Americans with Disabilities Act (ADA) Requirements for Health Care Providers

By: Carolina Guio

The Americans with Disabilities Act (ADA) is a comprehensive civil rights law in the United States that prohibits discrimination based on disability in everyday activities, including medical services. The ADA applies to healthcare providers and has implications for how they must treat individuals with disabilities to ensure equal access to medical services. 

Title II of the ADA applies to public hospitals, clinics, and health care services operated by state and local governments. Title III of the ADA applies to privately-owned and operated hospitals, clinics, and health care providers. Under Title III of the ADA, businesses that provide services to the public are called public accommodations. Public accommodations are private entities such as a doctor’s office, a dentist’s office, a psychologist’s office, a clinic, a hospital, a group practice, urgent care, a general physician, a physical rehabilitation facility, or other healthcare professionals. 

All public accommodations must comply with basic nondiscrimination requirements prohibiting exclusion, segregation, and unequal treatment. Furthermore, the ADA requires healthcare providers to make reasonable accommodations to ensure that individuals with disabilities have equal access to medical care and health facilities. Some critical aspects of how the ADA applies to health care are as follows: 

Modification in Policies, Practices, and Procedures: The health care provider must make reasonable modifications in its policies, practices, and procedures to accommodate a person with a disability. However, it does not need to modify a policy if it would fundamentally alter the nature of its services. A fundamental alteration would be something that causes a change in the essential nature of the business. If a particular aid or service would result in an undue burden, the provider must offer another effective aid or service that would not result in such. The health care provider may require people who need aids or services to request a reasonable amount of time in advance, based on the time the provider will need to get the aid or service. However, the provider may not impose excessive advance notice requirements. Walk-in requests for aid and services must also be honored to the extent possible.

Physical Accessibility: Ramps, elevators, accessible restrooms, and other accommodations must be provided to enable patients with mobility impairments to navigate the facility.

Service Animals: When a service animal needs to enter a medical facility with its handler, it must be permitted to accompany their handler wherever the public is usually allowed to go. This includes patient rooms, cafeterias, waiting areas, and examination rooms. However, a service animal may be prohibited from strictly sterile environments like an operating room.

Effective Communication: The business’s overall resources determine (rather than a comparison to the fees paid by the customer needing the interpreter) what constitutes an undue burden. If a specific communication method would be an undue burden, the business must provide an effective alternative if there is one.

In order to assist small businesses in complying with the ADA, the IRS Code includes a Disabled Access Credit (Section 44) for businesses with 30 or fewer full-time employees or with total revenues of $1 million or less in the previous tax year. Eligible expenses may include the cost of undertaking barrier removal and alterations to improve accessibility, providing sign-language interpreters, or making material available in accessible formats such as Braille, audiotape, or large print. Section 190 of the IRS Code provides a tax deduction for businesses of all sizes for costs incurred in removing architectural barriers in existing facilities or alterations. The maximum deduction is $15,000 per year. 

A violation of ADA regulations occurs whenever a business subject to its provisions fails to fulfill its obligation to provide reasonable accommodations and access to individuals with disabilities. A medical provider may violate the ADA when treating a patient with a disability if the provider denies services, lacks effective communication, fails to make reasonable accommodations, charges extra fees, and limits the patient’s treatment options. 

Failure to comply with the ADA’s provisions could result in legal action and penalties. Complaints of Title III violations may be filed with the Department of Justice. In certain situations, cases may be referred to a mediation program sponsored by the Department. The Department is authorized to bring a lawsuit where there is a pattern or practice of discrimination in violation of Title III or where an act of discrimination raises an issue of general public importance. Title III may also be enforced through private lawsuits. It is not necessary to file a complaint with the Department of Justice (or any Federal agency) or receive a “right-to-sue” letter before going to court.

The ADA is vital to healthcare because it ensures complete access to healthcare services and facilities. It requires that healthcare providers deliver services in a way that ensures that all people have equitable access to care. It’s crucial for healthcare providers to be familiar with the ADA’s requirements to ensure that they provide equal and accessible medical care to individuals with disabilities.

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.