An evidence-based look at Crohns Disease and Ulcerative Colitis. This blog explores various aspects of inflammatory bowel disease, including nutrition, treatment, and lifestyle based on clinical evidence.
Sunday, April 7, 2013
Legal Issues and IBD
There are a few unique legal issues surrounding IBD that
folks may or may not be aware of. One is
positive (the trend toward bathroom access), the second is negative (the
ability of private entities to set their own restrictions on the use of
restrooms). What does this mean for the
average IBD patient?
Access to bathrooms is something that is almost always on
the mind of anyone with IBD. It effects
when, where, and how we travel, eat, and generally live life. Most of us have developed restroom-radar –
the ability to always know when and where the closest bathroom is. Unfortunately, not all of those restrooms are
legally accessible to those with Crohn’s and Ulcerative Colitis.
Because most restrooms are in private establishments (restaurants,
retail stores, gas stations, etc…) their owners are free to establish whatever
restrictions they would like on their use.
All states have requirements for restrooms at food establishments that
allow dining in, but the owners can choose to limit their use to paying
customers only. There are good reasons
(from the business’s perspective) for doing so:
there is a cost to maintain clean restrooms, they may attract
undesirable individuals, and may increase liability for the establishment.
Building codes for restaurants require restrooms be made
available, but not necessarily adequate bathrooms for those with IBD. Virginia State Code, for example, requires
§ 3.2-5109. Washrooms and toilets.
Any place where food is manufactured, prepared, exposed, or
offered for sale shall have a convenient washroom and toilet of sanitary
construction, but such toilet shall be entirely separate and apart from any
room used for the manufacture or storage of food products.
The requirement does expand beyond sit-down restaurants, but doesn't give a lot of detail on how many toilets (or their condition). For the number of toilets, most states have
adopted the International Building Code.
The IBC requires a number of toilets based on the number of occupants
and the type of establishment (1 per 40 occupants for a bar, 1 per 75 occupants
for a restaurant). Normally, because the
facility counts are the same for men and women, men have more facilities
available. For male IBD sufferers,
however, the facilities may substitute a urinal for 50% of the required
toilets. This means that there may only
be one toilet for a restaurant with 300 person occupancy. If that toilet is out or occupied, you may be
out of luck (an unfortunate consideration in choosing places to eat).(1) Because urinals are cheaper and easier to
maintain, most restaurants/bars will take this option.
What about non-restaurant establishments? Until recently, there was no legislation that
offered any rights to those with medical conditions access to bathrooms in
retail establishments. Enter Ally Bain.
Everyone stateside with IBD owes a debt of gratitude to Ally
Bain and her mother Lisa. When she was
younger, Ally needed to use the restroom in a retail establishment and was
denied by the management. As a result,
she had the same accident many of us have had at one point or another. Instead of taking it lying down, Ally and her
mother fought and passed the first of what is known as “Ally’s Law” legislative
changes in Illinois.(2) Since then, 13
other states have passed similar laws:
Ally’s Law, or the Restroom Access Act, says something
similar in each state:
Definitions. In this Act:
"Customer" means an individual who is lawfully on the premises
of a retail establishment.
medical condition" means Crohn's disease, ulcerative colitis, any other
inflammatory bowel disease, irritable bowel syndrome, or any other medical
condition that requires immediate access to a toilet facility.
establishment" means a place of business open to the general public for
the sale of goods or services. "Retail establishment" does not
include a filling station or service station, with a structure of 800 square
feet or less, that has an employee toilet facility located within that
Section 10. Retail
establishment; customer access to restroom facilities. A retail establishment
that has a toilet facility for its employees shall allow a customer to use that
facility during normal business hours if the toilet facility is reasonably safe
and all of the following conditions are met:
customer requesting the use of the employee toilet facility suffers from an
eligible medical condition or utilizes an ostomy device.
(2) Three or
more employees of the retail establishment are working at the time the customer
requests use of the employee toilet facility.
(3) The retail
establishment does not normally make a restroom available to the public.
employee toilet facility is not located in an area where providing access would
create an obvious health or safety risk to the customer or an obvious security
risk to the retail establishment.
(5) A public restroom is not immediately
accessible to the customer.
(a) A retail
establishment or an employee of a retail establishment is not civilly liable
for any act or omission in allowing a customer that has an eligible medical
condition to use an employee toilet facility that is not a public restroom if
the act or omission meets all of the following:
(1) It is not willful or grossly negligent.
(2) It occurs
in an area of the retail establishment that is not accessible to the public.
(3) It results
in an injury to or death of the customer or any individual other than an
employee accompanying the customer.
(b) A retail establishment
is not required to make any physical changes to an employee toilet facility
under this Act.
Violation. A retail establishment or an employee of a retail establishment that
violates Section 10 is guilty of a petty offense. The penalty is a fine of not
more than $100.
The law is a great addition – I suggest you carry your CCFA
card and a copy of the law in your wallet.
While the penalties are not great, the negative publicity may be.
Multiple other states have similar laws in process. My own Virginia was a disappointment (except
Delegate Rob Krupicka, who introduced the bill) – they voted it down last year,
and the there was hardly a public outcry (see http://hamptonroads.com/2013/01/bathroom-bill-ends-where-it-belongs-down-drain
for a particularly insensitive response).
I suggest y’all write your local delegates in your states to see if
there is a similar law on the legislative agenda (or suggest one!)
Aside from trying to get a law passed, if you are denied
access to a restroom try contacting the franchise owner or corporate affairs
and educate them. If it is a small
business, contact the Better Business Bureau (assuming the owner is the one
that denied you – otherwise, talk to the owner and educate them).
My personal favorite location is hotels – they are open 24
hours, have lobbies that are open and have restrooms that are generally clean.
·In general, there aren’t a lot of laws requiring
individuals to allow you to use their restrooms.
·Ally’s Law and a few similar laws provide some
relief – if you don’t have a local version, contact your representative.