Settlement Agreement between the United States of America and Greater Southeast Community Hospital, Washington, D.C.

SETTLEMENT AGREEMENT BETWEEN

THE UNITED STATES OF AMERICA

AND

GREATER SOUTHEAST COMMUNITY HOSPITAL,
WASHINGTON, D.C.

D.J. No. 202-16-123

I. BACKGROUND AND PARTIES

A. The parties to this Settlement Agreement (“Agreement”) are the United States of America and Greater Southeast Community Hospital (“Hospital”), located in Washington, D.C.

B. This matter was initiated by a complaint filed with the United States Department of Justice (the “Department”) against Greater Southeast Community Hospital, D.J. No. 202-16-123, alleging violations of title III of the Americans with Disabilities Act of 1990 (“ADA”), 42 U.S.C. §§ 12181-12189, and its implementing regulation, 28 C.F.R. Part 36.

C. The Department is authorized to investigate alleged violations of title III of the ADA, and to bring a civil action in federal court if the Department is unable to secure voluntary compliance in any case that involves a pattern or practice of discrimination or that raises issues of general public importance, 42 U.S.C. § 12188(b).

D. Greater Southeast Community Hospital is a place of public accommodation covered by title III of the ADA. 42 U.S.C. § 12181(7)(F).

E. The ADA prohibits public accommodations, including hospitals, from discriminating against an individual on the basis of disability in the full and equal enjoyment of its goods and services. 42 U.S.C. § 12182(a). Ensuring that hospitals do not discriminate against persons who are deaf or hard of hearing is an issue of general public importance.

F. The Department finds that Greater Southeast Community Hospital violated title III of the ADA and its implementing regulation by discriminating against persons who are deaf and those related to or associated with them. Specifically, the findings suggest, inter alia, that Greater Southeast Community Hospital failed to provide appropriate auxiliary aids and services, including qualified sign language interpreter as requested, and where necessary for effective communication, for Garth Alexander, who is deaf, when he was hospitalized on September 23-26, 2003, with significant chest pain. In the complaint, the complainant asserts that despite repeated requests for interpreting services, he met with doctors, specialists, and nurses many times without a qualified interpreter. By failing to secure timely qualified interpreting services, the Hospital improperly imposed communication responsibilities on his wife and supervisor. Both had to act as interpreter between the Hospital and the patient. On September 26, Mr. Alexander underwent a variety of tests, without an interpreter, and the complainant asserts the Hospital did not explain to him what was happening. After his x-ray test, the complainant asserts that the nurses mistakenly locked Mr. Alexander in the bathroom. He was unable to get out of for 45 minutes. As a result of this experience, Mr. Alexander was frustrated, afraid, and confused. During Mr. Alexander's entire stay at the Hospital, hospital nurses and administrators failed to provide Mr. Alexander with access to a TTY despite repeated requests by his wife. Also during Mr. Alexander's entire stay at the Hospital, hospital nurses and administrators failed to provide Mr. Alexander with access to a captioned television despite repeated requests by his wife.

G. Although the Hospital disputes the complainant’s allegations, the parties agree to resolve this matter as set forth below.

II. DEFINITIONS
A. The term “appropriate 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, TTY’s, large print materials, acquisition or modification of equipment or devices, and other methods of delivering effective communication that may have come into use or will come into existence in the future.

B. The term “Hospital Personnel” means: all employees and independent contractors with contracts to work on a full-time basis for Greater Southeast Community Hospital (or on a part-time basis exclusively for Greater Southeast Community Hospital), including, without limitation, nurses, physicians, social workers, technicians, admitting personnel, billing staff, security staff and therapists and all volunteers, who have or are likely to have direct contact with “Patients” or “Companions,” as defined herein.

C. The term “qualified sign language interpreter,” “oral interpreter,” or “interpreter” means: an interpreter who is able to interpret competently, accurately and impartially, both receptively and expressively, using any specialized terminology necessary for effective communication in a Hospital setting to a “Patient” or a “Companion” who is deaf or hard of hearing. Someone who has only a rudimentary familiarity with sign language or finger spelling is not a “qualified sign language interpreter” under this Agreement. Likewise, someone who is fluent in sign language but who does not possess the ability to process spoken communication into the proper signs or to observe someone signing and change their signed or finger spelled communication into spoken words is not a qualified sign language interpreter.

D. The term “TTY’s” means: devices that are used with a telephone to communicate with persons who are deaf or hard of hearing by typing and reading communications.

E. The term “Patient” means: a person who is deaf or hard of hearing and is seeking and/or receiving medical services at Greater Southeast Community Hospital.

