Small steps toward equity for those with physical disabilities
I am a family nurse practitioner, and a student in the Doctor of Nursing Practice program at the University of Massachusetts. I am writing to express my favorable opinion of HB6298 – An Act Concerning Accessibility of Medical Diagnostic Equipment – that was proposed last legislative session, and I hope is brought back to the table next session. The purpose of this bill is to require medical diagnostic equipment purchased by healthcare facilities to meet technical standards for accessibility by persons with disabilities.
The majority of my full-time work is spent in a specialty rehabilitation hospital with persons with disability, often wheelchair-bound, often paraplegic or quadriplegic. In many instances, just getting inside of a medical office building presents challenges for a person in a wheelchair. Ramps may be unavailable or in disrepair, doorways and hallways too narrow, and automatic door openers may not be installed. Medical equipment is often inaccessible – scales, exam tables, radiology equipment such as MRI, CT scan, and mammography, just to name a few.
These individuals are more likely to be examined in their wheelchairs versus receiving a thorough head-to-toe physical exam that can be provided on an exam table, less likely to be weighed, and receive basic preventive health screenings such as mammography and Pap tests at a lesser rate than people without physical disability. We hear repeatedly that early cancer detection is key for treatment and survival, and yet women with physical disabilities are screened for the most common female reproductive cancers less frequently due to barriers to access.
To the average healthcare consumer, it likely seems that strong policies exist to protect the rights of those with disabilities. The most well-known of these policies is the Americans with Disabilities Act of 1990, which was intended to prohibit discrimination on the basis of disability, and yet 30 years after its inception, those with physical disabilities continue to struggle to find available, accessible, quality healthcare across the entire healthcare continuum.
While it may be argued that the costs of renovation to healthcare facilities are prohibitive, in fairness we’ve had 30 years to figure it out. HB6298 refers to newly purchased diagnostic equipment, and it seems reasonable that new purchases by healthcare facilities should be more accessible than what is currently available to the disabled community. Complete building renovation may not be feasible, but the purchase of one wheelchair scale, one patient lift, one height-adjusted exam table would be a start. Maybe it wouldn’t break down all the barriers, but it would break down some.
People with physical disabilities too often end up in emergency departments because the basic care they required was not accessible or available to them. Is that not a strain on our healthcare system? The creation of a primary care specialty center for persons with disabilities could serve to drastically reduce the disparities in care experienced by these individuals. Partnerships between primary care providers and specialty settings can be one step in the right direction toward obtaining justice for this ever-growing population of patients who deserve access to the same high-quality care that others without a disability can access. To serve a population, we need to create a space for that population.
While I also recognize that the COVID-19 pandemic has placed unprecedented strains on our healthcare system, the message given to persons with disabilities by continuing to ignore their health disparities is that their lives don’t matter. If we don’t start with small steps now, then when? The harsh reality that every able-bodied individual must remember is that spinal cord injury and other disabling conditions do not discriminate; any one of us could find ourselves trying to navigate life by wheelchair tomorrow.
Although the word “inclusion” has become popular and prevalent in today’s culture, disability is often not considered to be a public health issue, and is therefore not included on the agenda when high level decisions regarding access to healthcare are being made. This needs to change, and the reintroduction of HB6298 in the next legislative session would be a start.
Dottie Leighton lives in Middletown.
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