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Compliance Issues –
Health Care and the Law
Article 1: ADAAG Identity/Wayfinding Compliance
Health care facilities are being pressured by expensive litigation to comply with complex and sometimes political identity/wayfinding issues. These issues concern equitable consideration for the handicapped: wheel chair access; deaf or hard of hearing; blind or poor of sight. When we take into consideration that we live in a society with an aging population where these conditions are projected to increase in greater numbers, the concerns should include more than being legally compliant. Health Care providers should also be concerned about presenting a consistent image. The marketing material of most health organizations typically carries a theme of hard working teams of highly trained health providers telling us that above all else – “we care”. If health providers truly want to demonstrate that ‘care’ is more than a marketing word, then compliance will be voluntary rather than an expensive legally enforced process.
Is your facility compliant? The majority of existing health care facilities in the United States are non-compliant with ADAAG and many other state and municipal regulatory agencies.
Following are the basic criteria pertaining to signage in the ADAAG, (American Disabilities Act Accessibility Guidelines), legislation enforced by the United States Justice Department and the target of activist groups:
Interior Signage:
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Every permanent space made available to the general public shall comply with the provisions of 4.30 of the ADA Accessibility Guidelines as follows: (This means every room, office, cubical, alcove, lobby, restroom, stairwell and stair entry, elevator, etc., accessible to the general public.)
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4.30.2* Character Proportion. “Letters and numbers on signs shall have a width-to-height ratio of between 3:5 and 1:1 and a stroke-width-to-height ratio between 1:5 and 1:10 .” (The font used for signage can not be fonts with excessive ‘thick and thin’ strokes or overly condensed or extended. The purpose is to use a font that is easily read.)
4.30.3 Character Height. “Characters and numbers on signs shall be sized according to viewing distance from which they are to be read. The minimum height is measured using and upper case ‘X’. Lower case characters are permitted.” Overhead, suspended, or projected signs must be mounted no less than 84” from floor grade with copy no less than 3” in height.
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4.30.4 Raised and Brailed Characters and Pictorial Symbol Signs (Pictograms). “Letters and numerals shall be raised 1/32” (.079 mm) minimum, upper case, sans serif or simple serif type and shall be accompanied with Grade 2 Braille. Raised characters shall be at least 5/8” (16 mm) high, but no higher than 2 inches (50 mm). Pictograms shall be accompanied by the equivalent verbal description placed directly below the pictogram. The border dimension of the pictogram shall be 6 in (152 mm) minimum in height.” (In plain English this means that signs must have a special Braille with raised copy of no less than 5/8” nor more than 2” in height. Pictogram signs, or signs providing a representative symbol, such as an outline of a ‘Man’ for the ‘Men’s Restroom’ should be no less than 6” in height with the Braille description directly below the symbol.)
4.30.5 Finish and Contrast. “The characters and background of signs shall be eggshell, matte, or other non-glare finish. Characters and symbols shall contrast with their background – either light characters on a dark background or dark characters on a light background.” (Signs should be easy to read.)
4.30.6 Mounting Location and Height. “Where permanent identification is provided for rooms and spaces, signs shall be installed on the wall adjacent to the latch side of the door. Where there is no wall space to the latch side of the door, including at double leaf doors, signs shall be placed on the nearest adjacent wall. Mounting height shall be 60 in (1525 mm) above the finish floor to the centerline of the sign. Mounting location for such signage shall be so that a person may approach within 3 in (76 mm) of signage without encountering protruding objects or standing within the swing of a door.”
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The list goes on but the above regulations involve the most frequently cited infractions for non-compliance. All operating officers and facility engineers should be thoroughly familiar with these regulations in relation to the health care facility or have opted to retain a consultant to certify compliance. But then there are the ‘interpretations of law’ as imposed by individual inspectors. How do you determine what areas are ‘Public’ and other areas are ‘Non-Public’? What are ‘shared’ spaces?
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