The Basics of Health Care and the Americans with Disabilities Act (ADA)
Presented by the ADA National Network
October 26, 2023
Slide 1: The Basics of Health Care and the Americans with Disabilities Act (ADA)
Slide 2: Infographic: Disability Impacts All of Us
•	Up to 1 in 4 (27 percent) of adults in the United States have some type of disability. Outline of the United States map displaying figures in blue of people with a disability and figures in tan of people with no disability. 
•	Disability Impacts All of Us
source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Slide 3: Disability and Health
•	SUMMARY: Adults living with disabilities are more likely to be obese, smoke, have heart disease and have diabetes than adults without disabilities. 
•	Obesity: 41.6 percent of adults with a disability are obese while 26.2 percent of adults without a disability are obese.
•	Smoker: 29.6 percent of adults with a disability smoke while 13.4 percent of adults without a disability smoke.
•	Heart Disease: 9.6 percent of adults with a disability have heart disease while 3.4 percent of adults without a disability have heart disease.
•	Diabetes: 15.9 percent of adults with a disability have diabetes while 7.6 percent of adults without a disability have diabetes.
TABLE: Disability and Health of Adults with Disability and without disability. 
•	Table with 5 columns and 3 rows. 
•	Header row 1 (5 columns):  Disability (with/without), Obesity, Smoker, Heat Disease, Diabetes. 
•	Header column 1 (3 rows): Blank, With Disability, Without Disability. 
•	Column 2:  Obesity: With Disability: 41.6 percent; Without Disability: 26.2 percent.  
•	Column 3: Smoker: With Disability: 29.6 percent; Without Disability: 13.4 percent 
•	Column 4: Heart Disease: With Disability: 9.6 percent; Without Disability: 3.4 percent 
•	Column 5: Diabetes: With Disability: 15.9 percent; Without Disability: 7.6 percent. 
Slide 4: Disability and Health Care Access Barriers
Health care access barriers for working-age adults include:
•	1 in 4 adults with disabilities 18 to 44 years. 
o	Do not have a usual health care provider.
o	Have an unmet health care need because of cost in the past year.
•	1 in 5 adults with disabilities 45 to 64 years did not have a routine check-up in the past year. 
•	Disability Impacts All of Us
Source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Slide 5: Disability and Health Care: Health Insurance Coverage
Number of Uninsured People in United States (2020)
•	31.6 million (9.7%) people of all ages 
were uninsured - at the time of the interview.
•	27.5 million (13.9%) working-age adults (aged 18–64) 
were uninsured. 
•	Demographic Variation in Health Insurance Coverage: 
United States, 2020 [PDF, 15 pages ]
Source: Centers for Disease Control and Prevention (CDC)
Web: cdc.gov/nchs/data/nhsr/nhsr169.pdf
Slide 6: Why? Complex, Intersecting Barriers Contribute to Disparities
•	Poverty.
•	Prejudice and stereotypes.
•	Lack of provider training and cultural literacy.
•	Physical and programmatic inaccessibility.
•	Inadequate research.
•	ADA monitoring, implementation and enforcement.
Slide 7: An Overview of the Americans with Disabilities Act (ADA)
Jerri Davison, Director
Pacific ADA Center
Slide 8: What is the Americans with Disabilities Act (ADA)?
•	The Americans with Disabilities Act (ADA) is a civil rights law to protect the rights of persons with disabilities.
Slide 9: Who Does the ADA Protect?
•	People with physical, sensory, mental, cognitive, intellectual, or health conditions AND
•	These conditions affect the way you do everyday things like:
•	Walking, balancing, climbing
•	Seeing, hearing or speaking
•	Reading 
•	Understanding, remembering, or focusing
•	Sleeping
Slide 10: The ADA also protects people who…
•	Have a record of having a disability in the past
•	Don’t have a disability, but the person providing the goods, services or activities thinks they do
•	Are close to someone who has a disability like a child, parent, or spouse
•	Have a history of drug use but are in recovery and not actively using drugs
Slide 11: Who has responsibilities under the ADA?
•	Public entities (state and local government health care providers)
•	Title II of the Americans with Disabilities Act
•	Private health care providers
•	Title III of the Americans with Disabilities Act
Slide 12: What does the ADA Require?
