NATIONAL DISABILITY POLICY: A PROGRESS REPORT
November 1, 1998-November 19, 1999
National Council on Disability
1331 F Street, NW, Suite 1050
Washington, DC 20004-1107
May 15, 2000
202-272-2004 Voice
202-272-2074 TTY
202-272-2022 Fax
This report is also available in alternative
formats and on NCD's award-winning Web site (http://www.ncd.gov).
The views contained in this report do not necessarily
represent those of the Administration, as this document has not
subjected to the A-19 Executive Branch review process.
LETTER OF TRANSMITTAL
May 15, 2000
The President
The White House
Washington, DC 20500
Dear Mr. President:
On behalf of the National Council on Disability (NCD),
I am pleased to submit NCD's National Disability Policy: A Progress
Report, as required by Section 401 (b)(1) of the Rehabilitation
Act of 1973, as amended. The report uses as benchmarks the recommendations
for change made by disability leaders from throughout the country
and captured in the 1996 NCD document Achieving Independence. These
recommendations--elaborated upon in the ensuing annual Progress
Reports--reflect a wide array of public policy areas designed to
advance inclusion, empowerment, and independence of people with
disabilities of all ages from diverse backgrounds consistent with
the vision of the Americans with Disabilities Act of 1990 (ADA).
The attached report covers the period November 1,
1998, through November 19, 1999, the end of the 1st Session of the
106th Congress. It reviews federal policy activities by major issue
areas, noting progress where it has occurred and making further
recommendations where necessary. The recommendations apply to the
executive and legislative branches of the Federal Government and
in some instances apply to both.
NCD believes that Americans with disabilities have
witnessed incremental expansion of self-sufficiency and inclusion
this past year. However, far too much of our time is spent in sustaining
the bedrock civil and human rights protections of the past 30 years
against attempts to weaken laws such as ADA and the Individuals
with Disabilities Education Act. The change in responsibility for
the development of policy and program implementation from the Federal
Government to state government offers opportunities for innovation.
At the same time it adds tension and complexities to policy for
people with disabilities who rely on such programs as Social Security
benefits, vocational rehabilitation, Medicaid, Medicare, special
education, and workforce development.
Thank you for the opportunity to play the independent
role that our mission requires and to offer this objective assessment
of progress in the past 12 months. We hope these recommendations
will serve you well in the remaining months of your Administration
and as we prepare to celebrate the tenth anniversary of ADA.
We also call on you to work with leaders in Congress
and the next Administration to forge a disability agenda that brings
children and adults with disabilities into the mainstream of American
life.
NCD stands ready to work with you and stakeholders
inside and outside the government to see that the public policy
agenda set out in the attached report, in Achieving Independence,
and in other NCD reports is implemented.
Sincerely,
Marca Bristo
Chairperson
(The same letter of transmittal was sent to the President
Pro Tempore of the U.S. Senate and the Speaker of the U.S. House
of Representatives.)
NCD MEMBERS AND STAFF
Members
Marca Bristo, Chairperson
Kate Pew Wolters, First Vice Chairperson
Hughey Walker, Second Vice Chairperson
Yerker Andersson, Ph.D.
Dave N. Brown
John D. Kemp
Audrey McCrimon
Gina McDonald
Bonnie O'Day, Ph.D.
Lilliam Rangel-Diaz
Debra Robinson
Shirley W. Ryan
Michael B. Unhjem
Rae E. Unzicker
Ela Yazzie-King
Staff
Ethel D. Briggs, Executive Director
Jeffrey T. Rosen, General Counsel and Director of Policy
Mark S. Quigley, Public Affairs Specialist
Kathleen A. Blank, Attorney/Program Specialist
Geraldine Drake Hawkins, Ph.D., Program Specialist
Martin Gould, Ed.D., Research Specialist
Susan Madison, Fellow
Pamela O'Leary, Interpreter
Allan W. Holland, Accountant
Brenda Bratton, Executive Secretary
Stacey S. Brown, Staff Assistant
Carla Nelson, Office Assistant
CONTENTS
Executive Summary
Public Policy 2000 Platform
Introduction
Progress, Concerns, and Recommendations
A. Disability Demographics and Disability
Research
1. Census 2000
2. Demographics
3. Research Challenges and Recommendations
B. Civil Rights
1. Voter Registration and Voting
2. Supreme Court Rules on a Significant Number of ADA Cases
3. Hate Crimes
4. Enforcement
Equal Employment Opportunity Commission
Department of Justice
Department of Housing and Urban Development
Civil Rights Needs of Psychiatric Survivors
C. Education
1. IDEA
a. IDEA'97 Regulations
b. NCD Town Meeting on the Monitoring and Enforcement of IDEA
c. Garrett F. Supreme Court Decision
d. Charter Schools
e. IDEA Amendments
f. Juvenile Justice Bill Amendments to IDEA
2. Elementary and Secondary Education Act
3. Ed-Flex
4. Postsecondary Education Initiatives for Students with Disabilities
D. Health Care
1. Protections in Managed Care
2. Medicaid Buy-In
3. Medical Information Privacy
4. Physician-Assisted Suicide and Improving Pain Management
E. Long-Term Services and Supports
1. MiCASSA
2. Olmstead v. L.C.
3. Administration efforts
4. Child Care
5. Children's Health Insurance Program
F. Youth
1. Youth Task Force
2. The 1999 National Leadership Conference for Youth with Disabilities
G. Immigrants and Racial and Ethnic
Minorities with Disabilities
1. White House Forum on Disability and Cultural
Diversity
2. The President's Initiative on Race
3. Restoration of Legal Aliens' Eligibility for Disability and
Health Benefits
H. Social Security Work Incentives and
SSA and Medicare Solvency
1. Work Incentives Improvement Act
2. Social Security Solvency
3. Medicare Reform
I. Employment
1. The Workforce Investment Act of 1998
2. Job Training and Vocational Rehabilitation
3. Substantial Gainful Activity Rule Revised
4. Social Security Administration Next Steps
5. Tax Credit
6. Presidential Task Force on the Employment of Adults with Disabilities
7. Federal Government's Commitment to Hire People with Disabilities
J. Welfare-To-Work
1. Federal/State Efforts
2. Welfare Recipients with Disabilities
K. Housing
1. Section 8 Mainstream Housing Opportunities for
Persons with Disabilities Program
2. Home Ownership
3. Visitability
4. Compliance with Section 504 of the Rehabilitation Act by HUD
and Its Grantees
L. Transportation
1. NCD Air Travelers Report
2. DOT Action in Response to NCD Report
3. Over-the-Road Bus Rule
4. Greyhound Settlement
M. Technology and Telecommunications
1. Section 508 of the Rehabilitation Act Amendments
2. Federal Communications Commission
3. Research and International Developments
N. International Issues
1. World Bank
2. U.S. Department of State
3. U.S. Agency for International Development
4. Organization of American States
Conclusion
Appendix
Mission of the National Council on
Disability
EXECUTIVE
SUMMARY In 1999, public policy results in
an unemployment rate for people with disabilities exceeding 70 percent.
Public policy and expenditures give priority to institutional placements
and segregated housing over independent living with appropriate
support services. For households including youth with disabilities,
68 percent of the households had incomes of less than $25,000, while
in the general population--households with nondisabled youth--only
18 percent had incomes of less than $25,000. A majority of the nation's
6 million students with disabilities are not receiving special education
and related services in regular education environments. State and
local governments are challenging the constitutionality of civil
rights under the Americans with Disabilities Act (ADA).
Future public policy affecting health care, work,
transportation, technology, and all other aspects of the lives of
all Americans must be directed by the principles of inclusion, independent
living, economic self-sufficiency, and civil rights protections
in law that are protections in fact. The third edition of National
Disability Policy: A Progress Report by the National Council
on Disability (NCD) identifies the painfully incremental public
policy changes that occurred in the past year that support these
principles.
On December 17, 1999, President Clinton signed the
Work Incentives Improvement Act (WIIA), the last act to become law
in the millennium. This legislation gives people with disabilities
the opportunity to move into employment and reduce their dependence
on benefits and other assistance. The WIIA improves access to health
care by (1) expanding states' ability to provide a Medicaid buy-in
to people with disabilities who return to work; and (2) extending
Medicare coverage for people with disabilities who return to work.
The WIIA also attempts to improve access to health care by creating
a new Medicaid buy-in demonstration to help people with a specific
physical or mental impairment that is not severe enough to qualify
for health assistance, but is likely to lead to a severe disability
in the absence of medical treatment.
In addition, the WIIA will modernize the employment
services system by creating a "ticket to work and self-sufficiency"
that will enable Supplemental Security Income or Social Security
Disability Insurance beneficiaries to go to any public or private
provider for vocational rehabilitation.
The Federal Communications Commission issued final
rules for implementation of Section 255 of the Telecommunications
Act of 1996 that require manufacturers of telecommunications equipment
and providers of services to address the needs of persons with disabilities
as they design, develop, and fabricate their products and services.
It allows individuals with disabilities to be a part of the technology
revolution driving economic growth in the next century.
With the relentless oversight of NCD, the Department
of Transportation (DOT) issued a final rule that ensures over-the-road
bus service for passengers with disabilities. An agreement between
the Department of Justice and Greyhound Lines, Inc., brings the
largest provider of such services into compliance with DOT regulations.
An NCD report on inadequate enforcement of the Air Carriers Access
Act (ACAA) brought new DOT regulations eliminating caps for damage
to wheelchairs and other assistive devices and allowing individuals
to recover burdensome repair or replacement costs if their wheelchairs
are lost or damaged in flight. DOT also charged Continental Airlines
with violating the ACAA.
Final regulations for the Individuals with Disabilities
Education Act, as reauthorized in 1997, were issued and became effective
on May 11, 1999.
Important disability policy issues remain unresolved.
Solid leadership and commitment by enforcement agencies, as well
as adequate investment to enforce our civil rights laws, are needed
to help make sure that protections in law are protections in fact.
This is directed to the enforcement responsibilities of the Equal
Employment Opportunity Commission and the Department of Justice
on ADA and Title V of the Rehabilitation Act, the Department of
Housing and Urban Development on fair and nonsegregated housing,
and the Department of Transportation on various transportation access
laws.
A strong Patients' Bill of Rights must be enacted.
Legislation must be enacted to allow people with disabilities to
have a real choice about where they receive certain types of Medicaid
long-term services and supports. Also high on the reform agenda
are the Social Security and Medicare programs, both critical programs
to people with disabilities and both threatened with long-term financing
problems.
One of the fundamental civil rights of Americans is
exercising the right to vote for their representatives and leaders
at all levels of government. The year 2000 represents a critical
year in which a new President will be chosen, as well as the membership
and subsequent leadership of Congress. Candidates for these offices
are encouraged to establish their agendas to include individuals
with disabilities, with policies supporting the bipartisan principles
of inclusion, independent living, economic self-sufficiency, and
civil rights protections in law that are protections in fact.
PUBLIC
POLICY 2000 PLATFORM SPIRIT OF ADA FEDERAL DISABILITY POLICY FOR POLICYMAKERS
AND LEADERS The Public Policy 2000 Platform
is a nonexhaustive set of statements to inform the policy visions
of potential new leaders in Washington, DC, and across the country.
Individuals with disabilities, advocates, and parents are looking
for vision and platform statements from potential Presidential and
congressional leaders that advance the independence, full participation,
and productivity of people with disabilities. In exercising one
of the fundamental rights in a democratic society--voting--these
Americans are looking for specifics on how we:
Enforce human and civil rights laws protecting individuals
with disabilities, including the Americans with Disabilities Act,
the Individuals with Disabilities Education Act, Title V of the
amended Vocational Rehabilitation Act, the Fair Housing Act, Section
255 of the Technology Act, and the Air Carriers Access Act.
- Preserve and enforce the federal commitment to
quality education for all children, including children with disabilities.
- Establish a system of health care that supports
individualized care needs of people with disabilities, continued
work opportunities, prevention of secondary conditions, and long-term
care supports that allow individuals to live in their homes or
in the least restrictive environment.
- Create a continually improving accessible environment
in physical structures and pathways, transportation, and technology
utilizing the concepts of universal design.
- Ensure that generic education, health, workforce
development, housing, and other programs in which authority for
development of service systems has been substantially returned
to the states serve individuals with disabilities.
- Ensure a secure funding base for existing programs
serving individuals with disabilities through the next decade
under the goals and spending limits of the Balanced Budget Act
of 1998.
- Identify the key factors that need to be addressed
to significantly reduce the 75 percent unemployment rate of individuals
with disabilities.
- Take national and international steps to ensure
access to technology and participation in the global technological
economy.
- Establish a foreign policy that supports the goals
of access, civil and human rights, inclusion, and poverty reduction
of individuals with disabilities throughout the world.
In the new century, America will realize even
more of its promise because we have unleashed the promise of more
Americans.
--President William Clinton, at the signing
of the Work Incentives Improvement Act of
1999.
INTRODUCTION
The most significant legislative achievement for people with disabilities
of the past year was the milestone passage of the Work Incentives
Improvement Act of 1999. Enactment of this employment initiative
will facilitate and catalyze the spirit of equality, justice, and
opportunity embodied in the Americans with Disabilities Act (ADA).
At the signing ceremony on the site of the FDR Memorial, President
Clinton said:
Clearly, this is the most significant advancement
for people with disabilities since the Americans with Disabilities
Act almost a decade ago. It continues our administration's efforts
to replace barriers to opportunity with policies based on inclusion,
empowerment and independence.
The efforts of several years and sessions of Congress
came to fruition when some of the major, ongoing barriers to work
were addressed in the legislation. Having captured the attention
of people with disabilities, their families, and advocates across
the country, a bipartisan, bicameral effort was fueled by the hard
work of disability advocates and the bills' chief sponsors and their
staffs. Designed to enhance the employment of people with disabilities,
this law has five major features: health insurance improvements--at
the option of states; ticket-to-work and self- sufficiency; work
incentive enhancements; new work incentive service structure; and
a work incentive demonstration authority.
WIIA, along with the Workforce Investment Act of 1998,
can be models for the new millennium of customer-focused, multi-agency
partnerships to revamp public and private systems that help people
achieve gainful, competitive employment. Most prominent among the
barriers to employment that the Act removes is the disincentive
to work caused by inconsistent national policies; for example, if
a person with a disability gains employment she loses health and
other benefits. This legislation will enable individuals with disabilities
to go to work without losing their eligibility for Medicare and
Medicaid. However, states have a choice whether or not to participate
in this elective program. Disability advocates recognize the opportunity
and responsibility to promote the benefits of the law's provisions
and ensure that states elect to participate and successfully implement
the Act. The Presidential Task Force for the Employment of Adults
with Disabilities "push(ed) forward the message to all stakeholders,
including the Administration, Congress, Governors, State and local
officials, people with disabilities, employers, and other interested
parties: The Time for Action is Now." The Task Force's second report
to the President laid out an ambitious set of recommendations to
increase the employment rate of people with disabilities. Recognizing
that the era of isolation and specialized services is over, the
Task Force promoted progressive changes in generic employment and
training systems and supported various departmental initiatives
to build the capacity of these agencies to serve people with disabilities
successfully.
