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Fact Sheet

HHS PROTECTS HEALTH, LIFE, FAMILY, AND HUMAN DIGNITY FOR PERSONS WITH DISABILITIES

Overview: Today, 54 million Americans are living with at least one disability. Some are born with a disability; others acquire disabilities over the course of their lifetimes. At any time, anyone is at risk for acquiring a disability, whether through an illness, an injury, genetics, or other causes. With the "baby boom" generation approaching later life, increased numbers of persons will have or be at risk for a disability. That is why, in February 2001, the President announced the New Freedom Initiative to help give people with disabilities with the tools they need to fully access and participate in their communities with dignity and independence.

HHS leads the Federal government's response to the New Freedom Initiative, working to tear down the barriers that prevent persons with disabilities from full participation in community life. The Office on Disability was established in the Office of the Secretary as the focal point for disability program and policy across the Department, with other Federal agencies and Departments, with States and communities, and with public and private sector partners. The Office's activities span those of the President's New Freedom Initiative: housing, education, assistive technology, employment, transportation and community integration. A seventh domain - health - was added, since, the health and wellness of persons with disabilities extends beyond their disabilities.

HHS has undertaken a broad array of initiatives that promote the President's goal of engaged, active and participating community lives for persons with disabilities. The programs cross the lifespan; they encompass issues related to health and wellness, self-determination, family and community. They promote independence, and foster self-reliance and human dignity. Federal funding for persons with disabilities totals nearly $3.8 billion in 2005, up almost 25% since 2002. The most significant portion of HHS funding for persons with disabilities comes from four separate HHS agencies, the Administration for Children and Families (ACF), the Centers for Medicare and Medicaid Services (CMS), the National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

The goals and objectives of the New Freedom Initiative have been integrated with Secretary Leavitt's 500-day plan for the Department, and are focused on such key areas as transforming the health care system; modernizing Medicare and Medicaid; securing the homeland; and protecting life, family and human dignity.

TRANSFORMING THE HEALTHCARE SYSTEM

Promoting wellness, prevention and treatment

The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities, released in July 2005, is promoting community-based partnerships to improve the lives of persons with disabilities nationwide, consistent with the President's New Freedom Initiative and the principles of the HHS Secretary's 500-day plan. That report's focus on wellness promotion as well as on health care services marks a critical intersection between the work of the Department of Health and Human Services and the President's larger Healthier US initiative - promoting the wellness of all Americans, including those of all ages with disabilities. HHS' Office on Disability is coordinating a public/private partnership to move the Call to Action from paper to practice, by identifying ways to implement the health and wellness strategies outlined in the Call to Action through policy and program at the federal, state and community levels and in the education and training systems for health and wellness service providers nationwide. For more information about the Call to Action, go to www.surgeongeneral.gov.

Healthy People 2010, HHS' initiative to improve the health of all Americans, includes specific objectives related to the health and well being of people with disabilities. These goals include reducing the number of people with disabilities who report feelings of sadness, unhappiness or depression that prevent them from being active, and increasing the proportion of adults with disabilities who participate in social activities. More information on Healthy People 2010 is available at www.health.gov/healthypeople. The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded over $92 million to seven states over five years for Mental Health Transformation State Incentive Grants (MHT SIGs). These cooperative agreements will provide funds to transform state mental health service delivery systems - from systems dictated by outmoded bureaucratic and financial incentives to systems driven by consumer and family needs that focus on building resilience and facilitating recovery. The states that receive the awards, administered by SAMHSA's Center for Mental Health Services, will serve as platforms for learning about what strategies and activities do and do not work in transforming the states' mental health and related systems. In partnerships with these states, SAMHSA will communicate successful strategies and activities to other states, territories, and tribes and tribal organizations in order to improve and accelerate transformation across the nation.

Fitness for Children with Disabilities. The Department of Health and Human Services' I Can Do It, You Can Do It program is teaching over 6 million children and youth with disabilities how to improve their physical fitness and health for a lifetime. Using the President's Council on Physical Fitness and Sport fitness for youth model, this program reaches out to national constituent-based organizations to match adult mentors with children and youth with disabilities who want to become more physically fit. More information about this program is found at www.hhs.gov/od/physicalfitness.html.

