Advanced Accessibility Training

This transcript has been edited for clarity.

KHALILAH LEGRAND:
Hi, everybody. My name is Dr. Khalilah LeGrand. I am the Vice President for Communications and Public Relations here at ASTHO. Very nice to have you all today. And joining us for our, Part 2 Advanced Accessibility Training. Again, I apologize, I'm having a few technical difficulties, so I'm on my phone and trying to, manage between two devices and need to mute my computer. So that… You won't hear that.

But as, we do have, closed captioning for our, webinar today, and again, for those of you who might just be joining us, we are recording this, webinar as well, so if you don't catch the whole thing, or you want to share with someone else after, it will be, available. We'll be emailing those who have attended to let you know when the recording is ready. If you have questions for the panel, feel free to submit them in the chat as we go along, and we'll be monitoring that chat as well.

And so, without further ado, I will start, I'll do some introductions quickly and let them, kind of continue with introducing themselves. Very happy to have, fellow team members, Chris Preheim and Emily Lapayowker, who will be conducting our training today. I know that you all saw another name on our agenda today, we had one adjustment to a presenter, so we'll share a little bit more about that as well, but we still have a great presentation ready for you, and I will turn it over.

EMILY LAPAYOWKER:
Alright, thank you so much, Khalilah. My name is Emily Lapayowker. I am a member of the Web team. As Khalilah mentioned, Heidi was not able to join us today, but we are touching on just one small piece of the legal landscape, which is what she was going to be talking about. We'll be posting a recording of her section, which is gonna be more robust than what we touch on today, along with this recording, so you will have a chance to benefit from her knowledge. Yes.

So, welcome to Advanced Accessibility Training. The goal is, at the end of this, for you all to understand the ADA Title II Web Rule requirements, and also the legal and real-world impact of the requirements, to be familiar with common document remediation strategy, and to understand the commonalities between a website and document accessibility.

So we're gonna start with the big one, which is ADA Title II Web Rule. So there are a couple things that make this significant. The first is that I'm pretty sure it's the first time the federal government has explicitly named the standard that they want everyone to meet, and they've chosen, WCAG 2.1 AA, which is the gold standard, really. This also includes a hard deadline, the web rule does. For most of you, that's gonna be April 24th, 2026. But, special districts and jurisdictions of under 50,000, have another year to become compliant.

Excuse me. The web rule also contains a summary of exceptions, things that don't have to be made compliant in time, and also, kind of guidelines around that. And, it also allows for the use of conforming alternate versions for content that cannot be made accessible, so that's helpful as well.

Now, this is mostly Heidi's piece, she will be able to speak to it much more in her recording, but the important thing to know is that there has been a massive explosion of lawsuits related to accessibility lately. There have been over 25,000… er, yeah, 25,000 digital accessibility lawsuits filed since 2018, and more than 5,000 of them were in 2025 alone. So it's… it's a cottage industry that's growing.

The industries that are hit hardest tend to be e-commerce, food service, entertainment, healthcare, and banking.

The states with the most lawsuits are New York, California, and Florida.

Penalties. The ADA, Title III, allows only injective relief, but state laws, provides statutory damages. I'm gonna be honest with you, I cannot speak a lot to this one. You will have to check in with Heidi for that. But the last thing is really don't use overlays. The FTC has levied a $1 million fine against an overlay provider already. And accessibility overlays and widgets, which are JavaScript tools that claim to make websites accessible, they've been sold as, like, a quick fix, but they don't actually address any of the underlying code-level accessibility. So they can actually make things significantly worse, so if you're tempted to go in that direction, please don't.

Also worth noting, we're not lawyers, so if you do have real legal questions, please seek out an actual attorney. This is just the guidance that we have.

Okay, so WCAG, we mentioned before, 2.1 is the standard that the government has chosen. Now these standards are principle-based, which means that rather than requiring all web browsers meet a specific technical standard, they instead require that all content be developed with four principles in mind, the POUR principles, P-O-U-R. And they stand for Perceivable, which means all information must be presented in a way that ensures users can perceive it using at least one of their senses.

Operable O. A website is considered operable if all users can effectively navigate it, even those who employ assistive technology, like screen readers.

U is understandable. This is actually a two-pronged principle, so the first prong is that users must be able to, excuse me, understand how to use the site, and the second is that they have to understand the content as well.

And the R in p… I'm so sorry, the R in POUR, is that content has to be Robust enough that multiple technologies, including assistive devices like screen readers, can interpret it.

And… WCAG stands for Web Content Accessibility Guidelines. I believe I forgot to say that before. So hopefully that's helpful.

You know, and this… this might all seem academic, you might be getting some pushback from people… from people who think, that it's not really necessary to do this. But it is. 27.8% American adults identify as having some type of disability, which means you're risking leaving a third of your audience out, and you skip best practices. Worldwide, the impact is even larger. Roughly 1.3 billion people experience a significant disability, so that's like 16% of the world. An estimated 1 in 12 American males, or 8%, are affected by some form of colorblindness. And you know, disabilities can also be temporary. Things like a broken leg or temporary hearing loss because you went to a concert that was really loud, even a concussion are… all qualify. And the thing about the disability community is that it's the largest minority group in the world. It's also the only one that any of us could join at any time, so even if it doesn't feel like it's close to home, the truth is it probably is.

