Don't Get Caught Off Guard: Know the Standards That Shape Accessibility in Care

The HHS and the DOJ are both enforcing the 2017 Access Board Standards (36 CFR Part 1195), requiring medical diagnostic equipment to have a 17-inch to 19-inch low transfer height range.

The 2024 update, requiring a 17-inch low transfer height, is not yet enforced—but the HHS and DOJ have signaled intent to adopt it.

VAs must comply to section 504 of the Rehabilitation Act but are enforced by the VA Office of Resolution Management (ORMDI) and the DOJ.

According to the HHS and DOJ rulings, the general scoping requirements for medical diagnostic equipment state:

• At least 10% of the total number of units at a facility, but no fewer than one unit, must meet the Access Board Standards (MDE).

• At least 20% of the total number of units at a rehabilitation facility that specializes in treating conditions that affect mobility, but no fewer than one unit, meet the Access Board Standards (MDE).

Effective July 8th, 2024, for the HHS and October 8th, 2024, for the DOJ, newly acquired medical diagnostic equipment must meet the Access Board Standards (MDE) that were issued on July 1st, 2017, 36 CFR part 1195 requiring Medical Diagnostic Equipment to have a 17-inch to 19-inch low transfer height range until the scoping requirements are met.

Additionally, the HHS and DOJ have a minimum obligation for facilities until the general scoping requirements are met.

The HHS requires that each facility MUST HAVE one exam chair and weight scale that are compliant to the 2017 Access Board Standards (MDE) Standards by July 8th, 2026.

The DOJ requires that each facility MUST HAVE one exam chair and weight scale that are compliant to the 2017 Access Board Standards (MDE) Standards by August 9th, 2026.

• Examples of facilities required to comply to the HHS ruling: Public Hospitals (state/local/university), County Health Departments, Private Hospitals, Federally Qualified Health Centers, Physician Offices, Rehab Centers, Private Mental Health Center, VAs.

• Examples of facilities required to comply with the DOJ ruling: State/County Hospitals, Local Health Departments, Public University Hospitals.

• In any facility or program with multiple departments, clinics or specialties, the facility must disperse accessible MDE proportionately by department, clinic or specialty. Entities must ensure that the dispersion of their accessible MDE does not discriminate against people with disabilities.

• Denying a physical examination to a patient with a disability because of the lack of accessible MDE may violate the nondiscrimination obligation under 35.210 (DOJ) and 84.91 (HHS) which state that entities cannot exclude, deny benefits to or otherwise discriminate against people with disabilities in services, programs or activities.

• Reaching only 10% requirement may make scheduling patients more difficult. Even after a provider complies with the scoping requirements, if patients with disabilities have significantly fewer scheduling options than non-disabled patients, that could implicate the obligation under 35.212 (DOJ) and 84.93 (HHS) to make entities' services, programs and activities readily accessible to and usable by individuals with disabilities.