MODERNIZING MEDICARE AND MEDICAID

Because approximately twice as many persons with disabilities in the age ranges of 5 to 15 and 16 to 64 living in poverty as the non-disabled, the Medicare and Medicaid programs, both managed by the HHS's Centers for Medicare and Medicaid Services (CMS), have major implications for persons with disabilities. Over the past few years, CMS has taken important strides to identify and eliminate barriers to community living, consistent with the President's New Freedom Initiative. That work continues. President Bush's 2006 budget includes new initiatives to enhance community-based opportunities for persons with disabilities people to live meaningful lives in the community, proposing approximately $385 million in FY 2006 and $2.2 billion over 5 years including:

• Money Follows the Person Rebalancing Initiative Demonstrations both finance home and community-based Medicaid services for individuals transitioning from institutions to the community and help States rebalance their long-term support system. States have been encouraged to retool their community support systems to both offer citizens an effective balance of both community and institutional services and enable money to follow the person across long-term settings and providers.
• Home and Community-Based Care Demonstrations support respite services for caregivers of adults with disabilities and for caregivers of children with severe disabilities; and support community-based services for children residing in psychiatric residential treatment facilities.
• Spousal Exemption: Protects Medicaid coverage for eligible spouses of individuals participating in the Section 1619(b), Social Security work incentive program. Currently, if the spouse of a Medicaid-eligible individual participates in 1619(b), his or her earnings can result in the loss of Medicaid.
• Presumptive Eligibility for Home and Community-based Care Services: Establishes a State option to allow Medicaid presumptive eligibility for individuals being discharged from hospital to the community.

At the same time, CMS has continued its emphasis on community-based services through:

• Real Choice Systems Change. Since FY 2001, CMS has awarded approximately $208 million in grants to 50 States, the District of Columbia and two territories to develop programs that enable people of all ages with disabilities or long-term illnesses to live meaningful lives in the community. It includes grant funding to help States rebalance their long-term support systems (both institutional and community-based options) and permits funding to follow the individual to the most appropriate and preferred setting.
• Demonstration to Improve the Direct Service Community Workforce. Since FY 2003, CMS has awarded over $10 million in demonstration grants to 10 states and private, non-profit organizations to recruit, train, and retain direct service workers who provide personal assistance to people with disabilities.
• Independence Plus Initiative. This initiative, begun in May 2002, expedites the ability of States to request waivers or demonstrations that offer individuals or their families greater opportunities to take charge of their own health and direct their own services. There are 12 approved Independence Plus programs in 11 states (NH, SC, FL, LA, NC (2), CA, MD, DE, NJ, AR and CT), enabling 34,456 individuals with long-term care needs to self-direct their services.
• Ticket to Work and Work Incentives Act (TWWIIA) In FY 2005, CMS awarded $21.8 million in grants to 42 States and the District of Columbia to help persons with disabilities find and keep work without losing their health benefits. With these 2005 grants, HHS has awarded a total $100 million in Medicaid Infrastructure Grants to 47 States and the District of Columbia under this program. In FY 2006, CMS expects to award 15-25 additional grants totaling approximately $25 million. Thirty-one States currently operate Medicaid Buy-In programs that ensure health coverage for over 76,000 enrollees who work.
• In addition, in FY 2001 and FY 2004, CMS committed a total of over $152 million in grants to states (MS, TX, KS, LA, MN, DC, RI) to implement Demonstrations to Maintain Independence and Employment (DMIE) that helps assist states test the hypothesis that providing health care and other services early in the course of an illness may help promote self-sufficiency and prevent the need for cash assistance.

