Source: https://www.ada.gov/pike_co_healthattk.htm
Timestamp: 2018-02-22 04:56:00
Document Index: 410762577

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Settlement Agreement between the United States and The Pike County Health Department, Attachment K
The technical requirements and, where appropriate, the scoping requirements of the Standards are used as a guide for determining whether a program or activity held in an existing facility is “readily accessible to and usable by” persons with disabilities and for determining what changes are necessary to make this program or activity accessible if it continues to be provided in the existing facility in question. See 28 C.F.R. §§35.150(b)(1), 35.151.
In order to ensure that each of the Health Department programs, services, and activities operating at a facility that is the subject of this Agreement, when viewed in its entirety, are readily accessible to and usable by persons with mobility impairments, the Health Department will take the following actions:
1. Within 12 months of the effective date of this Agreement, the Health Department will complete the following modifications to the Pike County Health Department, Mary Pauline Fox Building, located at 119 River Drive, Pikeville:
Parking at patient entrance: Although the parking lot has a total of 2 parking spaces, and both parking spaces are reserved for people with disabilities, the spaces are not accessible because one of the spaces is not designated as a van accessible space, the access aisle is not wide enough to accommodate a van accessible space, and the vertical signs may be obstructed by a parked vehicle. On the shortest accessible route to the accessible entrance, provide a total of 1 van accessible space designated as reserved for people with disabilities. The van accessible space must be a minimum of 96 inches wide and served by an access aisle at least 96 inches wide. Provide a vertical sign with the International Symbol of Accessibility located such that it cannot be obstructed by a parked vehicle. Provide an additional “Van-Accessible” sign located below the International Symbol of Accessibility. The space and access aisle for persons with disabilities must be flat and level, with slopes and cross-slopes not exceeding 1:50 in all directions, and that their surfaces must be firm, stable, and slip-resistant. Standards §§4.1.2(5), 4.6, 4.30.7(1).
Patient entrance vestibule: The patient entrance, which has two doors in a series creating a vestibule, is inaccessible because the space between the doors is 38 inches (plus the width of the door swinging into the space). Provide an accessible entrance to the patient area, such that the space between any two doors in series is at least 48 inches plus the width of any door swinging into the space. Ensure that doors in series swing either in the same direction or away from the space between the doors. Standards §4.13.7, Fig. 26.
General parking lot (covered lot): Although the parking lot has a total of 68 parking spaces, there is no van accessible parking space reserved for people with disabilities, the 2 standard parking spaces reserved for people with disabilities share an access aisle that is 59 inches wide, the built-up curb ramp projects into the access aisle, and the spaces do not have vertical signs with the International Symbol of Accessibility. On the shortest accessible route to the accessible entrance, provide a total of 1 van accessible space and 2 standard spaces designated as reserved for people with disabilities. Ensure that standard accessible spaces are a minimum of 96 inches wide and served by access aisles at least 60 inches wide. Ensure that van accessible space is a minimum of 96 inches wide and served by an access aisle at least 96 inches wide. At all spaces designated as reserved for persons with disabilities, provide vertical signs with the International Symbol of Accessibility located such that they cannot be obstructed by parked vehicles. At van accessible spaces, provide an additional “Van-Accessible” sign located below the International Symbol of Accessibility. Ensure that all spaces and access aisles for persons with disabilities are flat and level, with slopes and cross-slopes not exceeding 1:50 (2%) in all directions, and that their surfaces are firm, stable, and slip-resistant. An acceptable solution is to expand the access aisle on either or both sides of the built-up curb ramp. Ensure that each designated accessible parking space has an adjacent, level access aisle that is at least 60 inches wide (96 inches wide if van-accessible). Standards §§4.1.2(5), 4.6, 4.30.7(1).
Permanent room signage: Throughout the facility, the signage is not mounted 60 inches above the finished floor. Provide permanent room signage with upper case, sans serif or simple serif type letters and numerals, meeting the requirements of the Standards for character height, raised characters, finish and contrast, accompanied by Grade 2 Braille; mounted on the wall adjacent to the latch side of the door or on the nearest adjacent wall at a height of 60 inches above the finished floor to the centerline of the sign; and located so that a person may approach within 3 inches of the signage without encountering protruding objects or standing within the swing of a door. Standards §§4.30.1, 4.30.4, 4.30.5, 4.30.6.
