Metroplus Provider Form

212. 908. 8885. Should you have any questions please contact Vivenne Beckford Director of Credentialing at 1. January 2014 Dear MetroPlus Provider The American with Disabilities Act of 1990 ADA is a federal civil rights law that prohibits discrimination against individuals with disabilities in every activities including medical services. This law ensures and requires that medical providers make their services accessible to members. Accessibility to doctors offices and clinics is essential in providing medical care to people with disabilities. Barriers to care can prevent individuals with disabilities from getting routine preventive medical care. MetroPlus providers are also required under the Accessibility of Service Standards located in the provider manual to provide members with access to health care facilities regardless of physical limitations. Enclosed with this mailing is an ADA attestation that must be completed. Please print your name title date and sign the attestation before returning it to us in the enclosed business reply envelope or by fax to 1. Can the accessible entrance be used independently and without assistance 12. Are doormats 1/2 inch high or less with beveled or secured edges 13. Examination tables and all equipment are accessible to people with disabilities. 3. If parking is provided spaces are reserved for people with disabilities pedestrian ramps at sidewalks and drop-offs 8 feet wide for a car and 5 foot access aisle Total Spaces 1-25 26-50 51-75 76-100 Accessible Spaces 5. Does the office have at least one wheelchair-accessible path from an entrance to an exam room Yes No 2. For a provider with a disability-accessible parking space is there a path of travel from the disability-accessible parking space to the facility entrance that does not require the use of stairs Is the path of travel stable firm and slip resistant Except for curb cuts is the path at least 36 inches wide 6. If there are stairs at the main entrance is there also a ramp or lift or is there an alternative accessible entrance 10. 15. The interior doors comply with the criteria set forth above regarding the exterior door. 16. The accessible routes to all public spaces in the facility are 31 inches wide. 17. There is a 5 foot circle or a T-shaped space for a disabled person using a wheelchair to reverse direction in public areas where services are rendered* 18. The call buttons in the hallway are not higher than 42 inches. The controls inside the cab have raised and Braille lettering. Is the public lavatory wheelchair-accessible 22. With respect to the public restroom the accessible route the exterior door and the interior stall doors comply with standards set forth above for exterior doors. Yes No 23. There is at least one wheelchair accessible stall in the public restroom that has an area of at least 5 feet by 5 feet clear of the door swing OR there is at least one stall that is less accessible but that provides greater access than a typical stall either 36 by 69 inches or 48 by 69 inches.