The technical specifications contained in the final MDE Standards were developed with the input of various stakeholders and through a multi-year deliberative process, during which many alternatives were considered. To gather a spectrum of alternative design options, the Access Board published the proposed standards, sought public comments, and established an advisory committee consisting of diverse stakeholders, including MDE manufacturers, health care providers, and disability rights advocates. The Advisory Committee considered a number of alternative design options for different types of MDE and the committee made recommendations on amendments to the proposed standards. Alternatives considered by the Advisory Committee are discussed at length in the committee’s report, available at

After extensive discussion of the various design options for the MDE equipment, the committee members reached consensus on all of their recommendations, except for the minimum height for adjustable transfer surfaces (e.g., exam table surfaces).

For the lowest height for transfer surfaces, the Access Board considered two options put forth by different stakeholders. One option was to set the minimum height at 17 inches from the floor and the other option was to set the minimum height at 19 inches from the floor. Each option seemed to have clear advantages and disadvantages. For example, many MDE manufacturers were concerned about challenges of designing and manufacturing the equipment that could be lowered to 17 inches from the floor; on the other hand, patient advocates argued that lowering the equipment to 17 inches from the floor could allow safer and easier transfer for some patients for whom a 19-inch transfer surface would be too high.

After carefully considering the comments and materials supplied by the public and by the Advisory Committee members, the Access Board has decided to use a range for the minimum height – that is, for equipment used by patients in a supine, prone, or side-lying position or in a seated position, a low transfer position would be required at a height of 17 inches minimum and 19 inches maximum. The final MDE Standards also include a provision that this minimum height specification will expire in 5 years of the rule publication.

In our view, the range for minimum height of transfer surface in the final MDE Standards strikes a balance between accessibility and potential costs based on currently available research. In the coming years, we will gather more information about the population that may benefit from a different transfer height standard and about changing technology that may affect manufacturing costs.