•	Services must be delivered so that all people:
•	Have an equal opportunity; 
•	To achieve the full benefit of the goods, programs, services and activities; and
•	In the most integrated setting appropriate.
•	ADA Titles II and III
Slide 13: What Does Equal Access Under the ADA Include?
Equal access to care and services includes:
•	physical accessibility of buildings and facilities;
•	accessible equipment;
•	effective communication; and 
•	modification of policies, practices, and procedures.
Slide 14: Are ADA Requirements Waived in an Emergency?
•	No. 
•	The ADA requirement of equal access to health care services applies at all times. 
•	It is particularly important during an emergency.
Slide 15: Facility Access
Emily Shuman, Director
Rocky Mountain ADA Center
Slide 16: 2010 ADA Standards for Accessible Design
•	Published on September 15, 2010 by DOJ.
•	Set the minimum requirements, both scoping and technical, for qualifying facilities to be readily accessible to and usable by individuals with disabilities.
•	The Standards do not serve as building code, but rather as physical representation of civil rights.
•	Applies to new construction, alterations, and existing facilities.
Slide 17: Parking Requirements
•	Parking facility includes parking lots and parking structures.
•	The number of parking spaces required to be accessible is to be calculated separately for each parking facility; not based on the total number of parking spaces provided in all the parking facilities provided on the site.
Slide 18: Parking Requirements - Scoping
•	SUMMARY: Parking Requirements - Scoping for minimum number of required accessible parking spaces based on total number of parking spaces provided in parking facility. 
•	TABLE: Parking requirements – Scoping – Number of Accessible Parking Spaces based on Total Parking Spaces. 
•	Table with 2 columns and 12 rows. 
•	Header row 1 (2 columns):  Total Number of Parking Spaces Provided in Parking Facility; Minimum Number of Required
Accessible Parking Spaces
•	Row 2: Total Spaces: 1 to 25; Minimum Required Accessible Spaces: 1
•	Row 3 Total Spaces: 26 to 50; Minimum Required Accessible Spaces: 2
•	Row 4: Total Spaces: 51 to 75; Minimum Required Accessible Spaces: 3
•	Row 5: Total Spaces: 76 to 100; Minimum Required Accessible Spaces: 4
•	Row 6: Total Spaces: 101 to 150; Minimum Required Accessible Spaces: 5
•	Row 7: Total Spaces: 151 to 200; Minimum Required Accessible Spaces: 6
•	Row 8: Total Spaces: 201 to 300; Minimum Required Accessible Spaces: 7
•	Row 9: Total Spaces: 301 to 400; Minimum Required Accessible Spaces: 8
•	Row 10: Total Spaces: 401 to 500; Minimum Required Accessible Spaces: 9
•	Row 11: Total Spaces: 501 to 1000; Minimum Required Accessible Spaces: 2 percent of total
•	Row 12: Total Spaces: 1001 and over; 
Minimum Required Accessible Spaces: 20, plus 1 for each 100, or fraction thereof, over 1000. 
Slide 19: Hospital Outpatient Facilities
•	Ten percent of patient and visitor parking spaces provided to serve hospital outpatient facilities must be accessible.
•	Intended to cover facilities or units that are located in hospitals and that provide regular and continuing medical treatment without an overnight stay.
•	Doctors' offices, independent clinics, or other facilities not located in hospitals are not considered hospital outpatient facilities.
Slide 20: Rehabilitation and Outpatient Physical Therapy Facilities
•	Twenty percent of patient and visitor parking spaces provided to serve rehabilitation facilities specializing in treating conditions that affect mobility and outpatient physical therapy facilities must be accessible.
•	Conditions that affect mobility:
•	Conditions requiring the use of a mobility aid;
•	Arthritic, neurological, or orthopedic conditions; 
•	Respiratory diseases and other conditions; and 
•	Cardiac conditions that impose significant functional limitations.
Slide 21: Van Parking Spaces
•	For every six or fraction of six parking spaces required to be accessible, at least one shall be an accessible van parking space.
Slide 22: Parking Requirements - Location
•	Accessible spaces for a particular building must be located on the shortest accessible route from parking to an accessible entrance. 
•	Where parking serves more than one accessible entrance, accessible parking spaces shall be dispersed.
•	In parking facilities that do not serve a particular building, accessible spaces must be located on the shortest accessible route to an accessible pedestrian entrance of the parking facility.
Slide 23: Car Accessible Spaces
•	Car Parking Spaces
•	8’ wide minimum
•	5’ wide access aisle
•	IMAGE: Diagram of appropriate measurements for accessible car parking spaces with minimum width of 8 feet and access aisle of 5 feet. 
Slide 24: Van Accessible Spaces
•	Van Parking Spaces
•	11’ wide minimum
•	5’ wide access aisle, OR
•	8’ wide minimum
•	8’ wide access aisle
•	Parking spaces for vans and access aisles and vehicular routes serving them shall provide a vertical clearance 
of 98 inches minimum.
•	IMAGES
•	Diagram of appropriate measurements for accessible van parking spaces with minimum width of 11 feet and access aisle of 5 feet. 
•	Diagram of appropriate measurements for accessible van parking spaces with minimum width of 8 feet and access aisle of 8 feet. 
Slide 25: Access Aisle
•	Must adjoin an accessible route.
•	Two parking spaces are permitted to share an access aisle.
•	Must extend the full length of the parking space.
•	Must be marked to discourage parking in them.
•	Must not overlap the vehicular way.
•	Van access aisles be on either side of the parking space, except with angled spaces.
Slide 26: Parking Surfaces
•	Parking space and access aisle surfaces must be stable, firm, and slip resistant.
•	Access aisles must be at the same level as parking spaces they serve.
•	Changes in level greater than 1:48 are not permitted.
•	Built-up curb ramps cannot protrude into access aisles.
•	IMAGE: Photo showing built-up curb ramp protruding into an access aisle of an accessible parking space. 
Slide 27: Parking Signage
•	Parking spaces must be identified with the International Symbol of Accessibility.
•	Signs identifying van parking spaces shall contain the designation "van accessible.“
•	Signs shall be 5 feet minimum above the finish floor or ground surface measured to the bottom of the sign.
•	Signs can be installed on posts, suspended from ceilings, or fixed to walls. 
Slide 28: Passenger Loading - Scoping
•	Where provided, at least one accessible passenger loading zone must be provided in every continuous 100 linear feet of loading zone space, or fraction thereof.
•	IMAGE: Photo showing 100 feet of loading zone space next to a building.
Slide 29: Passenger Loading – Required Facilities
•	Medical Care and Long-Term Care Facilities. 
At least one accessible passenger loading zone shall be provided at an accessible entrance to licensed medical care and licensed long-term care facilities where the period of stay exceeds twenty-four hours.
•	Valet Parking. 
Parking facilities that provide valet parking services shall provide at least one accessible passenger loading zone.
•	Mechanical Access Parking Garages. 
Mechanical access parking garages shall provide at least one accessible passenger loading zone at vehicle drop-off and vehicle pick-up areas.
Slide 30: Vehicle Pull-Up Space
•	Passenger loading zones shall provide a vehicular pull-up space 8 feet wide minimum and 20 feet long minimum.
•	IMAGE: An access aisle at a passenger loading zone is shown to be the full length of the vehicle pull-up space and 60 inches (1525 mm) wide minimum.  The aisle area is to be marked.
Slide 31: Passenger Loading – Access Aisle
•	Access Aisle. 
Passenger loading zones shall provide access aisles adjacent to the vehicle pull-up space. 
•	Access aisles shall adjoin an accessible route and shall not overlap the vehicular way.
•	Access aisles serving vehicle pull-up spaces shall be at least 5 feet wide.
•	Access aisles shall extend the full length of the vehicle pull-up spaces they serve.
•	Access aisles shall be marked to discourage parking in them.
Slide 32: Passenger Loading – Design
•	Vehicle pull-up spaces and access aisles serving them must be stable, firm, and slip resistant.
•	Access aisles must be at the same level as the vehicle pull-up space they serve.
•	Changes in level greater than 1:48 are not permitted.
•	Vehicle pull-up spaces, access aisles, and vehicular routes must have a vertical clearance of at least 114 inches.
