SETTLEMENT AGREEMENT BETWEEN THE UNITED STATES OF AMERICA AND MOUNTAIN STATES HEALTH ALLIANCE UNDER THE ADA

TITLE III COVERAGE AND FINDINGS

5. The United States Attorney for the Eastern District of Tennessee (“U.S. Attorney’s Office”) is authorized under 42 U.S.C. § 12188 and 28 C.F.R. Part 36, Subpart E, to investigate the allegations of the complaint in this matter to determine MSHA’s compliance with Title III of the ADA.  The U.S. Attorney’s Office has the authority to, where appropriate, negotiate and secure the full range of relief available under Title III of the ADA, including equitable/injunctive relief, requiring the provision of auxiliary aids and services, and seeking monetary damages and a civil penalty. 

6. Ensuring that medical care providers do not discriminate on the basis of disability is an issue of general public importance.  The United States is authorized to investigate alleged violations of Title III of the ADA and to bring a civil action in federal court in any case that involves a pattern or practice of discrimination or that raises issues of general public importance.  42 U.S.C. § 12188(b).

7. The Cantrells are individuals with disabilities within the meaning of the ADA.  They are deaf and use American Sign Language as their primary means of communication.  42 U.S.C. § 12102; 28 C.F.R. § 36.104.

8. MSHA is a private, not-for-profit corporation that operates in Tennessee and Virginia.  JCMC is a “public accommodation” within the meaning of Title III of the ADA, 42 U.S.C. § 12181(7)(F), and its implementing regulation at 28 C.F.R. § 36.104, because it is a private entity that operates places of public accommodation, including professional offices of health care providers and hospitals.

9. Under Title III of the ADA, no person who owns, leases (or leases to), or operates a place of public accommodation may discriminate against an individual on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation.  42 U.S.C. § 12182(a); 28 C.F.R. § 36.201(a).

10. As a result of its investigation, the United States has determined that:

11. JCMC did not take appropriate steps, including the provision of notice, to the Cantrells regarding their rights under the ADA or the availability of auxiliary aids and services that JCMC could provide.

12. JCMC either did not consult or did not sufficiently consult with the Cantrells to determine what type of auxiliary aids were needed to ensure effective communication.

13. Sydnei Cantrell spent one hundred and fifteen (115) days in JCMC, a MSHA hospital, during the last six months of her life.  During those admissions, the Cantrells, either both or one of them, were by their daughter’s side each day.  The Cantrells were companions, as defined by the Title III regulation, and as such, MSHA was obligated to provide effective communication to the Cantrells. 

14. The Cantrells both have a physical impairment which substantially limits the major life activities of hearing, speaking, receptive spoken communication, and expressive spoken communication.

15. The Cantrells require the services of a qualified American Sign Language interpreter to effectively communicate about lengthy and complex information, especially about the medical treatment and health of their daughter.

16. There were multiple interactions between the Cantrells and MSHA personnel and MSHA Affiliated Physicians where it was inappropriate for JCMC to rely on Sydnei Cantrell or another family member to provide interpretive services.

17. There were multiple interactions between the Cantrells and MSHA personnel and MSHA Affiliated Physicians that required an auxiliary aid or service but none was provided.

18. On the basis of its investigation, the United States has determined that MSHA denied the Cantrells appropriate auxiliary aids and services necessary for effective communication during their daughter’s treatment and stay in JCMC.  The aforementioned actions of MSHA are in violation of 42 U.S.C. § 12182(b)(2)(A)(iii); 28 C.F.R. § 36.303.

19. The Cantrells are aggrieved persons pursuant to 42 U.S.C. § 12188(b)(2)(B).

20. In consideration of the terms of this Agreement, the United States agrees to refrain from intervening in the pending civil suit, Cantrell v. Mountain States Health Alliance, Case No. 2:15-CV-324 (E.D. Tenn.), or filing its own civil suit in this matter regarding the areas covered under the Equitable Relief section of this Agreement, except as provided in the Enforcement section of the Agreement.

21. While denying many of the allegations raised by the Cantrells, but, in a spirit of cooperation toward ensuring full compliance with Title III of the ADA and in consideration of the United States’ agreement to refrain from possible litigation as set out below, MSHA agrees to take the actions specified in this Agreement.