F. The term “Companion” means: a person who is deaf or hard of hearing and is either (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; (b) a person legally authorized to make health care decisions on behalf of a patient; or (c) such other person with whom the hospital personnel would ordinarily and regularly communicate with concerning the patient’s medical condition.

III. TERMS OF AGREEMENT
A. Design and Implementation of Program

1. Within sixty (60) days of the effective date of this Agreement, Greater Southeast Community Hospital will design and implement a program (Program) that will effectively implement the provisions of this Agreement, including without limitation:

(a) Developing, coordinating and overseeing the development of specific procedures to fully implement this Agreement;

(b) Scheduling, announcing and promoting all training required by this Agreement;

(c) Drafting, maintaining and providing all reports required by this Agreement; and

(d) Modifying medical and intake forms as necessary to ensure that once a Patient or Companion enters the Hospital, the Hospital makes the communication assessment required in this Agreement. At a minimum, the Hospital must develop and use the Model Communication Assessment Form provided as Exhibit 1 to this Agreement.

2. The Program will include, among other things:

(a) The designation of an individual or office at the Hospital that will maintain full information about access to and the operations of the Program (“Information Office”). The Information Office will maintain a combination voice/TTY telephone line or a dedicated TTY telephone line, will publicize its purpose and telephone number broadly within the Hospital and to the public, will respond to telephone inquiries during normal business hours and will maintain a recording system for inquiries received after normal business hours.

(b) The designation of one or more individuals who will be available twenty-four (24) hours a day, seven (7) days a week, to answer questions and provide assistance and authorization for immediate access to and proper use of the appropriate auxiliary aids and services, and qualified sign language and oral interpreters available under the Program (as described below). Such Coordinators will know where the appropriate auxiliary aids are stored and how to operate them and will be responsible for their maintenance, repair, replacement and distribution. The Hospital will circulate and post broadly within the Hospital the names, telephone numbers, functions and office locations of such Coordinators, including a TTY telephone number that may be called by Patients and Companions in order to obtain the assistance of such Coordinators.

B. Provision of Appropriate Auxiliary Aids and Services

1. Immediate Aids and Services. Immediately as of the effective date of this Agreement, the Hospital will provide to Patients and Companions appropriate auxiliary aids and services that may be necessary for effective communication after making the assessment described below, including, but not limited to, access to interpreters through audio-video interpreting services.

2. General Assessment Criteria. The determination of which appropriate auxiliary aids and services are necessary, and the timing, duration and frequency with which they will be provided, will be made by the Hospital Personnel who are otherwise primarily responsible for coordinating and/or providing patient care services, in consultation with the Patient or Companion where possible. The assessment 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, including the Patient’s or Companion’s request for the provision of interpreting services through audio-video interpreting services or through an on-site interpreter;

(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); and

(d) The availability at the required times, day or night, of appropriate auxiliary aids and services.

3. Time for Assessment. The determination of which appropriate auxiliary aids and services are necessary, and the timing, duration and frequency with which they will be provided, must be made at the time an appointment is scheduled or on the arrival of the Patient or Companion at the Hospital, whichever is earlier. Hospital Personnel will perform and document in the Patient’s medical chart a communication assessment as part of each initial inpatient assessment. The Hospital shall reassess which appropriate auxiliary aids and services are necessary, in consultation with the Patient or Companion where possible, in the event that communication is not effective.

4. Ongoing Relationships. If a Patient or a Companion has an ongoing relationship with the Hospital, with respect to each of these subsequent visits, the Hospital 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. Hospital personnel will keep appropriate records that reflect the ongoing provision of auxiliary aids and services to Patients and Companions, such as notations in Patients’ medical charts.

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

6. Determination Not to Provide Auxiliary Aid or Service. If, after conducting a communication assessment, the Hospital determines that the circumstances do not warrant provision of an auxiliary aid or service, Hospital Personnel shall so advise the person requesting the auxiliary aid or service and shall document the date and time of denial, the name and title of the Hospital Personnel who made the determination, and the basis for the determination. A copy of this document shall be provided to the Patient (and Companion, if applicable), maintained with the log described in Section III.B.7, below, and placed in the patient’s medical chart.

7. Maintenance of Log. The Hospital will maintain a log of each request for an auxiliary aid and service, the time and date the request is made, the Patient’s (and Companion’s, where applicable) name, the time and date of the scheduled appointment (if a scheduled appointment was made), the time and date the auxiliary aid and service was provided, or a statement that the auxiliary aid and service was not provided. Such logs, and the documentation described in Section III.B.6, will be maintained by the Administrator(s).

