United States of America v. Washington Hospital Center - Settlement Agreement

II. COORDINATION AND OVERSIGHT

A. ADA Officer.

1. Appointment. Within 30 days of the Effective Date of this Agreement, as such term is defined in Paragraph VIII.N. below, in order to oversee the implementation of this Agreement and to perform the additional functions described below, WHC shall appoint an ADA Officer. The ADA Officer position shall be maintained throughout the Term of this Agreement, as defined in Paragraph VIII.R. below. The individual selected to be the ADA Officer and his or her successors shall be subject to approval by DOJ, which approval shall not be unreasonably withheld. DOJ shall approve or reject the proposed individual within 15 days of its receipt of the proposed individual’s qualifications. Any person appointed under this paragraph shall be a regular employee of WHC and shall have experience in hospital administration and a background or training in disability issues. The ADA Officer must have authority within WHC to implement changes and effectuate this Agreement. WHC has appointed and DOJ has approved Ms. Renee P. Landry as the ADA Officer for WHC. Ms. Landry currently serves as Vice President of Support Services and has experience in hospital administration. She will attend training on Title III of the ADA as it applies to medical facilities and disability awareness within 60 days of the Effective Date of this Agreement. Such training and the person(s) or organization(s) who will conduct the training shall be selected by WHC and approved by DOJ, which approval shall not be unreasonably withheld.

2. Responsibilities. The ADA Officer shall serve as WHC’s primary administrative contact on disability issues for the public and for the parties to this Agreement. The ADA Officer will be responsible for WHC’s compliance with Title III of the ADA and Section 504, and for implementing and administering WHC’s obligations under this Agreement, including compliance with all reporting requirements herein. The ADA Officer, jointly with the designated consultant or expert, shall carry out the obligations set forth in Sections III - VI below. The ADA Officer shall be responsible for ensuring that disability-related issues and complaints raised by patients and others are addressed and for supervising the Environment of Care Committee with respect to resolving disability-related matters, as set forth in Paragraph II.C. below. The ADA Officer will consult with the Advisory Resource Group established pursuant to Paragraph II.G. below, as needed, in carrying out his or her responsibilities.

B. Patient Complaint Process.

WHC will use its existing Patient Complaint Process for patients with disabilities or their family members to submit complaints, comments, and questions regarding accommodation or treatment issues. The Patient Complaint Process provides a phone number for patients, their friends, family, and other guests to use to lodge a complaint with the Patient and Guest Services Department ("PGSD"). This phone number is currently designated the Customer Care Number and, as of the Effective Date of this Agreement, will also be designated the ADA Disability Assistance Number. While the process for raising an ADA concern will be the same as for other patient complaints, the ADA Disability Assistance Number and ADA Disability Assistance Process shall be separately designated as such on all materials describing these services. When a PGSD representative receives a disability-related complaint, s/he will investigate and try to resolve the complaint. If s/he is unable to do so, s/he will consult with either the Clinical Specialist or Non-Clinical Specialist designated for this process, depending on the nature of the complaint. The Clinical and Non-Clinical Specialists are management-level employees with an expertise in an area relevant to the resolution of disability-related issues (e.g., background in facilities, equipment, lifting mechanics, etc. for Non-Clinical Specialist; and patient care education/training for Clinical Specialist), selected by WHC to participate in the ADA Complaint review process. If the Specialist is unable to resolve the complaint, the Specialist will notify the ADA Officer, who will assist in resolving the complaint. All reasonable efforts must be made to resolve the complaint in a timely way; what is timely will depend on the nature of the complaint. The PGSD will maintain regular Occurrence Reports documenting each complaint received and its resolution. A chart illustrating the Patient ADA Disability Assistance Process is attached as Exhibit A hereto and hereby made a part of this Agreement.

1. Within 60 days of the Effective Date of this Agreement, the Clinical and Non-Clinical Specialists designated for the ADA Disability Assistance Process will attend training on Title III of the ADA as it applies to medical facilities and interacting with individuals with disabilities.

2. Within 30 days of the Effective Date of this Agreement, WHC shall place a sticker on each inpatient room telephone that depicts the International Symbol of Accessibility, the phone number for the ADA Disability Assistance Number, and to the extent space allows, the words “ADA Disability Assistance Number.” The sticker shall also be added to all telephones available for patients that have special adaptive features, such as voice-activated telephones and TTY telephones. TTY telephones shall also have a sticker on them with the local Relay number (711).

3. Within the next scheduled publication cycle of WHC’s Patient Information Guide, but no later than 120 days from WHC’s receipt of DOJ’s approval of the language for the ADA Brochure, WHC shall revise its Patient Information Guide to incorporate the information developed jointly with DOJ for WHC’s ADA Brochure, as set forth in more detail in Paragraph V.G. below. This information shall include an explanation of patients’ rights and remedies under the ADA and Section 504 in a hospital setting, and shall contain WHC’s ADA Disability Assistance Number and an explanation of WHC’s ADA Disability Assistance Process. The Patient Information Guide shall be made available to individuals with vision impairments in compliance with the policy on effective communication to be developed under Section V below.

