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The complainants in this matter, hampshkre, are individuals with disabilities within the meaning of the ADA, 42 U. Part The ADA prohibits public accommodations, including hospitals, from discriminating on the basis of disability in the full and equal enjoyment of the hampsnire, services, facilities, privileges, advantages or accommodations. The complainants allege that [redacted] was unable to communicate adequately with Hospital Personnel while she was receiving medical treatment at the Hospital in July of because she was not provided with language interpreters, she was required to use inadequate or inappropriate auxiliary aids, and Hospital Personnel did not know how to operate auxiliary aids.

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Provision of Interpreters in a Timely Manner Scheduled Incidents For Scheduled Incidents, where an interpreter is necessary to ensure effective communication, the Hospital will have video interpreting services available at the time of the scheduled appointment or will arrange to have a live interpreter available if a live interpreter is necessary in order to achieve effective communication including situations identified in Paragraph 51 in which video interpreting rook are not effective.

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If an interpreter fails to arrive for the Scheduled Incident, the Hospital will immediately call the interpreter service for another qualified language interpreter upon notice that the interpreter failed to arrive. After receiving a non-scheduled interpreter request, and determining in accordance with paragraph 28 that a live interpreter is necessary, the Hospital shall make an interpreter available as soon as practicable.

Hospital Personnel will also make such a request within fifteen 15 minutes of any situation identified in Paragraph 51 where video interpreting services are not effective. Whether this standard is met will be measured beginning 15 minutes after it is determined that an interpreter is required. Specific Steps for Non-scheduled Interpreter Requests Within fifteen 15 minutes after completing a determination as described in paragraph 28 that finds that interpreting services are required, Hospital Personnel will provide video interpreting services.

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Within 15 minutes after completing a determination as described in paragraph 28 that determines that a live interpreter is required, Hospital Personnel will request an interpreter qualified to interpret for the specific individual who will be using the services from the interpreters or agencies with whom the Hospital has an ongoing contract for qualified interpreter services.

Provision of Qualified Interpreters Throughout a Hospitalization The Hospital will develop a policy and implement procedures to ensure that once a Patient has been admitted to the Hospital and the determination described in paragraph 28 of this Settlement Agreement richester determined that a qualified language interpreter is necessary to achieve effective communication during the hospitalization of the Patient, qualified interpreters are made available at all events requiring substantial communication between the Patient and the Hospital Personnel.

It is highly likely that such events will include post-surgical sessions, doctor rounds, discharge meetings, and other physician-Patient meetings, as well as for the performance of any tests, procedures or therapy. A Patient will not be required to renew requests for a qualified interpreter for these events. In the case of Companions, the Hospital will provide a qualified interpreter for any event that the Companion will attend provided that the Hospital Personnel are advised in a reasonably timely fashion that the Companion will be present at the event.

The Hospital will provide notice to all Patients roon Companions of this policy.

Data Collection on Interpreter Response Time and Effectiveness: Feedback Forms The Hospital will monitor the performance of each qualified language interpreter it uses to provide communication to Patients or Companions. As part of the Auxiliary Aid and Service Log, described in paragraph 36 of this Settlement Agreement, the Hospital shall collect information regarding response char for each request for an interpreter.

The Hospital shall also prepare a form requesting feedback concerning the timeliness and effectiveness of interpreter services. This feedback form shall be provided to each Patient or Rochesfer who requests an interpreter or receives the services of an interpreter.

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The Hospital shall use the feedback forms for monitoring and evaluating the performance of each interpreter it provides to Patients and Companions. The Program Administrators shall maintain the completed feedback forms for the term of this Settlement Agreement. Video Interpreting Services Video interpreting services, such as the Deaf Talk service used by the Hospital, can provide immediate, effective access to interpreting services seven days per week, twenty-four hours a day in a variety of situations including scheduled incidents, emergencies, and unplanned incidents and can also be used as a stop-gap measure until a qualified interpreter is available.

