ADA Website Accessibility Compliance: How to Protect Your Practice

By Officite

The focus of “ADA compliant” websites has become a hot topic of discussion lately. You’ve likely heard of the issue by now, but perhaps you’re not entirely sure what it means for your practice. Is it really true that a few simple mistakes can land you in legal hot water? In this short guide, we’ll explain the basics of how the ADA pertains to websites so that you can take the appropriate steps to provide the best care to your patients, and to protect your practice from unnecessary litigation.

This is by no means a comprehensive guide, nor is it meant to provide legal advice. If you find yourself facing an ADA-related claim, you should consult an attorney. Nevertheless, by the time you’ve finished reading this, we hope to reduce some of the fear and misinformation swirling around the issue. First, let’s cover the basics.

What is the ADA?

The Americans with Disabilities Act (ADA, sometimes AwDA) is a federal law passed in 1990 that aims to protect the rights of disabled people to ensure they are not discriminated against due to their disability. This is the same law that requires real-world public locations (referred to by the ADA as “places of public accommodation”) to be accessible to disabled patrons by offering accommodations such as wheelchair ramps and handicapped parking. The law is well-intentioned, and largely effective at improving the lives of disabled people. Unfortunately, however, the law did not account for the growing dependence of the internet, and did not provide specific language to cover any differences or similarities between physical locations and a website.

What do the Recent ADA Lawsuits Claim?

Until recently, many of these lawsuits had been in relation to actual physical locations. But over the past year or so, some dentists have received letters from lawyers claiming that their websites do not comply with The Americans with Disabilities Act, and thus have not provided the necessary accommodations for their clients. These letters often threaten legal action unless the practice agrees to pay an amount of money to settle the dispute outside of court. In order to prevent a potentially long and costly legal battle, many of these dentists have agreed to the settlement.

What Does It Mean to Be “ADA Compliant”?

If you take only one thing away from this guide, it should be this: as of today, there is no legal definition for an “ADA compliant” website. The current ADA regulations, which are enforced by the Department of Justice (DOJ), do not specifically mention websites and their accessibility requirements. The DOJ has stated that official regulations for website accessibility will not be released until at least Spring 2018. Until that point, all we have to work with are suggested guidelines, not hard-and-fast requirements.

Although there is no specific language (as of the date of this publication) within The Americans with Disabilities Act regarding website requirements, there are arguments that can be made that the language of the law insinuates websites as a place of public accommodation. Because of this lack of specificity, different state courts have different views, which can range from:

  • Websites are not required to be accessible to people with disabilities.
  • Only websites that have a connection to an actual brick and mortar location must be accessible to people with disabilities.
  • All websites must be accessible to people with disabilities.

Immediate Steps to Take

If you are a current client of Officite, then your website meets the current suggested ADA accessibility guidelines. In addition, Officite will keep all of its clients’ websites updated to meet these guidelines without any action required by its clients.

If your website is not hosted by Officite, you should take a moment to familiarize yourself with the basics of website accessibility. The DOJ has suggested the WCAG 2.0’s ‘Level AA Success Criteria’ as the best accessibility standards to follow. Again, these are suggested guidelines; they are not currently laws. Nevertheless, this checklist is a good place to start. If you can check every box of the Level AA Success Criteria, you are in the best position to defend your website from any “non-compliant” complaints you may receive.

Next, it’s a good idea to run your current website through an automatic evaluation tool that will help to reveal some of the most common potential accessibility problems.

Further Complications

Even if you have checked your website against the suggested ADA website accessibility guidelines and run the automatic evaluation tool, if you or your office staff add or modify content on your website, regardless of whether it is written or visual, it is difficult to guarantee that these changes fall within the suggested ADA website accessibility guidelines. If you do make changes to your website, it is best to use a website hosting company that meets the suggested ADA website accessibility guidelines and have their customer service team make the changes for you.

Additional Information

For health care practices that do not currently host their websites with Officite, Officite provides a complimentary ADA accessibility review to help gauge where your website stands in relation to the currently suggested ADA accessibility guidelines. To get this free evaluation, please call 888-700-3971 between the hours of 8 a.m.–5 p.m. Central Time, M-F or visit www.OfficiteFreeADAReview.com to schedule an appointment.

As the leader in website hosting and web presence solutions for healthcare practices, it is Officite’s goal to help all health care practices prosper and remain equipped for success in the future. Please feel free to share this FAQ document in its entirety. You also may direct additional questions to Officite’s team of Web Presence Advisors who can be reached at 888-700-3971.

 

This article was originally posted on Officite’s blog on July 19, 2017.

