D. Providing Dental Care
General Management Considerations
Americans with Disabilities Act
of 1990
The Americans with Disabilities
Act (ADA) is a federal law the prohibits discrimination against a person
with a disability who is seekig employment or access to services, including
dental services. The law was enacted in 1990. Under Title 3
of this law, a private dental office is considered a place of publice accommodation. As of January 26, 1992, this law requires dentists to serve persons with
disabilities.
According to the Americans with Disabilities Act,
the following individuals are considered to have a disability;
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a person who has a physical or mental impairment
that substantially limits one or more of that person's major life activities
(stroke, multiple sclerosis, mental retardation, spinal cord injury, etc.)
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a person who has a record of such impairment (history
of alcoholism, mental or emotional illness, but is now free of impairment)
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a person who, while not actually being disabled,
is "regarded" as having such an impairment (people misclassified as having
mental retardation or mental illness)
You are under no obligation to make accomodations
if a disability is not clearly discernable and the person does not inform
you that he/she is disabled.
What does this mean to the private dental practitioner?
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The law requires that you treat the person with a
disability on the same basis as you treat non-disabled patients. If, however, the disabled patient requires a procedure for which you would
oridnarily refer a non-disabled patient, you may legally refer the disabled
patient as well.
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You are required to make reasonable modifications
to facilitate access to your office by persons with diabilities unless
it can be shown that taking those steps would result in an "undue burden" or fundamentally alter the nature of the services you provide.
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What about hearing-impaired patients? The Act requires
that you communicate in such a way that the person can understand what
you are telling them. You may be able to use written notes,
pictures, and models. The best approach would be to let the patient
indicate which form of communciation to use. A sign language interpreter
may, at times, be appropriate. You may not have to hire an interpreter;
a family member or community service organization may provide this service. You may use a telephone relay service to communicate with a person who
is deaf; contact your local phone company for information.
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The Act prohibits imposing a surcharge on disabled
patients for the cost of auxiliary aids and services.
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Under the Act you must permit diabled persons to
bring service animals into your office but not necessarily into the operatory.
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If the disabled person poses a "direct threat" (significant
risk that cannot be eliminated using special procedures) to the health
or safety of others, you may refuse to admit that person to your office. For example, an aggressive patient may have to be treated under general
anesthesia.
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