Health: Access to Care
It is widely recognized that the healthcare system in the United States is failing. No group is more affected by this failure than individuals with disabilities. For us, problems cut across every aspect of healthcare including:
-
Lack of healthcare coverage
-
Inadequate coverage
-
Limits on benefits
-
Architectural barriers in the facilities of healthcare providers
-
Lack of accommodation and modification of policies and practices in healthcare settings such as:
-
lifting assistance
-
appointment flex-time
-
accessible examination tables, weight scales and diagnostic equipment
-
materials in accessible formats for blind or visually impaired patients
-
sign language interpreters for those who are Deaf or hard of hearing
-
-
Lack of professional training to ensure culturally competent care
-
Poor implementation of the 1990 Americans with Disabilities Act (ADA)
-
Restrictions on availability of assistive technology
-
Exclusion from prevention programs
-
Poor care and accommodations at school for children with diabetes and other chronic illnesses
Unequal treatment diminishes the opportunity of people with disabilities for longer, productive lives and can compromise the quality of those lives.
We are working to improve access to healthcare services and programs for people with disabilities by creating informational and training materials for advocates, parents and attorneys; creating assessment tools for health plans; drafting state and federal legislation; participating in the California Disability Health Coalition (DHC); and providing legal representation for children who require health services in school.
-
A Statement of the Problem
Read DREDF's "Disability Healthcare Access Brief," by Silvia Yee, April, 2007
Read "Structural Impairments that Limit Access to Health Care for Patients with Disabilities," by Kristi L. Kirschner, MD, Mary Lou Breslin, MA, Lisa I. Iezzoni, MD, MSc, in the Journal of the American Medical Association (JAMA), March 14, 2007, Vol. 297, No.10 (subscription required)
-
Promoting Programmatic Access
What does programmatic access mean in healthcare settings?
Read DREDF's short summary explanation.
-
Using the ADA and Section 504 of the 1973 Rehabilitation Act to Increase Architectural and Programmatic Access and Accommodations
Read the "DREDF Legal Position Paper on Medicaid Healthcare Accessibility for People with Disabilities," by Silvia Yee, May, 2005.
Short visual representation of the theories or legal responsibility for healthcare access presented in the DREDF legal position paper, May 2005.
-
The National Council on Disability Selects DREDF to Conduct Research Project on the Current State of Health Care for Americans with Disabilities
-
Ensuring that Disability Issues are a Part of Healthcare Reform in California - The Disability Health Coalition
Disability groups in the state have formed the Disability Health Coalition to advocate for specific healthcare principles that will affect all people with disabilities.
Read the California Health Coalition Health Care Reform Principles (updated Membership List 1.14.07).
Read the California Health Coalition Talking Points (updated Membership List 1.14.07).
Read the California Health Coalition Talking Points (español).
Disability Health Coalition Contact Information.
-
Initiative to Remove Annual Benefit Limits on Durable Medical Equipment in Private Health Plans in California
California Senator Sheila Kuehl introduced SB 1198 on February 13, 2008, legislation crafted by DREDF that will prohibit private health insurers from limiting benefits for durable medical equipment. DREDF and Protection and Advocacy are working together to advocate for the bill's enactment.

The California Senate Health Committee passed SB 1198 with a 10 to 0 vote on April 16, 2008.
The California Senate passed SB 1198 with a 27 to 8 vote on May 12, 2008.
The bill is scheduled to be heard by the Assembly Health Committee on June 17.
Read Questions and answers about DME coverage by private insurers in California
Read A survey of DME benefit limits among 214 California private health care plans
Read the bill
FAQ on SB 1198 (3.14.08)
-
Training Parents and Providers on School-Based Healthcare
Services for California Children with Chronic Health ConditionsDREDF, along with the American Diabetes Association, has developed a Sample 504 Plan and a Sample Health Plan for parents to use as a model when creating individualized plans for their own children.
-
Proposed Federal Legislation to Increase Healthcare Accessibility
Senator Tom Harkin (D-IA) has introduced legislation to establish accessibility standards for medical diagnostic equipment and create wellness grants to fund health programs that focus on the unique challenges faced by individuals with disabilities.
Read the "Promoting Wellness for Individuals with Disabilities Act of 2007"
For more information about our healthcare work contact us at info@dredf.org
The following publications and studies discuss this issue in greater detail.
The Future of Disability in America
Committee on Disability in America, Marilyn J. Field and Alan Jette, editors
Institute of Medicine of the National Academies
ISBN: 0-309-10795-4, 680 pages, 6 x 9, (2007)
This new and insightful report states, "The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities."
It Takes More than Ramps to Solve the Healthcare Crisis for People with Disabilities by Judy Panko Reis, Rehabilitation Institute of Chicago, Mary Lou Breslin, DREDF, Lisa Iezzoni, M.D., Harvard Medical School, and Kristi L. Kirschner, M.D., Rehabilitation Institute of Chicago. Published by the Rehabilitation Institute of Chicago. February 2004.
The U.S. Department of Health and Human Services Healthy People 2010
"The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities"
"Providing Primary Health Care for People with Physical Disabilities: A Survey of California Physicians" published by the Center for Disability Issues and the Health Professions (CDIHP).
Access to Medical Care: Adults with Physical Disabilities
A 22 minute video produced by the Oakland-based World Institute on Disability about mobility, vision, hearing and communication impairment in outpatient settings; a training curriculum and initial consultation is included.
DREDF joins with the Center for Disability Issues in the Health Professions and other groups in urging the California Department of Health Services to adopt performance standards for Medicaid MCO's that were identified by diverse stakeholders and submitted to the Department in November, 2005. These standards would improve access to healthcare services and programs for people with disabilities, if adopted.
Read the California Department of Health Services response to the proposed performance standards.
2006 Pilot Survey of Disability Access Services Provided by California Health Plans
"The Health and Health Care of People with Intellectual Disabilities"
New research studies conducted by Special Olympics found disturbing evidence that individuals with intellectual disabilities face widespread health problems, while physicians, dentists and other health professionals are not receiving adequate training in order to treat them.