8. Complaint Resolution. The Hospital Administration will maintain an effective complaint resolution mechanism regarding use of the Program by Patients and Companions and will maintain records of all complaints, whether oral or written, made to the Hospital and actions taken with respect thereto. The Hospital will notify deaf and hard of hearing persons of the Hospital’s complaint resolution mechanism, to whom complaints should be made, and the right to receive a written response to the complaint if requested. Copies of all complaints or notes reflecting oral complaints and the responses thereto will be maintained by Administration. Upon request, the Hospital will provide the Patient and Companion a written response to the complaint within 72 hours of said request.

9. Prohibition of Surcharges. All appropriate auxiliary aids and services required by this Agreement will be provided free of charge to the Patient or Companion who is deaf or hard of hearing.

10. Individual Notice in Absence of Request. If a Patient or a Companion who is deaf or hard of hearing does not request appropriate auxiliary aids or services but Hospital Personnel have reason to believe that such person would benefit from appropriate auxiliary aids or services for effective communication, the Hospital will specifically inform the person that appropriate auxiliary aids and services are available free of charge.

11. Communication with Inpatients and Companions. The Hospital will take appropriate steps to ensure that all Hospital Personnel having contact with a Patient or Companion who is deaf or hard of hearing are made aware of such person’s disability so that effective communication with such person will be achieved. In addition, the Hospital will take appropriate steps to ensure that all Hospital Personnel having contact with a Patient or Companion who is deaf or hard of hearing are aware of the Hospital’s Program and Administrator(s).

C. Sign Language and Oral Interpreters

1. The Hospital will provide qualified sign language interpreters to Patients and Companions who are deaf or hard of hearing and whose primary means of communication is sign language, and qualified oral interpreters to such Patients and Companions who rely primarily on lip reading, as necessary for effective communication.

2. The determination of when such interpreters will be provided to Patients or Companions will be made as set forth in Section III.B.2 (Assessment) above. Examples of circumstances when it may be necessary to provide interpreters include, but are not limited to, the following:

(a) Determination of a Patient’s medical history or description of ailment or injury;

(b) Provision of Patients’ rights, informed consent, or permission for treatment;

(c) Diagnosis or prognosis of ailments or injuries;

(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 apheresis (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 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 language interpreter is necessary to ensure a Patient’s rights provided by law.

The foregoing list does not imply that an interpreter must always be provide in these circumstances. Nor does it suggest that there are not other circumstances when it may be appropriate to provide interpreters for effective communication.

3. Chosen Method for Obtaining Interpreters. As of the effective date of this Agreement, the Hospital will enter one or more contracts with an interpreter service provider or providers (“the IS Provider”) to establish and operate a plan (“IS Plan”) to provide qualified sign language and oral interpreters at the request of the Hospital. The Hospital will provide on-site interpreter services in those situations where the use of audio-video interpreting services is otherwise not feasible or will not result in the provision of effective communication. In lieu of contracting with an IS Provider, the Hospital may hire one or more qualified sign language interpreters to be available 24 hours per day.

4. Interactive Conference System Technology. Audio-video interpreting services can provide immediate, effective access to interpreting services seven (7) days per week, twenty-four (24) hours per day, in a variety of situations including emergencies and unplanned incidents. When choosing the interactive conferencing system, the Hospital agrees to take appropriate steps whenever necessary to make the system effective, such as dedicating high-speed phone lines in appropriate locations for quick connection and clear picture, protecting patient confidentiality, and training staff in how to use it.

5. Provision of Interpreters in a Timely Manner.

(a) Non-scheduled incidents. For “non-scheduled incidents,” the Hospital will make an interpreter available within: (a) thirty (30) minutes when it makes an interpreter available through either audio-video interpreting services or an on-site staff interpreter, and (b) seventy-five (75) minutes when it makes an on-site interpreter available through either a contracting interpreting service or its staff interpreter who is located off-site at the time the non-scheduled incident arises. “Non-scheduled incidents” are situations in which there are less than two (2) hours (or less than four (4) hours if a request is made between the hours of 8 p.m. and 8 a.m. or on a weekend or holiday) between the time when a Patient or a Companion makes a request for an interpreter and the time when the services of an interpreter are required.

(b) Scheduled incidents. For “scheduled incidents,” the Hospital will make an interpreter available at the time of the scheduled appointment. “Scheduled incidents” are situations in which there are two (2) or more hours (or four (4) or more hours if a request is made between the hours of 8 p.m. and 8 a.m. or a weekend or holiday) between the time when a Patient or a Companion makes a request for an interpreter and when the services of the interpreter are required.

