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Play ball! The San Diego Padres are planning a new ballpark. I'm not going to debate whether we need a new ballpark; we're getting one. I am going to tell you about a meeting with Padres officials regarding accessibility and the new ballpark. Kevin McGuire, a Boston...read more
Katie Savage filed a lawsuit against her local mall because of its lack of an evacuation plan for people with disabilities. On Sept. 3, 2002, while the nation was on alert for the possibility of another September terrorist attack, the fire alarm sounded at the City...read more
Group offers praise for features at SBC Center. Details such as low counters, convenient places to slide wheelchairs into and wide spaces in bathrooms and elevators add up to make the SBC Center a nice place to visit, say people who toured the arena Friday as part of...read more
Let's say you're an owner or manager of a building -- an office complex, museum or any other facility to which the public has access -- and you want to devise an evacuation plan for people with disabilities. There are five major points you need to consider, according...read more
A group of companies that owns about half of the theaters on Broadway said yesterday that it had revamped 16 properties, all of them historical landmarks, to make them more accessible to theatergoers with disabilities. The Shubert Organization, whose theaters include...read more
Convention Officials Create Information Guide, Hire Accessibility Expert to Ensure Accessibility at July's Democratic National Convention Boston, MA Continuing its unconditional commitment to host the most accessible and integrated Convention in history, the 2004...read more
Developing an evacuation plan for people with disabilities When I was seven years old, I was hit by a drunk driver, which left me paralyzed from the waist down, forcing me to use a wheelchair. In addition to the normal challenges in life, I've had to worry about such...read more
He is the man with the answers to accessibility issues - yet McGuire spent more than 15 minutes watching two men tinker with the portable microphone before he could begin his speech on accommodating the disabled. In a wheelchair since the age of 7 after being hit by a...read more
In making emergency evacuation plans, employers must take particular notice of the needs of their disabled workers--some of whom may have undisclosed or temporary disabilities--according to participants in a June 7 roundtable discussion sponsored by the Equal...read more
The Americans with Disabilities Act has been law for 17 years, but is it working in sports? In the first of a two-part series, SportsBusiness Journal examines why the law still remains a work in progress. He went barreling down the incline from street level to Fenway...read more
The eBay listing made the two seats in Main Reserve 2, Row 1, behind home plate at Yankee Stadium sound as if they were designed for pleasure, rather than purpose. “This row is an ADA accessible row. It is an extra roomy, wider row with lots more leg room. … Perfect...read more
David Griffin paced The Hall at Patriot Place with his eyes gazing upward. Griffin, who is a teacher and director of the PAVE (Partnership of Academic and Vocational Excellence) Program at Foxborough High School, toured the new Patriots and New England football museum...read more
State-of-the-art video, audio feeds let disabled tackle museum at their own pace F OXBOROUGH - New England Patriots fans with visual or hearing impairments soon can get closer to their team, thanks to a hand-held device that resembles a BlackBerry set in a thick...read more
HOTEL accommodations, venue selection, catering and transportation – not a bad start to an event checklist. But how many times have we forgotten some of the most vital information? Unless your event is surrounded by athletes with disabilities, complying with federal...read more
Q. How often do you fly? A. I used to fly about once a week. Now, I’ve gotten it down to twice a month. Q. What’s your least favorite airport? A. Lambert-St. Louis International Airport. Its accessible bathrooms aren’t accessible, and the carpets are so thick it’s...read more
THERE are a lot of things that can go wrong when you fly. I take lost luggage, delays and cancellations in stride. But I had a little meltdown when someone took my wheelchair. Kevin G. McGuire is chairman and chief executive of McGuire Associates, based in Waltham,...read more
From his wheelchair, Kevin McGuire (CAS’83) leads the charge Kevin McGuire remembers when wheelchair users could enter a building only through the service entrance, when those who were blind didn’t go to the movies and those who were deaf could never enjoy the opera....read more
Kevin McGuire promises “brutally honest” address to SAR grads As one of the nation’s leading advocates for improving accessibility for the disabled, Kevin McGuire has traveled all over the country, consulting with such prominent clients as the New England Patriots,...read more
Just before the College World Series, it was mentioned at a press conference that TD Ameritrade Park is equipped with a “loop system.” Say again? Listeners heard right. At the ticket office and in certain seating sections, the 1-year-old ballpark features what's...read more
For 21 years Kevin McGuire has made his mark by helping make major sports stadiums, arenas, ballparks and race- tracks more accessible. Alas, he’s still one man. “It’s 1,000 leaks in the dyke, and I have only ten fingers,” says the CEO of McGuire Associates in...read more
Harvard’s services, options, and opportunities provide key to access By Robert Mitchell and Maura Rizzuto, FAS Communications The numbers can be staggering: In 2010, it was reported by the U.S. Census Bureau that about 56.7 million people — or 19 percent of the...read more
Today we’d like to introduce you to Kevin McGuire. Thanks for sharing your story with us Kevin. So, let’s start at the beginning and we can move on from there. I was struck by an intoxicated driver in 1968 (at the ag of seven) while playing baseball. The driver was...read more
Hospitals Failing Millions: Requires ADA Prescription
By: Kevin G. McGuire
“Physician, Heal Thyself”
I never knew what that old Biblical saying meant until recently. As someone with a law degree who just happens to use a wheelchair, I specialize in compliance with the Americans with Disabilities Act (“ADA”). My practice has me traveling around the country ensuring sporting facilities, theatres, buildings, and businesses are compliant.
