Telehealth services must comply with the Americans with Disabilities Act (ADA) to guarantee equal access for individuals with disabilities. This includes providing accommodations like sign language interpreters, screen reader compatibility, and accessible communication methods. Compliance isn’t just a legal requirement – it helps remove barriers that prevent patients from receiving quality care. Here’s what you need to know:

• Legal Requirements: ADA and Section 504 mandate equal access to telehealth services.
• Key Principles: Non-discrimination, effective communication, and reasonable modifications are essential.
• Accessibility Features: Screen reader compatibility, captions, high-contrast displays, and keyboard navigation are critical.
• Staff Training: Providers and staff must be trained to address accessibility needs effectively.
• Ongoing Monitoring: Regular audits, user feedback, and updates help maintain compliance.

Telehealth providers should also use accessible platforms and ensure their materials and communication methods meet ADA standards. By prioritizing these steps, providers can create fairer healthcare experiences for all patients.

What Is The Americans With Disabilities Act (ADA) And How Does It Relate To Telehealth?

Understanding ADA Requirements for Telehealth Services

The Americans with Disabilities Act (ADA) ensures equal access to healthcare, including digital and virtual services. Telehealth providers must meet the same legal obligations as in-person care, with added considerations for the virtual environment.

The ADA, along with Section 504, applies to all healthcare providers serving the public or receiving federal funding. In practice, this means most professionals offering telehealth services are required to comply, regardless of the size or structure of their practice. Let’s explore these requirements and how they specifically apply to telehealth.

Key ADA Requirements for Telehealth Providers

ADA compliance in telehealth revolves around three main principles: non-discrimination, effective communication, and reasonable modifications. Together, these principles ensure patients with disabilities have equal access to virtual healthcare.

Non-discrimination is the cornerstone of ADA compliance. Providers cannot deny services, charge extra fees, or deliver substandard care to patients because of their disabilities.

Effective communication requires telehealth providers to offer tools or services that help patients with communication disabilities. Examples include sign language interpreters, real-time captioning, large-print documents, and platforms that work with screen readers. For instance, if a patient is deaf, you might arrange for a qualified sign language interpreter or enable real-time captioning. A qualified interpreter must communicate effectively, accurately, and impartially, including using specialized medical terminology when necessary.

Reasonable modifications involve adapting standard practices to meet the needs of patients with disabilities. This can include allowing extra time for appointments, assisting with online forms, or enabling a support person to join a virtual session. For example, a telehealth provider working with a patient with an intellectual disability might schedule additional time before the appointment to familiarize the patient with the platform, ensure a support person can join remotely, and allocate extra time during the session to explain the discussion clearly.

Importantly, the cost of providing these accommodations must be covered by the provider. These are considered standard business expenses, not optional services for which patients can be charged extra.

What Counts as a Disability Under the ADA

The ADA takes a broad view of what qualifies as a disability, covering a wide range of conditions that impact everyday life. By law, a disability is defined as "a physical or mental impairment that substantially limits one or more major life activities; a record of such impairment; or being regarded as having such an impairment". This definition helps telehealth providers understand how to adapt their services to meet individual needs.

Major life activities include essential functions such as eating, speaking, breathing, walking, seeing, hearing, learning, and communicating, as well as the operation of major bodily functions like digestion or the immune system. This definition also encompasses conditions that may not be visible but still significantly affect a person’s ability to access healthcare.

For telehealth providers, this means accommodating a wide array of disabilities. For instance, a physical therapy practice might send exercise videos to clients. If one of their clients is blind, the practice would need to ensure their platform is compatible with screen readers and that the exercise videos include audio descriptions. These adjustments address the needs of individuals whose visual impairments impact their ability to engage with the service.

The ADA also protects individuals with a record of impairment, covering those who have previously had a disability, and those regarded as having an impairment, which applies to people perceived as disabled even if they do not have a qualifying condition. This inclusive approach ensures telehealth providers consider the full range of disability experiences when designing their services.

Choosing ADA-Compliant Telehealth Platforms

Picking the right telehealth platform isn’t just about convenience – it’s about ensuring accessibility for everyone, including patients with disabilities. With nearly 20% of the U.S. population living with some form of disability, having an accessible platform is a step toward serving a broader patient base effectively.

The U.S. Department of Health and Human Services has set clear guidelines for digital accessibility in healthcare, requiring platforms to meet WCAG 2.1 Level AA standards. These standards outline the technical requirements needed to guarantee equal access for all users.