6. Force Majeure Events. The foregoing response times are subject to “force majeure” events – i.e., any response time that is delayed because of a force majeure event is excluded from the determination whether the prescribed response criteria have been met. Force majeure events are events outside the reasonable control of the Hospital, the IS Provider or the interpreter called to respond, such as weather problems and other Acts of God, unanticipated illness or injury of the interpreter while en route to the Hospital and unanticipated transportation problems (including, without limitation, mechanical failure of the interpreter’s automobile, automobile accidents and roadway obstructions other than routine traffic or congestion).

7. Modification of Performance Standards. In the event that the response time performance standards set forth in Section III.C.5, above, cannot be maintained despite the Hospital’s good faith efforts, the Hospital is entitled to request modifications of such performance standards as may be reasonable under the circumstances. The Department will consider any such request reasonably and in good faith, and any such modification that is agreed to will be deemed an amendment to this Agreement.

8. Compliance with Applicable Laws. The Department’s consent to modification or amendment of this Agreement does not affect the Hospital’s independent responsibilities under any applicable federal, state or local laws or regulations.

9. Staff Interpreters. The Hospital may, but has no obligation to, satisfy its obligations under this Agreement by hiring qualified staff and/or contract interpreters. Staff interpreters must meet the definition of “qualified interpreters.” Patients and Companions who are provided with staff interpreters must have the same level of coverage (for both duration and frequency) as the Hospital is otherwise obligated to provide under this Agreement. The Hospital may assign other duties to staff interpreters, but the staff interpreters’ performance of those other duties will not excuse the Hospital’s requirements under this Agreement.

10. Notice to Patients and Companions Who Are Deaf or Hard of Hearing. As soon as Hospital Personnel have determined that an interpreter is necessary for effective communication with a Patient or a Companion, the Hospital will inform such person (or a family member or friend, if such person is unavailable) of the current status of efforts being taken to secure a qualified interpreter on his or her behalf. Additional updates are to be provided thereafter as necessary until an interpreter is secured. Notification of efforts to secure a qualified interpreter does not lessen the Hospital’s obligation to provide qualified interpreters in a timely manner as required by this Agreement.

11. Other Means of Communication. Between the time that an interpreter is requested and when an interpreter is made available, Hospital Personnel will continue to try to communicate with the 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. This provision in no way lessens the Hospital’s obligation to provide qualified interpreters in a timely manner as required by this Agreement.

12. 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, the Hospital may never require, coerce, or rely upon a family member, companion, case manager, advocate, or friend of a Patient or Companion to interpret or facilitate communications between Hospital Personnel and such Patient or Companion. In any case, such person may be used to interpret or facilitate communication only if the Patient or Companion who is deaf or hard of hearing does not object, if such person wishes to provide such assistance and if such use is necessary or appropriate under the circumstances, giving appropriate consideration to any privacy issues that may arise. This provision in no way lessens the Hospital’s obligation to provide appropriate auxiliary aids and services as required under this Agreement.

D. Notice to Community

1. Policy Statement. Within sixty (60) days of the effective date of this Agreement, the Hospital will post and maintain signs of conspicuous size and print at all Hospital admitting stations, the emergency department, and wherever a Patient’s Bill of Rights is required by law to be posted. Such signs will provide, in essential part:

Sign language and oral interpreters, TTY’s, and other auxiliary aids and services are available free of charge to people who are deaf or hard of hearing. For assistance, please contact any Hospital Personnel or the Information Office at ____________ (voice/TTY), room ________.

These signs will include the international symbols for “interpreters” and “TTY’s.”

2. Patient Handbook. The Hospital will include in all future printing of its Patient Handbook (or equivalent) and all similar publications a statement to the following effect:

To ensure effective communication with Patients and their Companions who are deaf or hard of hearing, we provide appropriate auxiliary aids and services free of charge, such as: sign language and oral interpreters, TTY’s, 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.

Please ask your nurse or other Hospital Personnel for assistance, or contact the Information Office at ____________ (voice or TTY), room ____.

The Hospital will also include in the handbook a description of the Hospital’s complaint resolution mechanism.

3. Website. If the Hospital currently has a website, the Hospital will include in its website a statement to the effect of the statement set forth in Section III.D.2, above.

E. Notice to Hospital Personnel and Physicians.

The Hospital will publish, in an appropriate form, a written policy statement regarding the Hospital’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 appropriate auxiliary aids and services such as sign language and oral interpreters, TTY’s, 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 ensure that such aids and services are provided when appropriate. All other personnel should direct that person to the [responsible] Administrator, located at _____, and available at telephone extension ______. This offer and advice must likewise be made in response to any overt request for appropriate auxiliary aids or services.

The Hospital will distribute this document within sixty (60) days of the effective date of this Agreement to all Hospital Personnel and affiliated physicians (physicians with practicing or admitting privileges), to all new Hospital Personnel and newly affiliated physicians upon their affiliation or employment with the Hospital, and to all Hospital Personnel on an annual basis.

