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Regulations: To prevent discrimination & ensure effective communication, places of public accommodation are generally required by federal law, to provide auxiliary aids to Deaf people such as the provision of a qualified interpreter. This includes providing ‘meaningful access’ to services for Limited English Proficient persons.

Regulation Guidelines and Resource Information

Tax Credits: To assist businesses with complying with the ADA, Section 44 of the IRS Code allows a tax credit for small businesses and Section 190 of the IRS Code allows a tax deduction for all businesses.

Tax Incentives for Businesses Tax Incentives for Improving Accessibility


Title III of the ADA applies to all private health care providers, regardless of the size of the office or the number of employees. It applies to providers of both physical and mental health care. Hospitals, nursing homes, psychiatric and psychological services, offices of private physicians, dentists, health maintenance organizations and health clinics.

Yes. To prevent discrimination and to ensure effective communication, places of public accommodation are generally required by federal law i.e. Americans with Disabilities Act ADA, Rehabilitation Act, and Civil Rights Act; to provide auxiliary aids to Deaf and hard of hearing people such as the provision of a qualified American Sign Language Interpreters or captioning services.

Places include retail stores, hotels, theaters, restaurants, doctors’ and lawyers offices, optometrists, dentists, banks, insurance agencies, museums, parks, libraries, day care centers, recreational programs, social services agencies, all types of state and local government agencies, and private schools. Also, both profit and non-profit organizations. All must give persons with disabilities an equal opportunity to participate in and to benefit from their services.

People who are Deaf or hard of hearing use a variety of ways to communicate, some rely on sign language interpreters or assistive listening devices, some rely primarily on written messages. Many can speak even though they might not be able to hear. The communication option that the hospital/organization/business provides will vary depending on the abilities of the person who is Deaf or hard of hearing and the complexity and nature of the required interaction/communication.

All healthcare providers are expected to treat the cost of providing auxiliary aids and services as a part of the annual overhead costs of operating a business. Interpreting services should be budgeted as part of your annual planning for accessibility services. It is true that on a pre-encounter basis, you may pay more for interpreting services than you generate in revenue for your company. However, if you consider the cost over the course of a year as an overhead cost of doing business, providing accessible services is quite reasonable.

The Deaf consumer is not responsible to place a service request, but the entity (paying party) is. All places should have predetermined protocols and trained staff members to ensure they know how to obtain interpreter services and other communication aids and services when needed by persons who are deaf or hard of hearing. The public entity, no matter whether they are a profit or non-profit organization. This especially holds true for any public entity who receives any kind of federal funding (including medicare/Medicaid).

Generally, no. Family members often do not possess sufficient sign language skills to effectively interpret in a medical setting. Even if they are skilled enough in sign language to communicate, family members and friends are very often too emotionally or personally involved to interpret “effectively, accurately, and impartially.” Finally, using family members and friends as interpreters can cause problems in maintaining patient confidentiality. Problems with using a friend or family member could be one or more of the following: objectivity, skill level, confidentiality, liability.

Businesses, agencies and other public facilities are required to provide accessibility for specified disabilities and for Deaf clients. This means they are being provided access to communication. Thus, the cost falls upon those who are providing the accommodations. The use of qualified sign language interpreters is a convenient, cost-effective way to provide such access.

A surcharge cannot legally be imposed on an individual with a disability directly or indirectly to offset the cost of the interpreter. The cost of the interpreter should be treated as part of overhead expenses for accounting and tax purposes.

The doctor may not charge the patient for the cost of interpreter service, either directly or by billing the patient’s insurance carrier: A public accommodation may not impose a surcharge on a particular individual with a disability or any group of individuals with disabilities to cover the costs of measures, such as the provision of auxiliary aids, barrier removal…and reasonable modifications… that are required to provide that individual or group with the nondiscriminatory treatment required by the Act or this part.