Responses within nonfederal hospitals in Pennsylvania to the Americans with Disabilities Act of 1990.Key Words: Disability, Hospital, Legislation, Rehabilitation rehabilitation: see physical therapy. . The Americans With Disabilities Act Americans with Disabilities Act, U.S. civil-rights law, enacted 1990, that forbids discrimination of various sorts against persons with physical or mental handicaps. of 1990 (ADA Ada, city, United States Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. ) was enacted on July 26, 1990 (Public Law 101-336).[1] This comprehensive law prohibits discrimination against individuals with disabilities in the areas of employment, public services Public services is a term usually used to mean services provided by government to its citizens, either directly (through the public sector) or by financing private provision of services. , public accommodations, and telecommunications Communicating information, including data, text, pictures, voice and video over long distance. See communications. . With an estimated 43 million individuals with disabilities in America,[2] the ADA is regarded by many observers as the most important civil rights legislation in the last quarter of a century.[3] Physical therapists have a responsibility to keep abreast Verb 1. keep abreast - keep informed; "He kept up on his country's foreign policies" keep up, follow trace, follow - follow, discover, or ascertain the course of development of something; "We must follow closely the economic development is Cuba" ; "trace the of current issues and legislation in the health care environment. With the ADA, physical therapists can perform an important role in the act's implementation and success. A "disability" under the ADA is defined as one of the following[1]: 1. A "physical or mental impairment Impairment 1. A reduction in a company's stated capital. 2. The total capital that is less than the par value of the company's capital stock. Notes: 1. This is usually reduced because of poorly estimated losses or gains. 2. that substantially limits one or more of the major life activities of such individuals." Speaking, breathing, walking, seeing, and learning are examples of vital activities necessary for daily living. 2. A "record of such an impairment." This record protects those individuals who have recovered from a physical or mental impairment. 3. "Being regarded as having such an impairment." This definition applies to those who are mistakenly mis·tak·en v. Past participle of mistake. adj. 1. Wrong or incorrect in opinion, understanding, or perception. 2. Based on error; wrong: a mistaken view of the situation. perceived to have a disability, or those who have a physical or mental impairment that does not appear to limit major life activities. Disorders such as speech and hearing impairments hearing impairment n. A reduction or defect in the ability to perceive sound. , cerebral palsy cerebral palsy (sərē`brəl pôl`zē), disability caused by brain damage before or during birth or in the first years, resulting in a loss of voluntary muscular control and coordination. , blindness, multiple sclerosis multiple sclerosis (MS), chronic, slowly progressive autoimmune disease in which the body's immune system attacks the protective myelin sheaths that surround the nerve cells of the brain and spinal cord (a process called demyelination), resulting in damaged areas , and mental retardation mental retardation, below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living. are considered disabilities under the ADA. Short-term impairments or conditions such as pregnancy, sprained ligaments, or fractures Fractures Definition A fracture is a complete or incomplete break in a bone resulting from the application of excessive force. Description are not regarded as disabilities. Title I of the ADA applies to employers with 15 or more employees, including health care facilities. The law mandates that individuals with disabilities may not be discriminated against in employment practices such as hiring, training, distribution of benefits, or promotions. An employer must accommodate a worker's disability unless it can be proven to pose a hardship (ie, requiring substantial difficulty or expense). Examples of "reasonable accommodation Reasonable accommodation is a legal term used in Canada, which is the legal obligation to modify a law or a norm when it is contrary to fundamental rights stipulated in Canadian Charter of Rights and Freedoms. " include modified work schedules, raised or lowered furniture, and adaptive equipment Adaptive equipment are devices that are used to assist with completing activities of daily living. Bathing, dressing, grooming, toileting, and feeding are self-care activities that are including in the spectrum of activities of daily living (ADLs). . Employers are prohibited pro·hib·it tr.v. pro·hib·it·ed, pro·hib·it·ing, pro·hib·its 1. To forbid by authority: Smoking is prohibited in most theaters. See Synonyms at forbid. 2. from making inquiries to determine whether an applicant has a disability. An employer may, however, inquire in·quire also en·quire v. in·quired, in·quir·ing, in·quires v.intr. 1. To seek information by asking a question: inquired about prices. 2. about an applicant's ability to perform "essential" job tasks. A medical examination may be required, but only after an offer of employment has been made to an applicant and only if all new employees are subject to the same examination. Job descriptions that outline the essential and nonessential non·es·sen·tial adj. Being a substance required for normal functioning but not needed in the diet because the body can synthesize it. functions of a job should assist in determining whether reasonable accommodations reasonable accommodations A standard of providing for a worker's or customer's needs, as mandated by the ADA, which requires that a business make appropriate changes in the environment to accommodate those with mental or physical disabilities as long as such are necessary. The ADA does not mandate that an applicant with a disability who can perform the essential functions of the job (with or without accommodation) should be hired over an applicant without a disability. The person who is best qualified for the job should be hired. Title II of the ADA applies to public services. State local governments may not discriminate dis·crim·i·nate v. dis·crim·i·nat·ed, dis·crim·i·nat·ing, dis·crim·i·nates v.intr. 1. a. against individuals with disabilities, and must provide accessible facilities. Furthermore, public transportation systems must offer services that are accessible to individuals with disabilities. Public hospitals are not required to make structural changes if other methods can be utilized to achieve accessibility.[4] New construction and alterations to current facilities must be accessible to individuals with disabilities in both public and private hospitals.[4] Public accommodations, and services operated by private entities, must increase accessibility in the most integrated setting to comply with Title Ill of the ADA. Businesses such as hotels, hospitals, restaurants, and theaters must allow "full and equal enjoyment" of their goods and services In economics, economic output is divided into physical goods and intangible services. Consumption of goods and services is assumed to produce utility (unless the "good" is a "bad"). It is often used when referring to a Goods and Services Tax. to individuals with disabilities. Architectural and communication barriers must be removed where removal can be readily achieved and accomplished without undue burden. Examples of Title III Title III Program is a U.S. Federal Grant Program to improve education History The Title III Program began as part of the Higher Education Act of 1965, which sought to provide support to strengthen various aspects of the schools through a formula grant program to accredited, changes in health care facilities include allowing access to service animals,[5] providing sidewalk A Microsoft service that was launched in 1997 to provide online arts and entertainment guides on the Web for major cities worldwide. In 1999, Microsoft sold Sidewalk to Ticketmaster, which continued to provide guides, ticketing and other information to the MSN network. curb cuts curb cut n. A small ramp built into the curb of a sidewalk to ease passage to the street, especially for bicyclists, pedestrians with baby carriages, and physically disabled people. ,[5] transporting patients or employees in accessible vehicles,[6] and supplying television captioning devices for individuals with disabilities.[6] Furthermore, hospitals and nursing homes must make 10% and 50% of their rooms, respectively, accessible to individuals with disabilities under Title III.