Reasonable Accommodation Research Articles

Culturally competent mental health care

Culturally competent mental health care

Anatomy for All: Accommodations for a Variety of Situations

Medical institutions of learning should be commended on their efforts to diversify matriculating student populations. As a result of increased university inclusion, healthcare educators are often called upon to modify their educational strategies to accommodate our increasingly diverse student body. Although a deficit in any sensory system can put a student at a disadvantage in the gross anatomy lab, visual deficits are by far the most debilitating. Gross anatomy is foundational to all aspects of medicine and is inherently biased towards visual learning. Students with neurotypical sensory systems often rely on vision to not only learn a structure’s location, but also rely on visual recall of atlas images to navigate through vision‐biased anatomy exams (i.e., students are typically not allowed to touch identified structures). Normal sighted students have difficulty identifying a cranial nerve or artery, a task made that much more difficult for one who may be legally blind. Here the authors present case studies of how to accommodate students with two types of visual impairments, bilateral coloboma and albinism. We interviewed and/or accommodated students that were legally blind, defined as a visual acuity (central vision) of 20/200 or worse in the best seeing eye or a visual field (peripheral vision) that is limited to only 20 degrees. Various strategies were used to enhance both the didactic and laboratory learning experiences, but this presentation focuses on exploring the ways we can help visually‐impaired students navigate cadaveric specimens since these learning tools best approximate future patients. As the students and their evaluators navigated their individual curricula, protocols were developed to maintain testing parity and fairness to best serve future students. We provided visually‐impaired students with dedicated assistants (tutors or faculty guides) with prior gross anatomy training to facilitate studying, dissection, and/or exams. These assistants served as an interface between the student and the dissection group, as well as between the student and the cadaver. “Reasonable accommodations” were also put into place, such as: palpation of specimens, oral descriptors of anatomical boundaries, and image‐based exams (which allowed for a picture/feature to be enlarged). The most helpful tool was palpation, which allowed learners to recall the “visual” map (proprioceptive/tactile map) of the body they had created during the learning process by tracing the course of structures with their hands. With the help of the visually‐impaired students, we hope our case studies serve as a model for the future education and evaluation of students with visual impairments.

The Americans with disabilities act and healthcare employer-mandated vaccinations

Battles around workplace vaccination policies often focus on the annual influenza vaccine, but many healthcare employers impose requirements for additional vaccines because of the increased likelihood that employees in this sector will interact with populations at increased risk of acquiring or experiencing harmful sequelae of vaccine-preventable diseases. The federal Centers for Disease Control and Prevention and many states recommend healthcare employees receive numerous vaccines, including measles, mumps, and rubella (“MMR”); tetanus, diphtheria, and pertussis (“Tdap”). However, recent outbreaks of once-eliminated diseases that are now resurgent and the rising antivaccination movement raise questions about how far employers can go to mandate vaccinations. While healthcare institutions are increasingly mandating that employees receive vaccinations, employee objections to vaccines, including litigation, have increased in recent years. Employer policies must comply with the Americans with Disabilities Act (“ADA”), which prohibits discrimination on the basis of disability. Although the ADA permits mandatory vaccine policies under certain circumstances, employers must consider reasonable accommodations, which are changes to the job or work environment that permit the employee with a disability to perform the essential functions of the job, within certain limits. This article analyzes two recent cases which suggest how employers seeking to protect their workforce and the patients they serve by requiring vaccines can work within the framework of the ADA to implement these policies.

New housing guidelines provide clarifications for documentation, expectations for support animals

The Trump administration has issued new guidelines regarding the reasonable housing accommodations of service and other assistance animals for people with disabilities. The guidelines, issued by the U.S. Department of Housing and Urban Development, refine and clarify some of the processes for accommodating requests for assistance animals, as outlined in the Fair Housing Act. Some of the clarifications involve the types of animals that can be considered reasonably accommodated under the FHA and what type of documentation should be considered as sufficient proof that an individual needs an animal as an accommodation.

