10400-ACB’s 2023 Leadership Conference
Medical Device Non-Visual Accessibility Act
February 27, 2023

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>>  CLARK RACHFAL:  Give the overview of another one of our legislative imperatives.  The Medical Device Non-visual Accessibility Act.  Take it away Swatha Nandhakumar.  
>>  SWATHA NANDHAKUMAR: The medical device imperative non-visual accessibility act, this imperative from last year, we need to get introduced because we have new Congress in session.  Last bills were all done and over with.  This one is new bills introduced.  So what this bill does, it requires FDA to consult with the export and create standards.  What the FDA calls class two and class three of medical devices.  These are more invasive and carry more risks if you use them incorrectly.  
These are devices like heart monitors or glucose monitors or all things that have a digital interface that tells you like what is going on -- what numbers and readings.  So these devices have been accessible -- inaccessible to blind folks and deaf folks and low vision folks.  They don't have speech output or markers or anything that could make it accessible for a blind person to use.  
So this bill was introduced not last year.  2021 by the House and it had no companion.  It was over 60 co-sponsors and from both parties.  Democrat and Republican sponsors.  I will leave it to Clark to tell you more about what meets for us
>>  CLARK RACHFAL: Thank you Swatha.  I want to highlight a couple things here.  This is a Bipartisan piece of legislation.  Both Democrats and Republicans went on the record to support the legislation in the House of Representatives.  Saying that this is important.  The food and drug administration must create accessibility standards for remote diagnostic and durable medical equipment.  I apologize before for not recognizing the -- the listeners and audience members that are joining us by listening to the Spanish language.  Feed.  For tonight's community event.  On this legislative imperative.  Thank you to our Spanish listening audience as well.  
And as we talk about our audience members, we want to talk about why this is important.  For our members.  Whether English or Spanish speaking.  
Many people in the United States who are blind, low vision, deaf/blind, has additional chronic or core morbid health conditions.  We see it a lot with working aged adults in the United States.  
Who have diabetes as the leading cause of blindness for people in this age bracket.  This is also diabetes being a condition that disproportionately impacts people of color.  Such as people with Hispanic Heritage or more likely to be listening on the Spanish language feed.  
In addition to diabetes we have older Americans that have age related vision loss.  That have other chronic or core more bid health conditions as well.  We know from data from the Centers for disease control prevention people that are low vision and blind in addition to diabetes and have high cholesterol and high blood pressure and hypertension and blood disease.  This is why it is important that the medical devices and remote monitoring equipment are accessible for people that are blind and low vision.  
If these other chronic morbid conditions were not bad enough, we just spent the last two years in the middle of a pandemic.  A pandemic where going out and about and taking trips to the doctor's office, became more dangerous onto themselves.  
During this time, we saw rapid growth in the adoption of telemedicine and virtual doctor visits.  Many of these visits and appointments are done in conjunction with home and remote monitoring equipment.  That relays information to our physicians to our doctors.  It is important that people who are blind and low vision have the same independent and private access to this equipment, to these medical tools as the rest of the population.  So they could be used safely, they could be used effectively, and that they could convey vital and necessary information to our care teams.  
Once we have accessibility built into these products, the end goal is a world where people are blind and low vision have more control and independence and we could take control of our own health.  I will turn it over to Swatha Nandhakumar to talk about what it means to ACB larger advocacy efforts
>>  SWATHA NANDHAKUMAR: Thank you Clark.  We have a committee or several focused on health and wellness.  This includes get up and get moving campaign.  Or committee.  Our committee that has access those all have been on the front lines of having -- accessibility of our medical devices and our at home diagnostic like Clark mentioned.  Glucose monitors and other monitors you may need to use in our normal Telehouse visit.  
We also have an affiliate ACB diabetics in action.  That deals or advocates with diabetes.  And in addition to blindness.  This is not an new issue.  This is a great way to advocate for accessibility to be built-in at the offset and not on the -- retrofit.  
So this bill really promotes accessibility being built-in.  And at the beginning stages of development and not in the end.  Like, most things are.  
Also, this bill has been introduced in last Congress.  And it is by partisan even though it is not both introduced into chambers of Congress.  This year with the momentum it has had from last Congress this bill will be by both parties and introduced in Senate and the House.  
