A recent discussion on the ACA (American Counseling Association) Open Forum caught my attention. Did you know that as a mental health provider you may be obligated to provide the costs for an interpreter for a deaf client?
According to the National Association for the Deaf:
Businesses and services providers must ensure effective communication with people who are deaf or hard of hearing under Title III of the Americans with Disabilities Act (ADA). This federal law applies to a wide range of “places of public accommodation,” including retail stores and the wide range of service businesses such as hotels, theaters, restaurants, doctors’ and lawyers’ offices, optometrists, dentists, banks, insurance agencies, museums, parks, libraries, day care centers, recreational programs, social service agencies and private schools. It covers both profit and non-profit organizations. Places of public accommodation must give persons with disabilities an equal opportunity to participate in and to benefit from their services. They must modify their policies and practices when necessary to provide equal access to services and facilities. In order to provide equal access, all public accommodations are required to provide auxiliary aids and services, such as qualified interpreters or captioning, when necessary to ensure effective communication.
Auxiliary aids and services must be provided unless the entity can demonstrate that doing so would fundamentally alter the nature of the service, or would constitute an undue burden (significant difficulty or expense). Whether or not a particular auxiliary aid or service constitutes an undue burden depends on a variety of factors, including the nature and cost of the auxiliary aid or service, and the overall financial and other resources of the business. The undue burden standard is applied on a case-by-case basis. Undue burden is not measured by the amount of income the business is receiving from a deaf or hard of hearing client, patient, customer, or member of the public. Instead, undue burden is measured by the overall financial impact on the whole entity. Therefore, it is possible for a business to be responsible for providing auxiliary aids and services even if it does not make a sale or receive income from a deaf or hard of hearing person, if the cost of the auxiliary aid or service would not be an undue burden on its overall operation.
For more information, see ADA Title III: Public Accommodations.
But what does this mean for me?
The general consensus on the forum seems to be that if you are working at an agency or hospital, then that agency or hospital is responsible for the costs of the interpreter, not you. However, if you are in private practice, you may be responsible for the bill, even if it exceeds the cost of your session.
As stated above, if you can prove “undue hardship” you will be exempted. But remember hardship isn’t calculated per session, but rather on how the cost would impact the business overall. For example, if you run a six-figure-per-year private practice, and a deaf client pays you $100 for a session for which you had to pay an interpreter $150, even though you just lost $50 on that client, because your business is so successful it may not be considered an “undue hardship.” Therefore you would be obligated to take on the client and lose $50.
As always with such matters, consult with your insurance company, an ACA ethics consultant, or your attorney.
Yours in the Joy of Knowledge,
Dr. Barbara LoFrisco