F. Training of Hospital Personnel

1. Emergency Department Personnel. Within ninety (90) days of the effective date of this Agreement, and annually thereafter, the Hospital will provide special mandatory in-service training to Hospital Personnel with patient responsibility who work or volunteer in the Emergency Department to address the special needs of deaf and hard of hearing Patients and Companions utilizing that department, and to ensure compliance with this Agreement, including, without limitation, Section III.B.3, and where applicable, Section III.C.10. This training will include the following objectives: to promptly identify communication needs and preferences of Patients and Companions who are deaf or hard of hearing; to secure qualified interpreter services as quickly as possible when necessary including training regarding how to operate any audio-video interpreting service equipment. Such training must be provided prior to the date on which the Hospital is scheduled to implement the IS Plan and annually thereafter.

2. Psychiatric Personnel and Social Workers. Within ninety (90) days of the effective date of this Agreement, and annually thereafter, the Hospital will provide specialized mandatory in-service training to Hospital Personnel with patient responsibility who work in the Department of Psychiatry (or its equivalent). This training will include the following objectives: to promptly identify communication needs and preferences of Patients and Companions who are deaf or hard of hearing; to secure qualified interpreter services as quickly as possible when necessary, including training regarding how to operate any audio-video interpreting service equipment; and to facilitate appropriate interaction between Patients who are deaf or hard of hearing and other Patients, when appropriate (e.g., group therapy sessions and other times when interactions with persons other than Hospital Personnel is encouraged).

3. Other Key Personnel. Within ninety (90) days of the effective date of this Agreement, and annually thereafter, the Hospital will provide specialized mandatory in-service training to key personnel not otherwise trained as provided above, including: all clinical directors and nursing supervisors; all senior-level administrators; personnel who staff the Admission desk (or its equivalent for in-patient registration), the Central Registry desk (or its equivalent for out-patient registration), the General Information desk; all triage nurses and other triage professionals; and heads of each department in which communication with Patients occurs. Personnel responsible for billing and insurance issues who routinely interact with Patients and Companions will receive training on the availability of auxiliary aids and services and the existence in the Hospital of an Information Office and Administrator(s).

4. Operators. All Hospital Personnel who receive incoming telephone calls from the public will receive special instructions on using TTY’s to make and receive telephone calls and will
receive training generally on the existence in the Hospital of an Information Office and Administrator(s) and complaint resolution processes.

5. Affiliated Physicians.

(a) Training Sessions. The Hospital will annually conduct one or more training sessions on the communication and psychological needs of persons who are deaf or hard of hearing, and will invite all physicians who are affiliated in any way with the Hospital (admitting or surgical privileges, etc.) to attend. The Hospital will provide training videotapes that contain substantially similar information to any affiliated physician upon request.

(b) Written materials. Within sixty (60) days of the effective date of this Agreement, the Hospital will distribute a set of materials to all affiliated physicians. These materials will contain at least the following: the Hospital’s Policy Statement and any relevant forms; a description of the Hospital’s Program and a request that physician’s staff members notify the Hospital about Patients and Companions as soon as they schedule admissions, tests, surgeries or other health care services at the Hospital.

6. Others. The Hospital will develop and implement an internal program that will provide appropriate training to all Hospital Personnel not trained under the preceding sections. This training will take place at such times as may be necessary to permit the Hospital to meet all of its obligations under this Agreement.

7. General Provisions. The Hospital will provide the training specified above to new Hospital Personnel (including without limitation Emergency Department, Psychiatric and Social Work personnel) within sixty (60) days after the commencement of their services for the Hospital. Such training must be comparable to training provided to specific departments as necessary. A screening of a video of the original training will suffice to meet this obligation. The Hospital shall maintain attendance sheets of all training conducted pursuant to this Section of this Agreement, which shall include the names and respective job titles of the attendees, as well as the date, time and location of the training session.

G. Miscellaneous Injunctive Relief

1. Discrimination by Association. The Hospital 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.

2. Retaliation and Coercion. The Hospital will not retaliate against or coerce in any way any person who is trying to exercise his or her rights under this Agreement or the ADA.

H. Specific Relief to Complainant. Within sixty (60) days of the effective date of this Agreement, the Hospital agrees to send a copy of this Agreement and Exhibits 2 and 3, hereto attached, to Alexander Garth by certified mail, return receipt requested, or by Federal Express. Exhibit 2, notifying Mr. Garth that an Agreement has been reached with the United States, includes an offer by the Hospital to pay Mr. Alexander $30,000.00 (thirty thousand dollars) as compensatory damages, and explains that, in order to accept the relief offered, he must return an executed “Release of All Claims,” Exhibit 3, the Hospital within thirty (30) days of receipt of said documents. The Hospital will send via express mail or other courier the undersigned counsel for the United States a copy of Exhibits 2 and 3 at the same time they are sent to Mr. Alexander.