The Federal Communications Commission put rules and
policies for implementation of Section 255 of the Telecommunications
Act of 1996 into place with the issuance of final regulations. The
statute and the regulations require manufacturers of telecommunications
equipment and providers of services to address the needs of persons
with disabilities as they design, develop, and fabricate their products
and services. It allows individuals with disabilities to be a part
of the technology revolution driving economic growth in the next
century.
Increased funding for civil rights enforcement proved
beneficial in lowering the backlog of complaints at the major enforcement
agencies, the Equal Employment Opportunity Commission, and the Department
of Justice, as well as in finding new enforcement strategies against
discrimination toward individual with disabilities.
Final regulations for the Individuals with Disabilities
Education Act, as reauthorized in 1997, were issued and became effective
on May 11, 1999.
Transportation policy supporting individuals with
disabilities included the April 1, 1999, publication of a final
rule that ensures over-the-road bus service for passengers with
disabilities as well as an agreement between the Department of Justice
and Greyhound Lines, Inc., which will bring the nemesis of the disability
community into compliance with Department of Transportation (DOT)
regulations. Current DOT regulations permit carrying riders, but
require Greyhound to provide life-equipped bus service on 48 hours'
notice beginning in October 2001. Funds from the Federal Transit
Authority are being made available for training and incremental
capital costs in making over-the-road buses wheelchair-accessible.
Partially in response to a National Council on Disability
(NCD) report on inadequate enforcement of the Air Carriers Access
Act (ACAA), DOT issued new regulations eliminating caps for damage
to wheelchairs and other assistive devices by allowing individuals
to recover burdensome repair or replacement costs if their wheelchairs
are lost or damaged in flight. DOT also charged Continental Airlines
with violating ACAA.
While these victories represent a persistent, but
hauntingly slow, pace for disability policy, several issues covered
in all our Progress Reports remain unresolved. Health care initiatives--that
now have broad-based bipartisan support--must receive action during
the Second Session of the 106th Congress. A strong Patients' Bill
of Rights must be enacted.
On November 16, 1999, the Medicaid Community Assistance
Services and Supports Act was introduced in the Senate as bill number
S. 1935, co-sponsored by Senators Tom Harkin (D-Iowa) and Arlen
Specter (R-Pennsylvania). The bill allows people with disabilities
to have a real choice about where they receive certain types of
Medicaid long-term services and supports. It also provides grants
to the States to assist them as they redirect Medicaid resources
into community-based services and supports. Supported by the U.S.
Supreme Court decision in Olmstead v. L.C., NCD calls for
the nationwide reform of long-term care services in the least restrictive
environment that this legislation provides.
Other important health care initiatives include medical
records privacy protections, health care options further empowering
Americans with disabilities to work free from concern of being uninsured,
increased funds for children's health insurance outreach, and support
services and coverage of legal immigrants.
Also high on the reform agenda are the Social Security
and Medicare programs, both critical programs to people with disabilities
and both threatened with long-term financing problems. Increasingly,
advocacy groups of and for people with disabilities are participating
in the ongoing discussions, a trend NCD is pleased to witness.
At the dawn of a new millennium, many Americans are
re-evaluating how they live, learn, work, and play. It is a natural
time to question whether the systems that comprise America's public
and private service provision are characterized by policies, programs,
products, and practices that empower and include all Americans.
During the second half of the past century, developments in public
policy led to unprecedented statutory affirmation of the civil rights
of people with disabilities, raising expectations of access, inclusion,
and participation in the mainstream of American society. NCD believes
that now is the time to transform systems to make good on the promise.
This report, which updates the Progress Report issued
by NCD in 1998, will describe significant policy developments in
the past year and offer recommendations for the President and the
Members of the 106th Congress of the United States of America.
PROGRESS,
CONCERNS, AND RECOMMENDATIONS
A. DISABILITY DEMOGRAPHICS AND DISABILITY
RESEARCH
1. Census 2000
In Achieving Independence, the National Council
on Disability (NCD) recommended that all federal statistical activities
that include data collection and reporting for other groups, such
as minorities and women, include the category of people with disabilities,
using definitions based on the Americans with Disabilities Act (ADA).
Based on in-depth results of a multi-agency working group, which
included the Census Bureau, recommendations were made to Congress
to include a new disability question set in Census 2000. Questions
are now integrated into Census 2000. This milestone accomplishment
will yield critical information. Twenty percent of Americans have
some type of disability and about 10 percent have a severe disability.
The law requires the Census Bureau to ask about disability; the
resulting statistical information supports programs that help people
with disabilities. The 2000 Census will ask three questions in the
long form, sent to one in every six households. When populations
are sparse, in rural areas or are residing on reservation land,
the frequency of surveys may increase. The three questions cover
general areas of defining disability, age, and ability to function
with a limitation:
1. The kind of disability and its limitation on
essential function of daily living;
2. The limitation to work resulting from disability;
and
3. The age whether over 16 in the year 2000 or
under 15 in the year 2000 and the limitation the disability may
effect on mobility/independence.(1)
NCD emphasizes the importance of individuals with
disabilities participating in Census 2000, when the nation will
count the general population and include disability issues as a
critical aspect of American demographics.
2. Demographics
The National Institute on Disability and Rehabilitation
Research (NIDRR) at the Department of Education (DOED) has published
an extensive Chartbook on Work and Disability in the United States
in 1998. Both NIDRR and the Social Security Administration published
The Summary of Data on Young People with Disabilities in
1999. These two sources draw on data from sources such as the National
Health Interview Survey, the National Center for Education Statistics,
the Current Population Survey, and the Survey of Income and Program
Participation.
Summary Data Highlights
- Among the 25.1 million people 15 to 21 years of
age, 12.1 percent have a disability, and 3.2 percent have a severe
disability.
- The head of household's educational attainment
was significantly lower for youth with disabilities. Parents or
guardians who had not completed high school were heads of household
for 41 percent of youth with disabilities. By comparison, the
heads of households who had not completed high school for youth
ages 12 to 17 in the general population was 22 percent.
- Typical household income for youth with disabilities
was considerably lower than for youth in the general population.
For 35 percent of the youth with disabilities, household income
was less than $12,500, compared with the general population of
youth age 12 to 17, where 18 percent of the households had incomes
of less than $12,500. For households including youth with disabilities,
68 percent of the households had incomes of less than $25,000,
while in the general population, households with nondisabled youth,
only 18 percent had incomes of less than $25,000.
- In 1987, about half of all youth with disabilities
lived in households that were receiving benefits from at least
one public source. Food Stamps comprised 24 percent, and Medicaid
or other state-supported health benefits comprised 22 percent.
The Chartbook on Work and Disability in the United
States, 1998 reported the following:
- 32.1 million working age people, ages 15-64, have
a disability. Of these, severe disabilities were reported by 14.9
million (8.7 percent).
- In the age group 18 to 69 years old, statistics
by race and ethnic origin were as follows:
Ethnic Group |
% Work Limitation |
% Unable to Work |
Native American |
17.3 |
10.4 |
Black Hispanic |
15.9 |
13.2 |
Black (non-Hispanic) |
14.3 |
10.3 |
White (non-Hispanic) |
11.6 |
6.2 |
White Hispanic |
9.5 |
6.3 |
Asian or Pacific Islander |
5.7 |
3.4 |
- The Chartbook reports substantially lower
monthly earnings income for working people with disabilities as
compared to the working nondisabled:
|
Median Monthly Earnings |
|
Men |
Women |
Severe Disability |
$1,262 |
$1,000 |
Nonsevere Disability |
$1,857 |
$1,200 |
No Disability |
$2,190 |
$1,470 |
3. Research Challenges and Recommendations
The challenge ahead is for data and research to meet
the decisionmaking needs of policymakers. In data collection and
research, what the person with a disability experiences within the
environment is an important perspective. The context of one's life
determines the success of choice and integration.
NCD recommends that the federal research community
emphasize cross-cultural studies and the experiences the environment
presents to people with disabilities in all age brackets. NCD recommends
that the Interagency Committee on Disability Research, required
by the reauthorized Rehabilitation Act, be provided with adequate
resources.
B. CIVIL RIGHTS "We
hold these truths to be self-evident, that all men are created equal,
that they are endowed by their Creator with certain inalienable
rights." The United States Congress and the President have recognized
the fundamental rights of people with disabilities to make choices,
pursue meaningful careers, live independently, and participate fully
in all aspects of society.
--President George Bush, at the signing
of the Americans with Disabilities Act
into law, July 26, 1990.
Overseeing civil rights protection of individuals
with disabilities is a vital responsibility of NCD. The 1996 Achieving
Independence report overwhelmingly set improved enforcement of civil
rights protections within its top priorities. In response, NCD established
the "Unequal Protection Under the Law" series. The multiple-year
series provides independent analyses of the federal enforcement
of existing civil rights laws, including ADA, Section 504 of the
Rehabilitation Act, the Individuals with Disabilities Education
Act (IDEA), the Fair Housing Amendments Act, and the Air Carriers
Access Act (ACAA). During the period of this progress report, NCD
released its first statute-specific analysis of the ACAA (March
1999). This report will be discussed in the transportation section
of this report.
The following section of the report, along with the
education, technology, and transportation sections, includes NCD's
analysis of specific developments in civil rights law, the courts'
construction of that law, and policy during the covered period.
It also reviews enforcement of existing civil rights statutes
for individuals with disabilities by the primary enforcement agencies
with those responsibilities. No American in the 21st century should
have to face discrimination when it comes to finding a home, getting
a job, going to school, or securing a loan. Solid leadership and
commitment by enforcement agencies, as well as adequate investment
to enforce our civil rights laws, are needed to help make sure that
protections in law are protections in fact.
Agencies with primary enforcement responsibilities
for civil rights for individuals with disabilities include:
- Department of Justice, Civil Rights Division. Adequate
funding and leadership would permit the Justice Department to
expand significantly investigations and prosecutions of criminal
civil rights cases (including hate crimes and police misconduct),
fair housing and lending cases, and the Division's enforcement
of ADA.
- Equal Employment Opportunity Commission (EEOC).
Major resources must be dedicated to reducing the backlog of private
sector cases and improving the federal EEO complaint process for
all protected classes, including individuals with disabilities.
- Department of Housing and Urban Development's (HUD)
Fair Housing Initiatives. Adequate resources would support HUD's
efforts to continue its review of policies needed to reduce housing
discrimination against individuals with disabilities. Such resources
would support the final year of a three-year, audit-based housing
discrimination study being conducted in 20 communities around
the country that includes specific questions on accessibility
for individuals with disabilities.
But first, the report looks at the fundamental civil
right necessary in a democracy: the right to vote. It also identifies
the critical nature of this right in the coming election year.
1. Voter Registration and Voting
One of the fundamental civil rights of Americans is
exercising the right to vote for their representatives and leaders
at all levels of government. The year 2000 represents a critical
year in which a new President will be chosen, as well as the membership
and subsequent leadership of Congress. Other critical policy decisions
and directions will be in the hands of the new President and Congress,
including (1) reapportionment of congressional districts for the
next decade, based upon the 2000 Census, and (2) the appointment
of new Supreme Court Justices who will determine the trend in judicial
decisions for many years to come. These actions will determine how
federal civil rights protections are going to be judicially decided
well into our lifetimes.
Efforts to improve the access of individuals with
disabilities to the entire voting process have been enacted in the
past two decades. Public Law 103-31, the National Voter Registration
Act (NVRA), established a national voter registration procedure
for federal elections that permits quick, convenient registration
at motor vehicle and other state agencies. It was the intent of
Congress to specifically encourage voting by people with disabilities
who traditionally have been left out of voter registration activities.
Section 7(a)(2)(B) of this Act requires each state to designate
agencies for registration of voters including "offices...that provide
services to persons with disabilities."
A review by NCD of the implementation of NVRA by state
vocational rehabilitation agencies, who serve as many as 650,000
new individuals with disabilities a year, found that implementation
of this law by states is inconsistent and poorly coordinated. Significant
differences in agency attitude toward proactively implementing the
Act were found. This included the level of commitment and practices
in advising individuals of their opportunity to register to vote,
training staff on their work responsibilities under NVRA, and assigning
NVRA management and performance oversight among staff at all levels
of the agency. The NCD report offers recommendations that have been
successfully enacted in agencies (http://www.ncd.gov/newsroom/publications/voter.html).
NCD encourages all public disability service agencies,
including special education agencies, to vigorously offer this public
service to ensure that registering and voting are made easier for
individuals with disabilities. NCD encourages bipartisan national,
state, and local voter registration and get-out-the-vote initiatives
for individuals with disabilities and their families and advocates.
NCD reiterates its challenge to the President and Congress to enact
legislation amending the 1984 Voting Accessibility for the Elderly
and Handicapped Act. Such amendments would include the recognition
of the right of all individuals to vote independently, guaranteed
accessibility to all stages of the electoral process (from voter
registration to election-day practices), and meaningful technical
assistance and enforcement mechanisms to ensure the right to vote.
2. Supreme Court Rules on a Significant Number of
ADA Cases
The U.S. Supreme Court continued its hearing of cases
interpreting ADA, beginning in the first year of the 1998-1999 term.
Overall, concerns raised in several Supreme Court decisions, caution
must be exercised in interpreting these new rulings, which represent
mixed results for the civil rights of individuals with disabilities.
To realize the promise of ADA, disability legal advocates and the
community must also follow the rulings with vigorous new strategies.
Olmstead v. L.C.
The Supreme Court issued a watershed opinion regarding
the proper construction of the anti- discrimination provision contained
in the public service portion (Title II) of the ADA in Olmstead
v. L.C. (138 F.3d.893.119 S. Ct. 633). The Court specifically
confronted the question of whether the proscription of discrimination
may require placement of individuals with mental disabilities in
community settings rather than in institutions. The Court answered
the question with a qualified yes.
For the disability community, the Supreme Court's
opinion in Olmstead v. L.C. represents a victory with strings
attached. The L.C. opinion is the most significant ADA decision
acknowledging that unjustified isolation is a form of discrimination
under the ADA's integration mandate. The L.C. decision expands
options for individuals who are currently in state mental institutions
because it affirms a right for an individual to receive community-based
services. As the Court noted: "Institutional placement of persons
who can handle and benefit from community settings perpetuates unwarranted
assumptions that persons so isolated are incapable or unworthy of
participating in community life and cultural enrichment."
The Court further stressed that confinement in an
institution severely diminishes the everyday life activities of
individuals, including family relations, social contacts, work options,
economic independence, educational advancement, and cultural enrichment.