Slide 33: Accessible Routes
•	Accessible Routes permit people with mobility disabilities access to participate.
•	Must be able to get to areas where services take place.
•	Accessible Route should connect to all critical areas of the facility a person might be expected to go.
•	Check-in area
•	Waiting area
•	Examination areas
•	Bed/private rooms
•	Toilet and bathing rooms
•	Discharge area
Slide 34: Accessible Routes - Scoping
•	At least one accessible route shall be provided within the site from accessible parking spaces and accessible passenger loading zones; public streets and sidewalks; and public transportation stops to the accessible building or facility entrance they serve.
•	IMAGE: Sign point the way to an accessible route with the international symbol of accessibility.
Slide 35: Accessible Routes - Location
•	The accessible route must be in the same area as the general circulation path. 
•	IMAGE: Diagram showing accessible route and site arrival points.
•	Two arrows point to two building doors: An accessible route must connect site arrival points to each accessible entrance they serve.
•	Arrow points to straight path between building door and bus stop shelter: Accessible routes must coincide with or be in the same vicinity as, general circulation paths (Section 206.3). 
Slide 36: Accessible Routes - Surfaces
•	Accessible route floor or ground surfaces must be firm, stable and slip resistant. 
•	IMAGE: Brick footpath in Philadelphia. 
Slide 37: Accessible Routes - Slopes
•	Walking surfaces should have a 5% maximum running slope.
•	Ramps should have a 5-8.3% maximum running slope.
•	Cross slopes should never exceed 2%.
•	IMAGE: Example of running slope less than 5 percent and cross slope of a sidewalk less than 2 percent. 
Slide 38: Accessible Routes – Gaps and Vertical Changes
•	Walking surfaces should be free from gaps greater than ½ inch. 
•	Vertical changes in level cannot be greater than ¼ inch. 
•	Vertical changes in level up to ½ inch should be beveled at 1:2. 
•	IMAGES
•	Cross section of surface opening 1/2" wide max with no max. depth.
•	Illustration showing a walking surface vertical change of 1/4 inch max.
•	Illustration showing a walking surface with a 1/2 in max vertical change being beveled at 1:2.
Slide 39: Accessible Routes - Width
•	Pathways should be 36 inches wide except at doors and for short distances, when it can be narrower (32 inches).
•	IMAGE: Illustration of ADA Standards requirements for accessible pathways.
Slide 40: Accessible Routes - Ramps
•	Ramps which rise more than 6 inches will need to have both handrails and edge protection.
•	Ramps must also have level landings at the top and bottom of each segment and where the ramp changes direction.
•	IMAGE: Illustration of ADA Standards requirements for ramps that rise higher than 6 inches.
Slide 41: Accessible Entrances - Scoping
•	Part of the accessible route.
•	Ensure people with disabilities have an accessible way in.
•	At least 60% of all public entrances must be accessible.
•	If direct access to a facility entrance is from a parking structure, each direct access entrance must be accessible.
•	If direct access to a facility entrance is from a pedestrian tunnel or elevated walkway, at least one direct entrance to the facility must be accessible.
Slide 42: Accessible Entrances - Design
•	Revolving doors, revolving gates, and turnstiles not allowed.
•	At least one side of double doors must be accessible. 
•	Door openings must have a clear width of at least 32 inches.
•	No protrusions below 34 inches from ground. Protrusions between 34-80 inches above the ground are limited to 4 inches.
•	Thresholds at doorways can be no more than ½ inch high.
•	Floor or ground surface requirements apply. 
Slide 43: Accessible Entrances – Maneuvering Clearances
•	Maneuvering clearances are required and vary.
Slide 44: Accessible Entrances – Doors
•	Operable parts of doors must not require tight grasping, pinching or twisting of the wrist. 
•	Operable parts of doors must be 34-45 inches above the ground.
•	Doors must close at a speed of no less than 5 seconds. 
•	IMAGE: Woman talking to a doctor. 
Slide 45: Common Barriers to Accessible Entrances
•	Curbs with no ramps.
•	Broken concrete walking surfaces.
•	Stairs of any number.
•	Grass on an expected walking path.
Slide 46: Barrier Mitigation at Entrances
•	Install temporary accessibility features.
