[Federal Register Volume 87, Number 69 (Monday, April 11, 2022)]
[Notices]
[Pages 21089-21091]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-07724]


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ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD


Notice of Public Meeting

AGENCY: Architectural and Transportation Barriers Compliance Board.

ACTION: Notice of public meeting.

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SUMMARY: The Architectural and Transportation Barriers Compliance Board 
(Access Board or Board) is hosting a virtual public meeting to obtain 
further information on the appropriate low-height specification for 
transfer surfaces for medical diagnostic equipment.

DATES: The public meeting will take place May 12, 2022, 2:00 to 4:00 
p.m. Eastern Time.

ADDRESSES: The virtual meeting will be open to the public and held via 
the Zoom Webinar Platform (https://www.zoomgov.com/webinar/register/WN_GFoTS44-R7qWdh6GF0xLPg). Requests to speak during the meeting must 
be submitted via email to Rose Marie Bunales at board.gov">bunales@access-board.gov by May 11, 2022. Please type ``Request to Speak'' in the 
email subject line. Speakers will be limited to three minutes during 
the virtual meeting. Written comments may be submitted until May 27, 
2022. Submit written comments via email to board.gov">mde@access-board.gov.

FOR FURTHER INFORMATION CONTACT: To register to attend this virtual 
meeting, visit: https://www.zoomgov.com/webinar/register/WN_GFoTS44-R7qWdh6GF0xLPg. For further information, contact Bobby Stinnette of the 
Access Board by email at board.gov">stinnette@access-board.gov or by phone at 202-
272-0021. Communication access via real-time translation and sign 
language interpretation will be provided. To request additional 
reasonable accommodations for the virtual meeting please contact Bobby 
Stinnette by May 5, 2022.

SUPPLEMENTARY INFORMATION:

Background

    Section 510 of the Rehabilitation Act charges the Access Board with 
developing and maintaining accessibility standards for medical 
equipment used by health care providers for diagnostic purposes, 
including examination tables and chairs, weight scales, and imaging 
equipment. 29 U.S.C. 794f. In January 2017, the Board issued a final 
rule establishing accessibility standards for medical diagnostic 
equipment (MDE Standards). 82 FR 2810 (codified at 36 CFR part 1195). 
The MDE Standards set forth minimum technical criteria to ensure that 
medical diagnostic equipment in physician's offices, clinics, emergency 
rooms, hospitals, and other medical settings is independently 
accessible to, and usable by, individuals with disabilities.
    The MDE Standards address the height and adjustability of MDE 
equipment that patients who use wheelchairs must transfer onto, 
including examination tables and chairs, procedure tables, and imaging 
equipment with tables. It is important that the height of these 
transfer surfaces align with a patient's wheelchair seat height to 
facilitate a safe transfer between diagnostic equipment and mobility 
devices. Transfer surfaces that align with the seat heights of mobility 
devices reduce the effort needed by patients to transfer since they do 
not have to lift their body weight to make up the difference between 
the two surfaces.
    In the Notice of Proposed Rulemaking for the MDE Standards, the 
Board sought public comment on whether the

[[Page 21090]]