Gambling on Disability Rights

In light of the recent legalization of sports betting across the United States, leading American sports organizations have increased their efforts to protect the integrity of their competitions. These efforts include the implementation and enforcement of what this Article calls “anti-tipping rules,” which are internal rules prohibiting athletes and other personnel from disclosing nonpublic information that can be used by gamblers. Under these rules, the disclosure of information about athletes’ psychosocial impairments might be considered prohibited “tipping,” because these impairments may affect athletes’ availability for and performance in sporting events. This Article argues that anti-tipping rules may encourage athletes to mask their impairments, leading to a chilling effect on the disclosure of information about mental health in the sporting arena. As a result, these rules may adversely affect psychosocially disabled athletes in at least three distinct ways: (1) They may exacerbate pre-existing impairments by preventing diagnosis, treatment, and the therapeutic impact of disclosure; (2) they may discourage athletes from seeking reasonable accommodations or modifications under the Americans with Disabilities Act; and (3) they may perpetuate the stigma of mental health issues and hinder a rising movement of athletes seeking to create a new, more accurate narrative of psychosocial disability. This Article examines these overlooked consequences of anti-tipping rules and, drawing on U.S. insider trading law, proposes several strategies to address these detrimental effects.

Reasonable Accommodation for Age

Ensuring equal liberties requires neutral, i.e. impartial, settings where nobody would be deprived of freedom because of their personal characteristics. Religion and disability appear as characteristics which may clash with the existing social and physical environments. Therefore, the necessity of adjusting the existing environment, i.e., reasonable accommodation, is mostly discussed in reference to religion and disability. I aim to discuss reasonable accommodation from a different perspective and ask whether reasonable accommodation should be extended to age issues. I propose that age can lead to differences in conscience or culture like religion. Age can also be a source of dis/ability so it can be compared to accustomed disabilities. Eventually, age may also clash with the existing social and physical environments. I further propose that age is not only similar to but also different from religion and disability when it comes to reasonable accommodation. Therefore, I defend, reasonable accommodation should be extended to age in a special way. The next question then is how age could be accommodated under the European Union (EU) law, especially when we consider that reasonable accommodation law does not have a wide scope in the EU, unlike in Canada.

Some Musings About the Limits of an Ethics That Can Be Applied – A Response to a Question About Courage and Convictions That Confronted the Author When She Woke Up on November 9, 2016

AbstractI experienced the 2016 Presidential election as a loss of innocence. For the first time in my life, the prospect of losing my most basic rights and freedoms did not feel so remote. Confronting this possibility prompted the musings in this article. I call them ‘musings' because the article is not a systematic defense of a clearly demarcated position. It is, rather, a somewhat circuitous exploration of the many questions that pressed themselves upon me as I struggled to understand what distinguishes (a) reasonable accommodations to injustice from (b) morally unacceptable accommodations. When is a commitment not really a commitment? When does reasonable fear become shameful cowardice? When does my knowledge that I can do something to resist injustice give me good enough reason to resist? Under what conditions is my reason an enemy of my ideals? What is the proper balance between valuing myself beyond price and appreciating that many, many things matter far more than my own life and security? In grappling with these questions, I have been reminded of the extent to which moral discernment does not involve applying a ‘philosophy' and the extent to which it cannot be secured by prior training.

Challenges Faced by Collegiate Athletic Trainers, Part II: Treating Concussed Student-Athletes.

Conflict between athletic trainers (ATs) and other stakeholders can occur because of competing interests over medical decisions regarding concussion. However, we are unaware of any studies specifically exploring these situations across various collegiate athletic affiliations. To investigate the challenges faced by ATs when treating concussed student-athletes. Qualitative study. Online questionnaire. A total of 434 ATs (267 women, 166 men, 1 missing data; age = 27.73 ± 3.24 years, experience = 5.17 ± 2.67 years) completed the questionnaire (response rate = 14.47%). Our participants represented multiple employment settings within intercollegiate athletics. We sent an online questionnaire to 3000 ATs working in the collegiate and university setting across the United States. A survey expert verified face, content, and construct validity of the questionnaire in 2 rounds of review, and 3 ATs completed a content-validity tool before we finalized the survey. We analyzed the qualitative data using a general inductive approach and ensured trustworthiness through multiple-analyst triangulation and peer review. When we examined the responses from our participants regarding their work with student-athletes who had sustained concussions, we found 2 major themes, each with subthemes. First, educational efforts appeared to be only modestly effective because of a lack of honesty, noncompliant actions, and coach interference. Second, return to learn was challenging because of a lack of communication among stakeholders, athletes being anxious about needing accommodations, and difficulty convincing faculty to provide reasonable accommodations. Based on our findings, we recommend continued efforts to improve the culture surrounding concussion in collegiate athletes. Athletic trainers should include key stakeholders such as coaches, student-athletes, parents, faculty, and other educational administrators in their educational efforts to improve the policies and culture surrounding concussion treatment.

