NurseWeek: And access for all: A decade of rights for people with disabilities

And access for all
A decade of rights for people with disabilities

By Chris Schreiber
September 18, 2000
Photo: Digital Stock

Activists say the ADA has been responsible for increased access in everyday places.


	You've read the article. Now tell us what you think. Related site ADA Home Page ADA Document Center

The civil rights movement for people with disabilities was not marked by violent confrontations. It did not inspire folk songs and it did not define a decade. But in the 10 years since its watershed moment, the passage of the Americans with Disabilities Act, these rights have become a part of the country’s collective consciousness.

Activists say the ADA has been responsible for increased access in everyday places – movie theaters, restrooms, offices and restaurants. The law has lowered barriers in employment and education, and required equal access to public places and government services. Health care professionals say the law has affected the quality and quantity of the care delivered.

Physical changes such as curb cuts, hand rails and ramps are some of the more obvious alterations the ADA has chiseled. But some less publicized victories are among its most significant, said Jim Weisman, general counsel of the Eastern Paralyzed Veterans Association. Weisman, who was part of the team that drafted the ADA, said the law’s broad scope has helped protect patients and health care workers.

"Clearly, as it relates to patients, patients have rights they didn’t have before," Weisman said. "They have the right to be cared for regardless of their disability, and that wasn’t the case 10 years ago."

Even health care facilities, traditionally far ahead of the curve in terms of physical accessibility, have felt the ADA’s influence. On July 26 – the 10-year anniversary of the ADA – three people with disabilities, members of Kaiser Foundation Health Plan in California, filed a lawsuit against the HMO. The lawsuit alleges that Kaiser is violating the civil rights of its members who have disabilities by not providing adequate care. Specific complaints include a lack of wheelchair-accessible exam tables and scales.

"Before the ADA, no one would have even dreamed of bringing such a lawsuit," Weisman said. "The expectations have changed. People with disabilities can now expect you to remove barriers. They know it and expect you to comply."

The business world adapts
For the most part, businesses have proved willing to make the effort, said Cindy Gatens, MSN, RN, clinical nurse specialist at the Ohio State University Medical Center. Gatens has been a nurse for almost 30 years. But she’s been in a wheelchair for 31, since she sustained a spinal injury as a teen-ager.

"I see more accessibility in general," she said. "When I go places now, I can assume things are accessible. Ten years ago, I couldn’t assume that."

Gatens attributes the move to adapt the physical landscape to the increased awareness of the ADA by businesses. "People are much more aware of their legal accountability," she said.

Improving physical access is not the ADA’s only legacy. The law mandates that all disabilities be accommodated by health care workers. For example, deaf patients can expect sign language interpreters to be provided by their physician or health plan.

Even diseases such as AIDS have been included in the scope of the ADA’s mandate. One of the first legal tests of the ADA came on the heels of a case in which a dentist refused to treat an HIV-positive patient for fear of infection. The patient’s legal right to care was upheld because the dentist’s fear was deemed "unreasonable."

Health care professionals with disabilities have reaped the benefits of extended rights as well. Injured employees can expect modifications in their workplace, are protected against demotion and cannot be denied promotions based on their disability.

Rehabilitation efforts
"The ADA almost defines what we do as a profession," said Diane Josephs, OTR, president of the Occupational Therapy Association of California. "The law allows therapists to practice and to train patients more effectively. In the past, patients got discharged and they got stuck without accessible resources at home and outside the hospital."

That doesn’t mean there is widespread acceptance of people with disabilities performing every kind of activity, said Mark Matthews, OTR, director of occupational therapy for Stonebridge Healthcare Center in Austin. Matthews specializes in giving driving lessons and adapting automobiles for a host of disabilities. The ADA is critical to protect the rights of people with disabilities and encourage their success, he said.

"The layperson has poor insight," Matthews said. "In many cases, it’s the family who doesn’t think that person can return to work, be gainfully employed or drive. It can be the family who’s limiting, conservative in their expectations. Ten years ago, there wasn’t any meat behind what therapists wanted to do. Today, with the ADA, it’s automatically accepted."

The struggle isn’t over, however, said Cynthia Jacelon, Ph.D., RN, president of the Association of Rehabilitation Nurses and clinical assistant professor at the University of Massachusetts Amherst School of Nursing.

"Ten years ago in New England, you could not go into the post office," she said. "They had to come outside to sell you stamps. The landscape is different now. The health care process is easier now. It broadens your options and broadens your choice.

"If your dentist is on the second floor, you can go to them now and be reasonably sure you can get to the second floor. But we still have a long way to go. It is better and people are more aware, but there is still a considerable amount of prejudice and people still don’t realize there are unique needs for people with disabilities."