# Dental Treatment Room Hinged Door



## Colockum Meghan (Jun 29, 2020)

Hello,
IBC 2018 and ANSI 117.1 2017


Some architects are doing this in some states and I have adopted it for our design work. The main theme being that the dental treatment room is a an area of 'restricted use to public access in that the public / patient can only enter by permission of staff'. 
The solution on a hinged door to avoid the requirement of 18" clear on the latch pull side of the door is to a) have a 'hold open' feature on the door and b) have a sign indicating as described above.
Your thoughts?


----------



## north star (Jun 29, 2020)

*@ ~ @ ~ @*

For clarity, what section or sections are you citing
that will allow this ?

*@ ~ @ ~ @*


----------



## Colockum Meghan (Jun 29, 2020)

Well I don't know exactly? The architect noted it acceptable at their local plan check as 'equivalent accommodation'.


----------



## Colockum Meghan (Jun 29, 2020)

I found this at the US Access Board site:

*Appendix A to Part 1194 – Section 508 of the Rehabilitation Act: Application and Scoping Requirements
508 Chapter 1: Application and Administration
E101 General*
E101.2 Equivalent Facilitation. The use of an alternative design or technology that results in substantially equivalent or greater accessibility and usability by individuals with disabilities than would be provided by conformance to one or more of the requirements in Chapters 4 and 5 of the Revised 508 Standards is permitted. The functional performance criteria in Chapter 3 shall be used to determine whether substantially equivalent or greater accessibility and usability is provided to individuals with disabilities.


----------



## Colockum Meghan (Jun 29, 2020)

I found this also but it seems to relate to renovations:
*2010 STANDARDS FOR STATE AND LOCAL GOVERNMENT FACILITIES: TITLE II

28 CFR 35.151 New construction and alterations*
*DOJ’s 2010 ADA Standards*
*(b) Alterations*
*(c) Accessibility standards and compliance date.
*
(1) If physical construction or alterations commence after July 26, 1992, but prior to the September 15, 2010, then new construction and alterations subject to this section must comply with either the UFAS or the 1991 Standards except that the elevator exemption contained at section 4.1.3(5) and section 4.1.6(1)(k) of the 1991 Standards shall not apply. Departures from particular requirements of either standard by the use of other methods shall be permitted when it is clearly evident that equivalent access to the facility or part of the facility is thereby provided.

(2) If physical construction or alterations commence on or after September 15, 2010, and before March 15, 2012, then new construction and alterations subject to this section may comply with one of the following: the 2010 Standards, UFAS, or the 1991 Standards except that the elevator exemption contained at section 4.1.3(5) and section 4.1.6(1)(k) of the 1991 Standards shall not apply. Departures from particular requirements of either standard by the use of other methods shall be permitted when it is clearly evident that equivalent access to the facility or part of the facility is thereby provided.


And this:
*2010 STANDARDS FOR TITLES II AND III FACILITIES: 2004 ADAAG
Chapter 1: Application and Administration

103 Equivalent Facilitation*
Nothing in these requirements prevents the use of designs, products, or technologies as alternatives to those prescribed, provided they result in substantially equivalent or greater accessibility and usability.


----------



## mtlogcabin (Jun 29, 2020)

Colockum Meghan said:


> The solution on a hinged door to avoid the requirement of 18" clear on the latch pull side of the door is to a) have a 'hold open' feature on the door and b) have a sign indicating as described above.
> Your thoughts?


As long as there is no automatic release of the hold open in the event of a fire or smoke alarm going off I do not see an issue.
Think of a patient who uses a walker is left in the room by themselves while the Novocain takes effect and an emergency happens. Will they be able to get out by themselves.


----------



## Colockum Meghan (Jun 29, 2020)

Thanks for your thoughts!


----------



## RLGA (Jun 29, 2020)

mtlogcabin said:


> As long as there is no automatic release of the hold open in the event of a fire or smoke alarm going off I do not see an issue.
> Think of a patient who uses a walker is left in the room by themselves while the Novocain takes effect and an emergency happens. Will they be able to get out by themselves.


