UNITED STATES DISTRICT COURT
DISTRICT OF MINNESOTA

UNITED STATES OF AMERICA,                                         Plaintiff                     and STATE OF MINNESOTA                               Plaintiff-Intervener           v. FAIRVIEW HEALTH SERVICES                                         Defendant.

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CIV. NO. 04-CV-4955 DSD/SRN

STIPULATED CONSENT DECREE AND ORDER

INTRODUCTION

Plaintiff United States of America (“United States”) commenced this action against Defendant Fairview Health Services pursuant to Title III of the Americans with Disabilities Act of 1990 (“ADA”), 42 U.S.C. §§ 12181-12189, and the U.S. Department of Justice’s implementing regulation, 28 C.F.R. Part 36, alleging, inter alia, that Fairview Health Services violated Title III of the ADA by discriminating on the basis of disability against persons who are deaf and/or hard of hearing and those related to or associated with them. The State of Minnesota intervened in this action and alleges, inter alia, that Fairview Health Services violated the Minnesota Human Rights Act, Minn. Stat. § 363A.11 (Supp. 2003), on the basis of disability against persons who are deaf and/or heard of hearing and those related to or associated with them.

SUMMARY OF CLAIMS

The Plaintiffs in each of the above-referenced actions allege that Fairview Health Services violated the ADA by failing to provide qualified sign language interpreters and/or other auxiliary aids and services necessary for effective communication to deaf patients and by imposing communication responsibilities on hearing family members who were expected to act as a conduit for information between deaf patients and health care professionals.

Claims Regarding Michael and Linda White

It is alleged that Fairview Health Services discriminated against Michael and Linda White on the basis of their disability by failing to provide qualified sign language interpreters and auxiliary aids and services during a portion of the Whites’ hospitalizations at Fairview University Medical Center in Minneapolis in June, July, and October 2002.

Claims Regarding Julie Oberley

It is alleged that Fairview Health Services did not provide qualified sign language interpreters for Robert Oberley, a deaf person, during a portion of his hospitalization at Fairview University Medical Center in Minneapolis in March and April 2002. The Complaint also alleges that Fairview Health Services’ failure to provide qualified sign interpreters resulted in Robert Oberley’s wife, Julie Oberley, having to interpret for Fairview Health Services staff and physicians during parts of Robert Oberley’s hospitalization.

Claims Regarding Michael and Ariana DeMarco

It is alleged that Fairview Health Services discriminated against Michael and Ariana DeMarco on the basis of their disability by failing to provide qualified sign language interpreters and auxiliary aids and services during a portion of Ariana DeMarco’s hospitalization at Fairview University Medical Center in Minneapolis in May 2003.

Claims Involving the Minnesota Human Rights Act

The State of Minnesota intervened in the action to allege violations by Fairview Health Services of the Minnesota Human Rights Act. The State of Minnesota alleges that Fairview Health Services’s failure to provide qualified sign language interpreters and/or other auxiliary aids and services necessary for effective communication to deaf and hard-of-hearing patients constituted discrimination on the basis of disability in violation of the Minnesota Human Rights Act, Minn. Stat. § 363A.11 (Supp. 2003).

AGREEMENT REGARDING SETTLEMENT OF CLAIMS

Plaintiffs and Defendant agree that the controversy should be resolved without further proceedings and without an evidentiary hearing and, therefore, consent to the entry of this Consent Decree. Plaintiffs recognize that Defendant has voluntarily taken several substantial steps to address the accommodation of deaf and hard-of-hearing patients. This Consent Decree shall not be construed as an admission by Fairview Health Services of any legal liability to the “Parties” or “Aggrieved Parties” (as defined in this Consent Decree).

AGREEMENT REGARDING JURISDICTION

Plaintiffs and Defendant agree that this Court has jurisdiction over the parties and the subject matter of this action.

IT IS THEREFORE ORDERED, ADJUDGED, AND DECREED:

I. JURISDICTION

This Court has jurisdiction over this action pursuant to 42 U.S.C. § 12188(b)(1)(B); 28 U.S.C. §§ 1331 and 1345; 28 U.S.C. § 1367.

II. VENUE

Venue is proper in this District pursuant to 28 U.S.C. § 1391, in that all claims alleged in the Complaint arose within this District. Declaratory relief is appropriate pursuant to 28 U.S.C. §§ 2201 and 2202.

III. PARTIES

1. Plaintiff in Case No. 04-CV-0000 is the United States of America.

2.Plaintiff-Intervener in Case No. 04-CV-0000 is the State of Minnesota.

3.Defendant in Cases 04-CV-0000 and 04-CV-0000, 04-CV-0000 is Fairview Health Services, a private, non-profit corporation that owns and operates several acute-care hospitals licensed by the State of Minnesota. Fairview Health Services operates facilities that are “public accommodations” within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation at 28 C.F.R. § 36.104, and owns and operates “places of public accommodation” within the meaning of the Minnesota Human Rights Act, Minn. Stat. §363A.03 Subd. 34.

IV. DEFINITIONS

1.“Auxiliary aids and services” means qualified sign language or oral interpreters, note takers, computer-assisted real time transcription services, written materials, telephone handset amplifiers, assistive listening devices, assistive listening systems, telephones compatible with hearing aids, closed caption decoders, open and closed captioning, TTYs, large-print materials, acquisition or modification of equipment or devices, universal sound signalers, sonic blink strobe receivers, telephone signalers, and other methods of delivering effective communication that may have come into use or will come into existence in the future.

“Hospital,” “Hospitals,” or “Fairview” means the following hospitals owned and operated by Fairview Health Services: Fairview University Medical Center in Minneapolis, Minnesota; Fairview Southdale Hospital in Edina, Minnesota; Fairview Ridges Hospital in Burnsville, Minnesota; Fairview Northland Regional Hospital in Princeton, Minnesota; and Fairview Lakes Regional Medical Center in Wyoming, Minnesota.¹

2.“Hospital Personnel” means all employees and independent contractors of Fairview including, without limitation, nurses, physicians, social workers, counselors, technicians, admitting personnel, billing staff, security staff, and therapists. Hospital Personnel also means all volunteers who have or are likely to have direct contact with deaf or hard-of-hearing “Patients” or “Companions,” as defined in this Consent Decree.

