(IDG) -- When Harry Stathos, chief financial officer at Northwest Permanente, in Portland, Ore., suffered a stroke that left him temporarily unable to read, his employer paid $4,000 for a scanner and two pieces of software that read documents and his e-mail to him.

"It made me functional and got me back to work faster than my doctors ever imagined," Stathos says. Although he researched the system himself, he credits the IT staff at Northwest Permanente, the regional medical arm of Kaiser Permanente, for their patience and interest in helping him to purchase and install the software.

"Without them, it would not have gotten installed," Stathos says.

Such accommodations stem from the Americans with Disabilities Act (ADA), which was passed nearly 10 years ago and requires offices with more than 15 employees to provide workers "reasonable accommodation" for their disability unless it would cause an undue hardship or be disruptive to the business.

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Yet many IT managers are unaware of how their buying decisions and system designs affect current and potential employees, according to assistive technology specialists. For instance, if a company has standardized on a Windows-based suite of applications that doesn't offer keyboard-equivalent commands, catering to many disabled workers becomes difficult.

"The real issue of accommodation is often tied to whether the initial system can be made accessible in the first place," says Debbie Cook, project director at Seattle-based Washington Assistive Technology Alliance.

When the issue has not been considered in advance, companies may eventually need to perform inefficient and inexpensive retrofits of systems based on individual requests.

Alan Cantor, principal of Cantor & Associates, a workplace accommodation consultancy in Toronto, recently worked with an employee unable to use a mouse. Her job required her to use seven different applications, only two of which were fully accessible from her keyboard.

"[Because of] the lack of a few access keys, this woman was not able to do her job, and there was clearly no mandate on the employer's part to make sure its software was accessible," Cantor says.

DEDICATED TEAMS. Organizations that are successful at making technology accessible often have specialized teams, either within IT or working closely with the department.

The U.S. Department of Education, in Washington, has a team within its 90-person information resources group dedicated to assistive technology. The four-person group of computer technicians responds to the needs of contractors, disabled employees, and their managers.

"A specialized team that knows the nuts and bolts of assistive technology makes all the difference," says Don Barrett, an assistive technology specialist at the department. "Retrofitting systems is a really expensive proposition. When you have an ongoing awareness, you're able to address it in the development stage."

Officials in Maine learned the same lesson a few years ago when they were standardizing on a Lotus application suite. They realized that a blind employee at the state Department of Labor couldn't use the software. In response, the state waived the standard and found suitable software for that employee. That case was the impetus for a process of identifying and solving accessibility issues.

"It was decided that we needed to attack this at the purchasing level," says Floyd White, a database analyst at the Maine Bureau of Information Services, who heads the state's Information Systems Managers Group task force on accessibility and is also visually impaired. "We are making progress with vendors, as well as in-house developers."

But building awareness among IT managers has been a struggle, White says. The most problematic issue is that software is still being purchased and installed that disabled employees need to use, yet there is no way to access it without a mouse. To get his message across, White tells IT managers to try to use the application without a mouse.

And White says disabled state employees don't yet have a clear system for addressing accessibility issues.

"It's a free-for-all," White says. "It becomes a cooperative effort that includes network services and desktop-support services, but there is nothing structured in place to help you find the right people."

LOOKING TO THE FUTURE. Examples of systematic thinking about accommodation are easier to find in the public sector than in private companies.

But this may change. In the next two years, federal standards will be established regarding information products used by companies that contract with the government, requiring more vendors and grant-seekers to make sure products and data are accessible.

"I think we're also likely to see more lawsuits, which is unfortunate because it is so avoidable and it's not the way these problems should be solved," says the Washington Assistive Technology Alliance's Cook.

Despite her fear that more disputes will end up in court, Cook thinks that attitudes are starting to change.

"I use the building analogy," Cook says. "We've come to accept that buildings will be designed with wheelchair accessibility. The same thing should hold true for information technology."

David Raths is a free-lance writer based in Portland, Ore.