Accessible Health Care Briefs: CHOOSING AND NEGOTIATING AN ACCESSIBLE FACILITY LOCATION

1. INTRODUCTION

1. a. Complying with the ADA

The major pieces of federal legislation governing equal access to health care services for individuals with disabilities are the Rehabilitation Act (Rehab Act) and the Americans with Disabilities Act (ADA). These laws constitute a national mandate prohibiting discrimination based on disability in the provision of goods and services available to the public.

Section 504 of the Rehab Act prohibits any organization that receives federal financial assistance from denying individuals with disabilities equal access to the services. For example, hospitals, clinics, and other health care facilities that accept Medicaid, Medicare, or any other form of federal funding must comply with the Rehab Act. Section 504 states, “No otherwise qualified individual with a disability . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” If the provider serves just one Medicare or Medicaid beneficiary, that provider’s entire operations must comply with the Rehab Act. Medicare and Medicaid managed care plans must provide programmatic access to all its enrollees with disabilitiesⁱ

ADA’s Title II extends the Rehab Act’s requirements to all state and local government activities. All health care providers who offer health care services, either directly or through contractual arrangements, to Medicare or Medicaid beneficiaries must comply with the Rehab Act because Medicare and Medicaid funding is considered federal financial assistance.

ADA’s Title III 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 by any person who owns, leases (or leases to), or operates a place of public accommodation.”ⁱⁱ

All health care providers, including hospitals, nursing homes, psychiatric and psychological services, private physicians’ offices, diagnostic centers, physical therapy centers, and health clinics, are places of public accommodations and therefore must comply with Title III.ⁱⁱⁱ

1. a. Private Businesses that Serve the Public

If you own, operate, lease, or lease to a business that serves the public, then, you are covered by the ADA and have compliance obligations for:

• Existing facilities,

• Altered facilities, and

• When a new facility is constructed.

While it is not possible for many businesses, especially small businesses, to make their facilities fully accessible, much can be done without much difficulty or expense to improve accessibility. Therefore, the ADA requires that accessibility be improved without taking on excessive expenses that could harm the business. (See: CDIHP Brief: Improving Accessibility with Limited Resources), www.cdihp.org/products

*Existing facilities are not exempted by "grandfather provisions" that are often used by building code officials.