3.“Qualified sign language interpreter,” “oral interpreter,” or “interpreter” means a person who is able to interpret competently, accurately, and impartially, both receptively and expressively, using any specialized terminology necessary for effective communication in a medical setting to a deaf or hard-of-hearing “Patient” or a “Companion,” as defined in this Consent Decree. In addition, to be a “qualified sign language interpreter,” “oral interpreter,” or “interpreter”, a person must have the following minimum certification qualifications (or their equivalents), which are current and up to date:

(a) valid Certificate of Interpretation (CI) and Certificate of Transliteration (CT) from the Registry of Interpreters for the Deaf (RID); or

(b) Comprehensive Skills Certificate (CSC) from RID; or

(c) valid Level 4 or 5 Certificate from the National Association for the Deaf (NAD).

For purposes of this Consent Decree, the Parties agree that future certifications that are the equivalent of these NAD or RID certifications will be considered valid minimum certification, so long as those certifications are kept current.

“TTYs” or “TDDs” means devices that are used with a telephone to communicate with persons who are deaf or hard of hearing by typing and reading communications. See 28 C.F.R. § 36.104; 28 C.F.R. § 35.164.²

4. “Patient” shall be broadly construed to include any individual who is seeking or receiving health care services, including mental health services, from Fairview, whether as an in-patient or an out-patient.

5. “Companion” means a person who is deaf or hard of hearing and is one of the following: (a) a person whom the Patient indicates should communicate with Hospital Personnel about the Patient, participate in any treatment decision, play a role in communicating the Patient’s needs, condition, history, or symptoms to Hospital Personnel, or help the Patient act on the information, advice, or instructions provided by Hospital Personnel; or (b) a person legally authorized to make health care decisions on behalf of the Patient; or (c) such other person with whom the Hospital Personnel would ordinarily and regularly communicate with concerning the Patient’s medical condition.

6. “Effective Date of this Consent Decree” means the date this Consent Decree is filed by the Court with the Clerk of Court.

7.“Parties” means Plaintiff United States of America, Plaintiff-Intervener State of Minnesota, Defendant Fairview Health Services, and the “Aggrieved Parties,” as defined in this Consent Decree.

8.“Aggrieved Parties” means Michael White, Linda White, Julie Oberley, Michael DeMarco, and Ariana DeMarco. Michael White, Linda White, Michael DeMarco, and Ariana DeMarco are deaf and thus persons with a disability within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation at 28 C.F.R. § 36.104, and the Minnesota Human Rights Act, 363A.03, subd. 12 (Supp. 2003). Julie Oberley is not deaf, but is a person known to have a relationship with a person with a disability within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation at 28 C.F.R. § 36.104, and the Minnesota Human Rights Act, Minn. Stat § 363A.03, subd. 12 (Supp. 2003).

V. INJUNCTIVE RELIEF

A. GENERAL OBLIGATIONS

Disability Nondiscrimination

Fairview will provide deaf and hard-of-hearing Patients and Companions with the full and equal enjoyment of the services, privileges, facilities, advantages, and accommodations of Fairview as required by this Consent Decree, the Americans with Disabilities Act, and the Minnesota Human Rights Act.

Nondiscrimination by Association

Fairview will not deny equal services, accommodations, or other opportunities to any individual because of the known relationship of the person with someone who is deaf or hard of hearing.

B. PROVISION OF AUXILIARY AIDS AND SERVICES

Auxiliary Aids and Services

Fairview will provide to deaf or hard-of-hearing Patients and Companions any auxiliary aids and services that may be necessary for effective communication.

General Assessment Criteria

Fairview will determine which auxiliary aids and services are necessary, and the timing, duration, and frequency with which they will be provided in accordance with its policy(ies) regarding auxiliary aids and services, which shall be consistent with this Consent Decree. The assessment made by Hospital Personnel will take into account all relevant facts and circumstances, including without limitation the following:

(a) the nature, length, and importance of the communication at issue;

(b) the individual’s communication skills and knowledge;

(c) the Patient’s health status or changes thereto;

(d) the Patient’s and/or Companion’s request for or statement of need for an interpreter; and

(e) the reasonably foreseeable health care activities of the Patient (e.g., group therapy sessions, medical tests or procedures, rehabilitation services, meetings with health care professionals or social workers, or discussions concerning billing, insurance, self-care, prognoses, diagnoses, history, and discharge).

In the event that communication is not effective, Hospital Personnel will reassess which auxiliary aids and services are necessary, in consultation with the person with a disability, where possible.

3. Time for Assessment

Scheduled Appointments

Hospital Personnel will determine which auxiliary aids and services are necessary, and the timing, duration, and frequency with which they will be provided, at the time an appointment is scheduled for the deaf or hard-of-hearing Patient. Hospital Personnel will perform and document, in the deaf or hard-of-hearing Patient’s medical chart, a communication assessment as part of each initial in-patient assessment.

Non-scheduled Incidents

The determination of which auxiliary aids and services are necessary, and the timing, duration, and frequency with which they will be provided shall be made by Hospital Personnel upon the arrival of the deaf or hard-of-hearing Patient or Companion at the Hospital. Hospital Personnel will perform and document, in the deaf or hard-of-hearing Patient’s medical chart, a communication assessment as part of each initial in-patient assessment.

Continuation of Provision of Auxiliary Aids and Services

After conducting the assessment described in V.B.2 above, Fairview will continue to provide auxiliary aids or services to the deaf or hard-of-hearing Patient or his or her Companion, in accordance with Paragraphs V.C.1 and V.C.2 of this Consent Decree, during the entire period of hospitalization and subsequent visits without requiring subsequent requests for the auxiliary aids or services by the Patient or Companion. Hospital Personnel will keep records that reflect the ongoing provision of auxiliary aids and services to deaf or hard-of-hearing Patients and Companions, such as notations in the Patients’ medical charts.

Medical Concerns

Nothing in this Consent Decree will require that an electronic device or equipment constituting an auxiliary aid be used when or where its use may interfere with medical or monitoring equipment or may otherwise constitute a threat to any Patient’s medical condition.

Determination Not to Provide Auxiliary Aid or Service

If, after conducting the assessment as described in Section V.B.2. of this Consent Decree, Fairview determines that the circumstances do not warrant provision of an auxiliary aid or service, Hospital Personnel will so advise the person requesting the auxiliary aid or service and will document the date and time of the denial, the name and title of the Hospital Personnel who made the determination, and the basis for the determination. A copy of this documentation will be provided to the deaf or hard-of-hearing Patient (and Companion, if applicable); will be maintained with the Auxiliary Aid & Service Log described in Section V.B.7 of this Consent Decree; and will be placed in the Patient’s medical chart.

