SETTLEMENT AGREEMENT
BETWEEN THE UNITED STATES OF AMERICA,
BHUPINDER S. MANGAT, M.D., AND SEMINOLE NEUROLOGY ASSOCIATES, P.A.
USAO # 2017v00648/DJ # 202-17M-515

PARTIES

1. The parties to this Settlement Agreement are the United States of America, Bhupinder S. Mangat, M.D. (hereinafter, “Dr. Mangat”), and Seminole Neurology Associates, P.A., a Florida professional corporation (hereinafter, “Seminole Neurology Associates”).
2. The United States Department of Justice (“United States”) is the federal agency responsible for administering and 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 filed with the United States against Dr. Mangat and Seminole Neurology Associates, 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, Complainant, B.K., alleges that Dr. Mangat (and employees and agents of Dr. Mangat) failed to provide Complainant with an interpreter for her medical appointment.  According to the complaint, Complainant, who is deaf, contacted Dr. Mangat’s office via telephone to schedule a medical appointment and, with the assistance of a relay interpreter, spoke with the receptionist. The receptionist asked whether Complainant needed an interpreter for the appointment and, after she responded yes, told Complainant that she would be responsible for bringing her own interpreter.  Complainant then explained to the receptionist that the office is responsible for providing an interpreter under the ADA.  The receptionist ultimately responded, “No,” and then hung-up the phone on Complainant.
4. Complainant is deaf and relies upon American Sign Language to communicate. Complainant is an individual with a disability within the meaning of the ADA.  42 U.S.C.   12102; 28 C.F.R.   36.104.
5. Dr. Mangat is a medical doctor who owns and operates Seminole Neurology Associates, located at 1403 Medical Plaza Drive, Suite 204, Sanford, Florida 32771. Seminole Neurology Associates is a professional medical office and 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. Mangat is obligated to comply with the requirements of Title III of the ADA.  42 U.S.C.   12182(a).
6. The United States is authorized to investigate alleged violations of Title III of the ADA, to use alternative means of dispute resolution, where appropriate, including settlement negotiations to resolve disputes, and to bring a civil action in federal court in any case that raises issues of general public importance.  42 U.S.C.    12188(b), 12212; 28 C.F.R.    36.502, 503, 506.  Ensuring that medical care providers do not discriminate on the basis of disability is an issue of general public importance.
7. 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)(2)(A)(iii); 28 C.F.R.    36.201(a), 36.303.

FINDINGS

8. As a result of its investigation, the United States has determined that Seminole Neurology Associates denied Complainant a full and equal opportunity to participate in and benefit from Seminole Neurology Associates’ goods, services, facilities, privileges, advantages, or accommodations within the meaning of 42 U.S.C.    12182(a), 12182(b)(2)(A)(iii); and 28 C.F.R.   36.303.
9. Seminole Neurology Associates has cooperated fully in the United States’ investigation and agrees that it is committed to full compliance with the ADA.
10. The United States and Seminole Neurology Associates have determined that the complaint filed with the United States can be resolved without litigation and have proposed and agreed to the terms of this Agreement.

DEFINITIONS

11. 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.
12. 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.
13. 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 Seminole Neurology Associates.
14. 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 the public accommodation should communicate. 

REMEDIAL ACTION

15. Consistent with the ADA, Seminole Neurology Associates will not discriminate against any individual, including both Patients and Companions, on the basis of disability in the full and equal enjoyment of Seminole Neurology Associates’ goods, services, facilities, privileges, advantages, or accommodations by excluding or providing unequal treatment to persons with disabilities.  42 U.S.C.   12182.
16. Immediately as of the effective date of this Agreement, Seminole Neurology Associates 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 (i.e., significant difficulty or expense) or a fundamental alteration would result.
17. The determination of appropriate auxiliary aids or services, and the timing, duration, and frequency with which they will be provided, will be made by Seminole Neurology Associates in consultation with the person with a disability.  Seminole Neurology Associates will perform a communication assessment as part of each initial Patient assessment, consulting with the Patient and/or Companion, and document the results in the Patient’s medical chart.  In making these determinations, Seminole Neurology Associates 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 individual’s communication skills and knowledge;
3. the Patient’s health status or changes thereto; and
4. the Patient’s and/or Companion’s 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 Patient’s medical history or description of ailment; and explaining or discussing a Patient’s diagnosis or prognosis; procedures, tests, and treatment; and medications prescribed.

18. The determination of appropriate auxiliary aids and services discussed in Paragraph 17 shall be made at the time an appointment is scheduled for the Patient or on the arrival of the Patient or Companion at Seminole Neurology Associates, whichever is earlier.  In the event that communication is not effective, Seminole Neurology Associates will reassess, in consultation with the Patient or Companion, as applicable, which auxiliary aids and services are needed to ensure effective communication and will document the results accordingly.
19. If a Patient or a Companion has an ongoing relationship with Seminole Neurology Associates, with respect to each of these subsequent visits, the 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.  Appropriate auxiliary aids or services shall be reassessed based on the treatment the Patient needs from Seminole Neurology Associates at any given time.  Seminole Neurology Associates 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.
20. If a Patient and/or Companion does not request auxiliary aids or services, but Seminole Neurology Associates has reason to believe that such person would benefit from auxiliary aids or services, Seminole Neurology Associates will specifically inform the Patient and/or Companion that auxiliary aids and services are available free of charge.
21. Immediately, as of the effective date of this Agreement, Seminole Neurology Associates 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.
22. Within thirty (30) days of the effective date of this Agreement, Seminole Neurology Associates will submit a draft written auxiliary aids and services policy to the United States for its review and approval.  The policy will explain that auxiliary aids and services, including interpreters, will be provided free of charge where such auxiliary aids and services are needed to ensure effective communication with Patients and Companions.  Once it has been approved by the United States, Seminole Neurology Associates will adopt, maintain, and enforce the policy for the duration of this Agreement.
23. Within thirty (30) days of the United States’ approval of the auxiliary aids and services policy developed pursuant to paragraph 23 of this Agreement, Seminole Neurology Associates shall provide training to all current employees on the policy.  All subsequent trainings dealing with Seminole Neurology Associates’ policies and practices must include reference to the auxiliary aids and services policies as well.
24. All employees who receive incoming telephone calls from the public shall receive instructions by Seminole Neurology Associates on using TTYs or relay services to make, receive, and transfer telephone calls.  Such training shall be provided within sixty (60) days of the effective date of this Agreement and shall be conducted annually thereafter.
25. Within thirty (30) days of the effective date of this Agreement, Seminole Neurology Associates 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.
26. Within thirty (30) days of the effective date of this Agreement, Seminole Neurology Associates will submit to the United States its list of qualified interpreter providers.
27. Within thirty (30) days of the effective date of this Agreement, Seminole Neurology Associates shall post and maintain signs of conspicuous size and print in the Practice waiting area, examination rooms, and wherever a Patient’s 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, 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.”

28. Seminole Neurology Associates will notify the United States in writing when the actions described in paragraphs 23-28 have been completed.  If any issues arise that affect the anticipated completion dates set for such actions, Seminole Neurology Associates will immediately notify the United States of the issue(s).
29. Seminole Neurology Associates shall not discriminate or retaliate against any person because of his or her participation in the matter.

COMPENSATORY RELIEF AND RELEASE FOR COMPLAINANT

30.  Within fifteen (15) days of the effective date of this Agreement, Seminole Neurology Associates will send by Federal Express or certified mail, return receipt requested, a check in the amount of five hundred ($500.00) dollars made out to the Complainant, the amount of which payment has been reduced in light of the circumstances presented and the hardship Seminole Neurology Associates demonstrated during the investigation.  The check shall be mailed to: Office of the United States Attorney, 400 West Washington Street, Suite 3100, Orlando, Florida  32801, Attn: Tiffany Cummins Nick.
31. Within ten (10) days of the effective date of this Agreement, the United States will deliver to Dr. Mangat and Seminole Neurology Associates a release signed by Complainant.  The release will be in the form of Attachment A. 

ENFORCEMENT

32. Three (3) months after the effective date of this Agreement, and annually thereafter during the term of this Agreement, Seminole Neurology Associates will provide the log described in paragraph 22 to the United States.
33. During the term of this Agreement, Seminole Neurology Associates will notify the United States if any individual brings any lawsuit, complaint, charge, or grievance alleging that Seminole Neurology Associates 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 Seminole Neurology Associates 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 Seminole Neurology Associates or any of its agents or representatives relevant to the allegation.
34. In consideration of the terms of this Agreement, the United States agrees to refrain from undertaking further investigation or filing a civil suit in this matter, except as provided in paragraph 36 below.
35. The United States may review compliance with this Agreement at any time.  If the United States believes that Seminole Neurology Associates 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 Seminole Neurology Associates 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 Seminole Neurology Associates, 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.
36. For purposes of the immediately preceding paragraph, it is a violation of this Agreement for Seminole Neurology Associates 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 timeframe imposed by the Agreement.
37. Failure by the United States to enforce this Agreement with regard to any deadline or any other provision herein shall not be construed as a waiver of the United States’ right to enforce other deadlines and provisions of this Agreement.
38. This Agreement shall be binding on the United States and on Seminole Neurology Associates and its agents, employees, shareholders, partners, and associates.  In the event Seminole Neurology Associates seeks to transfer or assign all or part of its 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, Seminole Neurology Associates shall obtain the written accession of the successor or assign to any obligations remaining under this Agreement for the remaining term of this Agreement.
39. This Agreement constitutes the entire agreement between the United States and Seminole Neurology Associates on the matters 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 Seminole Neurology Associates to comply with all aspects of the ADA.
40. This Agreement will remain in effect for three (3) years from its effective date.
41. The person signing this Agreement for Seminole Neurology Associates represents that he is authorized to bind Seminole Neurology Associates to this Agreement.
42. The effective date of this Agreement is the date of the last signature below.