Access Equals Opportunity

A. No. For making calls to or receiving calls from customers with hearing or speech impairments who use TTYs, retail stores will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow their customers or clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Retail stores can ensure effective communication by telling staff who answer the telephone to anticipate incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller and will also be using the relay system equipment to type communications from the retail store staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

For your information, however, a TTY is relatively inexpensive, usually costing about $275 and would be welcome service for customers with hearing or speech impairments. Businesses with TTYs should list their telephone number followed by “Voice/TTY” in any publications or advertisements to signify that customers can communicate with them by voice or TTY.

Q. Are retail stores that offer parking required to provide accessible parking spaces for people with mobility impairments? If such parking is required how many spaces must be provided?

A. Yes. If a retail store owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If a retail store is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if it is readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, a retail store must provide as many spaces as readily achievable and of readily achievable dimensions.

If it is not readily achievable to provide any accessible spaces, a retail store could consider providing valet parking as an alternative method of providing access.

Q. Are retail stores required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs or other mobility devices to have ready access to retail stores. If the only parking available is on a city street and the retail store does not own or control the sidewalk, the municipality, not the retail store, is responsible for providing curb ramps. If a retail store owns or controls the sidewalk, it must provide curb ramps if readily achievable. If a retail store is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

Q. Must all entrances to existing retail stores be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.” For most businesses, ramping one step or even several steps will be readily achievable.

Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If a public accommodation cannot meet the ADAAG’s technical requirements for ramps because of space or other limitations, it can deviate slightly from these specifications as long as the ramp is still safe.

If a permanent ramp cannot be installed, a portable ramp must be used if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct.

A retail store using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable. If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

If none of these access options is readily achievable, alternative means to provide service must be considered, such as curbside service at no additional charge.

Q. How does a retail store know if the doorway for the accessible entrance is wide enough for customers who use wheelchairs or other mobility devices?

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for customers who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual retail store.

Another measure that makes doors easier to use, not only for customers who use mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most businesses.

Q. Must retail stores allow service animals, including guide dogs, to accompany customers with disabilities into retail stores?

A.Yes.

Q. Can a retail store deny service to a person with a disability because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

Q. How do retail stores make their merchandise accessible to customers with various disabilities?

A. Customers who use wheelchairs, crutches, or other mobility devices, customers with limited manual dexterity, and customers who are blind or who have limited vision tend to experience certain types of access problems in retail establishments. For example, people who use wheelchairs often cannot move down aisles when stock or displays are placed in them.

Although widening aisles where merchandise is displayed is an ideal solution for customers who use wheelchairs, in many retail establishments it will result in a significant loss of selling space and is, therefore, in those cases not readily achievable.

Some retail stores, such as department stores, may be able to rearrange display racks and shelves in a way that does not result in a significant loss of selling space.

Placing lightweight items on higher shelves and heavier items on lower shelves and offering the use of a device for reaching high items will improve the usability of a store not only for customers with mobility impairments but also for customers with manual impairments. Otherwise, sales clerks should offer assistance in reaching items.

Moving boxes and displays that impede access to aisles or could trip a customer with a vision impairment is a simple, common sense solution to certain access problems that also makes access easier for other customers.

For retail businesses housed in cramped facilities, there may be no storage alternative for boxes placed in the aisles. If readily achievable, the store could provide service at the door to customers who are unable to move down the aisles.

Q. What is required to make retail store elevators accessible?

A. If readily achievable, stores must install raised letters and Braille on the control panels and outside the doors for blind customers.

Placing a large, high-contrast sign indicating the floor number outside the elevator.

If elevator controls are mounted out of reach of wheelchair users and it is not readily achievable to lower them, installing a stick or pointer near the control panel will help some customers operate the elevator independently. Door timers must also be adjusted so the doors do not close too quickly.

Q. Are retail stores that display merchandise on more than one floor reached only by stairs required to install an elevator?

A. Although installing an elevator will not be readily achievable for most stores, some access to floors above or below the ground level may be required. If there are only several steps to reach the additional levels, a ramp is required if it is readily achievable to install one. If there are many steps, installation of a wheelchair lift, which is much less expensive than an elevator, is required if readily achievable. Other alternatives include using accessible routes such as a freight elevator or rear entrance.

Retail establishments with limited space and resources and without accessible alternative routes available must take other creative steps to make the merchandise available. Courtesy and common sense should dictate what methods are most suitable. Alternative methods include bringing samples of the merchandise from the inaccessible level to the accessible level; using photo albums with price lists; and video taping the merchandise.

Q. Do dressing rooms need to be accessible?

A. If it is readily achievable, stores must alter one or more dressing rooms to allow use by customers who use wheelchairs or other mobility devices. If it is not readily achievable to provide an accessible dressing room, alternative methods must be used, such as establishing a liberal return policy so customers who cannot use the dressing rooms can take merchandise home to try on.

Q. Are clothing stores required to provide assistance in dressing rooms to people with disabilities?

A. Department of Justice states that dressing assistance is required in stores where individualized assistance in selecting and trying on garments is provided. In a store where such assistance is not offered generally, it is not required because it is not provided to other customers.

Q. What are the best ways to make signs and other written information accessible to people with vision impairments?

A. Store directories must be made accessible if this does not pose an undue burden. Options include Braille, large print, audio tape, and personal assistance. Audio cassettes are useful because many people who are blind do not read Braille. Large print signs and documents are helpful to people with limited vision, including older shoppers, and to those reading directories from a distance, such as people who use wheelchairs.

Q. Do price tags have to be in Braille for customers who are blind?

A. No. A salesperson could offer to assist customers who are blind or who have limited vision by describing the items and reading prices and labels. This is a low- or no-cost solution that embodies common sense, courtesy, and good business practice. For most retail establishments, putting all price tags in Braille could not be done without significant expense. Furthermore, many blind individuals do not read Braille.

Q. What measures are required in retail establishments for people with cognitive impairments such a mental retardation?

A. Accommodating people with cognitive impairments can include reading the price tags or product information, using color-coded pictorial maps showing what products are sold in particular locations in the store, and hanging a sign with a large question mark over customer service areas so people with cognitive disabilities know where to go for assistance.

Retail personnel should use simple, direct language and speak in short sentences.

Q. If a store is staffed with only a single cashier, is the cashier required to leave the cash register to assist a customer with a disability?

A. No. The ADA does not require a cashier to leave the register if doing so poses a security risk.

Q. How can a retail establishment communicate with a customer who is deaf or hard of hearing or who has a speech impairment?

A. Most customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When a salesperson has determined that a customer is deaf or hard of hearing, he or she can communicate by writing notes. Maintaining face-to-face contact is important for communicating with a customer who reads lips.

The services of a sign language interpreter are not necessary to accomplish most retail transactions that are short and straightforward with deaf individuals but may be necessary to communicate effectively in an unusually complex transaction.

Stores that use public address systems to announce special offers or sale days should consider providing electronic bulletin boards or print announcements near doors and check-out counters to announce these events as a way to communicate effectively with customers who are deaf or hard of hearing if they can do so without incurring significant difficulty or expense.

It is also important for retail businesses to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or to spell out a message on his or her word board are examples of methods to achieve effective communication.

Q. Must retail establishments install visual fire and other emergency alarms?

A. Where audible alarms are provided, visual alarms must be added if readily achievable. The ADAAG specifies the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to fire or other emergencies. It is suggested that signs be placed next to alarms indicating their purpose. Retail store maps or directories should also point out the location of visual alarms.

Q. Is a retail store required to stock special goods for customers with disabilities?

A. No. Retail stores are not required to stock special goods. For example, a book store is not required to stock Braille books. However, if the store routinely makes special orders for its customers and the special goods can be obtained from a supplier with whom the store customarily does business, it is required to make a special order for a customer with a disability.

Q. What must retail stores do to make check-out aisles accessible to people who use wheelchairs or other mobility devices?

A. If a store already has one or more accessible check-out aisles, customers with mobility impairments should be provided a level of convenience equivalent to that provided for other customers. The store must either keep an adequate number of accessible aisles open or otherwise modify its policies or practices. For example, if only one aisle is accessible and it is an express aisle limited to customers purchasing fewer than 10 items, the store must permit a customer who uses a wheelchair to make his or her purchase at the express lane, regardless of the number of items.

If the store has no accessible check-out aisles, then at least one accessible check-out aisle is required in facilities with less than 5,000 square feet of selling space if readily achievable. In facilities with 5,000 or more square feet of selling space, at least one accessible aisle of each design being used by the business is required if readily achievable.

Signs identifying the accessible check-out aisle(s) must also be provided if readily achievable. If it is not readily achievable to provide any accessible check-out aisles, stores must provide readily achievable alternative methods for customers to pay for merchandise, such as assistance at the check-out counter or manager’s desk.

Adjustments needed to provide access to check-out aisles must comply with the ADAAG if readily achievable.

Q. Must retail stores provide accessible rest rooms? How can rest rooms be made accessible?

A. If rest room facilities are provided for public use, at least one accessible rest room must be available when readily achievable. Certain relatively simple steps can increase access and usability. Widening entry and stall doors; moving obstacles such as vending machines; rearranging toilet partitions to increase maneuverability for customers using wheelchairs; installing a raised toilet seat; installing grab bars near the toilet; repositioning paper towel dispensers; installing lever handles on at least one sink; and installing insulation material around exposed lavatory pipes to prevent wheelchair users from burning their legs while sitting at the sink are examples of readily achievable measures for most businesses. If a retail store provides more than one rest room and not all are accessible, a sign should indicate where the accessible rest room(s) is (are) located.

Simple symbols indicating which facilities are for men or women are easier for some people with cognitive impairments (such as mental retardation) to understand than words or other images. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind, and large, high-contrast signs help people with limited vision. Retail stores must take all of these measures if readily achievable.

Q. Must retail stores have accessible drinking fountains?

A. If stores have drinking fountains, they must make them accessible if it is readily achievable to do so. To make fountains accessible, mount them low enough to be easily reached from a sitting position or install a paper cup dispenser within easy reach.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

Q. Are grocery stores required to have TTYs (TeleTYpewriters)?

A. No. For making calls to or receiving calls from customers with hearing or speech impairments who use TTYs, grocery stores will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow their customers or clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Grocery stores can ensure effective communication by telling staff who answer the telephone to anticipate incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller and will also be using the relay system equipment to type communications from the grocery store staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

A TTY is relatively inexpensive, however, usually costing about $275 and would be welcome service for customers with hearing or speech impairments. Businesses with TTYs should list their telephone number followed by “Voice/TTY” in any publications or advertisements to signify that customers can communicate with them by voice or TTY.

Q. Are grocery stores that offer parking required to provide accessible parking spaces for people with mobility impairments? If such parking is required how many spaces must be provided?

A. Yes. If a grocery store owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If a grocery store is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease of other contract.