However, the Court also ruled that this action hinges
on whether the "state's treatment professionals have determined
that community placement is appropriate, the transfer from the institutional
care to a less restrictive setting is not opposed by the affected
individuals, and placement can be reasonably accommodated, taking
into account the resources available to the state and needs of others
with mental disabilities."
NCD commends the court in its determination that
unjustified isolation is properly regarded as discrimination when
it is based on disability. The Department of Health and Human Services
is commended for its letter to state Medicaid Directors and others
emphasizing the Court's suggestion that a state could establish
compliance with Title II of ADA if it demonstrates that it has (1)
a comprehensive plan for placing qualified individuals with disabilities
in less restrictive settings, and (2) a waiting list that moves
at a reasonable pace not controlled by the state's endeavors to
keep its institutions fully populated.
NCD recommends that states involve institutionalized
individuals with disabilities in the development of the comprehensive
plan with key principles and practices that should be considered.
These principles and practices would address issues such as rendering
criteria for community placement, lessening the subjectivity of
treatment officials, and the chances of state funding allocations
taking precedence over individualized planning. Clarification is
needed of what resources must be considered by the state as causing
an inequitable burden, as well as many other issues.
Sutton v. United Airlines, Albertsons Inc. v. Kirkingburg,
and Murphy vs. United Parcel
The Supreme Court ruled on the "definition of disability"
in Sutton v. United Airlines (130 F.3d 893, 119 S. Ct. 2139),
Albertsons Inc. v. Kirkingburg (143 F.3d 1228, 119 S. Ct.
2162), and Murphy vs. United Parcel (141 F.3d 1185, 119 S. Ct. 1331),
stating that ADA does not cover those persons with correctable impairments.
If a person does not experience a substantial limitation in a major
life activity when using a mitigating measure such as medication,
glasses, or other corrective devices, then that person is not considered
disabled under the law. In Albertsons Inc., the Court ruled
that an employer who requires an employee as part of a job qualification
to meet applicable federal regulations does not have to justify
enforcing those regulations, even if there is an experimental waiver
program. These rulings unfortunately restrict coverage for people
with epilepsy, diabetes, and other serious long-term impairments.
The three cases involved people with poor uncorrected
vision, monocular vision, and hypertension who were challenging
discriminatory employer policies that unfairly excluded them based
on their impairments. NCD believes that, in deciding that these
people fall outside the civil rights protections of ADA because
their conditions are correctable, our highest court has left many
people with treatable conditions such as epilepsy, diabetes, and
bipolar disorder outside the law's protection as well. Anyone who
is functioning well with their disability is now at risk of losing
civil rights protections as a result of the Supreme Court's "miserly"
construction, to use Justice Stevens' characterization in his eloquent
dissent.
One of the core findings in ADA is that "disability
is a natural part of the human experience." This is a powerful statement.
"Disability" should not be interpreted by the Supreme Court to exclude
the many people whose conditions in their natural state result in
significant impairments in functioning but who can function well
with medication, assistive devices, or other mitigating measures.
The people who would be left out nonetheless will continue to encounter
bigotry and attitudinal barriers when they are turned down for jobs
or are passed over for promotions.
When Congress defined disability in ADA, they intentionally
used the inclusive, flexible definition that has been in place for
many years under the Rehabilitation Act. The ADA definition includes
not just people with physical or mental impairments that substantially
limit at least one major life activity, but also people with a history
of such impairments, and people who are regarded by others as having
such impairments.
If Congress wanted to limit coverage to people
in wheelchairs, blind people, and deaf people, they certainly could
have. Instead, Congress followed the advice of NCD and others and
incorporated an inclusive definition of the protected class that
would reach the many and varied ways that fears, myths, and stereotypes
come into play to unfairly limit people based on their physical
or mental conditions as opposed to their work experience and proven
abilities.
Cedar Rapids School District v. Garret F.
In Cedar Rapids School District v. Garret F. (106
F.3d 822, 119 S. Ct. 37), the Supreme Court affirmed the right of
all students with disabilities to attend school when they are medically
able to do so, regardless of the nature or extent of the health-related
services they may require during school hours, as long as those
services are not required to be provided by a physician.
The Court held that schools are required by IDEA to
provide students with nursing and/or other health-related services
during the school day. Garrett F. provides students in need
of medical services an equal opportunity to attend school alongside
their peers. To the extent that in-school health services are needed,
they must be provided. Thus Garrett F. provides children
with disabilities who need in-school health-related services meaningful
access to public schools
NCD encourages state governors and state attorneys
general to embrace and enforce the civil rights requirements of
ADA more vigorously and to seek more cost-effective ways to bring
the instruments of state and local government into compliance.
Cleveland v. Policy Management Systems Corp.
In Cleveland v. Policy Management Systems Corp.
(120 F.3d 513, 119 S. Ct. 900), the Supreme Court unanimously
held that pursuit and receipt of Social Security Disability Insurance
(SSDI) benefits does not automatically stop a recipient from pursuing
an ADA claim or create a strong presumption against success under
ADA. Key distinctions were made between ADA and SSDI claims. NCD
applauds the unanimous decision of the Court, bringing to an end
the dilemma the "estoppel" issue had held for individuals being
unable to pursue their civil rights while seeking the assistance
they needed to live while unemployed.
Wright v. Universal Maritime Service Corp.
Finally, the Supreme Court ruled in Wright v. Universal
Maritime Service Corp. (121 F.3d 702, 118 S. Ct. 900) that a
collective bargaining agreement general arbitration clause does
not require an individual to use the arbitration procedure for alleged
violation of the ADA. The individual may proceed to court with his
anti-discrimination claim.
3. Hate Crimes
Federal authorities currently may prosecute violent
civil rights abuses when state authorities are unable or unwilling
to do so. However, federal jurisdiction is triggered only when two
circumstances are present. First, the impetus for the crime must
have been based upon the victim's race, national origin, or religion.
Second, either the crime must have occurred while the victim was
enjoying a federally protected right--such as voting or serving
on a jury--or the crime must have interfered with the victim's ability
to engage in a similar right.
The Hate Crimes Prevention Act of 1999, added as an
amendment by the Senate to the Commerce, Justice, and State appropriations
bill, would extend the present hate crimes statutes to cover disability,
gender, and sexual orientation. The amendment would have allowed
federal officials to prosecute hate crimes even when the victim
is not engaged in "federally protected activity." President Clinton
vetoed the bill to fund the Departments of Commerce and State because,
amongst other reasons, it didn't include the Hate Crime Prevention
Act provisions. The final appropriations for these agencies negotiated
between congressional leadership and the President did not include
the hate crime protections. NCD believes we must do more to root
out forces of hate and intolerance and encourages the 106th Congress
and the President to reach agreement on strong hate crime protections
to those in our society who are still threatened by violence simply
because of who they are.
4. Enforcement
Equal Employment Opportunity Commission
Chair Comments on Supreme Court Decisions
EEOC chair, Ida L. Castro, has summarized the Supreme
Court's decisions this past year regarding cases related to the
Americans with Disabilities Act as significantly narrowing the scope
of those covered under ADA. However, the decision affirms EEOC's
standard of an individualized approach to the assessment of coverage
under ADA. Castro stated, "(P)eople who use mitigating measures
may still be substantially limited in major life activities and
thus enjoy the protection of the ADA." She also noted, "the Court
did not suggest that any conditions are per se excluded from
coverage under ADA, and the Court did not disturb the principle
that employers are required, as before, to provide reasonable accommodations
for people with disabilities and may not otherwise discriminate
against them." EEOC staff point out that the ADA still protects
people with past and perceived disabilities--even if they have no
current impairment at all. Many people who experience discrimination
on the basis of currently controlled conditions will be protected
under these prongs of the statute.
Budget Increases for Enforcement
The Omnibus Appropriation Bill passed by Congress
on October 21, 1998, funded the agency at a level of $279 million,
consistent with the President's Civil Rights Enforcement Initiative.
EEOC Enforcement Practices
Comprehensive Enforcement Program: During 1999,
EEOC began implementing an agency-wide Comprehensive Enforcement
Program (CEP) to improve all components of agency operations in
both the private and federal sectors. As a result of several years
of reform in management of incoming and pending complaints, the
pending inventory has been slashed to a 15-year low of 40,234--a
23 percent decline from 52,011 at the close of fiscal year (FY)
1998.
EEOC resolved more cases that impact large groups
of individuals. The resolution of systemic cases increased by 67
percent during FY 1999. EEOC resolved 50 such cases, compared to
30 in FY 1998. EEOC filed more lawsuits affecting multiple parties
or addressing discriminatory policies. EEOC filed 112 of these suits
in FY 1999 compared to 82 in FY 1998.
National Mediation Program: EEOC's National
Mediation Program was launched in February 1999 and became fully
operational in April 1999. By the end of FY 1999, the agency had
nearly tripled the number of successful charge resolutions handled
through voluntary mediations to 4,833 (up from 1,631 in FY 1998).
NCD compliments EEOC on its continued efforts toward
reducing the pending inventory of private sector charges and lowering
the average charge processing time. It is critical that improved
complaint processing cut across all protected classes, including
individuals with disabilities. ADA charges surrounding failure to
hire and to provide reasonable accommodations can be subtle and
complex, just as coding and other employer practices proved to be
in race-based cases. Continual evaluation of the Priority Charge
Handling Process and the new CEP practices must ensure that ADA
charges are proportionally among the cases determined meritorious.
NCD wants to make sure the increased merit factor rate, those charges
that show a favorable finding for the charging party (settlements
including mediation, cause resolutions including those litigated,
and charge withdrawals with benefits), represents all protected
classes. Data currently show the merit factor rate for non-ADA cases
as 17.4 percent, while the rate for ADA cases is 13.3 percent. NCD
commends the increased use of systemic and multiple party litigation
and recommends ADA-based discrimination as a part of the enforcement
plan for such litigation.
ADA-Specific Conciliations and Litigation
- A $167,000 settlement in a disability discrimination
suit brought under the Americans with Disabilities Act against
TMC Transportation of Des Moines, Iowa, on behalf of a former
TMC over-the-road truck driver. The suit alleged that TMC violated
ADA by refusing to schedule the driver's runs in a way that would
accommodate regularly-scheduled medical visits to treat his lupus
disease, and by firing him because of the disease rather than
returning him to work as a driver.
- A jury in the disability discrimination case against
the Chuck E. Cheese's pizza chain returned its verdict on damages
Friday, awarding a record $13 million in compensatory and punitive
damages to Donald Perkle. This verdict represents the largest
monetary relief awarded by a jury in a case brought by the EEOC
under the ADA. The jury found that Chuck E. Cheese's violated
the employment provisions of the ADA by discriminating against
Mr. Perkle when they fired him because of his disability, mental
retardation.
Policy Guidance and Regulations
Federal Sector Regulations: On July 12, EEOC
issued new regulations (29 C.F.R. Part 1614) to improve the federal
equal employment opportunity (EEO) complaint system by eliminating
unnecessary layers of review, modifying data collection, utilizing
alternative dispute resolution thro ughout the process, and addressing
perceptions of unfairness in the system.
ADA Guidance: On March 1, 1999, EEOC released
comprehensive policy guidance titled "Reasonable Accommodation
and Undue Hardship Under the Americans with Disabilities Act (ADA)."
The guidance provides answers to the most frequently asked questions
concerning what reasonable accommodations are, when they must
be provided, and when employers may refuse to provide them. It
points out that providing a reasonable accommodation does not
mean excusing poor performance or hiring unqualified people. The
guidance also represents the Commission's most complete discussion
to date of "undue hardship," which is a limitation on an employer's
obligation to make a reasonable accommodation.
NCD commends EEOC for instituting a series of actions
to review its own documents that may need to be revised and updated.
NCD wishes to work with EEOC and the new Reinventing Government
initiative on federal sector civil rights complaint processing practices
to ensure that the new Federal Sector Regulations adequately collect
data on federal employees with disabilities and provide adequate
procedural protections.
Department of Justice
ADA Penalties Adjusted for Inflation
The Department of Justice (DOJ) may file lawsuits
in federal court to enforce ADA and may obtain court orders including
compensatory damages and back pay to remedy discrimination. As of
September 29, 1999, the limit on possible penalties has been adjusted
upward for inflation to $55,000 for the first violation and $110,000
for any subsequent violation.
Circuits Split on Constitutionality of ADA Suits
Against States
DOJ has made concerted interventions in U.S. Courts
of Appeals and District Courts in upholding the constitutionality
of ADA suits against states and localities. This has become a critical
court test, likely to reach the Supreme Court during the second
half of the current Court term.
Two more U.S. Courts of Appeals have upheld ADA as
appropriate legislation to enforce the equal protection guarantees
of the U.S. Constitution. The Second Circuit in Muller v. Costello
(997 F. Supp. 299), an employment suit alleging discrimination
against a New York State prison, and the Tenth Circuit in Martin
v. Kansas (996 F. Supp. 1297), an employment claim against a
Kansas prison, ruled that it is constitutional for Congress to permit
individuals to directly sue states for ADA violations under Title
I because ADA is appropriately tailored to remedy and prevent discrimination
against people with disabilities.
On the other hand, the Eighth Circuit in Alsbrook
v. City of Maumelle (184 F. 3rd 999 [8th Cir. 1999]) ruled that
a Title II suit against the Arkansas Commission on Law Enforcement
Standards and Training was unconstitutional because ADA's protections
go beyond the equal protection rights guaranteed by the U.S. Constitution.
It also ruled for the same reason in DeBose v. Nebraska that
a Title I employment suit against Nebraska was unconstitutional.
In all four of these cases the DOJ intervened to defend the constitutionality
of the ADA. Seven of the eight circuits ruling on this issue so
far have upheld the constitutionality of ADA suits against states.
As urged by the Department, the U.S. District Court for the District
of Connecticut also upheld the constitutionality of a Title II suit
against the Connecticut Department of Corrections in Hicks v.
Armstrong.
The Department sought to intervene in two additional
district court cases, Campos v. San Francisco State University
N.D. Cal., 1999 (No. C-97-2326 MMC) and Jeffreys v. New Jersey,
in which states are arguing that it is unconstitutional for
Congress to permit ADA lawsuits directly against state governments.
California and New Jersey assert that Congress lacks authority under
the Fourteenth Amendment to subject them to lawsuits under ADA,
because ADA's protections go beyond the equal protection rights
guaranteed by the U.S. Constitution. The Department, however, believes
that ADA is constitutionally appropriate legislation to remedy the
history of pervasive discrimination against people with disabilities.
NCD commends DOJ in its efforts on this constitutional
issue critical to the entire meaning of ADA and Section 504 regarding
the civil rights of individuals with disabilities in their relationships
with state and local units of government. NCD encourages the Supreme
Court, should they review this issue, to determine that Title II
of ADA and Section 504 of the Rehabilitation Act constitutionally
apply to state and local governments.