Key Accessibility Features to Consider

When evaluating telehealth platforms, look for features that align with ADA standards. These features are essential for creating an inclusive experience:

• Screen reader compatibility: Many visually impaired patients depend on tools like NVDA, JAWS, or VoiceOver to navigate digital interfaces. The platform must work seamlessly with these technologies.
• Keyboard navigation: For patients who cannot use a mouse, the platform should allow full functionality using only keyboard commands. This is critical for individuals with motor disabilities or those using alternative input devices.
• Captions and transcripts: Ensure the platform supports live captions for video sessions and provides transcripts for recorded content. These features are vital for patients with hearing impairments.
• High-contrast displays and adjustable text: Platforms should offer options to modify color schemes and font sizes, making content easier to read for patients with visual impairments.
• Alternative text for images: Non-text elements like icons, charts, and images should include alternative text descriptions, allowing screen readers to convey visual information.
• Assistive technology compatibility: The platform should work well with tools like voice recognition software and hearing aids, further expanding accessibility.

Evaluating Your Platform for ADA Compliance

To ensure your telehealth platform meets ADA standards, a combination of automated tools, manual checks, and user feedback is essential:

• Automated testing tools: These can quickly flag common issues, such as missing alt text, poor color contrast, or broken ARIA attributes.
• Manual inspection: Go beyond automated checks by verifying that headings are logical, forms are user-friendly, and error messages are clear.
• Keyboard navigation testing: Use only a keyboard to navigate the platform. Test interactive elements like buttons, links, and forms to confirm full functionality without a mouse.
• Color contrast checks: Use contrast-checking tools to ensure that text and background colors meet accessibility standards.
• Screen reader testing: Tools like NVDA, JAWS, and VoiceOver can help identify navigation issues that might not be obvious during visual inspections.
• User testing with individuals with disabilities: Real-world feedback from users with disabilities can uncover barriers that technical testing might miss.

The results from these tests can guide targeted improvements, making your platform more accessible and user-friendly.

Improving Accessibility on Your Platform

If your platform doesn’t meet ADA requirements, there are actionable steps you can take to enhance its accessibility:

• Enable any built-in accessibility features the platform offers.
• Add third-party tools, such as captioning services or screen reader optimization plugins, to complement existing functionality.
• Provide alternative access options like phone-based consultations, simplified mobile interfaces, or assisted navigation services with extended consultation times.
• Offer device lending programs to help patients overcome technology access barriers.
• Develop multilingual resources and ensure access to qualified medical interpreters to address language challenges.

These improvements don’t just benefit patients with disabilities – they enhance the overall user experience. Features like clear navigation, good color contrast, and intuitive forms make the platform easier for everyone to use. Taking these steps showcases your commitment to accessible and inclusive telehealth services.

Making Materials and Communication Accessible

Accessible materials and communication aren’t just a good practice – they’re a legal requirement that impacts every interaction with patients. As Elizabeth Wright, ARM, CPHRM, CHC, explains:

"All providers (who are a covered entity) have a legal obligation to provide healthcare equally to all patients, whether in-person or virtually. While there is no requirement to provide telemedicine, any provider who is utilizing telemedicine must ensure equal access to all patients."

This responsibility applies to every piece of communication and material patients encounter, ensuring equitable healthcare access.

Creating Accessible Pre-Visit Materials

Pre-visit materials are critical in setting the stage for successful telehealth sessions, but they can unintentionally create barriers if not designed thoughtfully. To accommodate diverse needs, offer materials in multiple formats such as large print, Braille, and audio. These options are particularly helpful for patients with visual or cognitive challenges.

Audio recordings of written materials can be especially useful. Recording intake forms, instructions, and educational content helps not only those with visual impairments but also individuals with learning or cognitive difficulties.

For digital materials, ensure compatibility with screen readers by incorporating proper headings, alt text for images, and clear, descriptive link text. For example, a dietitian using a web-based platform should confirm that dietary recommendations are accessible for patients relying on screen reading software.

If videos are part of your materials, include audio descriptions for patients with visual disabilities. For instance, a sports medicine clinic sharing physical therapy exercise videos should add audio descriptions to convey essential visual details.

Communicating Effectively During Sessions

Once pre-visit materials are accessible, attention should shift to clear and adaptive communication during live sessions. Virtual appointments can pose unique challenges, particularly for patients with hearing loss who may struggle to follow conversations if they cannot clearly see the speaker’s face during video calls.

