this Agreement, except as provided in the Enforcement Section of the Agreement.

    DEFINITIONS

13. The term “Dr. Chang-Sing’s medical practice” means the professional medical office owned and operated by Dr. Peter Chang-Sing, currently located at 500 Doyle Park Drive, Suite 302, Santa Rosa, CA 95495, and includes all employees, staff members, and other individuals affiliated with the professional medical office. Should Dr. Chang-Sing relocate his medical practice to another location—or open an additional location—the obligations entered into in this Agreement shall apply to the new or additional locations.
14. The term "auxiliary aids and services" includes qualified interpreters on-site or through video remote interpreting (VRI) services; note takers; real-time computer-aided transcription services; written materials; exchange of written notes; telephone handset amplifiers; assistive listening devices; assistive listening systems; telephones compatible with hearing aids; closed caption decoders; open and closed captioning, including real-time captioning; voice, text, and video-based telecommunications products and systems, including text telephones (TTYs), videophones, and captioned telephones, or equally effective telecommunications devices; videotext displays; accessible electronic and information technology; or other effective methods of making aurally delivered information available to individuals who are deaf or hard of hearing. 28 C.F.R. §36.303.
15. The terms "qualified interpreter" means an interpreter who, via a video remote interpreting (VRI) service or an on-site appearance, is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any necessary specialized vocabulary. Qualified interpreters include, for example, sign language interpreters, oral transliterators, and cued-language transliterators. 28 C.F.R. § 36.104.
16. The term "Patient" shall be broadly construed to include any individual who is deaf or hard of hearing and who is seeking or receiving health care services from Dr. Chang-Sing’s medical practice.
17. The term "Companion" means a person who is deaf or hard of hearing and is a family member, friend, or associate of an individual seeking access to, or participating in, the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation, who, along with such individual, is an appropriate person with whom Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice should communicate.

    REMEDIAL ACTIONS

18. Consistent with the ADA, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will not discriminate against any individual, including both Patients and Companions, on the basis of disability in the full and equal enjoyment of Dr. Chang-Sing’s medical practice’s goods, services, facilities, privileges, advantages, or accommodations by excluding or providing unequal treatment to persons with disabilities. 42 U.S.C. § 12182.
19. Immediately as of the effective date of this Agreement, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will provide to individuals who are deaf or hard of hearing appropriate auxiliary aids and services, including qualified interpreters, where necessary to ensure effective communication unless an undue burden or a fundamental alteration would result.
20. The determination of appropriate auxiliary aids or services, and the timing, duration, and frequency with which they will be provided, will be made by Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice in consultation with the person with a disability. In making these determinations, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will take into account all relevant facts and circumstances, including without limitation the following:
    1. the nature, length, complexity, and importance of the communication at issue;
    2. the individuals communication skills and knowledge;
    3. the Patients health status or changes thereto; and
    4. the Patients and/or Companions request for, or statement of, need for an interpreter.

    Examples of circumstances when it may be necessary to provide interpreters include, but are not limited to, obtaining a Patients medical history or description of ailment; explaining or discussing a Patients diagnosis or prognosis; explaining or discussing follow-up care, including a Patient’s or Companion’s questions regarding the Patient’s condition and/or previous or future procedures, tests, and/or treatment; and medications prescribed.