•	Identify alternate accessible entrance.
•	IMAGES
•	Illustration showing alternate accessible entrance with signs pointing to it.
•	Illustration showing a portable ramp used at an inaccessible building entrance.
Slide 47: Patient Sleeping Rooms - Scoping
•	The minimum number of accessible patient sleeping rooms required vary based on the type of medical facility.
•	Accessible patient sleeping rooms must be dispersed throughout the facility.
•	IMAGE: Doctor explaining something to an older woman as she sits on the edge of a bed.
Slide 48: Sleeping Rooms – Turning Space
•	IMAGE: Diagram of a 60" diameter turning circle and  T shaped space that is 36 inches wide at the top and stem within a 60 inch by 60 inch space.
Slide 49: Sleeping Rooms – Clear Floor Space
•	Must provide a clear floor space at least 30 inches by 48 inches and located on both sides of the bed. 
•	IMAGES
•	A plan diagram from the Standards showing a dimensioned 30-inch by 48-inch minimum clear floor space parallel to a wall.
•	Photo of hospital patient room.
Slide 50: Patient Sleeping Rooms – Toilet and Bathing
•	If the patient sleeping room includes an attached bathroom, it must also meet accessibility requirements.
•	IMAGE: Plan diagram of accessible toilet and bathing room.  Clear floor spaces are shown at fixtures.  A person is shown transferring to the toilet and another maneuvering in the roll-in shower.
Slide 51: Medical Diagnostic Equipment (slide 1 of 2)
•	Accessibility Standards for Medical Diagnostic Equipment (MDE) have been developed by the U.S. Access Board. 
•	As of now, the standards are not enforceable and serve as a best practice. 
•	May become enforceable in the future. 
Slide 52: Medical Diagnostic Equipment (slide 2 of 2)
•	Proposed update to Section 504 of the Rehabilitation Act of 1973 includes requirement for accessible MDE for healthcare providers receiving federal funds.
•	In the absence of enforceable standards, providers still have an obligation to provide access to goods and services. 
•	May be accomplished using auxiliary aids/services or modification of policies/procedures.
•	Standards address technical standards; scoping is to be determined.
Slide 53: DOJ Guidance
•	Access to Medical Care for Individuals with Mobility Disabilities | ADA.gov
•	IMAGES
•	Cover of DOJ's Access to Medical Care for Individuals with Mobility Disabilities document.
•	Example page from the Access to Medical Care for Individuals with Mobility Disabilities document.
Slide 54: Effective Communication and Healthcare
•	Katie Warden, Director
Northwest ADA Center
Slide 55: Effective Communication
•	A public accommodation shall furnish appropriate auxiliary aids and services where necessary to ensure effective communication with individuals with disabilities. 
•	28 C.F.R. § 36.303(c)(1)
Slide 56: Basic Requirement
•	…communicate effectively with people who have communication disabilities…
Slide 57: Goal of Effective Communication
•	To ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals…
•	28 C.F.R. § 36.303(a)
Slide 58: Providing Effective Communication
•	Communication Aids and Services
•	“Auxiliary Aids and Services”
•	Devices or services that enable effective communication for people with communication disabilities.
•	42 U.S.C. § 12103(1)
Slide 59: Communication Aids & Services: Examples
•	American Sign Language interpreters
•	Video remote interpreting
•	Notetakers
•	Large print materials
•	Captioning
•	Accessible electronic and information technology
•	Other similar services and actions
•	28 C.F.R. § 36.303(b)
Slide 60: Telehealth Examples (1)
•	A physical therapy practice uses a telehealth platform to send patients messages and videos showing how to do physical therapy exercises. One of the physical therapists is sending messages and videos to a client who is blind or has a visual disability. 
Slide 61: Telehealth Examples (2)
•	To effectively communicate with this patient, the practice may need to make sure, for example, that:
•	its telehealth platform is compatible with screen readers;
•	its videos have audio descriptions, or audio tracks that describe and give context for what is happening on screen.
•	ADA.gov Telehealth
Slide 62: Telehealth Examples (3)
•	A nurse practitioner’s office uses telehealth to hold virtual appointments with patients by video. A patient who is deaf or has hearing loss schedules a virtual appointment with that office.
