On May 11, 2026, any healthcare-related service provided through websites, mobile applications, and kiosks needs to be accessible to people with disabilities according to the Department of Health and Human Services requirements. This includes:
- Health Care Providers
- Educational Institutions (Medical and nursing schools, health-related higher education)
- Social Services
The rule is specific to public and private recipients of Federal financial assistance from the Department of Health and Human Services (HHS).
I’m writing this from my perspective as a digital accessibility consultant. For a good blog post from the legal perspective, check out McDermott Will & Schulte’s post on the rule. However, if you fall into this category and are just now realizing this, what should you do?
Here’s a bit of good news. If your healthcare organization is under 15 employees, you have until May 10, 2027. Start now, if you haven’t already, and you should be able to comfortably meet the deadline.
If you have over 15 employees, you need to meet the May 11, 2026, deadline, and that’s going to be a challenge. So, what do you do? The short answer is you get started now. But let’s break that down into specifics. We’ll start with what needs to be done, then go over 6 clear steps you can get started on to address the requirements.
What needs to be done?
The effort of complying with the Department of Health and Human Services requirements boils down to needing to make anything digital that faces the public or patients accessible. The good news is that the rule has been very clear about the guidelines you need to follow to do this. The challenge is interpreting what conformance to those guidelines really means. In my 13 years as an accessibility consultant, I’ve never seen an organization conform to the guidelines at 100%. Moreover, as guidelines, they’re not intended to be perfectly applicable to all situations. Therefore, you want a good plan in place to become as conformant to the guidelines as possible. Let’s look specifically at the requirements.
Department of Health and Human Services Requirements
Web and Mobile Adherence to The Guidelines (Technical Standards)
The rule says that all web content and mobile applications made available by the hospital must conform to the WCAG 2.1 Level AA standards. This includes ensuring that visual information can be read by screen readers and that videos include captions for those who are deaf or hard of hearing. Adhering to this begins with an audit of the website and mobile applications.
Management of Third-Party Content
This can be a tricky one because it’s all about digital content that’s out of your control. We have some good news here. Content posted by the general public, such as social media comments, is exempt. However, the institution is responsible for the accessibility of third-party content used for contractual or licensing arrangements, such as third-party online payment processing websites.
Archived Web Content
So, what about all that old stuff on your website? Well, web content created before May 11, 2026, that is held exclusively for reference, research, or record-keeping does not need to meet the new standards, provided it is not updated or altered. However, if a person with a disability requests access to archived content, the hospital may still need to provide effective communication, such as adding captions to an archived video.
Kiosk Accessibility
The Department of Health and Human Services requirements also address Medical Kiosk Accessibility. A kiosk is any enclosed system – dedicated hardware and software that work together. Think of the devices you use to check into various places, self-service at the grocery store, and the handheld payment device at a restaurant. Healthcare institutions must ensure their programs are accessible when using kiosks. This can be achieved through the hardware itself or by implementing alternative procedures, such as allowing patients to bypass a kiosk and register directly with staff at a main desk.
Electronic Documents
Electronic documents are things like PDF or Word documents. The good news is that preexisting conventional electronic documents are generally exempt unless they are currently used to participate in the hospital’s programs. For individualized, password-protected documents like medical records, the hospital must provide the information in accessible formats to specific individuals who request it. This is largely a go-forward effort.
Burden of Proof for Non-Compliance
The intent is to make sure people with disabilities have equal access, not to impose unreasonable or damaging regulations. In that spirit, these standards must be met unless you can prove that doing so would cause a fundamental alteration in the nature of your services or result in undue financial and administrative burdens. Additionally, minor non-compliance may be acceptable if it has a minimal impact on a user’s privacy, independence, and ease of use.
The Action Plan
Step 1 – Involve your Legal Counsel
Contact your legal counsel. To successfully navigate this effort, reduce risk, and defend your efforts, you’re going to need legal counsel and a good accessibility consultant. It is their partnership that will work to manage these requirements for you and any challenges you have in meeting the deadline.
Step 2 – Know your Interim Obligations
While preparing for the deadlines, you are still required to provide effective communication, make reasonable modifications to avoid discrimination, and ensure individuals with disabilities have an equal opportunity to participate in programs offered online or through apps. It makes sense to immediately review your current policies and procedures around this with your legal counsel.
Step 2 – Take Inventory
The Department of Health and Human Services requirements cover websites, mobile applications, and kiosks. Close your eyes and think. Do you remember everything you have? Every website? All the apps your patients use? Don’t chance it. Many times, there are subsites or random apps that you’ve forgotten about. Pull together the list and have it ready for your accessibility consultant.