To improve communication, ensure video calls take place in well-lit spaces without backlighting, and use clear audio. Structured turn-taking can help avoid confusion. If a patient doesn’t understand something, rephrase it instead of repeating it word-for-word. Additionally, chat functions can be used to clarify details like medication names or appointment times. Starting each session with a brief agenda can also set the tone and guide the conversation.

Assistive technology, such as remote microphones or hearing aids, can improve accessibility, but it’s essential to plan ahead. Allow patients extra time to set up and test their devices to ensure a smooth start to the session.

Studies reveal that patients with hearing loss may avoid telemedicine appointments or rate them less favorably due to communication challenges. By prioritizing clear communication and encouraging the use of assistive tools, providers can create a more inclusive experience.

Finally, providing written follow-up materials – like session summaries or treatment plans – can reinforce verbal communication. These documents serve as accessible references for patients, ensuring they have the information they need for future care. By implementing these strategies, providers not only meet legal requirements but also improve the quality of care for all patients.

sbb-itb-b6e72a9

Making Reasonable Modifications and Training Staff

Providing accessible materials and communication is just one piece of the puzzle in telehealth. Providers also need to adjust their practices and ensure staff are equipped to implement accommodations effectively. Under the ADA, healthcare providers are required to make reasonable changes to their policies, practices, or procedures to avoid discriminating against individuals with disabilities. These adjustments help remove barriers without altering the core service, setting the foundation for proper staff training to ensure these practices are carried out successfully.

Examples of Reasonable Modifications

In telehealth, reasonable modifications often involve adjustments to scheduling, appointment structures, and support systems, all aimed at making care accessible for patients with disabilities.

• Extended appointment times: For instance, a dermatology practice might extend a 30-minute session to give patients more time to communicate. Similarly, patients with brain injuries may need additional time during telehealth visits to ask questions and discuss their health concerns at a comfortable pace.
• Pre-appointment preparation: Patients with cognitive disabilities may benefit from receiving extra time before an appointment to familiarize themselves with the telehealth platform. This preparation can reduce anxiety and lead to smoother sessions.
• Support person accommodations: Telehealth platforms should allow support persons or family members to join sessions, either from the same location or remotely, to assist patients as needed.
• Hands-on assistance: For patients with limited hand mobility, staff may need to guide them through digital forms and processes.

During appointments, providers should always speak directly to the patient about their care and take the necessary time to ensure the patient fully understands the discussion. These modifications not only align with ADA requirements but also demonstrate a commitment to accessible telehealth services.

Training Staff on ADA Requirements

Effective implementation of these modifications hinges on well-trained staff. Comprehensive, ongoing, and role-specific training is essential for ensuring ADA compliance in telehealth.

• Foundational training: Staff need to be familiar with telehealth equipment, legal compliance, and the process of making necessary modifications. This includes understanding how to communicate effectively with patients who may require communication aids or services.
• Digital communication skills: Virtual care presents unique challenges, and staff must adapt their communication techniques to meet the needs of patients with various disabilities. For example, they should learn to use communication devices and apps for patients with speech disabilities and allow ample time for patients to express themselves.
• Cultural humility training: This type of training helps combat stigma and misinformation, fostering empathy and understanding for the emotional challenges faced by individuals with disabilities.

Stony Brook University School of Medicine provides a great example of effective telehealth training through its Tele-Preventive Medicine (TPM) program. This program educates medical residents in virtual preventive care, enabling them to better serve disadvantaged populations. Since its launch, the TPM service has completed 59 virtual visits and addressed 22 gaps in care.

Organizations should also include modular, simulation-based training tailored to specific roles. This training should cover privacy protocols, assistive technologies, and practical skills like guiding visually impaired patients through digital platforms. Additionally, staff should be trained on billing and coding for telehealth services, ensuring the correct use of CPT codes and modifiers.

Ongoing education and refresher courses are vital to keeping staff up-to-date with evolving telehealth technologies and ADA requirements. Patient surveys can also provide valuable feedback on communication effectiveness, helping identify areas for improvement. By investing in consistent and targeted training, telehealth providers can ensure their services remain both accessible and compliant.

Monitoring Compliance and Staying Current

Setting up ADA-compliant telehealth practices is just the beginning; staying vigilant is key as both technology and regulations keep changing. In 2023 alone, over 4,500 ADA web accessibility lawsuits were filed in the U.S., highlighting the importance of ongoing compliance efforts for telehealth providers.

Running Regular Accessibility Audits

Regular accessibility audits are crucial for spotting and addressing potential issues before they escalate into legal problems or hinder patient access. Automated tools can help identify common issues like missing alt text, poor color contrast, or keyboard navigation barriers. However, these tools only catch about 30% of problems, making manual testing an essential part of the process.