Furthermore, federal judges need to develop greater
understanding of the principles of ADA and other disability civil
rights laws. NCD recommends to the President and Congress that they
work together to identify, appoint, and confirm to the federal bench
qualified lawyers and judges with disabilities who have an understanding
of the legal and philosophical principles of the disability civil
rights movement.
Department of Housing and Urban Development
Laws such as the Fair Housing Act (FHA) are intended
to end the unnecessary exclusion of persons with disabilities from
the American mainstream and to provide them with the freedom to
choose where they wish to live and be free of discrimination in
housing. In combination with Section 504 of the Rehabilitation Act,
FHA and ADA redress discrimination in housing and in community development
programs.
Complaint Investigations
The Department of Housing and Urban Development's
(HUD) field offices and state and local governmental agencies that
have substantially equivalent laws investigate complaints alleging
discrimination based on disability under FHA. Complaints alleging
discrimination on the basis of disability filed against both private
and federally assisted housing providers now constitute the second
highest number of complaints filed with HUD. FHA provides the same
or greater remedies to victims of discrimination as Section 504,
and a finding of discrimination can render a HUD recipient of funding
ineligible for future HUD funding. HUD's policy is that, any time
a Title VIII complaint is filed against a recipient of HUD funds,
that complaint also is filed under Section 504 as well as the ADA,
if the latter applies.
From October 1, 1989, to the close of FY 1998, 2,791
discrimination complaints alleging discrimination under Title VIII
and Section 504 and/or ADA were filed with HUD. Of those complaints,
HUD successfully conciliated 1,224. A determination of reasonable
cause was made in 43 HUD cases. These figures do not include the
relatively small number of complaints filed against HUD recipients
[?] that allege disability discrimination in employment or a program
unrelated to housing, which would be filed only under Section 504
or ADA. During the past five years, there has been a 68 percent
increase in the total number of Section 504 cases filed with HUD
compared with the previous five years.
Sections 810(f) and 817 of the FHA authorize referral
of fair housing complaints to state and local agencies certified
to provide substantially the same rights, procedures, remedies,
and judicial review as are found in the FHA and to reimburse those
certified agencies for effectively processing complaints referred
to them. Certified agencies received federal and technical assistance
through the Fair Housing Assistance Program (FHAP).
From FY 1991 to FY 1998, a total of 6,016 complaints
that alleged housing discrimination based on disability were filed
with FHAP agencies under Title VIII. Of those complaints, 96 resulted
in cause-type determinations. The number of disability complaints
filed with FHAP agencies during the latter half of this eight-year
period is more than double the number filed during the previous
four years. FHAP agencies conciliated 2,263 cases during the eight-year
period and, likewise, conciliated twice the number of cases during
the second four years than were conciliated during the first four
years. These FHAP conciliations obtained 534 housing units (a 200
percent increase over the first four years) and $3.9 million in
relief to complainants (a 767 percent increase over the first four
years).
Even though conciliations increased for FHAP agencies
during this period, these statistics also point out the concerns
of disability housing advocates. Accounting for cause-type determinations
and conciliations, 51 percent of the complaints made to HUD and
54 percent of the complaints filed with FHAP agencies remain unresolved
or nearly half have been closed without cause. Based upon previous
court decisions, HUD developed a guide for all investigators to
use in FHA and Section 504 disability fair housing discrimination
complaints. A review pointed out inquiries to the nature and severity
of an individual's disability and other factors unnecessary to the
determination of a person's eligibility for fair housing protection
and not ancillary to the facts surrounding the complaint. As a result
of discussions with advocates, the HUD Office of Fair Housing and
Equal Opportunity (FHEO) has agreed to modifications to the guide
questionnaire focusing on the actions of the parties identified
in the discrimination complaint.
NCD continues to recommend that HUD use consecutive
fiscal year increases in appropriations for fair housing to expand
its enforcement of the Fair Housing Act and Section 504 of the Rehabilitation
Act on behalf of people with disabilities. To the extent that HUD
continues its commitment to doubling enforcement efforts under the
Fair Housing Act, NCD recommends that HUD's efforts under section
504 also be doubled. This goal has not been met. The changes in
the FHEO guide and questionnaire for Fair Housing Analysts to conduct
these enforcement activities are commended.
Through the Real Estate Assessment Center, which reports
to the Secretary, HUD continues a three-year systematic review of
the physical plants of HUD-financed projects to assess compliance
with many different safety and conservation standards. Also being
surveyed are all newly constructed multifamily housing (with four
or more contiguous units) built since March 1991 (the effective
date of the Fair Housing Act's new construction guidelines). As
part of this effort, HUD inspectors are assessing compliance with
accessibility laws and regulations, such as section 504 of the Rehabilitation
Act. Four items are being assessed:
- Is there an accessible route to and from the main
floor entrances of buildings inspected (e.g., a level surface
to the door and, if there are stairs, a ramp)?
- Is the main entrance for every building inspected
at least 32 inches wide, measured from between the face of the
open door and the opposite door jamb?
- Are there accessible routes to all exterior common
use areas (e.g., curb cuts, stairs, ramps, lever-type door handles,
pathways at least 36 inches wide)?
- For multi-story buildings, are the interior hallways
to all units and common areas at least 36 inches wide?
While these questions will not determine whether full
access exists, the answers will provide statistically reliable information
on the numbers, types, and locations of buildings that do and do
not comply with even the basics of the Fair Housing Act. Initial
sample survey results have been collected by the Real Estate Assessment
Center, but the process for release of the data through FHEO or
HUD's Division of Policy Development and Research has not been established.
NCD strongly encourages HUD to make the results of this survey
public at statistically valid periods throughout the data collection
activities. This information could be invaluable in supporting appropriate
funding for Mainstream Tenant Based Rental Assistance (TBRA) and
the TBRA authorities of the 811 program. It will assist in the development
of State Consolidated Plans and local "Public Housing Authority
Plans" that adequately address the housing needs of individuals
with disabilities.
In March, U.S. Department of Agriculture (USDA) rural
Housing Programs representatives opened discussions with advocates
regarding fair housing and civil rights for individuals with disabilities
in rural USDA-funded rental and home ownership programs. NCD
commends USDA in this effort.
Civil Rights Needs of Psychiatric Survivors
A. NCD Albany Conference on Civil Rights for Psychiatric
Survivors
NCD conducted a hearing in Albany, New York, in November
1998, to learn more about the problems of psychiatric disability.
Psychiatric survivors are routinely deprived of their rights in
a way no other disability group has been. At the hearing, NCD heard
testimony from mental health professionals, lawyers, advocates,
and relatives of psychiatric survivors. However, unlike most investigations
on the topic of psychiatric disability, the primary participants
in this hearing were psychiatric survivors themselves, who testified
passionately and eloquently both about the mistreatment they had
experienced or witnessed and their proposals for real and viable
change. NCD heard testimony graphically describing how psychiatric
survivors have been beaten, shocked, isolated, incarcerated, restricted,
raped, deprived of food and bathroom privileges, and physically
and psychologically abused in institutions and in their communities.
The testimony pointed to the inescapable fact that psychiatric survivors
are systematically and routinely deprived of their rights and are
treated as less than full citizens or full human beings.
NCD has also concluded that one of the reasons public
policy concerning psychiatric disability is so different from that
concerning other disabilities is the systematic exclusion of people
with psychiatric disabilities from policy making. They must be allowed
to speak for themselves in policy-making forums.
Among other recommendations established in the report
of the hearing, NCD recommends that the use of involuntary treatments,
such as forced drugging and inpatient and outpatient commitment
laws, should be viewed as inherently suspect and as incompatible
with the principles of self-determination. Public policy should
be directed toward establishing a totally voluntary mental health
system.
NCD also recommends that aversive treatments, which
involve the infliction of pain or the restriction of movement for
purposes of changing behavior, should be banned, since they are
also incompatible with self-determination principles. Practices
that often would be illegal if administered to people without disabilities
are routinely used on psychiatric survivors in the name of "treatment."
Such practices should shock the consciences of all Americans.
All of the recommendations in NCD's report follow
the same basic principles: that people with psychiatric disabilities
are, first and foremost, citizens who have the right to expect that
they will be treated according to the principles of law that apply
to all other citizens. All laws and policies that restrict the rights
of people with psychiatric disabilities solely because of their
disabilities are at odds with basic principles of law and justice,
as well as with such landmark civil rights laws as the ADA.
B. White House Conference on Mental Health and Surgeon
General's Report
On June 7, 1999, Tipper Gore chaired the White House
Conference on Mental Health that brought together members of Congress
and the Administration, people with mental disabilities and their
families, mental health providers and advocates, and community,
state, private sector, and foundation entities from around the country.
The purpose was to announce new proposals and to expand community
responses to help those with mental illnesses.
On December 13, 1999, David Satcher, M.D., Surgeon
General of the United States, released a comprehensive report on
mental health. The report builds on the White House Conference on
Mental Health, highlighting mental illness as a public health problem
that warrants national concern. The report documents sound scientific
evidence for mental disorders and describes a system plagued with
treatment barriers, including stigma, discriminatory health insurance
practices, and the unavailability of appropriate services. Its final
chapter highlights the disparity between science and service delivery
and provides the evidence base for future policy initiatives.
Unlike NCD's Report of the Albany Conference, the
Surgeon General's report does not adequately address the issue of
coercion. NCD shares the view of the Bazelon Center for Mental Health
Law that this is especially regrettable because a climate of coercion
significantly impedes the help-seeking behavior that is the Surgeon
General's principal recommendation to the public.
C. EDUCATION Efforts
continued on the part of the Administration and Congress to increase
opportunities for all children to learn to high standards; however,
students with disabilities, parents, and advocates across the country
still continue to document high levels of noncompliance with IDEA,
particularly related to placement in the least restrictive environment,
transition services, and the requirements for a free, appropriate,
public education (FAPE).
While an amendment to the Juvenile Justice bill eroded
certain due process protections under IDEA for dangerous students,
another amendment nearly made it federal law that educational services
may not cease for any student even if suspended or expelled. The
Supreme Court decision in Garrett F. should increase the number
of students with disabilities educated in the regular classroom.
Finally, reauthorization of the Elementary and Secondary Education
Act (ESEA) was not completed, leaving the review and extension of
critical education provisions (e.g., school modernization, charter
schools) to the second session of this Congress.
1. IDEA
A. IDEA '97 Regulations
Effective May 11, 1999, the final regulations for
the IDEA amendments of 1997 appeared in the March 12, 1999, Federal
Register. Some of the major issues addressed in the regulations
are Individualized Education Programs (IEPs), assessment, discipline,
and parent and regular teacher involvement. Prior to 1997, the law
did not specifically address general curriculum involvement of students
with disabilities. The 1997 amendments and regulations shifted the
focus of IDEA to one of improving teaching and learning, with a
specific focus on the IEP as the primary tool for enhancing the
child's involvement and progress in the general curriculum. NCD
strongly encourages local jurisdictions to use the federal regulation
as a model in developing their own guidelines for implementing IDEA
and incorporating best practices drawing on their local successes.
Also, the final regulations address the IDEA '97 provisions
that incorporated prior court decisions and DOED policy that (1)
allow schools to remove a child for up to 10 school days at a time
for any violation of school rules as long as there is not a pattern;
(2) provide that a child with disabilities cannot be long-term suspended
or expelled from school for behavior that is a manifestation of
his or her disability; and (3) specify that services must continue
for children with disabilities who are suspended or expelled from
school. Federal policy must support solutions aimed at directing
resources toward creating safe and inclusive educational environments;
thorough, yet manageable, information management systems; and collaboration
between parents and state and local school personnel in meeting
the educational needs of all students.
B. NCD Town Meeting on the Monitoring and Enforcement
of IDEA
On September 22, 1999, NCD conducted a town meeting
in Arlington, Virginia, on the enforcement and implementation of
IDEA. More than 100 disability advocates, parents, and children
from across the country participated in the meeting intended to
highlight the release of the monitoring and enforcement report.
NCD recommends that DOED and DOJ recognize and correct the inadequacy
of current federal compliance monitoring activity. School systems
that fail to provide services required under IDEA are compromising
the futures of children with disabilities. Federal authorities must
develop more effective monitoring mechanisms to identify and challenge
failures to comply. School systems found not in compliance must
be held accountable for correcting deficiencies within specified
time frames or face sanctions. Where the will to fully implement
IDEA is lacking, sanctions must be applied in combination with positive
incentives to change resistance to definitive action.
C. Garrett F. Supreme Court Decision
The Court held that schools are required by IDEA to
provide students with nursing and/or other health-related services
during the school day. (See Civil Rights.)
D. Charter Schools
A letter of informal guidance was issued in fall 1998
by the U.S. DOE D concerning the responsibility of charter schools
to provide a FAPE to children with disabilities in accordance with
IDEA and Section 504 of the Rehabilitation Act of 1973, as amended.
It clarified that charter school programs are considered public
school programs with the obligation to provide FAPE and that DOE
D has broad discretion as to which enforcement options they may
use to ensure full compliance. NCD is concerned that public charter
schools are being created in some jurisdictions without actually
ensuring that the teachers and administrators are prepared to comply
with IDEA, ADA, and section 504 of the Rehabilitation Act when children
with disabilities seek to enroll. NCD encourages Congress to fund
a study determining the level of compliance of charter schools with
IDEA and Title II of ADA. DOED should use the full force of its
enforcement powers to provide technical assistance, oversight, and
monitoring to the growing number of charter schools to ensure compliance
and best practices for educating students with disabilities.
E. IDEA Amendments
Ed-Flex and two bills amending IDEA, H.R. 636 and
H.R. 697, were the first of several bills introduced this year that
could adversely impact children with disabilities. H.R. 636 would
amend IDEA to give schools flexibility in changing the educational
placement of children with disabilities by removing the 45-day maximum
that a child with a disability can remain in an alternative placement.
H.R. 697 would amend IDEA to allow state and local schools to establish
discipline policies.
F. Juvenile Justice Bill Amendments to IDEA
IDEA suffered a devastating blow in May 1999, when
the Senate voted 74-25 to amend IDEA. The amendment allows the cessation
of educational services to students with disabilities who are suspended
or expelled from schools for gun and/or firearms offenses.
The IDEA amendment was introduced as part of the Juvenile
Justice bill, the Violent and Repeat Juvenile Offender Accountability
and Rehabilitation Act. The amendment states that school personnel
may expel or suspend a child with a disability for an unlimited
amount of time as it would any other child, if that child carries
or possesses a gun or firearm to school or to a school function.
Further, the school would not be responsible for providing a free
and appropriate public education during the period of expulsion.
An amendment was introduced to the Juvenile Justice
bill, not IDEA, which would apply to all children and would achieve
the intended objective of making schools safer. The amendment passed
by voice vote. The amendment would require schools to provide appropriate
interventions and services, including mental health services, to
all children including children with and without disabilities removed
from school for acts of violence.
