Americans With Disabilities Act Research Articles

Perceptions and Bias of Small Business Leaders in Employing People with Different Types of Disabilities.

Despite existing employment-related legislation and governmental programs, people with disabilities continue to face significant barriers to competitive employment. These obstacles are partially due to biases among employers regarding the contributions of people with disabilities and perceptions about accommodation costs, which can affect their hiring decisions. Existing research on employment barriers and facilitators often treats people with disabilities homogenously and focuses mainly on large companies. This study helps to fill these gaps by exploring the motivations and challenges small employers face when hiring people with disabilities and how their attitudes and willingness to hire vary based on disability type. We surveyed business owners and decision-makers at companies with fewer than 100 employees resulting in a sample of 393 company respondents. Through descriptive analyses, we examined variations in respondents' willingness to hire and the prevailing attitudes among the company leaders sampled. We explored how employer attitudes can either hinder or support the hiring of people with disabilities. We conducted multivariate analysis to explore the connections among attitudinal barriers, facilitators, and willingness to hire individuals with various disabilities, reflecting disability's heterogeneous nature. Our findings reveal that, in terms of hiring people with disabilities, the most important concerns among employers are: inability to discipline, being unfamiliar with how to hire and accommodate, and uncertainty over accommodation costs. These concerns do not differ between employers covered by the Americans with Disabilities Act (ADA)and non-covered employers. However, ADA-coverage may make a difference as ADA-covered employers are more likely to say they would hire an applicant with a disability. We find that for small companies (less than 15 employees), the positive effect of the facilitators (positive perceptions about workers with disabilities) almost completely offsets the negative effect of the barriers. However, for the larger companies, the marginal effect for an additional barrier is significantly more predictive than for an additional facilitator. Among the disabilities we examined, employers are least likely to hire someone with blindness, followed by mental health disabilities, intellectual disabilities, deafness, and physical disabilities, underscoring that employers do not view all types of disabilities as equally desirable at work. Understanding small employers' underlying concerns and effectively addressing those factors is crucial for developing effective intervention strategies to encourage small employers to hire and retain people with different disabilities. Our results suggest greater openness among ADA-covered employers to hiring people with disabilities, but the perceived barriers indicate a need for ongoing information on effective intervention strategies to increase disability hiring among all small employers.

Service Animals in Health Care Settings

This JAMA Insights article reviews Americans with Disabilities Act (ADA) rules for patients, visitors, and other members of the public bringing service animals into health care settings.

Performance Metrics for Implementation of Americans with Disabilities Act Transition Plans

Safely walking or wheeling in a wheelchair in the community is a civil and human right. Some progress has been made in the US towards making walking/wheeling paths more accessible for people with disabilities through the construction of new curb ramps, fixing sidewalk barriers, and installing accessible pedestrian signals. However, pedestrians with disabilities continue to be limited by infrastructure barriers on sidewalks and streets. To encourage progress and government transparency, we developed a set of performance metrics for local governments to monitor and report their progress in implementing barrier removal plans, called Americans with Disabilities Act (ADA) transition plans. We used the five-step Nominal Group Technique to systematically develop and prioritize a set of performance metrics with an expert panel of ADA coordinators, disability organizations, and state and federal Department of Transportation staff. The research resulted in obtaining 53 metrics across five goals and 14 objectives that can be used to measure all phases of implementation and are intended to be customized to fit different community contexts and capacities. The metrics could be used by federal and state transportation agencies, as well as internationally, with some adaptation to ensure that adequate progress in barrier removal is being made. Local governments can use the metrics to document and communicate their progress and effectively reduce ADA compliance litigation concerns.

COVID-19 and the Americans with Disabilities Act: Implications for employment and higher education.