So Clark you want to add anything else?  
>>  CLARK RACHFAL: Thank you Swatha.  At this point I like to urge you to join us to advocate for another one of our legislative imperatives, the Medical Device Non-visual Accessibility Act.  Please urge your members of Congress to co-sponsor this important legislation, once it is reintroduced in the 118 Congress.  Like, Swatha said we are excited for the bill to be introduced in the House.  We are optimistic with the work that was done.  This bill will be introduced in the Senate and both chambers of Congress, this must be a bipartisan piece of legislation.  
So again, keep advocate.  And support the Medical Device Non-visual Accessibility Act.  
>>  SWATHA NANDHAKUMAR: We could move on right Clark?  
>>  CLARK RACHFAL: We could ask one of our hosts with the most, Deb Luis, you don't mind to run through the options we have for how folks may ask a question.  
>>  We have the usual Zoom way of asking questions and Travis butler is asking us.  You like to raise your hand in Zoom, Travis will call on you.  And we have the QA box.  I have a question in the QA box.  I had to step away to resolve a technical thing.  I may have missed if this is answered.  You could use the QA box as well.  
So those are both available.  For you to do.  We have club house.  You are in club house Jane is there for us we will take questions there.  You have lots of ways to chat with us.  The question in the QA box is from Ray.  He clarified whether Representative Jen from Illinois introduced the bill yet this was his understanding she would do it on February 21st.  
>>  CLARK RACHFAL: Great question, Ray.  We have not seen this bill introduced yet by Representative Schakowsky that was our understanding as well.  We anticipate it introduced before the legislative seminar.  I could say this so many weeks in the row before we are no longer before the seminar.  
(laughing).  
We are hopeful we will get introduced in the seminar we will have bill numbers to share for folks to advocate with.  
>>  We have hands in Zoom.  
>>  CLARK RACHFAL: Yes please Travis.  
>>  First is 510 ending in four 05.  
>>  Berkeley, you say it is a Bipartisan bill, last year, how many Republicans and Democrats voted for.  
>>  SWATHA NANDHAKUMAR: It was 60 Democrats and three Republicans.  
>>  It was.  60 Democrats and three Republicans.  We will take that.  We have plenty of room for growth.  It is a bipartisan bill none the less.  
>>  We only had three Republicans but thank you for knowing the answer.  
>>  Next is a phone number, 715, ending in 443.  
>>  CLARK RACHFAL: Hello to the individual with the 715 arrow code.  
>>  The first time I allowed them to talk it didn't work.  
>>  Hello this is Jennifer.  I was having trouble unmuting myself.
>>  CLARK RACHFAL:  We could hear you now.  
>>  I was talking to my grandma, the other night.  And she wants to know, she lived in a different state.  But she wants to know, what can she do to help us get these things passed?  
>>  CLARK RACHFAL: Absolutely.  That's a great question.  Swatha you like to begin?  
>>  SWATHA NANDHAKUMAR: Sure.  So we are pushing for all of our members here to talk with their members of Congress.  By a meeting.  We could also call them.  Or send an e-mail.  That number to call the Senate switch board to get your office.  Is.  
202) 224-3131.  You call them and tell them you are from California and you want to speak to your, Representative Rice.  They will connect to you that individual and their office.  And --
>>  CLARK RACHFAL: To add what Swatha is saying, we are providing information on the legislative imperatives as well as information on how affiliates can contact their members of Congress.  If you want to share that with your friends and family, but all means, go ahead.  You are able to enlist the support of folks such as your grandmother, your neighbors, and they want to contact their member of Congress as well, telling them to co-sponsor the Medical Device Non-visual Accessibility Act, that is great.  That -- we need all the allies that we could get.  By trying to gain support for this legislation.  This imperative.  
>>  Is there -- a place I could find where to -- to -- not only help myself.  If I want to call.  But to help my grandma and anyone else that wants to help support any and all these things we are trying to get passed?  
>>  CLARK RACHFAL: Absolutely.  A couple options for you.  On the ACB website, ACB.org, you could find information for the DC leadership conference under news or top links.  And on the page for the DC leadership conference, are our legislative imperatives.  