It's also just beneficial overall to start building accessibility best practices into your content. We have a saying in this field, "accessibility is necessary for some, but useful for all," and it's true. If you think about how often you've used curb cuts, ramps, automatic doors, captions… I mean, all of these things were developed as accessibility remediation, for lack of a better word right now. But we all benefit from them. And the same thing is true of web content. It helps with SEO to have accessible content. It makes it easy to scan, for sighted users, if you're using headings correctly. Too many links can overwhelm sighted users, as well as people using screen readers. High color contrast ratio always makes information easier to see, so, like, don't do yellow on white. That's terrible for everyone. And if an image doesn't load, your alt text will, so whatever value that image was bringing, it's still gonna bring, even if the image doesn't load.

It's also tempting to think of these accessibility efforts as happening in siloed groups. But, you know, a lot of the work is the same across different teams, departments, areas. So, accessible webpages and documents both use headers for structure. Correct color use and contrast are crucial to accessible visuals, documents, and web pages. Linking best practices are the same for documents and websites. Alt text, for all digital content is important, including social media. And plain language is considered a best practice across the board, so remember that Everybody working on different teams on this, you're using a lot of the same techniques.

I'm gonna pass it over to Chris now.

CHRISTOPHER PREHEIM:
Hi everyone, my name is Chris Preheim, I am the Graphic Design Manager here at ASTHO, and today I want to talk to you a little bit about design principles, as well as the expectations for accessibility with design.

Emily did a great job highlighting that ADA standards usually comply more towards web-based stuff. And it isn't really talked about, or there aren't as many resources for design.

On the graphic element, but that doesn't undercut its importance to make design products accessible, so I'm here to talk a little bit about that. And first off, it's understanding 7 key design principles that will ultimately help make your products look A lot more consistent, but also help with applying accessibility compliance to the product in the end.

So, first off, we have scale. This is kind of just, like, a very quick overview as to these principles, but scale, essentially, is, what it's trying to emphasize through… its… largeness, or through how small it is. And usually, in the instance, we want to draw attention to the eye through scale by making the most important thing the largest thing.

And that ties in with hierarchy, and that's ordering the importance of elements through their size. So, an example would be for a heading 1, You want the title, Heading 1, to be the largest title or header available that you see in the immediate. That shouldn't be, you know, competed with. And so, in the hierarchy, you want H1, H2, H3; Heading 1, Heading 2, Heading 3. You want to make sure that those aren't the same size, and they're in decreasing size as they go on. So, scale and hierarchy are linked together in that way.

Negative space. Like all things in life, we like a little bit of breathing room, and design is no different. So, with negative space, it helps not only the audience and consumer of your product kind of understand the flow of your information, but it also allows the software for the compliancy step to actually understand what it's trying to register and mark as, or tag, rather, what it's trying to tag. So, having space might sometimes feel empty, but it's also necessary, and it's very important to do so around in the margins. That provides a little bit more breathing room, and the margins are defined by the edge, and how much space between what's on the edge and then what's, like, the next graphic, or the text. So, that's an important direction to have.

And… on that note, direction. So… InDesign, particularly graphic design, but there's UX UI design, there's motion graphics, just design in general. Has the goal of making sure that your audience follows the information the way you want them to follow it. It's a little bit of psychology. So… Best practices for this are to create Three different types of letters to make sure that your audience members finds the information most efficiently, and that they don't get too bored. So, Z, L, and Y tend to be the best or more recommended options for how you should lay out your product. So, just… and that comes from how we as people in the United States of America read, specifically. If you were in Japan, they read from right to left, so that would be different. And so other cultures, it's not necessarily the same. Some read vertically differently than we do. So also be cognizant as to who your audience members are.

Repetition. This design principle offers the most opportunity for creativeness for a product, and people love to see repetition in their works. We're just naturally drawn to elements that are consistent with each other, because we like to find that order in the chaos of elements. So in this case, with the design and the icon example, you have a repetition of 3 graphics on the left side. On the left column, but there are 3 columns overall, as well. And then, color repetition.

We like it… our eye likes to kind of do a connect-the-dots scenario. So in this case, when you have 3 accent colors of orange, your eye draws to and tries to connect those dots. So it helps with the direction of the flow of information. So… It can be fun, it can be challenging, but if it's done well, it yields great results, and it's really kind of the most creative element out of the design principles in a compliance space.

Contrast, which we'll talk about later, more in depth. Actually, probably coming right up after this, I believe. So contrast is important because it helps with legibility, and that's often just noticed as the balance between light and dark, and thin and thick if you're talking about lines, and icons and graphics. So, there's a balance to that, but yeah, I think most people know, in general, contrast as a whole. But we'll go more in detail on that.

Balance. Again, everyone likes order to the chaos, so having a sense of balance and symmetry is pleasing to the eye, pleasing to the design, and it also makes the compliance a little bit easier, so long as you have, like, the negative space, the hierarchy, everything of the other design principles is well-balanced, then your product is going to shine, essentially.