[7] Regarding qualified interpreters, public hospitals must honor As a verb, to accept a bill of exchange, or to pay a note, check, or accepted bill, at maturity. To pay or to accept and pay, or, where a credit so engages, to purchase or discount a draft complying with the terms of the draft. an individual's auxiliary auxiliary In grammar, a verb that is subordinate to the main lexical verb in a clause. Auxiliaries can convey distinctions of tense, aspect, mood, person, and number. aide and service of choice unless the hospital can prove that effective communication can be achieved via another method.[4] Private hospitals are not required to give primary consideration to the aide of choice, but are encouraged to work with the individual to determine an effective method of communication for both parties.[4] Title IV seeks to bridge the gap between impaired telephone users and the general population. Interstate in·ter·state adj. Involving, existing between, or connecting two or more states. n. One of a system of highways extending between the major cities of the 48 contiguous United States. Noun 1. and intrastate in·tra·state adj. Relating to or existing within the boundaries of a state. Adj. 1. intrastate - relating to or existing within the boundaries of a state; "intrastate as well as interstate commerce" telecommunication relay services Telecommunication Relay Service (TRS), n a system that enables the deaf and hard of hearing to use the telephone. The caller talks to a third party, who types the information so the deaf party can read it on a TDD. must be provided for individuals with hearing or speech impairments. Title V of the ADA contains miscellaneous provisions, including the recovery of attorneys' fees and the exemption of homosexuals, transvestites, and compulsive com·pul·sive adj. Caused or conditioned by compulsion or obsession. n. A person with behavior patterns governed by a compulsion. compulsive the state of being subject to compulsion. gamblers from the term "disabled." Consequently, hospitals, as both employers and places of public accommodation, are responsible for complying with Titles I, II, and III of the ADA. A hospital, for example, may be held liable for discrimination if the hospital participates in a job fair that is physically inaccessible inaccessible Surgery adjective Unreachable; referring to a lesion that unmanageable by standard surgical techniques–eg, lesions deep in the brain or adjacent to vital structures–ie, not accessible. See Accessible. to individuals with disabilities.[4] In one instance, two rehabilitation facilities were included in a lawsuit lawsuit: see procedure; tort. filed by five individuals with disabilities. The plaintiffs claimed that they were discriminated against when they attended a conference sponsored by the two facilities at a hotel that did not have accessible rooms.[8] The organizations all settled by agreeing to hold future conferences in accessible facilities.[9] According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. McGarry,[10] the role of physical therapists in the ADA requires (1) a professional obligation to have an understanding of the ADA; (2) the ability to identify environmental obstacles and assist in finding reasonable, cost-effective accommodation options; (3) acting as "gatekeepers" by referring patients with complaints of limited accessibility to the appropriate hospital or community resources; and (4) providing services in combination with occupational therapists occupational therapist A person trained to help people manage daily activities of living–dressing, cooking, etc, and other activities that promote recovery and regaining vocational skills Salary $51K + 4% bonus. See ADL. and vocational rehabilitation Noun 1. vocational rehabilitation - providing training in a specific trade with the aim of gaining employment rehabilitation - the restoration of someone to a useful place in society specialists to create the most accessible environment possible. Regarding Title I, physical therapists may assist employers with quantifying essential job functions and performing functional capacity evaluations (FCEs) as needed as needed prn. See prn order. . In addition, therapists can educate employers as to how individuals with disabilities can perform job tasks differently but still produce the desired outcomes. Physical therapists may assist with Title III compliance by consulting with hospital architects. Therapists can tour the facilities and provide recommendations for improved accessibility based on their knowledge of space and endurance Endurance See also Longevity. Atalanta feminine name denotes power of endurance. [Gk. Myth.: Jobes, 148] Boston marathon famous 26-mile race held annually for long-distance runners. [Am. Pop. Culture: Misc. requirements to negotiate wheelchairs or to ambulate am·bu·late intr.v. am·bu·lat·ed, am·bu·lat·ing, am·bu·lates To walk from place to place; move about. [Latin ambul with assistive devices assistive device Public health Any device designed or adapted to help people with physical or emotional disorders to perform actions, tasks, and activities. See Americans with Disabilities Act, Architectural barriers, Assistive technology. . Furthermore, Frieden[11] notes that two thirds of working-age persons with disabilities desire to work but are unable to find a job due to discrimination. This population may represent a heretofore untapped resource. Consequently, physical therapists can serve an important role in helping individuals with disabilities return to work. Physical therapists also often have the first opportunity to inform people with disabilities, especially those with newly acquired disabilities, of their rights and responsibilities under the law (Michael Graham Michael Graham is an American author, columnist, and conservative talk radio personality on Boston's WTKK-FM (96.9). He authors a twice-weekly column for the Boston Herald. Career Graham was born in Los Angeles, California and raised in South Carolina. , National Association of Rehabilitation Facilities; personal communication; February 28, 1991). A primary concern in the implementation of the ADA is the expense for employers and operators of public accommodations to comply with the law. The financial implications of implementing the ADA have frequently been labeled "significant." For example, the American Hospital Association American Hospital Association (AHA), n.pr a nonprofit national organization of individuals, institutions, and organizations engaged in direct patient care. The association works to promote the improvement of health care services. predicts that the cost of implementing the ADA over the next decade will be between $20 billion and $40 billion.[12] There is a scarcity Scarcity The basic economic problem which arises from people having unlimited wants while there are and always will be limited resources. Because of scarcity, various economic decisions must be made to allocate resources efficiently. of data, however, to support or criticize crit·i·cize v. crit·i·cized, crit·i·ciz·ing, crit·i·ciz·es v.tr. 1. To find fault with: criticized the decision as unrealistic. See Usage Note at critique. these claims. Several sources state that most job accommodations can be achieved at less expense than some expect.[13-15] Statistics from the Job Accommodation Network reveal that 69% of suggested accommodations cost less than $500 and 50% cost less than $50.[15] Of those accommodations, 31% can be made at no Cost.[16] For example, from 1978 to 1992, the average cost per job accommodation at Sears, Roebuck and Co was 121.42.[17] Twenty-eight percent of the accommodations cost less than $1,000, and 69% were achieved at no cost.[17] Similar optimism may apply to Title III and the public accommodation provisions. Some of the lower cost estimates in the literature range from 0.5% to 5% of total construction costs as the additional costs necessary to comply with the ADA.[18-20] The Congressional Budget Office The Congressional Budget Office (CBO) is responsible for economic forecasting and fiscal policy analysis, scorekeeeping, cost projections, and an Annual Report on the Federal Budget. The office also underdakes special budget-related studies at the request of Congress. estimated the cost of the ADA as $31 million for each fiscal year 1994 and 1995.[1] This figure reflects the responsibility of organizations such as the Equal Employment Opportunity Commission (EEOC EEOC abbr. Equal Employment Opportunity Commission EEOC n abbr (US) (= Equal Employment Opportunities Commission) → comisión que investiga discriminación racial o sexual en el empleo ), the US Department of Transportation, the Architectural and Transportation Barriers Compliance Board, the Office of Technology Assessment, the US Department of Justice, and the Federal Communications Commission Federal Communications Commission (FCC), independent executive agency of the U.S. government established in 1934 to regulate interstate and foreign communications in the public interest. to determine the needs of individuals with disabilities, prescribe pre·scribe v. To give directions, either orally or in writing, for the preparation and administration of a remedy to be used in the treatment of a disease. regulations, and provide requisite enforcement mechanisms. The potential for the ADA to create a tremendous number of lawsuits due to the law's imprecise language Language might be said to imprecise because it exhibits one or more of the following features:
The EEOC estimated a 20% increase in general work load, or approximately 12,000 additional cases per year, once the ADA took effect.[21] As of january 1993, the agency was receiving close to the predicted 1,000 Title I complaints per month, but expected a higher rate in the future.22 By the end of 1994, almost half of the complaints received were related to employment discharges.[22,23] The second most frequent charge involved failure to provide reasonable accommodation.[22,23] In one case,[23] a nurse was restricted from lifting greater than 11.34 kg (25 lb) due to knee surgery. The Office of Civil Rights decided that the nurse was a "qualified individual with a disability" but that reasonable accommodation could not be made because lifting more than 11.34 kg was an essential function of her position. As of January 1993, the Justice Department had received more than 1,850 Title III complaints of alleged violations.[24] The Justice Department kept approximately 1,400 of the claims for investigation, and the remaining claims were referred to other agencies.[24] Most of the ADA literature focuses on interpretation of the law or prediction of the potential impact in terms of cost and litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. . Little literature exists regarding the actual outcome of the law. This dearth of information is plausibly plau·si·ble adj. 1. Seemingly or apparently valid, likely, or acceptable; credible: a plausible excuse. 2. Giving a deceptive impression of truth or reliability. 3. due to the short time period that has elapsed e·lapse intr.v. e·lapsed, e·laps·ing, e·laps·es To slip by; pass: Weeks elapsed before we could start renovating. n. since the passage of the ADA. Two studies have examined the "awareness" of the ADA. A 1991 Louis Harris Louis Harris (born 6 January 1921) is an American opinion-polling entrepreneur, journalist, and author. He ran one of the best-known polling organizations of his time, Louis Harris and Associates (LHA) which conducted so-called Harris polls. Survey revealed that only 18% of the general public was aware that a law to protect individuals with disabilities was recently passed.[25] In addition, Peter David Peter Allen David (often abbreviated PAD) (born September 23, 1956) is an American writer, best known for his work in comic books and Star Trek novels. David often jokingly describes his occupation as "writer of stuff". Blanck[26] found that 68% of the 47 Oklahoma employers in his study were not aware of the passage of the ADA. All of those in the study who knew of the passage of the ADA knew that they were not required to always choose "disabled" applicants over "nondisabled" applicants. In summary, little research has addressed the impact of the, ADA, including its effect on the health care field. Thus, further study is needed. The purpose of this descriptive study was to report the responses within nonfederal hospitals in Pennsylvania List of hospitals in Pennsylvania (U.S. state), sorted by location. A
1. How well the chief hospital administrators understand the ADA, including (1) the definition of "disability," (2) the proper use of preemployment medical examinations, (3) hiring requirements for applicants with disabilities versus applicants without disabilities, and (4) whether they know that alterations to existing hospital facilities must be accessible to individuals with disabilities. 2. Efforts at organizational education and compliance, including (1) the nature of educational training provided for management and employees, (2) whether a committee has been established to address the requirements of the ADA,(3) whether any individuals with disabilities are a member of the committee, and (4) whether any physical therapists are a member of the committee. 3. The financial impact on facilities to comply with the ADA, including (1) the average cost per job accommodation and (2) the estimated percentage of new construction costs spent in order to make the hospital more accessible to individuals with disabilities. 4. The number of complaints and lawsuits filed thus far regarding (1) the employment provisions and (2) the public accommodation provisions. In the 3 1/2 years since the passage of the ADA, it was expected that hospital administrators would be aware of and understand the ADA, and that most facilities would have implemented some form of educational training for their management staff and employees. Moreover, a substantial financial impact was not anticipated, primarily due to the recent effective dates of the ADA. Hospitals may not have had such data available at this early date. Furthermore, hospitals, as recipients of federal funds Federal Funds Funds deposited to regional Federal Reserve Banks by commercial banks, including funds in excess of reserve requirements. Notes: These non-interest bearing deposits are lent out at the Fed funds rate to other banks unable to meet overnight reserve , should already comply with the Rehabilitation Act of 1973. Finally, it was expected that fewer than a dozen complaints and few or no lawsuits had been filed since the ADA took effect. Although the ADA recently became effective, such a study would prove useful in determining the status of the preceding issues and providing baseline data for future studies. The "chief hospital administrators" were chosen for the study because they more than likely have a greater impact on ADA-related issues within an organization than, perhaps, a director of human resources The fancy word for "people." The human resources department within an organization, years ago known as the "personnel department," manages the administrative aspects of the employees. . In addition, the chief administrators should be familiar with the effects of both the employment and public accommodation provisions of the ADA. Examples of a "chief hospital administrator" included an executive director, a president, an administrator, a chief operating officer Chief Operating Officer (COO) The officer of a firm responsible for day-to-day management, usually the president or an executive vice-president. , a chief executive officer, or a superintendent. Method Subjects The target population consisted of all 277 nonfederal hospitals (with 270 chief administrators) in Pennsylvania that were licensed by the Pennsylvania Department of Health and Department of Public Welfare. Because the ADA does not address federal facilities, 9 federal hospitals were removed from the original population of 286 hospitals. The list of Pennsylvania hospitals was obtained from the Directory of Pennsylvania Hospitals,[27] published by the State Health Data Center of the Pennsylvania Department of Health, Harrisburg, Pa).(*) The reporting period for the data in the directory was July 1, 1990, through June 30, 1991. The latest addenda to the directory were on October 12, 1993. The scope of the study extended only to Pennsylvania because resources were not available to accurately survey the entire United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . In addition, Pennsylvania had a representative sample of all types of hospitals in the United States Lists of hospitals for each U.S. state:
The population hospitals were categorized cat·e·go·rize tr.v. cat·e·go·rized, cat·e·go·riz·ing, cat·e·go·riz·es To put into a category or categories; classify. cat by number of licensed beds (Tab. 1). The following bed ranges were chosen: (1) 1 to 250, (2) 251 to 500, (3) 501 to 750, and (4) [greater than or equal to] 751 beds. The hospitals ranged from a 6-bed for-profit dental hospital to a 1,515-bed nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive. Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law. general and psychiatric psy·chi·at·ric adj. Of or relating to psychiatry. psychiatric adjective Pertaining to psychiatry, mental disorders medical center. When the addenda to the directory indicated that a merger had occurred between two or three hospitals, the number of beds at each institution were combined into one number for the study. Information regarding the number of persons employed at each facility was not contained in the directory.
Table 1.