2. Elementary and Secondary Education Act
ESEA was up for reauthorization this year but the
committees did not complete the review and extension in time so
it will be taken up in the second session of the 106th Congress.
According to DOED, there are eight major themes to the Administration's
proposal:
- Academic excellence in high-poverty schools
- High standards in the classroom
- Using educational technology to improve teaching
and learning
- Strengthening safe and drug-free schools
- Equity, excellence, and public school choice
- Class-size reduction
- Helping limited English proficient students learn
English and reach high standards
- After school programs.
All of these areas are critically important to students
with disabilities and their families. NCD encourages the President
and Congress to take advantage of the opportunity provided by the
ESEA reauthorization to address the need for mainstream education
policy to integrate the needs of students with disabilities and
students from low-income families so that the educational outcomes
of all students may be improved. NCD encourages the President and
Congress to use the reauthorization to
- ensure that students with disabilities are meaningfully
included in standards- based reform and accountability systems
and are expected to meet high standards, with appropriate accommodations;
- expand parent training and information efforts
by building upon and promoting linkages with community-based parent
training and information centers funded under IDEA, so that all
parents can work together to promote high-quality programming
that meets the individual needs of all students; and
- improve teacher training and professional development
to better meet the diverse needs of students in mainstream settings.
NCD strongly encourages Congress to use this legislative
opportunity to amend IDEA to create a complaint-handling process
at the federal level to address systemic IDEA violations occurring
in a state education agency or local education agency and to provide
DOJ with independent authority to investigate and litigate cases
brought under IDEA.
School Modernization
Communities across the country are struggling to address
critical needs to build new schools and renovate existing ones to
make up for years of deferred maintenance, to accommodate rising
student enrollments, to help reduce class sizes, and to make sure
schools are accessible to all students and well-equipped for the
21st century.
According to a Government and Accounting Office report,
one-third of all schools--about schools--need extensive repairs.
The average public school in America is 42 years old, and school
buildings begin rapid deterioration after 40 years. A growing body
of research has linked student achievement and behavior to the physical
building conditions, and conditions such as overcrowding have negative
impact on the achievement of students. NCD urges the President
and Congress to pass legislation designed to provide states and
localities the incentives necessary (e.g., School Modernization
Tax Credit Bond, the School Renovation Loan and Grant Program) to
renovate schools. NCD strongly supports the President's initiative
to modernize our schools. NCD recommends that funding to support
school modernization must require compliance with Title II of ADA,
or a plan to achieve such compliance, thus making the new and renovated
schools models of universal design. Thus, all students, teachers,
and parents will be able to participate fully in all aspects of
the schools of the future.
3. Ed-Flex
The Education Flexibility Partnership Act of 1999
(Ed-Flex) gives states greater latitude in spending federal school
aid. The bill makes all 50 states eligible to waive many provisions
of ESEA and the Carl D. Perkins Vocational Education Act (Perkins).
Ed-Flex passed in the House (330-90) and Senate (98-1) on March
11. An IDEA discipline amendment was attached to the Senate version
of the Ed-Flex bill that adds language regarding weapons possession
"at school," "on school premises," and "at a school function" to
Section 615(k) of IDEA 1997.
The manner in which this provision was added, that
is, at the last minute with no debate, was very disturbing to disability
advocates and underscores the need for ongoing vigilance to ensure
that the civil rights of students with disabilities are not dismantled.
Without hearings or a written report, the Senate Committee on Health,
Education, Labor and Pensions reported out the Ed-Flex bill. Efforts
to recommit the bill for hearings, however, were unsuccessful. Another
amendment, dropped later during conference, would allow funding
for hiring new teachers included in last year's omnibus spending
package to be used on programs in IDEA. A third amendment authorized
an additional $500 million for special education.
4. Postsecondary Education Initiatives for Students
with Disabilities
Because of significant changes in education laws for
persons with disabilities, the proportion of first-time, full-time
freshmen with disabilities attending college increased more than
threefold between 1978 and 1994, from 2.6 percent to 9.2 percent.
The Chronicle of Higher Education reports that 17 percent
of students attending higher education programs in this country
have a disability. Yet research indicates that students with disabilities
are less likely to enroll in postsecondary education than their
nondisabled peers. Moreover, when students with disabilities attend
postsecondary programs, they are more likely to attend two-year
or vocational programs rather than four-year, degree-granting institutions
and when they do attend, they are less likely than their nondisabled
peers to persist in these programs and graduate.
The U.S. DOED's Office of Postsecondary Education
has initiated a discretionary grant program to increase the number
of students with disabilities who persist in attaining a four-year
degree. Approximately 20 grants were funded in 1999 that provide
technical assistance and professional development activities for
faculty and administrators in institutions of higher education,
in order to provide a quality education to students with disabilities.
This program is newly authorized by the Higher Education Act Amendments
of 1998 and funded for the first time in FY 1999 at $5 million.
D. HEALTH CARE 1.
Protections in Managed Care
In the 1997-1998 Progress Report to Congress,
NCD recommended that the 106th Congress "forge a strong, enforceable
['patient's bill of rights'] in managed care and in "medical rehabilitation."
This means that people with disabilities and their families have
access to the quality health care they require, and that people
with disabilities receive the appropriate level of necessary supports
and services from medical rehabilitation professionals.
In the second report of the Presidential Task Force
on Employment of People with Disabilities issued on November 15,
1999, titled Re-Charting the Course: If Not Now, When?, the
task force recommends the following:
Guaranteed access to emergency room services when
and where the need arises; continuity of care protections so that
patients will not have an abrupt transition in care if their providers
are dropped; access to a fair, unbiased, and timely internal and
independent external appeals process to address health plan grievances
and to help govern decisions about medically necessary treatments;
and an enforcement mechanism that ensures recourse for patients
who have been harmed as a result of a health plan's actions.(2)
Seven major patient protection bills have been introduced
in both houses of Congress since January 1999. The major area of
conflict for this legislation continues to be the definition of
medical necessity. Another major issue for people with disabilities
is which entity will decide what will be medically necessary--the
physician or the managed care organization. In the 105th Congress,
the major conflict was the structure of grievance and appeals.(3)
NCD recommends to the Congress the formulation
of a comprehensive Patients' Bill of Rights that will cover the
health care concerns of people with disabilities.
2. Medicaid Buy-In
Under Section 4733 of the Balanced Budget Act, states
now have the option to allow individuals with disabilities who start
or return to work the ability to purchase Medicaid coverage as their
earnings increase, up to 250 percent of the poverty level. Currently,
a number of states, including Oregon, South Carolina, Wisconsin,
Minnesota, Alaska, and Mississippi, have been approved by the Health
Care Finance Administration to amend their State Medicaid Plans
to exercise the option of extending Medicaid coverage to eligible
working individuals with disabilities. NCD commends the President
on his Executive Memorandum that directed the Secretary of Health
and Human Services to ensure that governors, state legislators,
and state Medicaid directors work with consumer organizations to
increase public information about the State "Medicaid Buy-In." NCD
also encourages other states to follow the example of the above-noted
states to adopt this option in their Medicaid coverage.
3. Medical Information Privacy
There is no comprehensive federal law that protects
the privacy of people's health information. The 106th Congress had
until June 1999 to develop a health privacy statute, a deadline
Congress had imposed on itself in prior legislation. That same legislation
requires the Secretary of Health and Human Services to issue regulations
by February 2000. Because the regulatory authority of the President,
through the Department of Health and Human Services (HHS), is limited,
those regulations are limited to privacy protections for medical
information stored or transmitted electronically.
With Congress failing to act, the President and HHS
Secretary Shalala proposed regulations that would apply to all health
plans and many health care providers, as well as to health care
clearinghouses such as billing companies. The regulations would
(1) limit the nonconsensual use and release of private health information;
(2) inform consumers about their right to access their records and
to know who else has accessed them; (3) restrict the disclosure
of protected health information to the minimum necessary; (4) establish
new disclosure requirements for researchers and others seeking access
to health records; and (5) establish new criminal and civil sanctions
for the improper use or disclosure of such information.
The President indicated that the need for comprehensive
federal privacy protections still exists. The HHS-proposed regulations,
for instance, do not cover all paper records. They do not directly
regulate many entities, including employers, other insurers, or
public health agencies--thus allowing for unlimited reuse of information
by such entities. Federal legislation is also needed to fortify
the penalties and to create a private right of action so that citizens
can hold health plans and providers directly accountable for inappropriate
and harmful disclosure of information. NCD calls upon the Administration
and Congress to complete the job of enacting comprehensive protections
of health information.
The Consortium for Citizens with Disabilities, a coalition
of approximately 100 national consumer advocacy, provider, and professional
organizations that advocate on behalf of persons with disabilities,
adopted the following principles:
Federal legislation should statutorily establish
an individual's right to privacy with respect to individually
identifiable health information, including genetic information.
It should prohibit the use or disclosure of individually identifiable
health information absent an individual's informed consent. Legislation
should guarantee an individual the right to access his or her
own health information and the right to amend such information.
Such legislation should establish strong and effective remedies
for violations of privacy protections. This legislation should
provide a floor for the protection of individual privacy rights,
not a ceiling. Finally, while protecting individual privacy
rights, federal legislation should not impede important clinical
and medical research.(4)
NCD concurs with these principles.
4. Physician-Assisted Suicide and Improving Pain Management
NCD finds that the countervailing arguments against
permitting physician-assisted suicide outweigh its benefits. In
making this finding, NCD notes that the benefits of physician-assisted
suicide apply only to the small number of people who actually have
an imminently terminal condition; are in severe, untreatable pain;
wish to commit suicide; and are unable to do so without a doctor's
involvement. Moreover, NCD notes the substantial dangers of permitting
physician-assisted suicide. These dangers include the already prevalent
pressures on people with disabilities to choose to end their lives
and the insidious appropriation by others of the right to make that
choice for them, compounded by the growth of managed care and "rationing"
of health care services and health care financing. NCD also notes
the societal devaluing of the lives of people with disabilities
and the historical experience in the Netherlands of coercion and
involuntary "euthanasia" for people with disabilities. NCD recognizes
the difficulty of crafting adequate procedural safeguards, which
inevitably would place unacceptable control in the hands of medical
and legal "experts," and the many societal barriers that continue
to limit life choices for people with disabilities. As NCD notes,
"[S]ociety should not be ready to give up on the lives of its citizens
with disabilities until it has made real and persistent efforts
to give these citizens a fair and equal chance to achieve a meaningful
life."
Events occurred during the reporting period that continue
to stem the "assisted suicide" movement. Dr. Jack Kevorkian, who
has assisted more than 130 people in committing suicide, was found
guilty of murder in the death of a person with Lou Gehrig's disease
in Detroit, Michigan.
The U.S. House of Representatives passed the Pain
Relief Promotion Act (H.R. 2260, H.Res. 339). The legislation states
that pain management, even if the pain management increases the
risk of death or speeds up the process of death, is a legitimate
medical use of controlled substances. But assisted suicide is not.
It also authorizes funding to educate health professionals on pain
management. NCD encourages the President to work with Congress
to craft a federal law that will protect the human rights of people
with disabilities and restrain the ability of physicians to prescribe
lethal drugs as a method of physician-assisted suicide.
In a similar vein, NCD, represented by Marca Bristo,
the chairperson of the National Council on Disability, joined with
the Princeton [University] Students Against Infanticide, Not Dead
Yet, and others to protest the appointment of Peter Singer as a
teacher of ethics to undergraduates at Princeton. Peter Singer,
in his book Practical Ethics, writes that some people with disabilities
have lives that are not worth living. Singer argues that disabled
infants may be killed ethically because they are not sentient (conscious)
beings. He bases this justification for killing on the future quality
of life of the disabled person. Yet people with disabilities usually
have a much higher perception of the quality of their lives than
people without disabilities have for them.(5)
E. LONG-TERM SERVICES AND SUPPORTS
As we move to implement the Olmstead decision,
there are three basic principles that all of us can agree on,
now. We can agree that no American should have to live in a nursing
home or state institution if that individual can live in a community
with the right mix of affordable supports. We can agree that we
all have the right to interact with family and friends in our
communities_to make a living_and to make a life. And we can agree
that it will take time, effort, creativity, and commitment from
all of us to make this a reality.
--Secretary of Health and Human
Services Donna Shalala, from
remarks to the National Conference
of State Legislators, July 1999
NCD recognizes that the enduring inability of people
with disabilities to secure consistent, affordable access to long-term
services and supports is the number one reason why more people with
disabilities do not live in their homes and communities and are
not gainfully employed. Community-based, long-term services and
supports--broadly referring to a range of services and supports
for people who, because of chronic illness or disability, need assistance
with activities of daily living--are finally being recast in the
political arena as valid, preferred alternatives to institutional
service provision.
Last year, a variety of legislative, regulatory, and
judicial events converged to yield the most progressive federal
policy activity to date on long-term services and supports for people
with disabilities. For example, the U.S. Supreme Court decision
in the Olmstead v. L.C. case, while qualified, was a win
for proponents of home and community-based services and supports.
Legislation to promote more consumer choice and long-term service
system flexibility, the Medicaid Community Attendant Services and
Supports Act (MiCASSA),was introduced on the heels of the passage
of the Work Incentives Improvement Act (WIIA) of 1999. Family supports
such as childcare and tax credits were also passed. NCD applauds
the 106th Congress for moving beyond rhetoric and implementing a
strategy for dramatically expanding consumer choice in long-term
care. NCD challenges Congress and the Administration to enact MiCASSA
by the end of the 106th Congress.
1. MiCASSA
On November 16, 1999, MiCASSA was introduced in the
Senate as bill number S. 1935. Co- sponsored by Senators Tom Harkin
(D-Iowa) and Arlen Specter (R-Pennsylvania), the bill allows people
with disabilities to have a real choice about where they receive
certain types of Medicaid long-term services and supports. It also
provides grants to the states to assist them as they redirect Medicaid
resources into community-based services and supports.
While there have been various iterations of the bill--MiCASSA--this
one would allow any person entitled to medical assistance in a nursing
facility or an intermediate care facility to use the money for community
attendant services and supports. NCD recognizes that personal assistance
services and supports are the lowest-cost and most consumer-friendly
services in the long-term care spectrum. Home- and community-based
care is not only what people want; it can also be considerably less
expensive. NCD gives its strongest recommendation that Congress
and the Administration enact MiCASSA by the end of the 106th Congress
to meet the needs and desires of older Americans and citizens with
disabilities to live in their own homes to the fullest extent possible
2. Olmstead v. L.C.
In summer 1999, the U.S. Supreme Court handed down
the landmark decision of Olmstead v. L.C. The Court recognized
that unjustified isolation and segregation of persons with disabilities
in institutional settings is a form of discrimination prohibited
by ADA. The Court sent a simple yet profound message that long-term
services and supports for people of all ages must be based on what
is appropriate for and desired by the individual. (See fuller discussion
of Olmstead on pages 18-19.),
3. Administration Efforts
The Clinton Administration proposed an ambitious,
four-part, $6.2 billion (over five years) initiative to take important
steps to address complex long-term care needs. The proposal included
(1) a $1,000 tax credit for children with disabilities, seniors
with disabilities, and their families; (2) a new National Family
Caregivers Support Program; (3) a national campaign to educate Medicare
beneficiaries about long-term care options; and (4) a proposal to
have the Federal Government offer quality private long-term care
insurance to federal employees. Most of these proposals were caught
in the legislative bottleneck at the end of the session and were
not funded. However, these proposals and others are among the top
priorities for the second session of Congress in long-term services
and support legislation.