So, when we talk about remediation, it's essentially making the product accessible when it wasn't prior. And for us at ASTHO, our process, which many of you might have something similar at your departments, but we don't apply accessibility until the product is at final approval steps. Because it's kind of a one-way process, a one-way street, where You can't do a whole lot of back and forth of edits, so it's best to do it once everything's been approved. And there are stipulations, there are exceptions, but ultimately, that's the best practice we've found.

And different softwares provide different levels of difficulty. So, on an easy level, you have Word documents, PowerPoint presentations, and most HTML pages. Those will have less detailed processes to make the product compliant. It will sometimes still take quite a bit of time, depending on the length of the product, but it's less detailed and, easier to work with, and there's kind of, like if you can ask the chat in the Word or PowerPoint, like, you know, "how do I fix this?" And it'll give you a link to some guidance on it. So, that one's a bit easier.

What's hard and difficult would be PDFs. I'm not sure where everyone's at in their journey with accessibility and PDFs, but if you haven't experienced it yet, it can be very difficult, because Adobe Acrobat is the main product and software that will actually be used, and that's what we'll showcase today a little bit. It's a little finicky. So… It… just be prepared for the dauntless tasks that Adobe Acrobat will be presenting in front of you. There's gonna be a lot of trial and error, there's gonna be a lot of points where, you know, you can't undo. The undo button doesn't work for everything. It works for some things, but not everything. sometimes you can be halfway through a product, and suddenly it doesn't read the text like it's supposed to, and they disappear. O's or U's, I've had countless products where I'm working, and all of a sudden. It's all gone. So… Very finicky, very difficult. I've put in some requests to Adobe to help assist with this, but until then, just notice that this is a very time-consuming process, so build out that time in your schedule. The learning curve for all this? there are resources available, and we're happy to discuss that during the Q&A, for sure, but… it's a little patchwork-ish, so we can help guide, but it will be a self-taught experience, largely, unless you're able to afford a certificate program of some sort.

What's impossible? An embedded dashboard from a platform does not support keyboard navigation. So, yeah, keyboard navigation is key, especially for web. Not having that automatically disqualifies it for accessibility, so… yeah, that would make it impossible. And if something can't be remediated, then you have to consider other ways to… have access to it, and those are called conforming alternate versions. So examples of that is that a conforming alternate version provides the same information in a second accessible format. And the user should be able to access the alternate version easily through obvious, accessible link, or by email. Yeah, it's… we can go further in depth on that, but that's more Q&A that Emily would probably be better at answering than me, but yeah.

And then we have this is a slide from our first training that talks about the six core pillars for design's approach to accessibility. So, we'll briefly go over these again, but then kind of showcase what these are like in the actual process of remediation. But first, let's break them down to when they should be applied.

So, color contrast and fonts. How many of you… know off the top of your head if your colors and fonts currently pass general WCAG AA standards. Okay, so some people actually took the initiative, good on ya. So, this is a crucial step, and I would, I highly, highly recommend that you take your colors for your brand and put them through a contrast checker, which I will show in a sec. Those are very important, and something that needs to be done at the very beginning, before you start design as a whole for a product.

This is the same case with fonts. This should be well-researched and determined ahead of time, so you're not scrambling to figure out, oh, is this successful or not, when you're already working on the final stages of accessibility.

Tables and graphs. Tables and graphs are going to be something that needs to be considered during the design phase. Because they depend on color coordination and legibility standards that you can't alter during the Acrobat check, the Adobe Acrobat check. You can to some extent, but it's finicky, and so it's best to do it during the design phase. And we'll go further in depth with that.

Alt text. So, after you have the final approval from design team or editorial, and these are the final steps going to compliance with Adobe Acrobat, then alt text, reading order, and tags will be pretty much what you will spend the majority of your time organizing and applying.

Alt text, I will say, is the easiest to work with. There is a little bit of finagling and a learning curve to actually make it a good explanation for what the graphic or photo was, and we'll go a little bit in detail on that.

Reading order is more time-intensive. Doesn't have the undo button do what you want it to do, so you have to save frequently. Command-S for those who are on Mac, I believe. Alt or Control-S, or maybe Shift- I haven't done Windows in a while.

So, reading order is crucial because that establishes the structure for what the screen reader is going to read in order of. And then tags. Tags will be the most time-intensive element of 508 compliance.

Early on, I highly recommend carving out a lot of time to understand why something doesn't work, why it needs to be nested and structured in the way it is. And there are quite a few complex things that take quite a bit of research to understand. I'm still learning, even. A year and a half, two years of going through this stuff.

So, back to color contrast. This is… Hey… Website, or really, toolness.github.io is what's being presented right now. This product, when I inputted the hex codes, for our brand. This showcases what passes as AA… WCAG AA compliant with the colors that are available on screen. So, this lets you know that, okay, you can have accent 1, if that background is there, it can have white text on top of it. So, in this case, it's only using the colors you see here. It would be a good idea to also include black, so you can see how black reacts to the different colors. Because, for example, for the Accent 2 and 3, black would also be feasible. I know that, because I've tested it. In this case, it's not showcasing that, but… This is essentially the process that you use to figure out if your colors are accessible. They have to have a 4.5 to 1 contrast ratio. That is the bare minimum ratio, and WebAIM.org has a contrast checker. That's one that I use frequently.