The spaces must comply with the dimensions specified in the ADAAG (see page 8) if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if it is readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, a grocery store must provide as many spaces as readily achievable and of readily achievable dimensions.

If it is not readily achievable to provide any accessible spaces, a grocery store could consider providing valet parking as an alternative method of providing access.

Q. Are grocery stores required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs or other mobility devices to have ready access to grocery stores. If the only parking available is on a city street and the grocery store does not own or control the sidewalk, the municipality, not the grocery store, is responsible for providing curb ramps. If a grocery store owns or controls the sidewalk, it must provide curb ramps if readily achievable. If a grocery store is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

Q. Must all entrances to existing grocery stores be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door”.

Stores that use devices such as turnstiles or stanchions to prevent people from removing shopping carts can provide Access for customers with mobility impairments by removing the devices, installing gates that remain open during business hours, or providing an alternate mean of entry.

If there are steps up to the entrance, ramping one step or even several steps will be readily achievable for most grocery stores.

Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If a public accommodation cannot meet the ADAAG’s technical requirements for ramps because of space or other limitations, it can deviate slightly from these specifications as long as the ramp is still safe.

If a permanent ramp cannot be installed, the store must provide a portable ramp if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct. A grocery store using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable. If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

If none of these barrier removal options is readily achievable, alternative methods to provide service must be considered, such as curbside service or home delivery at no additional charge.

Q. How does a grocery store know if the doorway for the accessible entrance is wide enough for customers who use wheelchairs or other mobility devices?

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for customers who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual grocery store.

Another measure that makes doors easier to use, not only for customers who use mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most businesses.

Q. Can a grocery store deny service to a person with a disability because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

Q. Must grocery stores allow service animals, including guide dogs, to accompany customers with disabilities into grocery stores?

A. Yes.

Q. How can grocery stores make their merchandise accessible to customers with various disabilities?

A. Customers who use wheelchairs, crutches, or other mobility devices, customers with limited manual dexterity, and customers who are blind or who have limited vision tend to experience certain types of access problems in grocery stores. For example, people who use wheelchairs often cannot move down aisles when stock or displays are placed in them.

Although widening aisles where merchandise is displayed is an ideal solution for customers who use wheelchairs, in many grocery stores it will result in a significant loss of selling space and is, therefore, in those cases not readily achievable. Some grocery stores, such as supermarkets, may be able to rearrange display racks and shelves in a way that does not result in a significant loss of selling space.

Placing lightweight items on higher shelves and heavier items on lower shelves and offering the use of a device for reaching high items will improve the usability of a store not only for customers with mobility impairments but also for customers with manual impairments. Otherwise, sales clerks should offer assistance in reaching items.

Moving boxes and displays that impede access to aisles or could trip a customer with a vision impairment is a simple, common sense solution to certain access problems that also makes access easier for other customers.

For grocery stores housed in cramped facilities, there may be no storage alternative for boxes placed in the aisles. If readily achievable, the store could provide service at the door to customers who are unable to move down the aisles.

Some people with disabilities cannot use shopping carts and must, instead, use hand-held baskets. This may require them to make several trips to the check-out counter to complete their purchases. Grocery stores should provide a temporary storage area for items selected by people who cannot use shopping carts.

Produce bag dispensers and number dispensers used at deli, bakery, and other food service counters must be mounted within easy reach of customers who use wheelchairs if readily achievable.

Q. Do price labels have to be in Braille for customers who are blind? What other auxiliary aids and services must be provided to people who are blind or who have limited vision?

A. No. For most grocery stores, putting all price labels in Braille could not be done without significant expense. Furthermore, not everyone who is blind reads Braille. A store employee could offer to assist customers who are blind or who have limited vision by describing the items and reading prices and labels unless an undue burden would result.

When merchandise and price information are available on a display board at a deli, bakery, or other service counter, high-contrast signs or large print handouts are helpful for people with limited vision. In most cases, these are low- or no-cost solutions that embody common sense, courtesy, and good business practice.

Signs that protrude into aisles from display shelves can be a hazard to people who are blind or have limited vision; these must be mounted in locations that do not impede travel if readily achievable.

Q. What measures are required in grocery stores for people with cognitive impairments such a mental retardation?

A. Accommodating people with cognitive impairments can include reading the price labels or product information, using color-coded pictorial maps showing what products are sold in particular locations in the store, and hanging a sign with a large question mark over customer service areas so people with cognitive disabilities know where to go for assistance.

Store personnel should us simple, direct language and speak in short sentences.

Q. How can a grocery store communicate with a customer who is deaf or hard of hearing or who has a speech impairment?

A. Most customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When a sales clerk has determined that a customer is deaf or hard of hearing, he or she can communicate by writing notes. Maintaining face-to-face contact is important for communicating with a customer who reads lips.

The services of sign language interpreter are not necessary to enable deaf person to make purchases at grocery stores because the transactions are short and straightforward.

Grocery stores that use public address systems to announce special offers or sales should consider providing electronic bulletin boards or print announcements near doors and check-out counters to announce these events as a way to communicate effectively with customers who are deaf or hard of hearing if they can do so without incurring significant difficulty or expense.

It is also important for grocery store staff to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or to spell out a message on his or her word board are examples of methods to achieve effective communication.

Q. If a grocery store is staffed with only a single cashier, is the cashier required to leave the cash register to assist a customer with a disability?

A. No. The ADA does not require a cashier to leave the register if doing so poses a security risk.

Q. Can grocery stores charge people with disabilities for deliveries?

A. If home delivery is the only readily achievable alternative to barrier removal that is offered, grocery stores may not charge for the home delivery to a customer with a mobility impairment. If, however, the store is accessible to customers with mobility impairments and home delivery is provided at an additional cost to customers, the store may charge customers with mobility impairments for home delivery.

Q. Must grocery stores install visual fire and other emergency alarms?

A. Where audible alarms are provided, visual alarms must be added if readily achievable. The ADAAG specifies the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to fire or other emergencies. It is suggested that signs be placed next to alarms indicating their purpose. Store maps or directories should also point out the location of visual alarms.

Q. Is a grocery store required to purchase special items for customers with disabilities?

A. No. Grocery stores are not required to carry special products for people with disabilities. However, if the store routinely makes special orders of un-stocked goods for its customers and the special goods can be obtained from a supplier with whom the store customarily does business, the store must make special orders for customers with disabilities, too.

Q. Can a grocery store that requires a driver’s license as identification for payment by check refuse to accept a check from a person with a disability who does not have a license?

A. People with disabilities such as blindness or limited vision who are ineligible to obtain a driver’s license must be permitted to present another form of identification, such as a school or work ID, to verify their identity when they wish to pay by check for the goods that they are purchasing.

Q. What must grocery stores do to make check-out aisles accessible to people who use wheelchairs or other mobility devices?

A. If a store already has one or more accessible check-out aisles, customers with mobility impairments should be provided a level of convenience equivalent to that provided for other customers. The store must either keep an adequate number of accessible aisles open or otherwise modify its policies or practices. For example, if only one aisle is accessible and it is an express aisle limited to customers purchasing fewer than 10 items, the store must permit a customer who uses a wheelchair to make his or her purchase at the express lane, regardless of the number of items.

If the store has no accessible check-out aisles, then at least one accessible check-out aisle is required in facilities under 5,000 square feet of selling space if readily achievable. In facilities with 5,000 or more square feet of selling space, at least one accessible aisle of each design being used by the business is required if readily achievable.

Signs identifying the accessible check-out aisle(s) must also be provided if readily achievable. If it is not readily achievable to provide any accessible check-out aisles, grocery stores must provide readily achievable alternative methods for customers to pay for merchandise, such as assistance at the check-out counter or curbside service.

Adjustments needed to provide access to check-out aisles must comply with the ADAAG if readily achievable.

Q. How can cashiers communicate effectively with customers who are blind or have limited vision, who are deaf or hard of hearing, or who have cognitive impairments?

A. In order to communicate effectively with customers with vision impairments, cashiers must tell the customer the total cost of his or her purchase.

Grocery stores could change the position of cash registers or add another price display to registers if doing so does not pose a significant expense, so customers with hearing impairments can see item prices and the total cost of a purchase. Other options include writing the total cost on a note pad or handing the customer the cash register tape.

Cashiers can communicate effectively with customers with cognitive impairments by saying aloud the total purchase amount.

Q. Must grocery stores have accessible drinking fountains?

A. Stores with drinking fountains must make them accessible if it is readily achievable to do so. To make fountains accessible, mount them low enough to be easily reached from a sitting position or install a paper cup dispenser within easy reach.

Q. Are grocery stores that provide public telephones required to provide wheelchair accessible public telephones?

A. If a grocery store provides public telephones, at least one telephone must be accessible to people who use wheelchairs or other mobility devices if readily achievable. If providing an accessible telephone is not readily achievable, then readily achievable alternative methods of providing access to a telephone are required. For example, grocery stores can offer customers who cannot use the public telephone the use of a private telephone. A sign should be posted near the public telephone(s) specifying the location of an accessible telephone and/or whom the person should contact to arrange for its use.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

Q. Are professional offices considered to be places of public accommodation?

A. Yes, private offices for lawyers, accountants, insurance agents, financial planners, stock brokers and management consultants, for example, are covered by Title III.

Q. Are professional offices required to have TTYs (TeleTYpewriters)?

A.No. For making calls to or receiving calls from clients with hearing or speech impairments who use TTYs, offices will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Offices should ensure effective communication by training staff who answer the telephone to handle incoming calls through the relay services. Relay calls may take longer because an operator at the relay system will be receiving typed communications from the caller using a TTY and will also be using the relay system equipment to type spoken communications from the office person to the caller.

For businesses who want or need one, a TTY is relatively inexpensive, usually costing about $275 and is a welcome service. If you have a TTY, remember to list your telephone number followed by “Voice/TTY” in any publications or advertisements to signify that clients can communicate with them by voice or TTY.

Q. Are professional offices that offer parking required to provide accessible parking spaces for people with “handicap” tags or placards? If such parking is required how many spaces must be provided?

A. Yes. If an office owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If an office is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant and may be allocated between the landlord and tenant in the lease or other contract.

The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The standards provide a formula for determining the appropriate number of accessible spaces necessary, and set out the requirements for their dimensions and locations. If it is not readily achievable to comply with the Standards, an office must provide as many accessible spaces as possible.

If it is not readily achievable to provide any accessible spaces, an office must provide other options. For example, valet parking as another way to provide access.

Q. Are professional offices required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) provide access to facilities for people who use wheelchairs, walkers or other mobility equipment. If the only parking is on a city street and the business does not own or control the sidewalk, the municipality, not the office, is responsible for providing curb cuts. If an office owns or controls the sidewalk, it must provide curb cuts if readily achievable. If an office is a tenant, responsibility rests with both the landlord and the tenant, and may be allocated in the lease or other contract.

