NOV 4 1992 The Honorable Thomas J. Bliley, Jr. U. S. House of Representatives 2241 Rayburn House Office Building Washington, D.C.

20515 Dear Congressman Bliley: This letter responds to your inquiry on behalf of Dr. John R. Partridge, regarding the regulatory requirements of the Americans with Disabilities Act (ADA) for accessible rest rooms in professional offices open to the public. The ADA authorizes the Department of Justice to provide technical assistance to individuals and entities with rights or obligations under the Act. This letter provides informal guidance to assist your constituent in understanding the ADA accessibility standards. However, this technical assistance does not constitute a legal interpretation of the statute and it is not binding on the Department. The ADA Accessibility Guidelines (which apply to new construction such as the facility planned by Dr. Partridge) do not specify the number of rest rooms required in any type of building or facility. Any number of rest rooms beyond what may be required by local building codes or plumbing codes is determined entirely at the discretion of the owner. Section 4.1.3 (11) of the Guidelines (page 35614 of the enclosed regulation) stipulates accessibility requirements for new construction of toilet rooms as follows: If toilet rooms are provided, then each public and common use toilet room shall comply with 4.22. Other toilet rooms provided for the use of occupants of specific spaces (i.e., a private toilet room for the occupant of a private office) shall be adaptable. cc: Records; Chrono; Wodatch; Harland; McDowney; FOIA; MAF. :udd:mercado:congresional.letters:harland.bliley.partridge 01-01698​ -2Rest rooms associated with examination rooms, laboratory

facilities, and staff support areas would be considered common use toilet rooms. All such rest rooms must be fully accessible. A doctor's private rest room, on the other hand, need only be adaptable. In other words, it must be designed to satisfy all space requirements but need not initially have grab bars or knee space below the lavatory, as long as such features can be added or modified without much difficulty when the need arises. The technical provisions for accessibility of individual elements such as doors or turning spaces are referenced in S4.22. Accessibility requirements do require some increase in floor area within a single-user rest room but, through careful and knowledgeable planning of a new building, there is often no increase in the overall size, or cost, of the facility. Please feel free to encourage your constituents to contact the Public Access Section any time they have questions or need information. The Department maintains a telephone information line to provide technical assistance regarding the rights and obligations of individuals, businesses, agencies, and others covered or protected by the ADA. This technical assistance is available by calling 202-514-0301 (voice) or 202-514-0383 (TDD) between 1:00 p.m. and 5:00 p.m., Monday through Friday. I hope the information we have provided is helpful to you and your constituent. Sincerely, John R. Dunne Assistant Attorney General Civil Rights Division Enclosure 01-01699​ Congress of the United States House of Representatives Washington, DC 20515-4603 September 10, 1992 Mr. John Wodatch Director Office of Americans With Disabilities Act Department of Justice P.O. Box 66738 Washington, D.C. 20036-9998

Dear Mr. Wodatch: I am writing you on behalf of my constituent, Dr. John R. Partridge, in regards to the problems he has encountered in complying with the Americans With Disabilities Act (ADA). Dr. Partridge is in the midst of planning a new health care facility and has run into, what we both believe to be, overly extensive and very costly compliance requirements. The health facility planned will house seventeen specialists, dividing them into several groups, each of which will occupy suitelike areas boasting seventeen or eighteen rest rooms. Such a set up would bring the total number of rest rooms to approximately sixty. Yet, according to the ADA, each of these rest rooms, regardless of how close together they are located or how the facility is designed as to their accessibility to disabled people, is required to comply to ADA standards. As you know, these standards include a sixty inch wheelchair turning area or a tshaped space, and an eighteen inch distance from the door to the corner. The loss of rent as well as the construction costs of such requirements will result in at least $500,000 in aggregate additional expense in the first decade of occupancy alone. These costs will be passed along to the consumer, and tacked onto the already high costs of medical care. In my mind, there must be a more economical way in which to make sure that facilities are accessible to disabled individuals, while keeping in mind the resources of small businesses. Perhaps by concentrating on the location and the arrangement of the 01-01700​ Mr. John Wodatch September 10, 1992 Page 2 bathrooms, as opposed to merely mandating that all bathrooms comply, a compromise can be reached. Enclosed is a copy of Dr. Partridge's letter for your comments. As building will begin shortly, time is an important factor in this situation. I thank you in advance for your time, and look forward to the