And then toolness.github.io is the one that has all-in-one. So this needs to be done and checked on before, like, if you haven't done it, I would suggest doing it now so that you don't have to worry about that for future products.

Fonts. Fonts are similar. This should be well-established and researched ahead of time. Four key… there's no exact defining principles as to what makes a font compliant.

And yes, the ratio is 4.5 to 1. And, they have that explained in the websites they use for the contrast checker. And we'll link those, down the road.

So, fonts have four main principles that let you know that, okay, this will be accessible. So, simple shapes, you don't want crazy flourishes like you would see on the Declaration of Independence. No one is going to be able to read that in this day and age. No one will want to read that in this day and age.

Clear distinctions, so there are certain fonts that, particularly with ones, L's, and I's, if I were to type, in all lowercase, one ligature and no spaces between. Would that one L&I be different enough that I could distinguish that, or would it all be looking like a bunch of 3 vertical lines? And it looks like… 3atures. So, you need to test by typing out various words, particularly ones that have F and I's near, F and L, FF, FFI, FFL, and TH, because those are the ones that tend to blend, and when that happens then acrobat will consider it a cliff and not read it, and sometimes will chuck it out, because it can't understand it. So, it can be very difficult to find a font that works with that. A way to showcase and fix that is to increase spacing between, but also be cognizant of the making sure they don't blend together.

You want high legibility, good spacing between letters and characters, with a high X height, And, as mentioned, tall lowercase letters. Font weights. You want a nice breadth of font family that has weights from italic, regular, or book that's the same, pretty much. Medium, bold, bold italic, bold, medium… you want something that can offer a good amount of weight, so then you can differentiate a text-heavy product, and add accents, and kind of put emphasis on text. That's harder to do if you have, you know, just regular and bold, you can't really differentiate as much.

Tables and graphs. So, this was the bit that I was talking about with tables being very nitpicky in the Software in Acrobat. So, Acrobat likes to try to highlight tables to the best of its ability. It doesn't tag it well all the time. It tags it a lot better if you help it with color coordination. And not only does that help the software, but it helps people's eyes in general. If you have a solid dark color top header row, it allows people to understand this is the header. And then if you have subsequent alternating color tints, then it helps the person's eye track across the entire row, rather than get lost. And this is particularly helpful for really long horizontal, or very vertical, tables. So, this might seem like extra work, but it really helps everyone involved, so it's important to do that.

I recommend a 15% tint. You can do 10, you can do 20, but know that if you're to print, tints don't always look as good printed versus digital, but granted, accessibility, you still have some elements you want to do if it's printed. You're not going to have the same checklist as you would if it's digital, but this would be one of the things that would help if it's printed as well.

Graphs are a little bit different, but color is very important. So, color coding your graphs, whether it's pie graph, or just a vertical bar chart. You need to be able to distinguish the colors enough that they have enough contrast to them that someone who is colorblind, or has an impairment that they're able to distinguish them enough. There are tests and ways you can make it so that the whole visual goes grayscale, but the best thing to do to… even if you don't have access or options to do that, is help provide a dividing line between the individual slices. That separates it and lets people know, oh, okay, these things aren't as blended as I thought, there's an actual stop to it.

And so, with that, you have to also include, which, for someone who doesn't have visual impairment, this might seem redundant, because we can see the color fine, but you need to also put the percentage or the amount directly or close to the individual slice or, bar, for the bar chart. So, that lets people know directly, okay, I don't have to rely necessarily just on color to know that this is A, and it's at 25%, or B at 27.5%. You can also differentiate further with textures. Sometimes that can be difficult, and you don't want it to… overtake the text of the amount, so in that case, you might want to put it off the actual pie chart. But yes, colors and having amounts nearby and divider lines are all very important, and they might seem like redundancies, but they are necessary.

Alt text. As I mentioned earlier, this might be the easiest part of The entire process for compliance for design. But it's still an art form, in the sense that you need to be succinct in your explanation, you need to highlight important information and what it conveys, avoid phrases like the image of, the graphic of, because the screen readers will already list it as that complex images and charts. You need to communicate what it's telling the users rather than what it looks like. Key, key thing here, especially for design and alt text. Not every single graphic needs to be labeled with alt text, believe it or not. Stuff that is decorative does not need alt text. There is an option, which we will show, where you just click on it, and it'll artifact the image, and it will just skip over and not recognize and read it out loud. So, in this case, if I were to do 508 compliance on this PowerPoint template, this top bar that contains the header as well as the logo, it would try to highlight that and say, "oh, this is a graphic," but you would not need to have that be read out loud. So because it's decorative, it's not essential to the purpose of what you're trying to convey, so, that's kind of a big thing.

Doing great alt text work is a bonus feature for SEO, and digital assistance and artificial intelligence. So, kind of, it's weird, but, how you explain and, provide the information in images as alt text correlates directly for SEO, and how AI recognizes and reads your products, and then puts it on Google, and, like, it recognizes that, like, oh, this is good information. So, it pays to have good alt text.

