Americans with Disabilities Act: An Overview

May 1, 2011 | Health System Risk Management


The Americans with Disabilities Act (ADA), enacted in 1990 and amended in 2008, is a landmark civil rights law that set in motion a legislative and enforcement system designed to give equal rights to people with disabilities. The purpose of ADA is “to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities and to provide strong, consistent, enforceable standards addressing discrimination against individuals with disabilities in the areas of employment, access to goods, services, transportation, accommodations, and telecommunications.” Many states followed the federal initiative by passing their own laws regarding treatment of people with disabilities. State antidiscrimination law may not conflict with federal law, but states may impose greater or additional antidiscrimination obligations that are not contrary to federal law.

Since its enactment in 1990, courts have had numerous opportunities to interpret ADA. A series of U.S. Supreme Court opinions rendered since 1999 interpreted ADA in an overly restrictive manner, resulting in lower courts finding that individuals with substantially limiting impairments and serious diseases, including mental illness, were not disabled, excluding them from the law’s protection (Thomas and Gostin). Congress believed that the court decisions did not reflect the intent of ADA, and consequently, Congress passed the ADA Amendments Act of 2008 (ADAAA), which President George W. Bush signed into law on September 25, 2008 (42 USCA § 12101). The amendments became effective January 1, 2009.

The 2008 amendments state that “physical or mental disabilities in no way diminish a person’s right to fully participate in all aspects of society, yet many people with physical or mental disabilities have been precluded from doing so because of discrimination; others who have a record of disability or are regarded as having a disability also have been subjected to discrimination.” Importantly, the amendments also make changes to the definition of the term “disability” by expressly rejecting the holdings in key U.S. Supreme Court cases and portions of ADA regulations that were promulgated by the U.S. Equal Employment Opportunity Commission (EEOC), a federal agency that is charged with developing implementation regulations for ADA’s Title I. These changes make it easier for an individual seeking protection under ADA to establish that he or she has a disability within the meaning of ADA.

Title III provides accessibility requirements for private businesses that are considered places of accommodation within one of 12 categories established by ADA. In September 2010, the U.S. Department of Justice (DOJ), which is charged with developing implementation regulations for Title III and enforcing them, published final revisions to the Title III regulations in the Federal Register. The revised regulations adopt new standards for accessible design that are consistent with guidelines published by the U.S. Architectural and Transportation Barriers Compliance Board (Access Board) and are effective March 15, 2011.

Healthcare facilities, including hospitals, nursing homes, rehabilitation facilities, and physician offices, are covered entities under ADA Title I in their capacity as employers and under ADA Title III as places of public accommodation. Although a wealth of resource and guidance material is available to assist covered entities in complying with ADA, healthcare facilities and physician office practices continue to become involved in litigation or enforcement proceedings for noncompliance. DOJ may file lawsuits in federal court to enforce ADA’s Title I requirements with regard to employment discrimination, and may obtain court orders, including compensatory damages and back pay, to remedy discrimination. Under Title III, civil penalties of up to $55,000 may be assessed for the first violation and up to $110,000 may be assessed for any subsequent violation. (U.S. DOJ...

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