Health care access and the Americans with Disabilities Act: A mixed methods study.

BACKGROUND: The Americans with Disabilities Act (ADA) requires that health care entities provide full and equal access to people with disabilities. However, results of previous studies have indicated that the ADA has been largely ineffective at creating systemic change in the delivery of health care. OBJECTIVE: The objective of this study was to examine the current barriers to health care access experienced by people with disabilities under Titles II and III of the ADA. METHODS: This study utilized a mixed methods multiphase design. In phase one, a survey and focus groups were conducted with individuals with disabilities who experienced barriers to health care access. In phase two, key informant interviews were conducted with individuals who had a role in ensuring equal access to health care for people with disabilities. RESULTS: In the current context of health care reform, people with disabilities continue to experience multiple barriers to health care access under Titles II and III of the ADA. However, a notable result is that several provisions of the Patient Protection and Affordable Care Act (ACA) have likely bolstered existing directives implementing requirements for health care access under the ADA. CONCLUSIONS: The results of this study provide additional support for a comprehensive examination of both the national standards for accessible health care and the enforcement of laws that prohibit discrimination on the basis of disability.

The Experience of Home Care Providers and Beneficiaries With Enhanced Training Requirements in Washington State.

Objective: Our objective was to understand the perceived impact of Washington State's upgraded training and certification requirements of long-term care workers providing personal care services from the perspectives of consumers and home care aides. Methods: We applied conventional qualitative content analysis to semi-structured interviews with 17 consumers and 10 certified home care aides. Results: We found that consumers in this study put a high premium on directing many aspects of their personal care services. We also found that while home care aides supported what consumers desired for their own care, some were unsure how to reconcile providing individualized services with the State's standardized, competency-based training and certification program. Discussion: State-based efforts, such as the one in Washington State, serve as an important starting point for building a broader effort toward the identification of competencies and associated training standards for the home care workforce.

Leadership for Addressing Aging in America: The Health and Aging Policy Fellowship.

The Health and Aging Policy Fellows Program funded by The John A. Hartford Foundation and Atlantic Philanthropies trains future leaders to influence healthcare policy, systems, and program development in aging. Following a rigorous residential training in Washington, DC, Fellows establish placements of up to 1 year in the executive, legislative, or judicial branch of government, at a federal agency, state or community agency or committee, or with a nongovernmental organization. The 2016-2017 Fellows' activities represent a broad scope of work, including contributions to national and local policy priorities expected to build over time far beyond the core fellowship year.