Three Federal Mandates that Ensure Access for Deaf Patients


There are three federal mandates created to ensure that people with disabilities have equal access to quality healthcare. Title VI of the Civil Rights Act of 1964 outlines requirements for providing language access in healthcare facilities that accept any type of federal funding. Section 504 of the Rehabilitation Act of 1973 states that any facility which receives federal funds, either directly or indirectly, must make all services accessible to people with disabilities. Furthermore, the Americans with Disabilities Act (ADA), passed in 1990, prohibits discrimination of individuals with physical or mental impairments.


The mandates of the ADA extend to both federally funded facilities and private health care providers. The ADA also mandates that physicians provide auxiliary aids that are necessary to provide effective communication, such as onsite interpreters, video remote interpreters, note-takers, captioning and assistive listening devices. Routinely overlooked by providers is the ADA requirement that accommodations also be made for the person who is with the patient (i.e. deaf or hard of hearing friend, or a family member of a hearing patient)

VRI is An Excellent Option if Guidelines are Followed

What can providers do now to ensure compliance without compromising patient care? Onsite interpreters can be expensive for medical providers when factoring in a minimum hourly fee plus the cost of travel for each interpreter. One option is the use of computer technology, WiFi, high speed Internet and state-of-the-art video interface devices that enable hospitals to deliver high quality care while maintaining compliance. Video Remote Interpreting (VRI) is an excellent resource for providers if certain guidelines are followed:

  • Equipment must be high quality and the monitor must be large enough to see. Audio needs to be loud and clear enough for everyone in the room to access.
  • Internet speeds should be high with wide bandwidth and a dedicated connection to provide high-quality video images that do not produce lags, choppy, blurry or grainy images, or irregular pauses in communication.
  • Providers should receive adequate training on the use of this technology in order to set it up quickly and efficiently. Providers also need to recognize when this technology can not be used due to medical or situational circumstances (e.g., limited mobility, vision or cognitive issues, or other limitations).
  • Provide information to Deaf and hard of hearing patients about the resources available to them, including onsite sign language and oral interpreters, video remote interpreting services, written materials, telephone handset amplifiers, assistive listening devices and systems, telephones compatible with hearing aids, televisions with caption capability or closed caption decoders.
  • And, with any patient in a healthcare setting, be sure to have an advocate present to ensure effective communication.

Hospitals are mandated to provide quality, effective communication for their Deaf patients and VRI is one way to meet that obligation. Deaf patients are entitled to quality and effective communication whether that comes in the form of an onsite or video remote interpreter. If VRI proves to not be effective due to environment, patient logistics, technology issues or lack of quality interpreting, an onsite should be requested.

While patient preference or even hospital preference may be the reason an onsite or VRI is initially requested or refused, the ultimate goal is clear, effective communication that satisfies legal obligations, protects patient care, and ensures efficient, accurate and cost effective language access.

For more information about ADA Law and the requirements healthcare providers need to know about providing qualified interpreters, Download the ADA Healthcare Q&A.

Site translation by Certified Deaf Interpreter Steven Stubbs. 

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