The Americans with Disabilities Act (ADA) is a federal law that protects individuals with disabilities from discrimination in all areas of public life. The ADA contributes to equal opportunity across policy areas, including the interconnected domains of higher education and employment. Since the onset of the COVID-19 pandemic in 2020, emerging research has begun to document the disparities in impact on people with disabilities, among other marginalized groups. However, no research to date has reviewed and synthesized literature that addresses disability discrimination related to COVID-19 that has implications for application of the ADA. This rapid evidence review aims to increase understanding about how COVID-19 has resulted in challenges for people with disabilities in the domains of employment and higher education that may be resolved through application of the ADA. Keyword searches were conducted in five electronic databases. Title, abstract, and full text screening was conducted followed by a thematic analysis of key ADA themes. Twelve final articles were included in this review, eight categorized within higher education and four within employment. In relation to the ADA and COVID-19, five studies revealed findings related to web accessibility, eight related to effective communication, and four related to reasonable accommodations. The findings provide a broad overview of the current research on how COVID-19 has affected accessibility, communications and accommodations in employment and higher education and identify gaps in the literature within these policy domains.

Change Is Slow: Acquisition of Disability-Accessible Medical Diagnostic Equipment in Primary Care Offices over Time.

The lack of disability-accessible medical diagnostic equipment (MDE) in primary care impedes the receipt of quality medical care by people with mobility impairments. Cross-sectional surveys and observational studies have found <40% of medical offices have disability-accessible examination tables or weight scales. Although government agencies and advocates recommend primary care acquisition of the accessible MDE, the rate of acquisition is unknown. Using panel data, the research examined if primary care offices audited for disability accessibility increased accessible examination table and scale presence between the first and second audit. Data for 2006-2009 (Time 1 [T1]) and 2013-2016 (Time 2 [T2]) came from 1293 primary care practices associated with Medicaid managed care organizations. Permutations of presence or absence of a height-adjustable examination table and accessible weight scale were analyzed to assess rate of change across time periods. More practices had disability-accessible examination tables or weight scales at the second observation, although total presence was low (12.9%, 7.9%). Practices added equipment between time periods; however, ∼60% of practices with accessible MDE at T1 no longer had it available at T2. The acquisition rate of accessible MDE was low, despite prior auditing. Studying change in accessible MDE presence in primary care offices requires attention to equipment acquisition and its retention. Stronger federal enforcement of Medicaid and Americans with Disabilities Act (ADA) access requirements, with regular standardized auditing of medical office accessibility, may be required to produce a more equitable health care experience for disabled people.

Requesting mental illness workplace accommodations: the roles of perceived need and stigma

PurposeResearch related to workplace accommodation requests for employees with mental illness is scarce, though evidence suggests that these individuals often fail to request accommodations even when needed. The authors' research study aimed to address these shortcomings by (1) assessing employees' knowledge of Americans with Disabilities Act (ADA) laws and how this knowledge influences employees' perceived need for and requests of accommodations; (2) examining the relationship between employees' perceived need for accommodations and employees' workplace outcomes and (3) examining the relationship between perceived need for accommodations and employees' actual accommodation requests, as well as how stigma influences this relationship.Design/methodology/approachThe authors used two survey studies to investigate their research questions. Study 1 participants were recruited through Amazon's MTurk, and Study 2 participants were recruited through support groups for individuals diagnosed with mood disorders (i.e. depression and bipolar disorder).FindingsThe authors found significant gaps in both subjective and objective ADA-related knowledge among participants in their sample. The authors' Study 1 results also revealed an interaction between the perceived need for accommodations and accommodation requests in predicting job satisfaction and turnover intentions. When employees needed accommodations but did not request them, it resulted in worsened workplace outcomes. In Study 2, the authors aimed to identify barriers to requesting accommodations. The authors found that the relationship between perceived need for accommodations and actual accommodation requests was moderated by both public and self-stigma, thereby showing that stigma can impede individuals from requesting needed accommodations at work.Originality/valueThe authors' study sheds light on a population that has been relatively understudied in the workplace accommodations literature, namely those with mental illness. The authors first identify the perceived need for accommodations as an important factor in making accommodations requests at work, as prior work has failed to differentiate how the need for accommodations can vary across individuals. Next, the authors show how workplace outcomes (i.e. job satisfaction and turnover intentions) are negatively affected when employees need accommodations but do not request them. Finally, the authors demonstrate how both public stigma and self-stigma can reduce the likelihood that individuals request accommodations at work, even when needed.

