What Web Accessibility Has To Do With The ADA & Section 508
Key Post Highlights
> What are the different web accessibility regulations — and who do they apply to?
> How are web accessibility laws enforced?
> What’s next for web accessibility?
We like to think we live in a world where most of the barriers people with disabilities face in accessing healthcare have been knocked down (think handicapped parking spaces, ramps leading into buildings, doors that open automatically).
The data, however, paints a much harsher reality:
Here are 5 questions to ask yourself while building your vision:
- 1 in 4 adults in the US have some kind of disability.
- 1 in 4 adults with disabilities between the ages of 18 and 44 do not have a regular healthcare provider.
- 1 in 4 adults with disabilities between the ages of 45 and 64 did not have a routine check up in the last year.
While there are many barriers to access that people with disabilities face when seeking healthcare, the inability to navigate your organization’s website should not be one of them. In fact, your healthcare organization may be legally required to provide everyone — including people with disabilities — equal access to your website. But if anything, the pandemic has brought into harsh focus just how far we have to go in this area.
If making your website accessible has usually been an afterthought — if it’s even been thought of at all — it’s time to shift your mindset. Regardless of whether you’re familiar with regulations like the Americans with Disabilities Act (ADA) or Section 508, your organization may be required to comply with certain accessibility standards.
Here’s what you should know about web accessibility regulations and enforcement in the US — including what they mean for healthcare organizations, and what may be coming in the future.
What Are The Different Web Accessibility Regulations — And Who Do They Apply To?
In the US, there are currently two main rules that may apply to your healthcare organization’s website: the Americans with Disabilities Act (ADA) and Section 508 of The Rehabilitation Act (Section 508). This depends on whether you are a business open to the public or a government business (or government contractor).
The Americans With Disabilities Act of 1990 (ADA)
Title III of the ADA requires businesses that are open to the public to provide people with disabilities “full and equal enjoyment of their goods, services, facilities, privileges, advantages, or accommodations” to prevent discrimination. This includes having an accessible website. The ADA website specifically lists “hospitals and medical offices” as an example of a “business open to the public.”
Other examples of businesses that fall under Title III include:
- Retail stores
- Banks
- Hotels
- Restaurants
- Theaters
- Sports arenas
While the ADA does not have its own web accessibility guidelines outlined in the law, the Department of Justice (DOJ) has recently suggested in accessibility-related cases (more on that below) that Web Content Accessibility Guidelines (WCAG), Version 2.1, Level AA is the gold standard it is looking for websites to reach in order to be considered accessible.
What’s WCAG?
The Web Content Accessibility Guidelines (WCAG) is a set of recommendations developed by the Web Accessibility Initiative to make web content more accessible across devices — like computers and mobile phones — for people with a wide range of disabilities (such as blindness, low vision, deafness, hearing loss, limited movement, speech disabilities, and photosensitivity).
There are 3 levels of WCAG conformance: A (lowest), AA (what most organizations aim for), and AAA (highest).
Following WCAG usually makes your website more usable for everyone.
Section 508 of The Rehabilitation Act (Section 508)
Section 508 requires information and communication technology (ICT) — which includes websites — that is “developed, procured, maintained, or used by federal agencies” to be accessible for “people with physical, sensory, or cognitive disabilities.”
Unlike the ADA, which uses the most recent WCAG 2.1 standards, Section 508 requires websites to meet level AA from the earlier WCAG 2.0.
With the exception of government websites or government contractors’ websites, most hospital and healthcare organizations do not have to meet Section 508 requirements. But the good news is, if your website is meeting the WCAG 2.1 AA standards as recommended by the ADA, you’re already meeting Section 508 standards as well. This is because 2.1 standards are built upon 2.0 standards.
How Are Web Accessibility Laws Enforced?
ADA Enforcement
The ADA is usually enforced for web accessibility violations in one of two ways: by private citizens filing lawsuits against companies with inaccessible websites, or by the Department of Justice (DOJ) investigating violations.
The DOJ usually gets involved if a violation is serious and has a profound effect on people with disabilities. For instance, in November 2021, the DOJ reached a settlement with Rite Aid, whose online COVID-19 Vaccine Registration Portal was not fully accessible.
In particular, the DOJ noted that “the calendar on Rite Aid’s website used for scheduling vaccine appointments did not show screen reader users any available appointment times, and people who use the tab key instead of a mouse could not make a choice on a consent form that they needed to fill out before scheduling their appointment.” This made the website inaccessible to people who use screen readers as well as people who use a keyboard rather than a mouse to navigate websites.
With people spending more time online during the pandemic, accessibility has come into the spotlight. And the Rite Aid case is just one example of how the COVID pandemic has brought an increased focus on web accessibility — and with it, an increase in accessibility lawsuits.
Section 508 Enforcement
Government websites have also come under the spotlight thanks to the increased need for accessible online services brought on by the pandemic. A 2021 report by the Information Technology & Innovation Foundation found that nearly 1/3 of the homepages for federal government websites — including the Food and Drug Administration and the National Cancer Institute — did not pass an accessibility test compared with benchmark nongovernmental websites.
And, as with the ADA, Section 508 can also be enforced through lawsuits brought on by consumer complaints. Even though Section 508 guidelines apply to government websites, anyone who uses them can sue for noncompliance, whether they are a government employee or a private citizen.
What’s Next For Web Accessibility?
So now what? With no clear, uniform standards — but a clear need to clean up the virtual house — where does this leave the state of web accessibility? And what does any of this mean for your healthcare organization?
In September 2022, Senator Tammy Duckworth and Representative John Sarbanes introduced the “Websites and Software Applications Accessibility Act” which, like the ADA, would require places of public accommodation to have accessible websites. What sets this proposed legislation apart, however, is that it states, “The Department of Justice (DOJ) must issue standards of accessibility for applicable entities to meet this requirement.”
In other words: web accessibility compliance would no longer be a matter of guesswork. You won’t have to wonder, “Which standards do I think my organization should be following?” Instead, it will only be a matter of implementation.
Admittedly, that may seem like no easy feat at first. But you may be a lot further along than you think. Interested in finding out where your website currently stands? CareContent’s comprehensive web accessibility audits have you covered.
How To Build A Strong Digital Strategy (Hint: Start With a Vision)
Key Post Highlights
> Building a strong digital strategy starts with determining your goals.
> Remember to always think about the actions your audiences should take.
> Don’t forget to focus on voice and tone.
Let’s get right to it: You can’t build a strong digital strategy without having a vision. But you also can’t start the process of creating a vision without knowing what exactly goes into a vision.
Without giving away all of our CareContent secrets, we’ll fill you in on how we get the process going.
Here are 5 questions to ask yourself while building your vision:
1. What are our goals — and what will happen if we don’t achieve them?
This is a pretty lofty task, but it’s also one of the most crucial.
The first step is to solidify your goals. For a healthcare system, these often include service lines you want to highlight to bring in more patients, or revenue streams you’re hoping to maintain or improve. A cancer research center’s goal may be to be the #1 destination for aspiring researchers.
For a nonprofit, the goal could be to bring in more donations. These goals can run the gamut, but it’s important to be as specific as possible.
The next part is to consider the worst case scenario. We like to ask what will happen if you don’t obtain, grow, or maintain [fill in the blank]. For instance, this could be:
- What will happen if we don’t grow our membership?
- What will happen if we don’t receive accreditation from a governing body?
- What will happen if we don’t maintain our current patient population?
- This helps reign in the focus of your goals even more and assists strategists as they create calls to action (CTAs).
2. Who are your key audiences?
There is a long list of potential clients — too long to list all of them here. But some of the most common audiences we focus on are:
- Current or prospective patients
- Providers
- CEOs or marketing managers
- Current or prospective employees
- Donors
- DEI or accessibility leaders
From there, it can be helpful to get even more specific. For example, think about your organization’s average patients’:
- Age
- Income
- Education level
- Current health status
- Potential health problems that could arise from their living situation (e.g., living in the city can worsen asthma for children in lower income families)
Values and beliefs
Also think about how your patients could benefit from your DEI efforts — and how you can go about meeting your DEI goals.
Without nailing down what your audiences should do after visiting your site or reading your content, you probably won’t have much luck in meeting those goals you identified in step #1.
In many cases, each audience has their own call to action (CTA). Some CTAs might overlap between audience groups.
We like to break these down into low-, medium-, and high-level “asks.” For instance, if you’re talking to prospective patients, CTAs might be:
- Low level:
- Follow us on social media
- Learn more about services
- Medium level:
- Find a provider
- Engage with content on social media
- Ask a question
- High level:
- Book an appointment
- Refer a loved one who is in need of care
4. How do you want your audiences to perceive you?
It’s time to focus on voice and tone. This is called your “message architecture.” At CareContent, we do this by giving a (long) list of words, and asking our clients to put each one into a category:
- Who we are
- Who we are not
- Who we want to be
It’s great to do this as a live discussion between multiple stakeholders, rather than sitting down to do it yourself. We’ve heard some fantastic conversations come out of people debating over certain words, and it gives the content team significant insight.
Some of the words we’ve had great discussions about include:
- Assertive
- Cool
- Elite
- Proactive
- Value-oriented
- Witty
- Cutting edge vs. bleeding edge
- Formal vs. informal
5. And finally…a bunch of other questions to consider.
I may be CareContent-grounded if I go into further detail about every single question to ask yourself. So I figure I’d save myself with a quick list:
- Who will you need to interview for discovery? (Stakeholders, audience members, etc.)
- What are the potential risks and roadblocks?
- Who will be in charge of content and design governance? (Rules and procedures for how everything will be overseen and approved)
- What are a few of the main distribution channels you’re aiming to use? (e.g., social media, email newsletters)
- Who are your competitors?
- What can you learn from them?
- What differentiates you from them?
- What will you need in order to achieve your goals from a technical or policy standpoint? (e.g., certifications, new website hosting capabilities, etc.)
Still a bit overwhelmed? Totally understandable. The CareContent team is here to get you started on creating your own digital strategy vision.
Your Healthcare Organization Needs More Women in Leadership Roles
Key Post Highlights
> Women make up 70% of healthcare workers, but they make up only 25% of healthcare leadership.
> Women leaders can help support women’s health initiatives.
> 31% of women leaders compared to 19% of male leaders are reported to provide emotional support to employees.
I believe in data. In the NBA, the data shows who the best players are. In content creation, the data points to what people are searching for and what they really care about. In healthcare, the data shows what’s effective in promoting quality healthcare — and what’s not.
In the case of women leaders in healthcare, the data has historically been a letdown. While women make up 70% of healthcare workers around the world, they make up just 25% of healthcare leadership.
This shouldn’t be a shocking statistic. If you’ve been in healthcare for any length of time, you’ve probably seen or even been a part of this uneven makeup of healthcare leaders.
This International Women’s Day, let’s look at why women are so underrepresented in healthcare leadership, why this is a problem, and why it’s important to support women as they climb their ladders of success.
Why We Need Women Leaders in Healthcare
Other than the obvious factor of women facing an unequal amount of hurdles when it comes to their career success, a lack of women leaders in healthcare is problematic for the health of our country, too.
Having too few women in healthcare leadership means the patient population isn’t accurately reflected in decision-making roles. This causes women to have a limited ability to influence health policies that are based on their lived experiences (not to mention the lived experiences of half of the country).
Women experience unique health issues, ranging from pregnancy to menopause to emotional challenges, like postpartum depression. Problems that are unique to women may not get the attention they deserve if women aren’t in a position to change how things are done.
