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ADA Guidelines: The Author RespondsHelen Jeffery’s report of architects, interior designers, planners, and building officials going beyond the letter of the Americans with Disabilities Act (ADA) to embrace the spirit of the law is encouraging. This attitude recognizes that ADA regulatory requirements represent a "floor" (that is, minimum standards) that are often insufficient to ensure that spaces are inclusive and welcoming to people of all abilities. Some states, therefore, mandate additional regulations to improve accessibility of the built environment. Whether the enthusiasm reported by Jeffery is widely shared remains unclear.1 Anecdotal reports from colleagues nationwide suggest that a more common response involves zeroing in on the bare minimum needed to pass ADA muster. I once spent a half-hour trying to convince architects and designers creating a new clinical space that (1) they should put handrails along a lengthy clinic corridor (which was not required under ADA regulations but would improve safety for patients with walking difficulties, weakness, or fatigue who use walls for support) and (2) they needed to put handrails on both walls (as humans are rarely ambidextrous, individuals would favor one side entering the clinic and the opposite side leaving). It was a tough sell, but the clinic installed the bilateral handrails—and patients use them. I hope that Jeffery and her colleagues will continue to advocate for health care buildings that meet the spirit of the ADA, which is—at its core—ensuring equity across all users of these spaces. Involving people with disabilities as full partners in design planning, along with the clinicians and other staff members who work in these settings, offers the best chance of achieving universally accessible and workable health care facilities.
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