You could also talk with your leadership of your state affiliate.  Your state affiliate is working to organize meetings with your representatives.  And your Senators.  So they will have the legislative imperative information.  And they will be able to provide you with guidance and talking points related to the legislative imperatives.  And then, last but not least, you could e-mail advocacy@ACB.org.  And Swatha will be more than happy to follow-up with you to insure that you have the resources and materials you need to conduct the outreach.  
>>  SWATHA NANDHAKUMAR: Yes.  
>>  CLARK RACHFAL: Isn't that right Swatha?  
>>  SWATHA NANDHAKUMAR: I could do that, thank you, Clark.  
>>  Thank you very much I don't need to attend this in-person to make a difference ; correct?  
>>  SWATHA NANDHAKUMAR: You could attend -- yeah.  We do virtual and in-person options as well as -- your office also has virtual and in-person options as well.  You could do whatever you feel comfortable for you.  
>>  CLARK RACHFAL: And -- you do not --
>>  I would not be able to attend virtually.  
>>  CLARK RACHFAL: You don't need to attend to make a difference.  Joining tonight are you helping to make a difference.  After this conversation this evening you want to run out to contact your members of Congress, please do so and go ahead.  We are -- of course welcome we want you to attend the virtual and in-person leadership conference.  That is not necessary to advocate for the legislative imperatives.  
>>  One more --
>>  Oops she is done.  
>>  CLARK RACHFAL: Oops.  That is quite all right.  That is -- several questions there.  We are good to move on to the next person.  
>>  I wanted to ask if we have more in chat or club house?  
>>  We don't have additional written questions.  
>>  Karen you are next.  
>>  Okay.  I hope you could hear me tonight.  
>>  Yes.  
>>  Beautiful.  I want to make sure this equipment is not only accessible but accurate.  Because we want it to be accurate like sighted people have.  
>>  CLARK RACHFAL: Absolutely.  Kary in the Food and Drug Administration has rules and regulations in place.  For medical devices durable medical equipment to be evaluated for safety and efficacy they need to be safe and effective and accurate.  But they don't have rules for accessibility.  
So any device that is being made accessible, will also need to comply with the rules that are in place for safety and efficacy.  Great question.  
>>  Got you, thank you.  
>>  CLARK RACHFAL: Thank you.  Thank you to the great State of Illinois.  And ILCB for having Representative that is the lead sponsor of the legislation.  
>>  Yup.  
>>  Next is Beth.  
>>  Okay.  Hello.  Clark.  
>>  CLARK RACHFAL: Hi.  
>>  I wanted to -- ask you if, besides being accurate and accessible, will they be affordable?  I know a lot of the medical products Medicaid doesn't -- Medicaid will not cover and there is a lot of people with disabilities that have Medicare and Medicaid.  And especially Medicaid, like our state it doesn't cover a -- they don't cover the talking glucose meters that you use with your -- in conjunction with your iPhone and stuff.  So will it be affordable?  And also, I was wondering, if you do want to attend any of these Zoom meetings with the people in Washington, how do you do that?  Would you attend it by Zoom?  By phone?  Or no?  
>>  CLARK RACHFAL: Thank you for the two questions.  Swatha would you like to begin?  
>>  SWATHA NANDHAKUMAR: Yes.  This legislation only addresses accessibility, but we do recognize affordability and coverage are issues that come up a lot.  So yeah, the push now is to get these agencies to cover any kind of devices.  In conjunction with accessibility.  But you are welcome to bring it up with your Congress person.  Senator as well.  
>>  CLARK RACHFAL: Yeah.  Just to add, those are both important issues right Swatha?  
>>  SWATHA NANDHAKUMAR: Yes.  
>>  CLARK RACHFAL: Accessibility and affordability.  This legislation is focus on accessibility.  We continue to work on affordability, as well, whether that is, you know, low vision devices or Medicare and Medicaid coverage.  And as well as the expanding Medicare and Medicaid coverage for vision hearing, dental, and things like that.  But this legislation and this ask is specifically related to accessibility.  And Swatha, the second question on how to be part of the meetings with members of Congress?  
>>  SWATHA NANDHAKUMAR: That question, so most affiliates are at the meetings are -- I would reach out to your President or new chapter local chapter.  And look where you are.  And join the meetings.  Or you could also do your own meeting, too.  
