# 71 III-4.4200 III-4.5000 III-5.


May 20, 1993


Mark Berg, M.D. Medical Director NorthWorks Program North Memorial Medical Center 3300 North Oakdale Robbinsdale, Minnesota 55422 Dear Dr. Berg: I am responding to your letter asking for clarification of the requirements of title III of the Americans with Disabilities Act (ADA), 42 U.S.C. 12101 et seq., and this Department's regulation implementing title III, 28 C.F.R. pt. 36. You have asked whether the ADA requires the North Memorial Medical Center to make its mobile health care screening vans accessible to people with disabilities, and, if it does not, what alternative arrangements to provide equivalent services for people with disabilities would be acceptable. The ADA authorizes the Department of Justice to provide technical assistance to individuals and entities that have rights or responsibilities under the Act. This letter provides informal guidance to assist you in understanding the ADA and the Department's regulation. However, this technical assistance does not constitute a determination by the Department of Justice of your rights or responsibilities under the ADA, and it is not binding on the Department. A medical center is a place of public accommodation subject to title III of the ADA. As such, it is required to make its services accessible to people with disabilities in accordance

with the full range of title III requirements, such as nondiscriminatory eligibility criteria; reasonable modifications in policies, practices, and procedures; provision of auxiliary aids; and removal of barriers in existing facilities. In addition, it is required to comply with the new construction and alteration requirements for buildings and facilities established by this Department's regulation implementing title III. Although mobile health care screening vans are "facilities" subject to title III, the Department's current regulation does not establish standards for the design and construction of such facilities. Therefore, the medical center is not currently required to purchase health care screening vans that meet specific design criteria. The medical center, however, is required to remove architectural, communication, and transportation barriers in its vans to the extent that it is readily achievable to do so. If it is not readily achievable to make the health screening vans accessible, then you must consider any alternative method of providing access to the health screening van's services that is readily achievable. Such services should be made available to individuals with disabilities at the same cost as the services provided at the van site. While we cannot tell you which alternative methods of providing access would be readily achievable for you, options that you may wish to consider include: providing comparable services at an accessible site at your medical facility, "bundled" in a way that would enable an individual with a disability to obtain the same range of services with a comparable degree of convenience as the services that are provided by the van; using the mobile health screening van to deliver the services to persons with disabilities in their own homes; or transporting people with disabilities from their homes or the van site to an accessible facility where they can receive the services that are being provided by the van. For your information, I am enclosing a copy of the

regulation implementing title III of the ADA and the Department's Title III Technical Assistance Manual, which was developed to assist individuals and entities subject to the ADA to understand the requirements of title III. I hope that this information is helpful to you. Sincerely,

John L. Wodatch Chief Public Access Section Enclosures