Using screen readers like NVDA or JAWS for manual testing offers valuable insights. By navigating your platform with these tools, you can better understand how visually impaired patients interact with your services. This process often reveals issues like confusing navigation or poorly organized content.

Feedback from actual users is another critical resource. Engaging patients with disabilities in your testing process provides a real-world perspective on how your platform performs. Establishing a patient advisory panel with individuals who have various disabilities can be particularly effective. Conduct quarterly feedback sessions, document their suggestions, and use this information to guide improvements.

When performing audits, keep detailed logs of your findings. Use tools like spreadsheets or accessibility management software to track issues by severity. Address critical problems – those that block access to key features – immediately, while scheduling less urgent fixes for future updates. This systematic approach not only helps prioritize tasks but also builds a solid compliance record.

Keeping Records of Compliance Efforts

Thorough documentation is a cornerstone of maintaining compliance and demonstrating your commitment to accessibility. It also provides legal protection should any issues arise.

Start by maintaining detailed training records for your staff. Include information like who completed training, when it occurred, the topics covered, any certifications earned, and the materials used. Update these records whenever your team completes additional training or refresher courses.

Document every accommodation made for patients with disabilities. For example, if a patient with a hearing impairment requests sign language interpretation, record the request, the solution provided, session details, and any feedback on the service. This level of detail ensures transparency and accountability.

Grievance procedures should also be well-documented. Platforms like Telehealth.org keep confidential records of all grievances, tracking the resolution process and any resulting policy changes. You can adopt a similar system to manage complaints, from the initial report through resolution, while noting any updates made to improve your services.

Technical compliance records are equally important. Keep audit reports, remediation plans, and proof of fixes, such as screenshots or videos showing before-and-after changes. These records demonstrate your proactive approach to maintaining accessibility.

Staying informed about regulatory updates is another critical aspect. Currently, three federal civil rights laws apply to telehealth: Section 504 of the Rehabilitation Act, the Americans with Disabilities Act (ADA), and Section 1557 of the Affordable Care Act. These laws can change over time, so it’s essential to stay updated.

Subscribe to updates from your Regional ADA Center and monitor official government websites for any policy changes. For example, Telehealth.HHS.gov provides the latest information on telehealth flexibilities, with its most recent update on March 20, 2025. Note that some telehealth flexibilities have been extended through September 30, 2025, but these may expire without further action from Congress.

Regularly check in with local provider relations representatives and Medicaid agencies to stay informed about changes to telemedicine codes and accessibility requirements for commercial, Medicare Advantage, and Medicaid plans. Document these communications to ensure you have a clear record of guidance received.

Finally, store all compliance records securely and establish clear retention policies. Digital records should be backed up regularly and protected with strong security measures. Consider creating an annual compliance report that summarizes your accessibility efforts, highlights improvements, and outlines plans for the future. This not only reinforces your commitment to accessibility but also provides a clear roadmap for continuous progress.

Using Humanly Spaces for Hybrid Care Models

As telehealth continues to grow, many wellness professionals are finding that hybrid care models strike the perfect balance – offering the convenience of virtual sessions alongside the personal touch of in-person meetings. However, making hybrid care work requires more than just flexibility. It demands both ADA-compliant technology and physical spaces that meet the same high accessibility standards. This ensures that clients experience consistent, barrier-free care, whether they’re online or in person.

"Almost every therapist switched to providing some form of teletherapy modality at the start of the COVID-19 pandemic, and many therapists maintain the use of teletherapy within their practices to this day." – Emily Decker, MS, LPC, NC

Humanly’s therapy spaces are specifically designed for hybrid care, offering full ADA compliance. These spaces provide the physical accessibility infrastructure to complement your telehealth platform, ensuring a smooth experience for clients, no matter how they connect with you.

Every therapy space is equipped with ground-floor accessibility, including accessible parking and well-graded ramps, making it easy for clients with mobility challenges to enter. In-suite bathrooms are ADA-compliant, offering privacy and convenience for clients with medical needs or personal care requirements. Thoughtful furniture layouts create wide pathways and provide seating options that work for clients using mobility aids. The professional, adult-focused design ensures a welcoming, respectful atmosphere, avoiding any décor that might feel condescending or inappropriate. On top of that, these spaces feature advanced technology to support hybrid care seamlessly.

Humanly spaces are equipped with high-speed internet, optimized lighting, and flexible scheduling options – whether you need the space hourly, daily, or monthly. This setup allows you to easily transition between virtual and in-person sessions, tailoring care to each client’s needs. Not only do these spaces meet ADA standards, but they also connect you with a network of professionals who are equally committed to accessible, inclusive care.