Brain injury, medical progress, and the disability paradox: Towards an Americans with Abilities Act.

It is helpful to think about the needs of patients with moderate to severe brain injury through the lens of disability law. However, there are limitations to current disability law that contribute to ongoing segregation and marginalization of individuals with severe brain injury. Indeed, one of the paradoxes of American jurisprudence is that more clear constitutional protections accrue to those who have definitively immutable conditions. Thus, as neuroscience brings new therapies to those with brain injury, they may become less protected by the constitutional elements of disability law because their conditions have changed and become mutable. This is the clinical progress that brain injury professionals all seek to achieve, but ironically these advances could potentially degrade the legal protections of patients who benefit from emerging treatments. In this paper, we will critically examine this paradox at the interface of medicine and the law and suggest that the Americans with Disabilities Act (ADA) could be nicely complemented by legislation we have named the Americans with Abilities Act (AWAA). Instead of focusing on disabilities that need protection, the AWAA seeks to sustain and foster newfound abilities made possible by the fruits of medicine and neuroscience.

Workplace accommodation requests: Experiences of barriers and facilitators among deaf and hard-of-hearing.

Despite the protections afforded by the Americans with Disabilities Act (ADA), workers who are deaf and hard-of-hearing (DHH) face workplace challenges that may require the aid of workplace resources and accommodations. Limited research has been conducted to understand the process of accommodation requests among DHH workers. This qualitative study examined barriers and facilitators to requesting accommodations among DHH workers. Fifty-nine DHH workers, recruited from organizations serving DHH workers across U.S., participated in the study. Participants' open-ended survey responses were analyzed and coded into themes representing barriers or facilitators to participants' decisions to request or withhold requests for accommodations. Facilitators to accommodation request include an employee's effective use of self-efficacy and self-advocacy; supportive work environments; and the presence of peers with disabilities. Barriers to accommodation requests include the anticipation of negative perception of stigmatization in the workplace; lack of knowledge related to accommodations and ADA; absence of workplace support; ineffectual workplace structure, policies, or procedures; concerns surrounding costs; and physical and access barriers in the workplace. To fulfill the workers' rights as guaranteed by the ADA, and to best serve the interests of the workplace, strategies are highlighted on how to assist DHH employees to take advantage of workplace accommodations with aims to promote job retention and success.

Small Empires: How Equipped are Small Business Owners to Hire People with Disabilities?

This study explores small businesses' knowledge base and practices concerning interviewing and hiring job candidates with disabilities, as they are not required to comply with the provisions of the Americans with Disabilities Act (ADA). We first conducted 18 in-depth interviews with small business owners to explore their knowledge of the ADA, their practices surrounding hiring (for those with and without disabilities), and their sense of the best practices for how a candidate should navigate the interview and request for accommodations. Responses were then used to create a survey of an additional 110 small business owners. Six themes arose from the interviews, illuminating the steep learning curve involved in each (1) hiring well, (2) the need to trust an employee's character as much as their skill set, (3) the need for an employee to fit within the small business's family-like environment, (4) the preference for job candidates to be transparent about their needs as early as possible, (5) the importance of personal experience with disability, and (6) the difficulty in obtaining precise information about the ADA. Survey responses supported the general findings of the interviews while also providing information about the relative rarity of encountering a job candidate with a disability. Hiring employees with disabilities is challenging for small businesses, and bias is difficult to avoid. The availability of clear information on how to comply with the ADA and other laws and practices would be welcome by many small business owners.

