Last updated: November 2026. Regulation text checked November 5, 2026 against the eCFR (Title 28 last amended October 27, 2026).
An ADA Title II web and mobile accessibility program organizes a public entity’s work under 28 CFR Part 35 Subpart H. Integral Healthcare Solutions (IHS) drafts inventories, vendor requirements and procedures for public hospitals, health departments and government-operated clinics; these documents do not establish technical conformance.
This engagement is for the compliance, legal and IT leaders of a public health provider. It is not an audit of your code or legal advice.
What does the ADA Title II web and mobile accessibility rule require?
The rule requires a public entity to ensure that the web content it provides or makes available, and its mobile apps, are readily accessible to and usable by individuals with disabilities. The governing text is Subpart H of 28 CFR Part 35, "Web and Mobile Accessibility," added by Attorney General Order No. 5919-2024 (89 FR 31337, April 24, 2024) and amended by Attorney General Order No. 6742-2026 (91 FR 20912, April 20, 2026). The text is on eCFR at 28 CFR Part 35 Subpart H.
Key points, in IHS's words:
- Reach. Section 35.200(a) covers web content that the entity provides or makes available "directly or through contractual, licensing, or other arrangements," and it covers mobile apps.
- Technical standard. Section 35.200(b) requires WCAG 2.1 Level A and AA success criteria and conformance requirements (W3C Recommendation, June 5, 2018), unless the entity demonstrates that compliance would fundamentally alter a service, program or activity or cause undue financial and administrative burdens. Section 35.204 preserves continuing duties.
- Exceptions. Section 35.201 lists five exceptions. Two of them: archived web content as defined in section 35.104 (content created before the compliance date or reproducing paper documents or other physical media created before that date; retained exclusively for reference, research or recordkeeping; neither altered nor updated after archiving; and organized and stored in dedicated areas clearly identified as archived), and content posted by a third party, unless the third party is posting because of a contractual, licensing or other arrangement with the entity. We do not summarize the other three.
- Conforming alternate versions. Section 35.202(a) permits WCAG 2.1-defined alternate versions of web content only when technical or legal limitations prevent direct accessibility.
- Undue burden and fundamental alteration. Section 35.204 places the burden of proof on the entity. The entity head or designee must consider all resources available for funding and operating the service, program or activity and issue written reasons. Compliance remains required to the extent it avoids the alteration or burdens. The entity must take any other action that would not cause such an alteration or burdens but would nevertheless ensure that individuals with disabilities receive the entity’s benefits or services to the maximum extent possible.
The technical-standard deadline depends on total population and special-district status. A Department of Justice interim final rule published at 91 FR 20902 moved both compliance dates by one year and took effect April 20, 2026 (28 CFR 35.200(b), amended at 91 FR 20912).
| Entity | Compliance date |
|---|---|
| Public entity with a total population of 50,000 or more, other than a special district government | April 26, 2027 (previously April 24, 2026) |
| Public entity with a total population of less than 50,000, or any special district government | April 26, 2028 (previously April 26, 2027) |
Use the total-population and special-district definitions in section 35.104. April 2026 for larger entities, or April 2027 for smaller entities and special districts, are superseded deadlines.
Who needs a Title II web accessibility program, and what triggers it?
This service supports public health providers covered by Title II. State funding alone does not establish public-entity status under section 35.104; counsel determines coverage. The dates above concern the technical standard, not the start of all Title II duties.
Situations that usually start a build:
- A compliance date is on the calendar and nobody has listed which web properties and apps the entity runs.
- Vendor-hosted portals, scheduling tools and telehealth apps need review: section 35.200(a) covers web content and mobile apps provided through contractual, licensing or other arrangements. IHS inventories them for counsel’s coverage review.
- Contractors post content for the entity. The third-party exception in section 35.201(c) does not cover posting under a contractual, licensing or other arrangement.
- A vendor contract for a portal, scheduling tool or app is being signed or renewed, which is the moment to write the accessibility requirement in.
How does IHS build a Title II web and mobile accessibility program?
IHS builds the program in five steps, working as an outside drafting team under your compliance officer, your counsel and your web team.
- Gap assessment against the text. IHS compares what you have to sections 35.200 through 35.204 and lists each missing document, owner and decision.
- Inventory and evidence mapping. IHS sets up the register of web content, mobile apps and vendor-hosted properties, marks which ones your counsel says fall under an exception, and maps each property to the record that will show its status.
- Drafting. IHS drafts the content inventory register, vendor accessibility requirements for contracts, the testing calendar and sign-off sheet, the exception and conforming-alternate-version procedure, an undue burden documentation template, a training outline and a remediation tracker. Your compliance officer, counsel and web team approve each one.
- Mock review. IHS reads the finished set as a reviewer would, asking each property's owner, last test date and exception.
- Readiness support. IHS drafts the briefing notes and evidence index for your leaders.
What you supply: your legal status and population category, determined with counsel; the list of web properties and apps; vendor contracts and platform access; the head of the entity or a designee for any burden determination; and the technical remediation.
The real limit: IHS does not test or fix code. A register and a calendar do not make a page accessible; only your web team or vendor can change what users see. IHS does not decide coverage, population or burden questions, and does not communicate with the Department of Justice for you.