>>  CLARK RACHFAL: Exactly.  So you want to participate with the American Council of the blind as part of the leadership Congress in the Hill meetings like Swatha said, contact your state affiliate and local chapter and tell them you like to be involved.  
They may have, you know, you have an effective meeting they may limit the number of members who are able to speak.  During a meeting.  With Congressional office.  A member of Congress or staff.  But I'm sure they would welcome the outreach and help for coordinating and scheduling and attending the meetings.  And as Swatha said, you -- members of Congress are always there whether you are reaching out on behalf of ACB.  Or you are reaching out as an individual.  
So you could always contact your member of Congress.  Whether your, Representative or Senator and Swatha provided the phone number before.  If you want to call the capital switch board and be connected directly to your, Representative or your Senators for your state, different meetings there between state Senator and U.S. Senator for your state.  That number again Swatha is
>>  SWATHA NANDHAKUMAR: 202) 224-3131.  We have it on our website, too.  Or actually on the website as well.  Let us know if you need the number again.  
>>  Just making sure.  All right.  Jane and club house your hand is up and it went down.  You have somebody there?  Getting no answer.  We will move back in Zoom here to Alice.  
>>  I'm sorry we did but he lowered his hand.  
>>  Okay.  
>>  Sorry.  
>>  Can you hear me?  
>>  SWATHA NANDHAKUMAR: Yeah.  
>>  Yes.  
>>  I was going to make a comment Clark on affordability.  Medicaid is state-by-state, it is behooves us to take the imperatives and take to our state representatives.  Georgia here the American of diabetes put forth a bill for Medicaid to cover the -- folks that are diabetic you need so many finger sticks or -- you want that affordable through Medicaid is becomes a state -- a state issue.  So I would take the imperatives to the State.  That is the comment I wanted to make.  
>>  CLARK RACHFAL: Alice, that is a great point, thank you.  Medicaid is administered there on the State level.  Many states or several states around the country have provided white cane coverage through state Medicaid.  So that is a great example of medical equipment like continuous glucose monitors where those items could be covered in terms of their affordability by the Medicaid program at the state level.  
So thank you for that, Alice.  
>>  Next up, we have Mr. Ray.  
>>  Good evening guys, Clark, Swatha.  Glad to be talking to you again.  I want to make a quick comment to Beth's point to affordability.  The more of this equipment that comes off the shelf that is accessibility the more we will have affordable equipment.  We can -- the iPhone and other equipment and things.  Apple and other companies have proven you could develop affordable accessibility equipment off the shelf.  In so the more equipment that we could make accessibility, out of the box, to Beth and others concerns, the more affordable equipment would be out there and likely insurance will cover it, if you need that.  
And it is just going to make for a better situation all around.  But what we need to do is get the equipment accessible and get that is required to be done.  So definitely looking forward to working on this legislation.  We got an appointment with our Representative.  On the 13th.  To talk about it and we've also ask her to be an original co-sponsor.  Hopefully, that will move the ball forward on this.  And that's all I have to say.  
>>  CLARK RACHFAL: Ray before you go, being from Illinois, not only do you have Senators that you hope co-sponsor this legislation.  Once it is introduced in the Senate.  For the first time.  
But you also have representatives that we hope are more supportive of this legislation while also being the home state of the representatives that introduced the legislation
>>  Exactly.  
>>  CLARK RACHFAL: What are the different conversations folks from Illinois will be having?  You will get a meeting with the representative the sponsor, how is that meeting different than your other meetings?  
>>  Well, we haven't -- actually said we were going to do that.  We probably will try to do that.  One thing -- this is something that people need to be aware of.  Is a lot of times Representatives offices will only take contacts through -- you need to e-mail them a schedule.  They will take it from people in the district.  So what we need to do is get somebody in her district to make the contact for us.  Is what we will do with her as opposed to our Representative, we will do with her is go in and thank her for introducing the legislation and talk about to reinforce why it is important.  What it means for people that are blind or visually-impaired.  
Someone like our Representative that is a new Representative from the same state, but a new Representative none the less, in Congress, we're going to want to talk to her about why she should sign on as original co-sponsor.  Of the legislation, too.  And the -- this brings up another point too Clark.  