I. If Garth Alexander provides a signed release as provided in Exhibit 3 within thirty (30) days of receipt of the release from the Hospital, the Hospital shall satisfy the Settlement Agreement by mailing by certified mail, return receipt requested, or by Federal Express, six checks, each in the amount of $5,000.00 (five thousand dollars) made payable to Garth Alexander, according to the following schedule: within thirty (30) days of receipt of the release, the Hospital shall mail the first check. Thereafter, the Hospital shall mail an additional check every thirty (30) days until six checks have been mailed. The Hospital will simultaneously provide to the United States a copy of the checks and transmittal letter at the same time they are sent to Mr. Alexander.

IV. ENFORCEMENT AND IMPLEMENTATION
A. Compliance Reports.

Six (6), nine (9), fifteen (15), and twenty-one (21) months after the effective date of this Agreement, and annually thereafter during the term of this Agreement, the Hospital must provide a written report (“Report”) to the Department of Justice regarding its efforts to comply with this Agreement. Each Report must state the identity of individuals admitted to the Hospital or their Companion(s) who are deaf or hard of hearing and the auxiliary aid(s) or service(s) provided to the individual(s). In the event that the Hospital does not provide auxiliary aid(s) or service(s) to a Patient or Companion who is deaf or hard of hearing, the Report must state (1) the procedure followed by the Hospital in determining whether to provide auxiliary aids and services to the Patient or Companion and (2) the Hospital’s reasons for not providing auxiliary aids and services to the Patient or Companion. The Hospital will make the most recent three Reports available for public inspection in the Information Office. The Hospital must maintain appropriate records, including, but not limited to, those described in this Agreement, to document the information contained in the Report.

B Complaints.

During the term of this Agreement, the Hospital will notify the Department if any individual brings any lawsuit, complaint, charge, or grievance alleging that the Hospital failed to provide auxiliary aids and services to Patients or Companions. Such notification must be provided in writing via certified mail within forty-five (45) days of when the Hospital has received notice of the allegation and will include, at a minimum, the nature of the allegation, the name of the individual bringing the allegation, and any documentation possessed by the Hospital relevant to the allegation.

C. Violation of Agreement.

1. If the Hospital violates this Agreement or any subpart of this Agreement, the Department will have such remedies as are allowed by law, provided that the first such violation by the Hospital will be deemed a subsequent violation of the ADA for the purpose of calculating civil penalties, if any.

2. The Department may review compliance with this Agreement at any time and may enforce this Agreement if the Department believes that it or any requirement thereof has been violated. If the Department believes that this Agreement or any portion of it has been violated, it will raise its concern(s) with the Hospital and the parties will attempt to resolve the concern(s) in good faith. The Department will give the Hospital twenty-one (21) days from the date it notifies the Hospital of any breach of this Agreement to cure that breach, prior to instituting any court action.

Failure by the Department to enforce any provision or deadline of this Agreement shall not be construed as a waiver of its right to enforce other provisions or deadlines of this Agreement.

D. Term of the Agreement. The Agreement shall remain in effect for three years from the effective date.

E. Entire Agreement. This Agreement constitutes the entire agreement between the parties relating to Department of Justice No. 202-16-123 and no other statement, promise, or agreement, either written or oral, made by any party or agents of any party, that is not contained in this written Agreement, including its attachments, shall be enforceable.

F. Binding. This Agreement is final and binding on the Hospital, including all principals, agents, executors, administrators, representatives, employees, successors in interest, beneficiaries, assigns, heirs, and legal representatives thereof. The Hospital has a duty to so inform any such successor in interest and to timely notify all parties of all such successors in writing. In the event the Hospital seeks to transfer or assign all or part of its interests in any facility covered by this Agreement, and the successor(s) or assign(s) intend(s) on carrying on the same or similar use of the facility, the Hospital, as a condition of sale, will obtain the written accession of the successor(s) or assign(s) to any obligations remaining under this Agreement for the remaining term of this Agreement.

G. Signatory. A signatory to this document in a representative capacity for Greater Southeast Community Hospital represents that he or she is authorized to bind that party to this Agreement.

