Health Reform WK-EDGE No sovereign immunity defense for hospital’s denial of sign language interpreter
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Tuesday, November 7, 2017

No sovereign immunity defense for hospital’s denial of sign language interpreter

By Jeffrey H. Brochin, J.D.

Louisiana State University’s Medical Center (UMC) failed to provide an American Sign Language (ASL) interpreter for a deaf patient, and was not entitled to sovereign immunity from a lawsuit brought pursuant to §1557 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), a federal district court in Louisiana has ruled. Sovereign immunity did not apply because part of a state health program or activity was the recipient of federal financial assistance (Esparza v. University Medical Center Management CorporationOctober 24, 2017, Africk, L.).

Background. A deaf patient who visited a UMC hospital on a number of occasions between October, 2016 and March, 2017 to receive medical care was not provided with a qualified ASL interpreter to assist her in communicating with staff and with learning healthcare-related information. Instead, the hospital offered her the use of a Video Remote Interpreting (VRI) machine; however, the patient alleged that use of the machine was not appropriate during certain visits because she had limited ability to sign with both hands due to an arm injury, and because the machine took several hours to set up. She filed suit alleging discrimination under §1557 of the ACA. The court denied the hospital’s and the university’s motions to dismiss.

Implied private right of action. The first issue the court considered was whether §1557 of the ACA provided an express private right of action for the patient, and if it did not, whether the act provided an implied one. The court ruled that the ACA does not provide an express private right of action under §1557. However, the court applied the appropriate four-factor test to determine whether an implied private right of action existed: (1) does the statute create a federal right for this person?; 2) is there evidence of a legislative intent to create or deny a private remedy?; (3) is a private remedy consistent with a legislative scheme?; and (4) is the cause of action traditionally relegated to state law? The court found that the answers to those questions resulted in an implied private right of action.

Sovereign immunity not waived. The hospital and the university filed motions to dismiss citing 11th Amendment sovereign immunity as a bar to adjudicating the issues in federal court. The court rejected this argument and pointed to the language of 42 U.S.C §2000d-7which provides that a state is not immune under the 11th Amendment for a violation of the provisions of federal statutes "prohibiting discrimination by recipients of federal financial assistance."

Because the university was the recipient of federal financial assistance, the court rejected the argument that they were immune from liability, specifically noting that if Congress did not intend §1557 to turn on the receipt of federal financial assistance, then all Congress had to do was delete those words from the statute. Accordingly, the court held that § 2000d-7 applies to §1557 of the ACA.

The case is Civil Action No. 17-4803.

Attorneys: Andrew David Bizer (Bizer Law Firm, LLC) for Kimberly Esparza. Leslie A. Lanusse (Adams and Reese LLP) for University Medical Center Management Corp. and Louisiana Children's Medical Center.

Companies: University Medical Center Management Corp.; Louisiana Children's Medical Center

Cases: CaseDecisions AccessNews LouisianaNews

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