Demographic Characteristics of Hospitals
Target Population Participating
Demographic of Facilities Facilities
Characteristic (N=277) (N=117)
Number of licensed beds (%)
1-250 66.0 60.7
251-500 25.9 29.1
501-750 6.1 5.1
[greater than or equal to]751 1.4 2.6
Unknown 0.7 2.6
Types of service
General 72.9 68.4
Psychiatric 13.7 16.2
Obstetrics/gynecology 0.4 0.9
Eye 0.4 0.9
Rehabilitation 6.5 6.8
Children's 1.8 1.7
Alcoholism 1.1 0.9
Oncology 0.4 0.9
Geriatric 0.4 0.9
Pediatric 0.4 0.0
Dental 0.4 0.0
Unknown 0.4 1.7
General and rehabilitation 0.7 0.0
General and psychiatric 0.7 0.9
Form of control
Nonprofit 87.0 83.8
Profit 7.6 5.1
State 4.7 8.5
Unknown 0.7 2.6
The directory used 11 categories to classify clas·si·fy tr.v. clas·si·fied, clas·si·fy·ing, clas·si·fies 1. To arrange or organize according to class or category. 2. To designate (a document, for example) as confidential, secret, or top secret. the hospitals by type of service provided (Tab. 1). in four instances, two types of service (such as general and psychiatric) were combined for the study due to mergers between hospitals. The directory also classified the hospitals by form of control, that is, the type of organization legally responsible for the operation of the hospital (Tab. 1). Information on form of control was necessary because hospitals that were controlled by a religious organization were exempt from Title III of the ADA. Instrumentation instrumentation, in music: see orchestra and orchestration. instrumentation In technology, the development and use of precise measuring, analysis, and control equipment. A 23-item questionnaire was developed by the principal investigator Noun 1. principal investigator - the scientist in charge of an experiment or research project PI scientist - a person with advanced knowledge of one or more sciences (DLJ DLJ Distributor License for Java DLJ Donaldson, Lufkin & Jenrette Inc. DLJ Drive Like Jehu (band) DLJ Defence Laboratory Jodhpur (India) DLJ Dead Letter Journal ) focusing on how well chief hospital administrators understand the ADA's provisions, efforts at organizational education and compliance, and the financial and legal impact on hospitals to comply with the ADA (Appendix). Whereas most of the questions had multipl-echoice options, a few of the education questions allowed participants to choose more than one response. Several open-ended questions A closed-ended question is a form of question, which normally can be answered with a simple "yes/no" dichotomous question, a specific simple piece of information, or a selection from multiple choices (multiple-choice question), if one excludes such non-answer responses as dodging a were provided in the legal and demographic sections. Comment sections were included throughout the questionnaire where appropriate. The first part determined the administrators' understanding of the ADA definition of "disability." The respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. had to decide which of 16 conditions listed are considered disabilities under the ADA. This part of the survey was followed by two employment scenarios related to Title I, and later by a public accommodation scenario related to Title III. The next section focused on ADA education of managerial and nonmanagerial employees, and whether a hospital had a committee established to address the requirements of the ADA. Managerial employees included those whose primary role was administrative. Those whose primary responsibilities focused on the delivery of services were considered nonmanagerial employees. The financial section requested the average cost per job accommodation at the respondents' facilities, along with the percentage of total new construction costs spent on increasing accessibility for individuals with disabilities. In the legal segment, participants were asked to comment on the nature and number of any complaints and legal matters regarding the employment and accessibility provisions. The final section dealt with demographic information, including the title, educational background, and hospital experience of the individual completing the survey. Participants were then given the opportunity to request a summary of the results of the study. Prior to its distribution, the instrument was examined by six individuals for clarity, content, and length. These individuals were (1) one former hospital administrator; (2) three current chief hospital administrators representing general, psychiatric, and rehabilitation hospitals Hospital devoted to the rehabilitation of patients with various neurologic, musculoskeletal, orthopedic and other medical conditions following stabilization of their acute medical issues. ; (3) one ADA specialist; and (4) one academic professor with published research on the ADA. Suggested revisions were made to finalize fi·nal·ize tr.v. fi·nal·ized, fi·nal·iz·ing, fi·nal·iz·es To put into final form; complete or conclude: "They have jointly agreed ... the survey instrument. For example, "not applicable" and "do not know" opytions were added to several questions to increase accuracy. Reliability testing of the survey instrument was not, however, conducted. Procedure In January 1994, the questionnaires were sent with a cover letter to the 270 chief administrators. The names of the administrators were obtained from the American Hospital Association's 1993 Guide to the Health Care Field.28 Hospitals were given 2 weeks to respond. The survey instrument was mailed one additional time to nonrespondents. In addition, phone calls were placed to facilities to encourage completion of the survey. The target response rate was 50%. Data Analysis The data were compiled and analyzed an·a·lyze tr.v. an·a·lyzed, an·a·lyz·ing, an·a·lyz·es 1. To examine methodically by separating into parts and studying their interrelations. 2. Chemistry To make a chemical analysis of. 3. with assistance from the University of Pittsburgh Office of Measurement and Evaluation of Teaching. The frequency of response and percentage of respondents were calculated for each question. For the 16 potential disabilities, the mean number of correct scores and standard deviation In statistics, the average amount a number varies from the average number in a series of numbers. (statistics) standard deviation - (SD) A measure of the range of values in a set of numbers. were calculated. In addition, three one-way analyses of variance (ANOVAs) were performed to determine whether a relationship existed between the respondents' understanding of the ADA definition of "disability" and their (1) educational background, (2) number of years of hospital experience, or (3) number of years employed at the current facility. Educational level was defined as undergraduate, graduate, and postgraduate postgraduate after first degree graduation, the registerable degree in veterinary science. postgraduate degree may be a research degree, e.g. PhD, or a course-work masterate with a vocational bias, or any combination of these. . The number of respondents with high school-level education was small (2.6%); therefore, this category was eliminated from the analysis. The number of years of hospital experience and number of years at the current facility were defined as: <1 year, 1 to 5 years, >5 years to 10 years, and >10 years. The number of participants with less than 1 year of hospital experience (0.0%) and the number of participants with less than 1 year of employment at the current facility (3.4%) were low and, therefore, were eliminated from the analyses. If a significant difference was found, a Scheffe post hoc post hoc adv. & adj. In or of the form of an argument in which one event is asserted to be the cause of a later event simply by virtue of having happened earlier: comparison procedure was performed to determine where the differences were. All statistical tests of significance were conducted at the .05 level. Results Demographic Characteristics One hundred seventeen individuals in nonfederal hospitals in Pennsylvania responded to the survey, for a response rate of 43.3%. Ninety-four of the participants (80.3%) requested a summary of the results. Despite the less than anticipated response rate, the respondents were representative of the population of all nonfederal hospitals in Pennsylvania. The participating facilities were similar to the population hospitals in terms of size, type of service, and form of control (Tab. 1). Table 2 presents the demographic characteristics of the respondents by job title, educational background, educational degree, years of hospital experience, and years at current hospital. Sixteen of the surveys (13.7%) were completed by hospital administrators. These 16 respondents had the following titles: Administrator, Executive Director, President, Chief operating Officer, Chief Executive Officer, and Superintendent. The survey was most frequently completed by human resources personnel. Table 2. Demographic Characteristics of Survey Participants Demographic Characteristic Percentage Job title Hospital administrators 13.7 Vice presidents 17.9 Assistant administrators 2.6 Human resources 36.8 ADA(a) coordinators 3.4 Other 11.1 Unknown 14.5 Educational background (%) High school 2.6 Undergraduate degree 26.5 Graduate degree 44.4 Postgraduate degree 21.4 Other 1.7 Unknown 3.4 Educational degrees Hospital/health administration 12.8 Business 21.4 Human resources 9.4 Nursing 4.3 Other 38.4 Unknown 13.7 Years of hospital experience (%) <1 0.0 1-5 13.7 >5-10 14.5 >10 70.9 Unknown 0.9 Years at current hospital (%) <1 3.4 1-5 30.8 >5-10 27.4 >10 36.7 Unknown 1.7 (a) ADA = Americans With Disabilities Act. Understanding of the ADA Sixty-five percent of the participants first learned about the ADA through their "professional association or literature." The second most frequently chosen response was the "news media" (14.5%). Table 3 demonstrates how the respondents replied to each of the 16 conditions examining their understanding of the definition of disability. The most frequently missed item was current alcohol abuse. Approximately 36% of the respondents mistakenly believed that current alcohol abuse is considered a disability' under the ADA. Table 3. How Well the Respondents Understand the Americans With Disabilities Act Definition of "Disability"