For Greater Southeast Community Hospital:

For the United States of America:

By:_________________________________
JOAN PHILLIPS, Ph.D.
Chief Executive Officer
1310 Southern Ave, S.E.
Washington, D.C. 20032
(202) 574-6611

Date:           6-17-05

BRADLEY J. SCHLOZMAN
Acting Assistant Attorney General for Civil Rights

By:_________________________________
JOHN L. WODATCH, Chief
RENEE M. WOHLENHAUS, Deputy Chief
ROBERT J. MATHER,Trial Attorney
Disabilty Rights Section - NYA
Civil Rights Division
U.S. Department of Justice
950 Pennsylvania Avenue., N.W.
Washington , DC 20530

Date:           6-22-05

updated December 29, 2005

(Return to Agreement)

Exhibit 1

Model Communication Assessment Form

We ask this information so that we can communicate with patients and or companions who are deaf or hard of hearing effectively. All communication aids and services are provided FREE OF CHARGE. If you need further assistance, please ask your nurse or other hospital personnel.

______________________________
Date

______________________________
Name of Person with Disability

______________________________
Patient’s Name

Nature of Disability:
          ____   Deaf
          ____   Hard of Hearing
          ____   Speech Impairment
          ____   Other:  ____________________________________________

Relationship to Patient:

          ____   Self
          ____   Family Member
          ____   Friend
          ____   Other:  ____________________________________________

Does the person with a disability want a professional sign language or oral interpreter?
          ____   No. He/she does not use sign language and does not use interpreters to lip read.
          ____   No. He/she prefers to have family members/friends help with communication.
          ____   Yes. Choose one (free of charge):
                     ____   American Sign Language (ASL)
                     ____   Signed English
                     ____   Oral interpreter
                     ____   Other. Explain:  ____________________________________________

Which of the following would be helpful for the person with a disability (free of charge)?
          ____   TTY/TDD (text telephone)
          ____   Assistive listening device (sound amplifier)
          ____   CART: Computer-assisted Real Time Transcription
          ____   Qualified note takers
          ____   Writing back and forth
          ____   Other. Explain:  ____________________________________________

If the person with a disability, or the patient who the person with a disability is with, is ADMITTED to the hospital, which of the following should be provided in the patient room?
          ____   Telephone handset amplifier
          ____   Telephone compatible with hearing aid
          ____   Closed caption decoders for television set
          ____   TTY/TDD
          ____   Flasher for incoming calls
          ____   Paper and pen for writing notes
          ____   Other. Explain:  ____________________________________________

Any questions? Please call our Effective Communication Program Office, ____________________ (voice), ____________________ (TTY), or visit us during normal business hours. We are located in room __________.

(Return to Agreement)

EXHIBIT 2

VIA CERTIFIED MAIL
RETURN RECEIPT REQUESTED

Garth Alexander
101 MelMara Drive
Oxon Hill, Maryland 20745

Re: Greater Southeast Community Hospital
      D.J. No. 202-16-123

Dear Mr. Alexander:

The United States and Greater Southeast Community Hospital (“Greater Southeast Community Hospital”) have entered into a Settlement Agreement to resolve your complaint, D.J. No. 202-16-123, alleging disability discrimination by Greater Southeast Community Hospital. A copy of the Settlement Agreement is enclosed.

Pursuant to the Settlement Agreement, Greater Southeast Community Hospital hereby offers you a monetary award of $30,000.00, payable in six (6) installment payments of $5,000.00 over a six (6) month period, which shall be considered compensatory in nature. To receive the monetary award, you must communicate your acceptance to Greater Southeast Community Hospital by executing the enclosed “Release of All Claims” and returning it to Greater Southeast Community Hospital within thirty (30) days of your receipt of this letter. You must send the signed “Release of All Claims” by mail to:

Joan Phillips, Ph.D.
Greater Southeast Community Hospital
1310 Southern Avenue, S.E.
Washington, D.C. 20032,

with a copy to:

David A. Denslaw
Doctors Community Healthcare Corporation
6720 North Scottsdale Road
Suite #274
Scottsdale, Arizona 85253

If you have any questions concerning the Settlement Agreement, you may contact Robert J. Mather, the attorney for the U.S. Department of Justice, at (202) 307-2236.

Sincerely,

___________________________
Joan Phillips, Ph.D.
Chief Executive Officer

Encls.

