Ada and health conference 2011


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Ada and health conference 2011

  1. 1. ADA Accessibility - Is your office ready for 2012 Requirements?  ----------  ----------  GUAM LEGAL SERVICES CORPORATION – DISABILITY LAW CENTER “ The Protection and Advocacy System for Guam.” September 2011
  2. 2. Outline <ul><li>ADA 1990 and 2010 Accessibility Standards </li></ul><ul><li>Effective date and enforcement schedule </li></ul><ul><li>Duties for private medical clinics </li></ul><ul><li>Duties for public medical clinics </li></ul><ul><li>A few standard changes </li></ul>
  3. 3. About the ADA <ul><li>Americans with Disabilities Act </li></ul><ul><ul><li>A federal civil rights law passed in 1990 that requires that public and private entities have accessible facilities and prohibits exclusion of persons with disabilities from public and private goods, services, and activities. </li></ul></ul>
  4. 4. Sample Common Question <ul><li>Taken from : “Access to Medical Care For Individuals With Mobility Disabilities” </li></ul><ul><li>Q: Can I decide not to treat a patient with a disability because it takes me longer to examine them, and insurance won’t reimburse me for the additional time? </li></ul><ul><li>A: No, you can not refuse to treat a patient who has a disability just because the exam might take more of you or your staff’s time. You must treat the individual. </li></ul>
  5. 5. Title II and III of the ADA <ul><li>The ADA requires access to medical care services and facilities. </li></ul><ul><li>Title II applies to public hospitals and public clinics as operated by state and local governments who must allow persons with disabilities to benefit equally from government services, programs, and activities. </li></ul><ul><li>Title III applies to private hospitals and medical offices as places of public accommodation (private businesses that provide services or goods to the public, such as restaurants, movie theaters, hotels, fitness clubs). </li></ul>
  6. 6. ADA Standards for Accessible Design <ul><li>Standards were originally issued by the Department of Justice in 1991, published in Appendix A of Title III of the ADA Regulations </li></ul><ul><li>Department of Justice published revised regulations for Titles II and III of the ADA in the Federal Register on September 15, 2010. These regulations are called the 2010 Standards for Accessible Design. </li></ul>
  7. 7. ADA – Accessibility Standard <ul><li>doorframe widths </li></ul><ul><li>ramp slope dimensions </li></ul><ul><li>Curb ramps and curb cuts </li></ul><ul><li>handrail heights </li></ul><ul><li>turning radiuses </li></ul><ul><li>and many other elements of accessibility were standardized. </li></ul>
  8. 8. Why standards revised? <ul><li>Design standards have been harmonized with the federal standards implementing the Architectural Barriers Act and private sector model codes adopted by many states. </li></ul><ul><li>New specific provisions and design requirements for medical care facilities, hospitals and rehabilitation facilities. </li></ul><ul><li>Medical care facilities and licensed long-term care facilities is where the patient’s period of stay exceeds 24 hours. </li></ul>
  9. 9. 2010 Standards Enforcement <ul><li>Effective as of March 15, 2011 </li></ul><ul><li>As of this date, policies and procedures and communication must be compliant with new requirements. </li></ul><ul><li>As of March 15, 2012, the 2010 standards must be followed for new construction, alterations, program access, and barrier removal . </li></ul>
  10. 10. 2010 Standards Enforcement <ul><li>Until March 15, 2012, entities can choose to use: </li></ul><ul><ul><li>The 2010 standards </li></ul></ul><ul><ul><li>The 1991 Standards </li></ul></ul><ul><ul><li>Or the Uniform Federal Accessibility Standards (standard established for federal government contractors). </li></ul></ul><ul><li>As of March 15, 2012, the 2010 Standards replace the 1991 Standards and must be followed. </li></ul>
  11. 11. “ Safe Harbor” <ul><li>If your facility was built of altered in the past 20 years in compliance with the 1991 standards, or you removed a specific barrier with those standards, you do not have to make further modifications to those elements. </li></ul><ul><li>Example: If you lowered the mounting height for your light switches to 54” in compliance with the 1991 standards, you do not have to lower them again to 48” (new standard under 2010 standards). </li></ul>
  12. 12. What does this mean for medical offices? <ul><li>Private clinic: If your are constructing a new facility or altering a portion of your facility, </li></ul><ul><ul><li>If before March 15, 2012, you must do so in compliance with the 1991 or 2010 standards. </li></ul></ul><ul><ul><li>If after March 15, 2012, it must be done in compliance with 2010 standards. </li></ul></ul><ul><li>In removing barriers, if done so after March 15, 2012, it must be in compliance with 2010 standards. </li></ul>
