As academic libraries prioritize accessibility for all individuals, they have carried out transformations of their physical and virtual spaces. For example, they have purchased new hardware, software, and furniture; adjusted websites for screen readers; modified handouts used in instruction; and advocated for change with vendors of leased and purchased content. Whether driven by campus mandates, state regulations, lawsuits, or more proactive motives, libraries have reviewed and improved the delivery of their content to better serve the needs of all users. Several surveys cover the disability and accessibility services available at libraries and how they have changed over time, but few studies examine who within the library provides support to users and how changes in campus and state requirements impact the delivery of these services. This article summarizes the results of a survey of Association of Research Libraries (ARL) institutions in October 2020 related to what services the library provides, whether they have changed due to campus or state requirements, which positions within libraries provide support, and what the impetus was for offering services. The authors also discuss implications for scalable support of disability and accessibility services at university libraries.