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Livable Communities--Accessibility

Iowa ’ s Community Access Project. Iowa’s Community Access Project. Livable Communities--Accessibility. COMMUNITY ACCESSIBILITY PROJECT OVERVIEW AND BACKGROUND. Iowa’s Community Access Project. What is the project’s purpose?

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Livable Communities--Accessibility

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  1. Iowa’sCommunity Access Project Iowa’s Community Access Project Livable Communities--Accessibility

  2. COMMUNITY ACCESSIBILITY PROJECT OVERVIEW AND BACKGROUND

  3. Iowa’s Community Access Project • What is the project’s purpose? • The purpose of the Community Access Project is to build livable communities; that is, communities that provide, for all its citizens: • Affordable and appropriate housing • Supportive community features • Accessible and responsive services • Adequate mobility options

  4. Community Access Project Goal Iowa’s Community Access Project Improving the physical and programmatic access of • Public health programs • Private health care facilities • Disaster shelters

  5. Role of the Access Specialist Iowa’s Community Access Project Promotes full inclusion of people with disabilities in all aspects of community services and life Through needs assessment, education, action, and advocacy Provides technical assistance and acts as a resource for the community

  6. Iowa’s Community Access Project Access Specialist Responsibilities • Meet with organizations and businesses to encourage them to complete an ADA audit • Answer common questions regarding the ADA Guidelines (ADAAG) • Assist the target programs in conducting ADA surveys • Work with the Office of Disability and Health to obtain a review and analysis of ADA surveys

  7. Iowa’s Community Access Project Access Specialist Responsibilities continued 5. Offer technical assistance to target programs to become ADA compliant 6. Make appropriate referrals to assist target programs with ADA compliance 7. Work with the community and specific businesses to identify and fill resource gaps 8. Develop incentives for ADA compliance and implement recognition programs

  8. IDPH Office of Disability and Health (ODH) Iowa’s Community Access Project Will assist Access Specialists by: • Identifying public health programs in their area • Providing training and consultation in completing the Iowa ADA Building Access and the ADA Program Access Surveys • Analyzing survey results • Preparing a letter that summarizes the findings from both surveys and provides recommendations to improve access • Providing on-site technical assistance if requested

  9. Center for Disabilities and Development (CDD) Iowa’s Community Access Project Will assist Access Specialists by: • Training, mentoring and certifying community Access Specialists • Providing technical support • Providing addition training and resources to enhance project • Evaluating the project

  10. COMMUNITY ACCESSIBILITY APPLYING ADA ACCESSIBILITY GUIDELINES

  11. Iowa’s Community Access Project The Access Specialist will: • Understand key concepts in the ADA Accessibility Guidelines (ADAAG) • Understand the difference in expectations for large, small and public businesses. • Demonstrate knowledge of reasonable accommodations for— • health care facilities. • public health facilities. • disaster shelters.

  12. Iowa’s Community Access Project Understanding the ADA • ADA language is confusing • It is important to understand the “intent” of the ADA • It is important to understand the application of the ADA • Become familiar with Titles I through IV

  13. Iowa’s Community Access Project Key Terminology: • “shall”means mandatory specification or requirement • “should” means it is an advised specification or requirement • “may”means options or alternative • “comply with”means meets one or more specification • “if…..then”means applies only when certain conditions exist Understanding the ADA

  14. Iowa’s Community Access Project Small vs Large Business Business owners who serve the public are responsible for removal of physical barriers that are “readily achievable” • Means it can be easily accomplished and without to much expense • Based on size and resources available • Don’t expect business’ to go bankrupt to achieve accessibility • Many things business’ can do to improve access that are inexpensive

  15. Iowa’s Community Access Project Reasonable Accommodations for Health Care Facilities • Privately operated medical and health care facilities are covered under Title III- buildings, services and products must be accessible to people with disabilities • Examples – doctor’s offices, dental offices, clinics, day surgery centers, family planning clinics, private hospitals, private psychologist or social work offices, and physical or other therapy treatment facilities • For physical access, think in terms of parking, entrance, common areas and bathrooms for the physical location