Why Electronic Documentation Can be Such a Pain

By Juanita Benedict, DPT, CEAS II

I get it. I understand why electronic medical records are necessary. Documenting in this format is supposed to decrease medical errors and improve coordination of health care. I even prefer electronic documentation in most circumstances. Honestly, who wants to sit and hand write 30 detailed notes at the end of the day? It’s a great concept, except … don’t we already spend too much time in front of a screen? Even before the implementation of the electronic record requirements, a study from the Council for Research Excellence in 2009 reported in the New York Times claimed that the average American spends more than eight hours per day in front of a screen! With more of our personal and business interactions being performed in front of the computer or mobile device, how much has that time increased almost seven years later?

Despite the benefits of electronic documenting for overall improved coordination of health and documentation compliance, the fact is that extended screen time is simply not healthy. Here are three reasons why:

1. More prolonged sitting. After sitting all or most of the day, the last thing your body needs is more sitting. However, it is unlikely that you have equipped your office with one of those cool treadmill desks. Sedentary activities promote cardiovascular disease, increase the risk of obesity and consequential health problems associated with it, decrease aerobic capacity and much more. Of course, there is a higher incidence of musculoskeletal pain in those who are more sedentary because the body is simply getting weaker.

2. More poor posturing. Proper posturing is just as important while using a computer as it is when working on patients to decrease risk of developing musculoskeletal dysfunction. Just as proper sitting postures often are lacking when delivering dental care, computer operating postures often leave much to be desired. If you are already experiencing neck/shoulder/back/wrist pain, your computer positioning may be a contributing factor that you have not considered. This is another area where those pesky muscle imbalances wreak havoc.

3. More visual stress. Eye strain is a problem for dental professionals. According to the American Optometric Association, extended time on computers can lead to a collection of symptoms that has been named “computer vision syndrome.” Symptoms include headaches, blurred vision, and even neck and shoulder pain. Since eye strain is already common in dentistry due to the demands of accommodation and such, adding more activities that promote poor eye health is not ideal.

As it becomes more necessary to increase your screen time at work, it becomes even more necessary to change your lifestyle habits. Here are just a few tips on how to counteract some of the consequences of extended computer use:

Unplug: Spend time away from computers, phones, tablets and TV screens! You may be amazed at how difficult this may be at first. However, after a while, this will seem like a refreshing oasis of time. Reconnect with those things you once loved.

Move: Any way you want. Dance. Walk. Swim. Bike. Go to the gym. Play with your kids. Help a neighbor move. Clean the house! It doesn’t matter what you do — just get going. This act alone has tremendous emotional and physical health benefits.

Eat well: With an increase of sedentary activities, there is a decrease in calories burned and increase in fat deposited throughout the body. If you are not training to run a marathon, make sure you are not eating as though you are. Stick to a healthy diet with a lot of fiber and water. Peristalsis tends to slow as we become more sedentary as well, which can lead to bloating and other very uncomfortable things!

Educate yourself: Knowing your risk factors for developing pain and compromising your health is necessary so that you can learn how to overcome them. Use quality and reputable resources to make changes in your daily practice. OSHA has provided a free guide to setting up a proper workstation environment to improve posturing. Other resources provide information on how to assess your computer stations and help you to configure a station that makes long hours of documentation, business transactions, emailing, and even reading blogs more comfortable and safe for you.

It appears electronic documentation is here to stay. So, it is of utmost importance that you learn how to protect your health from the devastating consequences that will result from hours of screen time.

As always: Be healthy and practice safely!


Juanita Benedict is a physical therapist in Florida who works specifically with dental professionals to reduce their pain while practicing as well as extend their careers. For more information, go to www.healthydentistrysolutions.com or contact her at 407.801.3324.

 

The FDA’s New Fluoridation Website is Your Go-to Source for the Facts!

By Dr. Johnny Johnson, American Fluoridation Society President

Quick! Answer the following questions within 30 seconds:

1. The patient in your chair goes into cardiac arrest. What is the first phone call you make?
2. What is the concentration of your preferred local anesthetic?
3. Is your community water fluoridated?
4. What is the recommended level of fluoride for community water fluoridation (CWF)?

I bet that the first two questions took you a split second to answer. The third question may have been just as quick. The fourth? Maybe quick, maybe not.

How can you be 100 percent sure that you are correct in your answers? Well, the Florida Dental Association (FDA) would like to introduce you to our new and outstanding fluoridation website: www.floridafluoridation.org!

As dentists, we are expected to be the experts in water fluoridation — and we should be. The proper level of fluoride in drinking water is critical in knocking out at least 25 percent of cavities that adults and children will ever get. It also reduces the severity of those cavities.