Structure and style. Okay, so we're getting close to doing the live remediation. Structure and style. Structure is essential. It's essentially providing… I equate it to being like a library catalog of just understanding where that information is and what it is. And so, you're building up this tree of information through headers. And you're providing that structure. So in the case of Microsoft Word in Figure 1, you'll see there's always that ribbon up top, and those are the header settings. Clicking on those and applying those to your actual document saves you time when you do accessibility for Acrobat, so it's well worth your interest to do that and spend the time working on that, because it'll save you time on the back end.

We talked about this a little bit on the first training, header hierarchy. It's very important that your headers and ASTHO struggles with this, and we're working on this as well. We've gotten much better. So your headers need to be in order from H1, H2, H3, H4. They cannot skip. They can't go from H1, H2 to H4 or H5. You need to have that numerical order for your headers in order for it to be considered compliant. It is difficult. That means talking with your editorial team, that means talking with your teams that are creating the products, and understanding how you want that information presented. So, it's a bit of a challenge, but… Have open communication with your teams to be able to best, have best practices for it.

Tags. Alright, this is the behemoth that will make or break a lot of people, so, just heads up on it. Tags are absolutely essential. They provide a hidden structural map within a PDF, And there is a lot of them. Hundreds, often, if not sometimes thousands of tags. So… It… pretty much, it's a label for everything, and they have their own categories, and so… tags have root tags, container and group tags, text tags, figure and formulas, tables, and others. And they all have their certain places to be, they all have certain nesting locations, which I'll show in a bit, which are primarily for, like, tables, bullets, and numbering.

So, it's very, very time-consuming, but it's essential, and that's… this is… manipulating and editing these, the tags, is what makes your products compliant, ultimately. It's the main source of compliance.

Alright, and then I'm going to share my screen and get into some live remediation. So, we have 3 products, and these are all, kindly given access to us by the Department of Public Health in Nevada. And so we are using real-world examples to kind of showcase a little bit of a live remediation.

This first one is an infographic that we're going to focus a little bit on more of the design principles, an explanation of that, and then we have two others that will focus on actually doing remediation.

So, with this infographic, it's very difficult to understand the direction as to which you want the eye to go. And because of that, there's no emphasis of scale in the important things versus the non-important things, not to say that there aren't important things, but some things definitely take precedence.

The establishment of hierarchy. It's… there's no clear sense of title as to what is being displayed here, and the eye doesn't want to go straight to a comparison of births among women in the state and mental health system and the general population. My eye, personally, Kind of… goes back and forth between the 10 and the 7? Because they are roughly the same size of the text for the title. So you want to eliminate that competing force and that competing factor. And overall, want it to be easy to follow.

Next principle for that would be negative space. So we talked about the margins. The margins here are a little close. A good rule of thumb is to start with at least a quarter of an inch. Half an inch is more preferred. So, and that's the case for all the way around the document. Because, unfortunately, if you design based on digital, but then someone changes their mind and wishes to have it printed, there is a much higher chance that it could get cut off if there's not enough margin. And also, it provides that breathing room, and people kind of feel a little bit more, compressed, and like, I just wanted a little bit more space, and being able to read all the information.

Direction. Oddly enough, this actually has a good direction flow to it. So… your eye immediately goes to the color and the size of this square here, and it travels along because you have something of a similar size, but a different bright color. And in this case, I imagine this has good contrast ratio, because it's yellow, but with black text on top. I'm not 100% sure what contrast ratio this would be for the pink. But yeah, your eye just kind of goes, and you have a similar sized text along the way. And then, our natural inclination, remember the Z? We'll go diagonally down the chart here, or graph. The graph here… Showcases a downward-type verticality just naturally, because you have, excuse me, you have a bunch of longer shapes kind of protruding out in the middle, so your eye naturally is starting to gravitate towards that, only to be pushed down again by color. And it just continues to go that way. So you have that downwards diagonal slope, and it continues with the color, again, on this chart area that has the circle graph and the bar graph, all in one. It's a little close and clustered, And, you know, there's not the added redundancies that we'd like. But… Yeah, it's got a good… size and color associated with it, and there's that trifecta of repetition that we talked about. You have the pink up here, the pink here, and the pink here, and your eyes kind of connecting the dots and following it down. So that part's really good.

Talked about contrast a little bit. Balance. Things feel a little imbalanced. You have the three-column system up here. But then a two-column system, although it's technically three columns over the course of two columns, which isn't a bad idea. That's actually pretty common to see. But then you have the immediate to two-column system. So it'd be nice to have a little bit of space to break that up, but, you know, there's some good points about it, and there's some points that need to be worked on, but that's all things in life, too. So that's just the design principles, now we're gonna go into the actual remediation process a little bit.

So, for this, we have a Department of Health and Human Services Maternal and Child Health Advisory Board, notes, essentially. Like, these are minutes that were recorded. So, for this, For those that don't know, actually, how to start with the remediation process, you can go to Prepare for Accessibility and check for accessibility. This is the main...products are the main button you'll be using to do accessibility.

There is an automatically tagged PDF. I have personally had issues with this, in terms of just, it doesn't tag correctly, but there are times when it is useful to have, and that will be explained coming up. So, once you do check for accessibility, you'll do…you don't uncheck anything, just keep it as is, start checking.

