Disability
ADAAA made what change to the ADA's definition of "disability"?
"..."disability" to include any impairment that is episodic or in remission if it would substantially limit a major life activity when active..."
Disability defined by Social Security Administration
"Disability" under Social Security is based on your inability to work: you cannot do work that you did before; decided that you cannot adjust to other work because of your medical condition(s); and your disability has lasted or is expected to last for at least one year or to result in death.
Undue burden/hardship
"Significant difficulty or expense incurred by a covered entity" with respect to the provision of an accommodation.
What are some of the potential implications for practicing PT in any setting when considering ADA and ADA-A?
*know this for an essay*
How much federal healthcare funding went to disabled persons of working age in 2008?
12%
Disability defined by Managerial and Supervisory Principles for Physical Therapists
A person with a disability is one who has a record of or is regarded to have a physical or mental impairment that substantially limits one or more major life activities
Healthcare costs annually for disability
About $300 Billion per year
Deinstitutionalized movement
Advances in civil rights and other human rights campaigns leading to greater numbers living at home in the community rather than institutions
Who or what groups are most impacted by Title I area?
All private sector employers who own, manage, or lease a business or are employers and who are involved with any type of business, public service, housing, or workplace should be familiar by regulations in Title I and III.
Who or what groups are most impacted by Title III area?
All private sector employers who own, manage, or lease a business or are employers and who are involved with any type of business, public service, housing, or workplace should be familiar by regulations in Title I and III.
Disability defined by Americans with Disability Act
An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered.
ICF body structure
Anatomical parts of the body such as organs, limbs and their components
Keys for client interaction with persons with a disability
Ask before you help Speak directly to the person with a disability Keep accessible paths of travel clear and free of objects Respect a person's with disabilities equipment Do not make decisions for the people with disabilities about what they can or cannot do
Reasonable accommodation
Assistance or changes to a position or workplace that will enable an employee to do his or her job despite having a disability
Role of PT in management of disability
Care provider Researcher Advocate Consultant
Americans with Disabilities Act of 1990
Comprehensive civil rights protection to individuals with disabilities in areas of employment, state, tribal, and local governments, public accommodations, transportation, and telecommunication.
ICF activity limitations
Difficulties an individual may have in executing activities
Short-term disability
Disability of 12 weeks or less
Chronic or long-term disability
Disability that lasts for the rest of a patient's life
Purpose of Americans with Disabilities Act of 1990
Extend the civil rights for people with disabilities to improve their opportunities in society Creates a more level playing field for persons with disabilities in education, jobs, healthcare and in all aspects of community
Equal Employment Opportunity Commission
Federal agency that administers and enforces civil rights laws against workplace discrimination
Americans with Disabilities Act is enforced by who?
Federally enforce by several agencies with the potential for significant penalties if discrimination is found
Key points to People First language and documentation
Focus on abilities Appreciate the person first Allow them to have their dignity Treat the person as an individual not as a disability Respectful and courteous interaction with people with disabilities
Patients, disabled or not, should expect that the PT provider is what?
Has expertise and knowledge about health care and wellness promotion The ability to hear and respond to articulated health concerns Ability to communicate clearly, culturally, and directly Willingness to spend time necessary to be responsive
Medical Model
Historically compartmentalized disability
Access symbols
Identifying accessible locations or entries Identifying availability of assistive devices to allow users to interact with the space or services provided
New Freedom Initiative 2001
Increasing access to assistive and universally designed technologies, expanding educational and employment opportunities, and promoting increased access into daily community life.
ICF participation
Involvement in a life situation
Cost of disability
Lost productivity costs Unemployment costs Costs of living to those who cannot work--Social Security payments
Disability historically
Most pitied Some feared All not expected to contribute to society at large
Qualified individual with a disability
One who meets the essential eligibility requirements for the program or activity offered by a public entity. The "essential eligibility requirements" will depend on the type of service or activity involved.
Americans with Disabilities Amendments Act 2008
Overturns a series of Supreme Court decisions that interpreted the ADA in a way that made it difficult to prove that an impairment is a "disability."
Disability domains
Physical Mental Communicative
ICF participation restrictions
Problems an individual may experience in involvement in life situations
ICF impairments
Problems in body function and structure such as significant deviation or loss
Title I definition
Prohibits an employer from discriminating against qualified individual with a disability based on that disability alone.
Section 504 of Rehabilitation Act of 1973
Prohibits discrimination against a class of individuals—persons with disabilities—by federally funded agencies
Title II definition
Prohibits discrimination based on disability in all services, programs, and activities provided to the public by State and local governments, except public transportation services.
Americans with Disabilities Act of 1990 functions
Prohibits discrimination by private sector and government Improves opportunity for employment Provides access to public transportation Provides access to telecommunications Provides access to public and commercial facilities
Title III definition
Prohibits private places of public accommodation from discriminating against individuals with disabilities.
Who or what groups are most impacted by Title II area?
Public entities—including all state and local governments regardless if they receive state/local funding
Impact of ADA on PT practice
Requires attention to accessibility of facilities and clinics Increases supports for independent living Promotes accommodations to enable employment
Disability severity and age relationship
Risk for severe disability increases with age
Risk of disability and age relationship
Risk of having disability increases with age
Disability measurement tools are required for disability assessment in areas including what?
Self-care Home management Work Community/leisure
2010 Standards for Accessible Design
Set minimum requirements - both scoping and technical -- for newly designed and constructed or altered State and local government facilities, public accommodations, and commercial facilities to be readily accessible to and usable by individuals with disabilities.
The Olmstead v. L.C. and E.W. decision of 1999
States can not place patients with disabilities together or in one institution alone—must have options
APTA policy on disability
Supports health care access for people with chronic disability
Who must request the accommodation for a disability?
The EMPLOYEE not the employer
ICF activities
The execution of a task or action by an individual
Disability defined by The Guide to PT Practice
The inability to perform or a limitation in the performance of actions, tasks, and activities usually expected in specific social roles that are customary for the individual or expected for the person's status or role in a specific sociocultural context and physical environment.
ICF environmental factors
The physical, social and attitudinal environment in which people live and conduct their lives These are either barriers to or facilitators of the person's functioning
ICF body function
The physiological functions of body systems (including psychological functions)
ADA Titles
Title I- Employment Title II- Public service and transportation Title III- Public accommodations Title IV- Telecommunications Title V- Miscellaneous provisions
Secondary consequences to a disability
Up to 87% of persons with disabilities reported experiencing a secondary medical condition