I never gave much thought to accessibility issues for hospitals and medical facilities, though. After all, they’re the good guys, the ones who are trying to heal. Of course they’re accessible.
But after a recent stay in a Boston area hospital I learned otherwise. My hospital room didn’t have an accessible bathroom, the MRI and x-ray machines were too high and not accessible and point of sales with accessible counters were always closed. I expect to find non-compliant rooms at a hotel but at a hospital!?
As I began to let some friends and colleagues know about my injury and the issues regarding my disability during the hospital stay, I started to realize that my experience was not uncommon. In fact, the more I reached out to other people in my network with disabilities, or to caretakers of those with disabilities, the more I heard that each had experienced issues where their hospitals and medical facilities were not prepared to care for them.
Failure To Communicate
A good friend of mine, who happens to be deaf, went in for preoperative tests with the medical staff prior to his scheduled cochlear implant surgery, at a major Boston hospital that specializes in hearing loss. He brought along his Communication Access Real-Time Translation (CART) provider, a stenographer who translates all the speech to text so that he didn’t miss any of the doctor’s instructions. CART services are very commonly used in hospital settings to help facilitate communication. One of the physicians became irritated that the CART provider took several minutes to set up his equipment, and snapped, “Is this really necessary? You can read lips, can’t you?”
Another friend, who was undergoing chemotherapy for cancer, wanted to bring her daughter who is deaf to her appointments and treatments. Her daughter was her caregiver and advocate, and my friend asked the hospital to provide a sign language interpreter to relay the doctor’s instructions. The hospital refused, saying they were not legally required to provide help to the caregiver when they are deaf. “If your daughter could hear but speak only Spanish, then we could probably find someone on staff to interpret for you,” they were told. It took the threat of a lawsuit for the hospital to realize that providing an interpreter was the most cost-effective path.
My colleague, Christine Griffin, Executive Director of the Disability Law Center in Boston, represents people with disabilities in legal cases like these. “There are a number of communication tools available for hospitals, like in-person consultants and CART providers as well as Video Remote Interpreting (VRI) services, which can be used quickly in emergency situations,” she explained. “But often the patient must file a complaint or lawsuit before some healthcare facilities are willing to change.”
Griffin has conducted forums with people with disabilities, and notes that as a group they are very reluctant to file a complaint against their health provider. “A person who is deaf has the right to be provided with a properly trained and certified sign language interpreter within a reasonable time after they arrive at a hospital,” she explains. “But filing a complaint or lawsuit is one area where people with disabilities become intimidated, and worry their complaint will negatively impact their doctor, their local healthcare facility, or their ongoing care.”
An associate from Philadelphia, Tim, who is blind and uses a white cane, regularly runs on a treadmill at his gym. Recently he had some stress-related chest pain, and went into the hospital to see a doctor. “The nurses froze as soon as they saw my cane, and none had been trained in how to be a sighted guide and lead me through their offices,” he told me. But his problems didn’t end there.
The doctor wanted to perform a stress test, and Tim explained that doing a treadmill test would be no problem. But the doctor balked, and said that he’d be administering a chemical stress test, which involves injecting the patient with a drug that affects the heart. Tim didn’t want the chemical stress test. “I’m not going to have you fall down on the treadmill and hurt yourself on my watch,” the doctor told him. The ensuing discussion and legal mediation ended up causing Tim to spend an extra night in the hospital. In the end, after being forced to be his own disabilities advocate as well as the patient, he was able to do the treadmill stress test.
People with cognitive disabilities often have sensitivity to sensory inputs like pain and sound, which can make their hospital visits agonizing. For many people with autism, loud sounds are torturous. A Los Angeles buddy who cares for her teenage son with autism has told me that one of his sensory triggers is sharp noises, especially babies crying. But after being injured in a car accident, her son was admitted into the hospital and, because of his age, was put in the pediatric ward, surrounded by crying babies.
Her son could, however, understand what was happening and every word the doctor and nurses were saying. The doctor came in to explain a particularly scary procedure he was going to perform, and spoke directly to the mother, not bothering to temper his speech or take her outside the room for the consultation. When her son became visibly frightened at what the doctor was describing, he said “Oh, he can understand me?”
Can I Get A Lift?
Often the issues had to do with the hospital not having accessible exam equipment. I’ve learned the hard way that most MRI and x-ray machines are not accessible for wheelchair users, and many exam tables are 4 feet off the ground and not adjustable. I could make that transfer myself when healthy, but even then it would be difficult. And a lot of specialized equipment, like ophthalmology and gynecology exam tables, are not adjustable either. This means the staff must manually transfer elderly people and patients like me. Not only is it uncomfortable, it’s also unsafe for the hospital staff.
