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Updated: Aug 16, 2026

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Reasonable modification or fundamental alteration? Recent developments in ADA caselaw and implications for behavioral
Sara Rosenbaum1, Joel Teitelbaum, D Richard Mauery
1Center for Health Services Research and Policy, The George Washington University Medical Center, School of Public health and Health Services, Washington, DC, USA.
Abstract:
This issue brief examines the concept of fundamental alteration under the Americans with Disabilities Act (ADA); specifically it considers when proposed modifications of public programs under Title II of the ADA will be considered to amount to the type of fundamental alteration that lies beyond judicial power to compel. The issue of when a program change constitutes a fundamental alteration is important in state community integration planning efforts, since these types of changes will require legislative action.
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