Twenty years of growing ADA awareness has helped people with disabilities participate more fully in American culture, but there are still glaring deficiencies. One of the biggest disappointments, especially in this year of health care reform, is the medical establishment’s persistent disregard of the need to make medical facilities and equipment fully accessible to people with mobility disabilities.

One reason for this lax attitude has been the Department of Justice’s reluctance to aggressively enforce the ADA. But there are signs that the Obama administration is taking the medical civil rights of people with disabilities seriously. In May 2010, the Department of Justice issued a document entitled “Access to Medical Care For Individuals with Mobility Disabilities,” the kind of publication that should have been widely distributed two decades ago. [You can view and download it at www.ada.gov/medcare_mobility_ta/medcare_ta.htm#part1].

“Due to barriers, individuals with disabilities are less likely to get routine preventative medical care than people without disabilities,” begins the publication. “Accessibility is not only legally required [under the ADA], it is important medically so that minor problems can be detected and treated before turning into major and possibly life-threatening problems. …”

The publication covers not only access to buildings, but also includes diagrams and dimensions of accessible exam rooms and exam tables, floor space, chairs, portable and overhead track lifts, radiologic equipment, mammography equipment, and scales. It also covers the need for proper lifting techniques and staff training.

California has had some success in changing the culture of inaccessible medical facilities and equipment, thanks mainly to Disability Rights Advocates, in Berkeley, Calif. A settlement with Kaiser Permanente in 2000, the state’s single largest medical provider, followed by dispute resolutions, has resulted in Kaiser supplying all of its facilities with accessible exam tables. “This equipment actually had to be developed from scratch,” says Larry Paradis, executive director of DRA, “but now [exam tables] are becoming more common. The price has come down from $10,000 to $2,000, and that’s a big step forward.”

DRA also entered into a settlement agreement with Sutter Healthcare in Calif-ornia. But the big news is DRA’s expansion to a more national role involving medical accessibility. “We just completed a settlement with Nash General Hospital in Boston. We’re also involved in investigations in New York City, and we’ll be opening an office there on July 26,” says Paradis.

Why has it taken 20 years for the medical establishment to begin taking the ADA seriously? “It’s the medical model of disability,” says Paradis. “In the culture of the medical establishment, the concept of independence for people with disabilities doesn’t enter their minds. The emphasis is on ‘fixing’ the person rather than looking at barriers in the medical environment.”

Look for more coverage of medical accessibility in our November issue.