Ensure that in-house staff and contractors responsible for webpage and content development are properly trained. Distribute the Department of Justice technical assistance document “Accessibility of State and Local Government Websites to People with Disabilities” to these in-house staff and contractors on an annual basis as a reminder. This technical assistance document is available on the ADA Home Page at www.ada.gov.
The prudent next step is running an audit on your site. The tools will crawl your site and identify all the areas that do not meet web accessibility standards for ADA compliance. The results will give you a very clear sense of the work involved so you can budget properly and weigh the benefits. Who knows, you may find out that your site is already fairly compliant, especially if you are on a fairly progressive platform and have used proper coding practices during your site build.
This past September marked the first time a judge ruled that the ADA applies even to businesses without a physical location. Scribd, an e-book subscription service is considered to provide "a place of public accommodation." Their services are not accessible to blind persons because they cannot be read with a screen reader. The judge reasoned, "Now that the Internet plays such a critical role in the personal and professional lives of Americans, excluding disabled persons from access to covered entities that use it as their principal means of reaching the public would defeat the purpose of this important civil rights legislation."
This title requires telephone and Internet companies to provide a nationwide system of interstate and intrastate telecommunications relay services that allows individuals with hearing and speech disabilities to communicate over the telephone. This title also requires closed captioning of federally funded public service announcements.  This title is regulated by the Federal Communication Commission. 
While legal considerations might be your biggest worry, making your site more accessible is simply good customer service. More than 39 million Americans are blind and another 246 million have "low vision," Another one million are deaf in the U.S. Add to that people with mobility issues that prevent them from using their hands and that's a huge portion of the country's buying power.
I own a medical practice in California with 5 employees. Since I have under 15 employees am I exempt from needing to have my website comply with the ADA? I know that my physical practice is exempt from ADA policies regarding employment (under 15) but I don’t know if that extends to websites. My website is not an important part of my practice and I don’t really want to sink any funds into it if I don’t need to.
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