"Research indicates that a primary reason for poor accessibility and poor disability competence within the counseling field is a lack of awareness around applicable laws and ethical codes combined with a fear of doing the ‘wrong thing,’ which in turn reinforces stigma and inhibits accessibility in therapy for clients of all disability statuses." – Emily Decker, MS, LPC, NC

By incorporating Humanly spaces into your hybrid care model, you address this gap in accessibility knowledge. These spaces are designed by experts who understand the unique needs of both therapists and clients, ensuring your physical environment aligns with the standards of your virtual care platform.

Humanly also fosters a collaborative professional community, connecting you with others who have successfully implemented hybrid care models. This shared network provides opportunities to exchange best practices and learn from real-world experiences. For clients, the consistency of attending sessions in the same accessible, welcoming space – whether in person or virtually – helps create a seamless care experience. Each space is designed to maintain strict confidentiality, ensuring privacy for both in-person and virtual sessions. By integrating Humanly spaces into your practice, you extend the accessibility and quality of your care across every platform and interaction.

Conclusion: Making Telehealth Accessible for Everyone

The strategies discussed earlier highlight the importance of creating telehealth systems that prioritize accessibility. By ensuring platforms are ADA-compliant, training staff effectively, and committing to ongoing compliance efforts, healthcare providers can make quality care available to individuals with disabilities.

In 2021, 37% of U.S. adults reported using telemedicine in the past year, revealing clear gaps in accessibility. Addressing these gaps is essential to ensure that underserved populations have equitable access to healthcare services.

Accessible telehealth doesn’t just fulfill legal obligations – it brings practical benefits. For example, it can reduce staffing costs and improve physician recruitment and retention, especially in rural areas. It also leads to better health outcomes. Erie County Medical Center Corporation’s remote patient monitoring program showed that 74% of patients achieved an average blood pressure below 140/90, with 80% maintaining control for over two months. These results demonstrate how inclusive telehealth can positively impact both patients and providers.

By combining thoughtful platform design, well-trained staff, and regular audits, healthcare practices can maintain accessibility across all service models. Whether it’s using telehealth platforms tailored for individuals who are deaf or blind, offering telephone consultations for those without internet access, or adopting hybrid care models, every effort contributes to a more inclusive healthcare system.

Following ADA standards in telehealth ensures equal access for all patients. By adhering to these standards, providers not only meet legal requirements but also create a healthcare environment that upholds fairness and equity for everyone.

FAQs

What are some practical ways telehealth providers can accommodate patients with disabilities?

Telehealth providers can take practical steps to make their services accessible to patients with disabilities. Here are a few examples:

• Scheduling longer appointment times for patients who may need extra support due to cognitive or communication difficulties.
• Assisting patients with limited hand mobility in completing online forms or paperwork.
• Ensuring accessible communication options, such as offering sign language interpreters or real-time captioning during appointments.

These measures not only help meet the needs of all patients but also align with ADA guidelines, promoting a more inclusive healthcare experience.

How can telehealth providers keep their services ADA-compliant as technology and regulations change?

To ensure compliance with the Americans with Disabilities Act (ADA), telehealth providers need to focus on making their platforms accessible. This includes incorporating features such as captioning, compatibility with screen readers, and intuitive navigation to accommodate users with disabilities. Staying informed about updates to ADA guidelines and federal regulations is equally important to keep up with any changes.

Regular accessibility audits are a must. Additionally, providers should invest in staff training and seek advice from specialists in disability inclusion. Taking these steps helps telehealth platforms remain inclusive and compliant, even as technology and regulatory requirements continue to evolve.

How can telehealth providers train their staff to meet ADA requirements and ensure accessibility for all clients?

To help staff effectively meet ADA standards, telehealth providers should prioritize training programs centered on accessibility and inclusivity. These programs should use real-world scenarios to give staff a clear understanding of the barriers clients with disabilities may encounter and practical ways to overcome them.

Regular education is key and should focus on essential areas like ADA compliance, clear communication strategies, and the use of telehealth tools designed for accessibility. Tailored training for specific roles, combined with hands-on assessments, can build confidence and ensure staff are equipped to deliver accessible services to every client.

Related posts

• How to Choose the Right Location for Your Therapy Practice
• How to Build a Hybrid Therapy Practice
• How to Design Therapy Spaces for Accessibility
• ADA Compliance Checklist for Therapy Spaces