Auxiliary Aid and Service Log

Fairview will keep a log (which may be one log or the aggregate of multiple logs) of auxiliary aids and services it provides. The log shall be incorporated into the Compliance Reports as described in Section VI.A.1 of this Consent Decree and shall include the following information: the time and date each auxiliary aid or service is provided; the time and date a request is made for an auxiliary aid or service by a Patient or Companion (if a request is made by a Patient or Companion); the time and date hospital staff requests an auxiliary aid or service; a code which identifies the deaf or hard-of-hearing Patient (and Companion, if applicable); the time and date of the scheduled appointment (if a scheduled appointment was made); and the nature of the auxiliary aid or service provided, or a statement that the auxiliary aid and service was not provided and the reason why it was not provided. As part of the Auxiliary Aid and Service Log, Fairview will also collect information regarding the response times, as described in Section V.C.5 of this Consent Decree, for each request for an interpreter, as well as the qualifications (certification levels) of each interpreter who responds to a request to interpret. Such logs will be retained by Fairview for at least three (3) years.

Deaf and Hard-of-Hearing Coordinators

Fairview will designate a Fairview System Deaf and Hard-of-Hearing Coordinator who will provide overall coordination for the Hospitals for the implementation of this Consent Decree and the accommodation of deaf and hard-of-hearing patients. In addition, Fairview will designate a Deaf and Hard-of-Hearing Coordinator at each of the Hospitals who will work with the Fairview System Deaf and Hard-of-Hearing Coordinator to implement this Consent Decree and to accommodate deaf and hard-of-hearing patients at his/her respective Hospital. In addition to the Coordinators, each Hospital will identify a group of employees and/or identify employees from one or more Hospital departments or functions (“Deaf and Hard-of-Hearing Response Team Members”) so that at least one of these employees is always on call and coverage is available twenty-four (24) hours a day, seven (7) days a week, to answer questions and provide appropriate assistance regarding immediate access to and proper use of the auxiliary aids and services and qualified sign language and oral interpreters. The Deaf and Hard-of-Hearing Response Team members will know where the auxiliary aids are stored and how to operate them. The Deaf and Hard-of-Hearing Coordinators will be responsible for their maintenance, repair, replacement, and distribution. Fairview will circulate and post broadly within the Hospital the telephone number(s), function, and office location(s) of the Deaf and Hard-of-Hearing Coordinators and the Deaf and Hard-of-Hearing Response Team Members, including a TTY telephone number, so that the Deaf and Hard-of-Hearing Response Team Members can be contacted twenty-four (24) hours a day by deaf or hard-of-hearing Patients and Companions in order to obtain the assistance of the Deaf and Hard-of-Hearing Response Team Members. The Deaf and Hard-of-Hearing Coordinators will coordinate with the Patient Relations Department at each Hospital regarding the complaint resolution mechanism described in Section V.B.9 of this Consent Decree.

Complaint Resolution

Fairview will use its current Patient Grievance/Complaint Policy and Process for the resolution of concerns or grievances/complaints raised by deaf and hard-of-hearing Patients and Companions regarding effective communication. Fairview will notify deaf and hard-of-hearing persons of Fairview’s complaint resolution mechanism, to whom complaints should be made, and the right to receive a written response to the complaint if requested. Fairview will use the Deaf and Hard-of-Hearing Coordinators, Deaf and Hard-of-Hearing Response Team Members and other appropriate Hospital Personnel to respond to and address any concerns or grievances/complaints raised by deaf and hard-of-hearing Patients and Companions regarding effective communication as soon as reasonably possible, with a goal of resolving all such matters raised while the Patient is in the Hospital so that effective communication is provided while the Patient is in the Hospital. Fairview will promptly provide the deaf or hard-of-hearing Patient and/or Companion a written response to the complaint, but no later than thirty (30) days after the resolution of the grievance/complaint. Fairview will maintain records of all grievances/complaints regarding effective communication with deaf or hard-of-hearing Patients and Companions, whether oral or written, including copies of all complaints or notes reflecting oral complaints, made to Fairview and actions taken with respect thereto for at least three (3) years.

Prohibition of Surcharges

All auxiliary aids and services required by this Consent Decree will be provided free of charge to the deaf or hard-of-hearing Patient and/or Companion.

Notice of Available Auxiliary Aids or Services to Individuals who Do Not Request Such Aids or Services

If a deaf or hard-of-hearing Patient and/or Companion does not request auxiliary aids or services, but Hospital Personnel have reason to believe, after conducting the assessment described in Section V.B.2 of this Consent Decree, that such person would benefit from auxiliary aids or services for effective communication, Fairview will specifically inform the deaf or hard-of-hearing Patient and/or Companion that auxiliary aids and services are available free of charge.

Communication with Patients and Companions

Fairview will take appropriate steps to ensure that all Hospital Personnel having contact with a deaf or hard-of-hearing Patient and/or Companion are made aware of such person’s disability so that effective communication with such person will be achieved.

Data Collection; Monitoring of Performance; Feedback Forms

Fairview will collect data on the effectiveness of the auxiliary aid and service provided and the performance of a sign language interpreter provided. Fairview will also prepare a form requesting feedback concerning the timeliness and effectiveness of interpreter services and other auxiliary aids and services. Such feedback form shall be provided to each deaf or hard-of-hearing Patient or Companion who was provided an interpreter or other auxiliary aid or service. Fairview will develop a convenient process to allow the patients to complete and return the feedback forms; the patient will choose whether or not to avail himself or herself of that opportunity. Outpatients who receive services on an ongoing basis do not need to receive a feedback form after every visit. Fairview shall use the feedback forms that it does receive for monitoring and evaluating the performance of each interpreter and the aids and services it provides to Patients and Companions. Fairview shall maintain the completed feedback forms for three (3) years.