As with parking spaces, the Standards establish requirements for construction of curb cuts.

Q. Must all entrances to professional offices be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.” If the main entrance is not accessible, a sign there should indicate where the accessible entrance is located.

Ramping one step or several steps usually will be fairly easy and inexpensive. A permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If the Standard’s technical requirements for ramps cannot be met because of space or other limitations, the ramp dimensions can deviate slightly as long as it is still safe.

If a permanent ramp cannot be installed, a safe portable or movable ramp may be used. Most portable ramps are relatively inexpensive to purchase or construct. An office using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door.

If none of these options is readily achievable, alternative means to provide services must be considered, such as curb service or home visits at no additional charge.

Q. How does a professional office know if the doorway is wide enough for clients who use wheelchairs or other mobility equipment?

A. The Standards for Accessible Design state that a minimum of 32 inches of clear opening is required to provide access for customers who use wheelchairs or other mobility devices. A clear opening is measured between the face of the door and the opposite stop when the door is opened 90 degrees. Offset hinges can increase the clear space by one or two inches.

Although not required, automatic or push button doors are best for access, if maintained properly. An office can determine whether or not installation would be readily achievable.

Lever or U-shaped handles make doors easier for customers with limited dexterity. Retrofit levers can cost less than $10 and make opening doors significantly easier.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. These examples of modifications should be readily achievable for most businesses.

Q. Must professional offices allow service animals, including guide dogs, to accompany clients into facilities?

A. Yes.

Q. If a professional office is in an historic building, is it exempt from the requirements of the ADA?

A. No. Barrier removal is required in all buildings, including historic buildings, if it is readily achievable. However, barrier removal is not considered readily achievable if it would threaten or destroy the historic significance of a building or facility that is eligible for listing in the National Register of Historic Places under the National Historic Preservation Act, or is designated as historic under State or local law.

Q. Can a person with a disability be denied service because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities. For example, people with Tourette Syndrome make sounds, words or facial movements that they cannot control.

Violent or disruptive behavior, however, is prohibited.

Q. What is required to make elevators accessible?

A. Facilities must install raised letters and Braille on the elevator control panels and provide floor number signs with raised and Braille characters on elevator door jambs.

A large, high-contrast sign indicating the floor number outside the elevator and opposite the elevator door helps orient people with limited vision.

If elevator controls are mounted out of reach of wheelchair users and it is not readily achievable to lower them, installing a stick or pointer near the control panel will help some clients operate the elevator independently. Door timers must also be adjusted so the doors do not close too quickly.

Q. Are offices with more than one floor required to install an elevator, if they do not have one?

A. In most cases, installing an elevator will not be readily achievable. However, some access to floors above or below the ground level may be required.

If only a few steps separate levels, a ramp is required if readily achievable. If there are many steps, installation of a wheelchair lift, which is much less expensive than an elevator, is required if readily achievable. Other alternatives include using accessible routes such as a freight elevator or rear entrance. Offices with limited space and resources and without accessible alternative routes must take other creative steps to make services available.

Courtesy and common sense should dictate what methods are most suitable. Alternative methods include setting up meetings in accessible locations; visiting the client’s home, performing the service on other, accessible levels; audio or video taping of contracts or written documents.

Q. What are the best ways to make signs and other written information accessible to people with vision impairments?

A. All important signs should be in accessible formats. Options include Braille, large print and audio tape. Many people who are blind or have limited vision do not read Braille so audio cassettes and large print signs and documents are the most helpful. Older clients and those reading from a distance will also benefit from these modifications.

Q. How can a professional service provider communicate with a client who is deaf or hard of hearing or who has a speech impairment?

A. Most clients who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures and will alert the professional to the best method of communication. Maintaining face-to-face contact is important to communicate with a client who reads lips.

A sign language interpreter should not be necessary in most minor transactions, but may be necessary to communicate effectively in an unusually complex transaction.

Professionals can share a computer with a client to type questions and answers back and fourth to each other, if the client finds this approach is sufficiently informative.

It is important to communicate effectively with customers who have speech impairments. Professionals must take the time for people with such a disability to express themselves or to communicate using a word board.

Q. How can a professional perform a service that requires confidential communication or written materials with a client who is deaf or hard of hearing?

A. For a client who is deaf or hard of hearing, effective communication may require a qualified sign language interpreter. Sign language interpreters are required to maintain the confidentiality of any conversations they interpret.

Q. What measures are required for people with cognitive impairments such a mental retardation?

A. Accommodating people with cognitive impairment can include reading the contract or other written information to them; providing an audio tape copy of the material; using pictorials to describe complex issues; and simple, common sense. Asking the client to repeat back the core of the discussion and using simple, direct sentences will assist effective communication.

Q. Must professional offices install visual alarms?

A. Where audible fire alarms are provided, visual alarms must be added if readily achievable. The Standards specify the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to emergencies. Signs can be placed next to alarms indicating their purpose and maps or directories should point out the locations of visual alarms.

Q. Must professional offices provide accessible rest rooms?

A. Most offices don’t have bathrooms open to the public. If bathrooms are provided for use by clients, those rest rooms must be made accessible where readily achievable. Simple steps can increase access and usability. If an office provides more than one rest room and it is not achievable to make all of them accessible, a sign should indicated where the accessible rest room(s) is (are) located.

Label the bathrooms clearly: “men” and “women”. For people with cognitive impairments such as mental retardation straight forward language is clearer. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind. Large, high-contrast signs help people with limited vision.

Q. Must a professional office that is located with in a private residence be accessible?

A. Yes. When a public accommodation is located in a private residence, the portions of the home used as a place of public accommodation are covered by the ADA. This is also true if those parts of the home that are used as public accommodation are also used for residential purposes.

The readily achievable standard continues to apply. Barrier removal will be required when considered in light of the financial and other resources of the professional office.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

A. No. For making calls to or receiving calls from customers with hearing or speech impairments who use TTYs, restaurants will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow their customers to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Restaurants and bars can ensure effective communication by telling staff who answer the telephone to anticipate incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller and will also be using the relay system equipment to type communications from the restaurant or bar staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

For your information, however, a TTY is relatively inexpensive, usually costing about $275 and would be welcome service for customers with hearing or speech impairments. If you have a TTY, be sure to list their telephone number followed by “Voice/TTY” in any publications or advertisements to signify that customers can communicate with them by voice or TTY.

A. Yes. If a restaurant or bar owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If a restaurant or bar is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease of other contract.

The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if it is readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, a restaurant or bar must provide as many spaces as readily achievable and of readily achievable dimensions.

If it is not readily achievable to provide any accessible spaces, a restaurant or bar could consider providing valet parking as an alternative method of providing access.

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs or other mobility devices to have ready access to restaurants and bars. If the only parking available is on a city street and the business does not own or control the sidewalk, the municipality, not the restaurant or bar, is responsible for providing curb ramps. If a restaurant or bar owns or controls the sidewalk, it must provide curb ramps if readily achievable. If a restaurant or bar is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant.

These responsibilities for compliance may be allocated between the landlord and tenant in the lease or other contract.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.” For many businesses, ramping one step or even several steps will be readily achievable.

Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If a public accommodation cannot meet the ADAAG’s technical requirements for ramps because of space or other limitations, it can deviate slightly from these specifications as long as the ramp is still safe.

If a permanent ramp cannot be installed, a portable ramp must be used if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct.

A restaurant or bar using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable. If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

If none of these barrier removal options is readily achievable, alternative methods to provide service must be considered, such as curbside service or home delivery at no additional charge.

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for customers who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual restaurant or bar.

Another measure that makes doors easier to use, not only for customers who use mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most businesses.

A. Restaurants and bars must make sure there is adequate lighting at the entrance to enable customers with limited vision disabilities to enter and exit safely.

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

A. When evaluating a restaurant or bar for accessibility to seating and other service areas, apply a few common sense rules.

If “getting through the door” is possible, a restaurant or bar should determine whether the pathways between tables, bars, and other facilities are wide enough for a customer using a wheelchair. Are there level changes between service areas? Are there vending machines or stock stored in hallways or other areas that might block passage? In some instance, minor, no cost changes to the arrangement of tables and storage items can facilitate access.

A. Accessible tables must, where practical, be distributed throughout the establishment. Accessible tables must be between 28 and 34 inches from the floor to the top of the table if readily achievable. Keep a list of accessible tables so the person who seats customers will be able to direct customers using wheelchairs to accessible tables.

If an individual wishes to transfer from her or his wheelchair to a regular seat, it is suggested that restaurant staff offer to remove the wheelchair to an out-of-the-way location.

A. Yes, at least five percent of the restaurant’s fixed tables must be accessible if readily achievable. Accessible tables (28-34 inches high) must, where practical, be distributed throughout the restaurant. For establishments with fewer than 20 tables, at least one table must be accessible. This provision is, in many cases, easy and inexpensive to meet by removing several of the fixed seats (but leaving the tables) and replacing them with seats that can be removed for a customer who uses a wheelchair. This measure also creates aisles wide enough to people using wheelchairs or other mobility devices to negotiate.

A. In many instances, restaurants with fixed seating may be able to create access aisles wide enough for passage by people with mobility impairments by removing some fixed seats and replacing them with moveable seats. If this is not readily achievable, restaurants may be able to put accessible tables near entrances or close to service counters.

A. Access to all seating areas is not required. However, if readily achievable, at least one area that the general public and people with disabilities may use must provide the same services and décor that are available in other, inaccessible areas.

A. Possibly. Although installing an elevator will not be readily achievable for most restaurants and bars, some access to floors above or below the ground level may be required. If there are only several steps to reach the additional levels, a ramp is required if it is readily achievable to install one. If there are many steps, installation of a wheelchair lift, which is much less expensive than an elevator, is required if readily achievable. Other alternatives include using accessible routes such as a freight elevator or rear entrance. If alternative access is impossible, the restaurant must offer bar service at the same prices to customers with mobility impairments in the restaurant.

Conversely, if the bar is on ground level and the restaurant is downstairs and cannot be reach using readily achievable methods, the restaurant must make the menu items available in the bar at no additional cost.

Restaurants must also ensure that stairwells to different levels are well lit so that people with limited vision can safely access all levels. This measure will be readily achievable in most circumstances.

A. Possibly. If the bar exceeds 34 inches in height, a 60-inch long protion of the counter must be lowered, where it is readily achievable, to between 28 and 34 inches from the floor to the top of the bar with knee space at least 27 inches high, 30 inches wide, and 19 inches deep, for customers who use wheelchairs. Another acceptable, inexpensive, and easy alternative is to provide accessible tables within the same service area.

A. Customers with vision impairments may need orientation to their seats. It is customary to offer a person with a vision impairment assistance to his or her seat. If he or she accepts the offer of assistance, the service person should offer his or her arm to the customer and guide the person to the table, alerting him or her to obstacles along the way.

