Enforcement Success Stories Involving Persons with Disabilities

Summary of Selected OCR Compliance Reviews and Complaint Investigations

  • Massachusetts Department of Children and Families - On January 30, 2015, the U.S. Departments of Justice (DOJ) and Health and Human Services (HHS) issued a joint letter finding disability rights violations by the Massachusetts Department of Children and Families (DCF).  DOJ found DCF has violated Title II of the Americans with Disabilities Act (ADA), and HHS found DCF has violated Title II and Section 504 of the Rehabilitation Act (Section 504), by denying a mother with developmental disabilities the opportunity to benefit from supports and services following the removal of her two-day-old infant and over the next two years as she was seeking to reunify with her daughter.
  • The Centers for Medicare & Medicaid Services (CMS) in the U.S. Department of Health and Human Services has entered into an agreement with OCR to ensure that individuals with disabilities can access information provided by CMS and its contractors in CMS programs. The Commitment to Action resolves two complaints filed by a national advocacy program concerning access for individuals who are blind or have low vision to communications in the Medicare program. In the comprehensive agreement, CMS further commits to ensuring effective communication for all individuals with disabilities in all CMS programs. (8/20/14)

  • The State of Florida has voluntarily revised applications for licensure in all of its health care and human service professions to ensure that they are in compliance with Title II of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability by public entities, including state entities that administer licensing and certification programs.  OCR had received complaints alleging that certain questions in applications for licensure in three health care fields impermissibly inquired into disability status.   Florida voluntarily revised those questions and also agreed to undertake a review of all of their other applications for licensure as a health care or human service professional to ensure their compliance with the ADA. States have a legitimate interest in ensuring that the individuals that they license to practice as health care and human service professionals are able to competently and safely practice, but they may not impermissibly screen out individuals with disabilities or subject them or additional burdens based on their disabilities.  These changes ensure that thousands of individuals with disabilities have an equal opportunity to be licensed to practice in over 30 different professions, ranging from doctors, nurses, and dentists to clinical social workers, massage therapists, and school psychologists.  http://www.doh.state.fl.us/mqa/med-boards.html.

  • The State of Colorado has voluntarily changed its applications for licensure as a doctor and a nurse to ensure that the applications do not impermissibly inquire into disability status of applicants.  OCR had opened compliance reviews of the Colorado Board of Nursing and the Colorado Board of Medical Examiners to determine whether their applications for licensure were in compliance with Title II of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability by public entities, including state entities that administer licensing and certification programs.  While state licensing boards have a legitimate interest in ensuring that individuals that they license can safely and competently practice as a health care professional, OCR found that some of the questions in the applications impermissibly inquired into an applicant’s disability status and subjected qualified applicants with disabilities to discrimination on the basis of disability.   The State and OCR are continuing to assess applications for licensure in other health professions to ensure their compliance with the ADA. https://www.colorado.gov/pacific/dora/Medical_Applications

  • Orthopedic Institute of Pennsylvania (OIP) - OCR secured a Settlement Agreement to ensure all deaf and hard-of-hearing patients are provided sign language interpreters and other auxiliary aids when needed for effective communication, as required by Federal law. OIP is an orthopedic surgical practice with 127 staff in six offices. The Agreement resolves OCR’s investigation of a disability compliant filed by a deaf individual denied a sign language interpreter when he called to schedule a medical appointment, in violation of Section 504 of the Rehabilitation Act of 1973.  Under the Agreement, OIP will consult with all deaf or hard-of-hearing patients to determine which appropriate auxiliary aids and services are needed to ensure effective communication.  