C. PROVISION OF SIGN LANGUAGE AND ORAL INTERPRETERS

Circumstances under which Interpreters will be Provided

As necessary for effective communication, Fairview will provide qualified sign language interpreters to deaf or hard-of-hearing Patients and Companions whose primary means of communication is sign language. As necessary for effective communication, Fairview will also provide qualified oral interpreters to deaf or hard-of-hearing Patients and Companions who rely primarily on lip reading. The determination of when such interpreters will be provided to such Patients and/or Companions will be made as set forth in Section V.B.2 of this Consent Decree. The following are examples of circumstances when it may be necessary to provide interpreters:

(a) determination of a Patient’s medical, psychiatric, psycho social, nutritional, and functional history or description of condition;

(b) provision of Patients’ rights, informed consent, or permission for treatment, and current condition;

(c) determination and explanation of Patients’ diagnosis or prognosis, and current condition;

(d) explanation of procedures, tests, treatment, treatment options, or surgery;

(e) explanation of medications prescribed (such as dosage, instructions for how and when the medication is to be taken and side effects or food or drug interactions);

(f) explanation regarding follow-up treatments, therapies, test results, or recovery;

(g) blood donations or aphaeresis (removal of blood components);

(h) discharge planning and discharge instructions;

(i) provision of mental health evaluations, group and individual therapy, counseling, and other therapeutic activities, including but not limited to grief counseling and crisis intervention;

(j) explanation of complex billing or insurance issues that may arise;

(k) educational presentations, such as classes concerning birthing, nutrition, CPR, and weight management;

(l) religious services and spiritual counseling;

(m) explanation of living wills or powers of attorney (or their availability); and

(n) any other circumstance in which a qualified sign interpreter is necessary to ensure a Patient’s rights provided by law.

The foregoing list of circumstances is not exhaustive and does not imply that there are not other circumstances when it may be appropriate to provide interpreters for effective communication. This list also is not intended to imply that an interpreter must always be provided in these and/or other circumstances.

Provision of Sign Language Interpreters Throughout a Hospitalization

During a hospitalization, it will not be necessary for the Patient to renew the request for a sign language interpreter or other auxiliary aid or service. Fairview will provide notice to all deaf and hard-of-hearing Patients and Companions of its policy to provide sign language interpreters and other auxiliary aids and services throughout a hospitalization without the need for continual separate requests for such aids. Fairview will make sign language interpreters available during a hospitalization in the circumstances set forth in V.C.1 and V.C.2 of this Consent Decree.

Method for Obtaining Interpreters

Fairview will hire one or more qualified sign language interpreters (“staff interpreters”) to be available twenty-four (24) hours per day and/or enter into one or more written contracts with Interpreter Service Providers (“IS Providers”) to provide qualified sign language and oral interpreters (“contract interpreters”) at the request of Fairview. The contracts with the IS Providers must specifically state that only “qualified sign language interpreters,” “oral interpreters,” and “interpreters,” as defined in this Consent Decree, will be utilized by Fairview and that the IS Providers agree to provide only such interpreters to Fairview. Fairview may, but has no obligation to, satisfy its sign language interpreter obligations under this Consent Decree by hiring qualified staff interpreters. Staff interpreters must also meet the definition of “qualified sign language interpreter,” as detailed in this Consent Decree. Deaf or hard-of-hearing Patients and Companions who are provided with staff interpreters must have the same level of coverage, for both duration and frequency, as Fairview is otherwise obligated to provide under this Consent Decree. Fairview may assign other duties to staff interpreters, but the staff interpreters’ performance of those other duties will not excuse Fairview’s requirements under this Consent Decree.

Qualification Records

Fairview will be responsible for ensuring that only “qualified sign language interpreters,” “oral interpreters,” and “interpreters,” as defined in this Consent Decree, are used in the Hospitals. Fairview will make proof of the current qualifications of the qualified sign language interpreters, including those of its employees and those interpreters provided by IS Providers, who provide services or who are scheduled to provide services to a particular deaf or hard-of-hearing Patient available for examination by that deaf or hard-of-hearing Patient and/or Companion within two (2) business days following a request by such Patient or Companion.

5. Provision of Interpreters in a Timely Manner

Non-scheduled Interpreter Requests

Fairview will meet the following time standards for providing qualified sign language interpreters to deaf or hard-of-hearing Patients and/or Companions in non-scheduled incidents:

(1) Fairview will maintain a response time of one (1) hour at least eighty percent (80%) of non-scheduled interpreter requests and of two (2) hours in one hundred percent (100%) of non-scheduled interpreter requests.

(2) The response time will be measured from the time beginning ten (10) minutes after an interpreter is requested by a Patient or Companion who is deaf or hard of hearing and ending when the interpreter begins interpreting for the Patient or Companion.

(3) The foregoing response times are subject to force majeure events. Force majeure events are events outside the reasonable control of Fairview, the IS Provider, or the interpreter called to respond, including but not limited to weather conditions and other “Act of God,” unanticipated illness or injury of the interpreter, and unanticipated transportation problems.

(4) Hospital Personnel will make requests for staff or contract interpreters within ten (10) minutes of the time a request is made for an interpreter by a Patient or Companion.

(5) “Non-scheduled interpreter requests” means a request for an interpreter which is made during the appearance at the Hospital by a deaf or hard-of-hearing Patient or Companion for examination or treatment that was not scheduled prior to the time such Patient or Companion came to the Hospital.

(6) If an interpreter is called for the non-scheduled event and then fails to show up, Fairview will take whatever additional actions are necessary to make a qualified sign language interpreter available for the Patient and/or Companion.

Scheduled Incidents

For scheduled events, Fairview will make a qualified sign language interpreter available at the time of the scheduled appointment. If an interpreter fails to show for the scheduled appointment, Fairview will take whatever additional actions are necessary to make a qualified sign language interpreter available to the Patient and/or Companion.

Modification of Performance Standards

In the event that the response time standards described in Section V.C.5 of this Consent Decree cannot be maintained despite Fairview’s good faith efforts, Fairview is entitled to request the consent of the United States and the State of Minnesota to such modifications of the response time standards as may be reasonable under the circumstances. The United States and the State of Minnesota will consider any such request reasonably and in good faith, and any such modification to which Fairview, the United States, and the State of Minnesota agree will be presented to the Court for approval and deemed an amendment to this Consent Decree.

Compliance with Applicable Laws

The consent of the United States and the State of Minnesota in this Consent Decree does not affect Fairview’s independent responsibilities under any applicable federal, state, or local laws or regulations.

Notice to Deaf or Hard-of-Hearing Patients and Companions

As soon as Hospital Personnel have determined that a qualified sign language interpreter is necessary for effective communication with a deaf or hard-of-hearing Patient or Companion, Fairview will inform such a person (or a family member or friend, if such person is not available) of the current status of efforts being taken to secure a qualified interpreter on his or her behalf. Fairview will provide additional updates to the Patient or Companion as necessary until an interpreter is secured. Notification of efforts to secure a qualified sign language interpreter does not lessen Fairview’s obligation to provide qualified interpreters in a timely manner as required by Section V.C.5 this Consent Decree.