benefit of your views. With kindest regards, I am Sincerely, Thomas J. Bliley, Jr. Member of Congress TJBj/elb 01-01701​ CHIPPENHAM OB-GYN ASSOCIATES, LTD. 7151 JAHNKE ROAD RICHMOND, VIRGINIA 23225 804-272-5808 1447 JOHNSTON WILLIS DRIVE RICHMOND, VIRGINIA 23235 804-323-3525 JOHN R. PARTRIDGE, M.D., F.A.C.O.G. L. DANIEL CROOKS, JR., M.D. (1942-1991) DAVID C. REUTINGER, M.D., F.A.C.O.G. WARREN A. BROOCKER, M.D., F.A.C.O.G. MARK S. KEGEL, M.D. J. HARRY ELLEN, JR., M.D., F.A.C.O.G. INGRID A. PROSSER, M.D. August 28, 1992 The Honorable Thomas J. Bliley, Jr. U.S. House of Representatives 2241 Rayburn House Office Building Washington, DC 20515 Re: Americans With Disability Act Dear Congressman Bliley: I am writing to you to seek urgent assistance from your staff in obtaining from the appropriate administrative agencies relief from certain provisions of the Americans With Disability Act, Title III from the Federal Register dated July 26, 1991, volume 56, number 144, section 4.22 regarding restrooms in facilities open to the public including professional offices. I am the senior partner of a six physician obstetrical practice that is seeking to build a new office at the new hospital facilities being constructed at Johnston-Willis Hospital

in Bon Air, VA. The physicians listed below are likewise heads of their respective practices and together we comprise a group of seventeen specialists in our field, all of whom are anticipating occupying new offices in the Atrium Building. Altogether, we render medical care for thousands of your constituents yearly; and the decisions we make affect numerous procedures, tests, and hospitalizations totalling many millions of dollars a year in medical care within your district. In designing our new offices, we have run up against what we feel to be totally unreasonable and unrealistic bureaucratic requirements for compliance under the above act. Specifically, in the design of restrooms for our office, we are being told that each restroom in the facility must have a five foot turning radius inside and the door must be eighteen inches from the corner of the room. In the case of each bathroom so affected, the requirement for additional square footage is considerable and, indeed, almost doubles the size of the restroom. This may be of relatively minor consequence in a fast food restaurant with one or two restrooms, but is of major consequence in a medical office in which there are 17 or 18 restrooms per group of 01-01702​ The Honorable Thomas J. Bliley, Jr. August 28, 1992 Page Two doctors. The total number of restrooms that will be constructed for the groups to whom I have referred will be in the range of 60. When one considers the additional construction costs of this extra square footage and the additional yearly rent that each of the groups will pay for extraneous bathroom space, the total tab faced at this one facility just for obstetrics becomes rather staggering. We will face at least $500,000 in aggregate additional expense that we would not have faced under former design requirements, just in the first decade of occupancy. It is illogical to suppose that we will not have to pass these costs on to our patients, who are your constituents. At a time when health costs are a concern to all Americans, including their congressmen, such a waste of expense seems unconscionable. What we would propose as a remedy under this act would be to give an exemption to bathrooms totally over a certain number per square foot of office space. For example, in a one practice office of 6,000 square feet, one might reasonably argue that one

bathroom equipped and suitably scaled for handicapped for each physician that would be actively seeing patients in the office at any one time would suffice. In our case for my practice, that would mean three or perhaps four such bathrooms for the total office. We would thus save on the expense of the other 14 bathrooms without impairing access of disabled individuals to medical care at all. The cost savings would obviously be passed on to the consumer. Time is of the essence if any relief is to be obtained for our facility since construction is under rapid progress and plans are being finalized. If we do not have relief within the next 60 days, we will be forced to go ahead with the more stringent provisions, but, again, this will significantly impact on health care costs in your district. Please take action to help us in our plight. Sincerely, John R. Partridge, M.D. JRP/sos cc: Erika M. Blanton, M.D. Adam J. Fiedler, M.D. Marijan Gospodnetic, M.D. 01-01703