Access to Health and Human Services FINALLY Addressed

For literally decades many people with disabilities have faced unacknowleged discrimination from two bizzare sources: health care and human services. But this spring new Section 504 Rules take a big bite out of that problem.

Key Provisions of 504 Rules https://acl.gov/504rule

  • Discrimination in medical treatment: The rule addresses discrimination in medical care and ensures that medical treatment decisions are not based on biases or stereotypes about people with disabilities, judgments that an individual will be a burden on others, or beliefs that the life of an individual with a disability has less value than the life of a person without a disability. These include, for example, decisions about life-sustaining treatment, organ transplantation, and rationing care in emergencies. (Remember Michael Hickson, the quad who they wouldn’t treat for COVID because of his disability?)
  • Community integration: The rule clarifies obligations to provide services in the most integrated setting appropriate to the needs of individuals with disabilities, consistent with the Supreme Court’s decision in Olmstead v. L.C (All these years later, there are still lots of people who want out of institutions but haven’t gotten out yet.)
  • Accessibility of medical equipment: The rule adopts the U.S. Access Board’s accessibility standards for medical equipment to address barriers to care, like exam tables that are inaccessible because they are not height-adjustable, weight scales that cannot accommodate people in wheelchairs, and mammogram machines that require an individual to stand to use them. The rule requires most doctors’ offices to have an accessible exam table and weight scale within two years. (Has your doctor ever blown of the physical exam or just examened you in your chair while their exam table stood by empty?)
  • Web, mobile app, and kiosk accessibility: The rule adopts the Web Content Accessibility Guidelines (WCAG) 2.1, Level AA accessibility standards for websites and mobile applications. It also requires web-enabled systems in self-service kiosks in medical providers’ offices to be accessible. These provisions are particularly important given the increased use of websites, apps, telehealth, video platforms, and self-service kiosks to access health care. (As computers and their kind take over more and more interaction with us, the public, this access gets more and more important)
  • Value assessment methods: Value assessment methods are often used to decide whether a medical treatment will be provided and under what circumstances. The rule prohibits the use of any measure, assessment, or tool that discounts the value of a life extension on the basis of disability to deny, limit, or otherwise condition access to an aid, benefit, or service. (Remeber that creepy experiment they did on babies with Spina Bifida in Oklahoma? No, check it out. There are some sick people out there, and I don’t mean the kids with disabilities.)

These new rules are a huge step forward for people with disabilities just trying to get some help, live their lives, etc. At a recent ADAPT meeting we asked who had access problems and/or been discriminated against by their doctor. Every disabled person in the room raised their hands.

The rules will only cover places that get federal funding, but that’s a lot more places than you might imagine. And, there are efforts to bring ADA, 504, Fair Housing and the Architectural Barriers Act into alignment so requirements will not be in conflict any more.

To find out more about these rules and related information click on this link.