SETTLEMENT AGREEMENT BETWEEN
THE UNITED STATES OF AMERICA
AND
CHARLOTTE RADIOLOGY, P.A.
DJ# 202-55-148

A. BACKGROUND

1. The parties to this Settlement Agreement (“Agreement”) are the United States of America and Charlotte Radiology, P.A. (“Charlotte Radiology”), a North Carolina professional corporation with its principal place of business in Charlotte, Mecklenburg County, North Carolina. 
2. This matter was initiated by a complaint filed with the United States Department of Justice (“DOJ”) against Charlotte Radiology under Title III of the Americans with Disabilities Act (“ADA”), 42 U.S.C. §§ 12181-12189          .  The Attorney General is authorized under section 308(b)(1) of the ADA, 42 U.S.C. § 12188(b)(1), to investigate complaints and bring a civil action under Title III in any situation where a pattern or practice of discrimination is believed to exist or where a matter of general public importance is raised.
3. Charlotte Radiology is a medical practice that provides radiology services to the public and its facilities are places of public accommodation covered by Title III of the ADA, 42 U.S.C. § 12181(7) and its implementing regulation, 28 C.F.R. § 36.104.
4. The ADA prohibits discrimination against individuals on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages and accommodations of places of public accommodation.  42 U.S.C. §12182(a); 28 C.F.R. § 36.201(a).  Ensuring that public accommodations that own, operate, lease or lease to medical centers or other professional offices of health care providers do not discriminate against persons with disabilities, including persons with mobility impairments, is an issue of general public importance.
5. Charlotte Radiology operates a medical practice that provides radiology services, including diagnostic imaging such as DXA or DEXA bone density scans, at numerous facilities located in Charlotte, North Carolina and the surrounding area.
6. The complainant, who has paraplegia and uses a wheelchair, alleges that she was denied full and equal access to the services provided by Charlotte Radiology because of her disability, when she attempted to schedule an appointment to have a DEXA bone density scan of the hip and spine, as ordered by her primary care physician.  Because of her disability, and the height of the equipment used by Charlotte Radiology, the complainant needed either assistance to transfer from her wheelchair to the DEXA machine, or to be scanned in accessible adjustable height equipment.  Complainant alleges that she was told that unless she brought someone to assist in a transfer to the exam table, Charlotte Radiology would not perform the bone density test on the hip and spine because it had a policy that its staff did not transfer patients.  Complainant was subsequently offered a forearm scan, which would not require transfer.  The complainant declined the forearm scan because the complainant alleges it was not medically equivalent to the bone and hip scan and did not meet her medical needs.
7. The ADA requires a public accommodation to make reasonable modifications in its policies, practices, or procedures, when such modifications are necessary to afford its services to an individual with a disability.  42 USC §§12182(b)(1)(A)(i), (b)(2)(A)(ii).  In addition, public accommodations are required to remove architectural barriers to access where it is readily achievable to do so.  42 USC § 12182(b)(2)(A)(iv).
8. The parties agree that it is in their best interest, and the United States believes that it is in the public interest, to resolve this dispute.  The parties have therefore voluntarily entered into this Settlement, agreeing as follows:

B. TERMS OF AGREEMENT

9. Within 30 days of the effective date of this Agreement, Charlotte Radiology will adopt and incorporate the Non-Discrimination Policy (attached as Exhibit 1) into its existing policies and post it in conspicuous locations in all of its offices, including waiting rooms, patient examination rooms and employee work areas.  Charlotte Radiology will also post and maintain a hyperlink to the Non-Discrimination Policy on the home page of its website.
10. When scheduling an appointment, Charlotte Radiology staff will ask the patient if he or she will need any reasonable modifications at the appointment because of a disability.  Charlotte Radiology shall take steps to be prepared to provide the necessary modification at the patient’s appointment.
11. Within 90 days of the effective date of this Agreement, all Charlotte Radiology medical and administrative staff who interact with patients or prospective patients will attend a training session or sessions on the requirements of Title III of the ADA as they apply to healthcare facilities, including training on interacting with individuals with disabilities, and techniques for safely assisting individuals with mobility disabilities to transfer to imaging equipment or examination tables.  The individuals to be trained may include doctors, technicians, aids, and receptionists.  The trainer(s) shall be approved in advance by the United States.   Among other things:
1. The training may be tailored to the duties performed by specific employees or classes of employees;
2. Charlotte Radiology will incorporate this curriculum into its routine new employee orientation for all future employees who will have contact with patients and prospective patients; and
3. Charlotte Radiology will maintain, for the duration of this agreement, training sign-in sheets for each training session conducted and will maintain a list of all employees, including job titles, who receive this training.
12. To ensure that it provides equal access to its services and medical equipment, Charlotte Radiology agrees to provide reasonable modifications to safely assist individuals with mobility disabilities to transfer to imaging equipment or examination tables.  Charlotte Radiology further agrees that within 60 days of the effective date of this Agreement, it will purchase or lease two (2) or more patient lifts designed to safely transfer a patient to existing DEXA machines, examination tables or equipment.  Charlotte Radiology will, in its discretion, place the purchased equipment in two (2) or more of its locations, based on an assessment of its current patient population, volume and needs.
13. Within six (6) months of the effective date of this Agreement, Charlotte Radiology will remove all architectural barriers to access as identified and described in Exhibit 2.  Charlotte Radiology agrees that all remedies to the facilities will fully comply with the ADA’s accessibility standards, including the 2010 Standards.  See 28 C.F.R. § 36.104.  Charlotte Radiology further agrees that, with respect to property not controlled by Charlotte Radiology, specifically, exterior, parking or “common areas,” that it will inform its landlord(s) of the architectural barriers identified and described in Exhibit 3, and that it commits to work with its landlord(s) to address these issues, in accordance with 28 C.F.R. § 36.201(b).
14. Within six (6) months of the effective date of this Agreement, Charlotte Radiology will conduct an assessment and/or inspection of its other facilities to identify and remedy any architectural barriers to access where it is readily achievable to do so.  In addition, any future construction or alterations to its facilities shall comply with the ADA, including the 2010 Standards. See 28 C.F.R. § 36.104.
15. Within 14 days of the effective date of this Agreement, Charlotte Radiology will offer to pay compensatory damages to the complainant in the amount of $2,500.00, subject to her execution and return of a release (attached as Exhibit 4).  Within 14 days of receipt of the executed release, Charlotte Radiology shall send, return receipt requested or by overnight delivery, a check for $2,500.00 to the complainant.
16. Should the complainant choose to seek treatment, testing or any other services of Charlotte Radiology, Charlotte Radiology agrees it will not engage in any retaliatory conduct towards complainant as a result of her filing a complaint with DOJ or participation in the investigation process.
17. In consideration of the terms of this Agreement, the DOJ agrees to close its investigation of this matter, DJ# 202-55-148, except as provided in Section C, below.

C. IMPLEMENTATION AND ENFORCEMENT

18. Within twelve (12) months of the effective date of this Agreement, Charlotte Radiology shall file a report with DOJ documenting its compliance with the actions described in Section B, above.  The report shall include identification of the make, model, and pictures of purchased or leased equipment.  It shall also include photographs of architectural modifications; representative photographs of the posting of the Non-Discrimination Policy; the dates of the training, and the names and job positions of the attendees.  The report shall be sent by regular mail to Katherine T. Armstrong, United States Attorney’s Office for the Western District of North Carolina, 227 W. Trade St., Ste. 1650, Charlotte, NC 28210, with copy by electronic mail to Katherine.Armstrong@usdoj.gov.
19. During the term of this Agreement, Charlotte Radiology will notify the Department if any individual brings any lawsuit, complaint, charge, or grievance alleging that it failed to provide any aid or service to an individual with a disability.  Such notification must be provided in writing via certified mail within thirty (30) days of the day when Charlotte Radiology has received 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 Charlotte Radiology or any of its agents or representatives relevant to the allegation.
20. DOJ may review compliance with this Agreement at any time during the term of this Agreement.  If DOJ believes that this Agreement or any of its requirements has been violated, it may institute a civil action in federal district court to enforce this Agreement or the requirements of Title III, following written notice to Charlotte Radiology of possible violations and a period of 30 days in which Charlotte Radiology has the opportunity to cure the alleged violations.
21. Failure by DOJ to enforce this entire Agreement or any of its provisions or deadlines shall not be construed as a waiver of the DOJ’s right to enforce other deadlines and provisions of this Agreement.
22. This Agreement shall be binding on Charlotte Radiology, its agents and employees.  In the event Charlotte Radiology seeks to transfer or assign all or part of its interest in the practice, and the successor or assign intends on carrying on the same or similar use of the practice, as a condition of sale Charlotte Radiology shall obtain the written accession of the successor or assign to any obligations remaining under this Agreement for the remaining term of this Agreement.
23. This Agreement constitutes the entire agreement between the parties on the matters raised here, 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 Charlotte Radiology’s continuing responsibility to comply with all aspects of the ADA.
24. If any term of this Agreement is determined by any court to be unenforceable, the other terms of this Agreement shall nonetheless remain in full force and effect, provided, however, that if the severance of any such provision materially alters the rights or obligations of the parties, the DOJ and Charlotte Radiology shall engage in good faith negotiations in order to adopt mutually agreeable amendments to this Agreement as may be necessary to restore the parties as closely as possible to the initially agreed upon relative rights and obligations.
25. This Agreement will remain in effect for two (2) years from its effective date.
26. The person signing this Agreement for Charlotte Radiology represents that he/she is authorized to bind Charlotte Radiology, P.A. to this Agreement.
27. The effective date of this Agreement is the date of the last signature below.

    Agreed and consented to: