SETTLEMENT AGREEMENT BETWEEN THE
UNITED STATES OF AMERICA AND
SRIVINAS MUKKAMALA, M.D., P.L.C.
UNDER THE AMERICANS WITH DISABILITIES ACT
DJ # 202-37-238

BACKGROUND

1. The parties to this Settlement Agreement are the United States of America and Srinivas Mukkamala, M.D., P.L.C., which includes Dr. Srinivas Mukkamala and all employees, staff members, and other individuals affiliated with the professional medical office (hereinafter, “Dr. Mukkamala”).
2. This matter is based on a complaint sent to the United States Attorney’s Office alleging that Dr. Mukkamala discriminated against him on the basis of his disability in violation of title III of the Americans with Disabilities Act of 1990, as amended (“ADA”), 42 U.S.C. § 12181 et seq.  Specifically, Complainant, who is deaf, alleges that Dr. Mukkamala failed to provide a sign language interpreter when requested.  Complainant alleges a sign language interpreter was needed to allow for effective communication and to afford him the equal opportunity to participate in the medical care of his minor child.
3. The parties have reached agreement that it is in the parties’ best interests, and the United States believes that it is in the public interest, to resolve this dispute.   The parties have therefore voluntarily entered into this Agreement, and have agreed to the terms as follows below.
4. This Agreement is neither an admission of liability by Dr. Mukkamala nor a concession by the United States that its claims are not well founded.  By entering into this Agreement, Dr. Mukkamala is not admitting that any action taken with respect to Complainant was wrongful, unlawful, or in violation of any local, state or federal act or statute.

JURISDICTION

5. The United States Department of Justice (“United States”), of which the United States Attorney’s Office is a component, is responsible for enforcing title III of the ADA, 42 U.S.C. §§ 12181 -12189, and its implementing regulation, 28 C.F.R. Part 36.
6. Complainant is an individual with a disability within the meaning of the ADA. 42 U.S.C. § 12102; 28 C.F.R. § 36.104. 
7. Dr. Mukkamala owns and operates a professional office of a health care provider located at 1170 Charter Dr, Flint, MI 48532, that  is a place of public accommodation covered by title III of the ADA. 42 U.S.C. § 12182 (7)(F); 28 C.F.R. § 36.104.  Accordingly, Dr. Mukkamala, as a public accommodation, is obligated to comply with the requirements of title III of the ADA.  28 C.F.R.§ 36.104.Under title III of the ADA, no person who owns or operates a place of public accommodation may discriminate against an individual on the basis of disability in the full and equal enjoyment of its goods, services, privileges, advantages, or accommodations, and must provide auxiliary aids and services when necessary to ensure effective communication.  42 U.S.C. §§ 12182(a), 12182(b)(1)(A)(ii), 12182(b)(2)(A)(iii); 28 C.F.R. §§ 36.201(a), 36.202, 36.303.
8. Ensuring that medical care providers do not discriminate on the basis of disability is an issue of general public importance.  The United States is authorized to investigate alleged violations of title III of the ADA and to bring a civil action in federal court in any case that involves a pattern or practice of discrimination or that raises issues of general public importance.
9. Dr. Mukkamala has fully cooperated with the United States’ investigation.
10. In consideration of the terms of this Agreement, the United States agrees to refrain from undertaking further investigation or filing of a civil suit in this matter regarding the areas covered under the Remedial Action or Compensatory Damages sections of this Agreement, except as provided in the Enforcement Section of this Agreement.

REMEDIAL ACTION

11. Consistent with the ADA, Dr. Mukkamala will not discriminate against any individual, including both patients and companions, on the basis of disability in the full and equal enjoyment of Dr. Mukkamala’s goods, services, facilities, privileges, advantages, or accommodations by excluding or providing unequal treatment to persons with disabilities. 42 U.S.C. § 12182.
12. The term “patient” shall be broadly construed to include any individual who is deaf or hard of hearing and who is seeking or receiving health care services from Dr. Mukkamala.  The term “companion” means a person who is deaf or hard of hearing and is a family member, friend, or associate of an individual seeking access to, or participating in, the goods, services, facilities, privileges, advantages, or accommodations of a public accommodation, who, along with such individual, is an appropriate person with whom Dr. Mukkamala should communicate.
13. Immediately as of the effective date of this Agreement, Dr. Mukkamala will provide to individuals who are deaf or hard of hearing, free of charge, appropriate auxiliary aids and services, including qualified interpreters, where necessary to ensure effective communication unless an undue burden or a fundamental alteration would result.
14. The term “auxiliary aids and services” includes qualified interpreters on-site or through video remote interpreting (VRI) services; note takers; real-time computer-aided transcription services; written materials; exchange of written notes; telephone handset amplifiers; assistive listening devices; assistive listening systems; telephones compatible with hearing aids; closed caption decoders; open and closed captioning, including real-time captioning; voice, text, and video-based telecommunications products and systems, including text telephones (TTYs), videophones, and captioned telephones, or equally effective telecommunications devices; videotext displays; accessible electronic and information technology; or other effective methods of making aurally delivered information available to individuals who are deaf or hard of hearing. 28 C.F.R. §36.303.
15. The terms “qualified interpreter” means an interpreter who, via a video remote interpreting (VRI) service or an on-site appearance, is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any necessary specialized vocabulary.  Qualified interpreters include, for example, sign language interpreters, oral transliterators, and cued-language transliterators.  28 C.F.R. § 36.104. The determination of appropriate auxiliary aids or services, and the timing, duration, and frequency with which they will be provided, will be made by Dr. Mukkamala in consultation with the person with a disability.  In making these determinations, Dr. Mukkamala will take into account all relevant facts and circumstances, including without limitation the following:
1. the nature, length, complexity, and importance of the communication at issue;
2. the individuals communication skills and knowledge;
3. the patients’ health status or changes thereto; and
4. the patients’ and/or companions’ request for, or statement of need for, an interpreter.

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

16. The determination of appropriate auxiliary aids and services, and the timing, duration, and frequency with which they will be provided, must be made at the time an appointment is scheduled for the Patient or on the arrival of the Patient or Companion at Dr. Mukkamala’s medical practice, whichever is earlier.  Dr. Mukkamala will perform a communication assessment as part of each initial patient assessment, consulting with the patient, and documenting the results in the patient’s medical chart. In the event that communication is not effective, Dr. Mukkamala will reassess, in consultation with the patient or companion, as applicable, which auxiliary aids and services are needed to ensure effective communication, and document the results accordingly.
17.  If a patient or a companion has an ongoing relationship with Dr. Mukkamala, with respect to each of these subsequent visits, Dr. Mukkamala will continue to provide the appropriate auxiliary aids or services to the Patient or Companion without requiring a request for the appropriate auxiliary aids or services by the patient or companion for each visit.  Dr. Mukkamala 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.
18. If a patient and/or companion does not request auxiliary aids or services, but Dr. Mukkamala has reason to believe that such person would benefit from auxiliary aids or services, Dr. Mukkamala will specifically inform the patient and/or companion that auxiliary aids and services are available free of charge.
19.  Immediately, as of the effective date of this Agreement, Dr. Mukkamala 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.
20. Within thirty (30) days of the effective date of this Agreement, Dr. Mukkamala 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 qualified 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, Dr. Mukkamala will adopt, maintain, and enforce the policy for the duration of this Agreement.
21. Within thirty (30) days of the United States’ approval of the auxiliary aids and services policy developed pursuant to paragraph 20 of this Agreement, Dr. Mukkamala shall provide training to all current employees on the policy.  All subsequent trainings dealing with Dr. Mukkamala’s policies and practices must include reference to the auxiliary aids and services policy as well.
22. Within sixty (60) days of the entry of this Agreement, Dr. Mukkamala shall post in the reception or waiting area, examination rooms, and wherever a Patient’s Bill of Rights is required by law to be posted, signs of conspicuous size and print stating:

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

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

23. Within thirty (30) days of the effective date of this Agreement, Dr. Mukkamala 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.
24. Dr. Mukkamala will notify the United States in writing when it has completed the actions described in paragraphs 20-24.  If any issues arise that affect the anticipated completion dates set for such actions, Dr. Mukkamala will immediately notify the United States of the issue(s).
25. Dr. Mukkamala shall not discriminate or retaliate against any person because of his or her participation in this matter.

COMPENSATORY RELIEF FOR COMPLAINANT

26. Within fifteen (15) days of the effective date of this Agreement and/or delivery of an executed release signed by the Complainant, in the form of Attachment B, whichever is later, Dr. Mukkamala will send by Federal Express or certified mail, return receipt requested, a check in the amount of five hundred dollars ($500.00) made out to the Complainant.

ENFORCEMENT

27. During the term of this Agreement, Dr. Mukkamala will immediately notify the United States if any individual submits a complaint, charge, grievance, or files a lawsuit, alleging that Dr. Mukkamala failed to provide any auxiliary aids or services to any individual with a disability.  Such notification must be provided in writing within fifteen (15) days of receipt and will include, at a minimum, the nature of the allegation, the name of the individual making the allegation, and any documentation possessed by Dr. Mukkamala or any of its agents or representatives relevant to the allegation.
28. The United States may review compliance with this Agreement or title III at any time. If the United States believes that Dr. Mukkamala has failed to comply in a timely manner with any requirement of this Agreement without obtaining sufficient advance written agreement with the United States for a modification of the relevant terms, the United States will so notify Dr. Mukkamala in writing, and will attempt to resolve the issue or issues in good faith. If the United States is unable to reach a satisfactory resolution of the issue or issues raised within thirty (30) days of the date it provides notice to Dr. Mukkamala, 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.
29. Failure by the United States to initiate any provision of this Agreement is not a waiver of its right to enforce other provisions of this Agreement.
30. This Agreement is binding on Dr. Mukkamala and its agents, employees, shareholders, partners, and associates as long as those agents, employees, shareholders, partners, and associates are serving in that capacity. In the event Dr. Mukkamala seeks to transfer or assign all or part of his interest in any entity covered by this Agreement, and the successor or assignee intends to carry on the same or similar use of the entity, as a condition of sale, Dr. Mukkamala shall obtain the written accession of the successor or assign to any obligations remaining under this Agreement for the remaining term of this Agreement.
31. This Agreement constitutes the entire agreement between the United States and Dr. Mukkamala on the matter raised herein, and no other statement, promise, or agreement, either written or oral, made by either party or agents of either party, that is not contained in this written Agreement shall be enforceable. This Agreement does not purport to remedy any other potential violations of the ADA or any other federal law. This Agreement does not affect the continuing responsibility of Dr. Mukkamala to comply with all aspects of the ADA.
32. This Agreement will remain in effect for three (3) years from its effective date.
33. The effective date of this Agreement is the date of the last signature below.