Litigation, legislation, research, and advocacy for accessible healthcare for people with disabilities

Serious health consequences have been documented for people with disabilities due to healthcare delivery settings and practitioners who are not prepared to provide primary and preventive care equivalent to that provided patients without disabilities. Large national surveys, qualitative studies, and lawsuits have documented the experience of patients with disabilities. Problems of physical accessibility exist despite the 15-year ADA prohibition against discrimination in the delivery of services, as well as instances of inadequate or denied care due to prejudice, hostility, or incorrect beliefs about disability, or inflexibility in healthcare delivery policies. Accessible healthcare requires changes in equipment, policies, knowledge, and attitudes about disability in physician offices and sites to which physicians refer patients, in the practices of health plans and managed care, and in the training of healthcare professionals. Multiple strategies are underway by a variety of actors, including the Disability Rights Education and Defense Fund, with which I have an association. Efforts across the nation include advocacy at the individual and systems level, new legislation, pressure for increased enforcement, education of professionals and the public, research on the prevalence of barriers, and strategic litigation. Possible points of intervention and strategies will be discussed and current successes presented, along with an analysis of the challenges remaining and the potential roles for those interested in joining the effort.