New Construction / Remodeling: Treatment / Exam rooms that receive 'non-accessible' medical equipment are still required to meet accessibility requirements pertinent to patient areas of a room and as noted above. Be sure to comply with accessibility requirements for doors, door clearances, turning space, accessible routes, protruding objects, and accessible reach range and operation requirements under sections 308 and 309, handwashing fixtures (if and where provided for patient use) under 606.
Alteration projects that are cosmetic only in nature and scope are typically not subject to the requirements of the building Standards, and are not required to provide any accessibility compliance that does not already exist. Check with the local AHJ for any specific requirements within the jurisdiction. An exception to this might be flooring which are covered by Sections 302 and 303. However, all such projects must provide accessibility compliant results to the extent that it is part of the project scope. Alteration projects that replace furnishings or small equipment that affect accessible routes and clearances within a room must result in such clearances being in compliance. In such projects the obligation is to locate furnishings and equipment in a manner that complies with all applicable accessibility requirements.
ADAS Section 805.4 Toilet and Bathing Rooms. Toilet and bathing rooms that are provided as part of a patient or resident sleeping room shall comply with 603. Where provided, no fewer than one water closet, one lavatory, and one bathtub or shower shall comply with the applicable requirements of 603 through 610.
Accessible Medical Equipment. (AME) The US Access Board has developed voluntary standards for 'Accessible Medical Equipment' which are expected to be adopted by the Department of Justice, but are likely to remain voluntary. Prudent design subject to owner /facility operator determination should consider providing 'Accessible Medical Equipment' in quantities and locations to provide access to medical care for people with disabilities.
Department of Justice 2010 ADA - Access to Medical Care for Individuals with Mobility Disabilities – Part 3:
(
http://www.ada.gov/medcare_mobility_ta/medcare_ta.pdf) states that “The number or examination rooms with accessible equipment needed by the medical care provider depends on the size of the practice, the patient population, and other factors. One such exam room may be sufficient in a small doctor’s practice, while more will likely be necessary in a large clinic.”
For guidance on the number of exam treatment rooms which should be provided with accessible medical equipment (AME) See Olson, et al. v. Sutter Health, et al., Case No. RG06-302354. The consent decree in that case established the follow tiers of accessibility:
Category 1 Services (Low Need): 10% - Provide AME in 10% of each type of exam / treatment room (minimum of one of each type)
Category 2 Services (Medium Need): 30% - Provide AME in 30% of each type of exam / treatment room (minimum of one of each type)
Category 3 Services (High Need): 75% - Provide AME in 75% of each type of exam / treatment room (minimum of one of each type)
Under the ADA public accommodations such as existing private medical building focused on maternity labor and postpartum services are required to remove barriers when it is readily achievable to do so. Many states have also adopted (and perhaps modified) ADAS Section 202.4 which addresses disproportionate cost determinations. In California CBC 11B-202.4, Exception 8 (20% rule) applies.
Keep in mind that the readily achievable barrier removal (RABR) obligation is an ongoing one and there are no corrolary triggering requirements as related to compliance with building codes. See 28 CFR 36.104.
Readily achievable means easily accomplishable and able to be carried out without much difficulty or expense. In determining whether an action is readily achievable factors to be considered include --
(1) The nature and cost of the action needed under this part;
(2) The overall financial resources of the site or sites involved in the action; the number of persons employed at the site; the effect on expenses and resources; legitimate safety requirements that are necessary for safe operation, including crime prevention measures; or the impact otherwise of the action upon the operation of the site;
(3) The geographic separateness, and the administrative or fiscal relationship of the site or sites in question to any parent corporation or entity;
(4) If applicable, the overall financial resources of any parent corporation or entity; the overall size of the parent corporation or entity with respect to the number of its employees; the number, type, and location of its facilities; and
(5) If applicable, the type of operation or operations of any parent corporation or entity, including the composition, structure, and functions of the workforce of the parent corporation or entity.
Source:
Definition of "readily achievable" in section 36.104 of "ADA Title III Regulation 28 CFR Part 36"
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