Step 4: Send a Letter to the Facility Requesting “Reasonable Accommodations”

If the primary reason that the facility is denying you access is related to your use of infusion or injection medication, it may be helpful to request that they provide you with a “reasonable accommodation” as required under the federal Americans with Disabilities Act (ADA). If a community of people is routinely denied access to behavioral health facilities because of a well-managed health condition, that is not equitable and may be illegal. Under the Americans with Disabilities Act, discrimination includes refusing “to make reasonable accommodations in rules, policies, practices, or services, when such accommodations may be necessary to afford such person with a disability equal opportunity to access medical care.”  A bleeding disorder (BD) is considered a disability under the ADA, and access to medical care includes access to inpatient/residential substance use disorder or mental health treatment. 

This request letter (or email) may be sent by you, your BD treatment team, or by both. The goal of the letter is to encourage the facility to engage with you and your BD treatment team about how they can ensure that you have access to your required medication while receiving treatment at their facility. This request letter is intended to initiate a conversation between the facility and your provider about how they can best accommodate you at their facility. 

The mental health and/or substance use disorder treatment facility may not give you exactly what you request (for example, they may not let you self-infuse), but it is important that they admit you and permit you access to your BD medication during your stay. For some creative solutions that other facilities have adopted, please see the resource “Brainstorming potential solutions with a facility.” Please keep in mind that mental health and substance use disorder treatment facilities are regulated at the state level so what is permitted in one state or locality, may not be in another.