1. Barriers to Healthcare for People who have Disabilities

2. Contact Information Larry Wanger Executive Director Arizona Statewide Independent Living Council 5025 E. Washington Street, #214 Phoenix, AZ

3. The Disability Experience
It has been rather consistent that tables at medical facilities are not adjustable, most of the time any medical testing has to be done from my wheelchair.
Not enough accessible parking, not large enough accessible family bathrooms, exam rooms are too small to get an electric scooter in comfortably

4. The Disability Experience
I have experienced barriers with outsourced X-ray and MRI facilities and with older medical offices. Also the lack of knowledge by the medical staff of how to transfer or work with a person with s disability
I was dropped from a hoyer lift by staff at a medical office in Tucson. This caused me to be hospitalized once again and to undergo rehabilitation for an additional two months.

5. The Disability Experience
I have had pressure sores where my doctor will not even look at it because the exam table is too high and he doesn't want staff to get hurt helping me transfer on to it. or other times when I had an injury in my pelvic area he just said go to the emergency let them see you. I haven't had a exam from him because he will not help me on the exam table, even if I'm sick or hurt.

6. Arizona Disability Data
1 in 5 or about 20 percent of Americans report they have a disability
Over 1.6 million people living in Arizona have a disability
This is 25.7 percent of the state population
Disability crosses all economic, geographic, ethnic and demographic categories.
Likely that you or someone close to you will personally be impacted by a disability

7. Arizona Disability Data
Hearing: 287,641
Vision: 300,425
Mobility: 313,209
Cognitive: 306,817

8. The Disability Experience
I was refused medical care by a doctor because I have a service dog.
While at the ER I was in a wheelchair and couldn't get into the restroom. When I approached the counter (nit was not low enough (height) to provide accessibility, (could not see the person behind the counter or easily interact with them)..I was told that the restroom I needed was in the main lobby of the hospital (in a different building) and they would not keep my place in line at the ER. I also could not use my scooter to go into Triage area and into triage examining room at the same hospital.

9. The Disability Experience
In most instances a lift is not available for me to transfer from the wheelchair to the exam table so I really do not get a thorough exam by the doctor. The only exception to this is when I go to the Emergency room and I am bodily transferred to the stretcher.
Drug instructions are not provided in an accessible format which resulted in my misusing a drug which reduced the benefit.

10. Arizona Survey Findings
60 percent of respondents described their level of accessibility at medical providers as challenging, difficult or unpleasant
56 percent said they had chosen not to see a medical provider for general healthcare, preventative tests and exams or treatment for an urgent medical issue due to concerns related to accessibility.
38 percent of respondents with a physical disability said a medical provider has told them they must have a friend or relative come with them to an appointment

11. Arizona Survey Findings
23 percent of respondents who use a wheelchair or other mobility device, 19 percent of hearing impaired respondents and 61 percent who are blind or have low-vision said they have been injured or a condition has worsened because a medical office, exam, procedure, equipment and or treatment/discharge instructions were not accessible.
51 percent of respondents said healthcare providers skipped exams, treatments or testing because they could not access medical equipment.
13 percent of those who identified as having a physical disability indicated they encountered barriers that prevented them from entering a medical office.

12. Arizona Survey Findings
49 percent of respondents with a physical disability said they have difficulties with narrow entrances or heavy doors when visiting medical providers.
43 percent said exam rooms are too small to navigate when using a wheelchair or mobility device.

13. Legal Requirements for Healthcare Providers
Titles II and III of the Americans with Disabilities Act
Sections 504 and 510 of the Rehabilitation Act
Patient Protection and Affordable Care Act

14. Legal Requirements for Healthcare Providers
Titles II and III of the Americans with Disabilities Act
Prohibit discrimination against people who have disabilities.
Require equal access to programs, services and goods provided by government (Title II) and private businesses/organizations (Title III).
Establish requirements for new construction and when alterations are made to existing facilities.

15. Legal Requirements for Healthcare Providers
Section 504 of the Rehabilitation Act
Prohibits discrimination against persons on the basis of disability.
Requires programs and services that receive federal funding to be fully accessible.
Healthcare providers: this includes any facility that receives Medicare and Medicaid reimbursements.

16. Legal Requirements for Healthcare Providers
Summary: The ADA and Rehabilitation Act Require
Full and equal access to healthcare services and facilities.
Reasonable modifications to policies, practices, and procedures when necessary to make healthcare services fully available to individuals with disabilities, unless the modifications would fundamentally alter the nature of the services (i.e. alter the essential nature of the services).

17. Strategies for Achieving Change
Regulations from the federal government concerning healthcare facilities and diagnostic equipment
State Medicaid agencies and health departments must be reminded of their role in insuring that all citizens, including people who have disabilities are receiving appropriate and effective healthcare.
State governmental entities that license and accredit healthcare providers must make accessibility mandatory.
People who have disabilities must demand accessible and appropriate healthcare as a civil right.

18. The Role of CILs and SILCs
Understand this is an issue in your community; rural or urban.
CILs are well positioned to address the issue; grassroots advocacy organizations directed by people who have disabilities.
The lack of accessible healthcare for people who have disabilities has a dramatic impact in their quality of life and ability to live independently.

19. Strategies for Achieving Change
Educate, Educate, Educate. Begin talking about this in your community at every opportunity.
Consider surveying consumers at your CIL or a larger survey conducted statewide to gathered data.
Identify healthcare providers in your community that make accessibility a priority. They can be allies in achieving change.
Promote the issue via newsletters, social media, presentations, Etc.

20. Strategies for Achieving Change
Meet with leadership from your state Medicaid agency. Remind them of their responsibilities under Section 504 and demand an action plan for how they plan to address the issue in your state.
Meet with leadership from the agency that licenses and accredits providers in your state. Remind them of Section 504 and ADA requirements and demand an action plan that identifies how they plan to address the issue.
Understand that you may not make progress with these efforts and that you may need to meet with your governor and or his/her staff.

22. What You Can Do Learn more: use the provide resource list and guide
If you are a provider:
Insure decision makers understand the scope of this issue
Insure your facilities are accessible, from the parking lot to the exam table
Seek out assistance to insure programs, practices and procedures can be modified to make accommodations as needed

23. Contact Information
Larry Wanger
Executive Director
Arizona Statewide Independent Living Council
5025 E. Washington Street, #214
Phoenix, AZ