Slide 63: Telehealth Examples (4)
•	To ensure effective communication during the appointment, the provider might need, for example, to:
•	give the patient the chance to request a communication aid or service when scheduling an appointment;
•	provide a qualified sign language interpreter during the appointment; or
•	ensure that the telehealth platform can support effective real-time captioning.
•	ADA.gov Telehealth
Slide 64: Choosing Communication Aids & Services
•	To decide what aid or service is needed to communicate effectively:
•	Consider the nature, length, complexity, and context of the communication.
•	Consider the person’s normal methods of communication.
•	28 C.F.R. § 36.303(c)(1)(ii)
Slide 65: Complex Communication
•	An interpreter may be required for:
•	Communication of medical history or diagnoses.
•	Conversations about medical procedures and treatment decision. 
•	Communication of instructions for care at home. 
•	ADA Business BRIEF: Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings
Slide 66: Additional Considerations 
•	Communication aids and services must be provided:
•	In accessible formats.
•	In a timely manner. 
•	In such a way as to protect the privacy and independence of the individual with a disability.
•	28 C.F.R. § 36.303(c)(1)(ii)
Slide 67: Surcharges Prohibited
•	Public accommodations may not place a surcharge on a particular individual with a disability to cover the costs of auxiliary aids and services.
•	28 C.F.R. § 36.301(c)
Slide 68: Companions
•	Entities must provide effective communication for companions who have communication disabilities.
•	Companions:
•	Any family member, friend, or associate of a person seeking or receiving an entity’s goods or services who is an appropriate person with whom the entity should communicate.
•	28 C.F.R. § 36.303(c)(1)(i)
Slide 69: Model Communication Assessment Forms
•	Barrier Free Health Care Initiative
web: archive.ada.gov/barrierfreehealthcare.htm
•	Dear Colleague Letter re: Effective Communication [PDF, 3 pages]
web: justice.gov/d9/2023-04/dear_colleagues_letter_for_healthcare_providers.pdf
•	IMAGE: Example of a model communication assessment form. 
Slide 70: Access to Health Care: Reasonable Modification of Policies, Practices, and Procedures
•	Pam Williamson, Assistant Director
Southeast ADA Center
Slide 71: What is a reasonable modification?
•	Term used in Title II of the ADA (state and local government agencies) and Title III of the ADA (public accommodations / private businesses
•	Definition: Adjusting policies, practices, and procedures, 
if needed, to provide goods, services, facilities, privileges, advantages, or accommodations.
•	Resource: Health Care and the Americans With Disabilities Act
source: ADA National Network 
web: adata.org/factsheet/health-care-and-ada
Slide 72: Reasonable Modifications in Medical Facilities
•	Today’s Areas of Focus:
•	Service animals in a medical facility. 
•	Reasonable modifications to visitor restrictions in medical settings.
•	Bringing personal equipment and supplies to a medical facility.
•	Masks. 
Slide 73: Reasonable Modification: Service Animals in Medical Facilities (slide 1 of 3)
1.	Service animals must be allowed access to medical facilities unless the presence of the animal creates a direct threat to other persons or a fundamental alteration in the nature of services.
•	Guidelines for Environmental Infection Control in Health Care Facilities
source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm
Slide 74: Reasonable Modification: Service Animals in Medical Facilities (slide 2 of 3)
2.	When a decision must be made regarding a service animal’s 
access to any particular area of the health-care facility:
a.	evaluate the service animal, patient, and health-care situation on a case-by-case basis;
b.	determine whether significant risk of harm exists; and 
c.	determine whether reasonable modifications 
in policies and procedures will mitigate this risk.
•	Guidelines for Environmental Infection Control in Health-Care Facilities
source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm
Slide 75: Reasonable Modification: Service Animals in Medical Facilities (slide 3 of 3)
3.	If a patient must be separated from his or her service animal while in the health-care facility: 
a.	determine with the person the arrangements that have been made for supervision or care of the animal during this period of separation; and
b.	make appropriate arrangements to address the patient's needs in the absence of the service animal.
