HHS’ Office for Civil Rights Secures Provider Compliance with Disability Rights Laws

OCR Resolves Two Complaints Alleging Denial of Effective Communication in Health Care

WASHINGTON— April 13, 2026 —The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) resolved two separate investigations under federal disability rights laws stemming from complaints alleging the denial of effective communication for deaf patients.

OCR enforces Section 504 of the Rehabilitation Act (Section 504) and Section 1557 of the Patient Protection and Affordable Care Act (Section 1557). Both Section 504 and Section 1557 require regulated entities to ensure effective communication with individuals with disabilities. This requirement may include providing qualified sign language interpreters or other auxiliary aids and services when needed. The effective communication requirement applies for all health care, including mental, behavioral, and maternal health care.

“Under federal disability rights laws, federally funded health care providers must be able to communicate effectively with patients who are deaf or hard of hearing.” said OCR Director Paula M. Stannard. “When providers fail to meet this obligation, it is not only a civil rights issue—it can also jeopardize a patient’s life or health.”

The resolutions secure a major psychiatric hospital’s and a regional health system’s compliance with federal civil rights requirements to ensure effective communication with individuals with disabilities.

OCR’s agreement with San Juan Capestrano Hospital, a psychiatric hospital in Puerto Rico, settles disputed claims and resolves OCR’s negotiations with San Juan Capestrano Hospital, which began when OCR issued a Notice of Violation and a proposed settlement agreement in 2024, finding that San Juan Capestrano Hospital violated Section 504 and Section 1557 on the basis of disability for failing to provide a qualified sign language interpreter to a deaf individual for a court-ordered psychiatric evaluation. San Juan Capestrano Hospital provides rehabilitation, inpatient, and outpatient services to patients struggling with addiction and mental health issues.

OCR’s agreement with Innovis Health, LLC, doing business as Essentia Health West, resolves an investigation based on a complaint from a deaf woman who uses American Sign Language to communicate. The complainant alleged that Essentia Health West asked her to bring an interpreter to her prenatal appointment, relied on faulty video-remote interpreting technology during an ultrasound, and failed to provide a qualified interpreter during labor and delivery. Essentia Health West is a Minnesota company that owns and operates health care facilities in Minnesota and North Dakota.

Under the respective agreements, San Juan Capestrano Hospital and Essentia Health West will implement system-wide changes to provide effective communication for persons with disabilities in compliance with Section 504 and Section 1557.

Each provider also agreed to:

• Assess communication needs for individuals with disabilities and document the assessment for subsequent visits.
• Modify policies and procedures for the effective communication requirements of Section 504 and Section 1557.
• Provide auxiliary aids and services, such as qualified interpreters, in a timely manner and free of charge.
• Use reliable video remote interpreting services that deliver real-time, high-quality audio and video without delays or interruptions.
• Designate a civil rights coordinator to facilitate compliance with Section 504 and Section 1557.
• Train staff on effective communication requirements and proper use of video remote interpreting technology.
• Notify OCR of any related complaints or legal actions and how they are resolved.

OCR will monitor implementation of the settlement agreement with San Juan Capestrano Hospital for two years. The agreement can be found at https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/agreements/sjch-settlement-agreement/index.html.

OCR will monitor implementation of the resolution agreement with Essentia Health West for one year. The agreement can be found at https://www.hhs.gov/sites/default/files/vra-with-essentia-health-west.

Today’s announcement follows a resolution announced earlier this year to resolve a complaint alleging the denial of a qualified interpreter in health care.  For recent success stories on effective communication for persons with disabilities, view summaries of selected OCR Compliance Reviews and Complaint Investigations.

If you believe that you or someone else has been discriminated against in programs or activities that HHS directly operates or for which HHS provides federal financial assistance, you may file a complaint with OCR. OCR enforces protections based on race, color, national origin, disability, age, sex, religion, and the exercise of conscience.

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