C. Environment of Care Committee.

The Environment of Care Committee ("EOCC") is a multi-disciplinary standing committee that meets at least quarterly. Within 30 days of the Effective Date of this Agreement, the members of the Committee will include the Clinical and Non-Clinical Specialists described in Paragraph II.B. above, and representatives from other disciplines needed to address compliance with this Agreement as determined by WHC. The EOCC will be used to ensure that the Patient Complaint Process is effectively addressing requests for ADA assistance from patients with disabilities or their families or guests. The EOCC will receive regular reports from the PGSD containing summaries of ADA complaints sufficient to ensure that any institutional issues that are leading to recurring problems are addressed and resolved. If necessary, the EOCC will also be available to consider disability-related policy issues that arise through other channels, such as the review and development of WHC’s disability-related policies and procedures as set forth in Section V below. The EOCC will report to the ADA Officer.

D. ADA Consultant on Policies and Training.

Within 30 days of the Effective Date of this Agreement, WHC shall appoint an ADA Consultant on Policies and Training (“ADA Consultant”). The individual selected to be the ADA Consultant and his/her successors shall be subject to approval by DOJ and ERC, which approval shall not be unreasonably withheld. DOJ and ERC shall approve or reject the proposed individual within 15 days of receiving the proposed individual’s qualifications. The ADA Consultant shall have experience in policy and training development and a background or training in disability issues in the health care field. The ADA Consultant shall serve in a consulting capacity, not as a regular employee, and shall serve as long as needed to fulfill WHC’s obligations under this Agreement. The ADA Consultant shall be paid by WHC. WHC has appointed and DOJ and ERC have approved Paul R. Rao, Ph.D, to be the ADA Consultant. Dr. Rao is currently the Vice President of Clinical Services, Quality Improvement and Corporate Compliance at National Rehabilitation Hospital in Washington D.C., and an expert on policy development, rehabilitation facilities and stroke rehabilitation.

The ADA Consultant on Policies and Training, jointly with the ADA Officer, will review, revise, and create policies and procedures relating to the treatment and care of individuals with disabilities, and will develop and coordinate the training program, as set forth in Sections V and VI below. The ADA Consultant may consult with the Advisory Resource Group, as necessary to obtain feedback and insight, as set forth in Paragraph II.G. below.

E. ADA Equipment Expert.

Within 60 days of the Effective Date of this Agreement, WHC shall appoint an ADA Equipment Expert. The individual selected to be the ADA Equipment Expert and his/her successors shall be subject to approval by DOJ, which approval shall not be unreasonably withheld. DOJ shall approve or reject the proposed individual within 15 days of its receipt of the proposed individual’s qualifications. The Equipment Expert shall have knowledge of the ADA and the needs of individuals with disabilities relating to using medical equipment, and shall have or be able to acquire knowledge of medical equipment currently available on the market and under development, especially with regard to adaptive equipment, and of the medical equipment needed to provide equal access to medical services for individuals with disabilities (e.g., padded leg supports on a gynecological exam table). The Equipment Expert shall survey certain equipment and determine necessary acquisitions and modifications, jointly with the ADA Officer, as set forth in Paragraph IV.C. below. The Equipment Expert shall consult with the Advisory Resource Group, as needed, regarding the survey of equipment, as set forth in Paragraph II.G. below.

F. ADA Architectural Expert.

Within 60 days of the Effective Date of this Agreement, WHC shall appoint an ADA Architectural Expert. The individual selected to be the ADA Architectural Expert and his/her successors shall be subject to approval by DOJ, which approval shall not be unreasonably withheld. DOJ shall approve or reject the proposed individual within 15 days of its receipt of the proposed individual’s qualifications. The Architectural Expert shall be responsible for surveying the WHC facility for architectural barriers, and for determining, jointly with the ADA Officer, appropriate barrier removal, as set forth in Section III below. The Architectural Expert shall have expertise in conducting ADA architectural compliance surveys, preferably in a medical setting.

G. Advisory Resource Group of Persons with Disabilities (“Advisory Resource Group”).

Within 60 days of the Effective Date of this Agreement, WHC shall appoint a resource group comprised of individuals with disabilities, who also have specific professional knowledge regarding the provision of health care to people with disabilities, to serve in an advisory capacity to the ADA Officer, ADA Consultant, and ADA Equipment Expert, as set forth in Paragraphs II.A., II.D., and II.E. above. The individuals appointed to the Advisory Resource Group and their individual successors shall be subject to approval by DOJ, which approval shall not be unreasonably withheld. The Advisory Resource Group or individual members of the Advisory Resource Group with the appropriate knowledge and experience shall be consulted with regard to the development of policies, the development of the training program, equipment purchases, and any other issues for which the input of the Advisory Resource Group will be helpful. The group members may be employees of WHC, MedStar, or its affiliates.