The Health Care Workforce: How to Understand Accommodations

The celebrations of the twenty-fifth anniversary of the ADA have sounded the somber note that people with disabilities continue to be under- and unemployed in disproportionate numbers. Health care — because it represents nearly 20% of GDP, is to some extent funded by pooled resources, and is familiar with disabilities and accommodations for them — ought to be an industry at the forefront of disability employment. Yet it is not; and in this article we document some of the reasons why. Health care employers are too likely to engage in stereotyped assessments of the ability of people with disabilities to perform essential job responsibilities or judgments of the likelihood that an employee poses a direct threat to patient safety — and courts are too likely to defer. Refusals by training programs to make accommodations adversely affect the pipeline of eligible workers. Deploying an account of reasonable accommodations as a civil right, we suggest strategies for individualized assessment to counter these barriers.