What the ADA Requires
The Americans with Disabilities Act of 1994 (ADA) requires psychotherapists to make accommodations to ensure that our services are available to persons with disabilities. It also prohibits us from charging a higher fee or attempting to recover any portion of the cost of the accommodation, even if that cost exceeds the fee we charge for our services. Healthcare professionals covered by the ADA also include doctors, nurses, dentists, chiropractors, massage therapists, and many others.
The thinking goes something like this: We provide services to a community that in turn provides us with a livelihood. As part of the cost of doing business, we’re expected to absorb the occasional expense of accommodating disabled people from that community.
For example:
- A hearing-impaired person wants psychotherapy but requires a sign-language interpreter. The therapist is responsible to pay for that service out of their own pocket.
- A client becomes too disabled to climb the steps to the office of a long-time massage therapist. The massage therapist must provide alternative arrangements without passing along any of the costs.
- On the first visit to a new dentist, a person in a wheelchair discovers that the restroom does not comply with ADA standards. The dentist must upgrade the restroom or provide alternate facilities.
A No-Win Situation
Unfortunately, the ADA places the burden of enforcement primarily on the shoulders of the disabled. This puts them in awkward, even untenable situations. If the dental patient in the last example sued the dentist, doing so would most likely jeopardize and possibly destroy a sensitive relationship. Would you want that dentist drilling in your mouth?
Some years ago, I attempted to return to therapy with someone I had seen several years prior, before I was in a wheelchair. Because her office was not accessible, we discussed meeting at my office instead. However, she wanted to charge for an extra hour to cover travel time. The ADA expressly forbids such an arrangement. I could have forced the issue and ended up with a resentful therapist—not a good basis for successful therapy! Instead, I chose to let the matter drop and sought therapy elsewhere.
As healthcare professionals, we bear the responsibility of being proactive in this arena. Otherwise, we put our disabled clients in the no-win position of having to enforce their civil rights against the very people who should be attending to their well-being.
To learn more about barriers to accessibility and how they can be remedied by enforcing the ADA, please visit my website Accessible Now.