You got -- we will have to get -- because the House is Republican controlled, we need to get Republicans to sign onto this bill.  To get it over the finish line.  And so, this brings up the issue that we've talked about in the past at legislative seminars before.  How you speak to different political parties and encourage them to support legislation.  For Republicans it is you say you talk about things like costs.  It is cheaper to have someone be able to be at home and monitor their own situations rather than having to go to a doctor's office or something.  You talk to them about privacy.  
No one wants to have to give personal medical information to other people.  So I hope that kind of explains how different representatives you have different types of meetings.  With those of you that do get Representatives that sign on as co-sponsors, you will want to thank them and reinforce why the bill is so important.  And if you have pieces of equipment that you could take with you, that may be aren't as accurate as you like them to be or whatever, I encourage you to do that.  You have in-person meeting you could demonstrate something or demonstrate something over Zoom even.  That is a good thing to do as well
>>  CLARK RACHFAL: And Ray, somebody that works in the technology field, certainly more cost-effective for medical equipment to be accessible by design.  Than retrofit it after-the-fact; correct?  
>>  Absolutely.  This bill is nothing -- takes nothing away from the wonderful companies out there like -- LSNS and others that put out equipment.  But we're a small population guys.  Every piece of equipment out there has accessibility built-in, anyone that needs it could use, it is going to bring down the cost.  We design it from the ground up with accessibility built-in, it is cheaper to do that.  I know Deb will agree with me on this.  To bolt it on in the end.  
>>  CLARK RACHFAL: Thanks Ray.  
>>  Uh-huh.  
>>  Next up is Ann.  
>>  Hi.  You said that this bill, you know, covers all pieces of equipment.  I wanted to clarify it will cover sleep pap machine.  For sleep apnea too.  
>>  CLARK RACHFAL: That is a good question.  The food and drug administration has different Class of products.  Class 1, 2, 3.  Class 1 products, are items that a patient may contact but they are non-invasive.  So like, a chair.  Or bed in doctor's office.  Class two and three products are products that are designed to be in contact with to capture bodily fluids or to be inserted or implanted in the body.  
So something like a CPAC machine is our belief that would be covered.  By this legislation.  Another aspect of the legislation is that it is designed to cover the products that are primarily intended for, you know, in home use by the patient.  
Versus products intended to be used by a physician or by a team of doctors in a medical setting.  So we want to focus on the items that patients will be using on their own.  And again, for that reason, we believe that once the Food and Drug Administration creates the rules, something like a CPAC machine continuous glucose monitor, pulse ox, heart monitor that measures your heart rhythm, and things like that.  Heck, home chemotherapy system, they exists.  They are becoming more and more common.  We think all of these types of products will be covered.  
Yes, we do believe a CPAC machine is covered.  
>>  All right.  Cassie is next.  
>>  Okay.  I do want to make a comment on what my experience is.  Just maybe help people out.  Some ask how to contact their Representatives and Senators.  There is two ways that e-mail form I found -- was not personal.  I was more successful to get two Reps my former and present Rep, by using the ACB and fill in my name and Representatives and all of that sort of thing.  Before I did that, I contacted the Congressman's office.  They gave me a scheduler that gave me the person that dealt with the legislative matters for that Congress people.  
And when I e-mailed the legislative people that handle legislative I got two appointments.  The e-mail form and one letter that had nothing to do what I wrote about.  I need to find out why that happened.  No response from another.  I will go down a different track.  I think the most easiest way to do it, get in contact with the person that schedules the meeting.  They will respond to you and tell you who handles the legislative matters and who you speak with on Zoom or in-person.  That is my experience so far.  
>>  CLARK RACHFAL: Casey, thank you for sharing.  Swatha, what do you think hearing Casey share that the -- the information that ACB put out about how to contact your, Representatives and Senators to schedule a meeting is affective.  
>>  SWATHA NANDHAKUMAR: I think it is effective for us here.  I would be happy to send that kind of template to anyone e-mails us at advocacy@ACB.org.  And need helps.  You reach out to us, Clark and I could send you that template.  
>>  All right.  Jane.  Club house, you have a question there?  
>>  Yes.  We have Micia.  
>>  Hi.  Sorry.  I'm riding.  But so I just came in -- I guess about -- five or six minutes or so ago I saw the topic in the room.  Was very interested.  I have a 16 year old with Type 1 diabetes.  And is this what I'm hearing correct, that I guess this act will make these things such as CGM's accessible?  Is that what this is about?  
