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Six-figure Inova settlement sheds light on patient-care issues

Six-figure Inova settlement sheds light on patient-care issues

Hearing-impaired not provided full services, advocate says

By Gregg MacDonald, 4/9/11

A federal complaint against Inova Health System has questioned whether medical facilities within Fairfax County are meeting patient requirements set forth in the American Disabilities and Rehabilitation acts.

Inova Health System has agreed to a $145,000 settlement after the U.S. Department of Justice filed a complaint on behalf of a hearing-impaired couple who claimed they were not properly provided with a sign-language interpreter after their newborn son developed medical complications while in Inova Fairfax Hospital.

The complaint, filed March 28 with a consent decree in the U.S. District Court for the Eastern District of Virginia, claimed Inova violated the laws by failing to provide appropriate auxiliary aids and services, including sign-language interpreter services, to the couple and other hearing-impaired individuals at Inova Fairfax Hospital.

According to the complaint, hearing-impaired individuals were denied the benefit of effective communication with hospital staff, the opportunity to effectively participate in medical treatment decisions, and the full benefit of health care services provided by Inova Fairfax Hospital.

Among its provisions, the ADA requires doctors, hospitals and other health care providers to provide equal access to patients and companions who are deaf or hard of hearing.

When medical services involve important, lengthy or complex oral communications with patients or companions, hospitals are required to provide qualified sign-language interpreters and other auxiliary aids, free of charge, to individuals who are deaf, are hard of hearing or have speech disabilities.

"Inova Fairfax Hospital is pleased to have resolved a dispute with the Department of Justice and a deaf couple involving accessibility for deaf and hard of hearing patients and their companions," Inova management said in a statement. "A consent decree negotiated three ways -- between the hospital, the Justice Department, and the deaf couple -- is intended to ensure that the hospital meets the needs of the deaf and hard of hearing community we serve through an improved system to deploy sign language interpreters and assistive technology."

The consent decree requires Inova Health System to pay $95,000 to the couple, as well as a $25,000 civil penalty to the U.S. Treasury; provide training to hospital staff on requirements of both laws; and adopt policies and procedures to ensure that auxiliary aids and services are promptly provided to patients or companions who are deaf or hard of hearing. Inova Health System also has separately agreed to pay a total of $25,000 to two other hearing-impaired individuals.

Although Inova was the target of the complaint, it might not be the only health care provider not meeting the federal requirements, according to Cheryl Heppner, executive director of the Northern Virginia Resource Center for Deaf and Hard of Hearing Persons.

"The ADA is very specific that health care providers must provide interpreters or aides to deaf or hard of hearing patients at their own expense, but obviously not everyone does. We often call physicians and other healthcare workers to educate them about that fact after we are contacted by their patients," she said.

According to Heppner, Fairfax County has more than 100,000 residents who are deaf or hard of hearing.

"I regularly receive calls from deaf or hard of hearing people who have problems getting access to interpreters or aides during health care procedures," she said. "This is not just a problem in hospitals but also in doctor's offices, health clinics and all aspects of health care."

Cost could be of the reasons for noncompliance.

The nonprofit Fairfax-Falls Church Community Services Board serves residents with mental health needs, substance abuse disorders and intellectual disabilities. The organization also assists infants and toddlers with developmental delays.

"When needed for any of our service areas, we access sign-language interpreters contracted through the county government," CSB spokeswoman Belinda Buescher said. "For the entire 2010 fiscal year, the CSB spent $112,178 for sign language interpreters. For the first seven months of [fiscal year] 2011 [July 2010 through January 2011] we spent $73,457 on sign-language interpreters, which was up 11.1 percent from the same period in [fiscal year] 2010."

But Heppner said unless the cost of providing interpreters or other aides for the hearing-impaired proves to be an "undue burden" on a health care facility, adequately providing them for the hearing-impaired is federal law, as Inova found out the hard way.

Heppner said the costs for these services should be factored into the cost of doing business for physicians and health care clinics.

"They should just think of it in terms of any other business expenditure, such as heating or electrical bills or staff costs," she said.

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