Tools For Decreasing Health Care Barriers
Updated 01/25/05
June Isaacson Kailes MSW, Associate Director
Christie Mac Donald MPP, Senior Policy Analyst
Center for Disabilities Issues and the Health Professions
Western University of Health Sciences
309 E. Second Street, Pomona, CA 91766
Voice-909.469.5213/TTY-909.469.5520, Fax 909.469.5503, ahcs@westernu.edu
When health care providers do not adapt their procedures to assist and accommodate you, you may not receive medical and preventive care that is as EQUALLY EFFECTIVE as that provided to others.
Unless someone like you cares a whole awful lot, nothing is going to get better. ... It's not.
Dr. Seuss
You can use the Americans with Disabilities Act (ADA) as a tool to raise the quality and the standard of care you and other people with disabilities receive. When you point out barriers and request that they be removed, you begin to make a significant difference for you and others.
No civil rights law, including ADA is self-enforcing. The ADA is complaint driven and you are the "ADA enforcement team" and the "ADA police!" The process of removing barriers can only be started if you are aware of your legal rights and act on that information. If you do not bring barriers to the attention of health care providers, they may never get removed.
One study shows how individual recommendations can make a difference. A survey of 379 Massachusetts health care providers found they made access changes based on:
- 60% ADA compliance,
- 49% State requirements,
- 33% Patient recommendations for improvements,
- 25% because they completed an ADA checklist and
- 25% JCAHO and other certifying agencies. 1
Tools to Advocate for Your Accessible Health Care
The Center for Disabilities and the Health Professions "Accessible Health Care" series is designed to educate managed care organizations, health care professionals, community organizations, advocates, and people with disabilities.
This series includes discussions, examples, illustrations, and resource information for improving access to health care services, programs, and products. Subjects include:
- Importance of Accessible Examination Tables
- Importance of Accessible Weight Scales
- Health Care Facilities Access
- Choosing and Negotiating an Accessible Business Location
- Barrier Removal: Improving Accessibility with Limited Resources
- Providing Information in Alternative Formats
- Accessible Web Site Design (provided by the University of Washington's Disabilities, Opportunities, Internetworking, and Technology Center)
- Tax Incentives for Improving Accessibility
- ADA Resources (forthcoming)
- Tax Incentives for Hiring People with Disabilities (forthcoming)
Examples of how to use these briefs as advocacy tools
You can use these tools to:
- Decrease barriers you encounter:
- Using an accessible path to, in and through a medical building,
- Getting weighed,
- Getting on and off an exam, treatment or procedural table, and
- Reaching brochures, pamphlets, coat hooks and shelves
- To help support the importance of your access requests.
For example, you can give the "Importance of Accessible Weight Scales" brief to the health care person in charge (decision maker) as a resource regarding why and how they can get an accessible scale. This brief includes: - Discussion reinforcing the importance of being weighed as a critical part of routine prevention screening,
- Pictures and resource information about accessible scales,
- ADA requirements regarding equal health care including getting weighed,
- Summary of private and public disability discrimination cases, and
- Tax incentives for purchasing medical equipment specially for improving access to medical services.
WHOSE JOB IS IT?
This is a story about four people named EVERYBODY, SOMEBODY, ANYBODY and NOBODY.
There was an important job to be done and EVERYBODY was sure SOMEBODY would do it. ANYBODY could have done it, but NOBODY did it. SOMEBODY got angry about that because it was EVERYBODY'S job. EVERYBODY thought ANYBODY could do it but NOBODY realized that EVERYBODY wouldn't do it.
It ended up that EVERYBODY blamed SOMEBODY when NOBODY did what ANYBODY could have done!
Author unknown
There are many reasons why people do not speak up, advocate for their needs and file complaints. You:
- May be too sick and in need of immediate attention. You are not in position to deal with the barrier in an assertive a manner, or even request an accommodation. (This is the only valid reason for not speaking up); or
- Don't know how; or
- Fear that you might anger your providers. You fear they may punish, penalize or get even in some way; or
- Blame yourself (it is my problem), or
- Feel:
- It is too much work;
- Too time-consuming, slow, and possibly costly;
- It can involve months and sometimes years getting results; and
- While you could achieve long-term change, it won't solve your current problem.
When you don't act, you decrease your access to quality and safe care. Work at getting access barriers on the radar screens of your health care providers. When your health care provides' facilities could be more accessible, always:
- Point this out,
- Make specific suggestions (for example, add hook on restroom door or grab bars),
- Ask "when will you be getting a height-adjustable hi/low exam table?"
- Pursue your request by following through and when needed filing complaints with the Department of Justice or by a law suit.
It's your health,
it's your life,
don't give up!
Fight the fight!
Make a difference!
To expect less,
to demand less,
does an injustice to you and to those who come after you!
(Adapted from Suzanne Smeltzer)
Endnotes
- Drainoni, M., Vedrani, M., Andrew, J., Bachman, S., Tobias, C., Weppler, S. (2003). Access to Health Care Services for Persons with Disabilities: Defining the Barriers and Successful Strategies for Change, Final Report, available from: Dr. Drainoni, Boston University School of Public Health, 200 Springs Road (152, Bedford, MA 01730, (781) 687-2867, fax: (781) 687-3106, drainoni@bu.edu.
Distribution is encouraged, and permission is granted provided that:
(1) This copyright notice and citation is attached to each copy;
Kailes, J., and Mac Donald, C., Tools for Decreasing Health Care Barriers, 2004. Published and distributed by the Center for Disability Issues and the Health Profession, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766 1854, (available at www.cdihp.org/products) Email: ahcs@westernu.edu Voice-909.469.5213/TTY-909.469.5520, Fax 909.469.5503,
(2) No alterations are made to the contents of the document;
(3) The document is not sold for profit; and
(4) The Center for Disability Issues and the Health Professions is notified of such use. Please contact the Center by way of fax (909) 469-5503 or e-mail: info@rerc-ami.org