Menu information must be accessible to people with vision impairments. The best way to provide access to the menu depends, in part, on the type of restaurant and its resources. One method is for employees to read menus and daily specials to customers. Large print menus are another inexpensive method for providing independent access to some customers with limited vision. An inexpensive magnifier is also useful to some people with vision limitations. Braille menus are an option, but not everyone who is blind reads Braille. Providing audio cassette tapes of the menu and a cassette player will provide effective communication with many individuals with vision impairments.

If a restaurant uses low lighting for ambiance, it could offer a small flashlight for use at the table.

A. Yes.

A. It is important for restaurants to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or read a message spelled out on a word board are examples of methods to achieve effective communication.

Sign language interpreters are not required for short and simple communications with deaf individuals. Use of a pen and note pad is adequate with a customer with a hearing or speech impairment who simply wishes to order a meal or drinks and pay the check.

A. No. The ADA prohibits public accommodations from using eligibility criteria that have the effect of discriminating against people with disabilities unless necessary to one’s business. Requiring a driver’s license as the sole acceptable document for proof of age discriminates against people with disabilities such as blindness who are ineligible to obtain a driver’s license. An exception to the policy must be made to permit these customers to present another form of identification that shows their age.

A. If rest room facilities are provided for public use, at least one accessible rest room must be available when readily achievable. Certain relatively simple steps can increase access and usability. Widening entry and stall doors; moving obstacles such as vending machines; rearranging toilet partitions to increase maneuverability for customers using wheelchairs; installing a raised toilet seat; installing grab bars near the toilet; repositioning paper towel dispensers; installing lever handles on at least one sink; and installing insulation material around exposed lavatory pipes to prevent wheelchair users from burning their legs while sitting at the sink are examples of readily achievable measures for most businesses. If a restaurant or bar provides more than one rest room and not all are accessible, a sign should indicate where the accessible rest room(s) is (are) located.

Simple symbols indicating which facilities are for men or women are easier for some people with cognitive impairments (such as mental retardation) to understand than words or other images. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind, and large, high-contrast signs help people with limited vision. Restaurants and bars must take all of these measures if readily achievable.

A. Where audible alarms are provided, visual alarms must be added if readily achievable. The ADAAG specifies the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to fire or other emergencies. It is suggested that signs be placed next to alarms indicating their purpose. Restaurant and bar personnel should also point out the location of visual alarms to people who are deaf or hard of hearing.

A. Restaurants are required to make reasonable modifications to their policies and procedures to prevent discrimination against customers with disabilities. Keeping straws on hand for use by customers with manual impairments and unwrapping them if requested; cutting up foods if requested by a customer; providing a glass, cup, or different sized dish that is easier for a customer to handle if requested; and providing assistance to customers who request help removing their coats or jackets are examples of reasonable modifications for most restaurants and bars.

Restaurants must be prepared to respond accurately to telephone inquiries from customers who wish to know about the restaurant’s accessibility. A common sense approach is to keep a typed list near the telephone outlining the restaurant’s access features that any employee can read in response to an inquiry.

These measures are courtesies that are generally accepted as good business practice. The ADA makes sure such courtesies are extended to all customers.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

Q. Are outpatient medical and health care facilities considered to be places of public accommodation?

A. Yes, privately operated medical and health care facilities are covered by Title III. Examples of such facilities are the offices of private doctors, dentists, optometrists, opticians, chiropractors, psychiatrists, psychologists and other therapists, acupuncturists, and nutritionists; clinics; family planning facilities; occupational and physical therapy facilities; laboratories and radiology facilities; an day care surgery centers located in facilities separate from hospitals. The public accommodation provisions of the Americans with Disabilities Act (ADA) also apply to the offices of private medical and health care providers located in private homes. This publication addresses all of these types of facilities. Private hospitals and other in-patient facilities, which are also public accommodation under Title III of the ADA, are not addressed here.

Q. Are there other federal laws protecting the civil rights of people with disabilities that medical and health care facilities should know about?

A. Yes. Section 504 of the 1973 Rehabilitation Act, which applies to recipients of federal financial assistance, may apply to medical and health care facilities. The ADA does not supersede Section 504. Facilities that have been subject to Section 504 must still comply with that law; these facilities may also be subject to additional requirements under the ADA.

Q. Are outpatient medical and health care facilities required to have TTYs (TeleTYpewriters)?

A. No. For making calls to or receiving calls from patients or clients with hearing or speech impairments who use TTYs, health care facilities will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow their patients or clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Health care facilities can ensure effective communication by training staff who answer the telephone to anticipate incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller and will also be using the relay system equipment to type communications from the health care facility staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

For your information, however, a TTY is relatively inexpensive, usually costing about $275 and would be welcome service for patients or clients with hearing or speech impairments. If you have a TTY, be sure to list your telephone number followed by “Voice/TTY” in any publications or advertisements to signify that patients and clients can communicate with them by voice or TTY.

Q. Are health care facilities that offer parking required to provide accessible parking spaces for people with mobility impairments? If such parking is required how many spaces must be provided?

A. Yes. If a health care facility owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If a health care facility is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if it is readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, a health care facility must provide as many spaces as readily achievable and of readily achievable dimensions. If it is not readily achievable to provide any accessible spaces, a health care facility could consider providing valet parking as an alternative method of providing access.

Q. Are health care facilities required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs or other mobility devices to have ready access to health care facilities. If the only parking available is on a city street and the facility does not own or control the sidewalk, the municipality, not the health care facility, is responsible for providing curb ramps. If a health care facility owns or controls the sidewalk, it must provide curb ramps if readily achievable. If a health care facility is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

Q. Must all entrances to existing health care facilities be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.” In multi-use facilities, a sufficient number of entrances must be accessible if readily achievable so that people with disabilities can reach all services offered at a particular facility. For most health care facilities that have steps, ramping one step or even several steps will be readily achievable.

Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If a public accommodation cannot meet the ADAAG’s technical requirements for ramps because of space or other limitations, it can deviate slightly from these specifications as long as the ramp is still safe.

If a permanent ramp cannot be installed, a portable ramp if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct.

A health care facility using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable. If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

If none of these barrier removal options is readily achievable, health care facilities must provide service through readily achievable alternate methods. For example, a doctor could examine a patient at no additional charge at a hospital where the doctor had privileges or at the patient’s home.

Q. How does a health care facility know if the doorway for the accessible entrance is wide enough for customers who use wheelchairs or other mobility devices?

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for customers who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual health care facility.

Another measure that makes doors easier to use, not only for customers who use mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most businesses.

Q. Are the offices of health care providers located in private homes required to make their facilities accessible to patients who use wheelchairs or other mobility devices?

A. All areas of the home used by clients or patients are places of public accommodation under the ADA. Therefore, health care providers must remove barriers to access in those areas if it is readily achievable to do so. As with other public accommodations, barriers at the entrance to the home office, as well as barriers to approaches, rest rooms, and hallways, must be removed if readily achievable.

Q. Can a health care facility deny service to a person with a disability because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

Q. Must health care facility allow service animals, including guide dogs, to accompany customers with disabilities into retail stores?

A. Yes, except in the rate circumstances that the presence of an animal would compromise health and/or safety standards, such as in an operating room.

Q. Are health care facilities allowed to ask patients or clients with disabilities about their medical history or whether they have certain conditions or diseases?

A. Medical and health care facilities may only ask questions that are necessary for the treatment and care of patients. Such questions must have a legitimate medical purpose. Facilities may not ask such questions as a method of eliminating patients or clients from services to which they are entitled. Nor can such questions be asked because of fear, myths, or stereotypes about certain conditions or diseases.

Q. Can health care facilities refer a patient or client with a disability to another practitioner solely because the other practitioner is familiar with the patient’s type of disability?

A. Medical and health care facilities that routinely make referrals may refer an individual with a disability to another facility for service only if the patient seeks or requires treatment or services outside the referring facility’s area of specialization. For example, a clinic specializing exclusively in drug rehabilitation could refuse to treat a person who is not a drug addict but could not refuse to treat a person who is a drug addict simply because the patient tests positive for HIV. Conversely, a clinic that specializes in the treatment of individuals with HIV could refuse to treat an individual who does not have HIV, but it cannot refuse to treat a person for HIV infection simply because that person is also a drug addict.

Q. How can a health care facility determine whether its premises are accessible to people who use wheelchairs or other mobility devices? What steps must they take to provide access?

A. These are some common sense approaches medical and health care facilities can use to determine whether their premises are accessible.

After determining whether “get through the door” is possible, facilities should determine whether aisles between office furniture and equipment are wide enough for a person using a wheelchair or other mobility device to pass. Examination, treatment, and dressing room doorways must also be wide enough for individuals using wheelchair or other mobility devices. (See earlier question for information about doorway widths.)

Widening doors and rearranging furniture and storage items are examples of methods to provide access that will be readily achievable for most health care facilities.

Registration and patient interview areas with built-in counters should be evaluated to determine whether individuals using wheelchairs can use them. If readily achievable, accessible counters (28 to 34 inches high, 30 inches wide, and 19 inches deep) must be made available. If it is not readily achievable to provide accessible counters, then readily achievable alternative measures must be taken to provide access, such as providing a table or clipboard which patients and clients can use while filling out forms.

Facilities should also evaluate whether there are level changes between treatment and service areas. For most health care facilities, providing a ramp for one or even several steps is readily achievable measure to provide access. If it is not readily achievable to install a permanent ramp, then a facility must use a portable ramp if it is save and readily achievable.

Q. Must health facilities provide accessible rest rooms? How can rest rooms be made accessible?

A. Rest rooms are an integral part of a health care facility’s services. Therefore, these facilities must take readily achievable measure to remove barriers to and in rest rooms.

Certain relatively simple steps can increase access and usability. Widening entry and stall doors; moving obstacles such as vending machines; rearranging toilet partitions to increase maneuverability for customers using wheelchairs; installing a raised toilet seat; installing grab bars near the toilet; repositioning paper towel dispensers; installing lever handles on at least one sink; and installing insulation material around exposed lavatory pipes to prevent wheelchair users from burning their legs while sitting at the sink are examples of readily achievable measures for most businesses.

If a medical or health care facility provides more than one rest room and not all are accessible, a sign should indicate where the accessible rest room(s) is (are) located.

Simple symbols indicating which facilities are for men or women are easier for some people with cognitive impairments (such as mental retardation) to understand than words or other images. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind, and large, high-contrast signs help people with limited vision. Health care facilities must take all of these measures if readily achievable.

Q. Are health care facilities with offices on both the ground floor and another floor reached only by stairs required to install an elevator?

A. Although installing an elevator will not be readily achievable for most facilities, some means of providing access to floors above or below the ground level may be required. If there are only several steps to reach the additional levels, a ramp is required if it is readily achievable to install one. If there are many steps, installation of a wheelchair lift, which is much less expensive than an elevator, is required if readily achievable. Other alternatives include using accessible routes such as a freight elevator or service entrance.

