Designing an Inclusive and ADA-Compliant Treatment Room
Setting up a treatment room that is both inclusive and compliant with the Americans with Disabilities Act (ADA) is not just a legal obligation, but a fundamental step towards creating an accessible and inviting environment for all. The ADA, established in 1990, is a pivotal civil rights law designed to prevent discrimination and promote equal opportunities for individuals with disabilities. Along with space planning and creating a furniture plan that is easy to navigate, we can look to the ADA for guidance. The ADA consists of various guidelines and regulations, with Title II (Public Services) and Title III (Public Accommodations) being particularly relevant to massage therapists and bodyworkers.
Though products can be designed to meet ADA guidelines, the federal government does not issue approvals or certify specific products as ADA-compliant, nor does any other body. The application, placement, and surroundings of the furniture, fixtures, and equipment within the space impact accessibility and usability. Any company “certifying” products as ADA compliant is providing information about the product only based on its own interpretations.
Buildings and workspaces can be determined to be compliant when assessed by the federal government, though this typically happens only if there is a complaint. Consultants and experts (such as interior designers) not associated with the federal government can help interpret and implement ADA regulations and may show a “good faith effort” has been made to meet the regulations, however, they do not have the ability to “certify” spaces.
Many products include features allowing for adjustment to an individual’s needs or comfort level—whether the individual is disabled or interested in using ergonomics to reduce the risk of development of a work-related musculoskeletal disorder. Using a hydraulic table is a primary example, a highly recommended investment, and is eligible for a tax credit. If you have not yet invested in an electric table, I highly recommend it! An electric table that lowers to 20” from the finished floor is considered ADA compliant and allows easier transfer for the client, as well as adjustability for the therapist to adjust height to different modalities performed and adjust for body size.
“The tax credit is available to businesses that have total revenues of $1,000,000 or less in the previous tax year or 30 or fewer full-time employees. This credit can cover 50% of the eligible access expenditures in a year up to $10,250 (maximum credit of $5000). The tax credit can be used to offset the cost of undertaking barrier removal and alterations to improve accessibility; providing accessible formats such as Braille, large print, and audio tape; making available a sign language interpreter or a reader for customers or employees, and for purchasing certain adaptive equipment.”
When your space is non-compliant with ADA regulations, it can result in a lawsuit. Though non-criminal, financial penalties can be costly depending on the specific infraction. Lawsuits are typically complaint driven. Further, as a business, you are also limiting your potential to serve more clients that would otherwise have access to your space if non compliant.
The 2010 ADA Standards for Accessible Design specifically state furniture that is not fixed to a floor or a wall is not subject to these standards. This is the case because product dimensions are not the only consideration for accessibility. Holistic consideration of universal usability includes attention to where the product is placed, and consideration of clearances, maneuverability throughout the space, and approachability.
Universal design and ADA considerations require attention to many aspects of use including, but not limited to clearance requirements (heights, depths, and widths), ease of approachability and maneuverability within the space, and the ease of manipulation of knobs, handles, or adjustments. The interior spaces should be considered, as well as the entrances, parking areas, and restrooms.
Be aware of standards including, but not limited to:
All door openings meet or exceed 32” clear width and 80” vertical clearance
All operable door handles located between 34” and 48” above the finished floor
Handles, pulls, latches, and locks can be operated with one hand and do not require tight grasping, pinching, or twisting of the wrist to operate
Doors require enough space for maneuverability for entrance, exit, and turning
The force required to fully open doors does not exceed 5.0 pounds (force requirement does not apply to latching bolts or other devices that hold the door in a closed position
Handles, pulls, latches, and locks can be operated with one hand and do not require tight grasping, pinching, or twisting of the wrist to operate
5.0 lbs of force or less to activate.
The absolute minimum square footage for a treatment room is 80 square feet, ideally closer to 120 sf. There should be a 60” radius of clearance next to the table for wheelchair accessibility. Assess the layout of your treatment space holistically, focusing on clearances related to heights, depths, and widths. If you have area rugs, the pile should be less than 1/2” high to avoid being a trip hazard.
There are several additional ADA considerations beyond the treatment room. Ensure that your practice's entrance is accessible, especially if it's not on the ground floor. Consider adding a ramp to facilitate access for clients who use wheelchairs or have mobility challenges. Make sure that pathways within your practice are wide enough to accommodate wheelchairs, walkers, and other mobility aids.
Provide accessible seating options in your waiting area. These seats should be stable, equipped with armrests, and comfortable for clients who may require extra support. Consider incorporating seating within your treatment room to accommodate clients who may need a resting place before or after their session, or need to sit to remove shoes. The average seat height is 18”, so be aware of heights that deviate too much from this height.
If your practice includes restroom facilities, ensure they comply with ADA standards. This involves providing ample space for maneuverability and installing handrails for added support. Accessibility features like grab bars are crucial for clients with disabilities to ensure a safe and comfortable restroom.
Communications should also be accessible to all clients. Your website may incorporate features like alt text for images, video captions, and user-friendly fonts to become ADA-compliant. Accommodate clients with diverse communication needs, including those who require information in Braille or the assistance of sign language interpreters. Offer a variety of scheduling options, such as online booking, phone reservations, or in-person scheduling, to accommodate differences, whenever possible.
If you own or manage a facility, train your staff to be sensitive to the needs and concerns of clients with disabilities. This includes understanding different types of disabilities and knowing how to assist clients accordingly.
Good lighting is essential, especially for clients with visual impairments. Ensure your practice is well-lit and free from glare, which can be uncomfortable for those with certain visual conditions. Dimmer switches are extremely helpful in creating adjustable lighting, as well as a variety of lighting sources, such as recessed lighting, wall sconces, floor or table lamps, and task lights.
Use clear and well-placed signage to help clients navigate your space. Signage should include information about restroom locations, emergency exits, and other essential areas.
Develop and document inclusive policies that underscore your commitment to ADA compliance and client inclusivity. Make these policies available to both your staff and clients so that everyone understands your dedication to creating a welcoming and accommodating practice.
An ADA-compliant and inclusive practice is a compassionate approach to providing accessible and accommodating services to all your clients. If you are remodeling or building out a space, you will have many opportunities, and building codes, that support universal design. Otherwise, working within existing spaces can be a challenge to adapt, yet there are many steps you can take to create greater accessibility.
RESOURCES
2010 ADA Standards for Accessible Design
ADA Checklist for Existing Facilities
