July 26th marks the 27th anniversary of the signing of the Americans with Disabilities Act (ADA). When it was signed, the ADA became the most comprehensive civil rights law for people with disabilities. It put in place requirements that fundamentally changed communities. Much of that change can be seen through things that we often take for granted today. Features such as curb cuts, accessible public transportation, Braille on signage or ATMs are all examples. While much progress has been made, people with disabilities quite often find that where they live there is still a long way to go. This is especially true in health care and health promotion.
People with disabilities still experience significant disparities when it comes to access to care and other behaviors that affect health. Health promotion providers (including health care, fitness and recreation) should be aware of applicable ADA requirements. The ADA is the minimum standard, in that it represents the least you must do. For this reason it makes sense that the ADA is a good starting point for any public health initiative or health promotion program.
ADA Compliance often means think simple first
For many health promotion providers, be they health departments, private health care providers, fitness centers or farmers markets, removing barriers often involves a low or no-cost solution. Staff training on interacting with people with disabilities, reading menus or product listings to customers with vision loss, propping open a heavy door when appropriate, or something as simple as keeping farmer’s market aisles clear and at least 3 feet wide are all easy fixes that increase access.
ADA compliance means planning ahead and planning long-term
While health promotion organizations should make every effort to accommodate an individual’s needs, there are accommodations you will need to prepare ahead of time. For example, if a deaf person wants to participate in a recreation program or go to a particular medical or dental practice, they have the right to be provided an interpreter at no charge (remember you cannot require a deaf individual to bring their own interpreter.) Covered organizations should budget funds to help provide accommodations.
There is a common myth that an organization can be “grandfathered” into the ADA. There is no such provision, but the law is written to be flexible. Places of public accommodation (such as a dental office or a fitness center) must remove barriers when it is “readily achievable.” State or local government programs have a similar standard of removing barriers when there is no administrative or financial burden. Whether or not these conditions apply is determined on a case-by-case basis. In many instances, there might indeed be items that would ensure access that are burdensome to buy (think a wheelchair-accessible scale or height adjustable exam table at a doctor’s office, a lift at a local swimming pool or accessible equipment at a playground or fitness gym). In these scenarios, the covered entity should provide alternative accommodations to the fullest extent possible and put a written plan in place to remove the expensive barriers over time. It’s also important to emphasize that obligations under the ADA do not go away. A good rule of thumb is to evaluate your accessibility annually to make sure access issues don’t get missed.
ADA compliance means program and physical access
The ADA is often thought of as an architecturally-based law, but it also requires program access. In addition to complying with the Standards for Accessible Design, health promotion and healthy community programs should be ready to ensure access to information and activities. This could mean ensuring web sites are accessible to those with vision loss, budgeting for materials in alternate formats such as large print, or providing staff training on how to interact with participants with disabilities. Programmatic access is a key component in moving a program towards full inclusion of people with disabilities.
ADA compliance means getting ahead of requirements
July is National Park and Recreation Month, and certain types of recreation facilities (such as fishing piers and platforms, boating facilities, playgrounds and sporting venues) have been required to meet the 2010 Standards for Accessible Design since March 15, 2012, (swimming pools since January 31, 2013). However, before any design standards in the ADA have the force of law, they are created by an independent agency called the US Architectural & Transportation Barriers Compliance Board, aka the Access Board. The Access Board develops what are known as the ADA Accessibility Guidelines, (ADAAG). The final versions of the ADAAG become enforceable standards. Two sets of ADAAG that parks and communities should be aware of are the ADAAG for Outdoor Developed Areas and the Public Rights-of-Way Accessibility Guidelines (PROWAG). To lessen the burden on places of public accommodation, businesses may be eligible for a tax credit or a tax deduction of up to $15,000.
ADA compliance is just the starting point!
ADA compliance may lead to an individual’s participation in recreation and health promotion programs, but it may not be on the same level as his or her peers. Seek to go beyond the minimum Standards for Accessible Design and ADA Accessibility Guidelines (ADAAG.) Incorporate Universal Design principles, develop partnerships with disability organizations and use available resources like www.nchpad.org. Ultimately health promotion organizations should strive for full inclusion. Inclusion happens when communities are transformed based on social justice principles and all members, including individuals with disabilities
-Are presumed competent;
-Are recruited and welcome as valued members of their community;
-Fully participate and learn with their peers; and
-Experience reciprocal social relationships.
This month we encourage any health promotion provider to celebrate the passage of the ADA by taking steps to ensure that the services you offer can be used by people of all abilities!