Guide to Accessibility for People with Disabilities in Healthcare Facilities (2012)
Background and Need
Disability affects nearly one in five people today, and this number is growing. Alarming health disparities exist for people with disabilities (PWD), and these are exacerbated by their continued lack of access to care despite the passing of the Americans with Disabilities Act (ADA) over two decades ago.1,2 Moreover, there is deeply concerning evidence that patients with disabilities are significantly less likely to receive preventive care, at times as a result of the physician focusing too much on the patient’s disability.3,4
In addition to physical access barriers, some obstacles that PWD face when seeking quality healthcare can be attributed to the lack of significant disability-related training offered to healthcare providers. Recently, the U.S. Surgeon General addressed the lack of trained primary and specialty healthcare professionals capable of working with individuals with developmental and other disabilities.5 Among nonelderly PWD, 25% reported that they had difficulty finding a healthcare professional who understood their disability.6 Drainoni et al. elaborated on this finding by identifying cultural and personal barriers that contribute to the difficulty many PWD have in accessing quality healthcare.7 These include misconceptions about PWD, insensitivity and lack of respect, failure to take patients and caregivers seriously, and reluctance or unwillingness to care for PWD.
We agree with Shakespeare, Iezzoni, and Groce, who said:
Doctors and other health professionals who encounter people with disabilities in their professional practice should be aware not only of the causes, consequences, and treatment of disabling conditions, but also of the incorrect assumptions about disability that are common within society.8
Unfortunately, unless taught otherwise, physicians are likely to assume that disability is incompatible with quality of life and with health and that PWD are a burden to their families and to society. In fact, negative attitudes and assumptions about PWD directly compromise the quality of care provided to patients with disabilities. Negative, limiting attitudes toward disability are a major determinant of the significant disparities in health and healthcare documented in this population.
Online Trainings for Improved Healthcare
In order to combat the disparities that exist for people with disabilities, the Ohio Disability and Health Program and the Ohio Association of Community Health Centers are collaborating to provide you with two courses that are available for free online.
These are approved for continuing education by the Centers for Disease Control and Prevention (CDC)for physicians, nurses, certified health education specialists and other health professionals. Pilot projects have shown that including training in disability has a positive impact on the attitudes health care providers have towards PWD.9,10,11 Such training prepares physicians and other healthcare workers to communicate effectively, express compassion and empathy, and to be aware of and sensitive to the needs of diverse patient populations like PWD.
The University of Cincinnati’s University Center for Excellence in Developmental Disabilities (UC UCEDD), one of the partners in the Ohio Disability and Health Program, has developed trainings for medical residents using modules from the Centers for Disease Control and Prevention (CDC) website. This Autism Case Training (ACT) for Residency Training is designed for training residents in screening, diagnosing, and treating autism spectrum disorders and other developmental disabilities.
Resources for Physical Accessibility
Please find documents pertaining to physical accessibility below. These guidelines from Department of Justice and U.S. Access Board refer often to the ADA and can help you to become part of the solution to the health inequities that exist for PWD today.
Access to Medical Care for Individuals with Mobility Disabilities
[PDF; Source: U.S. Department of Justice]
ADA Accessibility Guidelines for Buildings and Facilities (ADAAG): Excerpt Specific to Medical Care Facilities
[Word Document; Source: U.S. Access Board]
ADA Best Practices Tool Kit for State and Local Governments (Appendices 1 and 2): ADA Accessibility Survey Forms and Instructions
[Link; Source; Department of Justice]
Proposed Accessibility Standards for Medical Diagnostic Equipment
[PDF; Source: U.S. Access Board]
Example Applications of the Proposed Medical Diagnostic Equipment Accessibility Standards
[PDF; Source: U.S. Access Board]
Resources for Providing Gynecological Care to Women with Developmental Disabilities
Table Manners and Beyond: The Gynecological Exam for Women with Developmental Disabilities and Other Functional Limitations
This resource can help healthcare providers and other staff to understand the needs of women with developmental disabilities in the clinical setting.
- Long-Bellil LM, O’Connor DM, Robey KL, et al. Commentary: Defining disability in health care education. Academic Medicine. 2011;86(9):1066–1068.
- Yee S, Breslin ML. Achieving accessible health care for people with disabilities: Why the ADA is only part of the solution. Disability and Health Journal. 2010;3(4):253–261.
- Iezzoni LI, McCarthy E, Davis R, Siebens H. Mobility impairments and use of screening and preventive services. American Journal of Public Health. 2000;90(6):955–961.
- Reichard A, Stolzle H, Fox MH. Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disability and Health Journal. 2011;4(2):59–67.
- S. Department of Health and Human Services. The Surgeon General’s call to action to improve the health and wellness of persons with disabilities. Office of the Surgeon General, U.S. Department of Health and Human Services. Washington, DC: 2005.
- Hanson KW, Neuman P, Dutwin D, Kasper JD. Uncovering the health challenges facing people with disabilities: The role of health insurance. Health Aff. 2003. Available at: http://content.healthaffairs.org/content/early/2003/11/19/hlthaff.w3.552. Accessed November 20, 2012.
- Drainoni M-L, Lee-Hood E, Tobias C, et al. Cross-disability experiences of barriers to health-care access: Consumer perspectives. Journal of Disability Policy Studies. 2006;17:101–115.
- Shakespeare T, Iezzoni LI, Groce NE. The Art of Medicine: Disability and the training of health professionals. The Lancet. 2009;374(9704):1815–1816.
- Symons A, McGuigan D, Akl E. A curriculum to teach medical students to care for people with disabilities: Development and initial implementation. BMC Medical Education. 2009;9(78):1–7.
- Tracy J, Iacono T. People with developmental disabilities teaching medical students – Does it make a difference? J Intellect Dev Dis. 2008;33(4):345–348.
- Woodard LJ, Havercamp SM, Zwygart KK, Perkins EA. An innovative clerkship module focused on patients with disabilities. Disabilities Education. 2012;87(4):1–6.