Step 3 – Web and Mobile Auditing & Monitoring
To fully understand where your websites and mobile applications don’t meet the guidelines, you’ll need a manual technical conformance audit against WCAG 2.1 AA performed by an expert auditor. This is where the accessibility consultancy comes in. A good audit report will provide you with a lot of valuable information to help you prioritize and remediate any issues. It should inform you in several ways, including but not limited to:
- Where you have accessibility issues that don’t meet WCAG 2.1 AA
- Metrics to help you prioritize:
- Issue severity rating
- Who the issue affects
- Effort to remediate
- Clear, actionable, and detailed remediation advice
- Steps to recreate the issue
Your consultant should also include consulting and help during the remediation to ensure your success.
You’ll also want to put automated monitoring in place. While automation only captures a subset of the issues, it’s very useful for tracking progress and alerting when there is regression.
Step 4 – Web and Mobile Remediation
Once you understand the issues, it’s time to prioritize and begin fixing them. My recommendation for prioritization is to look at three things:
- What are your highest risk pages and interactions (what is being used the most)
- What issues are critical barriers for users with disabilities?
- Where are the quickest wins? Think easy to fix and fixes that affect multiple areas.
For example, if you have an issue that is a critical barrier in the navigation of your website. That’s a great place to start, particularly if it’s relatively easy to fix. Everyone uses the navigation; the issue is a blocker, it’s a quick win to fix, and the navigation replicates to every page of the site.
The idea here is to provide the most access possible as quickly as possible. It also reduces your risk as quickly as possible.
I recommend talking to all the stakeholders in the organization to ensure you’re considering everyone’s needs in the prioritization. Your legal counsel may have very different concerns from your product manager. That all needs to be balanced.
You also want to make sure you use your consultant during this phase. Asking Google or AI questions can be very risky. Your consultants’ helpdesk is your best remediation friend.
Step 5 – Web and Mobile Remediation Validation
Once you’ve completed remediation, you’ll want the auditor to validate that you corrected the issues and did not create any new ones. This will give you the opportunity to clean up anything that wasn’t done quite right.
Depending on how you and your team have decided to handle proof of conformance. This may be when you want your consultant to create an Accessibility Conformance Statement (ACR). Many times, people use the Voluntary Product Accessibility Template (VPAT) for this. You may want to consider a well-crafted statement on your website. This is an area where your legal counsel and accessibility consultant should work together.
Step 6 – Accessibility Capability Maturity
At this point, you’ve completed a good initial project, and your websites and mobile applications are more accessible. The secret now is to transition from that initial project to an ongoing process that incrementally improves your institution’s capability to create accessible digital assets that follow the HHS Rule. This is a whole big subject in and of itself. Check out the W3C Accessibility Maturity Model Explained blog post to understand how organizations are tackling this.
Wait, but that’s not all – PDF and Kiosk
We still haven’t addressed the documents (PDFs, Word Documents) or the kiosk requirements. Both of these pose unique challenges and tend to be very unique within each institution.
Documents
Documents on the surface can seem similar to web and mobile. However, there is one critical difference. Typically, with web and mobile, there are dedicated teams or third-party vendors that handle them. It’s centralized. It is, therefore, relatively easy to understand who needs to do what, as you see in the steps above. But everybody and their dog makes documents, which means making documents accessible can be like herding cats. This is going to require working with your accessibility consultant on a careful strategy. There is no one-size-fits-all answer here, unfortunately. Check out the PDF Accessibility and Compliance with WCAG and PDF/UA – Strategy Answers the Challenge blog post to get an idea of how we here at Inclusion Impact Accessibility think about this.
Kiosks
Kiosks are unique for a few reasons. One, they are dedicated hardware and software working together. Moreover, they are distributed to various physical locations. Therefore, updating both the hardware and software doesn’t happen easily, often, or perhaps at all. Retrofitting is not impossible, but it can be very challenging.
Further, there are often several vendors involved in one kiosk. Typically, there is at least a hardware and software vendor that will need to coordinate. This really requires good conversations to understand the full picture, and that should lead to a solid strategy. This is one that may end up being handled through a vendor contract rather than things your team does. Talk to your accessibility consultant. They’ll want to get the lay of the land, then they can help advise you.
Final Thoughts
This all may sound a bit overwhelming, but like any worthwhile effort, once you take the first step, you’re on your way. Incremental progress and good prioritization will be your friend. Don’t go it alone. You have a good team; loop them in. And use your professional resources. The lawyer, accessibility consultant team is much greater than the sum of its parts. They’re crucial to your success.
Feel free to reach out to us for a free initial consultation.
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