Americans With Disabilities Act: Frequently Asked Questions

Debra Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, and Richard F. Cahill, JD, Vice President and Associate General Counsel, The Doctors Company

The goal of the Americans with Disabilities Act, or ADA, is to eliminate discrimination against persons with disabilities and provide enforceable standards to address such discrimination. Under the ADA, a disability includes “a physical or mental impairment that substantially limits one or more of the major life activities,” “a record of such an impairment,” or “being regarded as having such an impairment” (42 USC §12101). Major life activities include caring for oneself, seeing, hearing, speaking, eating, sleeping, breathing, learning, walking, standing, sitting, reaching, working, and the operation of a major bodily function (28 CFR §36.105).

Not everything that restricts a person’s major life activities is an impairment. Examples of this include obesity (unless there is a physiological disorder), hepatitis A, and side effects from certain drugs. The definition of what constitutes an impairment or disability is, however, subject to expansion based on federal and state legislative changes and rulings by appellate courts and administrative law judges (Federal Register, July 26, 1991, 56[144], 35694, 35699).

Our experts frequently answer members’ questions regarding ADA compliance. In response, we have compiled a Q&A with resources to offer strategies for addressing the most common inquiries. Because claims involving the ADA are not generally covered under our professional liability insurance policy, it is important for every practice to be aware of potential issues and ensure compliance.

Additional Compliance Strategies

Every healthcare practice should be familiar with the ADA and its different applications in the office setting. This means that every member of the office should be trained in how to handle different types of phone calls and inquiries. Patients with disabilities generally know their rights, and so should every staff member in the office. Staff members should never have to guess how to interact with patients who have disabilities. We recommend the following strategies to prepare your practice:

  • Develop policies and procedures for managing different types of disabilities and language barriers. Periodically evaluate staff compliance and review the policies and procedures to confirm they conform to ADA and community standards.
  • Train new employees at orientation regarding the types of situations they may encounter over the phone or in interactions with patients in the office. Provide ongoing education to all staff as a refresher at needed intervals. Provide quizzes to test knowledge, and document education in administrative files. (If the practice is investigated, it may be asked to demonstrate that staff training has occurred.)
  • Use a “mystery caller” approach to test staff members on their patient interactions.
  • Review administrative paperwork and the practice website for ADA compliance.
  • Review patient documents—including questionnaires, educational materials, and other forms—for ease of understanding, particularly for patients with LEP. Make documents available in the most common languages seen in the practice.
  • Ensure clinical staff has received training in how to manage patients using mobility devices—including transfers to exam tables and basic safety protocols.
  • Assess your physical practice location for ADA compliance. See the ADA National Network’s tool Is Your Facility Accessible for All Patients? and the ADA Checklist for Existing Facilities.

If you have questions, please contact the Department of Patient Safety and Risk Management at (800) 421-2368 or by email or contact the ADA Information Line at (800) 514-0301.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

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