Answered Answered
Correctly(%) Incorrectly(%)
Condition (n=115) (n= 115)
Fractured elbow(a) 80.0 20.0 Multiple sclerosis 97.4 2.6 Blindness 99.1 0.9 Former drug use 68.7 31.3 Sprained ankle(a) 80.9 19.1 Cancer 76.5 23.5 Current alcohol abuse(a) 64.3 35.7 Organic brain syndrome 80.9 19.1 Diabetes 79.1 20.9 Pregnancy(a) 69.6 30.4 Cerebral palsy 96.5 3.5 Homosexuality(a) 93.0 7.0 Mental retardation 90.4 9.6 Compulsive gambling(a) 81.7 18.3 Deafness 97.4 2.6 Human immunodeficiency 80.9 19.1 virus [bar X]= 1 3.36 SD=2.30 (a) Condition is not considered a "disability" under the Americans With Disabilities Act. A knowledge of disabilities score was computed as the number of correct answers on the set of 16 items. Overall, the scores ranged from 6 to 16, with a mean score of 13.36 (SD=2.30). Twenty-seven of the 115 respondents 23.5%) answered all 16 of the items correctly. Fifty-four percent of respondents scored at least 14 correct answers. An ANOVA anova see analysis of variance. ANOVA Analysis of variance, see there revealed a relationship (P=.0000) between educational level (undergraduate, graduate, or postgraduate) and the number of correct answers on the knowledge scores (undergraduate mean = 14.13, graduate mean = 13.46, and postgraduate mean = 1 1.48). The Scheffe post hoc comparison procedure showed that the scores of the graduates and undergraduates were higher than the scores of the postgraduates. An ANOVA also revealed that there was no relationship between number of years of hospital experience (P=.3926) or number of years employed at the current facility (P=.1102) and the knowledge scores. The employment scenario question asked, "Under the ADA, when should a preemployment medical examination be performed?" One hundred five of the participants (89.7%) responded correctly that the examination should be performed after an offer of employment has been extended to an individual. The next scenario examined how well the respondents knew the hiring requirements for individuals with disabilities versus individuals without disabilities. One hundred nine of the participants (94.8%) answered correctly that they are required to hire whoever is best qualified for the job" under the ADA. The respondents also demonstrated how well they understood one of the Title III accessibility requirements (question 14). One hundred two participants (97.1%) in hospitals not affiliated with religious groups answered correctly that hospital renovations must be accessible to individuals with disabilities. Organizational Education and Compliance Approximately 91% of the respondents reported that managerial training had occurred in their facilities. Only 44.0% of the respondents, however, indicated that their nonmanagerial employees had received ADA training. Regarding the type of training that was received by management, the most frequent type of training was conducted by the organization and held on site. For nonmanagerial employees, the most frequent form of training was provided through written literature. Specific examples of training included viewing an ADA videotape videotape Magnetic tape used to record visual images and sound, or the recording itself. There are two types of videotape recorders, the transverse (or quad) and the helical. and incorporating the ADA into new employee orientation. Efforts at organizational compliance were determined by how many facilities had a committee established to address the requirements of the ADA. Forty-three of the 116 respondents (37.1%) reported having such a committee. The most frequently cited size of the committee was 6 to 10 members. Twenty of the committees included individuals with disabilities as members. Twenty-three of the committees included physical therapists. Fifty-one of the respondents reported having an ADA coordinator instead of a committee. Overall, 94 of the 117 hospitals (80.3%) had an ADA committee or ADA coordinator. Financial Impact Table 4 shows the average cost per job accommodation for employees with disabilities since the implementation of Title I on july 26, 1992. Fifty-four percent of the respondents reported that job accommodations cost less than $500. Thirty-eight percent of the participants did not know the average cost per job accommodation in their facility. Specific examples of job accommodations included one facility spending $2,500 for hearing devices for multiple employees, a different facility spending $2,000 for an electric scooter scooter: see motorcycle. for two employees, and another facility being able to provide flexible work hours as needed. Table 4. Average Cost Per Job Accommodation Since Implementation of Title I if the Americans With Disabilities Act on July 26, 1992 Category Percentage(a) $0-50 35.4 $51-200 10.6 $201-500 8.0 501-1,000 2.7 [greater than or equal to] @1,001 5.3 Do not know 38.1 (a) n= 113. Besides job accommodation costs, the ADA poses additional construction costs to ensure accessibility for individuals with disabilities. Table 5 shows the percentage of total new construction costs spent in hospitals not affiliated with religious groups to increase accessibility under Title 111. Approximately 45% of the respondents reported that the percentage, of new construction costs spent to increase accessibility in their facility was less than 4.9%. Almost 50% of the participants did not know the answer. Table 5. Percentage of Total New Construction Costs Spent in Hospitals Not Affiliated with Religious Groups to Increase Accessibility under Title III of the Americans With Disabilities Act Category Percentage(a) 0.0% 13.9 < 1.0% 12.9 1.0%-4.9% 17.8 5.0%-9.9% 3.0 [greater than or equal to] 10.0% 3.0 Do not know 49.5 (a) n=101. Legal Impact The final section of the survey addressed complaints and legal matters related to Titles I and III of the ADA (Tab. 6). Twenty-three of the 117 facilities (19.7%) reported having received at least one employment complaint. Only one respondent In Equity practice, the party who answers a bill or other proceeding in equity. The party against whom an appeal or motion, an application for a court order, is instituted and who is required to answer in order to protect his or her interests. commented on the nature of a complaint. In this instance, the hospital had received a complaint from an employee claiming a disability handicap when he only had a short-term injury." Twenty-one facilities (17.9%) reported at least one legal matter regarding employment. One facility reported an EEOC claim of discrimination under the ADA due to an employee "being laid off from a position." Another hospital reported one legal matter where promotion was the issue. Table 6. Legal impact of the Americans With Disabilities Act (ADA)
Title I Title III
Employment Accessibility
Provisions Provisions
(n= 117) (n= 117)