Workplace discrimination for persons with hearing loss: Before and after the 2008 ADA Amendments Act.

Individuals with hearing loss experience unique barriers to employment frequently documented in the areas of communication and education. The purpose of this article is to contribute to extend this inquiry to the uniqueness of workplace discrimination involving persons with hearing loss. This study investigated differences in allegations of workplace discrimination filed by persons with hearing loss ("Hearing") compared to those filed by persons with other physical or neurological disabilities (General Disability, or "GENDIS") before and after the enactment of the 2008 Americans with Disabilities Act Amendments Act (2008 Amendments). Using secondary data collected from the Equal Employment Opportunity Commission (EEOC) Integrated Mission System, we employ simple measures of proportion and odds ratios to describe differences between allegations derived from GENDIS and Hearing loss populations. These are population statistics, and not samples, of all allegations of discrimination reported to the EEOC through 2016. The comparisons involve Characteristics of the Charging Parties, Issues or discriminatory behaviors alleged, and closure statuses or Merit Rate of the EEOC's investigations - both before and after the 2008 Amendments. Following the 2008 Amendments, Charging Parties changed dramatically on age and gender status. Reasonable Accommodation, Hiring, Harassment, and employment Terms and Conditions showed unique features between groups and/or time periods. The "veracity" (confirmed truthfulness or merit) of the EEOC allegation (or Merit) rate also changed following the Amendments: higher for GENDIS; lower for Hearing. Possible rationale for these findings are offered, and new research questions are raised. Finally, implications for the cross-disability movement are presented.

L’angle mort de la « laïcité ouverte » : les processus de navigation et négociations dans le vécu religieux au Canada

Building on our critiques of the reasonable accommodation of religious minorities in Canada (see Selby et al., 2018a ; Beaman, 2017 ; Barras, 2016), this paper argues for attention to processes as intrinsic to everyday interactions of religiosity (following Tully, 1995, 2000 ; Van Quaquebeke et al., 2007). We contend that frameworks like Maclure and Taylor’s (2010) on ‘open’ and ‘closed’ secularism are useful for nation state comparison, but ineffectively account for the power asymmetries lodged within everyday religiosity. Their model protects the status quo ; it does not call institutional values or procedures into question, erases the navigation that occurs before an ‘accommodation’ is requested, and entrenches conflict as reflective of the experiences of religious minorities. Based on interviews with 90 self-defined Muslims in two cities, we propose a model of navigation and negotiation to better capture how religious practices are contextual and embedded in power relations.

Reefer Madness: The Legal Quagmire of Medical Marijuana in the Workplace

The film ‘Reefer Madness’1 propagandized the evil effects of marijuana in the 1930s.2 Nearly 83 years later, marijuana is largely decriminalized, chiefly for medicinal purposes. Less melodramatic than the side effects portrayed in Reefer Madness is the reality of how employment law will be impacted by medicinal marijuana use. Ordinarily, the Americans with Disabilities Act (“ADA”) would sufficiently address employee protections and permissible adverse employment actions, and, where it fails to provide guidance, surely state law would fill the gap. However, the current state of marijuana law presents a bizarre dilemma: how does a local or state jurisdiction regulate a medically and lawfully recommended drug that is outlawed federally? Does marijuana’s federal classification as a Schedule I drug permit an employer to claim preemption under the Supremacy Clause of the Constitution to avoid liability for adverse employment actions, such as discrimination, when state law would otherwise permit damages to be awarded? Where does an employee find balance between medical necessity and an organization’s business risk associated with medicinal side effects of marijuana? Why is reasonable accommodation even a legal answer for a drug used off site and after work hours? The current answers to these questions are divisive, pitting employer against employee and circuit against circuit. Yet the application of employment law is not at conflict with federal mandates. As this article will argue, the shortcomings of the ADA can therefore be remedied by applying an equitable balancing test to medical marijuana discrimination claims.