(Return to Agreement)

EXHIBIT 3

COMPREHENSIVE RELEASE OF ALL CLAIMS
D.J. No. 202-16-123

1. LET IT BE KNOWN that Garth Alexander, the undersigned, for valuable consideration received, to wit: $30,000.00, payable in six (6) installment payments, does for himself, his heirs, executors, administrators, personal representatives, beneficiaries, survivors, successors and assigns (hereinafter referred to as “Releasor”), hereby releases, acquits, and forever discharges Greater Southeast Community Hospital, Greater Southeast Community Corporation I, Doctors Community Healthcare Corporation, their predecessors, agents, servants, employees, owners, shareholders, officers, directors, partners, associates, attorneys, representatives, successors, assigns, heirs, spouses, firms, brokers, appraisers, associations, associates, partnerships, corporations and any and all of their insurance companies, and their agents and brokers, and each of them (hereinafter collectively referred to as “Releasees”) of and from any and all obligations, liability, guarantees, actions, causes of action, damages, judgments, executions, debts, costs, expenses, attorney’s fees, taxes, liens, notes, securities, stocks, bonds, investments, claims and demands whatsoever under the laws of the District of Columbia and of any other state of the United States and/or the United States of America, for, from, upon, under, on account of, or growing or arising out of or relating to any of the acts, transactions and occurrences between, among and/or involving Releasor and Releasees, including but not limited to, any and all obligations, liabilities, guarantees, actions, causes of action, judgments, executions, debts, costs, expenses, attorney's fees, damages, taxes, liens, notes, securities, stocks, bonds, investments, claims, charges and losses, of any kind, nature and character, now existing known or unknown, or hereafter becoming known, accrued or hereafter accruing, resulting directly or indirectly, approximately or remotely, from any and all of the matters and things arising from any cause whatsoever prior to the date this Release is executed, including but not limited to Cause #DJ No. 202-16-123 and the matters related thereto, and to hereby acknowledge full and complete compromise and settlement, complete satisfaction and payment thereof.

2. Releasor further understands and agrees that the sum embodied in this Release is a compromise of a disputed claim and that payment is not to be construed as an admission or liability on the part of Releasees by whom liability is expressly denied.

3. Notwithstanding the generality of the foregoing, this Release is intended to and does hereby fully and completely release the Releasees from any and all claims, suits and demands of any nature whatsoever, arising out of or in any way connected with Releasor's claims against Greater Southeast Community Hospital, Greater Southeast Community Hospital Corporation I, Doctors Community Healthcare Corporation, and other Releasees.

4. Releasor hereby agrees, in return for the consideration mentioned herein to completely indemnify and hold harmless Releasees from any and all claims or demands of any nautre or kind whatsoever which have been or may hereafter be made against Releases individually, collectively or any combination thereof based on or arising out of, on in connection with or related to the facts and circumstances specified herein or within the aforementioned action.

5. The Releasor specifically releases, acquits and forever discharges all persons, organizations, partnerships and corporations not otherwise listed above, of and from any and all obligations, liability, actions, causes of action, damages, judgments, executions, claims and demands whatsoever under the laws of the District of Columbia and/or of any other state of the United States and/or of the Untied States of America, from. upon, under, on account of, or growing or arising out of said claims, causes of action or any other claims or causes of action that exist or may exist as of the date this Release is executed, if said claims and causes of action would or may result in an indemnification action by the parties to said action against Releasees.

This Release constitutes the entire agreement between the Releasor and Releasees without exception or exclusion. This Release will be considered null and void in the event that Greater Southeast Community Hospital fails to make payments in accordance with the Settlement Agreement herein.

I acknowledge that a copy of the Settlement Agreement between the United States and Greater Southeast Community Hospital has been made available to me. I further acknowledge that I have had the opportunity to review the terms of this Release with an attorney of my choosing, and, to the extent that I have not obtained that legal advise, I voluntarily and knowingly waive my right to do so.

I HAVE READ THIS RELEASE AND UNDERSTAND THE CONTENTS THEREOF, AND I EXECUTE THIS COMPREHENSIVE RELEASE OF MY OWN FREE ACT AND DEED, REPRESENTING THAT I AM OF SOUND MIND AND QUALIFIED TO KNOWINGLY AND VOLUNTARILY EXECUTE THIS COMPREHENSIVE RELEASE.

Signed this _______ day of ____________, 2005.

Garth Alexander

Sworn and subscribed to before me this
_______ day of _____________, 2005.

Notary public

My commission expires:____________

(Return to Agreement)

Cases & Matters by ADA Title Coverage | Legal Documents by Type & Date | archive.ADA.gov Home Page

October 09, 2008

For Greater Southeast Community Hospital:	For the United States of America:
By:_________________________________ JOAN PHILLIPS, Ph.D. Chief Executive Officer 1310 Southern Ave, S.E. Washington, D.C. 20032 (202) 574-6611 Date: 6-17-05	BRADLEY J. SCHLOZMAN Acting Assistant Attorney General for Civil Rights By:_________________________________ JOHN L. WODATCH, Chief RENEE M. WOHLENHAUS, Deputy Chief ROBERT J. MATHER,Trial Attorney Disabilty Rights Section - NYA Civil Rights Division U.S. Department of Justice 950 Pennsylvania Avenue., N.W. Washington , DC 20530 Date: 6-22-05