to add new members).
Chapter 6.
Dental Office Design
20. What Laws Affect Office Design?
Many federal, state and local laws affect dental office design, including zoning laws, building laws, and disabilities laws such as the Americans with Disabilities Act (AwDA), which imposes minimum requirements regarding accessibility for people with disabilities. Similar state and local disabilities laws may impose more stringent requirements than the AwDA. Zoning laws and building codes may impose a wide array of requirements for purposes such as safety. Zoning laws must typically be addressed in order to commence construction. So, too, may other specific state or local laws, such as those related to environmental hazards.
In addition, federal and state laws on emerging issues such as ergonomics, waste management, privacy, and employee safety may indirectly shape dental office design requirements. For example, a dental practice may wish to include office design elements that could reduce the chance of a data breach by protecting patient information in paper files and on computers.
21. What Does the Americans With Disabilities Act (AwDA) Require for Office Design?
The Americans with Disabilities Act helps guarantee access to “places of public accommodations” for persons with disabilities. Under the Act, and many similar state and local laws, a dental practice is considered a place of public accommodation, so the practice must comply with the Act as well as with applicable state and local accessibility laws. The Act requires that places of public accommodation meet certain accessibility standards. The standards that apply depend on whether the office is an existing facility, being renovated, or new construction.
Related References and Resources
• Americans with Disabilities Act: ADA Guide for Small Businesses
• Americans with Disabilities Act: Access to Medical Care for Individuals with Mobility Disabilities
www.ada.gov/medcare_mobility_ta/medcare_ta.htm
• The ADA Practical Guide to Dental Office Design
adacatalog.org or 1.800.947.4746
22. Isn’t There a “Grandfather” Provision That Exempts Me From the AwDA?
No, the AwDA contains no grandfather provision regarding accessibility. Exceptions to the AwDA requirements are extremely limited, such as certain exceptions for buildings that are listed in the National Register of Historic Places or designated as historic under an appropriate state or local law. Private dental offices are viewed as places of public accommodations that must comply with the law. Under the federal law, a lesser standard applies to existing facilities, as opposed to renovated or new ones. In all cases, the federal law sets the minimum requirements and dentists must also comply with any more stringent standards imposed by state or local laws.
23. I Rent My Office Space. Isn’t AwDA Compliance the Building Owner’s Responsibility?
Landlords and tenants are each responsible for satisfying the accessibility requirements of the AwDA. Typically, they may decide to apportion this responsibility between themselves by contract. For example, the landlord may agree to be responsible for compliance for common areas and the tenant may agree to do the same for his or her office space. While the AwDA allows them to do so, agreeing by contract to apportion who will do what does not vitiate either party’s responsibility for the entire portion of the premises that an individual may visit, from curbside to dental chair and back.
Some dentists who lease their office space have anecdotally reported that their landlords would not take needed compliance steps. A lease provision requiring the landlord to do so with respect to common areas, and to indemnify the dentist-tenant for damages should the landlord fail to do so, may be one way to help protect against this risk.
24. What Are the AwDA Requirements for Existing Facilities?
The accessibility requirements for existing facilities are the lowest and easiest-to-meet standard. A dental practice in an existing office that does not require renovation must remove architectural barriers to the extent that doing so is readily achievable, which the Act describes as something that is “easily accomplishable and able to be carried out without much difficulty or expense.” The standard of readily achievable barrier removal does not mean the office must be “fully accessible.” However, a dentist may wish to undertake an audit of what barriers to access exist, and determine which barriers can be removed without significant difficulty or expense. Keep in mind that other laws, such as state and local accessibility laws, may impose even more stringent requirements that would require additional compliance steps.
Related References and Resources
• Checklist for Existing Facilities
25. What Are the AwDA Rules for Renovation and New Construction?
In contrast to the requirements for existing facilities, renovations and new construction must be accessible as defined in the regulations, standards and guidance. These materials are very specific regarding many requirements, such as those pertaining to parking lots, entrances, doors, operatory size, counter heights, restrooms, elevators and more. Let’s take a look at a few key points.2
Alterations (Renovations)
• Any alteration to a place of public accommodation or a commercial facility after January 26, 1992, shall be made so as to ensure that, to the maximum extent feasible, the altered portions of the facility are readily accessible to and usable by individuals with disabilities, including individuals who use wheelchairs.
• An alteration that affects or could affect the usability of or access to an area of a facility that contains a primary function shall be made so as to ensure that, to the maximum extent feasible, the path of travel to the altered area and the restrooms, telephones, and drinking fountains serving the altered area, are readily accessible to and usable by individuals with disabilities, including individuals who use wheelchairs, unless the cost and scope of such alterations is disproportionate to the cost of the overall alteration.
• Alterations made to provide an accessible path of travel to the altered area will be deemed disproportionate to the overall alteration when the cost exceeds 20 percent of the cost of the alteration to the primary function area.
New Construction
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