Good Practice: Duty to Accommodate

Business owners and others may have heard the term “duty to accommodate” before, perhaps in the context of working with a WCB client or when a colleague is pregnant. The phrase is often used in relation to an employer’s responsibility to accommodate an employee who requires a job modification. But what does “duty to accommodate” mean in the context of patient care and the Alberta Human Rights Act (AHRA)? What does it mean for physiotherapists? Who needs to be accommodated? Are there limits to the duty to accommodate?

What does accommodation mean?

Accommodation means making changes to rules, practices, physical environments or workplace cultures to ensure that they don’t have a negative effect on an individual due to the person’s mental or physical disability or any other protected ground.¹

What is a protected ground?

The AHRA establishes that in Alberta it is a “fundamental principle” and “a matter of public policy that all persons are equal in dignity, rights and responsibilities.” The legislation stipulates that it is against the law to:

• “Deny to any person or class of persons any goods, services, accommodation or facilities that are customarily available to the public, or
• Discriminate against any person or class of persons with respect to any goods, services, accommodation or facilities that are customarily available to the public,

Because of the race, religious beliefs, color, gender, gender identity, gender expression, physical disability, mental disability, ancestry, place of origin, marital status, source of income, family status or sexual orientation of that person or class of persons or of any other person or class of persons.”²

“If a standard (rule, policy, or practice) treats individuals or groups differently based on any of the protected grounds in the AHRA and results in harm to the dignity and self-worth of those affected, the standard is prima facie discrimination.”³

Does this apply to me?

Yes, under the AHRA, as public service providers all physiotherapists have a duty to accommodate individuals whom they come into contact within the context of care.¹

The College of Physiotherapists of Alberta’s Code of Ethics and Standards of Practice require physiotherapists to comply with legislation relevant to their practice,⁴ including human rights law. It is a contravention of our Code of Ethical Conduct⁵ and Standards of Practice to discriminate against or deny access to services to an individual on the basis of a protected ground.

The College of Physiotherapists of Alberta strongly supports that it is ethical and essential to facilitate equitable access to services for all individuals.

The intent of any accommodation is to enable equitable participation in society. Individuals may request an accommodation from a service provider if it is needed to overcome a disadvantage arising from the rules or practices of the service provider.¹ When it comes to physiotherapy services, an accommodation may be needed to ensure equitable access to services and public facilities.

What does accommodation look like?

Some examples of accommodation include changing physical environments to enable access for wheelchair users or allowing service dogs entry to businesses and public facilities.

Partial vs. full accommodation

It is important to note that accommodation can take many forms and may result in a full (perfect) or partial accommodation. For example, when communicating with a person who is hearing impaired or deaf, a perfect accommodation would be to have a sign language interpreter present. A partial accommodation would be to use written communication and allow extra time for the interaction, at no extra cost to the client. It is worth noting that “a person seeking accommodation has a duty to accept a reasonable accommodation even if it is not the one that the person suggests or prefers.”¹

Are there limits to the duty to accommodate?

There are limits to how far service providers are required to go to accommodate individuals. “The Supreme Court of Canada has ruled that employers and service providers have a legal duty to take reasonable steps to accommodate individual needs to the point of undue hardship.”¹

“In all situations where there is a duty to accommodate, the employer, landlord, or service provider must be prepared to provide accommodation to the point of undue hardship. Undue hardship is the point at which the value of a service or of an employment position is outweighed by the costs involved in accommodation.”² Undue hardship may arise due to financial cost, safety concerns, service disruption or the impact of the accommodation on other staff or clients, however it should be noted that “some hardship may be necessary in making an accommodation.”¹

Rights and responsibilities

For accommodation to work, the individuals requesting the accommodation and the service provider must work together and consider different options available to accommodate the individual’s needs. Both parties have a number of rights and responsibilities to consider.¹

Among other things, the person seeking an accommodation must:

• Ensure their concern falls under the protected areas and grounds identified in the AHRA.
• Inform the service provider of the need for accommodation.
• Provide information regarding the issue to the service provider (preferably in writing).
• Allow time for the service provider to respond to the request.
• Listen to and consider reasonable accommodation options.

The service provider must:

• Be aware that once a request is received, the onus is on them to accommodate.
• Respect the dignity and privacy of the individual making the request.
• Listen to and consider the needs of the person making the request and their suggestions for an accommodation.
• Be willing to take substantial and meaningful measures to accommodate the individual.
• Discuss options.
• Reply to the request within a reasonable time period.
• Follow up to ensure that the accommodation meets the person’s needs.

What if I don’t accommodate a person making a request?

If a service provider fails to provide accommodation to the point of undue hardship, then they may be found to be contravening the AHRA, and a complaint could be brought against them through the Alberta Human Rights Commission. However, if a “person seeking accommodation refuses a reasonable and appropriate accommodation, the service provider has likely met their legal responsibilities.”¹

Conclusion

Providing accommodations for individuals seeking physiotherapy services on the basis of protected grounds is a legislated requirement for all members of the College of Physiotherapists of Alberta. These requirements are further supported by the College of Physiotherapists of Alberta’s Code of Ethical Conduct and the Standards of Practice. Understanding the duty to accommodate, your rights and responsibilities, and the limits of your duty to accommodate will help you to respond professionally and appropriately when you encounter these situations.

Page updated: 20/04/2022