Reasonable Accommodation Policy

Introduction                                  

Ponce Health Sciences University (PHSU) is an institution of higher education that is committed with the well-being of the students in all aspects of their life. Our purpose is to provide services to students in accordance with “Americans with Disabilities Act of 1990” which includes changes made by the ADA Amendments Act of 2008, which became effective on January 1, 2009. Also, in compliance with Section 504 of the Rehabilitation Act 1973 and the Post-Secondary Reasonable Accommodation Passport Act. To abide to these laws, the office of reasonable accommodation are commitment to serve this community and provide them with accommodations that can help to eliminate barriers that can affect their ability to perform successfully academically given their functional limitations.

The Reasonable Accommodation Institutional Policy is a guideline to provide services based on these laws. All applicants accepted to PHSU must be able to meet the technical standards described in the PHSU Admissions Policy (see recommendation for standard review). PHSU is not required to modify its admissions requirements for applicants with disabilities if the prospective students are unable to meet them with or without reasonable accommodations.

Accepted candidates that need reasonable accommodation are responsible to contact the Rehabilitation Counselor; it is the student’s responsibility to make their accommodation need known to PHSU designated officials and to seek out assistance. To receive reasonable accommodation, the student must have a disability that substantially limits a major life activity. If you have a psychological disability or medical condition that you believe requires modification to the standards conditions, apply for accommodation.

PHSU does not discriminate on the basis of disability, history of disability, or appearance of disability. However, students who currently have disabilities are the ones entitled to receive reasonable accommodations.

Purpose

The purpose of this policy is to ensure equal opportunities to students with disabilities in both academic and clinical settings, providing services and support for maximizing their capabilities.

Terms Definition

• Disability: Physical or mental impairment that substantially limits one or more major life activities or a major bodily function.

• Major life activities: Include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, working, and operation of major bodily functions (ADA, 2008).

• Reasonable Accommodation: Modifications or adjustments to the tasks, environment or to the way things are usually done that enable qualified students with disabilities to have an equal opportunity to participate in an academic program or related services.  Reasonable accommodations are mechanisms that enable qualified students with disabilities to meet the curriculum requirements, learn academic material, demonstrate what they have learned, and have equal access to all services and facilities, without their disability being an impairment to doing so.  To determine the most effective reasonable accommodation on a case-by-case basis, a good-faith interactive process is conducted between the qualified student with disability and the PHSU staff. During this process, relevant information and documentation are exchanged for the determination to be made.  Any modification or adjustment will be considered reasonable, if none of the following apply to it: undue hardship, fundamental alteration, or direct threat to health and/or safety.

• Qualified student with disability: Is a student with a disability who meets the academic and technical standards required for admissions or participation in the institution’s educational program or activity, with or without reasonable accommodation.

• Assistive Technology: Any type of low or high-tech equipment created, adapted, or modified to be used by a qualified student with disability to improve or increase their functional abilities.  If could be a reasonable accommodation.  It does not include personal items such as glasses or hearing aids, etc.

• Provisional Accommodation: When it is known by the PHSU staff that there is a qualified student’s need for reasonable accommodation, but it has not been previously established through the standard approval process, or more evidence, updated evidence, or additional time is required to determine with certainty which would be the most appropriate, the most effective accommodations possible will be provisionally applied based on a diligent and timely individualized analysis of the documented interactive process with the student with disability to identify the most ready achievable available alternatives for the reasonable accommodation implementation.  Documentation should be provided by the student as soon as it is available if is needed to determine with more specificity the most appropriate accommodation for each student in an ongoing basis if needed.   Provisional reasonable accommodations will be offered until sufficient additional information is received to determine with more certainty that other reasonable modifications would be more appropriate for the student in each case.

• Temporary Accommodation: Refers to short-term modifications or adjustments made to assist students in ensuring they can participate fully and effectively in the educational setting. These accommodations, are applied when they have been recommended by the student’s health provider, are intended to be used for a limited period due to extraordinary situations such as surgery, pregnancy complications, fractures, etc.

• Undue Hardship: It refers to an action requiring significant difficulty or expense when considered in light of a number of factors. These factors include the nature and cost of the accommodation in relation to the size, resources, nature, and general structure of the PHSU’s operation.  It is determined on a case-by-case basis.

• Fundamental Alteration: It refers to an accommodation that significantly changes the educational program and related services’ essential nature or invalidates any of its essential requirements. It’s a change so substantial that it alters what the program or service is fundamentally meant to achieve.