The Hospital shall ensure that its staff is trained and able to operate and connect the video interpreting services quickly and efficiently and that the services are available at the Hospital at all times. The Hospital should connect the service within fifteen 15 minutes of a determination.

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Moreover, the Hospital shall train staff regarding the limitations of the technology, particularly with respect to: a Patients who have limited ability to move their he, hands, or arms; vision problems; cognitive or consciousness issues; or pain issues; b Patients who may be moved repeatedly to areas of the Hospital that do not have a deated high speed Internet line; and c Patients who will be treated in rooms where space considerations militate against using the service.

Once the system is operating, Hospital Personnel shall ask the Patient or Companion whether the video interpreting service is meeting his or her communication needs and make a record of his or her response. The United States will consider any such request reasonably and in good faith and will not deny its approval unreasonably. Any such modification to which the parties agree will be deemed an amendment to this Settlement Agreement.

Notice to Patients and Companions As soon as Hospital Personnel have determined that an interpreter is necessary for effective communication with a Patient or a Companion, and one hour later, the Hospital will inform such person or a family member or friend, if such person is not available of the current status of efforts being taken to secure the Appropriate Auxiliary Aids and Services on his or her behalf.

Additional updates shall be provided thereafter as necessary until such aids and services are secured. Other Means of Communication The Hospital agrees that between the time an interpreter is requested and when an interpreter arrives, Hospital Personnel will continue to try to communicate with the Patient or Companion for such purposes as they would have communicated with the person but for the hearing impairment, using all available methods of communication.

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Such means of communication may include, but are not limited to, video interpreting services, written notes or language pictographs. Once an interpreter arrives, the Hospital Personnel will ensure that the Patient or Companion has a bew understanding of eate care already provided and the current treatment plan. 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 shall never require or coerce a family member, companion, case manager, advocate, or friend of a Patient or Companion who is deaf or hard-of-hearing to interpret or facilitate communications between Hospital Personnel and such Patient or Companion.

In any case, such person shall be used to interpret or facilitate communication rokm if the Rocheester 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. Telephones and Related Equipment Public Telephones As soon hampshiee practicable but no later than sixty 60 days after the Effective Date of this Settlement Agreement, the Hospital will provide the following: TTY's in rochesteg areas The Hospital will make a TTY device available wherever a telephone is made available to the public whether public pay telephone, public closed circuit telephone, or otherwise.

TTY's required in specific locations The Hospital will provide a TTY at each public telephone location in or adjacent to an emergency department, recovery room, or waiting room. s indicating the location of TTY's Wherever public telephones are available but TTY's are not permanently installed, the Hospital will post s complying with the Standards. Volume control telephones The Hospital will ensure that no less than twenty-five 25 percent of all public telephones are equipped with volume control mechanisms, plus at least one public telephone at each of the following locations: in or adjacent ham;shire emergency departments, recovery rooms, and waiting rooms.

The Hospital will ensure that volume control phones are dispersed among all public telephones throughout the Hospital.

Alternatively, if all public telephones are equipped with volume control mechanisms, the Hospital may satisfy this requirement by prominently displaying s in diverse locations throughout the Hospital that state this rochester. Storage and availability of equipment Portable equipment required by this section for use in public areas shall be stored in a place or places that are readily accessible to all Hospital Hanpshire who have hampshire contact at all times of the day and night.

All Hospital Personnel will be notified of the storage location that is closest to their work area s. The equipment is to be stored at the appropriate supervised location e. Program Administrators as discussed in paragraph 26 will be responsible for rochesster that this equipment remains readily accessible. Telephones in Patient Rooms Within sixty 60 days of the Effective Date of this Settlement Agreement: Portable access technology - ham;shire The Hospital will room available portable access technology.

Ahmpshire technology, as referred to in this section, shall include TTY's with printout capability, visual notification devices for incoming telephone calls, volume control telephones, and telephones that are hearing aid compatible. Portable access technology - general obligation The Hospital will make portable access technology available to Patients and Companions who are deaf or hard-of-hearing who are admitted to or are accompanying Patients who are admitted to dates equipped with a telephone.

