Partners Insights October 14, 2024: Hospitals

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HOSPITALS Partner Insights

New Updates to Section 504 Clarify Nondiscrimination and Accessibility Mandates

To counter biases and stereotypes rooted in discrimination against people living with disabilities, earlier this year the Department of Health and Human Services (“HHS”) published a final rule, Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance (the “Rule”), which became effective on July 8, 2024. Federal grantees – including hospitals and health systems – should take heed of these changes and adjust their processes to ensure compliance.

Why Does this Matter?

The Rule modifies Section 504 of the Rehabilitation Act, which prohibits entities that receive federal financial assistance (and federal agencies) from discriminating against disabled individuals in areas including opportunities to participate in or benefit from federally funded programs (i.e., due to physical access barriers); and in employment opportunities, including advancement and training. Those subject to 504 include hospitals, healthcare providers, public schools, higher education institutions, and certain

nonprofit organizations, as just a few examples. Changes to 504 include: Nondiscrimination Obligations

Covered Entities (“CEs”) under 504 now are prohibited from denying or limiting treatment due to biases or stereotypes arising from a person’s disability. In a recent press release, HHS offered examples of such prohibited behavior:

• Denial of a heart transplant because the provider does not believe the patient, who lives with autism, can manage postoperative care; and

• Refusal to order a ventilator for a patient living with Alzheimer’s disease, because the provider believes the patient’s cognitive status should preclude the intervention.

Moreover, CEs must endeavor to administer programs in integrated (rather than segregated) settings, narrowly tailored to the specific needs of individuals with disabilities.

Accessibility Obligations –Kiosks, Websites, and Apps

CEs using self-service kiosks should ensure that their kiosks are accessible to individuals with disabilities or implement alternative procedures that allow those who cannot use the kiosks to access their programs. For example, CEs with kiosks that offer limited accessibility support to the visually impaired must allow individuals with visual impairment to go directly to the main desk personnel to register for necessary services.

Moreover, beginning on May 11, 2026, CEs with 15 or more employees must ensure that all web and app content complies with technical standards established by the widely recognized Web Content Accessibility Guidelines 2.1 levels A and AA (“WCAG”). Overall, the new WCAG compliance mandate will not apply to the following exempted content:

• Archived Web Content – Historic, outdated web and app content (provided certain conditions are met);

• Preexisting Conventional Electronic Documents – So long as they are not currently used to

Operating in a Health Care Environment

Health care is among the most heavily regulated industries in the nation. At Bond, we have a statewide practice with the leverage, integration and depth needed to navigate this ever-changing field.

To further serve you, we provide teams of integrated cross-practice attorneys who are accomplished in the fields of labor and employment, employee benefits, corporate and antitrust law, financial restructuring and complex litigation. Bond is here for you and ready to serve the unique needs of the health care industry.

Bond – Essential to Your Business

apply for or gain access to a CE’s programs, preexisting documentary materials (e.g., documents in .pdf, .pptx or .docx formats) created before May 11, 2026;

• Content Posted by a Third Party – All third-party content, unless the third-party posts content to a CE’s website pursuant to contractual, licensing, or other formal arrangement with the CE;

• Password Protected and Other Secured Documents – Password protected documents that contain information about a specific individual, such as medical records or treatment notes, provided that disabled individuals are able to access information from those documents that pertain to them; and

• Preexisting Social Media Posts – Any social media posts published prior to May 11, 2026, for organizations with 15 or more employees, and for organizations with fewer than 15 employees, posts published prior to May 10, 2027.

Enforcement

CEs with 15 or more employees must designate an individual to coordinate nondiscrimination and accessibility compliance efforts and adopt a grievance process for complaints. CEs also must notify employees, applicants, participants, beneficiaries, and other interested persons regarding the Rule’s compliance mandates.

What’s Next

The broad changes to 504 mean that organizations should:

• Designate an individual to serve as an organization’s Section 504 compliance coordinator;

• Create a formal grievance process;

• Assess current nondiscrimination policies to determine what updates need to be made; and

• Analyze websites and mobile apps against the WCAG standards to ensure all web content is compliant by May 11, 2026.

Bond attorneys regularly assist and advise clients in the healthcare, education, and nonprofit industries with respect to accessibility compliance. For more information regarding such matters, please contact Roger Bearden, Gabriel Oberfield, Mario Ayoub, or any Bond attorney with whom you have a relationship.

Mario F. Ayoub is an Associate at Bond, Schoeneck & King. He focuses his practice on the intersection of law and technology, including all aspects of data privacy and cybersecurity, as well as open source license review and technology vendor contract review and negotiations.

Roger Bearden is Senior Counsel at Bond, Schoeneck & King. He previously served in various senior roles in New York State government, including authoring New York State’s Olmstead Plan for serving people with disabilities and older adults in the most integrated setting.

Gabriel S. Oberfield is Senior Counsel at Bond, Schoeneck & King. He previously served as a senior healthcare trade association executive with a focus on long term care, in numerous New York City governmental roles, and in the non-profit sector.

Allison Gabala
Mario F. Ayoub
Roger Bearden
Gabriel S. Oberfield

St. John’s Riverside Hospital: Revolutionizing Emergency Care in Yonkers

In a groundbreaking move set to transform emergency healthcare in Yonkers, St. John’s Riverside Hospital is embarking on an ambitious expansion of its Emergency Department (ED). This visionary project, slated to break ground in the coming months, promises to elevate patient care with greater privacy, convenient access, and efficiency to unprecedented levels.

Raffaele Milizia, MD, Chief of Emergency Medicine at St. John’s Riverside Hospital, shared his enthusiasm for the project: “Yonkers has grown significantly, and our current ED, designed for 23,000 annual visits, now serves over 40,000 patients yearly. This expansion is not just necessary; it’s transformative.”

The cornerstone of this expansion is a dramatic increase in square footage and treatment room capacity, effectively doubling the current space. This growth addresses patients’ primary concern: privacy. “Our new design ensures patients won’t have to see or hear others during their visit, significantly enhancing comfort and confidentiality,” Dr. Milizia explained.

A key feature of the redesigned ED is its innovative layout. The new walk-in entrance, conveniently located near parking, will streamline patient flow. Dr. Milizia highlighted, “About 40% of patients will be treated in the front area and discharged from there, separate from the main ED where we care for more critical cases. This setup mirrors an urgent care model for less severe cases, drastically improving efficiency and patient experience.”

The expansion introduces a tiered care system:

1. A fast-track area for minor ailments

2. An intermediate zone for cases requiring more attention

3. The main ED for high-acuity patients

This structure ensures that patients with less serious conditions aren’t exposed to more critical cases, reducing stress and improving care delivery.

St. John’s Riverside Hospital has long been committed to providing top-quality care. “Over the past decade, we’ve focused intensely on delivering the highest quality of care. This expansion will now allow our patient experience to match that exceptional level of care,” Dr. Milizia proudly stated.

The new design also addresses logistical challenges. Currently, patients must park on the opposite side of the building from the ED entrance. The expansion will align parking and entrance locations, significantly enhancing accessibility and convenience.

As Yonkers grows, St. John’s Riverside Hospital is stepping up to meet the community’s evolving healthcare needs. This ED expansion is more than just a building project; it’s a commitment to the health and well-being of every resident.

With groundbreaking scheduled for later this year, the Yonkers community can look forward to a future where emergency care is not only prompt and high-quality but also comfortable, private, and tailored to individual needs. St. John’s Riverside Hospital is not just expanding its facilities; it is keeping our Community Strong.

Stephen Erosa, DO Leading Interventional Pain Management Specialist

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