Thanks for writing. While I’m not a lawyer I believe if your physical practice is ADA exempt your web presence, as an extension of that physical business would maintain the same exemption status. If you’d like to be absolutely certain I’d confer with an ADA lawyer (email us, questions at yokoco dot com if you need a referral) but I don’t believe you have reason to worry.
Upon discovering issues faced by disabled government employees and the public, revisions to section 508 were made. The issues that were uncovered involved websites, documents, and software programs. As of January 2018, the updated 508 standards require all federal agencies and contractors to create web content accessible to all. The updated standards also include Website 508 compliance.
The Supreme Court decided under Title II of the ADA that mental illness is a form of disability and therefore covered under the ADA, and that unjustified institutional isolation of a person with a disability is a form of discrimination because it "...perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life." The court added, "Confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."
State and local governments will often post documents on their websites using Portable Document Format (PDF). But PDF documents, or those in other image based formats, are often not accessible to blind people who use screen readers and people with low vision who use text enlargement programs or different color and font settings to read computer displays.
The trick to finding top web designers is to understand what you’re trying to build. There’s a big difference between designing a landing page meant to be the receiving end of a sales funnel and building an enterprise site that will serve corporate clients. The web designer is responsible for translating your unique brand identity into the visual elements that make up a website. The cost of your project will depend largely on your scope of work and the specific skills needed to bring your project to life.
Technology is changing, and many website designers are using creative and innovative ways to present web-based materials. These changes may involve new and different access problems and solutions for people with disabilities. This Chapter discusses just a few of the most common ways in which websites can pose barriers to access for people with disabilities. By using the resources listed at the end of this Chapter, you can learn to identify and address other barriers.
An employer cannot require you to take a medical examination before you are offered a job. Following a job offer, an employer can condition the offer on your passing a required medical examination, but only if all entering employees for that job category have to take the examination. However, an employer cannot reject you because of information about your disability revealed by the medical examination, unless the reasons for rejection are job-related and necessary for the conduct of the employer's business. The employer cannot refuse to hire you because of your disability if you can perform the essential functions of the job with an accommodation.
I know there may have been concerns that the ADA may be too vague or too costly, or may lead endlessly to litigation. But I want to reassure you right now that my administration and the United States Congress have carefully crafted this Act. We've all been determined to ensure that it gives flexibility, particularly in terms of the timetable of implementation; and we've been committed to containing the costs that may be incurred.... Let the shameful wall of exclusion finally come tumbling down.[41]
As a result, most ADA suits are brought by a small number of private plaintiffs who view themselves as champions of the disabled. For the ADA to yield its promise of equal access for the disabled, it may indeed be necessary and desirable for committed individuals to bring serial litigation advancing the time when public accommodations will be compliant with the ADA."[57]

The average cost for hiring a web designer varies greatly depending on the scope of the work, which may range from building a site from scratch to rebranding an existing one, as well as the amount of content and graphics the designer will create. In general, the more complex the project, the more time the design agency will have to spend. Because web designers often work on an hourly basis, the longer the project, the higher the costs; you can count on the web designer spending at minimum 10 hours to create a very basic website with just a handful of pages with few elements. Prices also depend on the designer’s skill set, the process, and the company’s rates. In general, the national average cost for a basic website package starts at $500, but a customized website can cost as much as $2,000 or more. Here are typical average hourly rates, broken out by the complexity of the work:
The type of operating system and hosting doesn’t matter much for design, but the platform is a factor. For instance, if you need a WordPress theme, the designer must work with WordPress themes and customize them in a way that a developer can feasibly code in CSS or JavaScript on the front end. If you use another CMS, the developer must work with those elements. Most designers specialize in specific platforms, so review their portfolios and experience for specific platforms before you invite them to bid on your project.
In January 1992, EEOC published a Technical Assistance Manual, providing practical application of legal requirements to specific employment activities, with a directory of resources to aid compliance. EEOC publishes other educational materials, provides training on the law for people with disabilities and for employers, and participates in meetings and training programs of other organizations. EEOC staff also will respond to individual requests for information and assistance. The Commission's technical assistance program is separate and distinct from its enforcement responsibilities. Employers who seek information or assistance from the Commission will not be subject to any enforcement action because of such inquiries.

Barden v. The City of Sacramento, filed in March 1999, claimed that the City of Sacramento failed to comply with the ADA when, while making public street improvements, it did not bring its sidewalks into compliance with the ADA. Certain issues were resolved in Federal Court. One issue, whether sidewalks were covered by the ADA, was appealed to the 9th Circuit Court of Appeals, which ruled that sidewalks were a "program" under ADA and must be made accessible to persons with disabilities. The ruling was later appealed to the U.S. Supreme Court, which refused to hear the case, letting stand the ruling of the 9th Circuit Court.[62][63]
Your site would need to have a text only option, with all functionality accessible through a keyboard for visitors with mobility issues. Once you make these and other changes to meet ADA guidelines, your site would need to be tested by a website development company familiar with ADA compliance issues to be sure that visitors who use assistive technology such as screen readers are able to access your web content fully.
Federal law isn't the only consideration for businesses. Additionally, each state interprets the law differently. Consider the case against Netflix in 2012. Lawsuits were brought in federal court in Massachusetts and California. Netflix was accused of violating the ADA by not offering "closed captioning" options for its Internet streamed movies. Illustrating the complexity of this issue, the courts reached completely opposite decisions. Massachusetts held that Netflix must comply with the ADA, while the California court found that Netflix did not fall under the ADA's definition of "public accommodation."

It isn’t a problem by default, a lot of it comes down to how it is built. I’d suggest either considering a highly accessible contingency option, or build those components in such a way that there is a level of accessibility baked into it. If you need help with that testing or review email us at questions at yokoco.com and we’ll be able to let you know the cost for us to lend a hand.
Level AA is a little more significant, and makes sites accessible to people with a wider range of disabilities, including the most common barriers to use. It won't impact the look and feel of the site as much as Level AAA compliance, though it does include guidance on color contrast and error identification. Most businesses should be aiming for Level AA conformity, and it appears to reflect the level of accessibility the DOJ expects. 
Additionally, in February 2018, Congress passed the ADA Education and Reform Act, a bill designed to make it harder for disabled Americans to sue businesses for discrimination. Republican lawmakers who wrote and passed the bill argue that the law will help curb “frivolous” lawsuits, while opponents have argued that this law will gut the ADA, essentially giving businesses little reason to follow the ADA guidelines at all.
Talk to your web designer about other techniques that will make your site more user-friendly for people with disabilities. Worried that’s not in your budget? Consider the fact that DOJ fines start at $75,000. And it's still yet to be determined if a non-compliant website is liable for one fine or will be charge per page for each violation. As the recent lawsuits illustrate, though, settlements quickly add up into the millions.
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