>>  SWATHA NANDHAKUMAR: Yeah.  It is not just CGM's it is all kinds of medical devices that are invasive.  
>>  Okay.  Right.  I meant something -- you know, as well as CGM's.  What about -- you know, the key tone strip monitors you put the ear on the little stick thing and put it into the machine it gives a reading as to if there is key tones in the urine or not.  Some work off blood.  Instead of urine.  Would that be one of those things?
(laughing).  
>>  CLARK RACHFAL:  So to that I would answer, that is a -- that is an FDA-approved medical device, then this legislation rules that come from the passage of the legislation would likely apply to that.  
>>  Okay.  Okay.  Awesome.  Good.  Finally.  
(laughing).  
All right.  Thank you so much.  Like I said, I just came in on the tail end I was trying to get a feel for the room and everything.  
>>  CLARK RACHFAL: Absolutely.  Thank you for the question and joining through club house and your interests in the Medical Device Non-visual Accessibility Act.  
>>  I have a question in the question box.  
>>  CLARK RACHFAL: Second question box question.  
>>  Yeah.  Third.  Because two people really did ask Ray's question.  I just validated it.  
>>  CLARK RACHFAL: It is good to have a question box moderator.  
>>  That is right you need to have one of these.  
(laughing).  
Donna asked for the legislation who helps developer to determine what is accessible and to get accessibility; correct?  Is that a role that ACB is playing in the legislation or how will it happen?  
>>  SWATHA NANDHAKUMAR: The bill right now, will consult with the access board is -- governing body.  Agency that does work on standards for accessibility.  That means, between this and through comment notice comments and all the input of community and others, these standards are set -- yeah, by them.  
So it will work for accessibility.  
>>  CLARK RACHFAL: Yeah.  And the US Access Board has existing expertise in this space.  Certainly as it relates to the Section 508 requirements for the accessibility of technology used by the Federal Government.  
And those standards incorporate the web content accessibility guidelines.  So that's a baseline; right?  But when we get into the medical equipment space, there is going to be learning that needs to occur.  Not only by the access board, the Food and Drug Administration, but also the companies that are involved.  So some learning that Swatha said will take place through the rule-making process notice and comment.  Where the public companies, organizations like ACB and individuals can weigh in with their thoughts and opinions.  
There will be ongoing advocacy work like ACB is doing and other organizations to engage with the companies.  To help inform them what exactly people with disability want and need.  What people who are blind need.  Because I think we could all agree we are better off when an organizations like ACB and our members are involved with these companies.  Involved in the design and testing process.  
We typically get better results than when somebody brings us a finished product and says look at what I did for you.  Aren't you happy?  Well, did you talk to anyone that is blind?  Okay.  Well, let's take it back to the drawing board.  So yes, I think there is a lot of opportunities for education and learning and certainly a role for ACB to be involved in the rule-making process.  As well as direct engagement with the companies.  
>>  All right.  Next up, we have Mona you may unmute.  
>>  Okay it is Malania.  You mispronounced my name.  
>>  There is a Mona, too.  I invited you when she didn't come up.  
>>  Got you.  Okay.  So I might be asking in the wrong forum about this question.  But I now thought about it.  I know we've been working on getting this legislation sponsored and passed for several years.  
I have a young niece who is fed through a feeding tube.  And a feeding machine.  Will that fall under durable medical equipment?  Does anyone -- Clark or Swatha you know about that?  
>>  SWATHA NANDHAKUMAR: This bill does cover devices have digital interface.  If your machine has a digital interface, it shows data or numbers it will cover it right Clark?  
>>  CLARK RACHFAL: Not being an medical professional I'm trying to make a educated guess.  It sounds like this is a feeding machine that feeds on a schedule, and the schedule is -- it sounds automated and controlled, and a feeding tube is invasive to the body, so I would guess, that is a likely class three medical device.  And because of the automated controls, it is a device like Swatha said with a digital interface, it is a relevant -- it sounds like a relatively complex piece of equipment.  
So likely it would not require a fundamental alteration or be undue burden to the company.  To add accessibility to a piece of equipment like this.  