An analysis of the duty to reasonably accommodate disabled employees: a comment on Jansen v Legal Aid South Africa

ABSTRACT Persons with disabilities are a historically marginalised minority, who have the capacity to make a valuable contribution in the workplace. Recent case law suggests that the duty to reasonably accommodate disabled employees remains a conundrum for employers in South Africa. In Jansen v Legal Aid South Africa (C678/14) [2018] ZALCCT 17 (16 May 2018) the Labour Appeal Court had an opportunity to make a definitive pronouncement on the meaning and reach of the employer's duty to reasonably accommodate a disabled employee. Even though the duty to reasonably accommodate disabled employees is set out in our legislative and policy frameworks, there is a need to have a more detailed framework. The Constitutional Court is yet to hear a case on the duty of employers to provide reasonable accommodation to employees with disabilities, and until we have such a precedent, more and more employees with disabilities will continue to suffer at the hands of their employers. Both the Code of Good Practice, as well as the Technical Assistance Guidelines , published by the Department of Labour, have gone "relatively unnoticed and unread" in the workplace. This article argues that employers should follow a broad interpretation of the guidelines contained in the Code, as well as in the Technical Assistance Guidelines. Employers need to undertake proper investigations, with the assistance of experts if needs be, to investigate an employee's incapacity. Keywords: Disability, Reasonable accommodation, Persons with disabilities.

Accommodating Absence: Medical Leave as an ADA Reasonable Accommodation

The Americans with Disabilities Act (ADA) is widely regarded as one of the most significant pieces of civil rights legislation in American history. Among its requirements, Title I of the ADA prohibits employers from discriminating against people with disabilities and requires that employers make reasonable accommodations for qualified individuals. Many questions about the scope of the reasonable-accommodation mandate remain, however, as federal circuit courts disagree over whether extended medical leave may be considered a reasonable accommodation and whether an employee on leave is a qualified individual. This Note argues that courts should presume finite unpaid medical leaves of absence are a reasonable accommodation under certain circumstances and shift the focus of judicial inquiry to the employer’s burden of showing undue hardship. Creating a presumption for medical leave is consistent with the text and purpose of the ADA, aligns with Supreme Court case law, and serves as a better framework for balancing competing policy concerns compared to existing approaches.

(Emotional Support) Peacocks on a Plane: Revising Federal Reasonable Accommodations Laws for Emotional Support Animals

In an era of increased healthcare and medication costs, using the comfort of an emotional support animal as a disability mitigation presents a valuable alternative to an overtaxed healthcare system. The rise in use of emotional support animals has outpaced the regulation of them, however. Four key federal statutes affect the legal rights and obligations for assistive animals under federal law — the Americans with Disabilities Act, the Rehabilitation Act, the Fair Housing Act, and the Air Carrier Access Act. While all four require accommodations for service animals, only the latter two require the same for emotional support animals. Even so, there is no consensus on how to define emotional support animals — the Americans with Disabilities defines them by exclusion, while the Air Carrier Access Act defines them by inclusion into a broader “service” animal category, and the rest merely defer to the latter. The resulting gap and confusion in federal regulation produce rather absurd results: peacocks on planes, alligators in apartments, and plenty of confusion regarding whether anyone can do anything about either. This Article argues for eliminating this gap in federal regulations with clear, prescriptive revisions to key disability laws and their reasonable accommodation requirements as applied to emotional support animals. Namely, it proposes that Congress should amend select reasonable accommodations laws so that the definition of “emotional support animal” mirrors the definition for “service animal.” These proposed revisions address three main problems plaguing the emotional support animal landscape: (1) fraudulent misrepresentation of pets as emotional support animals, (2) misrepresentation of absurdly untenable, wild, or exotic pets as emotional support animals, and (3) lack of accessibility to emotional support animals for disabled individuals who could greatly benefit from them. An emotional support animal under the proposed framework would be dog, cat, or miniature horse whose presence — or a task it performs — provides comfort or emotional support to a disabled individual. Moreover, this Article calls for eliminating the statement of need, which would further align the emotional support animal framework with that of the service animal. In doing so, it clarifies accommodation provider responsibilities with regard to these animals, and fair use of a valuable accommodation option for those disabled individuals seek to benefit legitimately from it.

Program Access Under Disability Discrimination Law

State and local governments and all federal grantees must operate their programs. services. and activities are readily accessible to persons with disabilities when the program, service, or activity is viewed in its entirety. This Article submits that courts should adopt an expansive reading of this program access requirement, imposing an obligation on governments and grantees to offer something of benefit to everyone, no matter the nature of that someone’s disability. The text of the federal regulations, relevant caselaw, and persuasive analogies require this reading. Moreover, this energetic interpretation of the Americans with Disabilities Act and Section 504 regulations resolves some of the thornier problems of current disability discrimination law: limits on reasonable accommodation and the distinction between access and content for legally required accommodations. Applied to the recent case of A.H. ex rel. Holzmueller v. Illinois High School Association, the proper reading of the program access regulations requires the creation of a para-ambulatory long distance road race in the state high school competition.

