Important notice for patients: Information about the TriZetto data incident and resources available to affected patients. Read the full notice →(Español)
Documented evidence for the WCAG 2.1 Level AA conformance claim — scope tested, methodology, findings, and accessible alternatives.
Audit date: May 7, 2026
Next re-audit scheduled: May 2027 (annual) or after any significant structural redesign.
1. Scope
This audit covers the public HTML pages of mnhc.org in both English and Spanish. The downloadable PDF files hosted at /documents/ are convenience copies of content that is also published in fully-accessible HTML — see Section 6 for the mapping. Where no HTML equivalent yet exists, the alternative-format request channel (Section 7) provides accessible versions within 10 business days at no cost.
Routes tested (both locales):
/
/services
/services/adult-senior-medicine
/services/pediatrics
/services/dental
/services/hiv-services
/locations
/locations/shotwell
/patients
/patients/appointments
/patients/sliding-fee
/patients/hipaa
/about-us
/about-us/our-board-staff
/about-us/annual-statement
/contact
/donate
/accessibility-statement
/nondiscrimination
/privacy
Routes not listed inherit the shared components (header, footer, skip-nav, alert banner) that were tested, so any shared-component finding applies sitewide.
2. Methodology
Automated testing: axe DevTools, Lighthouse, and WAVE on each route listed above.
Keyboard navigation: manual verification that every interactive feature is reachable by keyboard alone, in logical order, with no focus traps (WCAG 2.1.1, 2.1.2, 2.4.3).
Zoom and reflow: verified that content reflows without loss up to 200% zoom and at 320 CSS-px width (WCAG 1.4.10).
Color contrast: mathematically verified via OKLCH lightness caps documented in globals.css; minimum contrast ratios of 4.5:1 (normal text) and 3:1 (large text / non-text) confirmed (WCAG 1.4.3, 1.4.11).
Reduced motion: all animations and transitions collapse when the user requests prefers-reduced-motion (WCAG 2.3.3).
3. Accessibility patterns implemented
The following patterns are implemented at the template level, which means they apply to every page on the site:
Skip navigation: the first focusable element on every page skips to main content (WCAG 2.4.1).
Visible focus indicator: 2 px outline in the brand ring color, 2 px offset, on every focusable element (WCAG 2.4.7, 2.4.11).
Correct lang attribute: <html lang> matches the locale route, allowing screen readers to switch voice/pronunciation (WCAG 3.1.1, 3.1.2).
Main landmark: a single <main id="main-content"> per document, giving screen-reader users a stable skip-nav target.
Touch-target size: footer and mobile-nav links + buttons meet the 44×44 px minimum (WCAG 2.5.5 AAA, adopted as practice).
External links and PII warning: external links open in a new tab with rel="noopener noreferrer" and a screen-reader "opens in a new tab" suffix (WCAG G201).
Print stylesheet: pages print cleanly with URLs preserved on paper (relevant for compliance because patients commonly print the NPP, nondiscrimination notice, and sliding-fee schedule).
Form alternatives: the site does not host a general contact form (removed for HIPAA reasons); patients are directed to a phone line with bilingual staff instead of an unencrypted web form.
No third-party trackers: no Google Analytics, no Meta Pixel, no session replay — health-related browsing is never exposed to third parties, which also eliminates an entire class of third-party-script accessibility and performance problems.
4. HTML findings summary
Verdict: substantially conformant with WCAG 2.1 Level AA for the HTML pages tested. Remaining automated findings are minor and tracked in the list below.
Remaining HTML findings are minor and grouped below. None block the overall substantial-conformance claim:
Some decorative images on service pages would benefit from more descriptive aria-labels, though every image has valid alt text.
Tables on the sliding-fee page have proper <caption> and <th scope> headers but could use more explicit summaries for screen-reader users on wide columns.
The TriZetto incident banner uses role="alert" with aria-live="polite" — appropriate for the ongoing notice, but screen readers may announce it twice during initial hydration. Consider migrating to a separate aria-live pattern in a future iteration.
5. Browser and assistive-technology compatibility
Chrome (stable and extended-stable channels)
Microsoft Edge (stable)
Mozilla Firefox ESR + stable
Safari (macOS and iOS)
NVDA + Firefox / Chrome (Windows)
JAWS + Chrome (Windows)
VoiceOver + Safari (macOS, iOS)
TalkBack + Chrome (Android)
6. PDFs — accessible alternatives
How accessibility is provided: every operative legal notice (HIPAA NPP, nondiscrimination, language assistance, sliding fee, annual economic statement, accessibility statement) is published as fully-accessible HTML on this site; the PDF versions in /documents/ are convenience copies for offline reading and printing. For any PDF you cannot use with assistive technology, our alternative-format request channel (Section 7) provides an HTML, large-print, braille, or audio version at no cost within 10 business days.
Categories of PDFs and their accessible counterparts:
Patient notices: the HIPAA Notice of Privacy Practices, TriZetto incident notices, vaccine consent forms — the HTML version of the NPP at /patients/hipaa is the operative version; the PDF is being republished.
Transparency documents: Form 990, audited financial statements, IRS tax-exemption letter — available also via ProPublica as accessible HTML. The annual economic statement itself is entirely HTML.
Brochures and educational materials: virtual visit guides, HIV testing flyers, announcements — scheduled for HTML replacement.
Application forms: Adelante (new-patient enrollment) — the backlog prioritizes a web-form solution that is both accessible and HIPAA-compliant.