  16. Iowa’s Community Access Project Parking • Closest available to an accessible entrance • Upright signage using the universal symbol of disability • First space must be designated “Van accessible” • Access aisles must be available • Must have a clear, level path of travel • Curb cuts (ramps) near parking • Ratio 1 in 25

  17. Iowa’s Community Access Project

  18. Iowa’s Community Access Project Entrances • At least one accessible route leading to an accessible entrance, level with 36 inches wide surface • Connected to the accessible parking • Thresholds are no higher than ¾ inch for exterior sliding door and ½ for other doors with 32 inch clear opening • Door hardware that is easy to grasp with one hand and does not require tight grasping, tight pinching, or twisting of the hand and wrist to operate • Each entrance/exit is identified with the universal symbol of accessibility

  19. Iowa’s Community Access Project Common Areas • Common areas or interior circulation are public areas free from obstacles • All doors have a clear opening of “32 inches, with a push/pull weight of 5lbs • Door hardware is easy to grasp with one hand and does not require tight grasping, tight pinching, or twisting of the hand or wrist to operate • Interior doors shall not be over ½ inch, with a flat surface of five feet • Ramp ratio is 1/12 meaning the ramp rises one inch per each foot • Ramps is higher than 6 inches will have railings on each side with the rail extending one foot beyond the ramp • Any amenities offered to the public must be accessible, water fountains, phones, alert systems

  20. Iowa’s Community Access Project Restrooms • Identified with the universal symbol • Path of travel shall be free of objects • Doors have a 32 inch opening with push/pull of 5 lbs or less • 5 foot radius of open space in at least one stall or open floor in a single use restroom for transfer • The stall door should swing out and follow the person in • Grab bars are 1 ¼ to 1 ½ in diameter with 1 ½ inch from wall • The toilet are 17 – 19 inches from finished floor • Lever, push-type, touch-type, or electronically controlled handles on the sink • Protective insulation on hot/cold pipes under the sink to protect knees

  21. Iowa’s Community Access Project Stairs - Elevators • Elevators, wheelchair lifts and ramps may provide access to above floors • Cost may prohibit installation • Freight elevators and service routes can be used but must be a clear path of travel • If not readily achievable, alternate locations that are accessible can be used • Provide same or similar services

  22. Iowa’s Community Access Project Accessible Exam and Testing Equipment • Standard equipment in medical, dental and health care facilities prohibits certain exams and procedures • Primary health care providers can’t provide a full exam of a patient when they are in a wheelchair • Gold Standard = adjustable height exam table • May not be “readily achievable” -- $10,000 • Alternatives: • lower table the height of a wheel chair seat • transferring patient to table (safety?) • referral to use of equipment in another facility

  23. Iowa’s Community Access Project Service Animals • Service animals are any domesticated animal • Service animals that are dogs or cats are allowed anywhere their human partner goes – protected under the ADA • Health care facilities must allow their entrance except where they would compromise health or safety • Two questions allowed to determine if it is a service animal – • Do you need this animal due to a disability? • What tasks or work has this animal been trained to perform?

  24. Iowa’s Community Access Project Accommodations for Those with Hearing or Speech Disability • TTY’s (TeleTYpewriters) helpful but not required; a low-cost accommodation at around $250 • Train staff to use Relay Iowa • Use computer terminal or pad and paper for routine communications • Use licensed sign language interpreters when dealing with complex medical issues such as surgery or informed consent (rarely provided) • In Iowa providers can bill Medicaid for a licensed sign language interpreter for billing and consult • Allow extra time

  25. Iowa’s Community Access Project Accommodations for Those with Low- or No-Vision • Try to make all written materials available in large print, audio recording or Braille; placing materials online can be useful if the font size can be increased or the person has a Braille reader • Every effort should be made to have important forms such as informed consent or patient pre-procedure instructions available in alternate formats. • Other alternatives: • Provide a reader • Have a powerful magnifying glass available