Implementation of the Medicare Modernization Act's Prescription Drug Benefit. Medicare's new prescription drug coverage offers extra help to low-incomes beneficiaries with limited resources and to people with dual Medicare and Medicaid coverage, many of whom have one or more disability. Most beneficiaries with incomes below the federal poverty level will pay no premiums or deductibles; they will pay $1 for generic drugs and no more than $3 for brand-name drugs. On average, Medicare will pay over 95 percent of their drug costs. Drug plan formularies will generally provide access to medically necessary FDA-approved drugs and biologicals, as well as insulin and associated supplies, and drugs that help people stop smoking. Comprehensive review and oversight will ensure that beneficiaries get the medically necessary drugs they need. The process for both exceptions to formularies and appealing decisions has been streamlined; beneficiaries can get help from their doctor and from an appointed representative.

More information on Medicare and Medicaid is available at www.cms.hhs.gov/.

Cash and Counseling Demonstrations. Since 1996, HHS and the Robert Wood Johnson Foundation have provided grants to states to support demonstrations of a "Cash and Counseling" alternative for long-term care support to Medicaid recipients with disabilities. Under voluntary projects in three states (AR, NJ, FL), some persons with disabilities receive cash allowances to purchase the care services they feel will best meet their needs and supportive services to help them manage their cash allowances. A number of HHS-supported reports summarize the experiences under the Cash and Counseling Demonstration and Evaluation. HHS and the Robert Wood Johnson Foundation are facilitating the diffusion of the cash and counseling model of consumer-directed to 11 additional states. Information is available at http://aspe.hhs.gov.

ADVANCING MEDICAL RESEARCH

The National Institutes of Health (NIH) sponsors and conducts extensive research related to preventing disabilities and to improving the quality of life for individuals with disabilities.

• The National Eye Institute (NEI) conducts and supports research, including rehabilitation research that leads to sight-saving treatments, reduced visual impairment and blindness, and improved quality of life for people of all ages. For additional information see www.nei.nih.gov.
• The National Heart, Lung, and Blood Institute (NHLBI) supports research on congenital heart disease to reduce disabilities in infants and children, increase survival, and test early interventions; devices to keep arteries open and sustain failing hearts; methods to reduce disabling heart failure; and resuscitation devices and techniques for use in people severely disabled by life-threatening trauma or heart attack. For additional information see www.nhlbi.nih.gov.
• The National Institute on Aging (NIA) has supported a variety of epidemiologic research studies for more than 20 years that include identification of risk factors for disability outcomes such as functional limitations associated with aging; loss of skeletal muscle mass and strength; predictors of physical disability in later life; and pathways to mobility decline. The research provides insights and strategies for current intervention research to prevent or delay disability in community-living older persons. NIA also supports interventions to maintain physical and cognitive functions at older ages. For additional information see www.nia.nih.gov.
• The National Institute of Child Health and Human Development (NICHD) supports research and training to improve functioning in day-to-day activities for people with physical disabilities, including research directed at developing more effective medical rehabilitation interventions and assistive technologies. The Institute also provides access to expertise and technologies from allied fields such as neurosciences, engineering, applied behavior, and the social sciences. Descriptions of research to develop effective medical rehabilitation interventions are found at www.nichd.nih.gov.
• The National Institute on Deafness and Other Communication Disorders (NIDCD) supports research on hearing, balance, smell, taste, speech, voice and language. It also is supporting the development of better hearing aids and the development of assistive devices which substitute for lost/or impaired sensory and communication function. For additional information see www.nidcd.nih.gov.
• The National Institute of Mental Health (NIMH) is dedicated to understanding, treating, and preventing mental illness through research on mind, brain, and behavior, seeking new ways to translate findings from basic research into clinical findings relevant to public health, including mental health services research. The NIMH collaborates with other federal agencies to test early interventions to halt the development of symptoms and functional disability, in order to reduce the severity of mental disorders and to promote integration of persons with behavioral disabilities into community life. Additional information is available at www.nimh.nih.gov.
• The National Institute of Neurological Disorders and Stroke (NINDS) conducts and supports research on the causes, prevention, diagnosis and treatment of neurological disorders and stroke, including research on restorative, rehabilitative or adaptive therapeutic approaches such as the neural prosthesis program. The goal is to improve quality of life for individuals with disabilities as a result of injuries or disorders of the nervous system. For additional information see www.ninds.nih.gov.