Other Means of Communication

Fairview agrees that between the time an interpreter is requested and the time an interpreter arrives at the Hospital to interpret, Hospital Personnel will continue to try to communicate with the deaf or hard-of-hearing Patient or Companion for such purposes and to the same extent as they would have communicated with the person but for the disability, using all available methods of communication, including using sign language pictographs. This provision in no way lessens Fairview’s obligation to provide qualified sign language interpreters in a timely manner as required by Section V.C.5 of this Consent Decree.

Restricted Use of Certain Persons to Facilitate Communication

Due to confidentiality, potential emotional involvement, and other factors that may adversely affect the ability to facilitate communication, Fairview may never require or coerce a family member, case manager, advocate, or friend of a deaf or hard-of-hearing Patient or Companion to interpret or facilitate communications between Hospital Personnel and such Patient or Companion.

D. NOTICE TO COMMUNITY

Policy Statement

Within thirty (30) days of the effective date of this Consent Decree, Fairview will post and maintain at all hospital admitting stations, emergency departments, and wherever a Patient’s Bill of Rights is required by law to be posted signs of conspicuous size and print, which shall state to the following effect:

Free sign language and oral interpreters, TTY’s and other services are available to deaf and hard-of-hearing persons. Ask us for help or contact [Hospital Contact Information].

These signs will include the international symbols for “interpreters” and “TTYs.”

Patient and Visitor Information Brochures

Fairview will include in all future printings of its Patient and Visitor Information Brochures and all similar publications a statement to the following effect:

If you are deaf or hard of hearing, please let us know. We provide many free services including:

Sign language interpreters



Oral interpreters



TTY’s



Telephone amplifiers



Note takers



Written materials



Other services.

We also provide these free services to your family or to other people who may be deaf or hard of hearing, while they are with you in the hospital.

Ask us for help or contact [Hospital Contact Information].

These brochures will include the international symbols for “interpreters” and “TTYs”. Fairview will also include in the handbook a description of Fairview’s complaint resolution mechanism.

Website

Fairview will include on any website it maintains the statement described in Section V.D.1 of this Consent Decree.

Format of Notices

Within sixty (60) days of the effective date of this Consent Decree, Fairview will make the following written materials it provides to hearing patients available in American Sign Language (ASL) using videotape, DVD, or CD-ROM format:

(a) The Patients Bill of Rights;

(b) Health Care Directives pamphlet;

(c) Information regarding Fairview’s policies and procedures governing free sign language interpreter services, including a summary of the rights provided by this Consent Decree, and Fairview’s feedback form, described in Section V.B.13 of this Consent Decree;

(d) Complaint Resolution Procedures; and

(e) Notice of Privacy Practices.

E. NOTICE TO HOSPITAL PERSONNEL AND PHYSICIANS

Fairview will publish, in an appropriate form, a written statement regarding Fairview’s policy for effective communication with persons who are deaf or hard of hearing. The policy statement should include, but is not limited to, language to the following effect:

If you recognize or have any reason to believe that a patient, relative, or a close friend or companion of a patient is deaf or hard of hearing, you must advise the person that auxiliary aids and services such as sign language and oral interpreters, TTYs, note takers, written materials, telephone handset amplifiers, assistive listening devices and systems, telephones compatible with hearing aids, closed caption decoders, and open and closed captioning of most hospital programs will be provided free of charge. If you are the responsible health care provider, you must take reasonable and necessary steps to ensure that such aids and services are provided when appropriate. All other hospital personnel should direct that person to [add hospital contact information]. This offer and advice must likewise be made in response to any overt request for auxiliary aids or services.

Fairview will distribute, by mail, email or other means, this statement within thirty (30) days of the Effective Date of this Consent Decree to all Hospital Personnel and medical and allied health staff members. Fairview will also distribute this statement, by mail, email or other means, to all new Hospital Personnel and medical and allied health staff members upon their employment or affiliation with Fairview. In addition, this statement will also be distributed, by mail, email or other means, to all Hospital Personnel on an annual basis.

F. TRAINING

Training of Deaf and Hard-of-Hearing Coordinators

Fairview will provide special mandatory training for the Deaf and Hard-of-Hearing Coordinators and the Deaf and Hard-of-Hearing Response Team Members within sixty (60) days of them being designated as provided for in Section V.B.8 of this Consent Decree. Such training will be sufficient in duration and content to train the Deaf and Hard-of-Hearing Coordinators and Deaf and Hard-of-Hearing Response Team Members in: (a) the health care needs of the deaf and hard of hearing; (b) the various degrees of hearing impairment, language, and cultural diversity in the deaf community; (c) identification of communication needs of persons who are deaf; (d) the unique needs and problems encountered by late-deafened individuals; (e) the psychological implications of deafness and its relationship to interaction with hearing health care professionals; (f) recommended and required charting procedures governing requests for auxiliary aids and services; (g) types of auxiliary aids and services available in the community and Hospitals; (h) the proper use and role of qualified sign language interpreters; (i) making and receiving calls through TTYs and the Minnesota Relay Service; (j) the Hospital’s complaint resolution described in Section V.B.9 of this Consent Decree; and (k) any other applicable requirements of this Consent Decree.

Training of Other Key Personnel

Within ninety (90) days of the effective date of this Consent Decree, Fairview will provide training to Hospital employees who fall into the following categories: social workers, patient relations staff, care coordinators, nurse managers, charge nurses, billing office customer service representatives, clinical nurse specialists, telephone operators, patient registration staff and other employees as determined by Fairview. This training may be delivered by one or more in-service training methods. The training will address the special needs of deaf and hard-of-hearing Patients and Companions and will include the following objectives: (a) the requirements of Federal and Minnesota law to ensure effective communication with deaf and hard-of-hearing patients; (b) the terms of this Consent Decree; (c) the importance of the use of qualified interpreters and other auxiliary aids and services in providing care to deaf and hard-of-hearing patients; (d) types of communication modes and types of auxiliary aids and services; (e) the identify and role of the Deaf and Hard-of-Hearing Coordinators and Deaf and Hard-of-Hearing Response Team Members; (f) Fairview’s policy on and tips on assessing the communication needs of deaf and hard-of-hearing patients; (g) the use of the TTY Machines and the Minnesota Relay Service; and (h) Fairview’s procedures implemented to comply with this Consent Decree and other procedures specific to the employee’s employment category. Annually thereafter during the term of this Consent Decree, Fairview will supplement this training so as to remind such employees of the requirements of the Consent Decree, reinforce their previous learning and to address any issues or problems that may be arising. Fairview will provide the training specified above to new Hospital employees who fall into the categories identified in this Section 2 within sixty (60) days after the commencement of their services for Fairview. A screening of a video of the original training will suffice to meet this obligation.