Multiple-Stakeholder Perspectives on Accessibility Data and the Use of Socio-Technical Tools to Improve Sidewalk Accessibility

For people with disabilities, accessible pedestrian infrastructure can support independence, mobility, and improved quality of life. Yet, most pedestrian infrastructure presents barriers that impede movement. A major challenge for cities to improve pedestrian accessibility is the lack of reliable data on sidewalk accessibility. Little is known about the type of data needed for cities, as well as how different stakeholders perceive and use sidewalk data. Therefore, this study seeks to explore the perceptions of multiple stakeholders on the use, gathering, and application of sidewalk accessibility data. We conducted a series of workshops with 51 participants, including people with disabilities, caregivers, Americans with Disabilities Act (ADA) coordinators, and urban planners, to discuss sidewalk accessibility data and data collection tools. We used the socio-technological tool Project Sidewalk as an example. Participants identified various uses for the accessibility data such as route planning, barrier removal plans, and advocacy, and discussed issues of usability, trust, access, and accessibility of the data and tools. Our findings contribute to a better understanding of important factors that impact the use and application of accessibility data and how to implement accessibility data collection initiatives that utilize socio-technological approaches such as crowdsourcing.

Tips for Making Music Performances Sensory-Friendly and Inclusive

In today’s society, major arts organizations and other large-scale public venues are making additional accommodations for persons with disabilities beyond those under Americans with Disabilities Act (ADA). Often termed “sensory-friendly,” this approach makes it easier for individuals with sensory sensitivities to participate in social activities and community events. However, we rarely see similar efforts occurring in school-based music performances. Therefore, we set out to create an inclusive concert experience that welcomes all persons to attend regardless of their sensory, mobility, or other needs to benefit everyone—the students, the families, the school, and the community. During our journey, we realized several components were essential to the overall success of our concerts. In this article, we share five tips that may help you feel more confident implementing something similar in your school.

58 Inclusive Strategies for Course Development: Moving Beyond Ada Compliance

Abstract This session will present how New Mexico State University, through the Disability Access Services Department, works with students who disclose a disability or impairment that creates barriers in their courses or other University sponsored activities. It will include a brief overview of post-secondary trends and the most commonly reported disabilities and requests for accommodations in university settings. Attendees will become familiar with the process to implement accommodations that can mitigate such barriers and what it means to be a qualified student with a disability who can receive accommodations. After covering how to meet the requirements of the American’s with Disabilities Act (ADA), the session will provide strategies for course development that can be inclusive of every student and even reduce the need for students with disabilities to request accommodations. We will discuss Universal Design concepts and provide examples of strategies that can be built into a course.

Survey of Knowledge of ADA: Basic Concepts, Accessibility Fundamentals - Disabilities, Guidelines, and Laws, Web Accessibility Testing

Introduction: The purpose of the project is to measure the knowledge of persons with blindness or low vision (BLV), addressing the Americans with Disabilities Act (ADA), accessibility fundamental, and web accessibility of persons with low vision or blindness.&#x0D; Methods: A survey of knowledge addressing the Americans with Disabilities Act (ADA) Basics, Accessibility Fundamentals, Web Accessibility: Basic Methods and Tools, and Web Accessibility Testing: Screen Readers was developed and distributed through Qualtrics. The knowledge test was to take 30 to 35 minutes. A final question will ask if a participant would like to participate in a training program on the aforementioned topics. Data was analyzed using MS Excel.&#x0D; Results: Out of the target of 15 participants, seven elected to start the knowledge survey for a 47% return. However, five of the seven fully completed the knowledge survey. The average score was 33 out of 45 for an average percentage of 75%.&#x0D; Discussion: The findings demonstrate that persons with low vision or blindness need training and more knowledge of web accessibility. Additional research to explore knowledge accessibility of persons with low vision and blindness should be encouraged to explore careers and training in the field.&#x0D; Implications for Practitioners: Developing web accessibility training and providing resources for accessibility certification may be beneficial. It is essential to support persons with visual impairments to obtain licensure or certification. Career development and planning to help employment should be included.

Advocacy for patients with opioid use disorder: A primer for physicians and other clinicians on the Americans with Disabilities Act.

