The Americans with Disabilities Act (the "ADA") may require health care service providers to take affirmative measures to accommodate persons with disabilities. Title III of the ADA regulates all "places of public accommodation." Professional offices of health care providers; including doctor's offices, hospitals, and clinics, are covered under this definition. Unlike other federal laws, there is no minimum practice size that operates as a threshold for inclusion under the ADA. Neither is participation in a federal health care program necessary for the ADA to apply.
Failure to comply with ADA requirements may expose a professional office to lawsuit and liability unless the business or practice is entitled to an exemption from the law's requirements. To be exempt from the requirements of the ADA, a health care provider must show that providing services to the person with disabilities would "fundamentally alter the nature of the services being offered," or that accommodating such an individual would result in "undue burden." Generally, practitioners cannot demonstrate that the "nature of the services rendered would be fundamentally altered," so the issue becomes whether accommodating a disabled individual constitutes an undue burden. The case of hearing impaired patients provides a good example by which to illustrate the scope of this duty to treat.
Title III of the ADA generally requires that, at a minimum, the practitioner (and/or staff, as appropriate) facilitate communication by passing notes back and forth to a hearing-impaired patient. Providing a telecommunication device for the deaf would also be considered a reasonable accommodation in certain instances. In Mayberry v. Van Valtier, the court denied a motion for summary judgment after finding that a material issue of fact existed as to whether a physician violated Title III of the ADA by failing to provide an interpreter to a hearing-impaired patient instead of merely passing notes. The question arose as to whether providing an interpreter would constitute an "undue burden." The case was settled before trial.
As such, it remains uncertain whether there is an affirmative obligation to provide an interpreter to a hearing-impaired patient. A pragmatic assessment of the aforementioned case suggests that the cost of litigation and the change of losing at trial motivated the defense to seek settlement, and given the lawsuit it may simply be less costly to accommodate hearing-impaired patients rather than remain exposed to additional lawsuits with uncertain outcome and defense expenses even if the court ultimately vindicates the practitioner's positions.
It is essential that practitioners generally be aware of the scope of their obligations under the ADA, and in particular, of their obligations to provide reasonable accommodations to persons with disabilities. As shown by the example of the hearing impaired, the scope of a practitioner's duties under the ADA is not necessarily intuitive, even with the use of good faith and sound judgment.
Finally, practitioners should be aware that many state laws prohibit discrimination based on disability in public accommodations. These laws may create additional grounds for liability, may provide for different interpretations of responsibility, and may create additional obligations. A review of state laws relating to disability and public accommodations is advisable.