07/10/2014

What you need to know when renovating a dental practice


Whether a dentist is building a new practice or renovating his or her current office, there are specific laws that come in to play for office design.

One of the most important things dentists should consider is the state and federal requirements under the Americans with Disabilities Act (AwDA).

The AwDA helps guarantee access to places of public accommodation for persons with disabilities. Under the Act, and many similar state and local laws, a dental practice is a place of public accommodation, so the practice must comply with the Act and applicable state and local laws related to accessibility. The AwDA requires that places of public accommodation meet certain accessibility standards. The standards that apply depend on whether the office is an existing facility, being renovated or new construction.

According to CDA’s Legal Reference Guide, if a dentist is undertaking improvements in his or her office, it is advisable to consult with knowledgeable architects, contractors, and, if necessary, AwDA consultants to determine whether the proposed improvement will require the office to comply with AwDA guidelines. Dentists should make this determination before they enter into contracts for the improvements, so that they are aware of the scope and cost of the job, including AwDA compliance, before beginning the project.

Meeting AwDA requirements is not just the responsibility of the building owner.

Landlords and tenants are both responsible for satisfying the accessibility requirements of the AwDA, according to the Legal Reference Guide. Typically, they may decide to apportion this responsibility between themselves by contract. For example, the landlord may agree to assure compliance for common areas, and the tenant may agree to do the same for his or her office space. While the AwDA allows them to do so, apportioning who will do what contractually does not vitiate either party’s responsibility for the entire portion of the premises that an individual may visit, from curbside to dental chair and back.

Outside of the AwDA, state codes affecting office design include electrical, fire, mechanical, building, plumbing, energy and historical building codes, according to the Legal Reference Guide. Many state building codes are based on standards established by national and international industry groups. The state plumbing code, for example, is based on the Uniform Plumbing Code, and the state fire code is based on the International Fire Code. Some of these codes have health care facility-specific standards. The ADA monitors the various standard-setting organizations and comments on proposals as needed.

California limits exposure to air contaminants such as glutaraldehyde, formaldehyde and nitrous oxide. Dentists should ensure that the rooms where these chemicals are used are properly ventilated.

Dentists should also consider waste management in their office design. Some communities require installation of amalgam separators. Dentists may want to implement a comprehensive recycling program that separates different types of waste such as batteries, paper, plastic, fixer and amalgam.

Controlled substances must be stored in a secure area. If there are dental materials that require cold storage, dentists can install a separate refrigerator for personal and employee food items.

Relying on experts “in the know” about legal requirements and shaping contracts with them to assure compliance is the best way for a dentist to proactively address the important aspects of dental office design.

An attorney may assist the dentist with contracts that protect him or her from liability for the acts of the design professionals and contractors and that impose penalties on contractors who do not complete the work in a timely fashion.

The state also has a Certified Access Specialist program that dentists can take advantage of. Under the program, dentists can voluntarily hire a certified access specialist to inspect their practice for AwDA compliance. The specialist will provide an inspection report as proof that a certified specialist inspected the practice. Once the appropriate modifications are made, a specialist can also issue a window sticker letting those who walk by the facility know it is in compliance.

In addition to the specialist’s report outlining exactly where AwDA vulnerabilities exist, the inspection also provides some legal protection. If a business is sued after having an inspection, a 90-day stay of the lawsuit and an early evaluation conference can be requested.

Visit the Department of General Services’ website for more information.

The Division of the State Architect provides a reference manual outlining compliance with physical accessibility standards. Local building departments have the authority to interpret and enforce state building codes to best fit community needs.





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