Americans with opioid use disorder (OUD) have a disability that is protected under the Americans with Disabilities Act (ADA). Physicians may observe ADA violations when patients are forced to stop taking medications for opioid use disor-der (MOUD) as part of an entity's blanket policy that prohibits MOUD or when patients are denied medical treatment for various illnesses due to having an OUD diagnosis and/or receiving MOUD. Physicians and patients are likely unaware of how to identify potential ADA violations or what to do when they encounter one. This article will explain the ADA and how its protections are applicable to patients with OUD using several case examples. Physicians will learn to recognize possi-ble ADA violations and how to file a report with the Assistant United States Attorney. The article will outline how previous ADA settlements have addressed barriers to MOUD treatment access and highlight the need for more clinicians to serve as advocates to ensure all public entities and accommodations are in compliance with the ADA as it pertains to patients with OUD.

Recovery Ready Workplaces: A key strategy for reducing overdoses and sustaining recovery from substance use disorder.

In 2021, overdose deaths surpassed the 100,000 mark for the first time in the United States' history, and alcohol-related deaths continue to surpass 140,000 each year. Regulatory and societal barriers to effective treatment and prevention of substance use disorder (SUD) persist. Innovative strategies and approaches to support long-term recovery can help re-duce morbidity and mortality associated with SUD. Improving access to quality treatment and the availability of a broad range of policies and programs to support recovery and address social determinants of health, including employment supports, are key to curbing the overdose epidemic and rebuilding stronger communities. This article outlines the role Recovery Ready Workplaces can play in reducing overdoses and helping individuals sustain recovery from SUD, as well as in strengthening communities. This article describes how congressional and state legisla-tive action, Americans with Disabilities Act (ADA) enforcement and expansion, and other programmatic and fiscal policy changes at the state and federal levels will accelerate the adoption of Recovery Ready Workplaces as an element of a comprehensive response to SUD. The article also identifies existing state models and proposes specific federal- and state-level solutions to address some of the current limitations. Recovery Ready Workplaces benefit employees, employers, and the nation's economy. Recovery Ready Workplaces are a supportive tool and policy strategy to help those with SUD thrive in recovery and to bolster communities and the econ-omy as a whole.

Americans with disabilities act cases initiated by individuals with cochlear implants in the United States

ObjectiveThe Americans with Disabilities Act (ADA) is a federal law that forbids discrimination against individuals with certain disabilities, including hearing impairment. This study aimed to determine the nature of ADA discrimination complaints in individuals with cochlear implants. MethodsA search for court decisions containing the terms “cochlear implant” and (“Americans with Disabilities Act” or “ADA”) from 1985 to 2021 was performed with the Westlaw Campus Research legal database. Cases were included and analyzed if at least one of the plaintiffs had a cochlear implant and was claiming discrimination related to their hearing impairment based on the ADA. Results24 cases initiated between 2003 and 2021 in 19 US states were identified based on inclusion criteria. The highest number of cases occurred in California (N = 4, 16.7 %). The alleged discrimination most frequently took place at a K-12 school (N = 9, 37.5 %), workplace (N = 7, 29.2 %), or during an encounter with police/correctional officers (N = 4, 16.7 %). Fourteen (58.3 %) cases involved complaints under Title II (Public Services) of the ADA. Seven (29.2 %) involved Title I (Employment) and 4 (16.7 %) involved Title III (Public Accommodations). Summary judgment was given in favor of the defendant or the case was dismissed entirely in 16 (66.7 %) of the cases. ConclusionPatients with cochlear implants are still at risk of discrimination because of their disability. Cochlear implantees, school employees, workplace supervisors, and law enforcement personnel can benefit from ADA education.