Facilities that reported at least 23 (19.7%) 6 (5.1%) one ADA complaint Facilities that reported at least 21 (17.9%) 5 (4.3%) one ADA legal issue Moreover, six of the facilities (5.1%) claimed receiving at least one accessibility complaint (Tab. 6). Some of the complaints were that the "trays and silverware needed to be made accessible," that the distances from the "disabled parking spaces to the medical office building entrance" were too far, and that not all of the entrances to a facility were accessible. Furthermore, a complaint was even received at one institution stating that there were "too many disabled parking spaces." Five hospitals (4.3%) reported at least one legal issue regarding the accessibility provisions of the ADA. Discussion Demographic Characteristics Our target response rate was 50%. Although only 43.3% of the hospitals responded, the participating hospitals were representative of the population of all nonfederal hospitals in Pennsylvania (Tab. 1). This study was one of the first to examine initial responses to the ADA. Why was the response rate not higher? Some plausible explanations are (1) that hospital personnel are too busy to handle extra tasks such as completing surveys, regardless of content; (2) that due to the complex organizational structure  This article has no lead section.To comply with Wikipedia's lead section guidelines, one should be written. of hospitals, the survey could have been delegated to other personnel, such as human resources staff, or to those whose responsibilities do not require knowledge of the ADA; (3) that hospital personnel may not be familiar enough with the ADA to fully realize its probable effect on their facilities; or (4) that ADA-related issues may not have surfaced yet in some nonfederal hospitals in Pennsylvania. Understanding of the ADA The respondents scored high on the three scenario questions regarding understanding of the ADA (89.7%, 94.8%, and 97.1% correct answers, respectively). In particular, the high score (94.8% correct) on the hiring requirements scenario supports Blanck's findings--all of the Oklahoma employers in his study who knew of the passage of the ADA knew that they were not required to always choose "disabled" applicants over "nondisabled" applicants.[26] The study participants also were asked to decide which of the 16 conditions listed in Table I are considered "disabilities" under the ADA. A perfect score of 16 correct answers was achieved by 23.5% of the participants. The understanding of the ADA definition of disability was not affected by the number of years of hospital experience of the respondents nor the number of years employed at their current facility. Educational background, however, made a difference in how accurately the respondents replied to the question. Furthermore, graduates and undergraduates had higher scores than did postgraduates. The finding that respondents with an undergraduate or graduate level of education outperformed respondents with a postgraduate level of education appears to be counterintuitive coun·ter·in·tu·i·tive adj. Contrary to what intuition or common sense would indicate: "Scientists made clear what may at first seem counterintuitive, that the capacity to be pleasant toward a fellow creature is ... . Knowledge generally is expected to increase with further education. Only recently, however, has information about the ADA been incorporated into the curricula of academic programs. Therefore, respondents to the survey most likely gained their knowledge of the ADA through nonacademic sources such as their hospital or professional association or the news media. Organizational Education and Compliance Most facilities have trained their management team. Why is the training rate much lower for employees? Resources such as time and cost certainly are factors. Most likely, the types of training that were received were among the least expensive options. Perhaps, as the impact of the ADA becomes apparent in the future, employers will weigh the costs and benefits of employee education. After all, employees shape a visitor's initial impression of a facility. Furthermore, slightly over three quarters of the facilities had either an ADA committee or ADA coordinator. This number could be higher considering the comprehensive provisions of the ADA. In addition, more representation is needed on the committees by rehabilitation personnel and individuals with disabilities. There also is the possibility that ADA-related activities were occurring within the institutions but the person completing the survey was not aware of them. Financial Impact The conclusions in this study support some of the lower cost estimates found in the literature. For instance, the job accommodation findings seem consistent with statistics from the job Accommodation Network, which revealed that 69% of suggested accommodations cost less than 500.15 Regarding new construction costs, the results of this study are similar to estimates in the literature that range from 0.5% to 5%.[11-20] Thus far, the financial impact of the ADA does not appear to be noteworthy. Some reasons for this apparent low financial impact are that some hospitals are not tracking costs associated with the ADA; the ADA only recently became effective and, therefore, it may be too early to judge the final impact; and many hospitals, as recipients of federal funds, already comply with the Rehabilitation Act of 1973, the statutory predecessor of the ADA. Although the financial implications of the ADA appear to be low, the study revealed that 38.1% of the respondents did not know the average cost per job accommodation and 49.5% did not know the percentage of new construction costs spent to increase accessibility in their facilities. How may hospitals assess the financial impact of the ADA if the actual costs are unknown? One possible explanation for the high number of "do not know" responses on the questionnaires relates to the various job responsibilities of those individuals completing the survey. Future studies might further inquire about the nature of the participants' job responsibilities. It is hoped that this study will aid in encouraging hospitals to monitor their ADA-related activities and expenses. Legal Impact The legal impact of the ADA is more difficult to determine because the literature does not provide a measurable standard against which to judge its importance. In addition, it is difficult to obtain such information due to the nature of the topic. Not all respondents who reported complaints or legal matters specified the number of such occurrences. Furthermore, few comments were received regarding the nature of these matters. One pattern, however, is evident--more complaints and legal matters were received by facilities regarding the employment provisions of the ADA than were received regarding the accessibility provisions. Limitations The limitations of the survey included the following: (1) Hospitals may not be collecting data on the cost of complying with the ADA; (2) if a hospital had a large number of complaints or a lawsuit was filed against the hospital, the respondent may not admit this in the survey; (3) hospital administrators generally delegate A person who is appointed, authorized, delegated, or commissioned to act in the place of another. Transfer of authority from one to another. A person to whom affairs are committed by another. A person elected or appointed to be a member of a representative assembly. tasks such as completing surveys to other hospital personnel; (4) persons completing the survey may not have been aware of all ADA-related activities at their facilities; and (5) this study examined Pennsylvania hospitals, and how the results relate to other hospitals has yet to be determined. Future Studies It is hoped that this study has provided useful baseline data for future studies. Additional research could include (1) expanding this study to determine regional or national differences in the ADA, (2) examining the impact of the ADA in the private health care sector, (3) a longitudinal study longitudinal study a chronological study in epidemiology which attempts to establish a relationship between an antecedent cause and a subsequent effect. See also cohort study. of the ADA to determine its future impact, and (4) determining the impact of the ADA from the perspective of individuals with disabilities. Conclusion The signing of the ADA on july 26, 1990, signified sig·ni·fied n. Linguistics The concept that a signifier denotes. [Translation of French signifié, past participle of signifier, to signify.] Noun 1. a major step toward equal opportunity, rights, and access for all Americans with disabilities Americans with disabilities comprise one of the largest minority groups in the United States. According to the Disability Status: 2000 - Census 2000 Brief [1], approximately 20% of Americans have one or more diagnosed psycho-physical disability. . Former President George Bush "likened the ADA of 1990 to the dismantling dis·man·tle tr.v. dis·man·tled, dis·man·tling, dis·man·tles 1. a. To take apart; disassemble; tear down. b. of the Berlin Wall as a symbol of freedom for a once oppressed op·press tr.v. op·pressed, op·press·ing, op·press·es 1. To keep down by severe and unjust use of force or authority: a people who were oppressed by tyranny. 