Additionally, the Administration announced a proposal
to promote more flexibility in the Medicaid program to choose home-
and community-based care. Historically, Medicaid policy and practice
have inadvertently discriminated against people with long-term care
needs who want to live in their communities by allowing states to
expand Medicaid eligibility only to residents in nursing homes.
This new proposal would enable states to expand their programs to
cover community-based care as well as nursing home residents with
income up to 300 percent of the Social Security Income (SSI) limits.
Advocates are trying to learn how these proposals
would interact with MiCASSA. This proposal would, like MiCASSA,
offer people living in Skilled Nursing Facilities or Intermediate
Care Facilities the choice of a home or community-based setting
for their services and supports.
Other promising federal initiatives are under way
to expand access to home and community- based services:
- On October 1, 1999, the Health Care Financing Administration
(HCFA) and the assistant secretary for planning and evaluation
(ASPE) launched the Resource Network on Home- and Community-Based
Services. The mission of this initiative is to support the work
of states, the disability and aging communities, and other stakeholders
who are committed to expanding access to high-quality, consumer-directed
services in integrated settings in the most cost-effective way.
The Network will conduct national and community forums as well
as support a targeted technical assistance effort.
- ASPE and HCFA are also developing a primer to explain
in clear language all that is allowable under the Medicaid long-term
care program.
- Last year the two federal agencies awarded small
grants to Colorado, Michigan, Rhode Island, and Texas to develop
affordable ways to help nursing home residents move back into
the community if they are able and willing to do so.
- HCFA recently awarded another $2 million to support
similar demonstration projects in Vermont, New Hampshire, Wisconsin,
and New Jersey. The grants are meant to provide states with the
administrative and/or service funds necessary to remove the remaining
obstacles to returning to the community.
- In partnership with the Robert Wood Johnson Foundation,
ASPE and HCFA have designed and sponsored a controlled experimental
test of a consumer direction model, the Cash and Counseling Demonstration.
Findings from this study are expected to help identify practices
that enhance consumer choice as well as practices that hamper
consumer choice.
4. Child Care
Increasingly, child care is becoming a family support
issue. Long-term services and support naturally include some type
of quality childcare options. To receive funding under the Child
Care Development and Block Grant (CCDBG), states must address in
their child care plans the activities they will undertake to improve
quality in child care. In order to promote the inclusion of children
with disabilities in child care, the Child Care Task Force of the
CCDBG recommends that several critical activities must take place
at the state level related to quality, payment rate to childcare
providers, the definition of children with special needs, and collaboration.
Quality activities may include comprehensive consumer
education that includes training for childcare providers, state
accreditation agencies, licensing agencies, and parents on how providers
can meet their responsibilities to children with disabilities in
accordance with ADA.
Payment rates to childcare providers must be sufficient
to enable eligible children to access high- quality childcare programs,
and a separate payment rate for children with disabilities must
be substantially higher than the rate charged for children without
disabilities. Further, the state will need to find incentives for
providers to enroll children with disabilities.
CCDBG grants each state the authority to establish
a definition of children with special needs, which should be expansive
enough to include the age-appropriate definitions for children ages
birth through 5 found in IDEA. Head Start has adopted these definitions
for its programs. The definition should also include children at
risk of developmental delay, and states should report the numbers
of children with special needs who are served each year by the CCDBG.
Collaborative efforts should include the state lead agencies for
IDEA, Grants for Infants and Families Program, and the special education
preschool program. NCD commends the President and Congress for
making available funds to improve childcare options for children
with disabilities and their families. NCD encourages HHS and DOED
to work with the states and local governments to ensure that children
with disabilities are integrated into the childcare and after-school
care networks developed with the new funding. Also, in light of
the fact that many states currently have waiting lists for children
to get into quality childcare programs, NCD encourages the President
and the 106th Congress to continue to expand the federal commitment
to ensure that all children have access to quality, affordable,
accessible child care.
5. Children's Health Insurance Program
Despite the fact that the number of children enrolled
in the Children's Health Insurance Program (CHIP) has grown by more
than 1 million and is expected to more than double over the next
year, more than 10 million children are still uninsured. On October
12, at a meeting of the American Academy of Pediatrics, President
Clinton unveiled a series of steps to help enroll the millions of
uninsured children who are eligible for Medicaid and CHIP. The steps
include
- the first annual Interagency Report on Children's
Health Insurance Outreach, which details hundreds of outreach
activities by 11 federal departments and agencies;
- directing Cabinet secretaries to develop strategies
to promote effective partnerships to integrate children's health
insurance outreach into schools;
- new administrative guidance to state health and
education officials on school- based outreach; and
- new public-private partnership between HHS and
The David and Lucille Packard Foundation that will fund over $9
million to identify effective children's health insurance strategies.
More than 1,500 schools in 49 states have joined the
"Insure Kids Now! Through Schools" campaign to conduct outreach
for and enrollment in Medicaid and CHIP through regular school activities,
including parents' nights, registration, and school physicals, and
in letters sent to parents about immunization. NCD recommends
that aggressive steps be taken to increase the enrollment of uninsured
children, many of whom are children with disabilities.
F. YOUTH An
increasing number of youth with disabilities apply for SSI or SSDI
each year, despite significant investments in special education.
According to the Social Security Administration (SSA), approximately
60,000 youth between 18 and 24 years of age come on the rolls for
SSI and SSDI annually. Among SSDI recipients, fewer than 1 percent
ever leave the program.
1. Youth Task Force
In its second annual report, the Presidential Task
Force on Employment of Adults with Disabilities (PTFEAD), of which
NCD is a mandated member, called for a presidential directive for
a cross-agency Youth-to-Work Initiative. The agencies cooperating
in the Initiative would be the Departments of Labor, Education,
and Health and Human Services, the Social Security Administration,
the Office of Personnel Management, and other federal agencies,
under the leadership of PTFEAD.
The PTFEAD report also recommended a presidential
directive instructing HHS to develop a proposal allowing the Maternal
and Child Health Programs for Children with Special Needs to provide
Healthy and Ready to Work services to youth with disabilities who
are under the age of 16.
NCD is a member of the Expanding Employment Opportunities
for Young People with Disabilities Subcommittee of the PTFEAD. Specific
goals and steps of the subcommittee regarding youth include
- Develop internship opportunities in the Federal
Government and the private sector for young people with disabilities.
- Increase the number of young people with disabilities
who pursue postsecondary education.
- Increase leadership development activities for
young people with disabilities.
- Increase participation of youth with disabilities
in Federal agency programs that generically target youth.
NCD strongly recommends that the focus of transition
for youth with disabilities from school to work or higher education
must be a broader policy perspective than the traditional IDEA and
Rehabilitation Act authorities. While the linkages and practices
of these two funding and program authorities clearly need independent
evaluation and improvement, other program roles must be included.
Within the broader workforce development systems, programs like
Job Corps and apprenticeship training programs must begin to broadly
include youth with disabilities. Title V Maternal and Child Health
Program for Child with Special Needs must begin Health and Ready
to Work Services prior to the age in which many youth with disabilities
begin to drop out of school. Access to General Equivalency Degree
programs must greatly expand the number of youth with disabilities
taking advantage of this second opportunity at credentials necessary
for access to productive, higher paying work. SSA eligibility rules
must once again encourage, not discourage, higher education. NCD
firmly believes the proposed presidential directive for a cross-agency
Youth-to-Work Initiative must undertake its mission as an emergency
priority to prevent another generation of qualified youth with disabilities
from missing the only true way to economic self-sufficiency through
work.
2. The 1999 National Leadership Conference for Youth
with Disabilities
The June 1999 National Leadership Conference for Youth
with Disabilities was coordinated by NCD and sponsored by SSA, the
U.S. Departments of Education and Health and Human Services, PTFEAD,
and the President's Committee on Employment of People with Disabilities.
The Mitsubishi Electric America Foundation was the primary private
sponsor. Over 125 youth participated in the program.
Three main purposes were established for the conference:
- First, as a forum for youth to learn from national
disability leaders about national disability policy, civil rights,
the public policy process and leadership, employment opportunities,
and related programs available to them.
- Second, for young people to identify barriers to
their economic independence, provide input to the public policy
process, and identify future programs to support economic independence
and leadership among all youth with disabilities
- Third, to create solidarity and community among
the participants, building confidence and resolve to take action.
NCD will continue to support the National Leadership
Conference for Youth with Disabilities to ensure that new generations
of leaders for the disability rights movement are supported. NCD
will encourage states and other entities to emulate the success
of the Leadership Conference among youth with disabilities within
their geographic areas.
G. IMMIGRANTS AND RACIAL AND ETHNIC
MINORITIES WITH DISABILITIES 1. White House
Forum on Disability and Cultural Diversity
On July 26, NCD released the executive summary from
its report, Lift Every Voice: Modernizing Disability Policies
and Programs to Serve a Diverse Nation, at a White House forum
on disability and cultural diversity that also celebrated the ninth
anniversary of the passage of ADA. The forum, convened by the White
House and NCD with support from the Leadership Conference on Civil
Rights, focused on how to improve outcomes in education, employment,
and civil rights enforcement for people with disabilities from diverse
cultural backgrounds.6
NCD commends both the White House and Congress
in recognizing the importance of addressing the ongoing barriers
faced by people with disabilities from diverse cultural backgrounds.
At the same time, NCD proposes a multi-agency initiative to provide
ongoing, intensive "know your rights" seminars in diverse communities
throughout the country that would cover a range of disability civil
rights laws and disability assistance programs.
NCD urges federal civil rights enforcement agencies
to work together to develop culturally competent models for outreach
and training on federal civil rights laws and procedures in minority
racial and ethnic communities.
NCD commends the President and Congress for recognizing
the need to pay particular attention to disability issues in minority
communities. As the President and Congress continue to build on
these first steps, NCD encourages them to address the dramatic disparities
in labor force participation, health care, housing, and other areas
between the general population and minorities with disabilities.
2. The President's Initiative on Race
In January 1999, the President's Initiative on Race
released its final report on the Administration's effort to catalyze
meaningful conversations and action on race relations in America.
Along with dramatic statistics and thoughtful commentary, it included
volumes of promising practices in which any citizen may engage to
bring together diverse people in mutual respect and common enterprise.
NCD commends the President for launching this Initiative to help
all Americans recognize our common interests and to bridge the opportunity
gaps that are keeping us from becoming an America for all.
3. Restoration of Legal Aliens' Eligibility for Disability
and Health Benefits
Upon signing the 1996 welfare reform law, President
Clinton made a commitment to reversing unnecessary cuts in benefits
to legal immigrants that had nothing to do with the law's goal of
moving people from welfare to work. Though the Balanced Budget Act
protects the most vulnerable, restoration of important disability
and health benefits to additional categories of legal immigrants
still remains to be completed.
The Balanced Budget Act of 1997 and the Noncitizen
Benefit Clarification and Other Technical Amendments Act of 1998
invested $11.5 billion to restore disability and health benefits
to 380,000 legal immigrants who were in this country before welfare
reform became law (August 22, 1996). Restoration of eligibility
for SSI and Medicaid to legal immigrants who enter the country after
that date, if they have been in the United States for five years
and become disabled after entering the United States, should be
the next step in policy. NCD calls upon the Administration and
Congress to restore this program eligibility and the funds to support
it.
H. SOCIAL SECURITY WORK INCENTIVES
AND SSA AND MEDICARE SOLVENCY 1. Work Incentives
Improvement Act
On December 17, 1999, President Clinton signed WIIA,
the last Act to become law in the millennium. This landmark legislation
gives people with disabilities the opportunity to move into employment
and reduce their dependence on benefits and other assistance. It
does not address all issues, but it does bring positive change,
while balancing the concerns of key stakeholders.
WIIA improves access to health care by (1) expanding
states' ability to provide a Medicaid buy-in to people with disabilities
who return to work; and (2) extending Medicare coverage for people
with disabilities who return to work WIIA also improves access to
health care by creating a new Medicaid buy-in demonstration to help
people with a specific physical or mental impairment that is not
severe enough to qualify for health assistance, but is likely to
lead to a severe disability in the absence of medical treatment.
In addition, WIIA will modernize the employment services
system by creating a "ticket to work and self sufficiency" that
will enable SSI or SSDI beneficiaries to go to any public or private
provider for vocational rehabilitation. It provides beneficiaries
with disabilities both choice and expanded options in pursuing employment
and employment supports.(7)
Like President Clinton, NCD challenges the states
to take advantage of the new $250 million demonstration program
that tests whether early medical intervention, made accessible by
Medicaid coverage, will enable people with such disabilities as
muscular dystrophy, Parkinson's Disease, or diabetes to stay healthier
and keep working.
NCD notes that there are no incentives in WIIA for
ongoing supports and services, particularly that segment of the
disabled population who experience mental retardation, developmental
disabilities, or other significant disabilities. The concern is
that the ticket will result in "creaming" of those individuals who
are less costly to serve and easier to place in jobs, leaving those
with more significant disabilities described above with little hope
of assistance.
As regards providers of services, the individual
with a disability may not change networks during the five years
of ticket payment without showing "good cause." The choice of providers
should have fewer constraints, not more.
NCD recognizes that WIIA is not as enforceable
as ADA. The realization of economic advancement is not automatic,
let alone guaranteed. Individual states need to be persuaded that
WIIA is good government, and good for every citizen.
NCD encourages the Secretary of Labor to develop
step-by-step technical assistance programs to demonstrate how WIIA
can be integrated into the 1998 Workforce Investment Act (WIA) implementation
activities.
2. Social Security Solvency
SSA flatly states that Social Security benefits will
be there for current beneficiaries and future generations. Forty-four
million people receive retirement, survivors, and disability benefits
from the program. More than six million workers and family members
receive disability benefits.
NCD notes that the White House Conference on Social
Security Solvency included a significant number of disability advocates
and persons with disabilities. NCD commends the White House on the
inclusion of advocates and persons with disabilities in that conference.
NCD encourages the Secretary of Labor to develop
step-by step technical assistance programs to demonstrate how WIIA
can be integrated into the 1998 WIA implementation activities.
