This is an issue that many medical offices struggle with. Title VI of the Civil Rights Act states that if you receive money from any federal program (Medicare, Medicaid, etc), you must ensure that there is no barrier to care for any patient that speaks another language. The financial burden falls on the provider of health care and can be especially challenging for smaller offices, since they do not typically have trained interpreters on staff.
While our clinic has Spanish and Russian translators on staff, we do not have someone who is fluent in sign language. When we see these patients we do a number of different things....we might communicate by writing (or by typing on a laptop) if the patient is able to do that, we might also contact one of the two hopsitals that our physicians have privileges at - larger hospitals often have a physician relations representative and often they are willing to help out in a difficult situation (i.e. by sending a hospital interpreter over).
Good luck....on the face of it, ensuring that there is no barrier sounds very noble but when the reimbursement for a Medicaid or Medicare visit is pennies on the dollar, it feels very unfair to pay more to an interpreting service than we ourselves are getting paid. Take heart....we have a Spanish Speaking, Deaf and illiterate patient that we sometimes see....now there's a challenge.