Capitol Correspondence - 10.29.18

Kaiser Family Foundation Finds Many Physical Accessibility Challenges with Doctors’ Offices

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We are sharing this article written by the Kaiser Family Foundation for the Washington Post because of its relevance to the individuals our members supportOn a related policy note, ANCOR is one of the lead supporters of the HEADs UP Act (H.R. 6611), introduced by U.S. Representative Seth Moulton (D-MA), which would designate people with I/DD as medically underserved and seeks to prompt medical offices to generally increase their accessibility. ANCOR members interested in learning more can consult our one-pager on this bill.

“Laws meant to prohibit discrimination against the disabled fall short when it comes to visiting the doctor’s office, leaving patients with disabilities to navigate a tricky obstacle course that not only leaves them feeling awkward but also jeopardizes their care.

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Despite laws that require ramps and wider doors for access, many medical offices don’t have scales that can accommodate wheelchairs, or adjustable exam tables for patients who cannot get up on one.

The Affordable Care Act was set to update standards for accessible medical treatment within the Americans With Disabilities Act (ADA), which is enforced by the Justice Department. But the Trump administration stopped action on this change late last year as part of its sweeping effort to roll back regulations across the federal government.

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The ADA, a 1990 civil rights measure designed to prohibit discrimination against people with disabilities, requires public places to be accessible, meaning new buildings and certain commercial establishments must provide ramps and doorways wide enough for a wheelchair, handrails and elevators.

The law applies to only fixed structures, however, and doesn’t address “furnishings” unattached to buildings. At doctors’ offices, that means scales, tables, X-ray machines and other diagnostic equipment aren’t legally circumscribed.

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Space is also an issue, Munger said. Sometimes exam rooms simply aren’t big enough to accommodate larger tables and chairs for family members and still have enough space to maneuver a mobility device. Spotts said the rooms generally aren’t big enough, period.

Some medical systems are taking action.

The Department of Veterans Affairs has used the U.S. Access Board’s standards to adopt similar accessibility guidelines. In Colorado, Centene, the largest Medicaid insurer nationwide, adopted similar guidelines.

States are using their Medicaid programs for similar, limited efforts.

California has worked with the disability community to create a survey for Medicaid providers, finding where gaps are and creating regulations requiring accessible equipment such as exam tables and scales, going so far as to create a database of which providers have them. But with the Trump administration failing to move forward, what care people with disabilities receive may depend on where they live.”