How Duke Ensures an Accessible, Welcoming Environment for You

Q: What is Duke Access and Accommodation Services and what does it do?

A: We have a very broad charge at the university and health system. We serve anyone and everyone who requires accommodations under the Americans with Disabilities Act and other laws. We also assist individuals and units who have questions about making things more accessible or what we must do to meet certain legal obligations. We serve every kind of employee you can think of: Staff, faculty, temporary, those in their first 90 days, or who are from a third-party contractor. In addition, we serve the students, patients in Duke Health, visitors, and any others who may wish to access Duke's services or programs.

As part of the interactive process, we not only assist individuals requesting accommodations, we also work with those who will need to provide accommodations, such as faculty members or supervisors. We also assist folks who have questions about how they can make their units, their services, their supervisory style more accessible and inclusive in terms of a variety of disabilities.

The number of formal requests we received in 2023 was 523 – up from 102 in 2015.

Ultimately, I want to demystify what our office is about, because folks can access us in a variety of ways. We are available to discuss any questions that they might have or help them understand their options and resources.

Q: Who has a disability?

A: Nationally, the Centers for Disease Control and Prevention estimates that more than 1 in 4 Americans has a disability. Think about that: It's unlikely that you would know that any one person you are interacting with has a disability.

When we think about disabilities, there's such a significant portion of folks that it's not readily apparent. Because of this, we try to give guidance on suggested practices that can ensure our programs and spaces are accessible to as many people as possible without them needing to request modifications.

In terms of the legal definition of disability under the Americans with Disabilities Act, it is quite broadly defined. It includes any physical or mental condition that substantially limits one or more major life activities. Disability is such a large umbrella. It encompasses so many different types of disabilities, including the ones you don't necessarily think of. There are many that people are not familiar with or don't realize are disabilities that would entitle them to accommodations that help them do their work or access facilities. Some examples include anxiety, depression, cancer, diabetes or temporary conditions such as a broken wrist or fractured leg.

The areas where we're seeing more incidence of disclosed disabilities and requests for accommodations is in mental health, learning disabilities and chronic health. We're seeing these overarching increases across the board at Duke, and also in national numbers.

Q: What are examples of accommodations provided by your office?

A: It really depends on the person. Two people can have the exact same disability but benefit from completely different types of accommodations. Part of our process is in working with individuals to pinpoint any disability-related barriers they might encounter in their work and evaluate potentially effective accommodations to help mitigate those barriers. This is also done in partnership with Employee Occupational Health and Wellness (EOHW), which works with employees to gather documentation supporting any medically necessary restrictions.

One thing that's important to remember, especially for supervisors and managers around accommodations, is a significant portion of them are low-cost or no cost.

Oftentimes, it's modifications around supervisory and communication style, rethinking how you train, offering feedback in a written format, having more regular check-ins or having certain structures to those check-ins.

Other types of accommodations that we see include things like physical access or parking or transportation accommodations. Someone might need modifications to the structure of their physical environment. That's something that we can help with. It might mean getting access to transportation options or parking options that would allow more ready access, as well.

Other types of accommodations that we see is with assistive technology, identifying potential devices or tools that might help reduce barriers or mitigate barriers. That could be through something like read-and-write software or a screen reader that reads information in an electronic file into an audible format so that you're not having to use a visual way of getting that information. It can also be specific tools about for how you do the job, like magnifying glasses or things that someone could allow for greater grip strength.

Once we understand what accommodations are medically necessary and effective, we then go to a department or unit to determine which ones can be implemented reasonably. Again, this is a case-by-case assessment depending on the impact of that particular accommodation in that particular unit.

Q: How does the process of implementing accommodations work?

A: We try to identify individualized, effective accommodations, and then we go to a department or unit to determine which ones can be implemented reasonably. Part of that process includes a conversation to figure out: What’s your experience? What's worked for you in the past? What kinds of barriers are you experiencing, so we can identify solutions?

They can come to us very formally and go through the process where we work with them and the unit to identify what, if any, reasonable accommodations are available.

If folks have concerns about disclosing personal information, they can still meet with us, even without telling us who they are. I've had plenty of folks who come into the office in person and don't tell me their name, and that's absolutely fine. I want to make sure that people feel comfortable reaching out and exploring resources rather than not getting the accommodations or assistance that might support their continued success here.

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