Knob hardware: Throughout the facility, many interior doors use knob hardware that requires tight grasping and twisting of the wrist to operate. At each such location, provide doors with hardware that is easy to grasp with one hand and that does not require tight grasping, pinching, or twisting of the wrist to operate. Lever-operated mechanisms, push-type mechanisms, and U-shaped handles are acceptable designs. Standards §§4.1.3(7)(b), 4.13.9.
Elevator: The elevator is inaccessible because: (1) the hall call buttons are mounted 38 ½ inches above the finished floor, and (2) although emergency communications are provided, the system is not identified by raised lettering and symbol, the handset cord measures 26 inches and the system does not work without voice communication. Provide hall (lobby) call buttons with visual signals indicating when each call is registered and when each call is answered. Ensure that the call buttons are centered at 42 inches above the finished floor, a minimum of ¾ inch in the smallest dimension, with the button designating the up direction on top; that the call buttons are raised or flush; and that objects mounted beneath hall call buttons do not project into the elevator lobby more than 4 inches. Provide a two-way communication system such that it does not require voice communication, the highest operable part is a maximum of 48 inches above the finished floor of the car, and it is identified by a raised symbol and lettering located adjacent to the device. If the system uses a handset, ensure that the length of the cord from the panel to the handset is at least 29 inches. Standards §§4.10.3, 4.10.9, 4.10.14, Fig.20.
Lower drinking fountain: The water height of the “lower” drinking fountain measures less than 4 inches. Provide a drinking fountain that directs the water flow in a trajectory that is nearly parallel to the front of the unit and is positioned so the flow of water is within 3 inches of the front edge of the fountain and at least 4 inches high. Standards §§4.15, 4.27.4, Fig. 27.
Public telephone (located on the first floor, near the waiting and intake areas)
The knee space depth at the telephone measures 6 inches and there is no volume control mechanism. Provide an accessible telephone with a clear floor space of at least 30 inches by 48 inches that allows either a forward or parallel approach by a person using a wheelchair such that bases, enclosures, and fixed seats do not impede approaches to the telephone; with the highest operable part of the telephone mounted no more than 48 inches above the floor for a front approach or no more than 54 inches above the floor for a side approach; that is hearing aid compatible and has a volume control mechanism. Standards §§4.31, 4.30.7(2).
The telephone protrudes into the walkway and is not detectable to a low vision or blind person using a cane. Provide a circulation path at this location such that no objects with their bottom leading edges measuring between 27 inches and 80 inches above the finished floor protrude more than 4 inches into walks, halls, corridors, passageways, or aisles. Free-standing objects mounted on posts or pylons may overhang 12 inches maximum from 27 inches to 80 inches above the ground or finished floor. Providing a cane-detectable barrier is an acceptable solution. Standards §4.4.
Men’s and women’s 1st floor toilet rooms,
The toilet room signs are not mounted on the latch side of the door. Provide toilet room signs with the International Symbol of Accessibility and raised and Braille characters mounted on the wall adjacent to the latch side of the door with the centerline of the sign 60 inches above the finished floor and situated such that a person can approach within 3 inches of the sign without encountering an obstruction or standing within a door swing. Standards §§4.1.2(7)(d), 4.30.1, 4.30.4, 4.30.5, 4.30.6, 4.30.7.
The pressure required to open each toilet room door exceeds 5 pounds. At each location, provide doors that require no more than 5 pounds of force to open. Standards §4.13.11(2)(b).
No accessible mirror is provided in either toilet room. Provide mirrors with the bottom edge of its reflecting surface no more than 40 inches above the finished floor. Standards §4.19.6.
The lavatory in the women’s toilet room is inaccessible because the hot water pipes are not insulated or otherwise configured to protect against contact. Provide hot water and drain pipes that are insulated or otherwise configured to protect against contact. Standards §4.19.4.
Toilet stall for people using wheelchairs
No accessible coat hooks have been provided. At each location, provide coat hooks at a maximum height above the finished floor of 48 inches for a forward approach or 54 inches for a side approach and that is accompanied by clear floor space of 30 by 48 inches that allows a forward or parallel approach by a person using a wheelchair. Standards §§4.25.2, 4.25.3, 4.2.4, 4.2.5, 4.2.6.