21. The determination of appropriate auxiliary aids and services, and the timing, duration, and frequency with which they will be provided, must be made at the time an appointment is scheduled for the Patient or on the arrival of the Patient or Companion at Dr. Chang-Sing’s medical practice, whichever is earlier. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will perform a communication assessment as part of each initial Patient assessment, consulting with the Patient, and documenting the results in the Patients medical chart. In the event that communication is not effective, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will reassess, in consultation with the Patient or Companion, as applicable, which auxiliary aids and services are needed to ensure effective communication, and document the results accordingly. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice shall use the form attached hereto as Attachment A to perform this communication assessment.
22. If a Patient or a Companion has an ongoing relationship with Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice, with respect to each of these subsequent visits, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will continue to provide the appropriate auxiliary aids or services to the Patient or Companion without requiring a request for the appropriate auxiliary aids or services by the Patient or Companion for each visit. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will keep appropriate records that reflect the ongoing provision of auxiliary aids and services to Patients and Companions, such as notations in a Patient’s medical charts.
23. If a Patient and/or Companion does not request auxiliary aids or services, but Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice has reason to believe that such person would benefit from auxiliary aids or services, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will specifically inform the Patient and/or Companion that auxiliary aids and services are available free of charge.
24. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will maintain a written policy explaining that it will provide auxiliary aids and services, including qualified interpreters, where such auxiliary aids and services are needed to ensure effective communication with Patients and Companions.
25. Within sixty (60) days of the entry of this Agreement, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice shall post and maintain signs of conspicuous size and print in Dr. Chang-Sing’s medical practice’s waiting area, examination rooms, and wherever a Patients Bill of Rights is required by law to be posted. Such signs shall be to the following effect:

    In compliance with the Americans with Disabilities Act (ADA), qualified interpreters and other auxiliary aids and services are available free of charge to people who are deaf or hard-of-hearing.

    These signs will include the international symbols for "interpreters” and list the name and contact information for the person(s) to whom a Patient or Companion should speak in order to request auxiliary aids or services. The signs shall also contain the following statement:  “For more information about the Americans with Disabilities Act (ADA), call the Department of Justice’s toll-free ADA Information Line at 1-800-514-0301 (voice), 1-833-610-1264 (TTY) or visit the ADA Home Page at archive.ada.gov. ”

26. Within thirty (30) days of the effective date of this Agreement, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will establish and maintain a list of qualified interpreters or interpreter agencies that employ or arrange the services of qualified interpreters to ensure that qualified interpreter services are available.
27. Within thirty (30) days of the effective date of this Agreement, Dr. Chang-Sing will submit to the United States its list of qualified interpreter providers.
28. Immediately, as of the effective date of this Agreement, Dr. Chang-Sing’s medical practice will maintain a log of each request for an auxiliary aid or service. The log will record the time and date of the request, the name of the individual who made the request, the name of the individual for whom the auxiliary aid or service is being requested (if different from the requestor), the specific auxiliary aid or service requested, the time and date of the scheduled appointment (if a scheduled appointment was made), the time and date the auxiliary aid or service was provided, the type of auxiliary aid or service provided if different from what was requested, and, if applicable, a statement that the requested auxiliary aid or service was not provided.
29. Within sixty (60) days of the effective date of this Agreement, and annually thereafter, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will provide mandatory ADA  training  for all its employees, staff members, and other individuals who might interact with Patients and/or Companions. Such training will be sufficient in duration and content to train the individual in:
    1. the various degrees of hearing impairment, language, and cultural diversity in the deaf community;
    2. identification of communication needs of persons who are deaf or hard of hearing;
    3. recommended and required charting procedures governing requests for auxiliary aids and services;
    4. types of auxiliary aids and services available;
    5. the proper use and role of qualified interpreters;
    6. the proper use and role of video remote interpreting services;
    7. making and receiving calls through TTYs and the relay service;
    8. any other applicable requirements of this Agreement.
30. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will hire an outside advocacy group to conduct the initial trainings described in paragraph 29 of this Agreement. For the required annual trainings thereafter, Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice may conduct the trainings without the assistance of an independent group, but must sufficiently update and/or create training materials in order to ensure the trainings include any new developments to the ADA and its requirements. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice may also videotape the initial trainings for annual trainings thereafter so long as any new developments to the ADA and its requirements are also presented.
31. All employees who receive incoming telephone calls from the public will receive special instructions by Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice on using TTYs or relay services to make, receive, and transfer telephone calls. Such training must be provided within 60 days of the signing of this Agreement and will be conducted annually thereafter.
32. Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice will provide the training specified above in paragraphs 29-31 to new employees within thirty (30) days after the commencement of their services for the Practice.

