1 Beth Israel Deaconess Medical Center ADA Upgrade Overview

2 What is ADA? The Americans with Disabilities Act (ADA) (P.L ) is the most comprehensive civil rights legislation adopted to prohibit discrimination against people with disabilities. It extends civil rights protections to individuals with physical or mental disabilities in the following areas:

3 Population being served An individual is considered to have a "disability" if he/she has a physical or mental impairment such as; seeing, hearing, speaking, walking, breathing freely, and performing manual tasks, that substantially limits one or more major life activities

4 Settlement Agreement Parameters Duration: October 1, 2009 to September 30, 2015 Expected expenditures: $8,500,000

5 Requirements Designate and Train Compliance Officer and 2 Assistants Update BIDMC Web page to provide Accessibility Information Complete Access Audit of All BIDMC Facilities Install Directional Signage to Nearest Accessible Entrance and Bathroom

6 Requirements Continued Complete Database of Accessible Medical Equipment Insure One Accessible Exam Table in each Clinical Service Area Provide Accessible Entrances and Exterior Routes Provide Additional Accessible Parking

7 Requirements Continued Provide Hi-Top Van Accessible Parking Form Universal Access Patient Advisory Council Submit Annual Report

8 Changes to BIDMC Facilities Dept. A New Way of Business Design Review of All Projects for ADA Compliance Training for Project Management Team and in the future to other departments within the Medical Center

9 DOJ requires update to BIDMC website Public Transportation and links related to the methods of getting to BIDMC City transportation maps Locations of accessible entrances Accessible shuttles available between campuses

10 DOJ requires update to BIDMC website Continued Accessible public gathering locations internal to the buildings (i.e. cafeterias, restrooms) Locations of TTY / TTD facilities Location of the Sorenson Video Systems for the Deaf and Hearing impaired Campus maps

11 Access Audit of all BIDMC Facilities BIDMC hired the nationally recognized expert firm, Kessler McGuinness & Associates, LLC Complete survey of the 23 on-campus facilities as well as 3 suburban clinics BIDMC has created an ADA Access Plan for all 26 buildings that were audited

12 Implementation of ADA Access Plan Accessible Entrances and Exterior Routes Additional Accessible / Van Accessible Parking Installed Handrails on Interior Ramps Install Directional Signage to accessible toilet rooms and routes Hire Architects to assist in renovation designs to meet ADA Guidelines

13 Chelsea Main Entrance

14 Accessible Entrance Lexington Facility

15 Parking Garage

16 Parking Garage Interior Signage

17 Parking Garage Accessible Parking

18 PROACTIVE ACCESS IMPROVEMENTS Installed a Video Phone

19 Create a BIDMC Access Advisory Group Purpose T o better understand the impacts of accessibility issues on our patients, patient families, visitors and employees Mission Statement “To advise and support the medical center in providing a welcoming, accessible, and comfortable environment for individuals with disabilities and other access challenges”

20 Advisory Group Recommendations Purchase of motorized chair for consumer/patient use Increased use of ‘vibrating flashers’ to alert Deaf/hard of hearing consumer/patients when their appointment is being called Disability etiquette training program for BIDMC staff

21 Advisory Group Recommendations “Reservation System” to assure appropriate use of accessible exam rooms Purchasing scales that can be used by people in wheelchairs – at least 1/clinic (like accessible exam tables) Engaging Champions of Change for disability issues –esp. ‘mystery shopping’

22 Accessible Exam Rooms To date more than 86 accessible tables have been purchased and deployed bringing current total to 106. (slightly over 20% of total inventory) BIDMC has added the International Symbol of Access outside each accessible exam room to increase awareness on the part of doctors, staff, and patients about the availability of this equipment.

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Accessible Exam Room counters and supplies

26 Tables and Seating

27 Dining Surfaces Dining Tables and Surfaces Clear Floor Space 30” x 48” clear floor space minimum. Clear floor space may extend under the table 19” maximum. Knee Space 30” wide x 27” high x 19” deep must be clear of any obstructions. Table Height Height of table surface must be 28” - 34” high ” min 28” - 34” 19” max 48”min ” min 19” max 48” min 1

Items located on countertop

29 At desks with lower transaction counters – make sure they are clear of obstructions Yes No

Signage

31 In bathrooms labeled as handicap accessible – make sure there are no added items to reduce open floor space Yes No

32 Keep hallway obstructions to a minimum Yes No

> 27” < 27” > 27” < 27” FLOOR BARRIER OVERSIZED BRACKET OR BUILD-OUT LOWERED OBJECT Wall-Mounted Objects Cane-Detectable Barriers Floor Barrier Place a barrier on the floor below the protruding object. This may be a guard rail, wall protrusion or any other fixed object. Barrier must be the same depth as the protruding object. Oversized Bracket or Build-out Place a barrier with its leading edge below 27” AFF underneath the protruding object. This may be a large bracket, wall protrusion or apron. Barrier must be the same depth as the protruding object. Lowered Object Mount objects with their leading edge below 27” AFF

34 What can you do to become more compliant? Keep the accessible counters at registration desks free from clutter Make sure all paths of travel are clear including hallways, exam rooms and bathrooms Refrain from hanging wall mounted objects that protrude more than 4” into a path of travel Think ADA!!!