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Title II of the Americans with Disabilities Act (ADA) requires State and local governments to provide services, programs, and activities in a manner that is accessible to people with disabilities. In August 2024, the Department published a final rule adopting the U.S. Architectural and Transportation Barriers Compliance Board's (Access Board) Standards for Medical Diagnostic Equipment (MDE) to ensure that MDE is accessible to persons with disabilities in their participation in or benefit of services, programs, and activities provided by public entities.

The Department previously announced that it intended to issue an ANPRM, titled Nondiscrimination on the Basis of Disability by State and Local Governments and Places of Public Accommodation; Equipment and Furniture (RIN 1190-AA76) addressing possible revisions to its ADA regulations to ensure the accessibility of equipment and furniture generally. However, given the specialized nature of MDE, the Department decided to publish a separate NPRM addressing the accessibility of MDE. The NPRM was published on January 12, 2024, and the comment period closed on February 12, 2024.

Accompanying the NPRM, the Department published a fact sheet describing the NPRM’s proposed requirements in plain language to help ensure that members of the public understood the proposed rule and had an opportunity to provide feedback.  The Department also participated in a Community Engagement Call with the White House Office of Public Engagement on January 25, 2024.  During the call, the Department provided a plain language overview of the NPRM and explained how the public could submit comments on the proposed rule.

The Department received approximately 200 comments on the NPRM, including from individuals with disabilities, public entities, disability advocacy groups, members of the medical industry, members of Congress, and many others.  The Department’s final rule, published in August 2024, was informed by the feedback received.

Following publication of the final rule, the Department published a fact sheet describing the rule’s requirements in plain language. The rule, press release, and fact sheet were also posted on the website of the Administration for Community Living.

The Department’s Civil Rights Division also holds regular listening sessions with disability stakeholders where stakeholders discuss a range of topics, such as the need for accessible MDE.  During these listening sessions, the Department provides publicly available information about the status of the Department’s rulemaking efforts and any opportunities for public comment. For example, the Division convened a hybrid listening session with disability rights stakeholders on March 12, 2024.  The listening session was held both in person at the Department’s headquarters in Washington, D.C. and via videoconference.  Approximately 35 members of the public attended.  At the listening session, the Division provided an update that included publicly available information about the status of the MDE rule.  Attendees emphasized the importance of the rulemaking.  Following the listening session, the Department worked to finalize the rule as quickly as possible. 

Statement of Need:

MDE that is accessible to individuals with disabilities is often critical to a public entity's ability to provide an individual with a disability with equal access to its health care services, programs, and activities. The Department’s ADA regulations contain the ADA Standards for Accessible Design (the ADA Standards), which include accessibility standards for some types of fixed or built-in equipment and furniture. However, until the publication of this final rule, there were no specific provisions in the ADA Standards or the ADA regulations explicitly addressing the accessibility of MDE. While manufacturers have begun to offer MDE that is more accessible to and usable by people with disabilities and the Department has sought to ensure people with disabilities have equal access to medical care under the ADA’s general regulatory provisions through enforcement and the issuance of technical assistance, the Department recognizes that more specific standards are necessary to guarantee full and equal access to health care services, programs, and activities. This rule is necessary to ensure that inaccessible MDE does not prevent people with disabilities from accessing title II entities’ services, programs, and activities.

Summary of the Legal Basis:

The summary of the legal basis for this regulation is set forth in the above abstract.

Alternatives:

There are no appropriate alternatives to issuing this rule. In the NPRM, the Department discussed the regulatory proposal and solicited public comment on the proposal and alternatives that would ensure full access to MDE for individuals with disabilities.  The Department considered public comments as it worked to issue a final regulation and explained in the final rule why its approach was appropriate.

Anticipated Costs and Benefits:

The Department anticipates costs to covered entities (i.e., State and local governments). Entities may need to acquire new MDE to meet technical standards that the Department includes in its regulations. The Department also anticipates significant benefits to people with disabilities, who may obtain greater access to public entities’ services, programs, and activities, which may improve their health or potentially save their lives.

Risks:

Failure to adopt technical standards to ensure that people with disabilities have access to MDE in public entities’ programs, services, and activities would prevent people with disabilities from having the full and equal access to which they are entitled.  The health of people with disabilities may suffer as a result of unequal access to medical care.