And immediately off the bat, we actually don't have a whole lot of issues, which sounds great. This is actually what the DOJ, if they were to do an audit, they will be checking utilizing Adobe Acrobat. So in theory, if all we did was change the title, which in this case would be maternal and child health advisory board...frankly, that title's probably not enough detail, but based on how this is currently, we'll leave it as that.

And then if you were to do your logical reading order, contrast, and navigational links, in theory, this could pass. But that's where it comes in handy that you have to have the knowledge that oftentimes it's not going to read the way you want it to. So, let me go back real quick.

The buttons available to you are usually in the toolbar on the right. So, this is the accessibility checker view. You have below that a Resolve Reflow Issue button. The reading order, and then the tags. Though the bottom two are gonna probably be your most utilized ones, and you'll see why. So in this case, I'll click on the reading order. And essentially what this is showing now is how a screen reader would read your entire document. There's a lot of… I'm gonna… Make this a little bit larger. So, essentially, The reading order currently wants to have this seal up here red as the 45th product, which is going to read 1, 2, 3, 4, 5, 6, all the way down, down, and then once it gets to the bottom here for public comment at 44, it's going to start reading the seal. Doesn't make sense, logically to go back up and just read it. It's not in the correct order. And we also have issues, if you see some random blank spaces just appearing all throughout.So, the software is imperfect, and there's a lot of manual labor that has to go into fixing this. How you help to fix this? Is… up here, you have the triple dots, the options, Show Reading Order Panel. This is going to be your toolkit to help fix things. And it has a limited selection of items, unfortunately, and so it's best to familiarize yourself with it, do some research. But what you do to fix things is you would click on them. And, essentially, now you're choosing how you want to label it. So, background artifact gets rid and kind of pretty much labels it as decorative. That's what you would put for graphics or images that you don't want read. So, when you do that, they go away.

And you manually have to do this. It's a very manual process. So, this is one way to do it. Another is if I click on 15 here, and see that it has nothing that it's reading, and if you look over here on the side, 15 is highlighted, and it has nothing after it, you can also right-click and do Delete Selected Item Structure or Tag as Background Artifact, and that will delete that. So, this is what it means to structure and order the whole backend compliance element. So, you can… what you do is you drag over to highlight what you want to label things as. In this case, Department of Human and Health Services, Nevada Division of Public and Behavioral Health. So, in this case, the Department of Human and Health Services is kind of more of a logo than an actual title. So, you'd want to encase both and label it as a figure.

So, figures are recognized as images as well, but you would have to go back and provide alt text for that. Same with the seal, you want it as an image, so go to Figure. This logo here will be a figure, and a lot of elements like that. And… so this will be our Heading 1. A note on headers. There can only be one Heading 1 on the entire document. You can't have repeat header 1s. Everything after that first header 1 is going to be at least… it's going to be an H2. If, like, the next biggest thing is going to be an H2, and then you'll have H3s, H4s. So, make sure to make note of that. That took me a little while to figure out.

And then, you have other elements that are… Paragraphs and text, just plain text you want to highlight as paragraphs. And so on.

So, the things that are also repetitive on a page… or, Emily, did you come off mute? You wanna see?

LAPAYOWKER:
Oh, you can finish up. I was just gonna, talk about the content piece.

PREHEIM:
Okay, yeah, yeah, go ahead.

LAPAYOWKER:
Oh, just a couple things while we're talking about PDFs. One thing to ask yourself before you turn a Word document into a PDF is, "is this the right format for this content?" Now, there might be a very specific reason that Nevada needed to use a flyer for this, but if you are posting about an event, and you have all this information, all of this looks like it could go on a website, so maybe ask yourself, like, "would a web page be the more accessible option?" I think further down, we may actually have full URLs in this one, yeah, and it's really best practice not to like, link on a URL like this, because the screen reader will, in fact, read the entire thing phonetically. So, you know, usually you would turn those into words. So, you know, maybe you would, in this case, link "Nevada Division of Public Behavioral Health website," or something like that. Or something about information for this particular event. So, yeah. Exactly. So let's just… those are just some things to think about. This is another place where there's a cross-section between content development, and accessibility for both web and documents. So, sorry, go ahead, Chris, just wanted to...

PREHEIM:
Yeah, no, great information. And that's something that, again, we struggle with a little bit as well, but it's very helpful. Web is able to apply compliance stuff much quicker and with less fuss than doing things in a PDF with Acrobat. So, it is good to consider what's the best format for something.

I know we're coming a little close to the Q&A time. So, another thing I want to talk about is, for things that are repetitious throughout a document, like a footer, you don't want it to read for every single page, so just do it for the first page. The first time it comes up, highlight it, you know, label it as what it needs to be. If you really want the slogan in it that's kind of more of a choice, you probably don't need the slogan for it. But you just need it once. You don't want to have it repeat every single time. So that's something to consider.

And then… Let's hop over to this second document. So this one's gonna be a little bit more fun and exciting. I guess third document overall. This one has a few more problems with it. Quite a few. And you think, well, okay, design-wise, it actually looks… not bad. It's got the different color tints already. It's got the header row going and all that. Contrast seems pretty good. So, what gives? Well, if I go under tags to see, okay, how is everything tagged… No tags available.

Go ahead, Emily.

LAPAYOWKER:
Oh, I was gonna say, so don't do that. And I do know we're running close to time, so please, if you do have questions, drop them in the chat.