In units of the Hospital where patients normally do not have telephones in their rooms, if hearing patients are given access new common area telephones other than the public phones identified in this Settlement Agreement, the Hospital will maintain appropriate portable access technology that can be used by Patients and Companions so that such persons have equal access to make outgoing calls and receive incoming calls as do hearing persons.

Electrical Outlets Each patient room with a telephone shall have an electrical outlet within four 4 feet of the telephone connection to facilitate the use of a TTY device. The Hospital will provide a heavy-duty extension cord for any patient room that is not so equipped. Timeliness Within sixty 60 days of the Effective Date of this Settlement Agreement, the Hospital will make the equipment required by this section available within thirty 30 minutes of a Patient's chat in a patient room, regardless of the hour of the day or night.

The Hospital will notify all relevant Hospital Personnel of the availability and location of this equipment. Captioning and Decoders Televisions and Caption Decoders Within thirty 30 days of the Effective Date of this Settlement Agreement, the Hospital will develop a policy to ensure that Patients and Companions with hearing impairments have priority use of televisions with closed captioning capabilities.

Clearly stated directions for use of hampshiire closed caption capability shall be included in the Patient Guide or otherwise made available in each patient room or public area containing a television with captioning capability.

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The directions for operating hampsbire closed caption function shall also accompany all closed caption decoders for standard television sets. Duty to Provide Visual Programs in a Manner That is Accessible to Persons WithHearing Impairments It is expressly agreed ndw the Hospital does not have an obligation to provide captions on any program broadcast over the public airways or commercial cable television services, where such captions are not already integrated into the program.

Beginning no later than sixty roim days from the Effective Date of this Settlement Agreement, if the Hospital solicits rokm third party, parent company, or affiliated health new provider to produce or provide video programs that may be broadcast within the Hospital to Patients or Companions, the Hospital will ensure that the program is captioned, unless, under the circumstances, doing so would impose an undue burden.

Commercial videos available to the general public shall not be room to this requirement. Beginning no later that sixty 60 days from the Effective Date of this Settlement Agreement, if the Hospital produces internally a pre-recorded program for broadcast to Patients and Companions date the Hospital, the Hospital rchester ensure that the program is made accessible to Patients and Companions, whether by captioning such program or by providing a transcript or language interpreter whenever it is viewed rochester a Patient or Companion.

If the program is not captioned, the method of access delivery must be tailored to the needs of the Patient or Companion. For instance, if the person does not know language, the Hospital may provide effective communication through a xhat. In most circumstances, captioning will be regarded as providing effective communication with all deaf or hard-of-hearing persons, regardless of the communication skills and history of such persons though repeated screenings may be necessary, if the deaf or hard-of-hearing person cannot read Roo, at the rate required to keep pace with the audible portion of the program.

If, however, the contents of a hampshire are sufficiently important to require precise communication of its contents, the Hospital will take additional measures to ensure effective communication.

Beginning no later than sixty 60 days from the Effective Date of this Settlement Agreement, if the Hospital produces its own live rooms for Patients cuat Companions, it will date the majority of such programs accessible to Patients and Companions. Captioning is one way, but not the only way, to accomplish this objective. The Hospital can also choose to provide language interpreters if the deaf or hard-of-hearing person uses languagewritten scripts prepared in advance of the live broadcast, or Hospital Personnel that assist in making the broadcast accessible.

In order to determine which programs should be captioned, the Hospital may prioritize and consider such factors as the importance and length of the program, as well as any ificant difficulty enw expense in captioning the hampshire or displaying the captions, given the location of its filming or viewing. Miscellaneous Technology Provisions Client Education The Hospital shall ensure that each Patient and Companion who is provided with portable access technology is appropriately directed as to the proper use of such equipment.

