HHS Office for Civil Rights Issues Notice of Violation to Puerto Rico Psychiatric Hospital for Failure to Comply with Federal Civil Rights Laws on Disability

OCR takes enforcement action against San Juan Capestrano Hospital to strengthen access to health services and ensure effective communication for individuals who are deaf or hard of hearing

Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced the issuance of a Letter of Finding and Notice of Violation against the San Juan Capestrano Hospital, following a thorough investigation, for violating disability civil rights laws when it failed to provide a patient with a sign language interpreter, under Section 504 of the Rehabilitation Act (Section 504) and Section 1557 of the Affordable Care Act (Section 1557), laws which prohibit discrimination on the basis of disability.

"Effective communication during mental health evaluations is critical to ensure appropriate care and treatment for every patient. Patients who are deaf or hard-of-hearing must receive the same level of communication as patients without auditory disabilities," said OCR Director Melanie Fontes Rainer. "OCR will continue to rigorously enforce the laws and regulations in strengthening access to health services for individuals with disabilities to ensure equity and nondiscrimination in health care and human services."

Section 504 prohibits discrimination based on disability in any program or activity receiving federal financial assistance from HHS, while Section 1557 does the same with respect to certain health programs and activities. Collectively, Section 504 and Section 1557 prohibit any entity that receives Federal financial assistance from discriminating against qualified individuals with disabilities and requires an entity to take steps to ensure that communication with individuals with disabilities through the use of appropriate auxiliary aids and services is as effective as communication with others. OCR finalized important updates to the rules implementing Section 504 and Section 1557 this spring.

OCR received a complaint alleging the Hospital discriminated against a patient on the basis of disability by failing to provide a sign language interpreter for a court-ordered psychiatric evaluation at the Hospital, which denied the patient an equal opportunity to participate in or benefit from the Hospital's programs and services because of the disability. As a result of its investigation, OCR determined that:

• The patient was a qualified individual with a disability who used sign language as her primary form of communication;
• The patient needed a sign language interpreter to communicate effectively with others;
• The Hospital's use of handwritten notes, gestures, and lip reading was insufficient given the complexity of the communications required to perform a psychiatric evaluation and the centrality of communication to such an evaluation;
• The Hospital failed to take appropriate steps to ensure that communication with the patient was as effective as communication with persons who are not deaf or hard-of-hearing; and
• The Hospital failed to provide auxiliary aids and services where necessary to provide effective communication and afford the patient an equal opportunity to participate in and benefit from the Hospital's services.

OCR's determination advises the Hospital to contact OCR within thirty days and enter into a Settlement Agreement within sixty days. The Settlement Agreement outlines the actions that the Hospital must take to remedy the violations. If compliance has not been secured through a Settlement Agreement negotiation, the HHS division that has disbursed federal funding to the Hospital may take potential action. This action may ultimately result in limitations on continued receipt of HHS funds.

Click to read the Letter of Finding / Notice of Violation: https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/examples/disability/san-juan-capestrano-hospital-lof/index.html.

This action is just the latest in a series of efforts OCR has made to advance and protect the civil rights of people with disabilities. This includes the announcement of the Section 504 of the Rehabilitation Act of 1973 final rule and the Section 1557 of the Affordable Care Act final rule.

For more information on Section 504 of the Rehabilitation Act and how it protects individuals with disabilities, visit: https://www.hhs.gov/civil-rights/for-individuals/disability/index.html.

For more information on the nondiscrimination provisions in Section 1557 of the Affordable Care Act, visit: https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html.

If you believe that you have been discriminated against in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint for yourself or someone else at: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html.

Follow HHS OCR on X (formerly Twitter) at @HHSOCR.

Public link

Please use the above public link if you want to share this noodl on another website.