A recent study, reported in Annals of Internal Medicine, shows how pervasive this issue is. Researchers contacted 256 medical and surgical facilities in four different cities, and attempted to make an appointment for a (fictional) patient who uses a wheelchair and is unable to transfer from the chair to the exam table. A total of 56 practices (22%) reported they could not accommodate the patient at all, most often (at 47 of 56 practices) because they were unable to transfer the patient to a table in order to perform an exam. The percentage of inaccessible facilities rose to 44% when reporting was limited to gynecological practices. Of the 200 accessible practices in the study, 103 (51%) reported they planned to ‘manually transfer’ the patient from a wheelchair to a non-accessible high table without the use of a lift. Only 22 practices (11%) reported the use of accessible tables or a lift for transfer. (1)
Disability experts consider the manual transfer of patients to high exam tables to be an unsafe practice, both for the patients and the staff, who undoubtedly suffer injuries trying to lift patients. Why is it that barbershops have had height-adjustable equipment for over 130 years, but modern hospitals routinely do not?
The Need For Change
According to the U.S. Census Bureau, 54.4 million (18.7%) of our nation’s 291.1 million people in the population in 2005 had some level of disability, and 35 million (12%) had a severe disability. Rates of disability also increase with age. By 2030, the number of people aged 65 years and older is expected to increase to 69.4 million from 37.4 million in 2000.
People with disabilities are the largest and most important healthcare consumer group in the United States. But more than 20 years after the ADA was enacted, I’ve learned that it has had a limited impact on how healthcare is provided for this large segment of the population.
Part of the reason for this dissonance between hospitals and the healthcare needs of people with disabilities is the lack of training and education among healthcare practitioners. The National Council on Disability reported in 2009 that the absence of professional training on disability competency issues for practitioners is one of the largest barriers to receiving appropriate healthcare. In fact, the Institute of Medicine and many other organizations have warned that our policy makers and healthcare system have not yet responded to the current healthcare needs of people with disabilities, let alone the projected demographic increase in disability as our population ages.(2)
There are many reasons for this lack of disability competency among healthcare practitioners. Disability training is not a core curriculum requirement for accreditation or receipt of federal funding for most medical and dental schools, nor is it a requirement for hospitals to participate in federally funded medical student internship and residency programs.
Also, federal agencies like the Health Resources and Services Administration (HRSA), the primary federal agency for improving access to healthcare for people who are medically challenged, have not identified people with disabilities as an “under-served health care population”. As a result, there is little federal funding for adding disability competency to medical school curricula, and recent medical school graduates are not eligible for federal loan forgiveness programs if they work with organizations designed to serve people with disabilities.
Perhaps the biggest barrier to people with disabilities getting the healthcare they need is that federal agencies, including Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), and the HRSA, are not required to document whether those who receive federal funding to deliver healthcare are in compliance with the ADA and Section 504 of the 1973 Rehabilitation Act. Non-discrimination policies are simply passed from the state level in contracts with HMOs, health plans and provider organizations to the health providers with whom they contract for services. Thus, federal agencies, states, HMOs and health plans hide behind the providers, who are subject to the lowest level of ADA scrutiny.
Frustration Leads To Action
Hospitals and medical facilities still have miles to go before making peoples with disabilities feel completely welcome. But they are not going to change unless people speak up by voicing their opinions.
That is what motivated me to launch my own consulting practice and AbleRoad, a website and app that allows people with disabilities and medical conditions – including those who use a wheelchair or have other mobility, vision, hearing or cognitive disabilities – and their families and caregivers to review any public space or business, and rate them on a variety of factors relating to accessibility.
And most importantly, AbleRoad is a way for corporate America, including hospitals and medical facilities, to get the feedback they need to become more accessible.
Again, it is up to us to speak out so that experiences like mine and others no longer happen.
Kevin G. McGuire
Kevin is a renowned leader in disability policy, advocacy, and training. In 1991, he founded McGuire Associates, Inc., a leading consulting firm specializing in issues of compliance with Federal and State disability-related laws. Over the past 20 years he has grown his company operation serving the largest construction projects and corporations in the country and internationally.
Passionate about educating the professional world about the disability space, Kevin has conducted over 500 conferences, trained over 25,000 facilities staff people, and lectured widely to conventions, TV audiences, public sector workshops, and corporate compliance executives. He has extensive experience in producing and selling disability-related instructional videos as well as a background in motion picture and television productions, serving as technical advisor and in an onscreen featured role in “Born on the Fourth of July”, a technical advisor in “Gattaca,” and appearing in several daytime television dramas. As a wheelchair user, Kevin’s own spinal cord injury has afforded him a personal appreciation and deep insight into issues surrounding persons with disabilities.
1) Lagu, T et al. Access to subspecialty care for patients with mobility impairment: a survey. Ann Intern Med. 2013 Mar 19;158(6):441-6
2) National Council On Disability. (2009). The Current State of Health Care for People with Disabilities. Washington, D.C. Retrieved from http://www.ncd.gov/publications/2009/Sept302009