In the men’s toilet room, the toilet paper dispenser is mounted 38 inches from the rear wall. Provide a toilet paper dispenser that is mounted with its top at least 1½ inches under the side grab bar, or at least 18 inches above the side grab bar, at 36 inches or less from the rear wall and centered at least 19 inches above the finished floor. Standards §4.17.3, Fig. 30(d).
At each location, the far ends of the side grab bars are mounted 46 inches from the rear wall. Provide a side grab bar at each location that is at least 40 inches in overall length, with the far end mounted at least 52 inches from the rear wall and the closer end 12 inches or less from the rear wall. Standards §4.17.6, Figs. 30(a), (d).
Single user toilet room at Clinic A: There is no signage directing people with disabilities to the accessible toilet rooms in the intake area. Provide accessible directional signage with the International Symbol of Accessibility at inaccessible toilet rooms indicating the location of the nearest accessible toilet room, and provide accessible signage with the International Symbol of Accessibility at all accessible toilet rooms. Standards §§4.1.2(7)(d), 4.1.6(3)(e)(iii), 4.30.1, 4.30.2, 4.30.3, 4.30.5, 4.30.7.
Drinking fountain located on 2nd floor: Although a “lower” drinking fountain is provided, there is no drinking fountain provided for people who have difficulty bending or stooping. Provide a drinking fountain that is accessible to people who have difficulty bending or stooping. This can be accommodated by the use of a “hi-lo” fountain; by providing one fountain accessible to those who use wheelchairs and one fountain at a standard height convenient for those who have difficulty bending; by providing a fountain accessible to people who use wheelchairs and a cup dispenser, or by such other means as would achieve the required accessibility for each group of people. Standards §4.1.3(10)(a).
Men’s and women’s 2nd floor toilet rooms
The toilet room signs are not mounted on the latch side of the doors. At each location, provide toilet room signs with the International Symbol of Accessibility and raised and Braille characters mounted on the wall adjacent to the latch side of the door with the centerline of the sign 60 inches above the finished floor and situated such that a person can approach within 3 inches of the sign without encountering an obstruction or standing within a door swing. Standards §§4.1.2(7)(d), 4.30.1, 4.30.4, 4.30.5, 4.30.6, 4.30.7.
The pressure required to open the toilet room doors exceeds 5 pounds. Provide doors that require no more than 5 pounds of force to open. Standards §4.13.11(2)(b).
No accessible mirror is provided at either location. At each location, provide mirrors with the bottom edge of its reflecting surface no more than 40 inches above the finished floor. Standards §4.19.6.
The toilet seat cover dispenser in the women’s toilet room is mounted 60 inches above the finished floor. Provide a toilet seat cover dispenser with the controls a maximum height above the finished floor of 48 inches for a forward approach or 54 inches for a side approach and that is accompanied by clear floor space of 30 by 48 inches that allows a forward or parallel approach by a person using a wheelchair. Standards §§4.27.2, 4.27.3, 4.2.4, 4.2.5, 4.2.6.
Toilet stalls for wheelchair users
The side grab bars at the toilets are inaccessible because the far ends are mounted 46 inches from the rear wall. Provide side grab bars that are at least 40 inches in overall length, with the far ends mounted at least 52 inches from the rear wall and the closer ends 12 inches or less from the rear wall; mounted 33 to 36 inches above the finished floor; with a diameter between 1¼ and 1½ inches; with 1½ inches between the grab bar and the wall; and at least 1½ inches between the grab bar and any object beside or below it and at least 18 inches between the grab bar and any object above it. Standards §§4.17.6, 4.26.2, Figs. 30(a), (d), 39.
2nd floor renovations: The Health Department has altered employee areas on the second floor, including two single user toilet rooms. These portions must comply with the ADA Standards for alterations. The Health Department will submit to the Department for approval all construction plans and specifications for these alterations. In addition, the Health Department will submit photographs of the altered portions. Such photographs shall show a tape measure in the photos to document compliance with the Standards.