2. people.117 As rehabilitation providers, physical therapists should participate in ADA activities. Physical therapists can be proactive and volunteer to join, or create, ADA committees within their facilities. Their expertise in creating accessible environments for individuals with disabilities should prove invaluable. In addition, physical therapists can sponsor ADA training programs for employees and assist with developing reasonable accommodations for employees with disabilities. Regarding research, physical therapists have the opportunity to determine the impact of the ADA from the perspective of individuals with disabilities. Finally, as health care providers assume an active role in ADA education and research, perhaps there will be fewer instances in which an individual is discriminated against because of a disability. Acknowledgments Gratitude Gratitude agrimony traditional symbol for gratitude. [Flower Symbolism: Flora Symbolica, 172] Androcles because he had once extracted a thorn from its paw, the lion refrained from attacking Androcles in the arena. [Rom. Lit. is expressed to Peter David Blanck, PhD, JD, of The University of Iowa Not to be confused with Iowa State University. The first faculty offered instruction at the University in March 1855 to students in the Old Mechanics Building, situated where Seashore Hall is now. In September 1855, the student body numbered 124, of which, 41 were women. for his direction and Elaine Rubenstein, Phd, of the University of Pittsburgh Office of Measurement and Evaluation of Teaching for her statistical assistance. Special thanks are extended to Patrick Jones Patrick Jones (born 1965) is an Welsh poet, playwright and filmmaker. His work is often in collaboration with the rock band Manic Street Preachers; his brother, Nicky Wire, is their bassist. , Patricia Hutchison, Beatrice Maruca, Rosalyn Ambrose, and Danica Williams for their technical support. (*) These data were supplied by the State Health Data Center of the Pennsylvania Department of Health, which specifically disclaims responsibility for any analyses, interpretations, or conclusions. References [1] Public Law 101-336. US Code Congressional and Administrative News. 1990; codified cod·i·fy tr.v. cod·i·fied, cod·i·fy·ing, cod·i·fies 1. To reduce to a code: codify laws. 2. To arrange or systematize. at 42 USC An abbreviation for U.S. Code. secs 12101-12213. [2] Marcotte P. New disabilities law: business must accommodate handicapped employees. ADA Journal. 1990;76:21-22. [3 ] Susser PA. The ADA: dramatically expanded federal rights for disabled Americans. Employee Relations Law Journal The Employee Relations Law Journal is a legal journal which publishes articles in the field of labor and employment law. Articles in the journal cover key employment law issues such as the Americans with Disabilities Act, family medical leave, sexual harassment, 1990;16:157-176. [4] Pearle M. Hospitals ask about the ADA. Health Texas. 1992;48:8-9. [5] Council of Better Business Bureaus' Foundation. Access Equals Opportunity: Your Guide to the Americans With Disabilities Act. 1992. [6] Carmack PJ. The ADA: new directions for the disabled and hospitals. Health Systems Review. 1992;25:12-16, 20-22. [7] New access rules near for disabled. Pittsburgh Press The Pittsburgh Press, now defunct, was a major daily newspaper in Pittsburgh, Pennsylvania. It was one of many competing city newspapers published prior to the First World War including The Hearst Corporation owned Pittsburgh Sun-Telegraph . January 22, 1991;22: A-6. [8] Bucsko M. Access suit hits hotel, others. Pittsburgh Post-Gazette The Pittsburgh Post-Gazette, also known simply as the PG, is the largest daily newspaper serving metropolitan Pittsburgh, Pennsylvania, USA. Early history . july 2, 1993;66:B-2. [9] Stoffer H. Disabilities law opening doors. Pittsburgh Post-Gazette. February 13, 1994;67:A-1, A-7. [10] McGarry AM. Americans With Disabilities Act: compliance and implications. The Pyramid--Section on Administration, American Physical Therapy Association The American Physical Therapy Association (APTA) is a national professional organization representing more than 66,000 members. Its goal is to foster advancements in physical therapy practice, research, and education. . 1993;23:3. [11] Frieden L. The Americans With Disabilities Act of 1990: Will it work? Am J Occup Ther. 1992;46:468-469. [12] Greater accessibility for the disabled costing hospitals billions. Hospital Patient Relations Report. 1992;7:1-2. [13] Berkery PM Jr. The Americans With Disabilities Act: its impact on small business. National Public Accountant. 1990;35:42- 47. [14] Fagin Al, McAvoy JZ, Dorman AB. New federal legislation creates challenges, benefits for business. National Law Journal September 3, 1990; 12:18. [15] Job Accommodation Network. Cost of Job Accommodations. 1987. [16] Smith RB. Reasonable accommodation. Occup Health Saf. 1992;61:4. [17] Blanck PD. Communicating the Americans With Disabilities Act transcending compliance: a case report on Sears, Roebuck and Co. The Annenberg Washington Program. 1994:12. [18] Barton HM. Accessibility key to compliance under ADA. Tex Med. 1992;88:32-35. [19] Post NM. Still dazed daze tr.v. dazed, daz·ing, daz·es 1. To stun, as with a heavy blow or shock; stupefy. 2. To dazzle, as with strong light. n. A stunned or bewildered condition. by the disabilities act. Engineering News-Record Engineering News-Record (widely known as ENR) is a weekly magazine that provides news, analysis, data and opinion for the construction industry worldwide. It has been published since 1874. It is owned by The McGraw-Hill Companies. . 1992:28-30,,32. [20] Hunsicker JF. Ready or not: the ADA. Personnel Journal 1990;69:81-86. [21] Kemp n. 1. Coarse, rough hair in wool or fur, injuring its quality. EV Jr. EEOC gears up for the Americans With Disabilities Act: a message from the chairman. Federal Bar News and Journal 1992;39:37-38. [22] EEOC developments: more disability charges have been filed than estimated, General Counsel says. Bureau of National Affairs BNA (The Bureau of National Affairs, Inc.) is a Washington, D.C.-based publisher of news and information on legislation, regulations, and court decisions for professionals in business and government. It is the oldest wholly employee-owned company in the United States. . 1993; 11: 124. [23] Mirone JA. Reasonable accommodation in disability law. PT--Magazine of Physical Therapy. 1995;3:68-69. [24] Samborn R. A quiet birthday. National Law Journal. 1993;15:1,42. [25] National Organization on Disability. Willing to Act: Highlights of the 1991 Louis Harris Survey of Americans' Attitudes Toward People With Disabilities. 1991:1-20. [26] Blanck PD. The emerging work force: empirical study of the Americans With Disabilities Act. Journal of Corporation Law. 1991; 16:693-803. [27] Directory of Pennsylvania Hospitals. Harrisburg, Pa: State Health Data Center, Pennsylvania Department of Health; 1991:1-9. [28] 1993 Guide to the Health Care Field. Chicago, Ill: American Hospital Association; 1993. Appendix. Americans With Disabilities Act (ADA) of 1990 Survey With Emphasis on Nonfederal Hospitals in Pennsylvania Please indicate answers to the following questions by placing an x' in the box beside the best answer, or by writing in the answer where appropriate. Feel free to provide comments where appropriate. All responses will be kept strictly confidential. 1. How did you first learn about the ADA? [] Through the hospital [] School [] News media (television, radio, magazine) [] Professional association/literature [] Church [] Family [] Friend [] An individual with a disability [] An organization that represents individuals with disabilities [] Other, please specify: ------ 2. For each of the conditions below, please mark those that you consider a disability under the ADA: [] Fractured Fractured is the Industrial Music band created by Canadian Nick Gorman in 2003. Located in Toronto Canada, his self produced release CD-R demo entitled Contami-Nation caught the attention of European label Dependent Records, who signed them. elbow [] Multiple sclerosis [] Blindness [] Former drug use [] Sprained ankle A sprained ankle, also known as a ankle sprain, ankle injury or ankle ligament injury, is a common medical condition where one or more of the ligaments of the ankle is torn or partially torn. [] Cancer [] Current alcohol abuse [] Organic brain syndrome organic brain syndrome n. Abbr. OBS Any of a group of acute or chronic syndromes involving temporary or permanent impairment of brain function caused by trauma, infection, toxin, tumor, or tissue sclerosis, and causing mild-to-severe [] Diabetes [] Pregnancy [] Cerebral palsy [] Homosexuality homosexuality, a term created by 19th cent. theorists to describe a sexual and emotional interest in members of one's own sex. Today a person is often said to have a homosexual or a heterosexual orientation, a description intended to defuse some of the long-standing [] Mental retardation [] Compulsive gambling compulsive gambling or pathological gambling, a psychological disorder characterized by a persistent inability to resist the impulse to gamble. [] Deafness [] Human immunodeficiency virus human immunodeficiency virus n. HIV. Human immunodeficiency virus (HIV) A transmissible retrovirus that causes AIDS in humans. 