When it is not readily achievable to provide some type of access to the other level(s), medical and health care facilities must take other readily achievable steps to provide services to people with disabilities. For example, they may be able to provide services at alternative locations such as a colleague’s office on the ground floor, the home of the patient or client, or another suitable location.

Q. For health care facilities that have elevators what is required to make them accessible?

A. If readily achievable, facilities must install raised letters and Braille on the control panels and outside the doors for blind customers.

Placing a large, high-contrast sign indicating the floor number outside the elevator and opposite the elevator door helps orient people with limited vision.

If elevator controls are mounted out of reach of wheelchair users and it is not readily achievable to lower them, installing a stick or pointer near the control panel will help some customers operate the elevator independently. Door timers must also be adjusted so the doors do not close too quickly.

Q. What assistance must health care facilities provide for patients and clients who use wheelchair or other mobility devices to ensure equal and effective treatment and services?

A. Individuals with mobility impairments often find it difficult or impossible to use certain standard equipment found in medical and health care facilities. For example, people who are not ambulatory cannot use standard-height examining tables.

Therefore, health care providers cannot conduct certain examinations that require patients to lie prone or supine unless the individual is lifted onto the table. Such measures can be unsafe, embarrassing, and undignified for many patients. Although people who use wheelchairs or other mobility devices are most often affected by this particular barrier to treatment, older patients and others who are semi-ambulatory also can experience difficulty.

An adjustable-height examining table is an ideal solution if it is readily achievable to obtain one. Such tables can be lowered to the height of a wheelchair seat, thus enabling some patients who use wheelchairs to move independently or with minimum assistance from their wheelchairs to the table and back again. The adjustable feature also allows medical or health care personnel to elevate the table to a comfortable height to conduct an examination.

If it is not readily achievable to obtain such a table, facilities must obtain if readily achievable, an inexpensive, padded table the height of a wheelchair seat for use by patients who cannot use the conventional tables. This type of low table can also be used for some examinations of and consultations with patients who do not have disabilities. A group of physicians could purchase such a table and make arrangements to share its use.

If neither of these options is readily achievable, then medical and health care facilities must provide assistance to help patients onto the high tables, including lifting them if necessary. Such measures must be undertaken in a safe manner to avoid injury to both the health care personnel and the patient and to preserve the dignity of the patient as much as possible.

Similarly, health care facilities must provide such assistance to patients with mobility impairments who are having radiology exams or other tests conducted on surfaces that cannot be adjusted for height or that are inaccessible in some other way.

In all of these situations, medical and health care personnel should follow the instructions and preferences of the patient with regard to lifting or providing other assistance.

Modifications to the manner in which certain examinations are conducted are also required. For example, some X-ray equipment used to take mammograms is built so the patient must stand to have the X-ray taken. Other mammogram equipment requires the patient to sit on a wheeled stool with a swivel seat. In both situations, a woman with a disability that presents her from standing or sitting safely on such a stool would not be able to undergo the X-ray examination.

Replacing the stool with a stable chair or allowing the patient to undergo the examination from her wheelchair are appropriate methods of providing access.

Medical and health care facilities must provide assistance to undress and dress as needed or requested by patients with disabilities unless doing so fundamentally alters the services provided.

If they have a blanket policy prohibiting individuals other than patients in examination or treatment facilities, medical and health care facilities must modify the policy to allow a family member, friend, or personal care assistant to accompany a patient or client when necessary during the examination or treatment.

Q. What access problems do patients with mobility impairments encounter at dentists’ offices?

A. Some patients who use wheelchairs either cannot independently transfer into the dentist’s chair or must remain in their wheelchairs because of their disabilities. For a patient who does not have to remain in his or her wheelchair and wishes to transfer to the dentist’s chair, dental staff must provide assistance in transferring unless doing so would fundamentally alter the service provided.

Staff should follow the instructions and preferences of the patient with regard to lifting or providing other assistance. Cushions or pillows may be necessary to enable a patient to sit comfortably in the dentist’s chair for the examination or treatment.

Some procedures do not require the patient to transfer from the wheelchair. In these cases dentists should allow the patient to remain in the wheelchair if he or she wishes. Dentists must take steps, however, to ensure that the patient is made as comfortable as possible. If a patient can be treated only while seated in his or her wheelchair, dental staff must take whatever steps are necessary to conduct the examination and provide treatment unless doing so would fundamentally alter the nature of the treatment provided.

Q. How can health care facilities provide effective communication with patients who are blind or who have limited vision?

A. Patients and clients with vision impairments may need orientation to locate the examination or treatment room within the medical or health care facility. It is customary to offer to orient a person with a vision impairment to his or her surroundings. If he or she accepts the offer of assistance, the staff person should offer his or her arm to the patient or client and guide the person to the appropriate area, alerting him or her to obstacles along the way.

Printed material and information used by the health care facility such as consent-to-treatment and insurance forms must be accessible to people with vision impairments. Information about the condition for which the individual is seeking treatment, instructions that must be followed before certain tests, and release-of-information forms must also be made available in an accessible format.

The best way to provide access to this information depends on the needs of the individual patient, the type of facility, its resources, and whether a particular option would pose an undue burden.

Methods to make material accessible may include providing audio cassette tapes of the material and a cassette player. Offering large print materials is another inexpensive way to achieve effective communication with many patients and clients who have limited vision. An inexpensive magnifier is also useful for some patients with limited vision. Brailled materials are an option for patients or clients who are blind, but not all people who are blind read Braille. Another method to provide effective communication to patients and clients who are blind or have limited vision is for staff to read the materials to them.

It is also helpful to explain in advance the various procedures that are going to be performed. If instruments are going to be used, an explanation about their function and purpose is important. If possible, allow the person to touch the implements. Let patients handle three dimensional models if they are available in the office to explain procedures and treatments.

Q. What are the best ways to make signs and other written information accessible to people with vision impairments?

A. Office directories must be made accessible if this does not pose an undue burden. Options to improve access include printing the directory in large print and providing good lighting near the directory, providing the directory information on audio tape, and providing personal assistance to read the directory and/or help the person find the particular office or service he or she is seeking.

Large print formats for signs and documents are useful to people with limited vision, including older patients or clients. Large print directories are also helpful to those reading directories from a distance, such as people who use wheelchairs.

Q. How do health care facilities communicate with patients or clients who have hearing or speech impairments? Must they provide sign language interpreters to communicate with individuals who are deaf?

A. For communications that are short and straightforward, such as when a patient is having a simple blood test, using a pen and note pad or taking turns at a computer terminal are adequate ways to communicate effectively with a patient or client who is deaf or hard of hearing.

Sign language interpreters are required in situations when they are necessary for a doctor or other health care provider to communicate effectively with a patient or client and when providing an interpreter would not pose an undue burden. For example, when a doctor needs to discuss with a deaf patient a complex matter like treatment options for cancer and that patient is someone who communicates through sign language, a physician who can locate a qualified sign language interpreter and absorb the fee in his or her overhead without undue burden is required to provide interpreter service for communicating with that patient.

It is also important for medical and health care facilities to communicate effectively with patients with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or to spell out a message on his or her word board are examples of methods to achieve effective communication.

Q. What auxiliary aids and services must health care facilities provide to ensure effective communication with people with cognitive impairments such a mental retardation?

A. It is important to communication clearly and simply with an individual with a cognitive impairment. In situations involving complex matters, people with cognitive impairments can benefit from the careful restatement or interpretation of concepts that fosters effective communication. For example: Explain the purpose of the examination or treatment and give a step-by-step account of what will happen; speak slowly using simple, clear concepts; repeat the information if necessary; provide simple drawings or diagrams if they will aid the communication process.

If it is necessary to obtain a signed consent-to-treatment form, make sure the patient is capable of making an informed decision about the proposed treatment or action. If the individual is not able to provide his or her informed consent, consent must be obtained from a parent or guardian.

Q. Must health care facilities install visual fire and other emergency alarms?

A. Where audible alarms are provided, visual alarms must be added if readily achievable. The ADAAG specifies the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to fire or other emergencies. It is suggested that signs be placed next to alarms indicating their purpose. Directories should also point out the location of visual alarms.

Q. Must health care facilities have accessible drinking fountains?

A. Facilities with drinking fountains must make them accessible if it is readily achievable to do so. To make fountains accessible, mount them low enough to be easily reached from a sitting position or install a paper cup dispenser within easy reach.

Q. Are health care facilities that provide public telephones required to provide accessible public telephones?

A. If a facility provides public telephones, at least one telephone must be accessible to people who use wheelchairs or other mobility devices if readily achievable.

If providing an accessible telephone is not readily achievable, then readily achievable alternative methods of providing access to a telephone are required. For example, facilities can offer patients or clients who cannot use the public telephone the use of a private telephone. A sign should be posted near the public telephone(s) specifying the location of an accessible telephone and/or whom the person should contact to arrange for its use.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

Q. Are recreation facilities and fitness centers considered to be places of public accommodation?

A. Yes. Privately operated recreation and fitness facilities are covered by Title III. Examples include video arcades, gyms, health spas, bowling alleys, golf courses, billiard halls, and facilities where boating and swimming programs are offered.

Q. Are recreation facilities and fitness centers required to have TTYs (TeleTYpewriters)?

A. No. For making calls to or receiving calls from customers with hearing or speech impairments who use TTYs, such facilities will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Recreation and fitness facilities can ensure effective communication by training staff who answer the telephone to handle incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller using a TTY and will also be using the relay system equipment to type communications from the facility’s staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

For your information, however, a TTY is relatively inexpensive, usually costing about $275 and would be a welcome service for customers with hearing or speech impairments. If you have a TTY, remember to list your telephone number followed by “Voice/TTY” in any publications or advertisements to signify that customers can communicate with them by voice or TTY.

Q. Are recreation and fitness facilities that offer parking required to provide accessible parking spaces for people with “handicap” tags or placards? If such parking is required how many spaces must be provided?

A. Yes. If a recreation facility owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If a recreation or fitness facility is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, a recreation or fitness facility must provide as many spaces as readily achievable and of readily achievable dimensions.

If it is not readily achievable to provide any accessible spaces, a recreation facility could consider valet parking as an alternative method of providing access.

Q. Are recreation and fitness facilities required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs, walkers or other mobility devices to have ready access to recreational facilities. If the only parking is on a city street and the business does not have ownership or control of the sidewalk, the municipality, not the recreation or fitness facility, is responsible for providing curb ramps. If the facility owns or controls the sidewalk, it must provide curb ramps if readily achievable. If a recreation or fitness facility is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant.

These responsibilities for compliance may be allocated between the landlord and the tenant in the lease or other contract.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

Q. Must all entrances to recreation and fitness facilities be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.”

Recreation facilities that use security devices such as turnstiles can provide access for patrons with mobility impairments by installing gates or providing an alternate means of entry.