•	Guidelines for Environmental Infection Control in Health-Care Facilities
source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm
Slide 76: Reasonable Modifications to Visitor Restrictions in Medical Settings
•	Allow a caregiver, personal assistant, or family member to accompany a patient with a disability to ensure adequate support for decision-making and treatment. 
Slide 77: Reasonable Modification: Face Masks Required by Health Care Practices
•	Situation: 
•	A health care provider is requiring all patients to wear masks due to COVID-19.  
•	A person is unable to wear a mask due to his/her disability. 
•	Must the health care provider make a reasonable modification?
Slide 78: Reasonable Modification: Face Masks Required by Health Care Practices - Alternatives
•	Develop a policy that addresses face mask alternatives for people with different types of disabilities who might not be able to wear a traditional face mask.
Slide 79: Reasonable Modification: Bringing Personal Equipment and Supplies to a Medical Facility
•	Allow individuals with disabilities to bring and use personal equipment and supplies at the hospital.
•	Examples: assistive technology devices, a ventilator, wheelchair, or walker.
•	Medical facility may require that proper steps be taken to clean the equipment and prevent the spread of infectious diseases.
Slide 80: Tips to Ensure an Effective Process for Ensuring Reasonable Modifications
•	Establish a policy for requesting and receiving reasonable modifications.	
•	Ensure that all staff are trained to work with people with disabilities and understand the reasonable modification process.
•	Evaluate each situation on a case-by-case basis.
Slide 81: Resources: ADA and Health Care
Slide 82: Resources: ADA and Health Care Basics
•	Accessible Health Care
source: ADA National Network
web: adata.org/factsheet/accessible-health-care
•	Health Care andAmericans With Disabilities Act
source: ADA National Network
web: adata.org/factsheet/health-care-and-ada
Slide 83: Resources: ADA and Facility Access
•	2010 Americans with Disabilities Act (ADA) Standards for Accessible Design
source: U.S. Department of Justice (DOJ)
web: ada.gov/law-and-regs/design-standards/2010-stds/
•	Access to Medical Care for Individuals with Mobility Disabilities
source: U.S. Department of Justice (DOJ)
web: ada.gov/medcare_mobility_ta/medcare_ta.htm
Slide 84: Resources: ADA and Effective Communication (slide 1 of 3)
•	Accessibility at Drive-Thru Medical Sites 
source: ADA National Network 
web: adata.org/factsheet/accessibility-drive-thru-medical-sites
•	Communicating with Medical Personnel During Coronavirus
source: National Association of the Deaf (NAD)
web: nad.org/2020/04/07/communicating-with-medical-personnel-during-coronavirus/
Slide 85: Resources: ADA and Effective Communication (slide 2 of 3)
•	COVID-19: Deaf and Hard of Hearing Communication Access Recommendations for the Hospital
source: National Association of the Deaf (NAD)
web: nad.org/covid19-communication-access-recs-for-hospital/
•	Telehealth Accessibility for Deaf and Hard Hearing (guidelines for health care providers and consumers)
source: National Association of the Deaf (NAD) 
web: mailchi.mp/nad/covid-19-video-based-telehealth-accessibility?e=8e82494470
Slide 86: Resources: ADA and Effective Communication (slide 3 of 3)
•	American Council of the Blind COVID-19 Response
source: American Council of the Blind (ACB) 
web:  acb.org/acb-covid19-response
•	National Council on Independent Living's COVID-19 Information, Resources, and Opportunities
source: National Council on Independent Living (NCIL) 
web: ncil.org/covid-19/
Slide 87: Resources: Modification in Policies, Practices, and Procedures (slide 1 of 2)
•	ADA Title II: State and Local Government Regulations §35.130 
(scroll to paragraph (b)(7))
source: U.S. Department of Justice (DOJ)
web: ada.gov/law-and-regs/title-ii-2010-regulations/#-35130-general-prohibitions-against-discrimination
•	ADA Title III: Public Accommodations Regulations §36.302
source: U.S. Department of Justice (DOJ)
web: ada.gov/law-and-regs/title-iii-regulations/#-36302-modifications-in-policies-practices-or-procedures