  26. Iowa’s Community Access Project Accommodations for Those with Cognitive Disabilities • Communication should be clear and simple • Repetition can be helpful • Pictorial boards or simple drawings • If individual is not capable of giving consent, must get consent from parent or guardian

  27. Iowa’s Community Access Project Refusal of Treatment The ADA prohibits medical and health care facilities from denying treatment to a person with disability because of his or her disability Or denying treatment because of behavior resulting from a disability may be disturbing to other patients or clients That practice is discrimination

  28. Iowa’s Community Access Project Reasonable Accommodations for Public Health Programs • Public health services are covered under Title II • Public entity’s services, programs or activities must be readily accessible to and usable by people with disabilities • Know as “program accessibility”, applies to all existing facilities of a public entity • Not required to make all facilities accessible • Do not need to remove physical barriers if they can make their programs, services and activities through alternate methods

  29. Iowa’s Community Access Project Public Health Programs Continued Alternative methods • Relocating a service from third floor to first which is accessible • Provide an aide or personal assistant to obtain the service • Provide services in the individuals home • Provide services in an alternative location that is accessible

  30. Iowa’s Community Access Project Public Health Programs Continued Examples of Local Public Health Programs • Local departments of public health • WIC Programs • Maternal and Child Health Centers • Substance Abuse Treatment Programs • Domestic Violence Shelters • Chronic Disease Management Programs

  31. Reasonable Accommodations in Disaster Shelters Iowa’s Community Access Project • In Iowa, county Emergency Managers must locate facilities for temporary shelters. • These shelters and the goods and services provided must be accessible to people with disabilities. • Because these shelters are temporary, accessible features can be temporary i.e.; three parking spaces equal two accessible with the center as an access aisle, ramps can be built to create an accessible entrance • All “temporary” features must be safe

  32. Iowa’s Community Access Project Disaster shelters continued • If the shelter that the individual with a disability is taken to is not accessible, emergency responders shall identify an alternative site that is accessible • Possible alternative = A voucher for an accessible hotel that is located out of harm’s way • Medical shelters aren’t appropriate for most people with disabilities; they are intended for those in hospitals and nursing homes • Using medical shelters for most people with disabilities: • Separates them from family and personal support people at a time when they need support • Is a waste of precious county resources

  33. Iowa’s Community Access Project Disaster shelters continued Shelters should also be prepared to: • Handle service animals • Arrange for personal attendants to be near the individual with a disability they are helping • Provide or arrange to obtain needed assistive technology • Request and receive needed medications for residents • Stock foods for residents with special dietary needs and provide kitchen access if needed • Provide low stimulation or “stress-free zones” for residents whose disabilities are aggravated by stress

  34. Iowa’s Community Access Project COMMUNICATION ACCOMODATIONS IN ALL SETTINGS IANet Task Force Guidelines on: Communicating About Health Care to People Who Have Disabilities A copy is included in your Access Specialist Accessibility Resource Manual

  35. COMMUNITY ACCESSIBILITY CONDUCTING IOWA ACCESS SURVEYS

  36. Iowa’s Community Access Project The Access Specialist will: • Demonstrate knowledge of Iowa’s accessibility surveys. • Understand physical access issues. • Understand program access issues.