  • University of Utah Hospitals (UUHC) - OCR secured a signed Resolution Agreement to ensure that UUHC patients with hearing, vision or speech disabilities will be screened and provided with auxiliary aids and services, including sign language interpreters. The UUHC healthcare system, located in Salt Lake, Davis, Wasatch, Tooele, and Utah Counties, provides care for residents of Utah and five surrounding states, serving more than 850,000 patients annually. This Agreement resolves an OCR Region VIII compliance review, which identified areas of improvement needed to ensure that qualified individuals with disabilities receive equal access to UUHC programs and services. To resolve the matter, the UUHC healthcare system agreed to: (1) affirm its compliance with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; (2) issue and post policies to ensure that appropriate auxiliary aids and services, including sign language interpreters or video interpretation services, are provided to patients with hearing, vision or speech impairments within a two hour time period; (3) establish and post nondiscrimination policies and Section 504 grievance procedures; (4) train physicians, employees and contractors on procedures to ensure effective communication; (5) place TTY lines throughout its facilities; (6) issue customer service questionnaires to patients with disabilities; and (7) provide comprehensive compliance reports to OCR.

  • Florida Department of Children and Families (DCF) - OCR secured a statewide Settlement Agreement with Florida to provide effective communication as required by Federal law to an estimated 3 million deaf and hard-of-hearing persons. OCR’s investigation found that the State violated Federal non-discrimination laws when it failed to provide interpreters to deaf persons in critical situations, such as during child protective services investigations, and during treatment in State mental health hospitals and treatment facilities. Under the Agreement, all deaf and hard-of-hearing persons using DCF's programs and services will be provided with sign language interpreters or other auxiliary aids and services as necessary for effective communication.

  • Mid-Maryland Musculoskeletal Institute (MMI), Frederick, MD – OCR secured a Voluntary Resolution Agreement to resolve three complaints that alleged MMI failed to provide sign language interpreter services to deaf patients during their appointments.  MMI is an orthopedic practice, staffed by 11 doctors in three locations, serving 1,000 patients per month.  MMI entered into the Agreement to ensure that it provides effective communication with persons who are deaf or hard-of-hearing, consistent with Section 504 of the Rehabilitation Act of 1973 (Section 504) which applies to recipients of Federal financial assistance.  The investigation revealed that MMI had relied on note-taking and lip-reading to communicate regarding patient symptoms, diagnosis, the purpose and use of prescribed medication, the administration of injections, the benefits and risks of surgery, the demonstration of home medical equipment, and post-operative care and discharge instructions.  Based on the investigation, OCR identified Section 504 concerns with MMI’s policies and procedures for providing assistance to deaf or hard-of-hearing patients.  Under the Agreement, MMI agreed to modify its policies and procedures to provide deaf and hard of hearing patients and their companions with qualified interpreters as needed to ensure effective communication; assess patients with impaired sensory functioning at or prior to the time of scheduled appointments to determine an appropriate auxiliary aid; institute standards to provide qualified interpreter services in a timely manner; and provide notice about such auxiliary aids and services at no cost to patients.

  • Fort Washington Medical Center (FWMC), Fort Washington, MD – OCR secured a Settlement Agreement to resolve a complaint filed by the Washington Lawyers’ Committee for Civil Rights and Urban Affairs on behalf of a deaf patient, alleging that he was discriminated against on the basis of his disability (deafness) when FWMC failed to provide him with sign language interpreter services that were needed for him to communicate effectively with the hospital staff during an emergency room visit. OCR determined FWMC, a hospital that annually admits more than 2,800 patients and 45,000 individuals seeking ER services, violated Section 504 of the Rehabilitation Act when it failed to take appropriate steps to ensure effective communication with the deaf patient. Under the Agreement, FWMC agreed to: 1) conduct a timely assessment of deaf or hard-of-hearing patients and/or companions to determine an appropriate auxiliary aid or service; 2) document the communication assessment in the deaf or hard-of-hearing patient’s medical chart; 3) provide appropriate auxiliary aids or services throughout the patient’s stay or subsequent visits; 4) provide qualified interpreter services in a timely manner as necessary for effective communication; 5) never require or coerce a family member or companion to interpret; and 6) revise its policies and procedures for effective communication with deaf or hard-of-hearing patients and/or companions.  In addition, FWMC agreed to train its staff on the new policies and procedures and develop a notice of nondiscrimination that states that FWMC provides auxiliary aids and services free of charge, provides the grievance process, and provides contact information for the Section 504 Coordinator.  FWMC also will submit regular compliance reports to OCR.