IHS was founded in 2002 and is led by Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC. IHS works across three practice lines: accreditation consulting, compliance services and program development. This program sits in compliance services.
What should a public health provider have ready for a Title II accessibility review?
IHS recommends these assessment records; the rule does not prescribe this checklist. References are to 28 CFR Part 35 Subpart H and section 35.104, current text opened November 5, 2026.
- Counsel’s coverage and deadline assessment using the public-entity, total-population and special-district definitions (35.104; 35.200(b)).
- A register of the web content and mobile apps you provide or make available, including those provided through contractual, licensing or other arrangements (35.200(a)).
- For each property, the exception it relies on, if any, and the basis, with archived content and third-party content listed separately (35.201).
- Vendor contracts for portals, scheduling and telehealth, showing who is responsible for accessibility (35.200(a)).
- A testing plan with dates, written to the WCAG 2.1 Level A and AA target and your compliance date (35.200(b)).
- For a WCAG 2.1-defined conforming alternate version of web content, the technical or legal limitations preventing direct accessibility (35.202(a)).
- A burden-determination template covering the entity head’s or designee’s decision, all available resources, written reasons and continuing duties (35.204).
If most of these do not exist yet, a free introductory call with IHS can sort what to build first.
How does an outside accessibility program build compare with the other routes?
A public provider can use several routes, and they are not exclusive. The table lists them without ranking them.
| Route | What it involves | Where the work sits |
|---|---|---|
| Accessibility testing vendor or web agency | Audits pages and apps against WCAG 2.1 and fixes code. | Technical work, which IHS does not do. |
| Counsel | Advises on coverage, population and burden defenses. | Legal determinations, which IHS does not give. |
| Internal build | Compliance and IT staff write the inventory and procedures themselves. | Your staff time, with no outside drafting capacity. |
| Outside program drafting support (IHS) | IHS drafts the inventory, vendor terms, calendar and procedures for your teams to approve. | IHS drafts; your teams approve and run the program. |
The takeaway: testing and remediation change the pages; the program documents show who owns what and when.
What does an accessibility program build cost?
Subpart H does not state a fee schedule. Budget separately for staff time, accessibility testing and remediation.
IHS scopes each engagement after a free introductory call. Scope depends on the properties, apps, vendors and existing documentation.
What this is not
This is not legal advice. IHS is a consulting firm, not a law firm. Coverage, population category, exceptions and burden defenses are questions for your counsel.
It is not technical remediation or accessibility testing. IHS does not review or change code.
It is not a guarantee that a property conforms to WCAG 2.1. IHS does not communicate with the Department of Justice or any other agency for you.
Frequently asked questions
What does the ADA Title II web and mobile accessibility rule require?
Under 28 CFR Part 35 Subpart H, public entities must ensure accessible web content and mobile apps provided directly or through contractual, licensing or other arrangements. Section 35.200(b) specifies WCAG 2.1 Level A and AA success criteria and conformance requirements, subject to the subpart’s exceptions and limitations.
When do public hospitals and health departments have to comply?
The technical-standard deadline is April 26, 2027 for public entities with a total population of at least 50,000 other than special district governments, and April 26, 2028 for smaller public entities and all special district governments. Counsel should apply section 35.104’s definitions; these dates do not postpone all Title II duties.
Which content is excepted from the rule?
Section 35.201 lists five exceptions. Two are archived web content, as defined in section 35.104, and content posted by a third party, unless the posting is due to a contractual, licensing or other arrangement with the entity. Counsel decides whether any exception fits a property.
Does the rule cover vendor-hosted patient portals and apps?
Section 35.200(a) covers web content and mobile apps provided directly or through contractual, licensing or other arrangements. IHS includes vendor-hosted portals and apps in its inventory for counsel to assess coverage and exceptions.
What does a public entity have to show to claim undue burden?
Section 35.204 places the burden of proof on the entity; its head or designee must consider all available funding and operating resources and give written reasons. Compliance remains required to the extent it avoids the alteration or burdens. The entity must take any other action that would not cause such an alteration or burdens but would nevertheless ensure that individuals with disabilities receive the entity’s benefits or services to the maximum extent possible. Counsel advises on the defense; IHS drafts documentation.
How should a public provider inventory its web content and apps?
The regulation does not prescribe an inventory, and IHS treats one as the practical first step. List every web property and app the entity provides or makes available, including vendor-hosted ones, with the owner, vendor, exception relied on and test date for each.
Should a public provider use an internal team, an accessibility vendor or outside program drafting support?
The routes are not exclusive. A vendor or agency tests and remediates code, counsel gives legal advice, and your staff can build the documents. IHS drafts the inventory, vendor terms, calendar and procedures for your teams to approve, and does not touch code.
What does an accessibility compliance program build cost?
Subpart H does not state a fee schedule. IHS scopes each engagement after a free introductory call, based on the number of web properties and apps, how many are vendor-hosted and how much documentation already exists.
Related pages
See the Compliance Services overview | Compliance program development | Prison Rape Elimination Act standards compliance program | Respiratory protection program for healthcare employers.