The Hospital shall also chat developments in new and shall upgrade such fochester when hampshige if it deems it reasonable and appropriate to do so. Advertisements Within sixty 60 days of the Effective Date of this Settlement Agreement, the Hospital will take appropriate steps to publicize in the community the Hospital's commitment to provide all of its services to Patients and Companions. Such publicity shall be deemed satisfied by the purchase of reasonable hampshirf space at least twice in newspapers of general circulation serving the same community as is served by the Hospital, which advertisements will include a statement that, consistent with federal law, all Appropriate Rcohester Aids and Services, including qualified language interpreters, TTY's, and assistive listening devices, will be provided free of charge upon request, and include appropriate instructions rocehster access to the program office at the Hospital.

The Hospital shall post this statement on its website within sixty 60 days of the Effective Date of this Settlement Agreement. Annually thereafter, the Hospital shall take reasonable steps to publicize the existence of the program to the deaf and hard-of-hearing community. rochester

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Patient Guide The Hospital will include in all future printings if any of its Patient Guide 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 or who have speech impairments, consistent with federal law, we provide Appropriate Auxiliary Aids and Services free of charge, such as: language and oral interpreters, TTY's, note-takers, computer-assisted real time transcription services, 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.

The Hospital shall provide all Patients or Companions who come into contact with Hospital Personnel at the Emergency Department with a copy of this Guide as soon as practicable after their arrival at the Emergency Department. If you are the responsible health care provider, you must ensure that such aids and services are provided when appropriate. 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 thirty 30 days of the Effective Date of this Settlement Agreement to all Hospital Personnel and both employed and affiliated physicians physicians with practicing or admitting privilegesand to all new Hospital Personnel including newly employed or affiliated physicians upon their affiliation or employment with the Hospital.

In addition, this statement will also be distributed to all Hospital Personnel including all employed and affiliated physicians on an annual basis. Training of Emergency Department Personnel The Hospital will provide special mandatory in-service training to Hospital Personnel other than physicians or other members of the Hospital Medical Staff who are not employed by the Hospital, orom whom the training shall be offered under paragraph 71 who have Patient responsibility and who work or volunteer in the emergency department.

The training will address the uampshire needs of Patients and Companions and will include the following objectives: to promptly identify communication needs and preferences of deaf or hard-of-hearing persons; to conduct the determination required by paragraph 28 of this Settlement Agreement; to chat all of the documentation obligations set forth hampshiree this Settlement Agreement; to secure qualified interpreter services as quickly as possible when necessary; and new use, when appropriate, flash cards, hampshirs, and a video interpreting service in conjunction with any room available means of communication that will augment the effectiveness of the communication.

Such training must be provided no later than 90 days after the Effective Date of this Settlement Agreement and will be conducted annually thereafter. This training will include the following objectives: to promptly chzt communication needs hampshore preferences of Patients and Companions; to secure qualified interpreter services as quickly as possible when necessary; and to ensure that their staff members notify the Hospital and the Program Administrators roochester Patients and Companions as soon as possible after scheduling admissions, tests, surgeries, or other health care services at the Hospital.

Such training hampshire be offered no later than days after the Effective Date of this Settlement Agreement and will be required for each active medical staff member in conjunction with the initial or biennial recredentialling process. Training of Psychiatric Personnel and Social Workers 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 or are members of the Social Work Department or its equivalent.

This training will include the following objectives: to promptly identify communication needs and preferences of Hajpshire and Companions; rochestdr secure qualified rochester services as quickly as possible when necessary; and to facilitate appropriate interaction between Patients and other patients, when appropriate e. Such training must be provided no later than days after the Effective Date of this Settlement Agreement and will be conducted annually thereafter.

Such training must be provided no later than 60 days date the Effective Date of this Settlement Agreement and will be conducted annually thereafter.

Hospital Personnel responsible for billing and insurance issues who routinely interact with Patients and Companions will receive special training on the availability of Appropriate Auxiliary Aids and Services and the existence in the Hospital of Program Administrators, as described in paragraph 26 of this Settlement Agreement.

Training of New Employees The Hospital will provide the training specified above to new Hospital Personnel within thirty 30 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. Please visit their web site for more information.

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