Medical Diagnostic Equipment Standards for ADA Accessibility
The Architectural and Transportation Barriers Compliance Board (Access Board) has issued accessibility standards for medical diagnostic equipment (MDE). The image below shows an adjustable exam table on the left, as an example of MDE. The standards for medical diagnostic equipment (MDE Standards) contain minimum technical criteria to ensure that MDE, including but not limited to, examination tables, examination chairs, weight scales, mammography equipment, and other imaging equipment used by health care providers for diagnostic purposes are accessible to, and usable by, individuals with disabilities. The final rule was effective February 8, 2017. The MDE Standards will allow independent entry to, use of, and exit from the equipment by individuals with disabilities to the maximum extent possible. The MDE Standards do not impose any mandatory requirements on health care providers or medical device manufacturers. However, other agencies, referred to as enforcing authorities in the MDE Standards, may issue regulations or adopt policies that require health care providers, within the jurisdiction of the enforcing authority, to acquire accessible MDE that complies with the MDE Standards.
Accessible (left) and Non-Accessible Medical Exam Tables
On March 23, 2010, Section 4203 of the Patient Protection and Affordable Care Act (ACA) amended Title V of the Rehabilitation Act, which established the rights and protections for individuals with disabilities, by adding Section 510. Section 510 of the Rehabilitation Act charges the Access Board, in consultation with the Commissioner of the Food and Drug Administration, with issuing standards that set forth the minimum technical criteria to ensure that MDE used in (or in conjunction with) ‘‘physician’s offices, clinics, emergency rooms, hospitals, and other medical settings, is accessible to, and usable by, individuals with accessibility needs, and shall allow independent entry to, use of, and exit from the equipment by such individuals to the maximum extent possible.’’
The Access Board has divided the MDE Standards into separate technical criteria based on how the diagnostic equipment is used by the patient: (1) Supine, prone, or side lying position (M301); (2) seated position (M302); (3) while seated in a wheelchair (M303); and (4) standing position (M304).
Section 510 of the Rehabilitation Act instructs the Access Board to promulgate technical standards regarding accessibility of MDE, but does not give the Access Board authority to enforce these standards. Compliance with the MDE Standards becomes mandatory only when an enforcing authority adopts the MDE Standards as mandatory for entities subject to its jurisdiction. For example, the U.S. Department of Justice (DOJ) may adopt the MDE Standards as mandatory requirements for health care providers pursuant to its authority under Titles II and III of the Americans with Disabilities Act (ADA). Other federal agencies may adopt the standards as mandatory requirements for health care providers pursuant to their authority under Section 504 of the Rehabilitation Act.
Availability of accessible medical equipment is an important part of providing accessible medical care. Hospitals, doctors, medical facility owners, and other medical service providers must ensure that medical equipment is not a barrier to individuals with disabilities. Such equipment includes adjustable-height exam tables and chairs, wheelchair-accessible scales, adjustable-height radiologic equipment, portable floor and overhead track lifts, and gurneys and stretchers. The right solution or solutions for providing accessible medical care depends on existing equipment, the space available both within the examination room and for storage of equipment, the size of the practice and staff, and the patient population. What is important is that a person with a disability receives medical services equal to those received by a person without a disability. For example, if a patient must be lying down to be thoroughly examined, then a person with a disability must also be examined lying down. Likewise, examinations which require specialized positioning must be accessible to a person with a disability, which may require specialized equipment to assist the handicapped person into the special position.
So, as of the date of this post, the laws for MDE with respect to ADA accessibility are still pending acceptance of the standards included in Section 510. The standards in Section 510 are usable but not enforceable.