The Agency for Healthcare Research and Quality (AHRQ) examines access to and use of health services and how the health care system works. AHRQ also contributes to the development of research-based tools and information that help patients and consumers, including people with disabilities, make more informed health care decisions. In addition, health policy researchers contribute to developing, analyzing, and evaluating HHS policies and programs to serve the needs of people with disabilities. More information is available at www.ahrq.gov .

The Centers for Disease Control and Prevention (CDC) conducts research to promote the health, well-being, independence, productivity and full societal participation of people with disabilities and to reduce the incidence and severity of secondary conditions. The CDC works in collaboration with state health departments, universities and national organizations to improve tools for conducting research and disseminating health information to people with disabilities. More information on these efforts can be found at www.cdc.gov/ncbddd/dh/ . Information specific to the area of traumatic brain injury is at: www.cdc.gov/ncipc/didop/disability.htm.

Administration for Children and Families (ACF) funds 64 University Centers of Excellence in Developmental Disabilities Education, Research, and Service that are authorized under the Developmental Disabilities Act to serve as international resources, 33 of which are affiliated with medical centers or medical schools. These centers direct exemplary training programs for health and allied health professionals so they can effectively treat and interact with persons with developmental disabilities; provide community services and technical assistance; contribute to the development of new knowledge through research; and disseminate information.

The Assistant Secretary for Planning and Evaluation (ASPE) advises HHS on policy development in health, disability, human services, and science, and provides advice and analysis on economic policy. It undertakes special initiatives; coordinates the Department's evaluation, and research and demonstration activities; and manages cross-Department activities such as strategic planning, legislative planning, and review of regulations. To that end, ASPE conducts research and evaluation studies, develops policy analyses and estimates the costs and benefits of policy alternatives under consideration by the Executive or Legislative branches.

The Food and Drug Administration (FDA) approves conducts mission-related research that greatly expands knowledge of fundamental biological processes and provides a strong scientific base for regulatory review. A wide variety of technical and scientific issues related to the safety, potency, and efficacy of novel biological products requires knowledge of new developments and concepts of basic research in the relevant biological disciplines. Because of the rapid advancement in both conventional and new biotechnologies, the scope of research is both diverse and dynamic. For example, FDA researchers carry-out medical devices testing using standardized test methods, perform scientific investigations on emerging technologies, and contribute to national and international medical device standards. More information is available at www.fda.gov.

SECURING THE HOMELAND

HHS-Wide Activity. To implement President Bush's Executive order 13347 on Emergency Preparedness, the HHS has worked through the Coordinating Council on Emergency Preparedness and Individuals with Disabilities not only to include the needs of persons with disabilities in agency preparedness plans, but also to help ensure inclusion of persons with disabilities in emergency preparedness plans being developed at the Federal, state, local and tribal government levels. HHS has paid particular attention to the health issues that arise for persons with disabilities at the time of an emergency, and in the short-, mid- and long-term aftermath of such emergencies, whether natural or man-made. The HHS-led Health Subcommittee of the Coordinating Council is developing a toolkit for use by first responders, health care providers, administrators and community leaders to help them prepare for and respond to the special needs of persons with disabilities in emergency preparedness and response activities.

Substance Abuse and Mental Health Services Administration (SAMHSA). Following the terror attacks of September 11, and continuing through Hurricanes Katrina and Rita to the present, SAMHSA, in partnership with the States, continues to address the behavioral health factors, mental health, substance misuse/abuse and related concerns, such as suicide prevention that may arise following a disaster, whether natural or man-made. For example, immediately following hurricanes Katrina and Rita, SAMHSA's Emergency Response Center identified needed mental health and substance abuse supports throughout the hurricanes' affected areas and with almost 500 deployed staff and grantee volunteers, helped local mental health areas identify evacuees with mental/substance abuse issues, maintain service operations, provide guidance and housing supports. SAMHSA awarded Emergency Response Grants (SERG) funds totaling $600,000 to four impacted States (LA, TX, MS, and AL) within 14 days of Hurricane Katrina's landfall. These funds that went to the state-identified highest areas of need were allocated for clinical services including methadone in TX. SAMHSA also maintained its Suicide Prevention Hotline on 24-7 phone availability to first responders and survivors; and assembled and shipped over 1000 disaster mental health packets to school systems in the Hurricane-affected regions. The Agency will continue to prepare to reduce the potential for psychological distress in the general public, and to ensure continuity of care for people with mental and/or substance use disorders for future disasters, including the potential threat of an avian flu pandemic and bioterrorism.

