As a health care provider, you must provide reasonable accommodations to people with disabilities as long as the accommodation is not an undue burden. If you can’t reasonably accommodate your patient, you should refer them to a provider or facility that has the equipment or staff that your patient needs.
Both federal and state laws exist to ensure that people with disabilities have access to health care services. As a health care provider, you may have obligations under the following laws:
The Americans with Disabilities Act (ADA)
Under the ADA, Health care providers are required to offer people with disabilities the same quality of care as all other patients.
Sect. 504 of the Rehabilitation Act & Sect. 1557 of the Affordable Care Act
These federal laws prohibit discrimination on the basis of disability by health care providers who receive federal funding including providers who accept Medicaid or Medicare.
- Section 504 applies more broadly to all federally funded programs and activities–including things like education, employment, and housing.
- Section 1557 specifically bars discrimination in health care based on disability as well as other characteristics including race, sex, and national origin.
New Hampshire’s ‘Law Against Discrimination’ (RSA 354-A )
This state law makes it unlawful to discriminate in health care and other settings based on disability, age, sex, race, and other protected characteristics.
What is a “reasonable accommodation”?
A reasonable accommodation is a change in your rules, policies, practices, or services that make your medical services accessible to a patient or visitor with disabilities. Reasonable accommodations are practical, effective, and don’t drastically change how you operate. As the provider, you are generally responsible for covering costs associated with making reasonable accommodations.
Examples:
- Offering a sign language interpreter to patients who are Deaf or hard of hearing.
- Allowing service animals to accompany patients to their appointments.
- Providing a roll on-scale for patients who use a wheelchair.
- By August 9, 2026, all state and local government health facilities that use exam tablesor scales must have at least one that is accessible.
- Treating a patient in a different office or location if your office is not accessible and cannotbe made accessible.
What is an “undue burden”?
Accommodations that drastically change the purpose of the services you provide, cost a lotof money, or pose a direct and unavoidable threat to your staff or other patients might beconsidered an undue burden.
Reasonable accommodations to visitor policies
Patients and visitors with disabilities can request reasonable accommodations to healthcare visitor policies.
Examples:
- Your patient or their visitor has a service animal. Either of them can request an accommodation to your ‘no animals’ policy to allow their service animal to accompany them.
- Your patient or their visitor requires someone to physically or emotionally assist them during appointments, help them understand medical information, or manage their healthcare decisions. They can request an accommodation to your visitor policy.
When can a patient or visitor request a reasonable accommodation?
While prior notice can help with planning, accommodations may be requested at any time. As a provider, you must engage in a good faith, interactive process with patients and visitors to identify and provide appropriate accommodations.