The Evolution of Disability during the Last Years in Romania and EU Member States

Purpose: People with disabilities represent a major objective, a global public health issue. This disadvantaged category needs protection and integration into society by implementing an improved legislative framework. The effectiveness of the policy making, consolidating the benefit programs and enhancing equity of the social insurance system represent the key of The Governments strategy. Methods: The paper highlights comparable data and research related to disability and social insurance system from Romania and other Member States of the European Union. Internationally, a proper measurement of disability may lead to a successful removal of barriers which increase the vulnerability of people with disability. Results: According to official data, in Romania the number of disabled people decreased gradually one year to another (in the last 5 years). In the EU Member States, musculoskeletal disorders leading to disability were one of the most common compared to Romania where it ranked last. From the point of view of the share in the total number of people with disabilities, according to the degree of disability, both in the EU Member States and in Romania, the number of moderately disabled people was double, respectively triple compared to the number of those with severe disability. Conclusion: The Romania Government promotes social-professional integration of people with disabilities, being responsible for the guidance, vocational counselling and employment. In accordance with our law, “any person with disabilities, fit and included in the labor market in Romania is entitled to a reasonable accommodation of the workplace.”

COVID-19 and the inclusion of learners with disabilities in basic education in South Africa: A critical analysis

This article examines the extent to which basic education, which is compulsory under international law, was inclusive of learners with disabilities during the COVID-19 pandemic. To this end, it examines measures taken by the government to ensure the continuity of basic education and the extent to which these measures are inclusive of learners with disabilities. It argues that moving education to online platforms, and conducting classes via radio and television are not accompanied by related reasonable accommodation measures to ensure the inclusion of leaners with disabilities. Among others, study material and numerous resources, online platforms and media are not in accessible formats, and learners with disabilities do not have access to data or internet broadband. In addition, the parents of these learners with disabilities are not trained to assist their children to study from home. The exclusion from school of learners with special needs is also characterised by a limited number of special schools in the country. In making its case, the article relies on South African and foreign jurisprudence on equality and inclusive education to inform the analysis. Ultimately the article finds that learners with disabilities are not included in the education system in the time of COVID-19. It explores general lessons learned during the pandemic which could be considered as an opportunity to re-think how emergency education planning can be inclusive of children or learners with disabilities in the future. While the discussion focuses on South Africa, lessons learned apply across Africa where persons with disabilities generally are marginalised.

Self-Monitoring Support System for Reasonable Accommodation using Optical Heart Rate Wearable

Self-Monitoring Support System for Reasonable Accommodation using Optical Heart Rate Wearable

Disability Rights and The Louisiana Constitution

The Louisiana Constitution contains three Equal Protection Clauses. Article I § 3 prohibits discriminatory laws; but, as an original matter, should prohibit both discriminatory laws and government conduct. Article I § 12 prohibits discrimination by individuals (government or private) in regard to access to public places. Finally, Article I § 2, the Due Process Clause, also contains an Equal Protection component. Each clause prohibits discrimination on the basis of “physical condition,” which contains a general “disability” component. Based upon statements from the Louisiana Constitutional Convention and other modalities of constitutional argument, this article concludes that these clauses—individually or in conjunction—contain prohibitions on the following forms of disability discrimination: disparate treatment, failure to make reasonable accommodations or modifications, disparate impact, and failure to integrate or unjustified institutionalization. Realizing such components of the State Constitution would have significant and broad impacts—ranging from accessible parking tags to the death penalty.

The Americans With Disabilities Act, Reasonable Accommodations, and Medical Education.

The number of students with a disability matriculating into institutions of medical education, including physician assistant programs, is increasing. Educational institutions must develop procedures with regard to the Americans with Disabilities Act (ADA) including the provision of reasonable accommodations to provide equal opportunities for all. These procedures must be compliant with federal and state laws while protecting academic integrity, maintaining technical standards, and successfully navigating the institutional and individual faculty barriers. Knowledge of the ADA and the ADA Amendments Act of 2008 as well as some familiarity with the legal precedent regarding these laws will facilitate planning and decision-making for students with disabilities. This is imperative for educating not just those with specific disabilities but also the evolving learners of today. Such knowledge, coupled with the continued prioritization of technical standards and student outcomes, will assist in the curricular development of the future.