I agree, provided the door is not required to be fire-rated. 

For ANSI, it will be a matter of getting the building official to accept it. For ADA, it will be up to the DOJ should someone file a complaint. You could get advice from the Access Board's technical assistance.


----------



## Colockum Meghan (Jun 29, 2020)

Good points. . . I did contact the Access Board so we'll see if they salute. Thank you!


----------



## Colockum Meghan (Jun 30, 2020)

An update. I spoke with Bobby at the Access Board and he didn't think there was any problem with interpretation as 'equivalent accommodation'. However, he did advise me to contact DOJ to see what their interpretation might be. FYI


----------



## Tim Mailloux (Jul 7, 2020)

this only addresses handicap patients, what about a handicap dentist or dental technician?


----------



## Colockum Meghan (Jul 7, 2020)

Assistant's can't be in a wheelchair, they have to be able to perform CPR. I don't see how a dentist could be in a wheelchair and do procedures. Ergonomically seems not possible. However, I don't know of any so perhaps there are some? 
Front staff can be in a wheelchair, but this would apply to them also I would think?


----------



## classicT (Jul 7, 2020)

Colockum Meghan said:


> Assistant's can't be in a wheelchair, they have to be able to perform CPR. I don't see how a dentist could be in a wheelchair and do procedures. Ergonomically seems not possible. However, I don't know of any so perhaps there are some?
> Front staff can be in a wheelchair, but this would apply to them also I would think?


Accessibility does not mean wheelchair.

Other disabilities that may not preclude employment may require accessible features. Break an ankle and you may have a kneel-on scooter (image below). Or a walker, maybe crutches. 

And beyond that, if an employer can provide reasonable accommodation for a disability, typically they have to. Whats to say a disable assistant who is confined to a wheelchair cannot have someone assigned to assist if CPR is necessary. I can not foresee that someone is flat-out prohibited from being a dental assistant if they utilize a wheelchair.


----------



## Colockum Meghan (Jul 7, 2020)

Interesting thoughts, and of course part of the consideration for the design, thank you!


----------



## ADAguy (Jul 8, 2020)

Colockum Meghan said:


> Interesting thoughts, and of course part of the consideration for the design, thank you!



You need to be "aware" (at all times as a designer) that there are "no" limits to what those with limited abilities can do. Technology is a wonderful thing.


----------



## classicT (Jul 8, 2020)

ADAguy said:


> You need to be "aware" (at all times as a designer) that there are "no" limits to what those with limited abilities can do. Technology is a wonderful thing.


Case in point being standing wheelchairs.


----------



## mark handler (Jul 8, 2020)

Ty J. said:


> Case in point being standing wheelchairs.


Not everyone with mobility difficulties can use or afford these devices.


----------



## classicT (Jul 8, 2020)

mark handler said:


> Not everyone with mobility difficulties can use or afford these devices.


True, I was just defending my point that we cannot choose to ignore a provision of the building code (or ADA laws) because of a personal belief that a disabled person could not perform a specific task.

Just because dental assistants are required to be able to perform CPR, does not mean that an alternative does not exist. I am advocating for not being close-minded and suggesting that we can not take things at face value when it comes to accessibility.

Too often accessibility is discussed as an enhancement for those with a disability, but the truth is we all benefit from accessibility requirements.


----------



## Colockum Meghan (Jul 8, 2020)

I am 'aware' of the requirements for public and employee, thank you. You don't understand the ergonomics of dental work, it is different.


----------



## Tim Mailloux (Jul 8, 2020)

Colockum Meghan said:


> You don't understand the ergonomics of dental work, it is different.



your client can tell that to the judge at the ADA lawsuit hearing.


----------



## ADAguy (Jul 9, 2020)

Again   CM, you need to be "aware". Things can and will happen.
Also, is this a ground floor space or 2nd floor of a mixed use, with or without an elevator?


----------