Now, one thing to point out, is that this bill would apply to equipment once designed in the future.  It would not require existing equipment to be retrofitted.  But as equipment evolves and new equipment -- just like any other piece of technology, durable medical equipment is updated and revised and certified all the time.  So that's --
>>  Some is automated.  But like, if I wanted to say I was left alone with her, for an extended period of time, I would not be able to operate her feeding machine.  I can't think of what it is called now.  
>>  CLARK RACHFAL: Yeah.  This is something she uses at her residence or in the home?  
>>  She is a minor.  So you know her parents, my brother and sister-in-law, or my two other nieces, or anyone in her family or, you know, school, they are all able to operate it.  Because they could -- see what is on the screen.  
>>  CLARK RACHFAL: But it is equipment that is being monitored and used outside of a doctor's office or outside of a medical facility?  
>>  Yes.  She lives at home.  
>>  CLARK RACHFAL: Yup.  I would say yes, this is a great example of a type of device that we would like covered by this legislation.  And by the regulations.  And if you're going into a meeting with a member of Congress or their staff, this is a great example to share.  If you're comfortable.  
>>  Yeah.  Because I --
>>  CLARK RACHFAL: Sharing it in the words and language are you conveying to us here tonight.  Make it personable and relatable.  About having a family member and wanting to assist and care for them but not able to because the equipment is inaccessible.  
>>  Yes that is what I love to do.  And I've asked my sister-in-law if there is anyway -- she is an RN a registered nurse.  Is there any way that the machine is modified if I could do it if need be, now that is not possible.  Thank you.  
>>  SWATHA NANDHAKUMAR: Of course.  
>>  We have one hand left that is Mona.  
>>  Am on?  
>>  Yes.  
>>  Just a very quick comment.  We talk to our Representatives, and legislatures and aides we want to remember to mention that, all though we, represent the blind and low vision and legally blind, this Act will help the non- -- the print impaired people.  We have a large number of people that could see.  But for whatever reason could not interpret print.  Those dyslexic.  
>>  CLARK RACHFAL: Having devices with audio outputs?  Would be able to help those that are print disabled?  I think we lost Mona.  
>>  I didn't hear what he said my computer talked over him.  
>>  CLARK RACHFAL: I will repeat it.  Mona you are saying having audible output of the information on the screens or controls will be able to assist those that are print disabled?  
>>  Yes.  Like, my blood pressure kit.  Person that could not for whatever reason read print.  People that are dyslexic or artistic.  Or for whatever reason not able to learn to read print.  Will greatly benefit from this.  
>>  SWATHA NANDHAKUMAR: Yeah.  
>>  You don't have to be blind.  
>>  SWATHA NANDHAKUMAR: It is a good angle to put it in as well.  So make it universal.  
>>  CLARK RACHFAL: I think that one thing I really like about that Swatha and Mona, focusing on the problem; right?  Focus on what needs to be solved and why that's an impediment and a challenge for those are blind and low vision and print disabled.  Not able to have equal access to information.  Not able to have independent control.  
Of our health.  And that is what is going to make a difference when talking to our members of Congress.  Is expressing to them the problem with medical equipment today.  That this legislation can help solve.  
>>  You have two minutes left.  
>>  CLARK RACHFAL: Swatha you like to recap our legislative imperative and ask here this evening?  
>>  SWATHA NANDHAKUMAR: I could do that.  This bill, the Medical Device Non-visual Accessibility Act, it would create standards for class 1,2,3,more invasive and risky medical devices to make it accessibility for blind and low vision folks.  As Mona mentioned also print disabled folks.  
So what we're asking tonight and all of you to do at the seminar and with your Congress people, is to really push the imperative and push for it to be reintroduced in the Congress.  In both the House and Senate.  And we do hope this Bipartisan again like it was last Congress.  
So we really want you to talk to your Congress people about the topic.  Talk to them why it is important.  What it means to you to have access to your own health.  
>>  CLARK RACHFAL: That is right, thanks Swatha and everyone for joining here this evening.  To talk about the Medical Device Non-visual Accessibility Act.  Big thank you to our Spanish language interpreter and as well as the CART Captioner and the whole team from the ACB community.  And ACB media network that makes these events possible.  
So keep advocate for our health.  And the Medical Device Non-visual Accessibility Act.  
(end of event 5:30 p.m. PST)