Food and Drug Administration: FDA publishes information to assist the public and public health providers during emergencies, such as recommendations on reopening dialysis clinics after time without power or water and advice on handling medical devices that have been exposed to unusually high storage temperatures. FDA's Emergency Shortages Data Collection System allows quick identification of device manufacturers and available inventories to pinpoint potential shortages of medical and in vitro diagnostic devices that may be needed by emergency healthcare personnel in the acute phase of an emergency or disaster.

PROTECTING LIFE, FAMILY AND HUMAN DIGNITY

As a part of the New Freedom Initiative, the President issued Executive Order 13217. (June 2001), calling on the federal government to help states and localities implement the Olmstead decision and directing HHS to oversee federal review of barriers to community integration for persons with disabilities. The 2001 HHS report to the President, Delivering on the Promise: Preliminary Report of Federal Agencies' Actions to Eliminate Barriers and Promote Community Integration, outlined federal actions to address barriers to community-based living for persons with disabilities, consistent with the New Freedom Initiative and the Olmstead decision.
More information on the reports is available at www.hhs.gov/newfreedom.

Office on Disability (OD). To coordinate HHS resources and to promote collaboration across government, the HHS Office on Disability was established within the Office of the Secretary in mid-2002. The Office's activities span those of the President's New Freedom Initiative: housing, education, assistive technology, employment, transportation and community integration. A seventh domain - health - was added, since, the health and wellness of persons with disabilities extends beyond their disabilities alone. The OD has developed nationwide roadmaps for homeownership and universal design; it has helped bring the issue of late-life disability to the attention of the 2005 White House Conference on Aging. The OD has contributed markedly to emergency preparedness plans for persons with disabilities; it is leading the development of an action agenda to implement the Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities. It has highlighted the special issues confronting women and people of color with disabilities, and of children with disabilities who are in transition to adult life for particular attention. Further, the Office leads an international team to convene a biennial international congress on children with special needs, to bring the message of the New Freedom Initiative to the world. For more information see www.hhs.gov/od.

Substance Abuse and Mental Health Services Administration (SAMHSA) focuses on community-based services to promote engaged productive lives for persons with or at risk for mental and substance use disorders in the community.

• In July 2005, consistent with the recommendations of the report of President Bush's New Freedom Commission on Mental Health, SAMHSA released the Federal Mental Health Action Agenda, articulating objectives for a long-term strategy to move public and private mental health service delivery toward community-based care.
• The mental health and substance abuse block grant programs promote state capacity to provide effective, accessible, and affordable mental health and substance abuse treatment and prevention services.
• Grants to States assist in the building of cross-disability Olmstead State Coalitions to promote community based living for all individuals with disabilities, including those with mental illness.
• Professional capacity building is promoted through the development of treatment improvement protocols in substance abuse treatment and similar toolkits for the treatment of mental disorders. Discretionary grant programs also emphasize community-based services.
• Mental Health Transformation State Incentive Grants ($92 million over 5 years) provide funds to transform State mental health service delivery systems to systems driven by consumer and family needs that focus on building resilience and facilitation recovery.
• Self-Direction Initiative is being undertaken for persons with mental and/or substance use disorders in collabortion with CMS, the Office on Disability, and other Federal and State agencies, providers and consumers.
• Co-Occurring State Incentive Grants develop and enhance the infrastructure of State treatment service systems and increase the capacity to provide accessible, comprehensive, coordinated/integrated, evidence-based treatment services to persons with co-occurring substance use and mental disorders.
• Children's Services Grants promote a community-based, family-centered systems-of-care approach to meeting the service needs of children with serious emotional disturbances and their families by coordinating health, education, support and other services.
• Older Adult Grants help community-based organizations increase capacity or improve the array of services available to people 60 years and older who are at risk for or are experiencing mental health problems.

