A Cure for Inaccessible Health Care in NYC

NYLPI_1People in need of great health care fly in from all over the world seeking the expertise of New York’s top medical institutions. Most New Yorkers have long taken for granted their access to the high-quality care in their vicinity, but for many New Yorkers with disabilities, this care may as well be a world away.

For decades now, disability rights legislation, including the Americans with Disability Act of 1990 and the city’s own Local Law 58 of 1987, has required health care entities like hospitals and doctors and dentists’ offices to make reasonable accommodations to serve people with disabilities. The ADA requires all new construction to be wheelchair accessible, and tax credits and other incentives are available for businesses to upgrade existing structures. But while architectural barriers are, perhaps, the most obvious obstacles to access, they’re far from the only ones that have made (and too often continue to make) many health care facilities less than welcoming to health consumers with disabilities.

An Unsustainable Lack of Access

It would seem that health care providers would want to make their offices accessible to people with disabilities. After all, people with disabilities are “among the largest and most important health care consumer groups in the United States,” according to a 2009 report by the National Council on Disability.

The same report noted that “Federal agencies, policy makers and health care systems have not yet mobilized their resources to respond to the broad-ranging implications of this increase in disability for individuals and for society.”

Sad to say, in the five years since that report came out, the situation is hardly better, as this NY1 news report from May makes dramatically clear:

Even with disability rights legislation on the books, the powers that be move slowly to make change happen. That’s not news. But people with disabilities are far from powerless to pitch in and help speed up the process. When faced with inaccessibility, one of the strong cards an individual can hold is knowledge, and thanks to The New York Lawyers for the Public Interest (NYLPI), who collaborated with ICS on The Women’s Health Access Project featured in that NY1 story, the basic knowledge you need is easily obtainable in the form of a detailed fact-sheet promoting health access for all New Yorkers with disabilities.

Know Your Rights

“If you are a person with a disability, you have the right to equal access to health care,” the fact sheet states at the beginning, and then it goes on to explain what “equal access” actually entails. It defines the term “reasonable accommodation” and explains the many different kinds of changes providers may be required to make in order to reasonably accommodate consumers with disabilities. For example, medical providers may be required to:

  • Provide accessible medical equipment such as exam tables that raise and lower, Hoyer lifts, and platform weight scales for people who use wheelchairs or scooters. A doctor may need to have trained staff available or use positioning aids to comfortably and safely position you for a test or examination. You should not be required to bring a friend, family member, or aide to help you.
  • Remove architectural barriers such as by widening doorways that are too narrow for a wheelchair or scooter to pass through, installing ramps, and removing unnecessary furniture in exam rooms and waiting rooms.
  • Change policies such as making an exception to a “no dogs allowed” policy to allow a service animal to accompany someone with a visual impairment into an exam room.
  • Provide communication aids such as a qualified sign language interpreter, video remote interpretation (VRI), or materials in alternative formats such as Braille or large print, in order to ensure effective communication. The type of communication aid you are entitled to will depend in part on the complexity of the information you are discussing and the length of the conversation.
  • Take extra time to simplify or repeat explanations for a person with a cognitive or intellectual disability or listen to someone with speech impairment. Providers may also need to allow extra time  to communicate using an interpreter or to safely position someone for a test or exam. Reminder: Tell your health care provider about your need for reasonable accommodations, ideally when  you schedule your appointment, so they can properly prepare for your visit.
  • Note: Doctors must provide effective communication to patients as well as to companions, such as friends and family members, or anyone else the doctor would normally communicate with about the patient’s health

If you find yourself facing a barrier to your health care that you feel can be overcome by the provider making any of the above reasonable accommodations, don’t be afraid to ask for them. And be prepared for resistance. You may be told that the cost of an accommodation is prohibitive, for example. According to the NYLPI fact sheet, cost is usually not a sufficient reason to deny a request. (“Health care providers must treat the cost of your request as part of the overall cost of operating their business,” the sheet says.)

Recourse Resources

If you’re anxious about alienating a provider because you think it may make things more difficult for you, remember you’re not alone. It may help to know that the law is on your side. (It should be noted that ICS providers are required to affirm the accessibility of their services.)

The NYLPI fact sheet outlines two steps you can take to seek redress, including making an administrative complaint to any of the local, state or federal agencies charged with enforcing accessibility laws and, in some cases, filing a lawsuit. The sheet explains the time frames and consequences each action entails. The sheet also includes contact information for several of these agencies, including the US Department of Justice which is chiefly responsible for enforcing the ADA.

If you have questions about possible discrimination by a health care provider, or if you want more information about any of the processes to address discrimination, contact NYLPI’s Disability Justice Program any of the following ways:

New York Lawyers for the Public Interest
151 West 30th Street
11th Floor
New York, New York 10001-4017
Tel: 1.212.244.4664
TTY: 1.212.244.3692
Email: djintake@nylpi.org

Intake lines are open Monday and Friday, 9:30 am -1:30 pm and Wednesday 1:30 pm – 5:30 pm

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