• Direct Threat to the Health and/or Safety:  It refers to a significant risk of potential harm to the health or safety of the individual or others that cannot be eliminated or reduced by reasonable accommodation.  The risk must be more than a remote possibility; it needs to be a real and substantial danger.  The potential harm must be serious in nature, not trivial.  Case by case, a documented, good faith, interactive process with the individual must be undertaken to determine whether or not there is any poddihlr reasonable accommodation that may eliminate or significantly reduce the potential danger

• Interactive Process: It refers to an individualized collaborative dialogue between a qualified student with a disability and the PHSU’s staff that aims to determine what or how reasonable accommodations can be made to enable the student to have an equal opportunity to participate in an academic program or related services.  This process involves a back-and-forth exchange of information to identify effective accommodations or ways to implement it that address the student’s limitations to access equal opportunities.  PHSU staff will consider the student preferences and based on the available resources, determine the most effective way of reasonable accommodations possible.

• Service Animal: Any dog individually trained to perform tasks for an individual with visible or invisible disability. 

• Implementation: Involves a series of actions and practices designed to ensure that qualified students with disabilities have equal access to education and are provided with the necessary support to participate fully in academic and extracurricular activities. Modify teaching methods, materials, alternate format and assessments. Examples include extended time on tests, use of assistive technology, etc.

Scope

This policy applies to all Active PHSU students and/or PHSU’s visiting or international students who are assigned to academic activities in Main campus, East Campus, San Juan University Center and St Louis Campus. It also applies to students assigned to rotations/practicums in Allied Clinical Sites, however, health-care facilities have their own guidelines and procedures for reasonable accommodation.

Reasonable Accommodation Committee

The Reasonable Accommodation Committee comprises representatives from different academic programs. Led by the Rehabilitation Counselor serving as Chair, the committee collaborates to provide recommendations on cases under discussion or consultation. Committee members are selected by the Vice President of Academic Affairs and are required to possess foundational knowledge of laws and policies governing the reasonable accommodation process. Additionally, they are expected to demonstrate a high level of professionalism and sensitivity towards the needs of the population with disabilities.

Committee Meetings

The committee will convene at least twice a month throughout the academic year to review cases as requested by the Committee Chair. Additional meetings may be scheduled in response to a high volume of applications requiring committee attention. The committee will meet to:

• Revision of first-time applications.

• Revision of applications for renewals that require the committee to meet due to the complexity of the application.

Conflict of Interest Procedure

If a committee member has a direct professional relationship with the student applying for reasonable accommodation, which may compromise their capability to provide a non-biased opinion, that member must notify the committee and recuse themselves from the decision-making process regarding that specific student.

Reasonable Accommodation Procedure

Students with disabilities who wish to request reasonable accommodation must comply with the following:

Reasonable Accommodation Application for the first time at PHSU:

• Meet the Rehabilitation Counselor for orientation about the process and documentation required.

• Complete Reasonable Accommodation Request Form through Microsoft Forms and upload the Certification of Disability form, which is available at the Counseling Center, and on the Institutional Web Page. It is recommended that the student request reasonable accommodation at the beginning of the academic term. With the application, the student must include any relevant medical or psychological documentation, or other reasonable evidence that that reflects the student’s disability, the current functional limitations, and recommended accommodations. If the disability is invisible or difficult to perceive, the Certification of Disability and any other specific documentation to take into consideration for accommodation must be recent and dated within six months prior to the date of the request for accommodation and/or the date it is received at the Counseling Center. The Reasonable Accommodations Committee evaluates whether the documentation presented can replace the Certification of Disability. **Please, refer below to each condition individually for specific documentation requirements.**

• The Certification of Disability must be completed by a healthcare provider who specializes in the condition for which the student is requesting accommodations. This professional must accurately complete the document with relevant information about the student’s diagnosis and treatment, as well as appropriate detailed recommendations based on the student’s functional limitations, suitable to a professional health science program setting.

• Evaluations performed by members of the student’s immediate family until the fourth grade of consanguinity are not acceptable.

• Include evidence of prior reasonable accommodation, if any.

• The application for reasonable accommodation can be submitted once the student is admitted (accepted) into the academic program. It is the responsibility of the student with a disability to request accommodation with enough time in advance for the Reasonable Accommodation Committee to evaluate their request and submit the recommendations. The Committee will evaluate each case individually, to perform the interactive process, and submit recommendations. The day for the accommodation to come into effect will vary according to the period necessary to evaluate and implement the accommodation and usually will take one to four weeks if all the required information is provided.