PREHEIM:
So, yes, in this case, this would be an apt… absolutely timed thing to click on, automatically tag PDF. So it'll… Try to guess, to the best of its ability, how the tags should look, and… If you were to right-click anything that's, an X and do check again, it will do a quick check to that change, and a lot of stuff has been fixed, but if you look under the tags, and reading order, it still needs quite a bit of work. So… That needs to be considered.

There's also, like, if you have… And this is a case of reading order. If you have a bunch of lines of the same paragraph that are cut up. It doesn't need to be like that. You can just highlight it all. And label it all as one text paragraph. So that's cleanliness kind of thing, but not absolutely necessary, because it'll just read it line by line.

Nesting… I'm trying to find… was that on the second page, actually? Here's a second.

LAPAYOWKER:
Is it okay if we, like, take questions while you're working on this?

PREHEIM:
Yeah, yeah, yeah.

LAPAYOWKER:
In case anyone has any.

LEGRAND:
That is a… And there was a question earlier, I just wanted to make sure it may have already been answered about the, The ratio… can you say that ratio one more time?

LAPAYOWKER:
Yeah, so the ratio for regular text is, 4.5 to 1. And just as a point of comparison, black text on a white background is 21 to 1, so there's a lot of room to maneuver in terms of accessible color contrast.

LEGRAND:
Great, thank you. And, Michael, if I can get you to drop the evaluation, I'll turn it back to Chris, but just wanted to… I know in the, consideration of time, just wanted to be mindful of folks' time. Again, thank you, for joining. Wanted to just remind you all, if you could complete the evaluation, that would be helpful, so that we can continue to bring topics and, relevant trainings to you that you will find useful.

And I will also, just say, thanks to… special thanks to Nathan Orm of Nevada for letting us use some of their documents. This was helpful to actually use some real Real-world documents, so thanks to him.

And if anybody has a quick question that they want to come off mute for, feel free to do that at this time as well. And if not, we'll still be monitoring the chat. Again, the recording will be available on our Crisis Communications Hub page. I dropped that in the chat earlier. You'll get an email as well, and I'll turn it back to Chris to kind of finalize, and thanks again for your expertise to Chris and Emily.

PREHEIM:
Sure thing. Thanks, y'all.

So, real quick, I want to talk about the nesting element that I touched on briefly. So, tables have what's called nesting, and there are four properties that tables have to have in order to be considered compliant. You start with a table tag. A table row, and a table data cell. And when those get out of order, it automatically becomes non-compliant. There also comes the element of needing a header row. So, in this case, the software recognizes that this needs a header for this table. However, there is none that is currently being presented. So, like, no label for a header, it's just an icon. So that one's a little bit more dynamic and tricky to work with, but…yes, you need the nesting to be precise. And that's the case for bullets and numbering as well, specifically. So, those are the main time-consumers and all sorts of things. But if you ever need to create a new tag for something, you can just go up to… if you're in the tag toolbar, go up to new tag. And you have this list of all the different tags. That you're able to apply. So… If I needed the table header cell, I would click that. And it'll appear right here. And it looks a little bit different. So… and how you determine things get moved around is you just click and drag, and that can be a little chaotic too, so I think because of time, unfortunately, wasn't able to go as in-depth, but, I appreciate y'all tuning in and listening in, and we'll…go back to finalizing our PowerPoint.

LAPAYOWKER:
Alright, so just real quick, what are some things that you can do today, after this webinar, to start implementing best practices? One is to use the built-in heading and list styles in your Word documents and your emails. Bonus, if you do this in Word, Word will be able to generate a table of contents for you.

You should use label… or you should label tables, charts, and graphs in Word documents and websites. And if you do it in Word using the caption feature, then Word can generate, an index of tables and figures for you, which is always a win.

Use accessible color contrast ratios and never rely on color alone to indicate meaning.

Use best linking practices, which can basically be summed up as sparingly and on-descriptive text.

Use plain language whenever possible.

Include alt text for all images, even decorative ones, which is mostly just saying decorative.

Always have captions and transcripts for recorded video, and always have transcripts for recorded audio.

And that's it.

LEGRAND:
All right, thank you so much. Again, we really appreciate you all, joining today, and thank you for, allowing us to share a little bit about our expertise. We're looking forward to continuing to train, and as we navigate these, new requirements, you know, please share best practices with us as well. We don't know it all, we're still in our learning phases, and we really appreciate learning from you as well. But thank you so much, and you all have a great rest of your day! Thanks.

LAPAYOWKER:
Thank you all.

PREHEIM:
Thank y'all. Take care.

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HEIDI SATTER:
Hi, my name is Heidi Satter, and I'm the Director of Web and Data Solutions at ASTHO. And today, this is an additional piece to the Advanced Accessibility Training.

I first wanted to start with the legal landscape, but before I do that, I just want to make sure you know that I am not a lawyer, so you'll need to consult a lawyer for legal advice. I worked many years in law firms as a legal assistant and a legal administrative assistant and did legal assistant work for a private company as well, so I do have a background in this, but I am not a lawyer.

