5. Getting Changes Made
You made it through your visit, but you noticed some accessibility problems that need to be fixed. What do you do next?
5.1 Tell the Doctor and the Staff
Often, the health care facility is unaware that any problems exist and simple statements will make them aware of barriers. For example, you could say, “Did you know that the front door is very heavy and difficult to open?” Or you could say, “There isn’t a curb cut onto the sidewalk from the accessible parking and I had to roll in the street for a block.” In many offices, the office manager is responsible for purchasing new equipment and would be the best person to talk to.
5.2 Offer Suggestions
Be prepared to offer solutions. For example, you might say, “If you remove two chairs from the waiting room, it would be much easier for a wheelchair user to wait in and to get through the area.” Or you might say, “An accessible table would reduce the amount of lifting your staff has to do to help people get onto the exam table.”
5.3 Write a Letter
If you are not comfortable speaking with someone about the issues during your visit or there is not an opportunity to do so, or you do not get results from verbal requests, write a letter. Be sure to include specific information and resources on accessible equipment and the ADA.
5.4 Be Persistent, Strong and Clear
Do not accept “We’ll look into it” as an acceptable response. Ask for a specific timeline and follow up, for example, during your next appointment. Giving reminders and being persistent can be useful if you do not get immediate results.
5.5 Seek Assistance
Contact disability-focused organizations, such as a legal rights organization, Protection and Advocacy Service, or Center for Independent Living, and ask them if they can help you with your advocacy efforts.
5.6 File a Complaint with the Department of Justice
If your direct efforts do not work, you can file a formal complaint. The process can be lengthy, but it can also get results. Here is a brief description of the steps.
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Send a letter to the US Department of Justice with your contact information, the information about the facility that you believe has violated the ADA, and a description of the violation or discrimination you experienced.
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Your letter will be reviewed by the Disability Rights Section of the US Department of Justice. They will follow up and contact you to get any additional information they need to take the next steps, depending on the complaint.
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Complete information about how to file a Department of Justice complaint can be found on the Internet at http://www.ada.gov/enforce.htm
5.7 File a Lawsuit
Contact a legal aid organization or a lawyer for advice about taking legal action. You can find a lawyer through a referral organization (check your state Bar Association) or disability rights organizations. The cost will depend on the type of lawsuit you file, the lawyer or organization you work with, your ability to pay, and/or the outcome of the case. The process will involve a significant commitment of your time and energy, but the outcome can benefit you as well as many other people.
Sample Letter
Date
Dr. Ben Barrier
500 No Access Avenue
Speak Up, NOW 00000
Dear Dr. Barrier:
I was in your office for my appointment on Friday, May 12, 2007 at approximately 2 PM. If you recall, I have Cerebral Palsy and use a wheelchair for mobility. I am writing to bring to your attention some of the problems I encountered while at your office and suggest some solutions.
I was able to get into your office without difficulty, but the waiting room was too crowded for me to maneuver my wheelchair without moving chairs and disturbing your other patients. There appears to be enough room to simply rearrange the chairs to allow a 36-inch pathway. It would also be helpful to leave a couple spaces next to the chairs for someone using a wheelchair to sit. The restroom also was difficult to use without grab bars.
Though these were inconveniences, the biggest issue was the lack of an accessible exam table. I was not able to get onto your exam table without being lifted. An exam table that lowers to wheelchair height, 17 – 20 inches from the floor, would give me, and many others who have difficulty getting on the high tables, the ability to receive a thorough examination without the embarrassment and risk of injury associated with being lifted. I am enclosing information about accessible exam tables..
Please seriously consider purchasing an accessible exam table so you can provide quality health care to all of your patients. This accommodation along with changes to the waiting room and restroom would make your office more accessible to people with disabilities and activity limitations and more compliant with the Americans with Disabilities Act. Please contact me if I can provide any additional information. I look forward to hearing from you within the next three weeks.
Sincerely,
Ada Advocate
1000 Usability Way
Speak Up, NOW 00001
You can make a difference. A survey of 379 Massachusetts health care providers found that 60% of them made access changes in order to comply with the ADA and 33% made access changes in response to patient requests or recommendations.6
So you see, it pays to speak up and to bring accessibility barriers to the attention of health care providers. When you speak up, you make problems clear and noticeable, which may be enough to cause change. In addition, it is helpful to speak up even if you personally do not need the access. When you speak up, you remind health care professionals that a sizable portion of the people they serve will benefit from removing the barriers you point out.
Barriers in health care settings can greatly affect the quality of health care you receive. Your health is worth the hassle: The goal is to protect it, not neglect it! Remember, you have the right to the same equal access to health care as that provided to others.
6 Drainoni, M., Vedrani, M., Andrew, J., Bachman, S., Tobias, C., Weppler, S. (2003). Access to Health Care Services for Persons with Disabilities: Defining the Barriers and Successful Strategies for Change, Final Report, available from: Dr. Drainoni, Boston University School of Public Health, 200 Springs Road #152, Bedford, MA 01730, (781) 687-2867, fax: (781) 687-3106, drainoni@bu.edu.
It is your health,
It is your choice,
It is your voice,
It is your life.
Do not give up!
Fight the fight!
Make a difference!
To expect less, to demand less,
Does an injustice to you and
To those who come after you!
For 18 years, John, in his early 60’s with quadriplegia from a spinal cord injury, urged his health care clinic to install an accessible exam table. The clinic refused. Often no one was available to lift him onto the standard-height table and his clinicians frequently performed examinations from John’s wheelchair. His clinicians missed the pressure ulcer developing on his buttocks. When they finally examined him about a year after it began, the ulcer was infected and required surgery. In addition to the physical and psychological damage to John, this inaccessible and inadequate care caused a medical condition that was far more costly to treat than it would have been to prevent.
John used the ADA to help create change. He and two other wheelchair users sued Kaiser Permanente because they failed to provide equitable and adequate care for people with physical disabilities. It was the landmark case with a settlement agreement that required huge changes for Kaiser, including removing physical barriers, installing accessible exam tables and scales, and providing staff training on providing accessible health services to people with disabilities. This example shows how one person made a big difference in shaping how a major health care system provides care to people with disabilities. John and many other people with disabilities will have access to health care with fewer barriers because he took action.
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