height of transfer surfaces should be adjustable within a range of 17 
inches minimum and 25 inches maximum. 77 FR 6916, 6922 (Feb. 9, 2012). 
These dimensions were based on findings from a major study on the human 
measures of people who use wheeled mobility devices in the United 
States conducted by the University of Buffalo Center for Inclusive 
Design and Environmental Access (IDeA Center) with funding from the 
Access Board and the National Institute for Disability, Independent 
Living, and Rehabilitation Research. Completed in 2010, the 
Anthropometry of Wheeled Mobility Project collected anthropometric data 
on 495 subjects who use wheelchairs, power chairs, and scooters. 
Researchers measured wheelchair seat height, occupied length, turning 
radii, reach ranges, and other dimensions (Steinfeld, E., Paquet, V., 
D'Souza, C., Joseph, C., and Maisel, J. ``Anthropometry of Wheeled 
Mobility: Final Report'' (2010), available at http://idea.ap.buffalo.edu/wp-content/uploads/sites/110/2020/01/AnthropometryofWheeledMobilityProject_FinalReport.pdf).
    Findings from this project indicated that the occupied seat heights 
for people who use wheeled mobility devices vary considerably. Seat 
heights ranged from 16.3 inches to 23.9 inches for manual wheelchair 
users, 16.2 inches to 28.9 inches for power wheelchair users, and 18.8 
inches to 25.3 inches for scooter users. Based on this data, 
researchers concluded that a transfer surface that is adjustable from a 
height of 17 inches minimum to 25 inches maximum would accommodate the 
5th to the 95th percentile range of those who used wheeled mobility 
aids (Id., Section 4.3.2, p. 89).
    In an analysis of the data on seat height, researchers further 
determined that a low transfer height of 17 inches would exclude 6% of 
manual wheelchairs in the project database. According to this analysis, 
``[i]ncreasing the minimum above 17 in. even two inches . . . would 
exclude a significant proportion of the manual wheelchair group, in 
particular, over 30% of the females in the sample.'' D'Souza, C., 
Steinfeld, E., ``Analysis of Seat Height for Wheeled Mobility Devices'' 
(July 19, 2011), available at http://idea.ap.buffalo.edu/wp-content/uploads/sites/110/2019/08/23.pdf.
    In the Notice for Proposed Rulemaking, the Board sought comment on 
the height and adjustability of transfer surfaces and whether transfer 
surface heights should be adjustable from a low transfer position of 17 
inches to a high transfer position of 25 inches. 77 FR at 6922-6933. 
Most commenters supported a requirement for adjustability and a high 
transfer surface height of 25 inches but disagreed on what the low 
transfer height should be. Id.
    On July 5, 2012, the Access Board organized an advisory committee 
representing stakeholders to provide recommendations on how the MDE 
Standards should be finalized based on the public comments received. 77 
FR 39656. The MDE Accessibility Standards Advisory Committee, like the 
public commenters, was divided on the low transfer surface height and 
was unable to reach consensus regarding a minimum low transfer surface 
height specification. MDE Accessibility Standards Advisory Committee 
Report, 70, available at https://www.regulations.gov/document/ATBCB-2013-0009-0001. Advisory committee members submitted minority reports 
supporting their views.
    Minority reports submitted by the disability advocates and 
academics supported a minimum low height of 17 inches to ensure as many 
independent transfers as possible. They noted that a 17-inch low height 
provides the greatest number of individuals the opportunity to transfer 
independently. See Minority Reports from Boston Center for Independent 
Living Inc., National Network for ADA Centers, and Medical Diagnostic 
Equipment Advisory Committee. Id.
    The minority reports submitted by manufacturers supported a minimum 
low height of 19 inches. They asserted that examination tables and 
chairs that can meet the 19-inch height are available but that there 
were no products on the market that met the 17-inch height. See 
Minority Reports from the Brewer Company, LLC, Hologic, Inc., Midmark 
Corporation, MITA Advisory Committee Members, and Recommendation of 19-
inch Lower Adjustable Height as the Minimum Accessibility Standard 
(Joint Report). Manufacturers also expressed concern about the 
potential impacts of a 17-inch low height on diagnostic imaging medical 
equipment with tables, such as x-ray scanners, CTs, PETs and MRIs. A 
reduction in the low transfer surface height of a few inches may 
involve significant re-engineering and require FDA retesting and 
recertification according to these reports. See Minority Report of GE 
Healthcare, Phillips Healthcare, Siemens Healthcare, and Hologic, Inc. 
Id.
    On January 9, 2017, the Access Board issued the MDE final rule, in 
which the Board specified that transfer surfaces be adjustable from a 
low transfer position at a height of 17-19 inches to a high transfer 
position at a height of 25 inches. It also required that the transfer 
surface be adjustable to four unspecified heights between the high and 
low transfer height separated by a minimum of one inch. 36 CFR part 
1195, Appendix, M301.2.1 & M302.2.2. The 17-19 inch low transfer height 
was set as a temporary range with a five-year sunset provision. Id. As 
explained in the preamble to the final rule, the Board took this 
approach because ``there was insufficient information to designate a 
single minimum low height requirement at this time. Specifically, there 
[was] insufficient data on the extent to which and how many individuals 
would benefit from a transfer height lower than 19 inches.'' 82 FR at 
2816.
    During the five-year sunset period, the Board said it would further 
study this issue and collect additional information. Id. On February 3, 
2022, the Board issued a direct final rule to extend the sunset 
provision until January 10, 2025, to provide additional time to 
complete its research and the required rulemaking processes to 
establish a final specification for the low transfer surface height. 87 
FR 6037.
    In 2021, the Board commissioned a secondary analysis of the 
Anthropometry of Wheeled Mobility database and wheelchair seat height. 
This analysis was undertaken because some segments of the population in 
the Anthropometry of Wheeled Mobility Project test sample were over- or 
under-represented. Specifically, the test population was younger in age 
and included more men than women compared to the estimated U.S. 
population. In addition, the researchers intentionally oversampled 
powered wheelchair users, which tend to have seat heights higher than 
manual wheelchairs, in order to capture the sizes and space 
requirements of this group. (``Anthropometry of Wheeled Mobility: Final 
Report,'' Section 3.1, pp. 36-37).
    In this 2021 study, researchers statistically resampled data on 
occupied seat heights for manual and powered wheelchair users to create 
virtual samples that were proportionally representative of the total 
population of wheelchair users in the United States in terms of device 
type (manual wheelchairs or powered wheelchairs), gender, and age 
category (18 to 64 years or 65 years and older). Based on 
demographically representative sampling, the study estimates that 4.5% 
of wheelchair users have a seat height equal to or less than 17 inches, 
21% had a seat height equal to or less than 18 inches, and 42% had a 
seat height equal to or less than 19 inches. (D'Souza, C.,

[[Page 21091]]

(January 28, 2022), ``Analysis of Low Wheelchair Seat Heights and 
Transfer Surfaces for Medical Diagnostic Equipment: Final Report'' 
available at https://www.access-board.gov/research/human/wheelchair-seat-height/).

Announcement of Public Meeting

    In light of these latest findings from the resampling analysis, the 
Access Board has decided to hold a public hearing to gather additional 
information on the low transfer height for MDE transfer surfaces from 
disability advocates, manufacturers of MDE, researchers and other 
stakeholders and interested parties. The Board is particularly 
interested in information on what the low height is for adjustable MDE 
products that are currently on the market and any changes or 
innovations in their design and engineering that may have occurred 
since the Board issued the MDE standards in 2017. The Board is aware of 
at least some examination tables and chairs that can adjust to a height 
of 17 inches or less. The Board is also interested in updated 
information on the incremental costs for the design or redesign and 
manufacture of examination tables and chairs and diagnostic imaging 
medical equipment with tables that can provide a low transfer height of 
17 inches.

Christopher Kuczynski,
General Counsel, U.S. Access Board.
[FR Doc. 2022-07724 Filed 4-8-22; 8:45 am]
BILLING CODE 8150-01-P