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  • Steve Tomkowiak

American Sign Language Assistance Required in Health & Senior Housing Settings

Senior living and assisted living facilities that receive federal funds are subject to the Americans with Disabilities Act, as well as the Rehabilitation Act of 1973 and the Patient Protection and Affordable Care Act. These laws require housing facilities to provide American Sign Language interpreters or assistive listening devices for residents for certain interactions.

Additionally, regardless of federal funding, housing facilities may also be required to provide ASL services and other assisted listening devices as a reasonable accommodation under the Fair Housing Act.

What is American Sign Language?

ASL is used to communicate concepts visually through manual hand signs, gestures, and facial expressions. While most people believe ASL is a gestured form of English, ASL instead is its own visual, three-dimensional language. ASL uses grammar and syntax that differs from English and other spoken languages. In many instances, there is no one-to-one correspondence between signs in ASL and English words. Consequently, ASL is regarded as a distinct language.

Another common misconception is that lip-reading provides an effective means of communication, however it isn’t a substitute for ASL. Only 20-30% of spoken English is visible on the lips. Of the small percentage of spoken words that are visible, many appear identical to each other. As a result, an experienced lip reader will only see about 30% of what is said and must guess the rest. Less experienced lip readers see much less than 30% of what is said.

Why are ASL services so important?

ASL is the primary language and means of communication for many deaf individuals and ASL is the sixth most common language in the U.S.

Because of the importance of hearing and sound in learning an oral language like English, it is very difficult for a deaf individual to learn English, especially if the hearing loss is prelingual. As a result, many people who are deaf are functionally illiterate in English, including the written word.

Therefore, it is important to have an ASL interpreter available, especially for complicated and important conversations pertaining to healthcare and other significant life affairs. ASL interpreters and services are needed in a variety of settings, including:

  • Medical diagnosis and treatment

  • Business and financial affairs

  • Education and training

  • Interviews and training

  • Housing

When are ASL services required?

ASL services are required in places of public accommodation, such as medical, business and educational establishments that are open to the public. The ADA states: “No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation.”

Discrimination under the ADA includes the “failure to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services.” The ADA defines “auxiliary aids and services” to include “qualified interpreters or other effective methods of making aurally delivered materials available to individuals with hearing impairments.”

The Fair Housing Center of Metropolitan Detroit is available to answer questions concerning ASL services and other housing-related matters, free of charge, to Wayne, Oakland and Macomb County residents. For more information, visit or call 313.579.FAIR(3247).

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