DEPARTMENT OF JUSTICE COMPLAINT NUMBER 202-11-136

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A. BACKGROUND AND PARTIES

1.  This matter was initiated by a complaint filed with the United States Department of Justice (“Department”) against Valley Radiologists Medical Group, Inc. (VRI), a radiologic imaging center located at 285 South Drive, Suite 5, Mountain View, California. The complaint was filed by Ms. Nola Quinterno, who uses a wheelchair and cannot stand or walk due to multiple sclerosis. Ms. Quinterno came to VRI for a scheduled full body bone density x-ray. Ms. Quinterno is unable to transfer herself to an examination table without a mechanical lift or assistance from several individuals. Ms. Quinterno called before the appointment to find out if VRI would be able to provide the assistance necessary to get her onto the table for the examination, and alleges that she was assured that VRI would transfer her to the examination table. When she arrived for the appointment, VRI did not have a lift or adjustable height table, and several individuals tried to lift Ms. Quinterno onto the table but were unable to do so. VRI told Ms. Quinterno that they could not do the x-ray, and Ms. Quinterno left without having the x-ray done.

2.  The Attorney General is authorized under section 308(b)(1) of the Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. § 12188(b)(1), to investigate violations and bring a civil action under Title III where he has reasonable cause to believe that a pattern or practice of discrimination exists or a matter of general public importance is raised.

3.  VRI is a medical office that provides services to the public and is a place of public accommodation covered by Title III of the ADA, 42 U.S.C. § 12181(7); 28 C.F.R. § 36.104. VRI provides a full range of medical imaging services, including general radiology, bone densitometry, mammography, ultrasound, CT, and MRI. VRI has offices in eight locations in northern California, in San Mateo, Redwood City, Palo Alto, Mountain View, San Jose, and Los Gatos.

4.  The Department investigated the complaint. The Department determined that VRI denied Ms. Quinterno medical services on the basis of her disability. VRI failed to make reasonable modifications in policies, practices, or procedures, when such modifications were necessary to afford its services to Ms. Quinterno, and/or failed to undertake readily achievable barrier removal, by not providing her the assistance she needed to get onto the examination table, in violation of Title III of the ADA, 42 USC §§12182(b)(1)(A)(i), (b)(2)(A)(ii), (b)(2)(A)(iv).

5.  VRI disputes the Department’s findings and maintains that it provided Ms. Quinterno with all appropriate medical services and did not deny her treatment based upon her disability. VRI further maintains its policies, practices and procedures are non-discriminatory and it has engaged in barrier removal at all of its facilities.

6.  In order to avoid unnecessary and costly litigation, the parties have agreed to resolve this action as set forth below.

B. TERMS OF AGREEMENT

7.  In the course of this investigation, VRI purchased four Hoyer lifts (mechanical lift devices) and eight transfer boards to assist in transferring individuals with mobility disabilities from a wheelchair to an examination table. VRI already had an MRI Compatible Collapsible Gurney, ambulance style, which adjusts from 0 to 37 inches in increments of 4 inches. VRI agrees to maintain this equipment. This equipment will be used to assist in transferring individuals with mobility disabilities from a wheelchair to imaging equipment tables. Which equipment will be used will depend on the particular examination table and the individual’s disability. Exhibit A to this Agreement, the Equipment Accessibility Matrix, lists all of the imaging equipment available at VRI’s 8 locations, the height of each piece of equipment, and how staff should transfer a patient with a mobility disability from a wheelchair to that particular exam table. VRI staff shall follow the instructions listed in Exhibit A, except if the patient and staff agree that another available method is preferred.

8.  When scheduling an appointment, VRI staff will ask the patient if he or she will need any special assistance, modification of policy, or auxiliary aid or service at the examination because of a disability. If the patient may need assistance in transferring to an examination table because of a mobility disability, VRI will tell the patient the specific height ranges of the equipment to be used for his/her examination and the available additional transfer equipment, to allow the patient to determine what additional equipment or assistance, if any, he or she may need. VRI staff shall be prepared to provide the appropriate assistance and equipment at the appointment, consistent with the transfer techniques and equipment outlined in Exhibit A. If additional staff are needed to help with a transfer at a pre-scheduled appointment, VRI shall arrange for the additional staff to be there ahead of time. It shall not be a violation of this agreement for VRI to be unprepared to accommodate an individual with a disability who did not identify a need for that particular accommodation when asked by the staff person who scheduled the appointment, except when VRI can accommodate the individual without fundamentally altering the nature of its services.

9.  The MRI Compatible Collapsible Gurney will be shared between the two Los Gatos sites – Dandanelli Lane and the Community Hospital – which are located next to each other. Staff at these locations will ensure that the gurney is transferred to the office location where needed for a patient with a disability in advance of the patient’s appointment. The need for the gurney will be established by the staff, in consultation with the patient, when setting up the appointment, in accordance with Paragraph 8 above.

10.  Within 30 days of the effective date of this Agreement, VRI will adopt the non-discrimination policy attached as Exhibit B and post it in each of its office locations.