NCD continues to encourage the President and Congress
to ensure the meaningful inclusion of people with disabilities and
their families in discussions about the projected shortfall of the
Trust Fund; preserve the guarantees inherent in the disability insurance
program and the protections for survivors and dependents in the
Old Age, Survivors, and Disability Insurance programs of Title II
of the Social Security Act; protect the integrity of the benefits
provided so that they are at a reasonable level for support; protect
the value of the benefits so that the buying power of the benefits
does not diminish with inflation; and, finally, to take into account
any potential effect on the SSI program when assessing the impact
of any reform proposal.
Finally, NCD encourages the White House and the
2nd Sessions of the 106th Congress to work together in forging these
long-term reforms.
3. Medicare Reform
In previous actions, NCD recommended to the Bipartisan
Commission on the Future of Medicare that working-age Medicare enrollees
with disabilities be consulted and have input on how Medicare could
better meet their needs. NCD also asked the President and Congress
to make the scope of coverage under Medicare provide the kinds of
services and supports that working-age people with disabilities
require.
NCD recommends a comprehensive, bipartisan plan
to strengthen and modernize Medicare. Such a proposal must make
the program more efficient and competitive and increase access to
preventive care critical to individuals with disabilities to prevent
the development of secondary conditions. The proposal must dedicate
a portion of the existing budget surplus to keep Medicare solvent
past 2025 and help to pay for a long overdue voluntary prescription
drug program.
I. EMPLOYMENT
We need to do more to expand employment opportunities;
expand educational opportunities; invest in new technologies to
make our society more accessible; and enforce our civil rights
laws--so discrimination on the basis of disability becomes an
ugly relic of the past.
--Vice President Albert Gore
1. The Workforce Investment Act of 1998
The WIA of 1998 included the Rehabilitation Act Amendments
of 1998. NCD encouraged the Rehabilitation Services Administration
(RSA) to work closely with PTFEAD to develop multi-agency demonstration
and research initiatives. These initiatives should increase dramatically
the rate of employment of people with disabilities and should provide
policy options for RSA that addresses the range of disincentives
that prevent people with disabilities seeking employment from succeeding.
To that end, NCD commends the report of the Presidential Task
Force that notes the efforts of DOED's RSA, the Department of Labor's
Employment and Training Administration, and SSA to address the issues
of physical and program access in the implementation phase of WIA.
This joint effort includes technical assistance on assistive technologies,
compliance issues, customer service, and participation of people
with disabilities in the One-Stop Career Center systems.
Still, NCD recognizes that this multi-agency approach
to delivery of services for the employment of people with disabilities
in order to increase the employment rate for this population needs
to be improved. The era of isolated, specialized services for people
with disabilities is over. Federal agencies cannot work in isolation.
In addition, mainstream employment and training networks
should implement a comprehensive training module so that line staff
are well informed about resources available for people with disabilities
seeking employment and are well equipped to meet the needs of clients
with a wide range of disabilities.
2. Job Training and Vocational Rehabilitation
The Department of Labor (DOL) issued an Interim Final
Rule implementing Section 188 of the WIA. Essentially, this section
contains the statute's equal opportunity and nondiscrimination provisions.
The WIA supersedes the former job training programs as DOL's primary
mechanism for providing financial assistance for a comprehensive
system of job training and placement services for adults and eligible
youth. DOL's Interim Final Rule became effective on November 12,
1999. The Civil Rights Center of DOL is the agency responsible for
administering the nondiscrimination and equal opportunity provisions
of WIA.
RSA issued an Information Memorandum titled A Guide
for Developing Memoranda of Understanding with Local Workforce Investment
Boards as Required by the Workforce Investment Act. This Guide
is designed as a framework for negotiations in the development of
the memorandum of understanding (MOU). Components are drawn from
the WIA requirements for a memorandum and from questions submitted
by individuals with disabilities, community rehabilitation programs,
and state vocational rehabilitation programs.
NCD recognizes the release of the Information Memorandum
as a significant step, but encourages RSA to expedite its technical
assistance and policy guidance moving vocational rehabilitation
programs into a meaningful partnership with WIA in the multi-agency
One Stop workforce development system.
Through their respective discretionary programs and
joint funding, DOL's Employment and Training Administration (ETA),
SSA, and RSA have funded state and/or local projects to encourage
the development of interagency coordination best practices. Coordination
of evaluation strategies on the progress of these five-year projects
is also being planned.
NCD commends ETA, SSA, and RSA on this interagency
cooperation that may be a model for interjecting coordination practices
into the requirements of all discretionary grants supporting the
employment of individuals with disabilities. In addition, they may
well provide the best practices of the future for state-level coordination
in workforce and health care programs that serve people with disabilities.
3. Substantial Gainful Activity Rule Revised
SSA revised the rules for determining when earnings
demonstrate the ability to engage in "substantial gainful activity"
(SGA). The rule became effective on July 1, 1999. SSA raised the
average monthly earnings guideline from $500 to $700 to determine
whether work done by persons with impairments (other than blindness)
is SGA. The purpose is to encourage individuals with disabilities
to attempt to work, and to provide an updated indicator of when
earnings demonstrate the individual's ability to engage in SGA.
SSA believes that this is a significant improvement to work incentives.
NCD commends Social Security for making this rule
change from $500 to $700. Three thousand comments were received
from individual stakeholders (e.g., advocates, state and local government
entities, attorneys, SSA field office staff, a member of Congress,
and private citizens). Practically all of the respondents were in
favor of the increase. Many of the respondents recommended that
SSA should make further changes and NCD concurs in this opinion.
4. Social Security Administration Next Steps
- Establishment of SSA Office of Employment Support
Programs. In August of 1999, SSA established the new executive
Office of Employment Support Programs to improve quality of service
to people with disabilities who want to work.
- Small Business Administration (SBA) and SSA MOU
to help improve employment and entrepreneurial opportunities for
people with disabilities. The two agencies signed a partnership
agreement on October 20, 1999, to coordinate the efforts of SBA's
Welfare-to-Work Initiative and the SSA's Disability Insurance
and SSI programs to help adults with disabilities find gainful
employment or become entrepreneurs. One purpose is to link small
businesses seeking workers with Americans with disabilities. Each
agency will encourage its field offices to cooperate at the local
level, share information about business and nonprofit organizations
that train beneficiaries with disabilities, and work together
on job fairs and other community outreach activities.
NCD commends both SSA and SBA on signing this MOU
to help in developing small business and entrepreneurial activities
to increase the employment rates of adults with disabilities to
be as close as possible to that of the general adult population.
5. Tax Credit
On January 13, 1999, the President announced a new
proposal that will allow workers with significant disabilities to
receive an annual $1,000 tax credit to help cover the formal and
informal costs associated with employment, such as special transportation
and technology. Like the Jeffords-Kennedy-Roth-Moynihan Work Incentives
Improvement Act, this tax credit, which will assist 200,000 to 300,000
Americans, will help ensure that people with disabilities have the
tools they need to return to work. Congress did approve the President's
proposal. In addition, the Work Opportunity Tax Credit (WOTC) was
extended to December 31, 2001, and made effective retroactively
back to June 30, 1999, when it expired. WOTC provides a tax credit
to employers who hire individuals, such as individuals with disabilities,
in vocational rehabilitation programs.
6. Presidential Task Force on the Employment of Adults
with Disabilities
President Clinton signed Executive Order 13078 on
March 13, 1998, to establish PTFEAD. The Task Force mandate is to
examine the programs and policies related to the employment of adults
with disabilities to "determine what changes, modifications,
and innovations may be necessary to remove barriers to work faced
by adults with disabilities" and to recommend options for such
changes. "The ultimate mission of the Task Force is to create
a coordinated and aggressive national policy to bring adults with
disabilities into gainful employment at a rate that is as close
as possible to that of the general adult population."
NCD and PTFEAD recommend to the President the following:
To direct the Department of Labor to develop a
proposal, for consideration in the 2001 budget process, for the
establishment of an Office of Disability Policy, Evaluation, and
Technical Assistance (ODPET) to be headed by an Assistant Secretary
of Labor. ODPET would ensure ongoing efforts to integrate people
with disabilities into DOL's mainstream employment and training
programs; establish the National Disability Business Development
Board to serve as an advisory body to ODPET; maintain the principal
functions of the President's Committee on Employment of People with
Disabilities; and, finally, assist PTFEAD in implementing a coordinated
and aggressive national employment strategy for people with disabilities.
7. Federal Government's Commitment to Hire People
with Disabilities
The President directed the Office of Personnel Management
(OPM) to explore ways to eliminate the stricter standards applied
to Federal job applicants who have psychiatric disabilities. On
June 4, 1999, President Clinton signed Executive Order 13214 amending
the civil service rules relating to federal employees with psychiatric
disabilities. The same rule that allows people to convert after
two years from noncompetitive status to competitive status without
an examination (for people with severe physical disabilities and
mental retardation) applies now to employees with psychiatric disabilities.
Vice President Gore directed OPM to develop a model
plan to increase the representation of adult employees with disabilities
through federal employment. The President directed federal agencies
to implement the comprehensive plan immediately.
An interagency task force, the Federal Government
as a Model Employer Committee was established through PTFEAD and
focuses on the Federal Government's commitment to hire persons with
disabilities.
NCD commends the Administration on the Executive
Order in the hiring of people with psychiatric and other disabilities.
At the same time, the existing laws( e.g., ADA and Sections 503
and 504 of the Rehabilitation Act) must be leveraged for creating
change in both the public and private sectors. For example, Federal
contractors employ approximately 26 million people, or nearly 22
percent of the total civilian workforce. This is a critical area
for influencing the employment of people with disabilities. Federal
contractors need more information on Section 503 compliance and
best practices in their hiring strategies.
On October 16, 1999, the President released a plan
titled Accessing Opportunity: The Plan for Employment of People
with Disabilities in the Federal Government along with an employment
guide prepared by OPM.
NCD commends the President for giving federal agencies
detailed and practical information on ways to recruit people with
disabilities for positions at all levels of government; to provide
opportunities for students with disabilities; to ensure career opportunities
for people with disabilities; to collect and maintain data to monitor
their success; and to provide reasonable accommodations for applicants
and employees with disabilities.
J. WELFARE-TO-WORK 1.
Federal/State Efforts
The goal of the 1997 Welfare-to-Work Initiative was
to move the hardest-to-serve welfare recipients into unsubsidized
jobs and economic self-sufficiency by funding grants to states and
local communities for job creation, job placement, and retention
efforts (e.g., wage subsidies). Even though welfare caseloads are
at their lowest level in 30 years, the individuals remaining on
the rolls tend to be recipients with the greatest challenges to
employment: long-term recipients with poor work histories, low basic
skills, or substance abuse problems. The program also serves noncustodial
parents with barriers to employment whose children are long-term
welfare recipients.
A Department of Labor Welfare to Work research report,
prepared by the Brookings Institute, indicates that the few research
studies available have begun documenting the widespread occurrence
of disabilities--particularly learning disabilities--among welfare
recipients and the high correlation between disabilities and unsuccessful
efforts at employment. If this population of welfare clients is
to make a successful transition from welfare to work at a sustaining
wage, agencies must accurately diagnose clients' needs and explore
opportunities for workplace accommodations.
2. Welfare Recipients with Disabilities
The report established the following estimation of
need for special services among welfare recipients with physical
(unable to work) and learning disabilities:
Percentage of the Welfare Population Facing This Issue
Work-Related (Physical) Disabilities |
|
National estimates: |
10 to 20 percent |
State/local estimates: |
11 to 31 percent |
Learning Disabilities |
|
National estimates: |
25 to 40 percent |
State/local estimates: |
36 to 66 percent |
Other findings of the report include:
Relationship to Welfare Receipt
- Female welfare recipients are more than four times
as likely as nonrecipients to have very low basic skills.
- People receiving welfare five years or longer are
almost twice as likely to have very low basic skills than are
those receiving welfare less than two years.
- Among welfare recipients in a recent study, those
with special learning needs received welfare for 79 months, compared
to 61 months for those who did not have special learning needs.
Relationship to Employment Status
- People with any level of disability are much less
likely to be employed than those without a disability, and they
have a greatly reduced earnings capacity.
- People who report having work disabilities are
more than twice as likely as other workers to be unemployed but
actively seeking work--16 percent versus 7 percent.
- Welfare recipients with functional limitations
are half as likely to exit welfare for work in a given four-month
period than recipients without functional limitations.
- A large proportion of adults with learning disabilities
are thought to drop out of job training efforts because the programs
are not designed to meet their learning needs.
The report recommends the following steps that welfare
agencies should take to better serve clients with disabilities:
- Program Staff. If program
implementation is to be successful, welfare agencies must make
a substantial commitment to training staff on disability issues,
particularly on how to use screening and assessment tools to identify
clients with disabilities.
- Coordinated Delivery of Services.
To serve clients with disabilities successfully, welfare agencies
should develop partnerships with other organizations for the provision
of remediation, rehabilitation, and employment-related services.
- Service Capacity. To
serve clients with disabilities successfully, welfare agencies
must assess the extent to which current local service capacity
helps to serve, rehabilitate, and employ clients with disabilities
and, where gaps exist, address the shortage.
The Welfare-to-Work Initiative has been extended,
and several states, including Missouri, Wisconsin, and Nevada, have
targeted all or a significant amount of their Welfare-to-Work funds
to serving noncustodial parents. NCD commends the President and
Congress for recognizing the need to address housing, transportation,
and other barriers to enable people on welfare to obtain and retain
employment. NCD encourages another extension of the Welfare-to-Work
program. NCD encourages the President and administering agencies
for these new programs to recognize that a large percentage of the
population remaining on Temporary Assistance for Needy Families
has disabilities ranging from learning disabilities to psychiatric
disabilities to substance abuse issues. Accordingly, many of these
individuals must have their disability-related needs addressed in
order for the goal of obtaining long-term employment to be realized.
Moreover, NCD encourages the President and Congress to recognize
that the current efforts to move people from welfare to work may
have important lessons for the growing effort to move people from
reliance on disability benefit programs to employment. Issues such
as housing, transportation, and health care must be addressed for
the SSI and SSDI populations as well, if the transition to work
is to be successful.
K. HOUSING In
FY 1999, policy changes in the definition of housing for individuals
with disabilities, the concept of visitability, and an emphasis
on TBRA and home ownership began to be a part of the practices and
operations of HUD. This integration of earlier policy victories
into the operations of federal housing agencies establishes the
environment of statistical support and program successes necessary
for further policy changes toward a true civil rights approach to
meeting the housing needs of Americans with disabilities.