  13. 13. Readily Achievable Barrier Removal <ul><li>The ADA requires small businesses to remove architectural barriers in existing facilities when it is “readily achievable” to do so. 42 U.S.C. § 12182(b)(2)(A)(iv) </li></ul><ul><li>Readily achievable means easily accomplishable and able to be carried out without much difficulty or expense. 42 U.S.C. § 12181(9) </li></ul><ul><li>This obligation is continuing. Businesses should continually evaluate their facilities and develop priorities for removing barriers. </li></ul>
  14. 14. “ Readily Achievable” factors <ul><li>Nature and cost of the action needed </li></ul><ul><li>Overall financial resources of the facility, effect on expenses and resources </li></ul><ul><li>Overall financial resources of the entity or overall size of the business with respect to number of employees, number type and location of its facilities </li></ul><ul><li>Type of operation of the entity including composition, structure, functional geographic separateness. </li></ul>
  15. 15. Sample question: <ul><li>Q: If my clinic or part of my clinic is only reachable by a flight of stairs, do I have to add an elevator? </li></ul><ul><li>A: It depends. Only if it is “readily achievable” for the facility to do so and the cost is not overly burdensome. If it is small business facility, it may not have to. However, the clinic may still have to provide services in another form unless to do so is an undue burden. </li></ul><ul><li>Other example: widening the door to 30” rather than 32” </li></ul>
  16. 16. What does this mean for medical offices? <ul><li>Public hospitals and clinics: If constructing a new facility, each facility or part of the facility must be in compliance with the ADA standards. </li></ul><ul><ul><li>Before March 15, 2012, using either 1991 Standards or 2010 Standards or the UFAS standards. </li></ul></ul><ul><ul><li>After March 15, 2012, must use the 2010 standards. </li></ul></ul><ul><li>Governments do not have the barrier removal obligation, as it must provide access in all but the most unusual cases. </li></ul>
  17. 17. Fundamental Alteration <ul><li>State and local governments are not required to take any action that would result in a “fundamental alteration” in the nature of the service, program, or activity or in undue financial and administrative burdens. </li></ul><ul><li>States must ensure that a service, program, or activity “when viewed in its entirety” is readily accessible and usable by individuals with disabilities. </li></ul><ul><li>28 C.F.R. §35.150 </li></ul>
  18. 18. Some Changes <ul><li>Parking Spaces: </li></ul><ul><li>2010 Standard: one of every six accessible spaces must be van accessible (1991 standard only required one of every eight). </li></ul><ul><li>Hospital Outpatient facilities: 10% of spaces must be accessible (Rule 208.2.1) </li></ul><ul><li>Rehabilitation and outpatient physical therapy facilities: 20% must be accessible (Rule 208.2.2) </li></ul><ul><li>Other facilities: follow table in 208.2 </li></ul>
  19. 19. Sample Parking Table Total Number of Parking Space Provided in Parking Facility Minimum Number of Required Accessible Parking Spaces 1 to 25 1 26 to 50 2 51 to 75 3 76 to 100 4 101 to 150 5
  20. 20. Entrances <ul><li>60% of all new entrances must be accessible (Rule 206.4.1) (1991 required 50% of entrances to be accessible). This means 32” minimum width and if the level changes, a ramp or elevator must be provided. </li></ul><ul><li>All accessible routes connecting site arrival points and accessible building entrances must coincide with the general public/general circulation paths. Section 206. </li></ul>
  21. 21. Reach Range Requirements <ul><li>Forward reach= 48” max (1991 standard was 48”) Rule 308.2. </li></ul>
  22. 22. Reach Range Requirements <ul><li>Side reach range lowered to 48” max (1991 standard was 54”) Rule 308.3 </li></ul>
  23. 23. Patient Sleeping Rooms <ul><li>In hospitals, rehabilitation facilities, psychiatric facilities and detoxification facilities </li></ul><ul><ul><li>Facilities not specializing in treating conditions that affect mobility: at least 10%, but no fewer than 1, shall be ADA accessible </li></ul></ul><ul><ul><li>Facilities specializing in mobility conditions: 100% of the rooms shall be ADA accessible </li></ul></ul><ul><ul><li>Long-term care facilities: 50% but no fewer than 1 of each type of resident sleeping room shall be ADA accessible </li></ul></ul><ul><ul><li>Rule 223.2 and Rule 223.3 </li></ul></ul>
  24. 24. Clear Floor Space Clear floor space is 30” min by 48” min (Rule 305.3)
  25. 25. Turning Space <ul><li>Circular space: diameter of 60” minimum </li></ul><ul><li>T-shaped space: 60” by 60” minimum </li></ul>
  26. 26. More Information <ul><li> </li></ul><ul><li>2010 ADA Standards for Accessible Design </li></ul><ul><li>ADA Update: A Primer for Small Business </li></ul><ul><li>ADA Guide for Small Businesses </li></ul><ul><li>Access To Medical Care For Individuals With Mobility Disabilities </li></ul><ul><li>Readily Achievable Barrier Removal and Van Accessible Parking Spaces </li></ul>
  27. 27. Thank you! Guam Legal Services Corporation – Disability Law Center 113 Bradley Place, Hagatna, GU 96910 Phone: (671) 477-9811 Fax: (671) 477-1320 Email: Web: