Health care provider as employer

Most often, health care providers are thought of in terms of their relationship to patients or patrons. Significantly, however, the role of a health care provider as an employer cannot be overlooked. Title I of the Americans with Disabilities Act (ADA) applies to private employers with fifteen or more employees, state and local governments, employment agencies, labor unions, and joint labor-management committees. Title I protects the rights of qualified individuals with disabilities in all aspects of employment from recruitment, to the application, to the interview and pre-employment inquiries, to testing, and to employment itself and all of the benefits, privileges, practices, procedures, and policies related to employment. An employer, including a health care provider, cannot discriminate against an applicant or an employee with a disability.

An employer may need to provide a reasonable accommodation to an applicant or employee with a disability. A reasonable accommodation is a change in the work environment or in the way things are typically done in order to ensure an equal employment opportunity. An employer does not have to grant a reasonable accommodation that would cause an undue hardship. The Equal Employment Opportunity Commission, the federal agency that establishes the regulations for Title I, defines an undue hardship as one that is “excessively costly, extensive, substantial, or disruptive, or that would fundamentally alter the nature or operation of the business.” When an employer is attempting to determine if an accommodation is an undue hardship, it must factor in its size, operation, and all resources available.

An employer can require that an employee not pose a direct threat to the health or safety of the employee with a disability or to others. Direct threat must represent a “significant risk of substantial harm” based on objective analysis and medical evidence. The employer must also determine if the risk can be sufficiently reduced or eliminated through provision of a reasonable accommodation.

As with the rest of the ADA, Title I is intended for ensure equal opportunity for individuals with disabilities. Health care providers must be aware of their role not only to serve the public, but their own employees and applicants as well.


Job Accommodation Network, Equal Employment Opportunity Commission. (1992). Technical Manual: Title I of the ADA.


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