Do You Know Your Legal Obligations to Disabled Patients?

Equipment & Staffing Considerations

Ms. Marslett

Equipment is another area practices don’t always think about as having ADA exposure. It is not legally acceptable, for example, to do a physical exam of a patient in their wheelchair. In such cases, an adjustable-height examination table that can be lowered to the appropriate level so your patient can easily transfer to it may be required.

Have you considered the chairs in your waiting and exam rooms? “You should have seats that are wide enough and arms that are strong enough to let a person lift themselves up and out of them,” Ms. Marslett says.

Staff training can also be important. With the increase in obesity and accompanying disabilities, making sure staff have adequate education in safe lifting practices is another access-to-care issue.

“The law requires a reasonable accommodation to the needs of the disabled,” says Ms. Marslett. “This doesn’t mean a special exam table or instruments in every room. Depending on the size of the practice and types of patients, you may only need one room with an accessible exam table to fulfill your requirements under the law.”

Resources Available

The ADA webpage, under the auspices of the U.S. Department of Justice, has a wealth of information on rules, regulations, design standards and technical assistance materials. If your practice has ties to an area hospital, they may have an office that can be of service. Check in with state and national professional organizations to see if they have suggestions or groups that discuss these issues.

Although for the most part, the expenses of compliance with access requirements fall on the practice, some small changes are being made. Billing codes now exist that can be used to offset at least some of the additional time required to see and treat disabled patients. In addition, tax credits in place to reduce the costs of equipment and building changes survived the last round of tax reform. Contact your accountant for more information.

“One of the most critical aspects for administrators is to closely monitor regulations,” says Ms. Marslett. “Make sure when there is an update you assess your practice to see if there are any changes you need to make.” 

Kurt Ullman is a freelance writer based in Indiana.

Reference

1. Agaronnik ND, Pendo E, Campbell EG, et al. Knowledge of practicing physicians about their legal obligations when caring for patients with disability. Health Aff (Millwood). 2019 Apr;38(4):545–553. doi: 10.1377/hlthaff.2018.05060.