If there are steps up to the entrance, ramping one step or even several steps will be readily achievable for most recreation and fitness facilities. Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If the public accommodation cannot meet the ADAAG’s technical requirement for ramps because of space or other limitations, it can deviate slightly as long as it is still safe.

If a permanent ramp cannot be installed, a portable must be used if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct.

A recreation or fitness facility using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable.

If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

Q. How do recreation and fitness facilities know if the doorway for the accessible entrance is wide enough for clients who use wheelchairs or other mobility devices?

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for clients who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual facility.

Another measure that makes doors easier to use, not only for customers who use wheelchairs or other mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most facilities.

Q. Must recreation and fitness facilities allow service animals, including guide dogs, to accompany customers with disabilities into facilities?

A. Yes.

Q. Can a recreation and fitness facility exclude a person with a disability because his or her disability or behavior resulting from the disability may be disturbing to other customers or clients?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

Q. Can recreation or fitness facilities exclude people with disabilities from their facilities because of increased insurance costs or the fear of increased insurance costs?

A. No. Recreation and fitness facilities cannot discriminate against or otherwise exclude people with disabilities from joining or from using a facility based on fear of, or an actual increase in, liability insurance premiums. Recreation and fitness centers also cannot refuse to admit or accept for membership an individual with a disability because of concern that the person would inadvertently injure himself or herself.

Q. If an individual with a disability is injured while using equipment at a recreational or fitness facility, is the facility liable for the injury?

A. The ADA does not create standards governing liability in case of injury. If an injury occurs, state negligence laws will govern liability. The ADA prohibits businesses from refusing service to a person with a disability because of fear of injury to the person.

Q. Can a recreation or fitness facility require that people with disabilities use separate facilities or attend separate programs?

A. No, provided the individual meets the eligibility requirement for participation in the program available to the general public. Relegating people with disabilities to separate facilities or programs is prohibited by the ADA unless necessary to provide an equally effective opportunity to participate. The ADA requires that people with disabilities be provided an equal opportunity to participate in programs in integrated settings.

Q. Does the ADA preclude recreation or fitness facilities from establishing safety requirements for the use of their equipment? How can a recreation or fitness facility determine if a person with a disability is capable of operating the exercise equipment?

A. Recreation facilities and fitness centers may impose neutral, legitimate safety requirements that are necessary for the safe operation of its equipment. However, the facility must ensure that its safety requirements are based on real risks, not on speculation, stereotypes, or generalizations about people with disabilities. For example, a wilderness tour company may require participants to meet a certain level of swimming proficiency to participate in a rafting expedition.

Also, a recreation or fitness facility is not required to guarantee that an individual with a disability will achieve an identical result or level of achievement as people who do not have disabilities. For example, an individual who uses a wheelchair may not be excluded from an exercise class at a health club because he or she cannot do all the exercises and derive the same results from the class as people who do not have disabilities.

The best way for recreation facilities or fitness center to assess the abilities of a person with a disability is to ask whether he or she is able to operate the equipment in question, has some previous experience with the equipment, meets any safety requirements, or requires some modification or adaptation of equipment, policies, or procedures in order to participate.

Recreation facilities and fitness centers should act in the spirit of collaboration with the individual to make an appropriate case-by-case determination about an individual’s capability to operate equipment or meet safety requirements.

Q. How can a recreation or fitness facility determine whether its premises are accessible to people who use wheelchairs or other mobility devices? What steps must be taken to provide access?

A. Although there are significant differences between various types of facilities, a few general, common sense rules apply to a basic evaluation of accessibility for most recreation and fitness centers.

For indoor facilities, determine whether pathways and doorways between activity areas, such as video machines, lounges, bowling lanes, bars, classrooms, pools, saunas, hot tubs, and other facilities are wide enough for a person using a wheelchair or other mobility devices. Are there vending machines or supplies stored in hallways or other areas that might block passage?

Rearranging exercise equipment, furniture, and storage items and widening doors and stalls are examples of methods to improve access that will be readily achievable for most facilities.

Are there level changes between locker rooms and the exercise equipment, saunas, lounges, bowling lanes, or other activity areas? Installing a permanent ramp for one or even several steps is a method of improving access that will be readily achievable for most businesses. If installation of a permanent ramp is not readily achievable, safe, portable ramps are required if readily achievable.

If portable ramps are used, a sign should indicate how the ramps can be obtained.

For outdoor facilities, determine whether there are steps or other obstacles along paths or walkways that would prevent someone who uses a wheelchair or other mobility device from traveling on them or from reaching an activity area such as a swimming pool or picnic ground. As with indoor facilities, ramps are required to provide access if readily achievable.

For picnic, boating, or other outdoor recreation or fitness facilities, evaluate whether people with disabilities can reach and use the facilities. Can people with disabilities reach the picnic tables? Does spectator seating provide wheelchair access? Is there an adequate sight line from the wheelchair accessible seating area to the events? Removal of such barriers is required to provide access when it is readily achievable.

When it is not readily achievable for a recreation or fitness facility to remove some or all barriers to access, the facility must devise other readily achievable alternatives to barrier removal.

Q. If an individual with a mobility impairment wants to use equipment or facilities on another level of a facility that is not serviced by an elevator, does the facility have to provide a means of access to the upper level?

A. Perhaps. Although installing an elevator will not be readily achievable for most facilities, some access to other levels may be required. If there are only several steps to reach other levels, which might be the situation in a bowling alley, a ramp is required if readily achievable to install one. If there are many steps, providing access to other levels might require installation of a wheelchair lift, which is much less expensive than an elevator. Other alternatives include using accessible routes such as a service entrance.

Facilities that have limited space and resources and no alternative routes available must take other creative, readily achievable steps to make the facilities and services on other levels available. Courtesy and common sense should dictate what methods are most suitable. Alternative methods could include moving a small selection of video games, exercise or other equipment, or some classes to the accessible level.

Q. Are recreation and fitness facilities required to provide any assistance to individuals with disabilities so they can participate in the facilities programs and activities?

A. In some situations reasonable modifications of policies, practices, or procedures to include minimal staff assistance may be required if the modification does not result in a fundamental alteration of the program. For example, staff members in some weight rooms stabilize weight lifters’ wheelchairs even if they do not routinely provide similar assistance to other clients or members. Some facilities also provide additional instruction about the use of particular exercise machines to individuals who have intellectual or cognitive disabilities. Likewise, some health clubs assist individuals with disabilities into and out of pools and hot tubs, and some of them have installed floor-mounted pool lifts. If staff is limited, a customer or member could be allowed to provide his or her own attendant at a waived membership rate.

Q. How can recreation and fitness facilities communicate effectively with members, clients, and customers who are blind or have limited vision?

A. Any printed information about the facilities, including program descriptions, price lists, and class schedules, must be available in formats that are accessible to people with vision impairments if providing them does not result in an undue burden. Large print formats are useful to people with limited vision, including older people. Providing taped information and a cassette player is a good alternative for many people with vision impairments. Recreation and fitness facility staff can also read materials to patrons where it is appropriate to do so.

The floor designations on elevators control panels and signs indicating rest room facilities must be made accessible by providing raising letters, Braille, and large, high-contrast letters if readily achievable. Instructions posted or mounted to explain how to use exercise equipment must be made accessible by providing the information verbally, in large print, by audio cassette, or in Braille, as appropriate, if this can be done without undue burden.

Q. How can a recreation or fitness facility communicate effectively with a member, client, or customer who is deaf or hard of hearing or who has a speech impairment?

A. Most members, clients or customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When a staff person has determined that an individual is deaf or hard of hearing, he or she can communicate by writing notes or taking turns with the customer at a computer terminal. Maintaining face-to-face contact is important for communications with a customer who reads lips.

If a recreation or fitness facility offers an activity such as martial arts training where complex concepts must be communicated clearly, the facility must provide a qualified sign language interpreter for deaf patrons if doing so does not cause an undue burden. If it offers an exercise class or other activity where communications are not complex, the instructor could meet with deaf patrons beforehand and inform them about the program or activity using a pen and note pad or computer terminal to communicate or could provide printed information for them.

Instructors or group leaders can communicate effectively with individuals who are hard of hearing by allowing the individual(s) to sit or stand near the instructor or group leader.

It is also important for recreation and fitness facilities to communicate effectively with customers who have speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself to spell out a message on his or her word board are examples of methods to achievable effective communication.

Q. Must fitness centers provide accessible rest rooms and showers? How can these facilities be made accessible?

A. Shower and rest room facilities are central components in many fitness centers’ programs. Therefore, when readily achievable, at least one accessible rest room and shower must be available.

Certain relatively simple steps can increase access and usability of rest rooms. Widening entry and stall doors; moving obstacles such as vending machines; rearranging toilet partitions to increase maneuverability for people using wheelchairs; installing a raised toilet seat; installing grab bars near the toilet; repositioning paper towel dispensers; installing lever handles on at least one sink; and installing insulation around exposed lavatory pipes to prevent individuals who use wheelchairs from burning their legs while sitting at the sink are examples of changes that will be readily achievable for most businesses.

Where showers are available, an accessible shower stall must also be available if readily achievable.

If a fitness center provides more than one rest room and shower and not all are accessible, a sign should indicate where the accessible facilities are located.

Simple symbols indicating which facilities are for men or women are easier for some people with cognitive disabilities to understand than words or other images. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind and large, high-contrast signs help people with limited vision. Fitness centers should take all of these measures to make shower and rest room signs accessible if readily achievable.

Q. Must recreational and fitness facilities have accessible drinking fountains?

A. Facilities with drinking fountains must make them accessible if it is readily achievable to do so. To make fountains accessible, mount them low enough to be easily reached from a sitting position or install a paper cup dispenser within easy reach.

Q. Are health and fitness centers that provide public telephones required to provide accessible public telephones?

A. If a facility provides public telephones, at least one telephone must be accessible to people who use wheelchairs or other mobility devices if readily achievable.

If providing an accessible telephone is not readily achievable, then readily achievable alternative methods of providing access to a telephone are required. For example, facilities can offer customers, clients, or members who cannot use the public telephone the use of a private telephone. A sign should be posted near the public telephone(s) specifying the location of an accessible telephone and/or whom the person should contact to arrange for its use if readily achievable.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.

Q. Are automobile dealers, rental establishments and service stations required to have TTYs (TeleTYpewriters)?

A. No. For making calls to or receiving calls from customers with hearing or speech impairments who use TTYs, automotive establishments will be able to rely on the relay systems that telephone companies must establish by July 26, 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow their customers or clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Automotive establishments can ensure effective communication by training staff who answer the telephone to anticipate incoming calls through the relay services. Handling these calls may take longer because an operator at the relay system will be receiving typed communications from the caller and will also be using the relay system equipment to type communications from the staff person to the caller. Training should be undertaken as soon as possible because at least 40 states already offer some type of relay service.