  37. Iowa’s Community Access Project Iowa ADA Building Access Survey • Developed by the Department of Human Rights, Division of Persons with Disabilities • Focuses on physical accessibility in four areas: • Parking • Entrances/Exits • Common Areas (Internal Circulation) • Restrooms • Appropriate for use in private health care facilities and public health programs

  38. Iowa’s Community Access Project Iowa ADA Program Access Survey • Developed by the Community Access Project team for testing in the pilot • Focuses on program access issues: • Accessible exam and testing equipment • Communication for those with hearing or speech disability • Communication for those with visual disability • Appropriate for use with private health facilities and public health programs

  39. Iowa’s Community Access Project ADA Checklist for Emergency Shelters • Produced by the US Department of Justice • For use with Emergency/Disaster Shelters • To be completed the county Emergency Manager • The role of the Access Specialist: • Facilitate completion of the survey • Provide TA to Emergency Managers on making shelters accessible

  40. COMMUNITY ACCESSIBILITY PROVIDING TECHNICAL ASSISTANCE TO IMPROVE ACCESS

  41. Iowa’s Community Access Project The Access Specialist will: • Understands the concept and content of a compliance action plan. • Identifies resources to assist programs in making their facilities and services accessible. • Guides programs in developing their compliance action plan.

  42. Analysis of Surveys and Development of Recommendations for Compliance Iowa’s Community Access Project • Completed surveys will be reviewed by the ODH • Letters will be sent to providers with recommendation for compliance if necessary • Access Specialist will be notified when these letters go out • Your responsibility will be to provide technical assistance in identifying and accessing resources for compliance • Access Specialist should create a resource file, especially resources in area • See Appendix A, pages 68-76 for examples

  43. An Accessibility Compliance Action Plan Iowa’s Community Access Project • Help providers develop a Compliance Action Plan that: • Identifies achievable outcomes • Sets realistic goals with a timeline, e.g. “In 6 months all doors will have lever handles • Help providers who can not “readily achieve” accessibility identify other accessible locations they can use. • Advocate for inclusion of the Compliance Action Plan in the organization’s strategic or business plan. • Help the organization establish an Accessibility Compliance Folder

  44. Iowa’s Community Access Project Develop an Accessibility Resource File Include: • ADA Ramp and Other Construction Contractors—Contact Iowa COMPASS at -800-779-2001 • Accessible Medical Equipment or Assistive Technology—Check will local durable medical equipment companies or call Iowa COMPASS • TTYs (TeleTYpewriters)—Call Iowa COMPASS

  45. Iowa’s Community Access Project Accessibility Resource File Continues • Relay Iowa--7-1-1 or 1-800- 735-4313 (voice) • Licensed sign language interpreters—Go the Iowa State Interpreters for the Deaf web site at http:/www.new.iowastaterid.org/ and select Interpreter Search or contact Iowa COMPASS for referral to an on demand virtual interpreter provider • Brailling—Contact the Iowa Department for the Blind at 1-800-362-2587 for referral to a certified contract Braillist.

  46. COMMUNITY ACCESSIBILITY GETTING STARTED—DEVELOPING YOUR PLAN OF ATTACK

  47. Iowa’s Community Access Project The Access Specialist will: • Understand how to identify and target programs within the community. • Demonstrate competency in creating a message and making a presentation to the targeted programs. • Is familiar with the tax incentives available to businesses who wish to become ADA compliant. • Know the options available for creating a rewards program for businesses who become ADA compliant. • Demonstrate competency in approaching and engaging programs and creating a positive climate for change.

  48. Iowa’s Community Access Project Decide Which Programs to Target • Determine your geographic area • Make a list of the health care facilities and public health programs in your area • Develop criteria to select programs, e.g., • All in a smaller geographic area • A certain type of facility, e.g. doctor’s offices • Use/conduct a mini-community assessment to decide • Target more than you can handle; not everyone will participate. • NOTE: Most hospitals are physically accessible. Problems are in program accessibility.

  49. Iowa’s Community Access Project Your Message and Presentation • A message tells your target audience: • what they are being asked to do, • why it is worth doing, and • the positive impact their action can have. • You will have a limited amount of time, so know what you are going to say ahead of time

  50. Iowa’s Community Access Project Two Rules for Messages • Keep it simple • Keep it short and to the point • Limit yourself to two or three main points, and focus on your best supporting arguments • Data you can use for supporting arguments is in Appendix B, pages 77-78 • Know your audience • What motivates them • What past work they have done with ADA accessibility

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