For instance, American women are three times more likely to die in childbirth compared to women in Norway or Sweden. They also report being more emotionally distressed compared to women in Germany or France. With the right resources and support, women’s health issues might take more of a priority, benefitting the health of all women.
What’s more, women offer a unique — and beneficial — approach to leadership compared to their male counterparts. Women are reported to be more:
- Considerate of the well-being of their employees
- Engaged in providing emotional support
- Supportive of a work-life balance
- Focused on preventing burnout
Women leaders are also more likely to spearhead diversity, equity, and inclusion efforts.
Burnout, emotional distress, a lack of work-life balance, a lack of diversity — these are all common challenges in healthcare. With women in leadership roles, there’s more of a chance they’ll be addressed. In turn, more supportive work environments can lead to happier employees and higher retention rates, which leads to better patient care.
The Future of Women in Healthcare Leadership
The solution to this problem is straightforward — hire more women and support them as they grow in their careers. This doesn’t mean giving them more opportunities than men, but it means evening out the playing field.
Provide reasonable support for working moms, talk about and address gender biases within your organizations, and appoint qualified and deserving women to leadership roles.
As for the next generation of women leaders, here’s my advice to you: Plan your life.
Don’t think that things are just going to fall into place. Plan when you want to have kids. Plan at what point in your career you want to focus on those kids. Plan when in your career you want to grind and try to crash through the glass ceiling.
Remember, life is about using our talents and gifts, but it’s also about being spiritually and emotionally fulfilled. That typically requires making sure you hit several high notes in your personal and professional life.
This International Women’s Day and every day, let’s celebrate all women — working women, women who are the primary caregivers for their children and other family members, and women who inspire other women. It’s together that we will achieve the most for ourselves and the people around us.
Top 10 Take-Home Messages From Modern Healthcare’s Next Up
One of the highlights of this crazy year for me has been producing and hosting a podcast for Modern Healthcare called Next Up. It’s a twice-monthly podcast for emerging healthcare executives.
Next Up came right on time — a year in which healthcare has been on the front and center of everyone’s mind. I was able to talk to several of our nation’s healthcare leaders about diversity in healthcare leadership, how to actually lead, and of course, the impacts of the COVID-19 pandemic.
Next Up’s 3 Most Popular Episodes
- Dealing with Two Crises: COVID-19 and Civil Unrest with Dr. Carladenise Edwards
- You Said What? How Women Healthcare Leaders Can Communicate More Effectively with Dr. Joanne Conroy
- Gender Equity During COVID-19 with Dr. Rosemary Morgan
Here are 10 key takeaways from Modern Healthcare’s Next Up during 2020.
1. On the implications of lacking female representation in healthcare leadership:
“The percentage of women in the health workforce worldwide — it’s 75%. But women only make up 25% of the global health or health workforce decision-making roles or leadership roles, which is a huge discrepancy…So, if these task forces are all made up of men, what does that mean for [women’s] needs?”
–Dr. Rosemary Morgan, John Hopkins Bloomberg School of Public Health, on Next Up’s COVID-19’s Gender Gap, May 30, 2020
2. On going beyond filling the diversity grid in healthcare leadership:
“The next step is actual inclusion, where now that you’ve brought the people into the organization or you’ve given them a seat at the table, are you taking the right steps for them to be included and to actually feel included? What you need is diversity of thought and opinion, so that you can make business decisions, clinical decisions, scientific decisions, based on the knowledge that that person is bringing to the conversation.”
–Dr. Carladenise Edwards, Senior Vice President and Chief Strategy Officer of Henry Ford Health System, on Next Up’s Dealing with Two Crises, June 24, 2020
3. On the power of silence:
“Women often fill up the space, but silence can actually be very powerful, even though it may feel a little uncomfortable. If you’ve said something important, a little silence after it is okay.”