  • Washington State Department of Social and Health Services (DSHS)- OCR secured a signed Voluntary Resolution Agreement to resolve a complaint that alleged that DSHS failed to ensure that children with developmental disabilities residing in the Fircrest Residential Habilitation Center received an appropriate education.  DSHS voluntarily entered into this agreement to facilitate the provision of an appropriate education to children residing in all five of the Residential Habilitation Centers (RHCs) run by DSHS throughout the State of Washington, consistent with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, and Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. § 12131.  One of the components of an appropriate education is the education of a qualified child with a disability in a setting with children who do not have disabilities, to the maximum extent appropriate to the needs of the qualified child with a disability.  Under the resolution agreement, DSHS agreed to develop and implement policies and procedures to facilitate and monitor the timely provision of an appropriate education, and to address steps that DSHS will take in instances where it appears that children with disabilities residing in the RHCs may not be receiving an appropriate education.  DSHS also agreed to establish a grievance procedure that incorporates due process standards, take continuing steps to notify parents and employees of its grievance procedure, nondiscrimination policy, and Section 504 Coordinator, and to provide staff training on the policies and procedures.  This resolution agreement complements resolution agreements entered into in related cases by the U.S. Department of Education’s Office for Civil Rights with Shoreline School District #412 and the Washington Office of the Superintendent of Public Instruction, that together help ensure the provision of an appropriate education to children with disabilities in Washington State. Read the DSHS Agreement

  • Schenectady County Department of Social Services (SCDSS), Schenectady, New York - OCR secured a signed Voluntary Resolution Agreement which resolves a disability discrimination complaint against SCDSS, a social services agency serving the 150,818 residents of Schenectady County, one of the fastest growing counties in upstate New York. The complainant, who has a mobility impairment and walks with a cane, reported that structural barriers make SCDSS's offices at 487 Nott Street and 104 Erie Boulevard inaccessible to individuals with physical disabilities; and that SCDSS had failed to designate an employee to coordinate its compliance efforts under Section 504 of the Rehabilitation Act of 1973 (Section 504), and Title II of the Americans with Disabilities Act of 1990 (Title II of the ADA). After receiving the complaint, OCR's Region II New York office conducted a thorough investigation, including surveys of the SCDSS offices to identify architectural barriers. OCR and SCDSS established the following objectives under the agreement: (1) physical accessibility of SCDSS' new 797 Broadway office, which is currently being constructed to be a fully accessible office space free of architectural barriers; (2) structural modifications at SCDSS' existing 104 Erie Boulevard office to ensure the physical accessibility of its parking lot, entrance doors and public restroom; (3) the implementation of interim procedures to ensure program accessibility at SCDSS' existing 487 Nott Street office, including establishing a dedicated telephone line so that individuals with disabilities can be served, if possible, within 24 hours and posting outside signage with the telephone number and a statement that services are available at other locations; (4) a notice informing consumers of their rights and responsibilities under Section 504 and/or Title II of the ADA be developed and distributed; (5) establishment and publishing of procedures for consumers to file grievances alleging disability discrimination under Section 504 and/or Title II of the ADA; (6) the appointment of a senior SCDSS staff member to coordinate its compliance efforts under Section 504 and/or Title II of the ADA, train SCDSS employees on approaches to prevent and/or address disability discrimination, and respond timely to grievances filed by consumers alleging disability discrimination; and (7) the provision of regular compliance reports by SCDSS to OCR for the one year term of the agreement.