For your information, however, a TTY is relatively inexpensive, usually costing about $275 and would be welcome service for customers with hearing or speech impairments. If you have a TTY, be sure to list your telephone number followed by “Voice/TTY” in any publications or advertisements to signify that customers can communicate with them by voice or TTY.

Q. Are automotive establishments that offer parking required to provide accessible parking spaces for people with mobility impairments? If such parking is required how many spaces must be provided?

A. Yes. If an automotive establishment owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If an automotive establishment is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease of other contract. The spaces must comply with the dimensions specified in the ADAAG if it is readily achievable to meet those standards. The ADAAG also specifies a formula for determining the appropriate number of accessible spaces which must be followed if it is readily achievable to do so. If it is not readily achievable to comply with the ADAAG standards for the number and dimensions of accessible spaces, an automotive establishment must provide as many spaces as readily achievable and of readily achievable dimensions.

If it is not readily achievable to provide any accessible spaces, an automotive establishment could consider providing valet parking as an alternative method of providing access.

Q. Are automotive establishments required to remove barriers posed by sidewalk curbs?

A. Curb cuts (also known as curb ramps) enable people who use wheelchairs or other mobility devices to have ready access to businesses. If the only parking available is on a city street and the automotive establishment does not own or control the sidewalk, the municipality, not the business, is responsible for providing curb ramps. If the automotive establishment owns or controls the sidewalk, it must provide curb ramps if readily achievable. If an automotive establishment is a tenant, responsibility for providing curb ramps rests with both the landlord and the tenant. These responsibilities may be allocated between the landlord and tenant in the lease or other contract.

The ADAAG establishes standards for construction of curb ramps that must be followed if readily achievable.

Q. Must all entrances to automotive dealers, rental, and service establishments be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.”

For most businesses, ramping one step or even several steps will be readily achievable.

Installation of a permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If a public accommodation cannot meet the ADAAG’s technical requirements for ramps because of space or other limitations, it can deviate slightly from these specifications as long as the ramp is still safe.

If a permanent ramp cannot be installed, a portable ramp must be used if readily achievable. Portable, i.e., moveable, ramps also must be safe. Most portable ramps are relatively inexpensive to purchase or construct.

It would be helpful for an automotive establishment using a portable ramp to install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door if readily achievable.

If the accessible entrance is one other than the main entrance, a sign at the main entrance should indicate where the accessible entrance is located.

If none of these barrier removal options is readily achievable, alternative methods to provide service must be considered, such as meeting a customer in an accessible location or providing curb service at no additional charge.

Q. How does an automotive establishment know if the doorway for the accessible entrance is wide enough for customers who use wheelchairs or other mobility devices?

A. The ADAAG standard states that a minimum of 32 inches of clear opening measured between the face of the door and the opposite stop when the door is opened 90 degrees is required to provide access for customers who use wheelchairs or other mobility devices. Offset hinges can increase the amount of clear space by several inches.

Automatic or push button doors are the best for providing access. Whether installing them is readily achievable or not depends on the circumstances of the individual automotive establishment.

Another measure that makes doors easier to use, not only for customers who use mobility devices but also for those who have conditions that limit their manual dexterity, is to install lever or U-shaped handles. Some retrofit levers cost less than $10 and can improve access significantly.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. Widening doors, installing accessible door handles, and making door adjustments are examples of modifications that will be readily achievable for most businesses.

Q. Must automotive establishments allow service animals, including guide dogs, to accompany customers with disabilities into their places of business?

A. Yes.

Q. Can an automotive establishment deny service to a person with a disability because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities.

Q. Do all parts of automotive establishments, including service facilities, need to be accessible?

A. No. Automotive establishments must take all readily achievable measures to remove barriers in all areas that customers normally use, including customer waiting areas, cash register areas, public telephones, and any vending or food service areas that are provided for customers’ use and comfort. For most businesses, clearing the path of travel, rearranging the furniture and display shelves, and relocating stock that blocks aisles are readily achievable methods to provide access.

Q. Must automotive establishments provide accessible rest rooms? How can rest rooms be made accessible?

A. When rest rooms are open to the public, at least one accessible rest room must be available when readily achievable. Certain relatively simple steps can increase access and usability. Widening entry and stall doors; moving obstacles such as vending machines; rearranging toilet partitions to increase maneuverability for customers using wheelchairs; installing a raised toilet seat; installing grab bars near the toilet; repositioning paper towel dispensers; installing lever handles on at least one sink; and installing insulation material around exposed lavatory pipes to prevent wheelchair users from burning their legs while sitting at the sink are examples of readily achievable measures for most businesses.

If an automotive establishment provides more than one rest room and not all are accessible, a sign should indicate where the accessible rest room(s) is (are) located.

Simple symbols indicating which facilities are for men or women are easier for some people with cognitive impairments (such as mental retardation) to understand than words or other images. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind, and large, high-contrast signs help people with limited vision. Automotive establishments must take all of these measures if readily achievable.

Q. Must automotive establishments have accessible drinking fountains?

A. If businesses have drinking fountains, they must make them accessible if it is readily achievable to do so. To make fountains accessible, mount them low enough to be easily reached from a sitting position or install a paper cup dispenser within easy reach.

Q. Are automotive sales establishments required to provide vehicle hand controls so a customer can test drive a car?

A. For many dealers, installation of hand controls will be readily achievable. Dealers may request reasonable advance notice from customers who need hand controls to ensure that a properly equipped vehicle will be available.

Q. What other alternative methods can automotive sales establishments use to deliver services if it is not readily achievable to remove barriers to “getting through the door”?

A. Automotive sales personnel must provide brochures and other information about available vehicles to customers at curbside, at other convenient locations, or by mail. Alternative accessible locations must be selected to conduct and finalize sales negotiations, or they can be conducted by telephone or at the customer’s home.

Q. How does an automotive sales establishment ensure effective communication with customers who are deaf or hard of hearing or who have speech impairments?

A. According to DOJ, if a deaf individual becomes serious about making a purchase, the services of a qualified interpreter may be necessary because of the complicated nature of the communications involved in buying a car, unless providing one would pose an undue burden.

To locate a qualified sign language interpreter, contact local organizations operated by or for people with disabilities for a referral.

Interpreters are not required if a deaf customer has come into a sales showroom merely to look at the latest models. In this situation, the dealer would be able to communicate general information about models available by providing brochures, exchanging notes by pen and note pad, or taking turns at a computer keyboard. Maintaining face-to-face contact is important for communications with customers who read lips.

It is also important for automotive sales establishments to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or to read a message spelled out on a word board are examples of methods to achieve effective communication.

Q. What other alternative methods can automotive sales establishments use to deliver services if it is not readily achievable to remove barriers to “getting through the door”?

A. Automotive service establishments can meet customers at curbside to make arrangements for repairs or service, or they could provide home pick-up and delivery at no extra charge if readily achievable.

Q. How can an automotive service establishment communicate with a customer who is deaf or hard of hearing or who has a speech impairment?

A. Most customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When an auto service person has determined that customer is deaf or hard of hearing, he or she can communicate by writing notes. Maintaining face-to-face contact is important for communications with a customer who reads lips.

The services of a sign language interpreter are not necessary to accomplish transactions that are short and straightforward.

It is also important for auto service establishments to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or read a message spelled out a word board are examples of methods to achieve effective communication.

Q. Is an auto rental establishment required to accept the credit card of a person with a disability who is not the driver and who has arranged for someone else to operate the rental vehicle?

A. Yes. This would be a reasonable modification of normal business practice necessary to avoid discrimination against a person with a disability who wants to rent a car. The driver, however, must meet the other eligibility requirements to rent the vehicle, such as having a current driver’s license.

Q. If the rented vehicle is located in a lot apart from the location where the vehicle is rented, does the rental establishment have to provide wheelchair accessible transportation to the lot for customers with mobility impairments, including individuals who use wheelchairs?

A. If the rental establishment provides shuttle transportation to the lot for its customers, the ADA requires that comparable services be provided to customers with disabilities. This can be achieved by using portable ramps to enable a customer with a mobility impairment to board the shuttle, or the agency can deliver the rental vehicle to the customer at curbside.

Q. Are automotive rental establishments required to provide vehicle hand controls so a customer can rent a car?

A. For many rental establishments, installation of hand controls will be readily achievable. Reasonable advance notice may also be required from customers who need hand controls to ensure that a properly equipped vehicle will be available.

Q. Is an auto rental establishment required to provide a special operator’s dashboard identification card so customers with disabilities may use parking spaces reserved for them?

A. As a courtesy to customers, it is suggested that auto rental establishments provide dashboard identification cards so customers can park in spaces reserved for people with disabilities. Rental establishments should accept parking permits or personal dashboard cards from customers as proof of eligibility for their card. It should be noted that some local authorities do not recognize or honor the rental establishment’s dashboard card.

Q. How can an automotive rental establishment communicate with a customer who is deaf or hard of hearing or who has a speech impairment?

A. Most customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When a rental clerk has determined that customer is deaf or hard of hearing, he or she can communicate by writing notes. Maintaining face-to-face contact is important for communications with a customer who reads lips.

The services of a sign language interpreter are not necessary to accomplish rental transactions that are short and straightforward with a deaf individual.

It is also important for auto rental establishments to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or read a message spelled out a word board are examples of methods to achieve effective communication.

Q. Are service station attendants on duty at self-service only stations required to pump gas for customers with mobility or manual impairments who are unable to pump gas themselves?

A. Yes. This simple service will almost always be readily achievable unless there is only one attendant on duty and that attendant is required to stay in a security booth to prevent public access to the cash register.

Q. Are attendants at service stations that offer both full service and self-service pumps required to pump gas at self-service pumps for customers with mobility or manual impairments who are unable to pump gas themselves?

A. Yes. This is the only practical alternative to barrier removal at a gas station. Attendants are not required to provide the full array of services available at full service pumps, such as cleaning windows and checking oil. However, attendants must pump gas for people who cannot do so themselves, and they must charge the self-service prices because businesses may not assess surcharges on individuals with disabilities for alternative services under the ADA.

Q. How can a service station communicate with a customer who is deaf or hard of hearing or who has a speech impairment?

A. Most customers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures. When a service station attendant has determined that customer is deaf or hard of hearing, he or she can communicate by writing notes. Maintaining face-to-face contact is important for communications with a customer who reads lips.

The services of a sign language interpreter are not necessary to accomplish transactions that are short and straightforward with a deaf person.

It is also important for service stations to communicate effectively with customers with speech impairments. Allowing sufficient time for a person with such a disability to express himself or herself or read a message spelled out a word board are examples of methods to achieve effective communication.

Q. Are travel and tour agencies considered to be places of public accommodation?

A. Yes, private offices for travel agents, tour booking agents and cruise ship lines are examples covered by Title III.

Q. Are travel agencies required to have TTYs (text telephones for people with speech impairments or who are deaf or hard of hearing)?

