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The devil is in the details: more than a decade later, the ADA is still a tricky law to follow.



After 13 years, the Years, The

the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109]

See : Time
 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.  still cause facility owners to stumble.

It's been more than a dozen years since the Americans with Disabilities Act became law, guaranteeing those with a variety of handicaps the right to work and access to public buildings. While the landmark civil rights legislation has had a profound impact in many ways, its myriad rules and standards still pose a problem for all institutions, including long term care facilities.

Cynthia Leibrock--a Livermore, Colo., interior designer who now specializes in universal design and aging, and the author of Design Details for Health (John Wiley John Wiley may refer to:
  • John Wiley & Sons, publishing company
  • John C. Wiley, American ambassador
  • John D. Wiley, Chancellor of the University of Wisconsin-Madison
  • John M. Wiley (1846–1912), U.S.
 & Sons)--says she's still never found a nursing home that is 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.
 compliant.

But that doesn't meant that Leibrock finds problems in the form of steep stair-cases and inaccessible bathrooms. The problems for most facilities are usually in the smaller issues that muddy the ideal of being fully compliant with the ADA.

"People don't get the nuances of the ADA," says Leibrock. "They get the basics right, but they miss the details."

It's those details that Leibrock closely examines when she surveys a nursing home. When she does, she can be sure that she'll literally find "hundreds of violations"--even in facilities built since the ADA became law.

"Not many [of the violations] are life-threatening," she says. "They are smaller matters."

A typical example, Leibrock said, is a Dutch door. Many facilities use these divided doorways to give residents a view of a room or hall without fully opening the door. But ADA restrictions say that any object that is lower than 80 inches above the floor and higher than 27 inches can't protrude pro·trude
v.
1. To push or thrust outward.

2. To jut out; project.
 more than three inches. The top half of the dutch door is therefore non-compliant.

But "even the smaller details can disable To turn off; deactivate. See disabled.  someone," says Leibrock. The height requirements are to protect blind people who use a cane to sweep the landscape in front of them: They would have no way of knowing that the top half of the Dutch door would open in their path.

States of inconsistency in·con·sis·ten·cy  
n. pl. in·con·sis·ten·cies
1. The state or quality of being inconsistent.

2. Something inconsistent: many inconsistencies in your proposal.
 

Perhaps the biggest obstacle to a facility being 100 percent compliant with the ADA is the lack of consistency in regulations and restrictions from state to state. Federal ADA standards and state building codes differ, and state building codes aren't uniform from place to place.

Jim Terry Jim Terry is the creator of the now-defunct Eastern Indoor Football League and owner of the Mahoning Valley HitMen, a team within that league. He also ran the website Arena Football Weekly. , a Birmingham, Ala., architect and chief executive officer of Evan Terry Associates, RC., routinely hears the complaint from clients who operate facilities throughout the 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. . "They tell us it would be great if there were one national standard so they could have a national model to duplicate."

But, says Terry, "that's not possible. Something that one state requires, another won't allow."

One state, for instance, requires a bathroom grab bar to be 33 inches off the floor. Another mandates a height of between 34 inches and 36 inches. Even toilet paper holders defy uniformity: In California and many other states, the holder must be 7 inches to 9 inches in front of the water closet. The ADA regulations say the holder may not be more than 36 inches from the rear wall. "So, in a 30-inch water closet," says Terry, "the holder would be too close for the state standard."

States are making an effort to align their accessibility standards accessibility standards (akses´abil´itē),
n.pl the requirements designed by the Americans with Disabilities Act (ADA), by which public places must provide disabled individuals with barrier-free access to
 to at least be compatible with, the ADA standards, says Terry. And, a revised set of combined ADA/ABA (Architectural Buildings Act) regulations now open to comment may help down the road. But it's unlikely that all the involved parties will ever get together on a single code.

"There's so much politics involved," says Terry. "These issues are emotional and critically important to people. Advocates have worked hard to win battles, and they don't want to give them up to harmonize with standards won by other people with different agendas.

"Everyone's pulling for their own needs on different sides of each issue," Terry continues, and there may be or four sides to the issue. Politics don't even land in the same place twice. We don't wind up with the same sorts of compromises."

Courts of enforcement

The result is that 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.
 has become the chief enforcer of the ADA. "There are lots of advocacy groups out there," says Terry, "and they're saying people aren't doing anything until we sue them. So we're going to file as many suits as possible.

"These groups' members are saying the law's been in place a long time now. It's time It's Time was a successful political campaign run by the Australian Labor Party (ALP) under Gough Whitlam at the 1972 election in Australia. Campaigning on the perceived need for change after 23 years of conservative (Liberal Party of Australia) government, Labor put forward a  for these places to be compliant."

Terry believes most lawsuits could be stopped through preventive work. "Ninety-nine percent of the companies that call us have a lawsuit because they had a problem with patient care. After that, the plaintiffs began looking for Looking for

In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with.
 everything they could find."

Leibrock and Terry advocate hiring ADA specialists to survey a facility and identify non-compliance issues. Services vary: Terry's architectural firm An architectural firm is a company which employs one or more licensed architects and practices the profession of architecture. History
Architects (master builders) have existed since early in recorded history. The earliest recorded architects include Imhotep (c.
 performs five types, ranging from a "high-speed walkthrough" to a "standard barrier survey." Costs increase with thoroughness, says Terry. The simple walkthrough costs as little as $2,000, but may identify only 25 percent of the issues noted in the most detailed survey. The barrier survey--which also prioritizes problems and suggests solutions--can run between 25 and 40 cents per square foot.