Training of Substantially all Employees in the Identified Categories

Fairview will use its best efforts to provide the Training identified above in Sections 1 and 2 to substantially all of those employees within the identified time frame. The Parties recognize that certain employees may be on leave of absence or in similar categories which may prevent such employees from being trained within the identified time frame.

Training of Emergency Room Personnel

Fairview also will provide annual in-service training to the non-physician employees in the Hospital emergency rooms on: (1) promptly assessing the communication needs of deaf and hard-of-hearing patients; (2) securing the services of qualified interpreters as quickly as possible; and (3) the use of other aids to augment effective communication with deaf and hard-of-hearing patients.

Training Attendance Sheets

Fairview will maintain documentation of all training conducted pursuant to Sections V.F.1 this Consent Decree, which will include the names and respective job titles of the participants, as well as the date and location, if applicable, of the training session.

Training of Medical and Allied Health Staff

Training Sessions

Fairview will annually conduct one or more training sessions on the communication needs of persons who are deaf or hard of hearing and will invite all medical and allied health staff to attend. Fairview will provide training videotapes that contain substantially similar information to any affiliated physician upon request.

Written Materials

Within sixty (60) days of the Effective Date of this Consent Decree, Fairview will distribute, by mail, email or other means, a set of materials to all medical and allied health staff. These materials will contain at least the following: (1) Fairview’s policy statement and any relevant forms; and (2) a request that physicians’ staff members notify Fairview of those deaf and hard-of-hearing Patients and Companions as soon as they schedule admissions, tests, surgeries, or other health care services at a Hospital.

VI. REPORTING, MONITORING AND VIOLATIONS

A. REPORTS

Compliance Reports

On the dates detailed below, Fairview will provide a written report (“Compliance Report”) to the U.S. Attorney for the District of Minnesota, the Minnesota Department of Human Rights, and the Aggrieved Parties regarding the status of its compliance with this Consent Decree. The Compliance Report will include data relevant to the Consent Decree, including but not limited to:

(a) the number of requests for qualified sign language interpreters received by Fairview at the Hospitals by deaf and hard-of-hearing Patients and Companions;

(b) the number of times a qualified sign language interpreter was provided by Fairview;

(c) the number of times Fairview denied a request for a qualified sign language interpreter and the reason for the denial;

(d) the number of times Fairview requested a qualified sign language interpreter but the interpreter failed to show and, for each such situation, the reasons for the failure;

(e) in the case of a “non-scheduled interpreter request” as defined in Section V.C.5.a.(5), the date and the time a qualified sign language interpreter is requested by a deaf or hard-of-hearing Patient or Companion and the date and time the interpreter actually began interpreting for such Patient or Companion;

(f) for “scheduled interpreter requests,” as discussed in Section V.C.5.b, Fairview shall report the time and date of the appointment and the time the interpreter arrived.

(g) an explanation of the reasons for the delay in obtaining a qualified sign language interpreter in those cases where the response time, as defined by Section V.C.5 of this Consent Decree, is more than one (1) hour for any request; and

(h) the number of complaints received by Fairview Health Services at the Hospitals by deaf and hard-of-hearing Patients and Companions regarding auxiliary aids and services and/or effective communication and a notation as to whether or not Fairview considers the matter(s) resolved.

Fairview will submit the Compliance Reports to the U.S. Attorney, the Minnesota Department of Human Rights, and the Aggrieved Parties on or before the following dates: Three (3) months after the Effective Date (due within 30 days of the end of that period) and at 6-month intervals thereafter (due within 30 days of the end of each of those periods).

Fairview will maintain appropriate records to document the information contained in the Compliance Reports and will make them available, upon request, to the U.S. Attorney’s Office for the District of Minnesota and the Minnesota Department of Human Rights. Fairview shall keep the records throughout the 3-year Consent Decree period and shall hold on to those records for an additional year following the expiration of the Consent Decree.

The reporting requirements of this Consent Decree do not require Fairview to disclose or make available protected health information as defined in 42 C.F.R. 164.501.

The Minnesota Human Rights Department and the Department of Justice are bound by various state and federal laws concerning public access to information.

In order to reach agreement on the matters contained in this Agreement, Fairview and the Aggrieved Parties agree to the following concerning the Reports:

1. Fairview will disclose the Reports to the Aggrieved Parties at the same time as it discloses them to the Minnesota Department of Human Rights and the U.S. Department of Justice.

2. For the purpose of monitoring Fairview’s compliance with this Consent Decree and to enforce the Consent Decree in court proceedings, the Aggrieved Parties may disclose the Reports to consultants and witnesses, including potential expert witnesses, who agree to be bound by this Agreement.
3. The Aggrieved Parties will not disclose the Reports to persons other than those persons described in Paragraph 2 above (subject to paragraph 4, following).

4. In the event that a party requests relief from the Court for alleged violations of the Consent Decree, the Aggrieved Parties may submit the Reports at issue to the Court under seal. The Reports shall remain sealed unless and until the Court rules otherwise. The Aggrieved Parties do not waive their right to ask the Court to unseal the Reports.

Complaints

During the Term of this Consent Decree, Fairview will notify the U.S. Attorney for the District of Minnesota and the Minnesota Department of Human Rights if any person commences a lawsuit or administrative charge or files a complaint or grievance alleging that Fairview failed to provide auxiliary aids and services to deaf or hard-of-hearing Patients or Companions or otherwise failed to provide effective communication with such Patients or Companions. Such notification must be provided in writing via certified mail within twenty (20) days of the date Fairview received notice of the allegation and will include, at a minimum, the nature of the allegation, the name of the person making the allegation, and any non-privileged documentation possessed by Fairview relevant to the allegation. Fairview will reference this provision of the Consent Decree in the notifications.

B. DISPUTE RESOLUTION PROCESS

In the event that the United States, the State of Minnesota, or the Aggrieved Parties and/or Fairview Health Services have a dispute about any of the terms of this Consent Decree, the Parties agree to attempt to negotiate a settlement of such dispute in good faith.

In the event that the United States, the State of Minnesota, or the Aggrieved Parties believe that Fairview Health Services has violated any provision of this Consent Decree, the United States, the State of Minnesota, or the Aggrieved Parties shall notify Fairview Health Services and all the other Parties to this Consent Decree and enter into informal discussions to address the alleged violation. The Parties agree to attempt to address alleged violations in good faith.

