[LETTERHEAD]
[DATE]
[PHARMACY]
[ADDRESS]
[CITY, STATE ZIP CODE]
Dear Sir/Madam:
I'm
an advocate for the blind and writing on behalf an individual who is in
need of assistance utilizing your pharmacy services. This individual is
blind and regularly receives numerous prescription medications. Please
direct this letter to the person in your organization responsible for
ensuring compliance with the following regulations:
- 45 CFR § 92.202 (Effective Communication for Individuals with Disabilities; final rule effective July 18, 2016. Reference: 81 FR 31376 - Nondiscrimination in Health Programs and Activities), and
- 28 CFR § 36.303 (Nondiscrimination on the Basis of Disability by Public Accommodations and in Commercial Facilities; Specific Requirements; Auxiliary Aids and Services).
[NAME
OF PHARMACY CUSTOMER], whose address is [ADDRESS OF PHARMACY CUSTOMER]
and whose phone number is [PHONE NUMBER OF PHARMACY CUSTOMER] hereby
makes a request, pursuant to the above referenced rules (copies of which
are enclosed for your convenience), that your pharmacy supply his/her
prescription information in an accessible format.
Please let me know if you have any questions.
Sincerely,
[NAME OF ADVOCATE]
attachments:
45 CFR § 92.202 - select provisions
45 CFR § 92.4 - definitions applicable to 45 CFR §92.202; select provisions
------------------------------
45 CFR § 92.202 - Effective communication for individuals with disabilities.
(a)
A covered entity shall take appropriate steps to ensure that
communications with individuals with disabilities are as effective as
communications with others in health programs and activities, in
accordance with the standards found at 28 CFR 35.160 through 35.164.
Where the regulatory provisions referenced in this section use the term
“public entity,” the term “covered entity” shall apply in its place.
(b)
A recipient or State-based Marketplace℠ shall provide appropriate
auxiliary aids and services to persons with impaired sensory, manual, or
speaking skills, where necessary to afford such persons an equal
opportunity to benefit from the service in question.
------------------------------
45 CFR § 92.4 - Definitions
Auxiliary aids and services include:
(1)
Qualified interpreters on-site or through video remote interpreting
(VRI) services, as defined in 28 CFR 35.104 and 36.303(b); note takers;
real-time computer-aided transcription services; written materials;
exchange of written notes; telephone handset amplifiers; assistive
listening devices; assistive listening systems; telephones compatible
with hearing aids; closed caption decoders; open and closed captioning,
including real-time captioning; voice, text, and video-based
telecommunication products and systems, text telephones (TTYs),
videophones, and captioned telephones, or equally effective
telecommunications devices; videotext displays; accessible electronic
and information technology; or other effective methods of making aurally
delivered information available to individuals who are deaf or hard of
hearing;
(2)
Qualified readers; taped texts; audio recordings; Braille materials and
displays; screen reader software; magnification software; optical
readers; secondary auditory programs; large print materials; accessible
electronic and information technology; or other effective methods of
making visually delivered materials available to individuals who are
blind or have low vision;
(3) Acquisition or modification of equipment and devices; and
(4) Other similar services and actions.
Covered entity means:
(1) An entity that operates a health program or activity, any part of which receives Federal financial assistance;
(2) An entity established under Title I of the ACA that administers a health program or activity; and
(3) The Department.
Disability
means, with respect to an individual, a physical or mental impairment
that substantially limits one or more major life activities of such
individual; a record of such an impairment; or being regarded as having
such an impairment, as defined and construed in the Rehabilitation Act,
29 U.S.C. 705(9)(B), which incorporates the definition of disability in
the ADA, 42 U.S.C. 12102, as amended. Where this part cross-references
regulatory provisions that use the term “handicap,” “handicap” means
“disability” as defined in this section.
Electronic
and information technology means the same as “electronic and
information technology,” or any term that replaces “electronic and
information technology,” as it is defined in 36 CFR 1194.4.
Federal financial assistance.
(1)
Federal financial assistance means any grant, loan, credit, subsidy,
contract (other than a procurement contract but including a contract of
insurance), or any other arrangement by which the Federal government
provides or otherwise makes available assistance in the form of:
(i) Funds;
(ii) Services of Federal personnel; or
(iii) Real and personal property or any interest in or use of such property, including:
(A) Transfers or leases of such property for less than fair market value or for reduced consideration; and
(B)
Proceeds from a subsequent transfer or lease of such property if the
Federal share of its fair market value is not returned to the Federal
government.
(2)
Federal financial assistance the Department provides or otherwise makes
available includes Federal financial assistance that the Department
plays a role in providing or administering, including all tax credits
under Title I of the ACA, as well as payments, subsidies, or other funds
extended by the Department to any entity providing health-related
insurance coverage for payment to or on behalf of an individual
obtaining health-related insurance coverage from that entity or extended
by the Department directly to such individual for payment to any entity
providing health-related insurance coverage.