3. Under the ADA, when should a preemployment medical examination be performed? (Check only one) [] Before an offer of employment has been extended to an individual [] After an offer of employment has been extended to an individual [] it does not matter when the examination is performed [] Do not know 4. John and Paul John and Paul ((Italian) Giovanni e Paolo) are saints in the Roman Catholic Church. They were martyred at Rome on 26 June. have applied for the some pharmacy pharmacy, art of compounding and dispensing drugs and medication. The term is also applied to an establishment used for such purposes. Until modern times medication was prepared and dispensed by the physician himself. In the 18th cent. position at a local hospital. Both applicants have similar levels of education, work experience, and skills necessary to perform the job. Paul discloses that he has a disability and would require some assistance to perform the main tasks of the job. John could perform all the tasks by himself. Under the ADA, who are you required to hire? (Check only one) [] John [] Paul [] Whoever is best qualified for the job [] Do not know 5. Have your managers received any training with regard to the ADA? [] Yes [] No [] Do not know a. If no, do you have plans for training in the future? [] Yes [] No [] Do not know [] Not applicable b. How was the training provided (or how will it be provided)? (Please check all that apply) [] Conducted by the organization and held on site [] Conducted by an external agency but held on site [] Conducted by an external agency but held off site [] Other, please specify: [] Not applicable, no training has been or will be provided c. If training has already occurred, what percentage of your managers have received such training? [] 1%-25% [] 26%-50% [] 51%-75% [] 76%-100% 6. Have your nonmanagerial employees received any training with regard to the ADA? [] Yes [] No [] Do not know a. If no, do you have any plans for training in the future? [] Yes [] No [] Do not know [] Not applicable b. How was the training provided (or how will it be provided)? (Please check all that apply) [] Written literature [] Facility wide in-service(s) [] Departmental in-service(s) [] Other, please specify: ------ [] Not applicable, no training has been or will be provided c. If training has already occurred, what percentage of your employees have received such training? [] 1%-25% [] 26%-50% [] 51%-75% [] 76%-100% 7. Does your facility have a committee established to address the requirements of the ADA? [] Yes (Answer questions 8-10) [] No (Go to question 11) [] Do not know (Go to question 12) 8. How many members are included on the committee? [] 1-5 [] 6-10 [] 11-15 [] 16-20 [] [greater than or equal to] 21 [] Do not know 9. Are any individuals with disabilities a member of the committee? [] Yes [] No [] Do not know If yes, how many? [] One [] Two [] Three [] Four [] > Five [] > Five [] Do not know 10. Are any physical therapists a member of the committee? [] Yes [] No [] Do not know 11. If there is no committee, do you have a person designated as an ADA coordinator? [] Yes [] No [] Do not know [] Not applicable (there is a committee) 12. What has been the average cost per job accommodation for employees with disabilities in your facility since July 26, 1992? Examples of job accommodations include purchasing special equipment, modifying work duties, or rearranging work schedules to assist individuals with disabilities. [] $0-$50 [] $51-$200 [] $201-$500 [] $501-$1,000 [] [greater than or equal to] $1,000 [] Do not know Comments: 13. Is your facility governed gov·ern v. gov·erned, gov·ern·ing, gov·erns v.tr. 1. To make and administer the public policy and affairs of; exercise sovereign authority in. 2. by a religious organization? [] Yes [] No If yes, skip to question 16 14. A local hospital is converting its "D" wing from a maternity MATERNITY. The state or condition of a mother. 2. It is either legitimate or natural. The former is the condition of the mother who has given birth to legitimate children, while the latter is the condition of her who has given birth to illegitimate children. unit to a medical-surgical unit. Under the ADA, must the renovations be accessible to individuals with disabilities? [] Yes [] No [] Do not know 15. What percentage of total new construction costs have been spent on making your hospital more accessible to individuals with disabilities starting from the following dates: -- January 26, 1992, for public hospitals? -- January 26, 1993, for private hospitals? [] 0% [] <1% [] 1%-4.9% [] 5%-9.9% [] [greater than or equal to] 10% [] Do not know 16. Are you aware of any complaints from employees or hospital clients/families under the ADA regarding: a. Employment procedures in your hospital (such as hiring, firing, promotion, or training procedures)? [] Yes [] No If yes, please specify the number of complaints: ----- Comments: b. The accessibility of your hospital (skip this question if your hospital is governed by a religious organization)? [] Yes [] No If yes, please specify the number of complaints:----- Comments: 17. Are you aware of any legal matters/situations brought by an employee or client of your hospital under the ADA regarding: a. Employment procedures in your hospital? [] Yes [] No If yes, please specify the number of situations:----- Comments: b. The accessibility of your hospital (skip this question if your hospital is governed by a religious organization)? [] Yes [] No If yes, please specify the number of situations:----- Comments: 18. Please mark the approximate percentage of sources of reimbursement Reimbursement Payment made to someone for out-of-pocket expenses has incurred. for your hospital (note: total should equal 100%): Private pay ----% Medicare ----% Medicaid ----% Private insurance ----% Charity care ----% Other ----% 19. Title of individual completing the survey: ----- 20. Educational background of individual completing the survey (please check the highest level attained): [] High-school diploma DIPLOMA. An instrument of writing, executed by, a corporation or society, certifying that a certain person therein named is entitled to a certain distinction therein mentioned. 2. [] Undergraduate degree “First degree” redirects here. For the BBC television series, see First Degree. An undergraduate degree (sometimes called a first degree or simply a degree Major:------ [] Graduate degree Major:------ [] Postgraduate degree Major:------ [] Other: ----- Major:------ 21. Number of years of hospital experience of individual completing the survey: [] < 1 year [] 1 year-5 years [] >5 years- 10 years [] 10 years 22. Number of years employed at current facility: [] < 1 year [] 1 year-5 years [] > 5 years-10 years [] > 10 years 23. Would you like to receive a summary of the results of the study? [] Yes [] No Thank you for your time and effort. DL Jones, PT, is Coordinator of Education, Physical Therapy Department, University of Pittsburgh Medical Center The University of Pittsburgh Medical Center (UPMC) is a leading American healthcare provider and institution for medical research. It consistently ranks in US News and World Report's "Honor Roll" of the approximately 15 best hospitals in America. , Montefiore University Hospital, 200 Lothrop St, Pittsburgh, PA 15213 (USA) (DLJST4@vms.cis.Pitt.edu); Clinical Assistant Professor, Department of Physical Therapy, University of Pittsburgh, 101 Pennsylvania Hall Pennsylvania Hall may be:
n. An academic degree conferred by a college or university upon those who complete at least one year of prescribed study beyond the bachelor's degree. Noun 1. candidate, School of Health and Rehabilitation Sciences, University of Pittsburgh, at the time the study was conducted. Address all correspondence to Ms Jones at the first address. VJM VJM Vincent J. Maloney Junior High School Watzlaf, PhD, RRA RRA Registered Record Administrator. , is Assistant Professor, Health Information Management Department, School of Health and Rehabilitation Sciences, University of Pittsburgh. D Hobson, PhD, is Associate Professor and Director of Rehabilitation Technology Program, School of Health and Rehabilitation Sciences, University of Pittsburgh. J Mazzoni, RRA, is Assistant Professor, Health Information Management Department, School of Health and Rehabilitation Sciences, University of Pittsburgh. This study was presented at the Annual Conference of the Pennsylvania Physical Therapy Association; November 4-6, 1994; Philadelphia, PA. This study was approved by the University of Pittsburgh Institutional Review Board for Psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects. psy·cho·so·cial adj. Involving aspects of both social and psychological behavior. Research (IRB IRB See: Industrial Revenue Bond #93291). This study was supported in part through funding received from the SHRS SHRS School of Health and Rehabilitation Sciences SHRS School Health Resource Services Research Development Fund, School of Health and Rehabilitation Sciences, University of Pittsburgh. This article was submitted May 31, 1995, and was accepted August 15, 1995. |
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