If the Parties cannot in good faith address the alleged violation during the informal process, the United States, the State of Minnesota, or the Aggrieved Parties may serve on Fairview Health Services a Notice of Violation, which shall detail how Fairview has violated the Consent Decree, the provisions of the Consent Decree allegedly violated, and a suggested course of action for remedying the alleged violation. Fairview shall have forty-five (45) days after the date it receives the Notice of Violation to cure the violation, but any violation that prevents or restricts a deaf or hard-of-hearing Patient from receiving urgent health care services must be cured without delay. If Fairview Health Services cures the violation, as provided above, the matter shall no longer be considered a violation of this Consent Decree or any subpart of this Consent Decree and no court intervention or additional relief shall be necessary. Within twenty (20) days after the date Fairview Health Services receives a Notice of Violation, Fairview shall respond in writing to all of the parties indicating whether it is attempting to cure the alleged violation, whether it disagrees that a violation has occurred, or otherwise responding to the Notice of Violation. If Fairview, in good faith, disagrees that a violation has occurred, the Parties will meet to resolve the disagreement in good faith and the cure period shall be extend by the time period that the Parties are meeting to resolve the disagreement over the alleged violation, but not to exceed thirty (30) days.

If after forty-five (45) days following the date Fairview receives the Notice of Violation, the violation has not been satisfactorily cured by Fairview, the United States, the State of Minnesota, or the Aggrieved Parties may petition the Court to resolve the matter.

This process is in addition to the processes provided in the Minnesota Human Rights Act, Minn. Statute chapter 363A, and nothing herein prevents the State of Minnesota or its Department of Human Rights from using the processes in the Minnesota Human Rights Act for alleged violations of the Act.

VII. COMPENSATORY DAMAGES AND CIVIL PENALTIES

A. COMPENSATORY DAMAGES TO AGGRIEVED PARTIES

In settlement of claims by the Aggrieved Parties for compensatory damages alleged, Fairview Health Services has agreed to pay the Aggrieved Parties as follows:

• Linda White $41,000
  
  
• Michael White $41,000
  
  
• Ariana DeMarco $41,000
  
  
• Michael DeMarco $22,500
  
  
• Julie Oberley $22,500

Form 1099’s shall be issued to the Whites, the DeMarcos, and Julie Oberley in the amounts of the payments set forth above, and they shall be solely responsible for the payment of any and all taxes due in connection with such payments.

A. CIVIL PENALTIES

Civil Penalty to the United States

Fairview Health Services will pay to the United States, as authorized by 42 U.S.C. § 12188(b)(2)(C)(i), $20,000 as a civil penalty. This payment is less than the $55,000.00 civil penalty ordinarily authorized in an ADA enforcement action in consideration of the extent to which Fairview Health Services has worked with the United States to confirm Fairview Health Services’s commitment to the foregoing provisions of this Consent Decree. Payment of $20,000 to the United States shall be made by Fairview Health Services in accordance with directions provided by the United States.

Civil Penalty to the State of Minnesota

Fairview Health Services will pay to the State of Minnesota, as authorized by Minn. Stat. § 363A.29, subd. 4 (Supp. 2003), $20,000 as a civil penalty. Payment of $20,000 to the State of Minnesota shall be made by Fairview Health Services in accordance with directions provided by the State of Minnesota.

B. RELEASES

To receive the monetary relief provided for under this Consent Decree, the Aggrieved Parties will each complete and execute the Release Form attached as Exhibit A to this Consent Decree and mail or deliver the original Releases Forms to counsel for Fairview Health Services, with copies thereof to counsel for the United States and State of Minnesota.

XIII. MISCELLANEOUS PROVISIONS

A. TERM OF CONSENT DECREE

The United States District Court for the District of Minnesota will retain jurisdiction over this action for the purpose of ensuring compliance and enforcing the provisions of this Consent Decree for three (3) years from the Effective Date of this Consent Decree, after which time its provisions will be terminated unless the Court determines, based on findings of noncompliance of Fairview Health Services, that it is necessary to extend any of its requirements, in which case those requirements, after hearing, may be extended subject to the requirements of equity.

B. PUBLIC AGREEMENT

This Consent Decree, along with its exhibits, constitutes a public agreement and a copy of the Decree may be made available to any person.

C. CHANGING CIRCUMSTANCES

During the Term of this Consent Decree, there may be a change in circumstances such as, for example and without limitation, an increased or decreased availability of qualified sign language or oral interpreters or developments in technology to assist or improve communications with persons who are deaf or hard of hearing. If any Party to this Consent Decree determines that such changes create opportunities for communicating with deaf or hard-of-hearing Patients and Companions more efficiently or effectively than is required under this Consent Decree, or create difficulties not presently contemplated in the provision of auxiliary aids and services, the Party may propose changes to this Decree by presenting written notice to the other Parties. Such changes will then only be presented to the Court for incorporation in this Consent Decree if all the Parties to this Consent Decree grant their approval, which will not be unreasonably withheld. The Parties will negotiate in good faith prior to proposing any changes to the Court.

D. BINDING

This Consent Decree is final and binding on the Parties, and the Aggrieved Parties including all principals, agents, executors, administrators, representatives, successors in interest, beneficiaries, assigns, heirs, and legal representatives thereof. Each Party and the Aggrieved Parties has a duty to so inform any such successor in interest.

E. NON-WAIVER

Failure by the United States or the State of Minnesota to seek enforcement of this Consent Decree pursuant to its terms with respect to any instance or provision will not be construed as a waiver to such enforcement with regard to other instances or provisions.

F. SEVERABILITY

In the event that the Court determines that any provision of this Consent Decree is unenforceable, such provision will be severed from this Consent Decree and all other provisions will remain valid and enforceable, provided however that if the severance of any such provision materially alters the rights or obligations of the Parties hereunder, they will, through reasonable, good faith negotiations, agree upon such other amendments to this Consent Decree as may be necessary to restore the Parties as closely as possible to the relative rights and obligations initially intended by them hereunder.

G. RETALIATION

Fairview Health Services will not retaliate against or coerce in any way any person who is trying to exercise his or her rights under this Consent Decree, the Americans with Disabilities Act, or the Minnesota Human Rights Act.