  • Scottsdale Healthcare – Osborn (SHO) - OCR secured a signed Resolution Agreement that resolves a disability discrimination complaint against SHO, a 337-bed hospital and trauma center, serving 150,000 patients each year in Scottsdale, Arizona. The complainant, who has severe hearing loss, reported that she was denied a sign language interpreter when treated in the SHO emergency room and intensive care unit. After receiving her complaint, OCR's Region IX office conducted an investigation. To resolve the matter, SHO agreed to: (1) affirm its compliance with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; (2) issue and post revised policies to ensure that appropriate auxiliary aids, including sign language interpreters or video interpretation services, are provided to deaf or hard-of-hearing patients or companions within a two hour time period; (3) develop procedures to assess the sign language interpreter needs of patients or companions; (4) train hospital personnel and physicians on its revised policies and procedures to ensure effective communication; (5) place TTY lines throughout its facility; (6) maintain a centralized telecommunication number 24-hours per day, 7-days per week for sign language interpreter requests; and (7) provide regular compliance reports to OCR. Read the SHO Resolution Agreement

  • Sullivan County Department of Family Services (DFS) – The complainant, who is deaf and receiving food stamps, reported that DFS staff declined to provide her with a sign language interpreter unless she was willing to pay between $150 and $170 per hour. After receiving her complaint, OCR’s Region II office conducted an investigation of DFS, a New York social services agency serving 4025 food stamp users per month. To resolve the matter, DFS signed an OCR Resolution Agreement, agreeing to: (1) prohibit surcharges on auxiliary aids and services, including sign language interpreters, note takers, assistive listening devices, and computer-assisted real time transcription; (2) affirm its compliance with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; (3) designate a Section 504 Coordinator and develop a Section 504 grievance procedure; (4) issue and post revised policies to ensure that requested sign language interpreters are provided to deaf or hard-of-hearing patients or companions within a two hour time period; (5) develop procedures to assess the sign language interpreter needs of patients or companions; (6) train DFS staff on its revised policies and procedures to ensure effective communication; (7) accept relay operator calls; and (8) provide regular compliance reports to OCR.  Read the DFS Resolution Agreement

  • Catskill Regional Medical Center (CRMC)  – The complainant, who is deaf, reported that CRMC staff failed to provide her with a sign language interpreter on several occasions. OCR’s Region II office subsequently conducted an investigation of CRMC, which has an emergency response helicopter, a trauma center, and a 162-bed hospital, serving 56,000 patients each year in Sullivan County, New York. To resolve the matter, CRMC signed an OCR Resolution Agreement, agreeing to: (1) prohibit surcharges on auxiliary aids and services, including sign language interpreters, video interpretation services, note takers, assistive listening devices, and computer-assisted real time transcription; (2) affirm its compliance with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794; (3) designate a Section 504 Coordinator and develop a Section 504 grievance procedure; (4) issue and post revised policies to ensure that appropriate auxiliary aids, including sign language interpreters or video interpretation services, are provided to deaf or hard-of-hearing patients or companions within the time periods set by the New York State Department of Health; (5) develop procedures to assess the sign language interpreter needs of patients or companions; (6) train CRMC personnel on its revised policies and procedures to ensure effective communication; and (7) provide regular compliance reports to OCR.  Read the CRCM Resolution Agreement

  • Hanover, Virginia Department of Social Services (DSS) - OCR worked with a county department of social services to develop and issue a service animal policy so that persons with disabilities who use service animals throughout the county will be able to access social services. OCR found that the policy that the county previously had, requiring documentation of certification of a service animal, violated Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. OCR also determined that DSS violated these laws when it failed to appropriately consider a request for a reasonable modification by a woman with a disability who asked for permission to be accompanied by her “therapy/service” dog in meeting with staff. To ensure that staff would comply with the law and that individuals with disabilities who used service animals would be aware of their rights, DSS agreed to post notices of its new service animal policy in key locations visible to clients and members of the public and to conduct training for all staff on serving people with disabilities, providing reasonable modifications, and understanding and applying the new service animal policy. The DSS also committed to inform all new hires of its service animal policy and to periodically the training and policies. DSS took these steps within six weeks of receiving the letter from OCR, informing DSS of the violation findings. As a result of these actions, not only persons with disabilities who use service animals, but all persons with disabilities who reside in this county of almost 100,000 people, will have access to the variety of social service programs and benefits that the county offers.  Read the DSS Letter of Findings




 

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