Fact Sheet: New Rule on the Accessibility of Medical Diagnostic Equipment Used by State and Local Governments (2024)

Medical diagnostic equipment (MDE) is equipment used in, or in conjunction with,medical settings by health care providers for diagnostic purposes. Examples of MDEinclude:

• examination tables
• examination chairs (including chairs used for eye examinations or procedures, and dental examinations or procedures)
• weight scales
• mammography equipment
• x-ray machines

The Department made this rule using a process sometimes called “notice and commentrulemaking.” As part of this process, the Department published a Notice of ProposedRulemaking (NPRM). The NPRM was basically a first draft of the regulation. It let thepublic know about the requirements the Department was considering and gave anopportunity for feedback.

The Department got feedback from the public on the NPRM. Based on that feedback, the Department made changes to certain parts of the rule. A description of the feedback the Department got and how it updated the rule is available in the appendix to the rule.

Like the rest of Title II, the rule applies to all state and local governments (which includesany agencies or departments of state or local governments) as well as special purposedistricts, special district governments, and other instrumentalities of state or localgovernment.

Examples of state and local government entities include:

• Public hospitals
• Public health care clinics
• Public colleges’ and universities’ health care systems

State and local government entities that contract with other entities to provide publicservices also have to make sure that their contractors follow Title II. For example, if astate agency has a non-profit organization run a health clinic on behalf of the agency, theagency needs to make sure that the non-profit organization follows Title II.

For more information about the responsibilities of state and local governments underTitle II,visit our State and Local Governments page.

• A technical standard says specifically what is required for something to be accessible. For example, the existingADA Standards for Accessible Designare technical standards that say what is needed for a building to be physically accessible under the ADA, like how wide a door has to be or how steep a ramp can be.
• In 2017, the U.S. Access Board issued technical standards on the accessibility of MDEin physicians’ offices, clinics, emergency rooms, hospitals, and other medical settings.We call these the “MDE Standards.”
• This rule adopts the MDE Standards and makes them enforceable under the ADA byincorporating them into the Department’s ADA Title II regulation.

• The rule generally requires all MDE that state and local government entities purchase,lease, or otherwise acquire after October 8, 2024 to be accessible, until theentities have the amount of accessible MDE specified in the rule.
• State and local government entities may choose to acquire additional accessible MDEas long as they have the amount specified in the rule.

• By August 9, 2026, any state or local government entity that uses an examination tablemust purchase, lease, or otherwise acquire at least one examination table that meets theMDE Standards, unless the entity already has one.
• By August 9, 2026, any state or local government entity that uses a weight scale mustpurchase, lease, or otherwise acquire at least one weight scale that meets the MDEStandards, unless the entity already has one.

• State and local government entities must also address barriers caused by a lack ofexisting accessible MDE. Examples of access barriers could include exam tables thatare not height adjustable or weight scales that do not accommodate wheelchairs.
• State and local government entities do not necessarily have to make all of their existingMDE accessible.
• The rule requires state and local government entities to operate each service, program,or activity offered through or with the use of MDE so that the service, program, or activityas a whole is readily accessible to and usable by individuals with disabilities. Thisapproach is similar to the program accessibility requirements in the Department ofJustice’s existing regulation implementing Title II of the ADA.
• State and local government entities can meet this requirement in many ways. Forexample, they can provide services at another location, through home visits, or byacquiring accessible MDE.

• State and local government entities cannot deny health care services to a patient with adisability that they would otherwise provide because they lack accessible MDE.
• State and local government entities cannot require a patient with a disability to bringsomeone along with them to help if patients without disabilities are not required to do thesame.

• The rule requires state and local government entities to ensure that their staff cansuccessfully operate accessible MDE, assist with transfers and positioning of individualswith disabilities, and carry out the rule’s requirements for existing MDE.
• At all times when services are provided to the public, state and local government entitiesare expected to have staff who can operate accessible MDE.
• Often, the most effective way for state and local government entities to ensure that theirstaff can successfully operate accessible MDE is to provide staff training on the use ofaccessible MDE.

• Under the current ADA rules, state and local government entities do not need to makechanges that would be a fundamental alteration or cause undue financial andadministrative burdens. They still do not need to do that under this rule.
• For more information about fundamental alteration and undue burdens, see theDepartment’sState and Local Governments page.

• The rule allows state and local government entities to use different designs, products, ortechnologies as alternatives, as long as the state or local government can prove that thealternatives provide the same or more accessibility and usability as the MDE Standards.