So although federal ADA Title II sets a national baseline, there is a lot happening in the states. So I will get into that soon. But I do want to address that there is one rumor going around in the legal — going around with legal experts right now, and that is around a potential interim final rule that has supposedly been put out at the Office of Information Regulatory Affairs, it's currently under review with them. The rumor is that it went in around February 13th, and that it's not 100% confirmed that this action at the OIRA is actually an interim final review, or final rule, but there is that rumor's out there, and basically it hasn't been published on a federal register and there hasn't been any public comment available. The main thing to know about that is regardless if it gets put into law, there are other laws that already require us to be compliant with accessibility already require that there be accessibility compliance. So all legal folks that have been discussing this content and this topic in particular have suggested that we still move forward full speed ahead, making sure you're compliant by the deadline.

Now to move on to the state piece. I just wanted to point out that a lot of states have their own statutes, executive orders, and procurement rules, and a lot of them are that they require WCAG 2.0 or 2.1 AA for their websites. Some of them require accessibility policies that are embedded in their procurement process. So it requires vendors to provide VPATs, which will actually allow you to know a lot more about their services and what they provide on an accessibility basis. This is something for you all in your area to know about because you may hire vendors and you want to make sure that they are supporting your brand and your voice and your documents and your presentation creations and make sure that they're all accessible.

Some states will require training mandates for the employee. Any employee that publishes digital content, we've heard this a lot. And then a lot of states have civil rights statutes that actually mirror these ADA obligations. So they like to reinforce the rules.

There are a lot of states that have, or there are several states that have enacted laws that actually go beyond federal requirements, such as the California UNRWA Civil Rights Act. I've heard some variations to the amount here, but the consistency I've heard is $4,000 minimum statutory damages per violation, and it applies to websites and mobile apps that serve California residents. New York is also pretty aggressive with enforcement and they have a high lawsuit volume. So that's understandable. Colorado, they have a mandates accessibility for their state and their local government technology. And then we have a couple of other states at the bottom that have active accessibility statutes and enforcement. Emily did cover this in her piece, but I am gonna just reiterate a few things.

One being the 25,000 digital accessibility lawsuits filed since 2018. That's just such a high number, especially when you look at the 5,000 plus in 2025 alone. That is, and we just keep seeing it and hearing it from other legal experts that the number is increasing. She outlined all the industries here that are covered. I will just point out healthcare, public health, just from a web perspective, even our perspective, since COVID-19, we have definitely been targeted a lot more as far as bot traffic. And I think as we get more light shone on healthcare and public health in general. It just gets us more exposure, which also is both good and bad. It could mean if you're not accessible, that's more exposure, more potential for lawsuits. So wanted to point that out.

We went through the, there's state hotspots listed here that Emily went over, and then we talked about penalties a little bit. ADA Title 3 only allows injunctive relief, but there's state laws like the California Unruh Act that provides statutory damages. And the last one that I will point out, there are a couple of really good lawsuits here that I advise you to look up if you have a moment. But the big one that I wanted to make sure I highlighted is the FTC $1 million fine against an overlay provider. There's a lot of lawsuits about overlay providers.

Overlays are those floating, often floating little widgets on the side of a website that will allow you to click certain actions that will be applied to the website that supposedly make it more accessible for screen readers and things along those lines. There has been a lot of documentation and a lot of lawsuits that have shown that that actually is not the case. These JavaScript tools, they basically overlay or sit over the underlying code of a site, and often they add additional barriers. And they don't actually address the issue with your code itself. So it's like the more layered a website is, the more opportunity there is for issues with accessibility and just performance, as well as a variety of other things. So advice, I will tell you advice is to avoid the overlay.

And I did also want to just touch very quickly on AI-assisted accessibility. AI is blowing up everywhere, it can be used to really help you with anything. I'll just advise you to just be careful with generating alt text and summaries. It can be inaccurate or misleading, alt text and captions. There's a loss of semantic structure and proper tagging when you use artificial intelligence to help with accessibility. It could introduce bias, and it does have cultural blind spots, so I'd advise you to keep that in mind. And then, if you apply accessibility at scale to a large volume of things that you're applying it to, and...the errors aren't caught, that's going to take a lot of time for you to go back and remediate and fix that.

So I just wanted to advise you of that and then show some AI governance and best practices that I suggest you do to just kind of keep it at bay, make sure it really is assisting you and not doing your work for you. Human in the loop right now, it's a wild west with AI out there. So I would highly suggest human in the loop for everything you do. Make sure if it's AI generated output, it's reviewed and it's validated by a human, especially if it's high stakes content. Make sure you include structured prompts and metadata. It just helps you with uncertainty and make sure that you get the right information.

And then there's this piece about provenance and transparency. Make sure you label AI-generated content and you keep your records for auditability. It'll help you if it's expensive to have lawsuits against you with images and content as well there. So just make sure you're covered. Governance, accountability, documentation.

And the last one is this policy alignment. Document your AI use, like I said. Align it with your organizational accessibility and your data governance frameworks. That way, make sure everything is working together. And even if there's different people in different areas, it's good to just coordinate with each other and make sure that you're all moving in the same direction.

So ultimately, use it as an assisted tool, but it's not a substitute for compliance. And then just continue to monitor because as you know, things are always changing.

So I hope this helps. Please reach out if you have any questions and thanks for listening.