–Joanne Conroy, President and CEO of Dartmouth-Hitchcock on Next Up’s You Said What? How Women Healthcare Leaders Can Communicate More Effectively, July 11, 2020
4. On how to make sure you’re considered for a C-suite role in healthcare:
“Some people have their eyes so much on the next job, they’re not really doing the current one to its full capacity. Sometimes, it’s going outside the traditional lines of the job — offering yourself for a complex project, taking on something that no one else wants to do. Those are the things that often really have people stand out.”
–Nancy Schlichting, former CEO of Henry Ford Health System, on Next Up’s Finding Your Place in Line, July 25, 2020
5. On having what it takes to move up the ranks in healthcare:
“…Get into the trenches. Walk the floors, meet the workforce, understand what are the pressures, the concerns, the highs and lows of your clinical staff. Understand the pressures and highs and lows of your non-patient-facing workforce. And start to make some determinations on where you fit in …”
–Darci Hall, Chief Learning Officer, Providence St. Joseph Health, on Next Up’s Are You Ready to Lead a Hospital?, September 5, 2020
6. On making sure you’re always growing in your healthcare career:
“I would tell myself to be more open to opportunities as they come up…I talk about self-confidence, but I always add the additional admonition — self-confidence without arrogance. We just can’t afford to move in these positions and be arrogant in them, because how will we help others coming behind us if we’re experiencing the queen bee situation?”
–Dr. Vivian Pinn, first full-time Director of the Office of Research on Women’s Health at the National Institutes of Health, on Next Up’s What Would I Tell My 40-Year Old Self?, September 19, 2020
7. On what it takes for hospitals to be prepared for the next pandemic:
“Don’t ever try to fix the roof when there is a storm. You fix the roof when the sun is shining… You should become unbelievably familiar with all the other parts of your organization and become not only familiar, but develop relationships with the leaders and all of the other components. Because that level of trust, and that integration of relationship, is imperative during any kind of a crisis. It’s, in fact, imperative to make sure the system actually works even in normal times.”
–Michael Dowling, CEO of Northwell Health, on Next Up’s Leading Through a Pandemic, October 17, 2020
8. On what to anticipate in healthcare during the Biden-Harris administration:
“I think that this team has been not only monitoring, but preparing for more testing and tracing [of COVID-19], and a much clearer, singular message around the types of sensible public health measures that everyone can and should be taking. That’s the social distancing, the handwashing, the mask-wearing …”
–Ceci Connolly, President and CEO at Alliance of Community Health Plans, on Next Up’s How to Navigate the Murky Post-Election Waters, November 11, 2020 (Bonus Election Episode)
9. On possible solutions for obstacles rural healthcare organizations are facing:
“It’s been a continued goal of a lot of these standalone hospitals to try to find partners through some sort of merger or acquisition. A lot of times they have more resources and can offer better deals, higher salaries to doctors, specialists, nurses, even administrative staff. That goes a long way.”
–Alex Kacik, Hospital Operations Reporter for Modern Healthcare, on Next Up’s Saving Rural Health, November 11, 2020
10. On how healthcare systems can actually impact public health:
“It’s not about patients — it’s about populations, it’s about policy. We need to lean on healthcare for their power. Take something like asthma, and you have kids who are coming into the ER. If the reason they’re coming in is because of something in the apartment building that they live in, then there’s no clinical remedy to that. You have to actually change the environment. So, there is a real argument for healthcare putting low-interest loans on the street, to that property owner, so they can change out the HVAC. The hospital makes its money back on the loan, and all of a sudden, we resolve the issue that was driving the children into the ER with asthma.”
–Brian Castrucci, President and CEO of the de Beaumont Foundation, on Next Up’s COVID-19, Social Determinants Highlight Health Inequities — What Next?, November 28, 2020
Check out our latest episode with Carter Dredge, Senior Vice President and Chief Transformation Officer at SSM Health, about what aspiring leaders need to know about the role of disruption and innovation in healthcare.
