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This is the great thing about designing with web standards - accessibility comes as default. Sure, there are further methods and approaches that can enhance accessibility and provide greater benefits to the user, but by keeping presentation separate from content, and by using the right markup for the right job, you increase the chances that any visitor, regardless of ability, can access your content unhindered.
The golden rule with accessibility is simple. Anyone, anywhere, regardless of platform, technology, experience, or ability, should be able to access your core content. By adhering to web standards with your content, you are free to apply outrageous presentation using CSS, safe in the knowledge that under the hood, none of your content is compromised, so a person with visual impairments using a screenreader will be able to use your web site just fine. Of course, web accessibility isn’t just about visual impairments - there are also cognitive disabilities to consider, and many more. For more information about web accessibility, check out the book Web Accessibility: Web Standards and Regulatory Compliance (Friends of ED, 2006) and look at the great online resources available, such as http://www.accessify.com and http://diveintoaccessibility.org.