Local nonprofit CEO fights for accessible services

Editor’s Note:

CSBJ is partnering with AdvocacyDenver to bring our readers interviews with some of the state’s prominent leaders and policy makers in health care. AdvocacyDenver is a nonprofit, civil rights advocacy organization serving children, teens and adults with developmental or intellectual disabilities — and their families. The interviews are conducted by Health Care Policy Consultant Catherine Strode.

The New York Times recently ran an article about a patient, who was a quadriplegic, almost being dropped onto the floor because the doctor’s office was not equipped with a Hoyer lift. A sensational report? Perhaps. Realistic? Very.

Patricia Yeager

Patricia Yeager

So says Patricia Yeager, CEO of The Independence Center in Colorado Springs. The center supports independent living services, home health care services and statewide advocacy for people with disabilities in eight counties. In an interview, she said while Colorado is taking historic measures to make health care more financially accessible, many medical facilities throughout the state are not physically in compliance with the American Disabilities Act. Her message: People with disabilities have the same right to good health care as everyone else.

 

How would you grade the accessibility of health care to people with disabilities in Colorado?

 

I think probably a ‘C’ and maybe even as much as a failing grade. There are some doctors who have made strides in making their offices accessible. But, by and large, peoples’ attitudes, doctors’ attitudes toward people with disabilities have not changed. People with disabilities won’t go where they’re not welcome, where they are viewed as second-class citizens, or viewed with paternalism. Health care is the last field where we really have to move to do a lot of work around making the system accessible. After Section 504 of the Rehabilitation Act passed in the 1970s, higher education had to go through this change and made their buildings accessible, their programs accessible.

State and local governments have been through this. In 1990 the ADA was passed and that meant anyone providing public services had to be accessible. That’s been 23 years now. A lot has been done to make this country much more accessible to people with disabilities. I think health care has lagged behind.

 

How do you define accessibility?

 

I think we have to define ‘accessibility’ in two ways, and that was one of my first lessons as an advocate in the health care world. Doctors and the public policy people define access as how close to the doctor’s office do you live and can you afford to use a doctor, and transportation, and that sort of thing. For people with disabilities, there’s an added thing such as “Can I get in the building? Can I get to the doctor’s office? Can I get on the table?” So often people with significant disabilities will wait until they’re very sick and then go to the emergency room where they cost four, five, six times more to treat. Whereas, if they were welcome, and if the offices were accessible, and the doctors and the nurses were competent in terms of delivering respectful health care to someone who had a functional limitation without inducing shame, you could reduce the cost of that care.

 

Would you say the state of Colorado is in compliance now?

 

I don’t think so at all. I haven’t seen any survey of doctors’ offices that says how many are accessible or not. I think doctors have escaped scrutiny, partly because people with disabilities don’t want to go there. Or may not know they have rights. The Department of Justice is looking for complaints about doctors’ offices, the federal qualified health clinics, the hospitals, to send a signal to the care field that they have to be accessible to people with disabilities. Too many of our friends have died unnecessarily, either avoiding care or getting into a medical situation that didn’t offer competent care because of their disability, and it’s time for that to stop.

 

What can be done?

 

The state is getting ready to receive a contract from the Center for Medicare and Medicaid that allows them to put people who are dually eligible (those who receive both Medicaid and Medicare) into a coordinated managed fee-for-service health care delivery system. We’re looking at Regional Care Collaborative Organizations (RCCOS) taking on the managing of that care. I don’t know that the doctors are prepared at all. There may be a few here and there. But by and large, the system as a whole, I don’t believe is accessible.

One way the RCCOS could help is by doing surveys of doctors’ offices and figure out where are the accessible elements in their system. Put that on a Section 508 accessible website that everyone, including blind people, can use. Consumers of that RCCO can then see where the accessible elements are and choose a doctor based on that. I am hopeful the RCCO can take a leadership role in helping doctors understand disability culture, assuring there are sign language interpreters and alternate print materials available. In this way, the RCCO can play a cheerleading role to encourage doctors to provide disability friendly health services.

Editor’s Note:

CSBJ is partnering with AdvocacyDenver to bring our readers interviews with some of the state’s prominent leaders and policy makers in health care. AdvocacyDenver is a nonprofit, civil rights advocacy organization serving children, teens and adults with developmental or intellectual disabilities — and their families. The interviews are conducted by Health Care Policy Consultant Catherine Strode.