What is the Americans with Disabilities Act (ADA)?

The Americans with Disabilities Act (ADA)

The Americans with Disabilities Act (ADA) is a comprehensive federal civil rights law that prohibits discrimination against people with disabilities in several areas, including employment, transportation, public accommodations, communications and access to state and local government programs and services. 1

Key Components of the ADA

The ADA consists of five main titles that address different aspects of public life:

1. Title I: Employment

   • Prohibits discrimination in employment against qualified individuals with disabilities
   • Requires employers to provide reasonable accommodations to employees with disabilities
   • Applies to employers with 15 or more employees 1
   • Protects individuals from discrimination in job application procedures, hiring, advancement, compensation, training, and other terms of employment

2. Title II: Public Services

   • Prohibits discrimination by state and local government entities
   • Requires public entities to make their programs, services, and activities accessible to individuals with disabilities
   • Includes public transportation systems

3. Title III: Public Accommodations

   • Prohibits discrimination in places of public accommodation, including private businesses open to the public
   • Requires reasonable modifications to policies, practices, and procedures
   • Applies to restaurants, hotels, theaters, doctors' offices, retail stores, museums, libraries, parks, and other public spaces

4. Title IV: Telecommunications

   • Requires telephone and internet companies to provide services for people with hearing and speech disabilities

5. Title V: Miscellaneous Provisions

   • Contains various provisions related to the ADA as a whole
   • Includes provisions prohibiting retaliation against individuals who assert their rights under the ADA

Who Is Protected Under the ADA?

The ADA defines a person with a disability as someone who:

• Has a physical or mental impairment that substantially limits one or more major life activities
• Has a record of such an impairment
• Is regarded as having such an impairment 1

Important amendments to the ADA in 2009 expanded the definition of disability to include impairments that affect major bodily functions. For example, all persons with diabetes are now considered to have a disability within the meaning of the law because diabetes constitutes a substantial limitation on endocrine system functioning. 1

Reasonable Accommodations

A key aspect of the ADA is the requirement for "reasonable accommodations" in various settings:

• In employment: Modifications to job duties or the work environment that enable a qualified person with a disability to perform essential job functions
• In schools: Accommodations that allow students with disabilities to participate fully in educational programs
• In public spaces: Physical accessibility features and policy modifications

Accommodations are considered "reasonable" if they do not cause "undue hardship" or fundamental alteration of the program or service. 1

Limitations of the ADA

Despite its broad protections, the ADA has some limitations:

• Small businesses with fewer than 15 employees are exempt from Title I employment provisions
• Religious organizations have certain exemptions
• The ADA does not cover all forms of insurance (life, disability, or long-term care insurance) 1
• Programs operated by religious organizations are not subject to nondiscrimination obligations unless they receive federal funds 1

Impact on Healthcare

The ADA has significant implications for healthcare settings:

• Prohibits healthcare providers from discriminating against patients with disabilities
• Requires accessible medical facilities and equipment
• Ensures effective communication for patients with sensory disabilities
• Protects patient confidentiality regarding disability status

For example, the American Academy of Pediatrics supports the right of pediatricians and other specialists to participate in healthcare delivery without discrimination based on various factors, including disability. 1

Enforcement

The ADA is enforced by various federal agencies:

• Equal Employment Opportunity Commission (EEOC) enforces Title I
• Department of Justice enforces Titles II and III
• Federal Communications Commission (FCC) enforces Title IV

Individuals who believe they have been discriminated against can file complaints with these agencies or pursue private lawsuits.

Practical Applications

The ADA has practical applications in various settings:

• Schools and childcare: Requires individualized assessment of children with disabilities like diabetes and reasonable accommodations to ensure their safe participation 1
• Workplace: Prohibits blanket policies that exclude people with certain conditions (like diabetes) from specific jobs without individual assessment 1
• Public transportation: Ensures accessibility for people with disabilities 2
• Digital accessibility: Increasingly applied to websites and digital communications 3

Recent Developments

The COVID-19 pandemic has raised new questions about ADA application, particularly regarding:

• Remote work as a reasonable accommodation
• Web accessibility for virtual services
• Effective communication in digital environments 3

The ADA continues to evolve through court interpretations and regulatory updates to address emerging issues and technologies.

By prohibiting discrimination and requiring reasonable accommodations, the ADA aims to ensure that people with disabilities have the same rights and opportunities as everyone else, promoting their full participation in all aspects of society.