The Issue of Protection of Disabled Persons Rights

This article covers the present condition of disability rights in the United States, focusing on the continued obstacles experienced by those with disa-bilities in the workplace, public spaces, and sporting venues. Despite the fact that the Americans with Disabilities Act (ADA) offers extensive safeguards for those with impairments, these provisions are seldom implemented. In 2019, the United States Equal Employment Opportunity Commission re-ceived over 24,000 complaints of disability-related employment discrimina-tion, illustrating the persistent difficulties experienced by handicapped work-ers. In addition, the United States Department of Justice received approxi-mately 8,000 complaints involving accessibility issues in public areas, under-scoring the ongoing need for stricter enforcement of laws governing public accessibility. Participation in sports has been proven to provide substantial advantages for those with disabilities, but it remains difficult to ensure that sports facilities are really accessible and inclusive. According to the article's premise, full application and enforcement of disability rights laws in the United States requires more education and awareness among employers, public accommodations, and sports management.

Reflection on the application of the Consolidated Framework for Implementation Research to a national policy to improve inclusion of people with disabilities

People with disabilities face many barriers in the built environment impacting their mobility, health, and social participation. In the US, under the Americans with Disabilities Act (ADA), municipalities were required to develop and implement barrier-removal plans for pedestrian infrastructure, called ADA transition plans, but very few have done so. Many communities know they need a plan but do not know how to get it done because of a lack of understanding of the many different implementation considerations. Implementation science offers a useful approach for understanding complex policy implementation such as ADA plans. This paper provides a reflection on the adaptation of the Consolidated Framework for Implementation Research (CFIR) to evaluate the implementation of ADA transition planning. To apply the CFIR, we tailored the construct definitions and modified them to fit the specific context of the ADA transition planning process. We documented the constructs that were more challenging to apply, those that were not relevant, and those that were particularly useful. This paper can serve as a valuable example that other researchers can use when considering adapting the CFIR or other implementation frameworks for the evaluation of complex social policy beyond the ADA.

Aging and Disability: An Exploration of Barriers and Facilitators to Community Living

Demographic data projections for the United States indicate a significant increase in the population of older persons with disabilities. The Americans with Disabilities Act (ADA) mandates community access for individuals with disabilities, including older individuals who are aging with or aging into disabilities. However, there is limited research regarding the knowledge and the use of the ADA among this population specific to their perceptions and experiences regarding barriers and facilitators to community access and participation as mandated under the Act. The purpose of this qualitative focus group study was to explore the perceptions and experiences of a sample of older adults with disabilities regarding their community access, and their knowledge and utilization of the provisions of the ADA to facilitate community participation. Analysis of results identified three predominant themes within this sample of older adults: experiences with structural and attitudinal barriers to community access leading; fear of loss of autonomy and independence in the community, and how they deploy; coping and advocacy strategies to address barriers. Recommendations for improving ADA knowledge, access, and utilization among the population, as well as senior service providers, are also addressed.

Improving Care for Opioid Use Disorder in Nursing Facilities.

As this issue of The Senior Care Pharmacist focuses on elder abuse, it is critical to recognize that people with opioid use disorder (OUD) are federally protected under the Americans with Disabilities Act (ADA). This was affirmed in 2022 by physician and Director of the Office of National Drug Control Policy, Dr. Rahul Gupta, in a recent public workshop on medications for opioid use disorder (MOUD) hosted by the National Academies of Sciences, Engineering, and Medicine. While the ADA specifies that discrimination against those with OUD is illegal, it also affords legal protection to access to health services and treatment for those with OUD that includes skilled nursing facilities (SNFs). The policy guidance document from the US Department of Justice Civil Rights Division titled “The ADA and Opioid Use Disorder: Combating Discrimination Against People in Treatment or Recovery” explicitly states that if a SNF refuses to admit a patient with OUD predicated on the patient taking a clinician prescribed MOUD or the SNF prohibited any of its patients from taking MOUD, then this exclusion/prohibition would be in violation of the ADA. Refusal to provide care for patients experiencing a drug overdose at emergency departments or to provide health services for a patient with OUD are also in violation of the ADA. The refusal of a city to open an OUD treatment center on the basis of hostility toward people with OUD may also be in violation of the ADA.