For additional information about SAMHSA programs, see www.samhsa.gov.

Administration on Aging (AoA) Through Older Americans Act formula grants to States and Tribal organizations, as well as discretionary grants in support of program innovation, AoA funds programs to help older Americans with disabilities and their caregivers, including:

• National Family Caregiver Support Program that assists states and communities develop systems of support for family caregivers
• Alzheimer's Disease Demonstration Grants to plan, establish and operate programs for persons with Alzheimer's disease or related disorders and their families and care providers.
• Aging and Disability Resource Center (ADRC), a collaboration between AoA and CMS, helps states develop "one-stop" centers for people with disabilities of all ages, providing them with comprehensive information, personalized assistance, and streamlined access to long-term support services. Through FY 2005, forty-three states have received ADRC grants.
• National Family Caregiver Support Program provides formula grants to States and Tribal organizations to support development of systems of support for family caregivers, including information and assistance, counseling, training, support groups, and respite care.

For additional information about AoA and its programs, see www.aoa.gov.

Office for Civil Rights (OCR). OCR undertakes public education, outreach, complaint investigation and resolution, reviews, and other compliance activities to prevent and eliminate discriminatory barriers for individuals with disabilities, with an emphasis on their right to be served in the most integrated setting under the Supreme Court's Olmstead decision. It also promotes effective communication in health and human services for individuals who are deaf and hard-of-hearing; the right to non-discriminatory treatment and services for individuals who have HIV/AIDS; equal access for individuals with disabilities to the Temporary Assistance for Needy Families program. For more information about the work of the OCR, see www.hhs.gov/ocr.

Indian Health Service (IHS): Collaborating with the Tribes, and other organizations and agencies, to develop a long-term care model that supports elders and individuals with disabilities, and their families, with medical, personal, and social services delivered in a variety of settings to ensure quality of life, maximum independence, and personal dignity. The IHS is incorporating three main health initiatives -Behavioral Health, Health Promotion and Disease Prevention, and Chronic Disease Management -into a useful framework for developing a comprehensive health system to better meet the needs of our elders and individuals with disabilities, now and in the future.

Assistant Secretary for Planning and Evaluation: As the treatment of mental disorders has evolved, programs and systems have been refined, documented and evaluated. Fundamental to this development has been financing, and ASPE has developed a number of relevant products for the field.

• Evaluation of the 2001 Federal Employees Health Benefits Program policy of parity for mental and substance abuse treatment found that all plans complied with the parity policy, none reported major problems with implementation and two-thirds incurred no added administrative costs. FEHBP enrollees were found to experience enhanced benefits. The report is at http://aspe.hhs.gov/daltcp/reports/parity.pdf.
• Because Medicaid and at least 39 other Federal programs provide funding for mental health and related services and supports, ASPE developed "Using Medicaid in Support of Working Age Adults with Serious Mental Illnesses in the Community: A Handbook" describing the role of Medicaid in the delivery of services to adults with serious mental illnesses. The Handbook is at http://aspe.hhs.gov/daltcp/reports/handbook.htm.

Food and Drug Administration (FDA) FDA regulates drug, biologic, and medical device products on the leading edge of technology for individuals with disabilities. FDA ensures that these products are safe and effective with honest and accurate information provided to the public, working to protect the public from adverse events or counterfeit products. In recent years, FDA has approved a number of devices that make a real difference in lives of thousands of people with disabilities. FDA websites provide information on cochlear implants, cardiovascular products, diabetes and others. More information is available at www.fda.gov.