The Health Department is currently evaluating whether the Phelps Clinic will be relocated to an existing or new facility or renovated in its current location. If the Health Department chooses to provide program access to the programs, services, and activities at the Phelps Clinic at a different location, within 12 months of the effective date of this Agreement, the Health Department will submit to the Department for approval all construction plans and specifications for alterations or new construction of the clinic. Alternatively, within 18 months of the effective date of this Agreement, the Health Department will complete the following modifications to the Phelps Clinic located at 38217 State Highway 194E, Phelps:
Parking: Although the parking lot has a total of approximately 3 parking spaces, the parking space reserved for people with disabilities is not accessible because its surface is not firm, stable, and slip resistant; it does not have an access aisle; it is not on the shortest possible route to the accessible entrance; and the vertical sign does not have additional “van accessible” signage. On the shortest accessible route to the accessible entrance, provide a total of 1 van accessible space designated as reserved for people with disabilities. The van accessible spaces must be a minimum of 96 inches wide and served by access aisles at least 96 inches wide. Provide vertical signs with the International Symbol of Accessibility located such that they cannot be obstructed by parked vehicles. Provide an additional “Van-Accessible” sign located below the International Symbol of Accessibility. The space and access aisle for persons with disabilities must be flat and level, with slopes and cross-slopes not exceeding 1:50 (2%) in all directions, and their surfaces must be firm, stable, and slip-resistant. Standards §§4.1.2(5), 4.6, 4.30.7(1).
Route to main entrance ramp: The route from the parking area to the main entrance ramp is not firm, stable, and slip-resistant, and there is an abrupt change in level (approximately 1 inch to 1 ½ inches) where the grass meets the wooden landing at the bottom of the ramp. Provide at least one accessible route within the boundary of the site connecting these elements that, to the maximum extent feasible, coincides with the route for the general public. The accessible route must have a surface that is firm, stable, and slip resistant; and have no level changes in excess of ½ inch vertically. Standards §§4.3, 4.5, Fig. 7.
Ramp: The ramp to the main entrance is inaccessible because the slope is 13.3% to 16.9%, the surface is not level due to the uneven planks, there is a 1 inch change in level between the ramp base and first leg, there is inadequate edge protection on the left side of the ramp, there is no handrail on the left side of the ramp; the handrail on the right side lacks extensions at the top and bottom of the ramp, the ends of the handrail are not rounded or returned smoothly to the floor or post; the gripping surface of the handrail is 5 inches wide, and the handrail is not smooth and free of splinters. Provide a ramp that is at least 36 inches wide with a slope not exceeding 1:12 (8.33%) and a cross slope not exceeding 1:50 (2%); with level landings at least as wide as the ramp and 60 inches long at the top and bottom of the ramp; and with edge protection at least 2 inches high at the drop off sides. Provide handrails that are between 1¼ inches and 1½ inches in diameter with a continuous gripping surface along both sides of the ramp, extending at least 12 inches beyond the top and bottom of the ramp parallel with the ground surface. Ensure that handrails are mounted between 34 inches and 38 inches above the ramp surface and 1½ inches from the wall, with ends rounded or returned smoothly to the floor, wall, or post, and that they do not rotate within their fittings. Ensure that the ramp and approaches are designed so that water will not accumulate on walking surfaces. Standards §§4.3.8, 4.8.
Main entrance: There is a 1 inch change in level at the threshold to the door. Provide an accessible door with a threshold that is no greater than ¼ inch, or is no greater than ½ inch and is beveled with a slope no greater than 1:2. Standards §§4.13.8, 4.5.2.
Ramp to emergency exit: The ramp is inaccessible because the surface is not level, the cross slope at the top of the ramp measures 3.3%, the top landing is not level (2.4% cross slope, 5.6% running slope); the bottom landing is not level (5.4% running slope), the handrails lack extensions at the top and bottom of the ramp, the ends of the handrails are not rounded or returned smoothly to the wall or post, the handrail gripping surface measures 5 inches wide and is not free of splinters; and there is a 1 to 1 ½ inch gap between the base of the ramp and the landing. Provide a ramp that is at least 36 inches wide with a slope not exceeding 1:12 (8.33%) and a cross slope not exceeding 1:50 (2%); with level landings at least as wide as the ramp and 60 inches long at the top and bottom of the ramp; and with edge protection at least 2 inches high at the drop off sides. Provide handrails that are between 1¼ inches and 1½ inches in diameter with a continuous gripping surface along both sides of the ramp, extending at least 12 inches beyond the top and bottom of the ramp parallel with the ground surface. Ensure that handrails are mounted between 34 inches and 38 inches above the ramp surface and 1½ inches from the wall, with ends rounded or returned smoothly to the floor, wall, or post, and that they do not rotate within their fittings. Ensure that the ramp and approaches are designed so that water will not accumulate on walking surfaces. Standards §§4.3.8, 4.8.