• Once the Reasonable Accommodation Committee provide their recommendations, the Rehabilitation Counselor send the official letter to the student and the program dean/director within no more than five working days after receiving the final approval. The student is responsible for sending the reasonable accommodation letter to their professors and meeting with them to discuss the implementation of the accommodations. The letter includes the approved reasonable accommodations and their effective dates, which depend on the disability, functional limitations and reasonable accommodations recommended. The effective dates can be either one (1) year or two (2) years. It is recommended that the renewal process start one month before the expiration date.

• The student is responsible for sending the reasonable accommodation letter to their professors and meeting with them to discuss the implementation of the accommodations.

• It is the professor’s responsibility to establish a good-faith interactive process with each student to coordinate the best way to implement reasonable accommodations in their class.

• Guidelines for physical, visual and other disabilities provided by organizations like the National Board of Medical Examiners, the Association of American Medical Colleges (AAMC) for the American Medical College Admission Test (MCAT), the Educational Testing Services (ETS) and other professional organizations will be revised as a reference during the determination.

• If any PHSU’s staff member becomes aware at any time that obviously a qualified student with a disability requires reasonable accommodation that has not been previously established through the standard procedures detailed above, they must provide it promptly and diligently as a provisional reasonable accommodation based on the identified need and resources. Once the provisional reasonable accommodation has been provided, the student may request the same or other modification to be approved through the standard procedure, if necessary, to document it.

Renewal of Reasonable Accommodation

• Students with active accommodation and whose accommodation is close to expiring, as established in their letter, must begin the renewal process one month before the expiration date, to facilitate updating and continuity.

• The Reasonable Accommodation Committee reserves the right to request new evidence in cases it deems necessary. In case of requested new documentation, the student can ask their healthcare provider for an updated medical certification with recommendations for reasonable accommodations. The professional may supplement the original report with a letter describing any changes from the previous report.

• The student must wait for the Committee to extend the accommodation.

• The student must coordinate a follow-up appointment with the Rehabilitation Counselor.

• If while the student is waiting for the standard approval, it becomes obvious the student’s need for reasonable accommodation and it has already expired, the student must be provided with a provisional reasonable accommodation while the process is completed.

Revision of Reasonable Accommodation

• Students with an active accommodation request a review of their current accommodation to modify, remove, or add any accommodation.

• The Reasonable Accommodation Committee reserves the right to request new evidence in cases it deems necessary. In case of requested new documentation, the student can ask their healthcare provider for an updated of the medical certification with recommendations for reasonable accommodations.   The professional may supplement the original report with a letter describing any changes from the previous report.

**The Reasonable Accommodation Committee will not be able to proceed with a recommendation until all required documents have been received. **

PHSU requires that the documentation come from a healthcare provider with experience and expertise in the area related to the student’s disability.

Neurodevelopmental Disorder (ADHD, Autism, Learning Disability, etc.)

• Reports for Neurodevelopmental Disorder should reflect the current functional limitations of the student and include the results of a battery of psychoeducational tests (psychoeducational or neuropsychological evaluation) designed to identify these impairments.

• In addition, must be provided a clinical summary. The summary must include recommendations of specific accommodations and assistive devices needed, and how they will reduce the impact of functional limitations, including medication.

Chronic Health, Physical or Sensory Disabilities

• Reports for Chronic Health, Physical or Sensory Disabilities should reflect the current impact of the diagnosed condition and should indicate the prognosis of the condition.

• Documentation should state medications, other treatments or any coexisting condition that can affect the student functioning.

• It must include relevant observations, and recommended accommodations.

Psychological Disabilities

• Reports for Psychological/psychiatric Disabilities should include current functional limitations and how they interfere in the educational environment. Besides, should include the severity, symptoms, and prognosis.

• Documentation should state medications, other treatments or any coexisting condition that can affect the student functioning.

• It must include relevant observations, and recommended accommodations.

Temporary Disabilities

PHSU recognizes that individuals with temporary disabilities that are a result of injuries, surgery or short-term medical illness may need access to services and resources like those with permanent disabilities. An expedited process is determined for these specific cases.

Students with temporary disabling conditions that need assistance or modification in the academic setting must provide documentation from the healthcare provider for verifying the nature of the condition, expected duration and describing the accommodation deemed necessary. If the anticipated recovery date is later postponed due to a change in the student’s recovery prognosis, an updated note from the provider should be requested and kept on file. This evidence must be present to the Rehabilitation Counselor.

If the student requires other modifications, such as accessible parking, they should contact the Rehabilitation Counselor for the necessary process. Temporary services are determined on a case-by-case basis. The effective date of the accommodation will vary according to the time needed to evaluate and implement the accommodation; it will usually take one week or less if all the required information is provided and the resources for the accommodation are available.