    COMPENSATORY RELIEF FOR AND RELEASE FROM COMPLAINANT

33. Within fifteen (15) days of the effective date of this Agreement and/or delivery of an executed release signed by the Complainant, in the form of Attachment B, whichever is later, Dr. Chang-Sing will send by Federal Express or certified mail, return receipt requested, a check in the amount of four thousand dollars ($4,000.00) made out to the Complainant. The check shall be mailed to: Office of the United States Attorney, Northern District of California, 450 Golden Gate Avenue, San Francisco, CA 94102-3495, Attn: Erica Blachman Hitchings, AUSA.

    ENFORCEMENT

34. Three (3) months after the effective date of this Agreement, and annually thereafter during the term of this Agreement, Dr. Chang-Sing will provide a certification to the United States that the required trainings described in paragraphs 29-31 were completed.
35. Three (3) months after the effective date of this Agreement, and annually thereafter during the term of this Agreement, Dr. Chang-Sing will provide the log described in paragraph 28 to the United States.
36. During the term of this Agreement, Dr. Chang-Sing will notify the United States if any individual brings any lawsuit, complaint, charge, or grievance alleging that Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice failed to provide any auxiliary aids or services to any individual with a disability. Such notification must be provided in writing via certified mail within fifteen (15) days of the day when Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice has received oral or written notice of the allegation and will include, at a minimum, the nature of the allegation, the name of the individual making the allegation, and any documentation possessed by Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice or any of its agents or representatives relevant to the allegation.
37. The United States may review compliance with this Agreement at any time. If the United States believes that Dr. Chang-Sing and/or Dr. Chang-Sing’s medical practice has failed to comply in a timely manner with  any  requirement of  this Agreement without obtaining sufficient advance written agreement with the United States for a modification of the relevant terms, the United States will so notify Dr. Chang-Sing in writing, and will attempt to resolve the issue or issues in good faith. If the United States is unable to reach a satisfactory resolution of the issue or issues raised within thirty (30) days of the date it provides notice to Dr. Chang-Sing, it may institute a civil action in federal district court to enforce the terms of this Agreement or Title III and may, in such action, seek any relief available under law.
38. For purposes of the immediately preceding paragraph, it is a violation of this Agreement for Dr. Chang-Sing to fail to comply in a timely manner with any of the requirements in this Agreement without obtaining sufficient advance written agreement with the United States for an extension of the relevant time frame imposed by the Agreement.
39. Failure by the United States to initiate enforcement of this Agreement with regard to a deadline or other provision herein shall not be construed as a waiver of the United States’ right to enforce that or other deadlines and provisions of this Agreement.
40. This Agreement shall be binding on the United States and on Dr. Chang-Sing and its agents, employees, shareholders, partners, and associates as long as those agents, employees, shareholders, partners, and associates are serving in that capacity. In the event Dr. Chang-Sing seeks to transfer or assign all or part of his interest in any entity covered by this Agreement, and the successor or assignee intends to carry on the same or similar use of the entity, as a condition of sale, Dr. Chang-Sing shall obtain the written accession of the successor or assign to any obligations remaining under this Agreement for the remaining term of this Agreement.

41. This Agreement, including Attachments A and B, constitutes the entire agreement between the United States and Dr. Chang-Sing on the matter raised herein, and no other statement, promise, or agreement, either written or oral, made by either party or agents of either party, that is not contained in this written Agreement shall be enforceable. This Agreement does not purport to remedy any other potential violations of the ADA or any other federal law. This Agreement does not affect the continuing responsibility of Dr. Chang-Sing to comply with all aspects of the ADA.
42. This Agreement will remain in effect for three (3) years from its effective date.
43. The effective date of this Agreement is the date of the last signature below.