H. NOTICES

Any notice required under this Consent Decree will be provided to the following persons at the following addresses:

For Plaintiff United States:

Chief, Civil Division
U.S. Attorney’s Office
600 U.S. Courthouse
300 South Fourth Street
Minneapolis, MN 55415

For Plaintiff-Intervener State of Minnesota:

Commissioner
Minnesota Department of Human Rights
Sibley Square by Mears Park
190 East Fifth Street, Suite 700
St. Paul, MN 55101

For Defendant Fairview Health Services:

Chief Executive Officer
General Counsel
Fairview Health Services Health Services
2450 Riverside Ave.
Minneapolis, MN 55454

For Plaintiffs Michael White, Linda White, Michael DeMarco, and Ariana DeMarco:

Minnesota Disability Law Center
430 First Ave. North, Suite 300
Minneapolis, MN 55401-1780

Dated: 12-7-04	THOMAS B. HEFFELFINGER United States Attorney
	s/Gregory G.  Brooker                                          By: Gregory G. Brooker Assistant U.S. Attorney Attorney ID Number 166066 600 U.S. Courthouse 300 South Fourth Street Minneapolis, MN 55415 (612) 664-5600 Attorneys for Plantiff United States of America
Dated: 12-7-04	MIKE HATCH Attorney General State of Minnesota
	s/Erica Jacobson                                          By: Erica Jacobson Atty: Reg. No. 49360 Assistant Attorney General NCL Tower, suite 900 445 Minnesota Street St. Paul, MN 55101 (651) 296-3546 Attorney for Plantiff of Minnesota
Dated:	MINNESOTA DISABILITY LAW CENTER
	s/ Roderick J. Macpherson                                          By:Roderick J. Macpherson III Atty. Reg. No. 66163 430 First Avenue North Suite 300 Minneapolis, MN 55401-1780 (612) 746-3737 Attorneys for Aggrieved Parties/Plantiffs Michael & Linda White and Michael & Ariana DeMarco
Dated: December 7, 2004	FAIRVIEW HEALTH SERVICES
	s/ George Chresand                                          By: George Chresand Atty. Reg.No. 0016494 Deputy General Counsel Fairview Health Services First Floor, Corporate Offices 2450 Riverside Avenue Minneapolis, MN 55454-1395 (612) 672-6812

It is so ORDERED, this 8th day of December 2004.

s/ David S. Doty                                         
UNITED STATES DISTRICT JUDGE

Attachments:
Exhibit A: Release Forms

¹This Consent Decree, including the certification requirements set forth in Paragraph 4 (infra), does not apply to Fairview University Medical Center's Minnesota Chemical Dependency Program for Deaf and Hard-of-Hearing Individuals, a program specifically to address the needs of chemically dependent deaf and hard-of-hearing patients. Fairview Health Services does agree, however, that the Americans with Disabilities Act and the Minnesota Human Rights Act apply to this and all other programs and services Fairview Health Services offers through its public accommodations.

(Return to Consent Decree)

²Citations to statutes and regulations for certain provisions of this Consent Decree are given to indicate the legal source of such provisions. They are not intended to and will not be used to limit, expand, modify, or interpret such provisions.

(Return to Consent Decree)

EXHIBIT A

RELEASE

Julie Oberley for the consideration of Twenty-Two Thousand Five Hundred Dollars ($22,500), the receipt and sufficiency of which is hereby acknowledged, does for herself, her heirs, executors, administrators, heirs, and assigns, release and forever discharge Fairview Health Services and its members, directors, trustees, representatives, employers, employees, agents, and all other persons in active concert or participation with Fairview Health Services from all claims, demands, damages, actions, or causes of actions, whether administrative, legal or equitable, on account of or in any way resulting from the allegations set forth in (or could have been set forth in) the United States’ Complaint and the State of Minnesota’s Complaint filed in United States v. Fairview Health Services, Civ. No. ___________ (D. Minn.).

It is further understood and agreed that the terms of this Release are contractual and not a mere recital and that this Release is binding upon and adheres to the benefit of the parties jointly and severally, and the executors, administrators, personal representatives, heirs, successors and assigns of each.

The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned.

Dated:_______________________________	__________________________________ Signature
	Printed Name: Julie Oberley

Subscribed and sworn to before me
this ___ day of _____________, YYYY.


_________________________________
Notary Public

RELEASE

Michael and Linda White for the consideration of Forty-One Thousand Dollars ($41,000) each (or a total of Eighty-Two Thousand Dollars ($82,000)), the receipt and sufficiency of which is hereby acknowledged, do for their selves, their heirs, executors, administrators, heirs, and assigns, release and forever discharge Fairview Health Services and its members, directors, trustees, representatives, employers, employees, agents, and all other persons in active concert or participation with Fairview Health Services from all claims, demands, damages, actions, or causes of actions, whether administrative, legal or equitable, on account of or in any way resulting from the allegations set forth in (or that could have been set forth in) the United States’ Complaint and the State of Minnesota’s Complaint filed in United States v. Fairview Health Services, Civ. No. ___________ (D. Minn.).

It is further understood and agreed that the terms of this Release are contractual and not a mere recital and that this Release is binding upon and adheres to the benefit of the parties jointly and severally, and the executors, administrators, personal representatives, heirs, successors and assigns of each.

The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned.

Dated:_______________________________	__________________________________ Signature
	Printed Name: Michael White

Subscribed and sworn to before me
this ___ day of _____________, YYYY.


______________________________
Notary Public

Dated:_______________________________	__________________________________ Signature
	Printed Name: Linda White

Subscribed and sworn to before me
this ___ day of _____________, YYYY.


______________________________
Notary Public

RELEASE

Michael and Ariana DeMarco for the consideration of Twenty-Two Thousand Five Hundred Dollars ($22,500) and Forty-One Thousand Dollars ($41,000) respectively, the receipt and sufficiency of which is hereby acknowledged, do for their selves, their heirs, executors, administrators, heirs, and assigns, release and forever discharge Fairview Health Services and its members, directors, trustees, representatives, employers, employees, agents, and all other persons in active concert or participation with Fairview Health Services from all claims, demands, damages, actions, or causes of actions, whether administrative, legal or equitable, on account of or in any way resulting from the allegations set forth in (or that could have been set forth in) the United States’ Complaint and the State of Minnesota’s Complaint filed in United States v. Fairview Health Services, Civ. No. ___________ (D. Minn.).

It is further understood and agreed that the terms of this Release are contractual and not a mere recital and that this Release is binding upon and adheres to the benefit of the parties jointly and severally, and the executors, administrators, personal representatives, heirs, successors and assigns of each.

The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned.

Dated:_______________________________	__________________________________ Signature
	Printed Name: Michael DeMarco

Subscribed and sworn to before me
this ___ day of _____________, YYYY.


_____________________________________
Notary Public

Dated:________________________________	__________________________________ Signature
	Printed Name: Ariana DeMarco

Subscribed and sworn to before me
this ___ day of _____________, YYYY.


______________________________________
Notary Public

(Return to Consent Decree)