Slide 88: Resources: Modification in Policies, Practices, and Procedures (slide 2 of 2)
•	ADA Title II: State and local regulations
source: U.S. Department of Justice (DOJ)
web: ada.gov/topics/title-ii/
•	ADA Title III: Public accommodations regulations
source: U.S. Department of Justice (DOJ)
web: ada.gov/law-and-regs/title-iii-regulations
Slide 89: Resources: Service Animals in Health Care Facilities (slide 1 of 4)
•	Understanding How to Accommodate Service Animals in Healthcare Facilities
source: Administration for Strategic Preparedness and Response, 
U.S. Department of Health & Human Services (HHS) 
web: aspr.hhs.gov/at-risk/Pages/service_animals.aspx
•	Guidelines for Environmental Infection Control in Health-Care Facilities
source: Centers for Disease Control and Prevention (CDC) 
web: cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm
Slide 90: Resources: Service Animals in Health Care Facilities (slide 2 of 4)
•	Fact Sheet: Service Animals 
source: ADA National Network
web: adata.org/factsheet/service-animals
•	Service Animals and Emotional Support Animals Booklet
source: ADA National Network
web: adata.org/guide/service-animals-and-emotional-support-animals 
Slide 91: Resources: Service Animals in Health Care Facilities (slide 3 of 4)
•	ADA Requirements: Service Animals
source: U.S. Department of Justice (DOJ)
web: ada.gov/resources/service-animals-2010-requirements/
•	Frequently Asked Questions about Service Animals and the ADA
source: U.S. Department of Justice (DOJ)
web: ada.gov/resources/service-animals-faqs/
Slide 92: Resources: Service Animals in Health Care Facilities (slide 4 of 4)
•	Guidelines for Environmental Infection Control in Health-Care Facilities
source: Centers for Disease Control and Prevention (CDC)
web: cdc.gov/MMWR/preview/MMWRhtml/rr5210a1.htm
•	Understanding How to Accommodate Service Animals in Healthcare Facilities
source: U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response (ASPR)
web: aspr.hhs.gov/at-risk/Pages/service_animals.aspx
Slide 93: Resources: Hospital Visitors
•	Evaluation Framework for Hospital Visitor Policies [PDF, 8 pages]
source: Center for Public Representation
web: centerforpublicrep.org/wp-content/uploads/Disability-Org-Guidance-on-COVID-19-Hospital-Visitation-Policies_5-14-20_Final.pdf
Slide 94: Resources: Masks
•	The ADA and Face Mask Policies
source: Southeast ADA Center 
web: adasoutheast.org/disability-issues/ada-and-face-mask-policies/
•	Face Coverings and Businesses: Balancing the ADA with Public Health During COVID-19
source: Northwest ADA Center 
web: nwadacenter.org/index.php?q=factsheet/face-coverings-and-businesses-balancing-ada-public-health-during-covid-19-0
Slide 95: Resources: General, Hospital Visitors
•	COVID-19 and the ADA
source: U.S. Department of Justice (DOJ)
web: ada.gov/resources/2021-08-25-covid-qa/
•	Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation [PDF, 5 pages]
source: New York State Department of Health
web: dmna.ny.gov/covid19/docs/all/DOH_COVID19_RevisedHospitalVisitationandFAQ_052020.pdf
Slide 96: Resources: ADA National Network (ADANN) COVID-19 Information
•	Disability and COVID-19
web: adacovid19.org
•	Emergency Preparedness Resources 
(including COVID-19 resources)
web: adata.org/emergency-preparedness
Slide 97: Resource: Centers for Disease Control and Prevention
•	Become a Disability A.L.L.Y. in Your Community and Promote Inclusion for All
source: Centers for Disease Control and Prevention
web: cdc.gov/ncbddd/humandevelopment/become-a-disability-ALLY.html
Slide 98: Contact ADA National Network: Information, Guidance, and Training on the Americans with Disabilities Act (ADA)
•	Phone: 800-949-4232 (toll free)
•	All calls are confidential. 
•	Your call will be directed to the regional ADA Center that serves your state (based on area code of number dialed).
•	Email (online form): adata.org/email
•	Web: adata.org  
Slide 99: Connect and Follow: ADA National Network
•	Facebook @adanetwork
•	X (formerly Twitter) @ADANational
•	LinkedIn @ada-national-network
•	YouTube @ADANationalNetwork