Pregnancy

If medical complications from pregnancy arise, the student might become eligible for services under the ADA law and can request reasonable accommodations while medical conditions or disability persist.  The student must provide documentation detailing medical restrictions and recommendations for accommodation to complete academic task due to complications due to pregnancy. 

Types of Accommodations

Accommodations provided must allow a student to get an opportunity to benefit from the education program equal to that of nondisabled students. Accommodations that are not considered reasonable because they impose extraordinary difficulty or burden for the institution or require fundamental changes of academic standards or coursework may be declined. The professor is not obliged to offer reasonable accommodations until they receive the official letter unless the qualified student’s need for reasonable accommodation is obvious.

PHSU Reasonable Accommodations include but are not limited to the following:

1. Didactic (classroom), exams and labs setting

   1. Additional time (time and a half) for in-class exams.

   2. Additional time for delivery of work and assignments: The extended time must not exceed the course end date.

   3. Breaks during class/exams

   4. Reduced distraction environment

   5. Enlarged print

   6. Priority seating

   7. Special seating

   8. Alternative format test

   9. Assistive technology (iPad, personal laptop, calculator, etc.).

• Voice recording device (the student must sign the Audio Recording Agreement)

  1. Use of noise-cancelling headphones during PHSU exams. For NBME’s or USMLE exams, only allow the use of earmuffs (non-electronic devices). Students must bring their own.

1. Clinical setting

   1. Scheduling clerkships: change of rotation order

   2. Prioritization clerkship placement due to location barriers.

   3. Program modification (time-off for disability-related appointments, absences)

2. Clinical Skills Exams

   1. Additional time for case or patient note (depends on the purpose of the assessment and the barriers experienced)

   2. Reduced distraction environment

3. Physical Accessibility

   1. Elevator

   2. Accessible parking

   3. Ramps

Assistive Technology

Some accommodation may include the use of assistive technology. These devices will be specified in the reasonable accommodation letter provided to the student. Students who have their own devices are encouraged to bring them to the Rehabilitation Counselor to verify that they comply with the accommodations. Additionally, the Counseling Center has assistive devices available for loan to students for a specified period, subject to availability. Students must complete the Assistive Technology Loan Form to borrow a device and agree to the Terms and Conditions.

The devices available at the Counseling Center are:

• Voice recorder

• Noise-cancelling headphones

• Noise-reduction earmuffs (non-technological)

• Reading pen

• Laptop

• Sound amplifier

Note: Difficulties such as test anxiety or having Spanish or English as a second language do not automatically qualify as disabilities under the Americans with Disabilities Act (ADA). However, if these difficulties are related to a documented condition that substantially limits a major life activity, students may be eligible for reasonable accommodations.

Licensing, Certification and Board Exams

These exams are a critical part of professional’s advancement and require additional steps for student with disabilities requesting accommodations. The student must visit the official exam webpage for the guidelines and requirements for each individual exam. If you need help, you can schedule an appointment with the Rehabilitation Counselor or disability services of PHSU. Being a Reasonable Accommodation participant at PHSU does not guarantee approval of accommodations in external entities coordinating licensing, certifications or Board Exams.

Rights and Responsibilities

1. Student

   1. Rights

      1. An equal opportunity to access to the courses, programs, services and activities at the university

      2. Request reasonable accommodations, academic adjustments, or services

      3. Confidentiality of information regarding disabilities, except as disclosures are required or permitted by law.

   2. Responsibilities

      1. Self-Identification as student with disability to the Rehabilitation Counselor.

      2. Submit required documentation.

      3. Request accommodation and renewal.

      4. Meet the technical standards of the program, and the academic and institutional requirements.

      5. Contact the Rehabilitation Counselor if the modifications are not being implemented or are not effective.

      6. Follow procedures for requesting and maintaining accommodation.

      7. If changes occur in the condition or functional status, the student will be responsible for bringing properly updated the Certification of Disability and recommendations of the specialist for the academic/ clinical scenario.

      8. Deliver the reasonable accommodation letter to their professors and meet with them to discuss the implementation of the accommodations.

2. University

   1. Rights

      1. Request and receive current documentation about disability.

      2. Suggesting appropriate accommodation regarding documentation submitted.

      3. Deny any accommodation that fundamentally alters a course, program or activity, or represent an undue hardship, or direct threat to the health and safety.