11.  Within 90 days of the effective date of this Agreement, VRI will conduct training for all its medical and administrative staff on: (1) an overview of the requirements of Title III of the ADA as it relates to medical facilities, including sensitivity training on interacting with individuals with disabilities, (2) operation of the transfer equipment, and (3) techniques for assisting individuals with mobility disabilities to transfer to the exam table. The trainer must be approved in advance by the Department. This training shall be conducted, in the future, for newly hired staff within three months of their hire. If the staff have already been trained in some or all of the elements listed above, VRI may demonstrate to the Department that sufficient training has already been conducted. The Department will not unreasonably withhold approval of existing training.

12.  Within 120 days of the effective date of this Agreement, and every 12 months thereafter until the expiration of this Agreement, VRI shall file a report with the Department. The report shall cover: (1) the training described in paragraph 11 above, including the dates of the training, the names and job positions of the attendees, the name and affiliation of the trainer, and the subjects covered in the training; and (2) a list of incidences when VRI has assisted a patient who uses a wheelchair to transfer to the imaging equipment, including the date, location, equipment used, and whether the patient received the exam, and if not, why. The report shall be sent by fax or overnight mail to Amanda Maisels at U.S. Department of Justice, Disability Rights Section, 1425 New York Ave., Washington DC 20005.

13.  In consideration of the terms of this Agreement, the Department closes Complaint #202-62-104. No civil penalties shall be assessed against VRI.

C. IMPLEMENTATION AND ENFORCEMENT

14.  The Department may review compliance with this Agreement at any time and may enforce this Agreement if the Department be-lieves 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 VRI and the parties will attempt to resolve the concern(s) in good faith. Department will give VRI 21 (twenty-one) days from the date it notifies VRI of any breach of this Agreement to cure that breach, prior to insti-tuting any court ac-tion.

15.  Failure by the Department of Justice to enforce this entire Agreement or any of its provisions or deadlines shall not be construed as a waiver of the Department’s right to enforce other deadlines and provisions of this Agreement.

16.  This agreement shall be binding on VRI, its agents and employees. In the event VRI seeks to transfer or assign all or part of its interest, and the successor or assign intends on carrying on the same or similar use of the facility, as a condition of sale VRI shall obtain the written accession of the successor or assign to any obligations remaining under this agreement for the remaining term of this agreement.

17.  The effective date of this Agreement is the date of the last signature below.

18.  This Agreement constitutes the entire agreement between the parties on the matters raised here, and no other statement, promise, or agreement, either written or oral, made by either party or agents of either party, that is not contained in this written agreement, shall be enforceable. This Agreement does not purport to remedy any other potential violations of the ADA or any other federal law. This Agreement does not affect VRI’s continuing responsibility to comply with all aspects of the ADA.

19.  The Agreement will remain in effect for three years from the effective date of this Agreement.

20.  By executing this Agreement, VRI does not make any admissions with regard to the allegations contained in the complaint in this matter or otherwise.

	For the United States:
VALLEY RADIOLOGISTS MEDICAL GROUP, INC. By:                                              Michael L. Silhol Radiologix, Inc. 3600 JPMorgan Chase Tower 2200 Ross Avenue Dallas, Texas 75201 (214) 303-2711 (214) 303-2849 (fax) Date:     8/19/05	Bradley J. Schlozman Acting Assistant Attorney General Civil Rights Division John L. Wodatch, Chief L. Irene Bowen, Deputy Chief                                              Amanda Maisels Trial Attorney Disabilty Rights Section U.S. Department of Justice 950 Pennsylvania Avenue, NW Washington , D.C. 20530 (202) 305-8454 (202)305-9775 (fax) Date:     11/2/05

Exhibit
A

Valley Imaging Partners
Equipment Accessibility Matrix

(Return to Agreement)

EXHIBIT
B

VALLEY RADIOLOGISTS
MEDICAL GROUP, INC.NONDISCRIMINATION POLICY AND PROCEDURE

In accordance with Title III of the Americans with Disabilities Act (ADA), Valley Radiologists Medical Group, Inc. (VRI) does not discriminate on the basis of disability in the provision of its medical services. VRI will make reasonable modifications to its policies and procedures when necessary to provide its medical services to individuals with disabilities, unless such modifications would fundamentally alter the nature of its medical services. VRI will remove barriers when doing so is readily achievable. Individuals with disabilities will not be denied services on the basis of their disability.

When scheduling an appointment, VRI staff will ask the patient if he or she will need any special assistance, modification of policy, or auxiliary aid at the exam because of a disability. If the patient may need assistance in transferring to an examination table because of a mobility disability, VRI will tell the patient the specific height ranges of the equipment to be used for his/her examination and the available additional transfer equipment, to allow the patient to determine what additional equipment or assistance, if any, he or she may need. If additional staff are needed to help with a transfer at a pre-scheduled appointment, VRI shall arrange for the additional staff to be there ahead of time.

When a patient with a mobility impairment (e.g., a wheelchair user) needs assistance to transfer to an examination table, VRI staff will provide safe and appropriate assistance, consistent with the transfer techniques and equipment outlined in the Equipment Accessibility Matrix. VRI staff will first ask the patient exactly what assistance he or she needs, and how he or she prefers to be assisted in order to provide a safe and effective transfer. VRI staff will be trained in proper techniques to assist an individual with a mobility impairment to transfer to an exam table.

(Return to Agreement)

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December 29, 2005