Author: NC Services for Deaf & Hard of Hearing, (919) 874-2212
The Americans with Disabilities Act (ADA), and other federal laws, prohibit discrimination and seek to ensure equal opportunity for persons with disabilities in employment, state and local government services, public accommodations, commercial facilities and transportation.
In certain circumstances, providers are required to provide reasonable accommodations to qualified individuals with disabilities to ensure access to services. Accommodations could include a variety of things, including but not limited to the provision of auxiliary aids and availability of interpreters.
For individuals who are deaf, blind, deaf-blind, or hard of hearing, effective communication is paramount to achieving equal access to services. “Effective communication” is information that is equally clear and understandable to all parties. In a healthcare setting the lack of effective communication can lead to misdiagnoses and improper medical treatment, among other detrimental outcomes. All providers are expected and legally required to ensure that individuals with disabilities are provided with the resources reasonably necessary to ensure effective communication.
Communication aids could include: American Sign Language (ASL), written English, or Braille. Providers should cooperate with individuals to determine the best way to ensure effective communication for both the individual and the healthcare provider. As an example, if the most effective means of communication is through the use of ASL, the provider should utilize a qualified sign language interpreter which allows both parties to communicate in their preferred and natural language. Chapter 90D of the North Carolina General Statutes requires sign language interpreters to be licensed in order to provide services for a fee.
Expenses associated with hiring a translator or providing any other reasonably necessary communication aid are accounted for in Medicaid reimbursement rates. Failure to provide reasonably necessary accommodations to ensure effective communication is a direct violation of federal law and regulation as well as the Provider Administrative Participation Agreement (“Provider Agreement”) entered into by all Medicaid providers.
There are no circumstances under which the cost of providing reasonable accommodations may be passed on to the individual seeking services. The Department is authorized to withhold payment and/or terminate the Provider Agreement of a Medicaid provider that fails to comply with any applicable federal laws including the ADA.
Staff members from the NC Division of Services for the Deaf and Hard of Hearing (DSDHH) are available to provide consultation, guidance, and training to healthcare providers at no charge for purposes of ensuring effective communication for all individuals. Contact information the DSDHH regional centers can be found at www.ncdhhs.gov/divisions.dsdhh.
The following is a list of licensed sign language interpreters in North Carolina by region.
DSDHH Statewide Licensed Interpreter Area Directories:
• Raleigh
• Wilson
• Cued Language Transliterators (statewide)
• Interpreting Service Agencies (statewide)
Guidelines for procuring interpreting/transliterating services are available to assist healthcare providers in selecting an interpreter who is qualified to interpret in healthcare settings at available at: www.ncdhhs.gov/divisions.dsdhh.
Additional Resources:
• ADA