The FDA’s fluoridation website is the best website that I have seen anywhere in the U.S. — or in the world for that matter! I know because I have worked with many of you in protecting, restarting and/or initiating CWF in your communities. And we have been an awesome force in ensuring that all of our residents — rich or poor, regardless of age, race, ethnicity, level of education or access to dental care — continue to receive this safe and effective public health benefit.

There are many great resources for information on CWF. However, when it comes to concise information that is user-friendly and state-based, the FDA’s website is primo!  The information is easy to find, concise and presented for both professionals and the public to use.

I challenge you to do these three things:

1. Immediately — right now! — find out what the fluoride level is in your community’s water.1,2,3,4
2. Pull up the FDA’s water fluoridation website.
3. Hang up a poster on CWF in your office — please!

An ounce of prevention is worth a pound of cure. CWF is the best bang for the buck for everyone in our state to benefit from the cavity reductions without a single behavioral change.

If you have any questions, challenges or needs, the FDA and I are here to help you. No question is dumb; the only dumb question is the one not asked. We are here to serve you. Call on us. Thank you for fighting the GREAT fight.

Dr. Johnson is a pediatric dentist in Palm Harbor, Fla. and the president of the American Fluoridation Society. He can be reached at drjohnnyjohnson@gmail.com.

References:

1 My Water’s Fluoride (annual water quality report)
2 Dr. Johnny Johnson
3 Florida Department of Health
4 American Dental Association, American Fluoridation Society, Campaign for Dental Health

Could Your Practice’s Website Reveal Your HIPAA Non-compliance?

By Dr. Danika Brinda, CEO, Planet HIPAA

Did you know that your practice’s website can reveal to the world that you are out of compliance with HIPAA?

A quick look around your website could reveal to a HIPAA auditor that your practice is struggling with HIPAA compliance. Wondering what I am referring to? It’s the Notice of Privacy Practices! The regulations state that your practice must ensure that the most current version of your Notice of Privacy Practices is posted on the practice’s website (if one exists). Here is the specific language from the regulations:

CFR 164.520(c)(3)(i) – A covered entity that maintains a website that provides information about the covered entity’s customer services or benefits must prominently post its notice (of privacy practices) on their website and make the notice available electronically through their website.

Go ahead, give it a try. Head on out to your website (or another practice’s). Try and find the Notice of Privacy Practices. Were you successful or did you find something that is called Privacy Policy? If you look through the Privacy Policy, most of the time the language is something specific to the privacy policy of the website and not the Notice of Privacy Practices. Keep searching for the Notice of Privacy Practices. If you are unsuccessful at finding it, the basic elements of the regulations are not met. If you found the Notice of Privacy Practices – great work! You are compliant, right? NOT NECESSARILY!

Even with your Notice of Privacy Practices posted on your website, you must make sure that the document is your most current version and matches the one available in your office. You also must make sure it meets all the requirements that were defined in the 2013 HIPAA Privacy Regulations and the 2013 HIPAA Omnibus Rule. If any of the following three statements are true, your website revealed that you are out of compliance with HIPAA:

  1. Your Notice of Privacy Practices was not posted on your website.
  2. Your Notice of Privacy Practices was dated prior to Sept. 23, 2013.
  3. The Notice of Privacy Practices on your website isn’t the most up-to-date copy.

If you think the auditors will not be looking on your website to make sure your Notice of Privacy Practices is posted, think again. In the OCR 2016 HIPAA Desk Audit Guidance on Selected Protocol Elements, it states the covered entity must “upload the URL for the entity’s website and the URL for the posting of the entity’s notice.” In fact, the instructions for the HIPAA auditors state that they must:

“Determine whether the entity maintains a website. If so, observe the website to determine if the Notice of Privacy Practices is prominently displayed and available. An example of prominent posting of the notice would include a direct link from homepage with a clear description that the link is to the HIPAA Notice of Privacy Practices.”

Not only does it have to be posted on your website, but it must be in a location that is easy to find with an easy description!

The Notice of Privacy Practice is not a difficult area to comply with for the HIPAA regulations; however, it is a common area of non-compliance. To be compliant with this regulation, the following four items should be established:

  • Notice of Privacy Practices
  • Notice of Privacy Practices Policy and Procedure
  • Acknowledge Form of the Notice of Privacy Practices
  • Making the notice available on the practice’s website

The specific elements that need to be defined in the Notice of Privacy Practices are specifically defined in the regulations. More information can be found here.

 

Dr. Danika Brinda is the CEO of Planet HIPAA and has more than 12 years of experience in health care privacy and security practices. She also is a nationally recognized speaker on a variety of health care privacy and security topics, and specializes in helping dental organizations implement a HIPAA-compliance program.

This article was first published on Planet HIPAA on Sept. 5, 2016.