Hospital Waiting Rooms Challenges

Hospital waiting rooms can be a challenge for the wheelchair users. 

First of all, the question of how many handicapped spaces are required.  Assembly areas has the answer of 4-25 seats = 1 wheelchair space; 26-50 seats = 2 wheelchair spaces; 51-150 seats = 4 wheelchair spaces.  Now, can the spaces be all together?  The answer is no, the spaces need to be dispersed.

There is a requirement for one companion seat for every wheelchair space and the two are required to be able to sit should to should.  So, that companion seat can not be against a wall because for the that wheelchair user to sit should to should, that wheelchair needs to be 12 inches further behind the companion seat.  Is there a requirement to identify the wheelchair space?  The answer is no.  However, in some situation it may be a good idea for the protection of the owner just to let everyone know that wheelchair spaces have provided.

The condition that is usually overlooked is that of someone with hearing challenges.  It is the hospitals' responsibility to communicate with the hearing impaired.  The best solution I have seen is that pager that vibrates and flashes when your number is called.

Bench seating now has greater definition in Section 903 of the ADA, where it lists the requirement that one bench be accessible, again based on the 5% rule.That bench is required to have a back support that is a minimum of 42" long and extend from a point of 2" maximum above the seat surface to a point  of 18" minimum above the seat surface.  The height of the bench see to between 17-19 inches.  The structural bench strength be able to hold a 250 pound force applied at any point on the seat, fastener, mounting device or supporting structure.

If you find that the appropriate spacing for a wheelchair user is not provided, let us know.  Take a camera with you and take pictures, lots of pictures and send them to us.  We'll determine whether the waiting room is in compliance or not.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

Litigating Attorney Role - Part 1

What I've learned from one of the leading litigating attorneys, who always prepared for both sides for the case, is that the best way to prepare oneself for any litigation is to always research the case and find the both strengths and weakness of the case in the filing.That's what I call thoroughly preparing for the litigation of the case. 

Is this work that the attorney should be doing?

Not really, the ADA knowledge and experience rest with ACCESS.  It's our job to get it into the attorney's hands and be sure they understand what they have.  There hasn't been much case law concerning buildings complying with the ADA.  There has been a lot of litigation pertaining to the employment area of the ADA over the last 20 years.  So, attorneys do not have much experience with ADA building compliance law.

My experience tells me that litigating attorneys do not like to lose, well neither do I.  The reason I have never lost a case is my preparation and ability to communicate my experience and knowledge to the attorneys on our team.  In other words, you're in good hands with ACCESS.

I'll expand more on the roll of the litigating attorney in a future post.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

How Are Bars Designed to be Accessible?

We had this challenge over then years ago on a very large hotel casino project that was under construction and also under investigation by the U.S. Department of Justice.  The actual bar had gaming machines built into the bar.  The bar is an assembly area, so scoping gives us the the number of wheelchair spaces that are required. 

Next we needed width, which would include the wheelchair space and the companion seat.  The companion could be another wheelchair so that dimension is 66" in width.  That 66" is a minimum dimension and architects never design to the minimum or maximum, so the design dimension will be 68" in width.  There is a range in the bar height between 28"-34".  So, the design will be set at 32" above the finish floor. 

The approach to the bar is a frontal approach.  There will be a requirement for knee and toe clearance underneath the top of the bar.  The knee clearance has a 27" dimension under the bar, so the design dimension will be 28" above the finish floor, with a design depth of 12 ".  The toe design depth is 19" and the overall width of this pocket is a design width of 32".  The bar stool will not work so the seat is comparable lounge chair. 

We always design the handicapped area to be in the center area, not at the end of the bar.  The design challenge, in the opinion of ACCESS, is to not have the accessible part of the bar look like a handicapped area.  A good solution is a "U" shaped pod that seats 4 - 5 people in chairs around the "U" with a 30" walk way in the middle of the "U" for the bar tender.  Any chair can be removed and a wheelchair inserted in the space for a frontal approach.  I know, this part of the bar becomes very popular.  If a wheelchair person comes in and all the accessible spaces are occupied with non-handicapped people do they have to move?  The ADA law does not require them to move, the ADA law just requires the owner to provide so many accessible spaces. 

That accessible space is like the accessible stalls in a restroom where anyone can use the accessible stalls; not like handicapped accessible parking stalls where only people with handicapped stickers can use the handicapped parking space.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

Are there different accessibility requirements for hospitals?  The answer is yes, but let's get everything into perspective.

There are some general areas in all buildings.  I call one area the site.  This is everything on the outside of the building, such as: sidewalks, curb ramps, benches, signage, parking, loading zones, stairs, railings and any recreational facilities.  Then the inside of the building we have the medical equipment, such as: surgery, radiology, treatment areas, exam rooms, exam tables, beds and any, and all, other medical equipment that is found in a hospital.

Lastly, we have the building itself, and here I really do not see anything different from any other building.  Every hospital has areas of specialization, of which there may be 6 or more.

The ADA talks about dispersions and that means the disabled has to have the same choice.  So, there has to be a handicapped room or space in each area of specialization.  A good rule of thumb is 5% of the spaces needs to be wheelchair user accessible.  This means there has to be at least one, and add a second based on the 5% rule. 

Let me give you an example by taking a hospital bed. 

We need an accessible bed in each area of specialization.  So using the 5% rule, once our bed count in an area of specialization goes over 20 bed, there is an ADA requirement to have another accessible bed.  So, what is an accessible bed?  There is an ADA transfer requirement height and that is 17"-19".  The hospital bed is also used for examining of the patient and treatment.  The accessible bed now is going to have an adjustable height from 17" on the low end to whatever the standard height of the bed is.  The height needs to be controlled by the patient, so the push button needs to not only control the head, the foot, but the overall height.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

Hospital Passenger Loading Zones

I have had some questions regarding loading zones.  So lets look at Section 209.2.1.