Health
program or activity means the provision or administration of
health-related services, health-related insurance coverage, or other
health-related coverage, and the provision of assistance to individuals
in obtaining health-related services or health-related insurance
coverage. For an entity principally engaged in providing or
administering health services or health insurance coverage or other
health coverage, all of its operations are considered part of the health
program or activity, except as specifically set forth otherwise in this
part. Such entities include a hospital, health clinic, group health
plan, health insurance issuer, physician's practice, community health
center, nursing facility, residential or community-based treatment
facility, or other similar entity. A health program or activity also
includes all of the operations of a State Medicaid program, a Children's
Health Insurance Program, and the Basic Health Program.
Individual
with a disability means any individual who has a disability as defined
for the purpose of Section 504 of the Rehabilitation Act of 1973, 29
U.S.C. 705(20)(B)-(F), as amended. Where this part cross-references
regulatory provisions applicable to a “handicapped individual,”
“handicapped individual” means “individual with a disability” as defined
in this section.
Qualified
individual with a disability means, with respect to a health program or
activity, an individual with a disability who, with or without
reasonable modifications to policies, practices, or procedures, the
removal of architectural, communication, or transportation barriers, or
the provision of auxiliary aids and services, meets the essential
eligibility requirements for the receipt of aids, benefits, or services
offered or provided by the health program or activity.
Recipient
means any State or its political subdivision, or any instrumentality of
a State or its political subdivision, any public or private agency,
institution, or organization, or other entity, or any individual, to
whom Federal financial assistance is extended directly or through
another recipient and which operates a health program or activity,
including any subunit, successor, assignee, or transferee of a
recipient.
------------------------------
28 CFR § 36.303. Auxiliary aids and services
(a)
General. A public accommodation shall take those steps that may be
necessary to ensure that no individual with a disability is excluded,
denied services, segregated or otherwise treated differently than other
individuals because of the absence of auxiliary aids and services,
unless the public accommodation can demonstrate that taking those steps
would fundamentally alter the nature of the goods, services, facilities,
privileges, advantages, or accommodations being offered or would result
in an undue burden, i.e., significant difficulty or expense.
(b) Examples. The term "auxiliary aids and services" includes-
...
(2)
Qualified readers; taped texts; audio recordings; Brailled materials
and displays; screen reader software; magnification software; optical
readers; secondary auditory programs (SAP); large print materials;
accessible electronic and information technology; or other effective
methods of making visually delivered materials available to individuals
who are blind or have low vision;
(3) Acquisition or modification of equipment or devices; and
(4) Other similar services and actions.
(c) Effective communication.
(1)
A public accommodation shall furnish appropriate auxiliary aids and
services where necessary to ensure effective communication with
individuals with disabilities. This includes an obligation to provide
effective communication to companions who are individuals with
disabilities.
(i)
For purposes of this section, “companion” means a family member,
friend, or associate of an individual seeking access to, or
participating in, the goods, services, facilities, privileges,
advantages, or accommodations of a public accommodation, who, along with
such individual, is an appropriate person with whom the public
accommodation should communicate.
(ii)
The type of auxiliary aid or service necessary to ensure effective
communication will vary in accordance with the method of communication
used by the individual; the nature, length, and complexity of the
communication involved; and the context in which the communication is
taking place. A public accommodation should consult with individuals
with disabilities whenever possible to determine what type of auxiliary
aid is needed to ensure effective communication, but the ultimate
decision as to what measures to take rests with the public
accommodation, provided that the method chosen results in effective
communication. In order to be effective, auxiliary aids and services
must be provided in accessible formats, in a timely manner, and in such a
way as to protect the privacy and independence of the individual with a
disability.
(2)
A public accommodation shall not require an individual with a
disability to bring another individual to interpret for him or her.
(3)
A public accommodation shall not rely on an adult accompanying an
individual with a disability to interpret or facilitate communication,
except—
(i)
In an emergency involving an imminent threat to the safety or welfare
of an individual or the public where there is no interpreter available;
or
(ii)
Where the individual with a disability specifically requests that the
accompanying adult interpret or facilitate communication, the
accompanying adult agrees to provide such assistance, and reliance on
that adult for such assistance is appropriate under the circumstances.
(4)
A public accommodation shall not rely on a minor child to interpret or
facilitate communication, except in an emergency involving an imminent
threat to the safety or welfare of an individual or the public where
there is no interpreter available.
...
(g)
Alternatives. If provision of a particular auxiliary aid or service by a
public accommodation would result in a fundamental alteration in the
nature of the goods, services, facilities, privileges, advantages, or
accommodations being offered or in an undue burden, i.e., significant
difficulty or expense, the public accommodation shall provide an
alternative auxiliary aid or service, if one exists, that would not
result in an alteration or such burden but would nevertheless ensure
that, to the maximum extent possible, individuals with disabilities
receive the goods, services, facilities, privileges, advantages, or
accommodations offered by the public accommodation.