Definitions

Effective Communication

Effective communication with a Deaf or hard of hearing individual is defined as “communication that allows the person an equal opportunity to participate in, and enjoy the benefits of, a service, program, or activity.”

Covered Entities

Health care providers—whether a doctor’s office, a clinic, a hospital, a group practice, an urgent care provider, a general physician, a dentist, or some other type of health professional—are usually considered “covered entities” by federal civil rights laws that prohibits discrimination based on disability.

In the context of interactions with Deaf and hard of hearing individuals, covered entities are responsible for ensuring effective communication takes place.

Qualified Individuals

Qualified individuals with disabilities include patients, companions and patient representatives who:

• Have a physical or mental impairment that substantially limits one or more major life activities (such as hearing, speaking, sleeping, thinking, learning, working or the operation of a major bodily function);
• Has a record of such an impairment; and
• Is regarded as having such an impairment.

In healthcare settings, qualified individuals with disabilities must, with or without reasonable modifications, meet the essential eligibility requirements for the specific service, program or activity.

Examples:

• A 40-year-old hard of hearing individual would not be a qualified individual with a disability for a program limited to people over 55.
• A 15-year-old Deaf child would likely be a qualified individual with a disability for a vaccination program that is provided to all school-age children.

Primary Consideration

Primary consideration means that the covered entity will inquire as to the choice of auxiliary aid or service of the individual with a disability and will honor the expressed choice unless it can demonstrate that another equally effective means of communication is available.

Auxiliary Aids and Services

Auxiliary aids and services are devices or services that enable effective communication. Different auxiliary aids and services may be required for the same person at different times depending upon the complexity of the communication. Auxiliary aids and services may include, but are not limited to:

• qualified interpreters*
• note takers
• transcription services
• written materials
• telephone handset amplifiers
• assistive listening devices
• assistive listening systems
• telephones compatible with hearing aids
• open and closed captioning
• videophones
• cued language transliterators
• text telephones (TTYs)
• video relay service (VRS)
• refreshable braille display
• videotext displays, or other effective methods of making aurally delivered** materials available to individuals who are deaf or hard of hearing

* A “qualified interpreter” is an interpreter who is able to interpret effectively, accurately, and impartially, both receptively and expressively, using any necessary specialized vocabulary.

** “Aurally delivered information” is information that is delivered through sound, including through speech, intercoms, telephones, recorded messages, loudspeakers, alarms, etc.