Clinic “A”: The clinic door has knob hardware. Provide a door with hardware that is easy to grasp with one hand and that does not require tight grasping, pinching, or twisting of the wrist to operate. Lever-operated mechanisms, push-type mechanisms, and U-shaped handles are acceptable designs. Standards §4.13.9.
Hallway from lobby: The route is 33 inches wide. Provide an accessible route with a minimum clear width of 36 inches, except at doors, where the width may decrease to 32 inches. Standards §§4.3.3, 4.13.
Clinic “B”
The door to Clinic B has an opening width of 27 inches. Provide a door with a clear opening of 32 inches with the door open 90 degrees, measured between the face of the door and the opposite stop. Standards §4.13.5, Fig. 24.
The clinic door has knob hardware. Provide a door with hardware that is easy to grasp with one hand and that does not require tight grasping, pinching, or twisting of the wrist to operate. Lever-operated mechanisms, push-type mechanisms, and U-shaped handles are acceptable designs. Standards §4.13.9.
The clinic door, which is approached from the latch side, is inaccessible because there is approximately 27-28 inches of maneuvering depth at the latch on the pull side of the door. On the pull side of the door, provide a path of travel at least 48 inches wide for a side approach and at least 24 inches of clear maneuvering space adjacent to the latch side of the door. Standards §4.13.6, Fig. 25(c).
The door to the toilet room, which is accessed from a latch or hinge side approach, is inaccessible because there is 17 inches of maneuvering clearance at the latch on the pull side of the door. On the pull side of the door, provide a path of travel at least 48 inches wide for a side approach and at least 24 inches of clear maneuvering space adjacent to the latch side of the door. Standards §4.13.6, Fig. 25(c).
No accessible mirror is provided. Provide a mirror with the bottom edge of its reflecting surface no more than 40 inches above the finished floor. Standards §4.19.6.
The paper towel dispenser requires tight grasping to operate. Provide a paper towel dispenser with mechanical controls, if any, that can be operated with 5 lbf or less and that can be used with one hand and without tight grasping, pinching, or twisting of the wrist (lever-operated, push-type, and electronically controlled mechanisms are examples of acceptable designs). Standards §4.27.4.
47. The lavatory is inaccessible because the hot water pipes are not insulated or otherwise configured to protect against contact. Provide hot water and drain pipes that are insulated or otherwise configured to protect against contact. Standards §4.19.4.
The toilet centerline measures 23 inches from the side wall. Provide a toilet with a centerline that measures 18 inches from the near side wall. Standards §4.16.2, Fig. 28.
The toilet flush control is on the “closed” side of the toilet. Provide a flush control mounted on the “open” side of the toilet’s clear floor space; 44 inches or less above the finished floor; and requiring a maximum of 5 pounds of force to operate; or provide an automatic flush device. Standards §§4.16.5, 4.27.4.
The side grab bar at the toilet is inaccessible because the far end of the grab bar is mounted 45 inches from the rear wall and portions of the space between the grab bar and the wall measures 3 inches. Provide a side grab bar that is at least 42 inches in overall length, with the far end mounted at least 54 inches from the rear wall and the closer end 12 inches or less from the rear wall; mounted 33 to 36 inches above the finished floor; with a diameter between 1¼ and 1½ inches; with 1½ inches between the grab bar and the wall; and at least 1½ inches between the grab bar and any object beside or below it and at least 18 inches between the grab bar and any object above it. Standards §§4.16.4, 4.26.2, Figs. 29, 39.
Portions of the space between the rear grab bar and the wall measures 3 inches and there is a 1 inch space between the rear grab bar and the top of the toilet tank. Provide a rear grab bar that is at least 36 inches in overall length, with the closer end no more than 6 inches from the side wall; mounted 33 to 36 inches above the finished floor; with a diameter between 11⁄4 and 11⁄2 inches; with 11⁄2 inches between the grab bar and the wall; and at least 11⁄2 inches between the grab bar and any object beside or below it and at least 18 inches between the grab bar and any other object above it. Standards §§4.16.4, 4.26.2, Figs. 29, 39.