August 2024 - Colleen Angela Van Etten

Agency Guidance Now a Mandate

People with disabilities continue to face barriers to getting medical care because of inaccessible Medical Diagnostic Equipment (MDE). Barriers can include exam tables with heights that cannot be adjusted, mammography machines that require a person to stand, or weight scales that do not accommodate wheelchairs. These barriers result in inequities and exclusion from basic health services for individuals with disabilities, contributing to poor health outcomes.

Twice I have written blog posts on inaccessible MDE. Remember my question on April 19, 2021:

“Does anyone hear the call to advocate for making accessible MDE mandatory?”

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How about the question and answer in my March 18, 2022 post:

“So where do we go to file a discrimination complaint? The answer is NOWHERE.”

Three years later, I’m excited to report that two federal agencies—Health and Human Services (HHS) and the United States Department of Justice (DOJ)—have adopted “Standards for Accessible MDE” developed by the Architectural and Transportation Barriers Compliance Board (Access Board). This is monumental news! The Standards are no longer mere guidance, but are enforceable federal law under section 504 of the Rehabilitation Act or Title II of the Americans with Disabilities Act (ADA)!

HHS was the first agency to adopt the Access Board’s “Standards for Accessible MDE on May 9, 2024” when it adopted the 2017 edition which allowed a low transfer height of 17 to 19 inches. However, the Access Board revised the accessible MDE Standard on July 25, 2024 to specify a low transfer height of 17 inches for MDE used in the supine, prone, side-lying, and the seated position. Although HHS has indicated its’ intent to adopt the update, until this happens the 17-inch mandate is not enforceable.

On August 9, 2024, the DOJ issued a final and enforceable rule under ADA Title II to improve access to MDE for people with disabilities. The rule clarifies how public entities that use MDE, like hospitals and health care clinics operated by State or local governments, can meet their obligations under the ADA. As Assistant Attorney General Kristen Clarke, Civil Rights Division, DOJ, announced:

“Thirty-four years after passage of the ADA, people with disabilities should not have to forgo needed medical care due to inaccessible medical diagnostic equipment.”

Highlights of the DOJ rule requires the following of State and local government entities:

Beginning on October 8, 2024, all MDE that state and local government entities purchase, lease, or otherwise acquire must be accessible, until the entities have the required amount of accessible MDE.
Although not every piece of existing MDE is required to be accessible, entities must ensure that their services, programs, and activities that use MDE are accessible to individuals with disabilities.
Entities that use examination tables and weight scales must have at least one accessible examination table and weight scale by August 9, 2026.
Entities must have staff qualified to operate accessible MDE.

ALERT: On September 5, 2024, from 2:30–4:00 p.m. (ET), the Access Board will provide an overview of its’ July 26, 2024 final rule on accessibility standards for MDE. See https://www.accessibilityonline.org/ao/schedule/.

You may also want to read:

“Nondiscrimination on the Basis of Disability; Accessibility of Medical Diagnostic Equipment of State and Local Government Entities.” Civil Rights Division, U.S. Department of Justice. August 9, 2024. https://www.federalregister.gov/documents/2024/08/09/2024-16889/nondiscrimination-on-the-basis-of-disability-accessibility-of-medical-diagnostic-equipment-of-state.

“Fact Sheet: New Rule on the Accessibility of Medical Diagnostic Equipment Used by State and Local Governments.” Civil Rights Division, U.S. Department of Justice. August 08, 2024. https://www.ada.gov/notices/2024/08/08/mde-fact-sheet/

“U.S. Access Board Issues Final Rule Setting Low Transfer Height for Certain Medical Diagnostic Equipment.” Access Board. July 26, 2024. https://www.access-board.gov/news/2024/07/26/u-s-access-board-issues-final-rule-setting-low-transfer-height-for-certain-medical-diagnostic-equipment/

“Standards for Accessible Medical Diagnostic Equipment.” Architectural and Transportation Barriers Compliance Board (Access Board). July 25, 2024. https://www.federalregister.gov/documents/2024/07/25/2024-16266/standards-for-accessible-medical-diagnostic-equipment

“Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance.” Health and Human Services Department. May 9, 2024. https://www.federalregister.gov/documents/2024/05/09/2024-09237/nondiscrimination-on-the-basis-of-disability-in-programs-or-activities-receiving-federal-financial

Angela Muir Van Etten. “MEDICAL DIAGNOSTIC EQUIPMENT: Proposed for State and Local Government Entities.” Blog post, January 15, 2024. https://angelamuirvanetten.com/medical-diagnostic-equipment-proposed-for-state-and-local-government-entities/

Angela Muir Van Etten. “Tackling Inaccessible Medical Equipment, Part II.” Blog post, March 18, 2022. https://angelamuirvanetten.com/tackling-inaccessible-medical-equipment-part-ii/

Angela Muir Van Etten. “Tackling Inaccessible Medical Equipment.” Blog post, April 19, 2021. https://angelamuirvanetten.com/tackling-inaccessible-medical-equipment/

The celebration of National Book Lovers Day on August 9th started me thinking about the outtakes cut from a draft manuscript to manage book length. Readers miss out on engaging material. But authors often save the outtakes for later use. This post includes a few outtakes from “Pass Me Your Shoes.”

Bobby hesitated to set our wedding date on October 31^st because itwas Halloween. I convinced him it wouldn’t be an issue because New Zealand doesn’t celebrate Halloween. Although there was no hint of Halloween on our wedding day, I didn’t think about our wedding anniversary being in America on Halloween every year thereafter. Now we have to find a way to avoid getting caught up in the annual celebration of superstition and occult themes.

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One summer we encountered an access problem that was resolved through ingenuity not confrontation. We were sleeping in a friend’s guesthouse when a persistent, high-pitched noise woke us. We finally identified the smoke detector on the ceiling as the culprit. It was time to change the battery! There was no escaping the noise and it would have been an assault on our host’s hospitality to call him at one o’clock in the morning. We had to solve this problem on our own.

It was an involved process. We dragged the dining room table to the bedroom door, tilted it on end and maneuvered it through the doorway without gauging a hole in the wall. We set the table back on its legs and lifted a chair onto the table. Robert climbed onto the table and then onto the chair. I held the chair while Robert disconnected the battery. Sleep was now possible.

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Robert was excited when his niece asked if her cat, Kendall, could live with us. All he had to do was convince me. It’s not that I dislike cats so much as they make me sneeze and I don’t like getting pawed or scratched. I agreed for Kendall to move in on two conditions: (1) Robert take full responsibility for all Kendall’s needs; and (2) the bedroom would be off-limits.

Kendall had everything going for him: personality, gorgeous fur, amazing eyes, and a contortionist’s ability to squeeze into unlikely places. There was one big problem—Kendall refused to use the litter box. Robert consulted cat lovers and tried three different box designs and litter types. However, after three weeks of Kendall toileting anywhere but in the litter box, Robert couldn’t take it anymore. He found him a home with a devoted lover of Himalayan Persian cats.

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Chocolates for a Little People of America fundraiser were being delivered to our address. But the truck driver could not navigate our community without churning up lawns and breaking sprinkler heads. So Robert met the driver outside the gate. He was amazed to see a huge semi-truck and trailer and dumbfounded when the driver opened the back door. Our few boxes of chocolate were the only cargo!

And for the whole story, read the second book in my dwarfism memoir trilogy, “PASS ME YOUR SHOES: A Couple with Dwarfism Navigates Life’s Detours with Love and Faith,” https://angelamuirvanetten.com/pass-me-your-shoes/.