For all its complexities, the ADA "has done a lot of good," says Leibrock. "The United States is the most accessible nation in the world." Still, she believes the law could be improved. "There are many problems that actually work against older people."

Leibrock cites Japanese research that led to the development of angled bathtub grab bars. These bars don't demand the same upper-body strength as the horizontal bars horizontal bar

Event in men's gymnastics competition in which a steel bar fixed about 8 ft (2.4 m) above the floor is used for swinging exercises. Competitors generally wear hand protectors and perform routines that last 15–30 seconds.
 mandated by the ADA, making them more appropriate for older, weaker residents. But in some places, the angled bars aren't compatible with what's required by the ADA and state codes.

"You can claim [the modified bars] are a conditional equivalent to what's required," says Leibrock. "The law allows that. But no one will sign off on it--no state inspector and no one in the federal government.

"In the future," says Leibrock, "the regulations should be based on performance specifications. We need to stop giving lip service lip service
n.
Verbal expression of agreement or allegiance, unsupported by real conviction or action; hypocritical respect:
 to the idea of meeting people's needs and really design an environment that allows people to do things for themselves."

THE ACT ITSELF

The AMERICANS WITH DISABILITIES ACT of 1990

S. 933

One Hundred First Congress of the United States Congress of the United States, the legislative branch of the federal government, instituted (1789) by Article 1 of the Constitution of the United States, which prescribes its membership and defines its powers.  of America at the second session

Begun and held at the City of Washington on Tuesday, the twenty-third day of January, one thousand nine hundred and ninety.

An Act

To established a clear and comprehensive prohibition of discrimination on the basis of disability.

Sec. 2

(b) Purpose.--It is the purpose of this Act--

(1) to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities;

(2) to provide clear, strong. Consistent, enforceable standards addressing discrimination against individuals with disabilities;

(3) to ensure that the Federal Government plays a central role in enforcing the standards established in this Act on behalf of individuals with disabilities; and

(4) to invoke the sweep of congressional authority, including the power to enforce the fourteenth amendment Fourteenth Amendment, addition to the U.S. Constitution, adopted 1868. The amendment comprises five sections. Section 1


Section 1 of the amendment declares that all persons born or naturalized in the United States are American citizens and citizens
 and to regulate commerce, in order to address the major areas of discrimination faced day-to-day by people with disabilities.

RELATED ARTICLE: Sweating the small (and not so small) stuff.

Long term are facilities typically provide good patient care, but they fall down in providing good visitor care, according to Jim According to Jim is an American situation comedy television series originally broadcast by ABC. The show premiered with little publicity in October 2001, following the surprise hit comedy My Wife and Kids.  Terry, an Alabama architect specializing in accessibility and ADA issues.

The places that are good at it are making accommodations for visitors as well as patients, 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.
 Terry. They know that the people who are deciding where to place a spouse or family member may need some type of accommodations themselves. "Their first impression is going to be, 'Hey, I got a parking spot,'" Terry says. "You can let them decide whether to go or not, rather them shooing them out of your building."

Terry tells building managers to "look out year window and see if your handicapped places are full most of the time. If they are, you need more spots."

Other building Suggests looking at:

* Water fountains. Some low for people in wheelchairs, others high for people who have trouble bending

* Furniture. Firm raised (18-20 inches) seats, with armrests that extend to the chair's edge.

* Signage. Visual impairments Visual Impairment Definition

Total blindness is the inability to tell light from dark, or the total inability to see. Visual impairment or low vision is a severe reduction in vision that cannot be corrected with standard glasses or contact lenses and
 make low-contrast, high-glare and warm colors hard to read.

* Bathrooms. "The ADA doesn't require grab bars in every room, but the more you have, the better," says Terry.

* Easy-to-operate hardware. Try to operate any hardware with your fingers taped together or your hand balled into a fist. That's why levers are better than knobs.

* Door forces. Non-fire rated doors shouldn't require more than five pounds of force.

* Floor surfaces. Walk the route from the parking lot to the rooms. Pay close attention to thresholds and to transitions between different flooring types.

* Curb ramps A curb ramp is an accessible transition from the low side of a curb to the high side (usually 6" change in level). Accessible curb ramps are a minimum of 3 feet wide. They are sloped no greater than 1:12 (8. . Keep the slope gentle and never paint them (the paint is slippery). If they aren't right, says Terry, "rip 'em out. It's cheaper to rip out to rap out, to utter hastily and violently; as, to rip out an oath.

See also: Rip
 100 ramps than it is to defend one lawsuit." "None of these are really expensive," says Terry, "and they serve a huge portion of the population. They also say a lot about your care of people who need these accommodations. They pay off in goodwill, new business and references."

--T.C.
COPYRIGHT 2004 Non Profit Times Publishing Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:Design; Americans with Disabilities Act
Author:Clark, Thomas
Publication:Contemporary Long Term Care
Geographic Code:1USA
Date:Jan 1, 2004
Words:1566
Previous Article:Forecast 2004.
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