Title II prohibits state and local government agencies, departments, special purpose districts, and other instrumentalities from discriminating against people with disabilities in their programs, services, and activities. This includes, but is not limited to, public educational programs, courts, voting, town meetings, social services, health care, and recreation.

Public entities must make reasonable modifications to their policies, practices, and procedures to allow equal opportunity for individuals with disabilities to participate unless doing so would fundamentally alter the nature of service, program, or activity. They must provide auxiliary aids and services for effective communication for individuals with sensory disabilities, permit the use of service animals, and provide integrated program access through nonstructural and architectural modifications, and meet Title I employment provisions with all employees and contractors.

Public entities are not required to take any action that would result in undue financial or administrative burdens, in a direct threat, or a significant risk of substantial harm to health and safety.

A public entity must operate their programs so that each program, when viewed in its entirety, is readily accessible to and usable by individuals with disabilities. As such, public entities do not need to remove all physical barriers in existing buildings as long as programs provided in those buildings are readily accessible to users with disabilities in another facility.

New construction and alterations must comply with 2010 ADA Standards for Accessible Design. Title II includes administrative requirements for all state and local government entities including provisions for self-evaluation and transition plans. Title II entities with 50 or more employees are required to designate an ADA Coordinator and establish grievance procedures.

Title II also seeks to ensure that individuals with disabilities have equal access to existing public transportation services. All newly purchased buses and other vehicles must be accessible, which means they must be fitted with ramps or lifts and securements which tie down wheelchairs. Stops and stations must be announced and there must be some means by which buses and routes are identified at stops and stations for individuals with vision and intellectual disability. In cases in which a person with a disability is unable to access fixed route systems, public entities must provide paratransit services comparable to the level of service provided by fixed route systems.

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