   2. Responsibilities

      1. Keep a student record and guarantee the confidentiality required by law to its documents and information.

      2. Determine accommodation.

      3. Assist with the implementation of reasonable accommodation.

      4. Assist student when implementations are not properly applied.

      5. Follow-up students with disabilities.

Confidentiality

The Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act Regulations, and the Family Educational Rights and Privacy Act (FERPA) prohibit the unlawful disclosure and use of information concerning an individual’s disability. The student disability records will be kept separate from the student’s academic records.

Complaint and Grievance Process for Reasonable Accommodation

This procedure is aligned with Ponce Health Sciences University’s institutional Grievance Policy to ensure that students with disabilities have access to a fair, consistent, and transparent process for resolving concerns related to reasonable accommodations.

Appeals to Denial of Accommodations

If the concern relates specifically to the denial of an accommodation, the student may appeal in writing to the Reasonable Accommodation Committee within five (5) working days of receiving the initial decision. This appeal should include:

• A clear explanation of the disagreement with the decision.

• Supporting documentation.

• A proposed resolution or requested accommodation.

The Reasonable Accommodation Committee will review the appeal, may request additional information, and may meet with the student. The Committee’s decision will be communicated in writing.

If the student is not satisfied with the Committee’s decision, they may still pursue further mediation or formal grievance through the institutional process described below.

Any student who believes they have been discriminated against based on disability, whose request for reasonable accommodation has not been adequately addressed, or who feels their accommodations are not being properly implemented, has the right to seek resolution.

Informal Resolution

Students are encouraged to first attempt to resolve the matter informally by communicating directly with the office responsible for processing reasonable accommodations, the relevant faculty member, classmate, or administrative staff. If the concern persists, or if the student prefers not to address it informally, they may proceed with a formal complaint.

Formal Complaint - Following the Institutional Grievance Policy

Complaint Form

Students may submit a formal written grievance to the Office of the Vice President of Student Affairs, in accordance with PHSU’s institutional grievance policy. The written report should include:

• A clear and concise description of the issue.

• A timeline of relevant events.

• Any steps taken to resolve the concern.

• A description of the remedy or resolution sought.

The Vice President of Student Affairs or their designee will gather pertinent information, meet with involved parties, and attempt early resolution. If the matter is resolved, a written report and follow-up will be conducted. If not, the case will be referred to an Investigation Committee, as outlined in the institutional grievance procedure.

Students will be informed of all steps and decisions throughout the process. If dissatisfied with the outcome, the student may appeal to the President of PHSU, initiating the Due Process described in the institutional policy, which may involve a review by the Vice President of Academic Affairs and potentially an Ad Hoc Committee.

Faculty Responsibilities about Reasonable Accommodation

Ensuring adherence to the ADA is a shared responsibility, with faculty members playing a pivotal role in the institution’s compliance efforts. As a civil rights law, the ADA and the Rehabilitation Act, Section 504, guarantees that students with disabilities can participate in higher education without facing discrimination. Faculty support this mission by providing reasonable accommodations and services, which are crucial to fostering an inclusive and equitable educational environment.

As part of our commitment to assist faculty in complying with reasonable accommodations for our students, here are the responsibilities of the faculty:

Faculty members may have questions about specific accommodation and how to implement it. The Office of Reasonable Accommodation may provide insights and recommendations about how to implement this accommodation. Faculty will fill out a form that will be available to be completed online.

As stated on the Confidentiality section of this policy, the Office of Reasonable Accommodation will not divulge any information regarding the disability of any student at PHSU. Therefore, faculty are prohibited from asking about a student’s diagnosis, treatment, information provided by the healthcare provider or other information about the student’s disability.

Divulgation

The Reasonable Accommodation Policy and other institutional policies can be found in PHSU Student Policy Manual and PHSU Catalog. The PHSU community can access these documents in the PHSU webpage, Public Folders (Outlook), and at the Students Affairs Office.

Information and Community Support Services

For support students with disabilities whether one choose to file an official concern, students are encouraging to obtain information, support and counseling, both on and off campus. Information, support and advice are available (see resources below) for anyone in PHSU community.

Amendments

An amendment to this policy may be recommended by the Reasonable Accommodation Committee based on regulatory changes of the ADA guidelines. The Institutional Administrative Board will have the responsibility to approve the recommendations for amendments.

Repeal and Validity

This policy does not repeal the provisions established by other policies such as the Technical Standards, the Satisfactory Academic Policy, or the Graduation Requirements among others but rather offers specific provisions to comply with “Americans with Disabilities Act of 1990” which includes changes made by the ADA Amendments Act of 2008, which became effective on January 1, 2009. Also, in compliance with Section 504 of the Rehabilitation Act 1973.