Health Resources and Services Administration (HRSA): HRSA provides leadership in health care for children with special needs through the Maternal and Child Health Services Block Grant, supporting community-based, family-centered care for children and youth with special health needs. Thirty percent of the block grant funds must be devoted to programs for these children and youth. Under the President's New Freedom Initiative HRSA was charged with responsibility to develop and implement a plan to achieve appropriate community based service systems for children with youth with special health care needs (and their families. To that end, the Agency has undertaken a variety of programs and initiatives:

• State Implementation Grants for Integrated Community Systems is a grant program that is supporting statewide implementation of the HRSA component of the President's New Freedom Initiative to create inclusive community-based systems of care for children and youth with special health care needs.
• National Center of Medical Home Initiatives for Children with Special Needs, undertaken by HRSA in collaboration with the American Academy of Pediatrics, promotes the concept of "medical home," a community-based system of care approach addressing special needs of children and youth with chronic healthcare problems, providing physicians, parents, administrators, and other health care professionals with educational, resource, and advocacy materials, provider training, guidelines for care, evaluation tools, and technical assistance.
• Community of Learners and Mentors is a family led program to assist State Title V Children with Special Health Care Needs Programs and their partners implement statewide family networks and Family-To-Family Health Information Centers.

For more information on HRSA, view the links at http://mchb.hrsa.gov/2010express/Express2010.htm.

Administration for Children and Families (ACF). The ACF supports programs and initiatives that promote the economic and social well-being of families, children, individuals and communities, including efforts to meet the special needs of persons with disabilities to promote independent lives in the community. Among the programs are:

• Head Start Programs Head Start, designed to increase the school readiness of children from low-income families, makes at least 10 percent of its enrollment opportunities available to young children with disabilities. In 2005, over 110,000 children with disabilities and their families participated in Head Start and Early Head Start programs, over 12.4% of program enrollment nationwide. ACF promotes collaboration between Head Start programs and state and local agencies serving persons with disabilities.
• Developmental Disabilities Programs. ACF' serves many of the nearly 4 million Americans with developmental disabilities. Working in partnership with state governments, local communities and the private sector, the agency helps people with developmental disabilities reach their maximum potential through increased independence and community integration. Its Family Support 360 program has established One-Stop Centers with a focus on helping to preserve, strengthen and maintain unserved and underserved families with a member with a developmental disability. Each grantee was designated by their Governor as the lead agency for their State or Territory.
• Child Care and Development Fund (CCDF) CCDF funds assist low-income families in accessing child care while parents work or participate in training or education activities CCDF funds are also used to improve the quality and availability of child care in States and communities. Through partnerships with Federal and State agencies, ACF is working to increase access to high quality childcare for young children with disabilities.
• Adoption Assistance and Child Protection. The Adoption Assistance Program provides funds to States to subsidize families adopting children with special needs who cannot be reunited with their families, thus preventing long, inappropriate stays in foster care and offering children the opportunity to grow up in a permanent, loving home. In fiscal year 2006, an estimated average of 369,500 children per month, will have payments made on their behalf. The CAPTA state formula grant program, with $27.3 million in FY 2005, provides grants to States to improve child protective service systems, including services to disabled infants with life-threatening conditions and their families.

IMPROVING THE HUMAN CONDITION AROUND THE WORLD

• Biennial International Congress on Children with Special Needs. The HHS Office on Disability is responsible for the ongoing HHS Initiative to plan and convene Biennial International Congresses on Children with Special Needs. The 2004 Congress, with representatives from over 50 nations, addressed the role of families and communities in building cross-disciplinary systems of support that integrate health, education, and social needs of children and young adults. Of particular importance were issues related to human rights of people with disabilities, inclusive programs within everyday communities, the critical roles families play in partnership with professionals and politicians, and sustaining progress over time. The Office on Disability is now planning the 9^th International Congress, to be held in December 2006 in Washington, DC, with the theme, "community access and inclusion for children with special needs and their families," consistent with President' Bush's New Freedom Initiative.
• University Centers on Developmental Disabilities. The Administration on Children and Families' University Centers on Developmental Disabilities are authorized to serve as international resources under the Developmental Disabilities Act, disseminating information on subjects such as nursing, Rett syndrome, autism and severe cognitive disabilities to health care providers, policymakers, administrators, clinicians, academic communities, and others worldwide.

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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last Revised: February 21, 2006

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