• 209.2.1 Passenger Loading Zones.  Passenger loading zones, except those required to comply with 209.2.2 and 209.2.3, shall provide at least one passenger loading zone complying with 503 in every continuous 100 linear feet (30m) of loading zone space, or fraction thereof.

So what is applicable here for hospitals? 

Section 209.2.2 is for bus loading zones and Section 209.2.3 is for on-street bus stops, but is not applicable here for hospitals.

The words "at least one" means there may be conditions where more than one accessible passenger loading zone will be required.  Section 209.2.1 does not say accessible, it is inferred as it is in the ADA and ABA Accessible Guidelines; Final Rule.  Section 209.2.1 says every continuous 100 linear feet; if the loading zone is over 100 feet, two accessible passengers loading zones would be required.  That would also hold true for each 100 linear feet; 450 linear feet would have 5 accessible passenger loading zones.  Really, where are these

 hospital accessible passenger loading zones?

A hospital is a very complicated facility with many entrances.  Each entrance is required to have an accessible passenger loading zone.  When there are two entrances that are designed to work together, one accessible passenger loading zone may work. 

Now for the real challenge: Where is an accessible passenger loading zone?  In architecture, we say design follows function.  I always look and see where people are being dropped-off, or picked-up.  That is the areas that is functioning as a loading zone and where an ADA accessible passenger loading zone is required. 

One thins is for sure, and that is hospitals will have more than one accessible passenger loading zone.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank

The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

Access Board: Thier Roll in Access to Medical Diagnostic Equipment

I have had some questions on the Access Board, and how they work regarding access to medical diagnostic equipment.  They start with meetings.

• The purpose of the meetings is to gather information form stakeholders, including consumers, equipment manufacturers, the health care industry, government agencies, and others with an interest in the new standards.  The first meeting will begin with presentations by the Board on the rule making process, the regulatory steps involved, and a proposed timetable for completing the standards.  The agenda will include panel discussion on various topics and opportunities for public comment.  Subjects to be discussed and explored include the range of equipment to be addressed, access barriers to equipment, design challenges, key issues, reference standards, and other topics encompassed by this rule making.

They will then publish in the Federal Register a proposed guideline for comment.  The comments will all be evaluated and some changes made.  There then is a Final Rule.  That Final Rule will be sent to the Office of Management and Budget (OMB) for their review.  With OMB approval, it will be printed in the Federal Register with an effective date of 60 days later.

• The Department of Justice (DOJ), which regulates and enforces key provisions of the Americans with Disabilities Act (ADA), recently issued new technical guidance on accessible medical care.  Access for people with disabilities to medical care has been problematic and the subject of DOJ compliance investigations.  The 19-page guide, "Access to Medical Care for Individuals with Mobility Disabilities," outlines requirements and best practices for achieving access and covers exam rooms, including entry and circulation, exam tables and chairs, radiological and mammography equipment, scales, available lift devices, transfer techniques, staff training, and common questions.  The document is available on DOJ's ADA website at www.ada.gov.

The DOJ will see litigation in their enforcement roll pertaining to the ADA and will issue opinion letters to help the public understand ADA.  In the opinion of ACCESS, these opinion letters are really for the Federal Judges who rule on the ADA matters.  The DOJ wants to be sure the Federal Judges do not wander off the reservation and rule, which might be the DOJ's thinking.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.

Hospitals and the ADA

Hospitals are required to comply with the ADA.  The current ADA is the Americans with Disabilities Amendments Act of 2008 (P.L.110-325) which became effective on January 1, 2009.

Section 12182. Prohibition of discrimination by public accommodations

   (a) General Rule

• No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.

Section 12182 applies to hospitals and everything within the hospital in the full and equal enjoyment. 

Last year, Congress passed the "Patient Protection and Affordable Care Act" (Obama Care).  That Act calls for the Access Board to issue standards for medical diagnostic equipment in two years to comply with the ADA. 

A little history: The Architectural and Transportation Barriers Compliance Board (Access Board) is a Federal Government agency that has existed for about 50 years and is responsible for writing standard, or sometimes called guidelines, that became the "Safe Harbor" for Design and Construction to be compliance with the ADA. 

So what does all this really mean? 

Hospitals have to comply with the ADA today, and medical diagnostic equipments has to comply with today's ADA compliance.  For the Access Board to write these standards in two years will be a real challenge, as the Access Board is not use to moving at such a fast pace.  The "Obama Care" law requires these standards from the Access Board in consultation with the Food and Drug Administration. 

In the opinion of ACCESS, good luck with the standards.

In the real world these standards are just common sense.  The major manufacturers of medical diagnostic equipment are moving and have moved to get the equipment accessible and in compliance with the ADA.  Again, this is in the opinion of ACCESS.  I want to be perfectly clear here, just because there is no Access Board written standard for medical diagnostic equipment for ADA compliance does not mean the medical diagnostic equipment does not have to comply with the ADA.  Remember, the effective date was January 1, 2009.

Give us your questions or thoughts on the above article.  You can post them here or on our FaceBook page at http://www.facebook.com/pages/Access-Technologies-Services-Inc/268659564730.  You can also reach us at hfalstad@accessts.net or call us at (702) 649-7575.  We look forward to hearing from you.

Hank


The above are opinions of Hank Falstad, AIA, Managing Senior Associate of Access Technologies Services, Inc. (ACCESS).  See our web site for additional information:  www.accessts.net.