A. Yes. If the primary means of offering goods and services to the public is by telephone, TTYs are required.

No. For making calls to or receiving calls from customers or clients with hearing or speech impairments who use TTYs, offices will be able to rely on the relay systems that telephone companies must established in 1993. Operators employed by relay systems will relay communications between TTY-users and people using conventional telephones. Only those businesses that allow clients to make outgoing calls on more than an incidental convenience basis must provide TTYs.

Agencies should ensure effective communication by training staff who answer the telephone to handle incoming calls through the relay services. Relay calls may take longer because an operator at the relay system will be receiving typed communications from the caller using a TTY and will also be using the relay system equipment to type spoken communications from the office person to the caller.

For businesses who want or need one, a TTY is relatively inexpensive, usually costing about $250 and is a welcome service. If you have a TTY, remember to list your telephone number followed by “Voice/TTY” in any publications or advertisements to signify that clients can communicate with them by voice or TTY.

Q. Are facilities that offer parking required to provide accessible parking spaces for people with “handicap” tags or placards? If such parking is required how many spaces must be provided?

A. Yes. If a facility owns and operates the parking lot, it must provide accessible parking if it is readily achievable to do so. If an office is a tenant, responsibility for providing accessible parking rests with both the landlord and the tenant and may be allocated between the landlord and tenant in the lease or other contract.

The spaces must comply with the dimensions specified in the Standards for Accessible Design, if it is readily achievable to meet those standards. The standards provide a formula for determining the appropriate number of accessible spaces necessary, and set out the requirements for their dimensions and locations. If it is not readily achievable to comply with the Standards, an office must provide as many accessible spaces as possible.

If it is not readily achievable to provide any accessible spaces, an agency or business must provide other options. For example, valet parking as another way to provide access.

Q. Are facilities required to put curbs cuts in sidewalks?

A. Curb cuts (or curb ramps) provide access to facilities for people using wheelchairs, walkers or other mobility equipment. If the only parking is on a city street and the business does not own or control the sidewalk, the municipality, not the office, is responsible for providing curb cuts. If an office owns or controls the sidewalk, it must provide curb cuts if readily achievable. If an office is a tenant, responsibility rests with both the landlord and the tenant, and may be allocated in the lease or other contract.

As with parking spaces, the Standards establish requirements for construction of curb cuts.

Q. Must all entrances to facilities be accessible?

A. No, but one entrance, preferably the main entrance, must be accessible, making it possible for people with disabilities to “get through the door.” If the main entrance is not accessible, a sign there should indicate where the accessible entrance is located.

Ramping one step or several steps usually will be fairly easy and inexpensive. A permanent ramp, rather than a portable one, is required unless such installation is not readily achievable. If the Standard’s technical requirements for ramps cannot be met because of space or other limitations, the ramp dimensions can deviate slightly as long as it is still safe.

If a permanent ramp cannot be installed, a safe portable or movable ramp may be used. Most portable ramps are relatively inexpensive to purchase or construct. An agency using a portable ramp should install a doorbell or intercom (with an appropriate sign) to summon an employee to bring the ramp to the door.

If none of these options is readily achievable, alternative means to provide services must be considered, such as curb side service or home visits at no additional charge.

Q. How does an agency know if the doorway is wide enough for clients who use wheelchairs or other mobility equipment?

A. The Standards for Accessible Design state that a minimum of 32 inches of clear opening is required to provide access for customers who use wheelchairs or other mobility devices. A clear opening is measured between the face of the door and the opposite stop when the door is opened 90 degrees. Offset hinges can increase the clear space by one or two inches.

Although not required, automatic or push button doors are best for access, if maintained properly. An office can determine whether or not installation would be readily achievable.

Lever or U-shaped handles make doors easier for customers with limited dexterity. Retrofit levers can cost less than $10 and make opening doors significantly easier.

Adjusting door closers or springs and oiling hinges are also inexpensive steps that make it easier to open doors and prevent them from closing too quickly. These examples of modifications should be readily achievable for most businesses.

Q. Must agencies and other offices allow service animals, including guide dogs, to accompany clients into facilities?

A. Yes. However, service animals tend to spook wild animals in parks and zoos. Therefore, some zoos like those in San Diego provide a place for service animals to stay while their owners are accompanied during their visit by trained zoo staff.

Q. If a travel agency is in an historic building, is it exempt from the requirements of the ADA?

A. No. Barrier removal is required in all buildings, including historic buildings, if it is readily achievable. However, barrier removal is not considered readily achievable if it would threaten or destroy the historic significance of a building or facility that is eligible for listing in the National Register of Historic Places under the National Historic Preservation Act, or is designated as historic under State or local law.

Q. Can a person with a disability be denied service because his or her disability or behavior resulting from the disability may be disturbing to other customers?

A. No. The ADA specifically prohibits this type of discrimination against people with disabilities. For example, people with Tourette Syndrome make sounds, words or facial movements that they cannot control.

Violent or disruptive behavior, however, is prohibited.

Q. What is required to make elevators accessible?

A. Facilities must install raised letters and Braille on the elevator control panels and provide floor number signs with raised and Braille characters on elevator door jambs.

A large, high-contrast sign indicating the floor number outside the elevator and opposite the elevator door helps orient people with limited vision.

If elevator controls are mounted out of reach of wheelchair users and it is not readily achievable to lower them, installing a stick or pointer near the control panel will help some customers operate the elevator independently. Door timers must also be adjusted so the doors do not close too quickly.

Q. Are agencies with more than one floor required to install an elevator, if they do not have one?

A. In most cases, installing an elevator will not be readily achievable. However, some access to floors above or below the ground level may be required.

If only a few steps separate levels, a ramp is required if readily achievable. If there are many steps, installation of a wheelchair lift, which is much less expensive than an elevator, is required if readily achievable. Other alternatives include using accessible routes such as a freight elevator or rear entrance. Offices with limited space and resources and without accessible alternative routes must take other creative steps to make services available.

Courtesy and common sense should dictate what methods are most suitable. Alternative methods include setting up meetings in accessible locations; visiting the client’s home; or performing the service on other, accessible levels.

Q. What are the best ways to make signs and other written information accessible to people with vision impairments?

A. All important signs should be in accessible formats. Options include Braille, large print and audio tape. Many people who are blind or have limited vision do not read Braille so audio cassettes and large print signs and documents are the most helpful. Older travelers and those reading from a distance will also benefit from these modifications.

Q. How can travel agents and tour guides communicate with travelers who are deaf or hard of hearing or who have speech impairments?

A. Travelers who are deaf or hard of hearing will identify themselves by writing a note or using hand gestures and will alert the professional to the best method of communication. Maintaining face-to-face contact is important to communicate with a client who reads lips. A sign language interpreter should not be necessary unless the travel agent is engaged in an unusually complex transaction. Alternatively, an agent should write schedules and options by hand or on a computer so that the traveler can make choices.

Preparing for the interaction with printed materials and brochures is always a good idea.

To communicate effectively with travelers with speech impairments, agents and guides must be patient and take the time for people with such a disability to express themselves or to communicate using a word board.

Q. How can a professional perform a service that requires confidential communication or written materials with a client who is deaf or hard of hearing?

A. For a client who is deaf or hard of hearing, effective communication may require a qualified sign language interpreter. Sign language interpreters are required to maintain the confidentiality of any conversations they interpret.

Q. What measures are required for people with cognitive impairments such a mental retardation?

A. Accommodating people with cognitive impairment can include reading the travel arrangements or other written information to them; providing an audio tape copy of the material; using color-coded maps and pictures to describe places to visit; and simple, common sense. Asking the traveler to repeat back the core of the discussion should help finalize trip arrangements.

Tour guides and agents should use simple, direct sentences and clear language.

Q. Must agencies install visual alarms?

A. Where audible fire alarms are provided, visual alarms must be added if readily achievable. The Standards specify the types of alarms that meet this requirement.

People who are deaf or hard of hearing depend on visual alarms to alert them to emergencies. Signs can be placed next to alarms indicating their purpose and maps or directories should point out the locations of visual alarms.

Q. Must agencies provide accessible rest rooms?

A. Most facilities don’t have bathrooms open to the public. If bathrooms are provided for use by customers, those rest rooms must be made accessible where readily achievable. Simple steps can increase access and usability. If an agency provides more than one rest room and it is not achievable to make all of them accessible, a sign should indicated where the accessible rest room(s) is (are) located.

Label the bathrooms clearly: “men” and “women”. For people with cognitive impairments such as mental retardation straight forward language is clearer. Raised letters and Braille differentiating men’s and women’s rest rooms are important for people who are blind. Large, high-contrast signs help people with limited vision.

Q. Must a travel or tour agency that is located with in a private residence be accessible?

A. Yes. When a public accommodation is located in a private residence, the portions of the home used as a place of public accommodation are covered by the ADA. This is also true if those parts of the home that are used as public accommodation are also used for residential purposes.

The readily achievable standard continues to apply. Barrier removal will be required when considered in light of the financial and other resources of the agency.

Q. Can a cruise ship or tour company insist that a person with a disability travel with a companion?

A. No. Requiring that a person with a disability have a traveling companion, if that is not a requirement for people who do not have disabilities, violates the ADA. The cruise line or tour company, however, does not have to provide services of a personal nature.

Q. How does the ADA address the physical accessibility and construction of cruise ships?

A. Places of public accommodation aboard ships must comply with all of the Title III requirements, including removal of barriers to access when readily achievable. Currently, however, a ship is not required to comply with specific accessibility standards for new construction or alternations, because specific accessibility standards for new construction or alteration of cruise ships have not yet been developed.

It should be noted, however, that cruise ships are still subject to the requirements of Title III. Physical barriers must be removed it if is readily achievable to do so, programmatic barriers must be eliminated, and travelers with disabilities cannot be treated differently from passengers who do not have disabilities.

Q. May an amusement park, or other public accommodation, refuse to serve an individual with a disability because of limitations on coverage or rates in its insurance policies?

A. No. Public accommodation may not rely on such limitations to justify exclusion of individuals with disabilities. Any exclusion must be based on legitimate concerns about the safety of others.

For example, an amusement park cannot require that individuals meet a minimum height requirement that excludes some individuals with disabilities from certain rides because of a limitation in its liability insurance coverage. The limitation in insurance coverage is not a permissible basis for the exclusion.

However, the minimum height requirement would be a permissible safety criterion, if it is necessary for the safe operation of the ride.

This Guide provides general information to promote voluntary compliance with the Americans with Disabilities Act of 1990 (ADA). It was prepared under a grant from the U.S. Department of Justice. While the Office on the Americans with Disabilities Act has reviewed its contents, any opinions or interpretations in this document are those of The Council of Better Business Bureaus’ Foundation and the Disability Rights Education and Defense Fund and do not necessarily reflect the views of the Department of Justice. The ADA itself and the Department’s ADA regulations should be consulted for further, more specific guidance.