1. Section 8 Mainstream Housing Opportunities for
Persons with Disabilities Program
Increased TBRA and Section 8 portable vouchers became
a larger part of housing policy when HUD's Notice of Fund Availability
allowed 50 percent of its section 811 program funds (Supportive
Housing for People with Disabilities) for TBRA. On March 8, 1999,
HUD allocated $88.5 million for Section 8 rent subsidies targeted
to people with disabilities. Because of a significant modification
in the Section 8 Mainstream Housing Opportunities for Persons with
Disabilities Program, for the first time, nonprofit disability organizations
are eligible to apply. Previously, only Public Housing Authorities
were eligible to apply and only a woeful 10 percent were willing
to do so, leaving no other way for people with disabilities to obtain
these rent subsidies in their communities. Congress urged HUD to
make this modification during the 1999 budget process and has made
available $48.5 million in five-year rent subsidies. NCD commends
HUD for doubling the traditional 25 percent of 811 funds available
for TBRA activities. Congress is commended for broadening the access
of the Section 8 Mainstream funds to nonprofit organizations. NCD
still recommends that 100 percent of the section 811 program funds
be used for person-based, rather than project-based, housing resources.
This change would be consistent with the requirements in section
504 of the Rehabilitation Act and the Fair Housing Act that housing
resources be provided in the most integrated setting appropriate.
Also critical to the wider use of TBRA is the availability
of modification funds for low-income individuals with disabilities.
HUD's continued notification to cities and housing authorities encouraging
the use of Community Development Block Grants for home modification
of rental- home-owned properties for individuals with disabilities
has assisted. NCD encourages HUD to build on these steps by creating
a national home modification fund for low-income people with disabilities,
both renters and owners. HUD thereby will empower more people with
disabilities to become homeowners or tenants in community settings.
2. Home Ownership
Home ownership for low-income individuals with disabilities
moved forward with implementation of the Quality Housing and Work
Responsibility Act of 1998, Title V of P.L. 105-276. Provisions
of the Act allow for home ownership with the Section 8 TBRA funds
described above.
3. Visitability
In HUD's continued HOPE (Housing Opportunities for
People Everywhere) VI Notices of Funding Availability, the agency
included bonus points for developers when they seek to build or
rehabilitate structures with three or fewer units that include visitability
by people with disabilities. This visitability concept would require
all such new housing to have at least one no-step entrance and 32-inch
doorways so people with disabilities could visit their friends who
live there. HUD's commitment to a visitability policy was strengthened
with the publication of a guide by the Office of Public and Indian
Housing explaining basic access design. NCD commends HUD for
embracing visitability as a goal for HUD-financed housing and for
recognizing that the move from project-based housing to town homes
and other detached dwellings does not need to mean a reduction in
accessibility if developers are encouraged to build in such features
in the design stage.
4. Compliance with Section 504 of the Rehabilitation
Act by HUD and Its Grantees
Concerns among self-advocates with disabilities remain
regarding the continued segregative housing practices and policies
in Section 811 programs that place individuals with disabilities
into diagnosis-specific housing and services of a residential provider.
An example is the new programs announced by HUD under the McKinney
Continuum of Care Homeless Assistance Programs.
In February 1999, HUD announced three programs that
can provide housing for people with disabilities who meet the HUD
definition of homeless, that is, people who are living on the streets,
in emergency shelters, or in a transitional housing program. These
programs include
- the Supportive Housing Program allowing the development
of transitional housing or supportive services for homeless people,
- the Shelter Plus Care Program funding permanent
housing for homeless people with disabilities with rental subsidies
that are matched with an equal amount of service funding, and
- the Section 8 Moderate Rehabilitation for Single
Room Occupancy (SRO) Dwellings providing 10-year project-based
rent subsidies to rehabilitate permanent housing for homeless
individuals.
HUD set aside 30 percent of the total funding made
available through the McKinney Homeless Assistance Program to be
used to fund permanent housing projects for homeless persons including
the Supportive Housing Program--permanent housing for persons with
disabilities. It is this type of housing that likely segregates
this group of individuals with disabilities into a geographical
area with support services linked to a single provider system. NCD
recommends that HUD reform the programs under which people with
disabilities receive assistance with housing to ensure that these
programs reflect the most integrated setting requirement of section
504 and independent living philosophy of the disability rights movement.
L. TRANSPORTATION
The programs and policies we are announcing today
affirm that transportation is about more than concrete, asphalt,
and steel. It is the means by which people get to where they need
to go: to jobs, to schools, to markets. All Americans must have
access to all opportunities our great nation offers. Accessibility
is a civil right.
--Secretary of Transportation Rodney E. Slater
On the ninth anniversary of ADA, Secretary of Transportation
Rodney E. Slater announced a new departmental policy on accessibility
as well as action items to ensure access to transportation for people
with disabilities. The policy statement is to ensure access for
people with disabilities to all modes of transportation, including
trails and walkways, and DOT's action items include chartering a
ONEDOT accessibility task force composed of representatives from
all modes of transportation to develop programs and benchmarks to
help ensure transportation access for all Americans.
1. NCD Air Travelers Report
On February 26, 1999, NCD submitted the first in a
series of reports on enforcement of federal laws protecting the
civil rights of children and adults with disabilities, titled Enforcing
the Civil Rights of Air Travelers with Disabilities: Recommendations
for the Department of Transportation and Congress. The ACAA
enforcement study reports some of the facts explaining why, 12 years
after the law was enacted, people with disabilities continue to
experience so much discrimination. The causes are many and complex,
but a lack of strong federal enforcement has been a big contributing
factor. Some of the most serious deficiencies in enforcement include
- Severe understaffing and underfunding: DOT's
budget and staff for ACAA enforcement are too small to be effective.
- Inadequate public education efforts: The
majority of people with disabilities who travel by air do not
know about their rights under the law. A major public education
effort is needed to inform the public about the legal rights of
air travelers with disabilities and how to obtain these rights.
- Insufficient monitoring of disability complaints
received directly by airlines: DOT monitors the discrimination
complaints it receives against each airline and meets regularly
with the airlines to discuss them. DOT does not, however, monitor
the complaints received directly by airlines, which are 36 to
100 times the number received by DOT.
- Inadequate technical assistance and inconsistent
monitoring of airline compliance: There is no formal technical
assistance program designed to help airlines comply with regulatory
requirements and solve implementation problems. When problems
are found during compliance reviews, follow-up is not consistent
to ensure that airlines take corrective action.
Weaknesses in the law itself undermine ACAA enforcement:
- Civil penalties are too small to be effective,
where a formal complaint has resulted in a finding of discrimination.
The current maximum civil penalty is $1,100 per discrimination
offense.
- Plaintiffs who bring a civil lawsuit and win are
not entitled to reasonable attorney's fees under law, or even
compensatory damages.
- Foreign air carriers operating in the U.S. market
are not subject to ACAA nondiscrimination requirements. Although
prohibited from "unreasonable discrimination" under another provision
of the Federal Aviation Act, the provision was not successfully
applied to a disability discrimination claim against a foreign
air carrier until September 1998.
2. DOT Action in Response to NCD Report
Air Carriers Access Act
During the summer of 1999, DOT formally charged
Continental Airlines with violating the ACAA and offered to work
with them to make corrections under the law. The action against
the air carrier started with consumer complaints of inadequate
employee assistance to travelers using wheelchairs and stowing
wheelchairs in the storage compartment with luggage instead of
in the passenger cabin as required by DOT regulations.
DOT Rulemaking on Compensation for Damages to
Assistive Devices
As part of the Clinton Administration's ongoing
efforts to ensure fair treatment for airline passengers with disabilities,
a new rule to eliminate airline liability caps for damage to wheelchairs
and other assistive devices was instituted. "Now passengers with
disabilities can recover burdensome repair or replacement costs
if their wheelchairs are lost or damaged in flight." The new rule
makes final a proposal issued on February 19, 1999.
NCD urges DOT to seek additional resources for
enforcement of ACAA and to target specific areas where it will
initiate action, in concert with the disability community, the
aviation industry, and other stakeholder groups, to correct persistent
implementation and compliance problems. NCD encourages DOT to
establish an ACAA civil rights enforcement unit that is separate
from consumer affairs monitoring to investigate allegations of
discrimination.
NCD also encourages Congress to increase DOT's
ACAA enforcement budget and to amend ACAA, through reauthorization
of the Federal Aviation Act, extending its nondiscrimination mandate
to all airlines serving U.S. markets, strengthening DOT's enforcement
mandate, and authorizing those whose civil rights have been violated
to obtain appropriate legal remedies.
3. Over-the-Road Bus Rule
On April 1, 1999, DOT published a notice of request
for comments on its final rule on accessibility of over-the-road
buses that requires bus companies to document lack of service to
people with disabilities. The final rule has four different record-keeping
and reporting requirements. The first deals with 48-hour advance
notice and compensation. The second has to do with equivalent service
and compensation. The third deals with reporting information on
the number of riders on accessible fixed-route buses. The fourth
has to do with reporting information on the purchase and lease of
accessible and inaccessible new and used buses.
The purpose of the information collection requirements
is to provide data that DOT can use in its regulatory review and
to assist DOT in its oversight of compliance by bus companies. In
addition, DOT allocated $2 million in Federal Transit Administration
Over-the-Road-Bus grants from a program created by the Transportation
Equity Act for the 21st Century (TEA-21) for training and to assist
in the incremental capital costs of making over-the-road buses wheelchair
accessible.
4. Greyhound Settlement
The DOJ reached an out-of-court agreement with Greyhound,
the nation's largest intercity bus company, after allegations of
discrimination were leveled against it. Greyhound will pay damages
and agreed to take steps before regulatory deadlines to phase-in
lift-equipped buses. The bus company also agreed to train all of
its employees in assisting riders with disabilities and to create
other policies and procedures to improve transportation options.
NCD strongly encourages enforcement strategies
on the over-the-road bus regulations to erase the brazen disregard
for the law, demonstrated by the largest intercity bus company,
since the passage of the ADA. The data collection provisions of
the over-the-road regulations, coupled with the DOJ settlement,
provide DOT with basic information for altering enforcement and
technical assistance activities to ensure full compliance by the
date established in the regulations.
M. TECHNOLOGY AND TELECOMMUNICATIONS
Technology and telecommunications are becoming
increasingly more critical factors in the education, employment,
and independence of the daily lives of all Americans. Making sure
individuals with disabilities have equitable access to technology
and telecommunications becomes imperative for these same aspects
of their lives. Recent legislation is in place to bring us closer
to this goal. The Federal Government's strong enforcement of these
laws, reinforcement of research in universal design in technology
and telecommunications systems and products, and use of its huge
purchasing power in accessible electronic and information technology
becomes the focus of determining progress in disability policy in
this area.
1. Section 508 of the Rehabilitation Act Amendments
The Workforce Investment Act of 1998, signed into
law on August 7, 1998, contains amendments to the Rehabilitation
Act of 1973. The changes to section 508 of the 1998 amendments to
the Rehabilitation Act were designed to strengthen enforcement of
long-standing law obligating federal departments and agencies to
provide accessible technology and information to individuals with
disabilities, including employees and members of the public.
The changes in the enforcement provisions of section
508 require federal agencies to conduct a self-evaluation of the
accessibility of their electronic and information technology and
provide the results to the Attorney General for a report to the
President by February 7, 2000. Authority was given to the Access
Board for issuing accessibility standards by February 7, 2000. The
General Services Administration (GSA) and federal agencies are required
to incorporate the standards into their acquisition regulations
for purchasing electronic and information technology by August 7,
2000. Finally, individuals with disabilities employed by or receiving
services from these agencies can file complaints under similar provisions
established under Section 504. Progress on implementing these enforcement
provisions to date is detailed below.
Attorney General
On April 2, 1999, the Attorney General issued a memorandum
to all federal agencies and departments advising them of the requirements
of Section 508 and providing instructions and documents for conducting
self-evaluations of the extent their electronic and information
technology is accessible to and useable by individuals with disabilities.
A report of the self-evaluation results was due to the Attorney
General by June 15, 1999. The report to the President is being prepared.
Access Board
The Access Board appointed the Electronic and Information
Technology Access Advisory Committee (EITAAC) to develop recommendations
for section 508 standards. EITAAC issued their final report May
12, 1999. The report provides recommended standards for federal
procurement officers and commercial suppliers of electronic and
information technology and services that will result in access to
and use of the technology and information by individuals with disabilities,
as well as recommendations addressing their implementation through
the federal procurement system.
The next step for the Access Board is the issuance
of a Notice of Proposed Rule Making, based upon the EITAAC recommendations,
establishing the standards required by the Act. The regulatory process
is time consuming and the Board will not meet the February 7, 2000,
deadline.
General Services Administration
The GSA has received an appropriation of $2.5 million
to enable it to procure assistive technology for the larger federal
agencies and to better ensure that these agencies are able to fulfill
technology access for its employees. GSA has also received $1 million
to test hardware and assistive technology, and to help fully implement
Section 508. Specific strategies for use of these funds are still
in the development stage.
NCD recommends that the Access Board, the Office
of Management and Budget, and the GSA expedite the issuance of standards
and the necessary changes to federal and agencies' acquisition regulations
to ensure implementation of Section 508 statutory requirements prior
to the end of fiscal year 2000.
2. Federal Communications Commission
Section 255 of the Telecommunications Act
The Federal Communications Commission (FCC) released
final regulations implementing section 255 of the Telecommunications
Act of 1996 on September 29, 1999. The regulations implement the
mandate of section 255 that telecommunications service providers
and equipment manufacturers must make their services and equipment
accessible to people with disabilities, to the extent that it is
readily achievable to do so. Supporting the recommendations of the
disability community, the commission identified authority to include
e-mail, voice mail, and other common communication tools within
the definition of "telecommunications." The final report also included
a Notice of Inquiry proceeding to study how the development of Internet
telephony will impact accessibility.
Video Description
On November 18, 1999, FCC proposed that commercial
television broadcasters in the top 25 television markets, and the
largest national video programming distributors, introduce video
description in a portion of their transmissions to allow individuals
with visual disabilities to better follow the visual action in television
programs.
FCC Reorganization
FCC created two new bureaus, the Enforcement Bureau
and the Consumer Information Bureau, effective November 8, 1999.
The organizational change strengthens FCC's ability to serve the
public by improving the effectiveness of the agency's enforcement
program in a competitive marketplace. It also improves the ability
of consumers to obtain quick, clear, and consistent information
about their rights under communications laws. A Disability Rights
Office is also established within the Consumer Information Bureau
to provide guidance to the commission on disability accessibility
policy and to ensure that individuals with disabilities benefit
from the progress of telecommunications.
E-Rates
The 'e-rate,' part of the Telecommunications Act of
1996, is providing $2.25 billion in 20 to 90 percent discounts to
connect schools and libraries to the Internet, with the deepest
discounts going to the poorest schools that need it most. The e-rate
alone has provided Internet access for children in more than a million
classrooms.
NCD commends FCC and Chairman Kennard for pressing
accessibility issues within the Telecommunications Act and continuing
the cause for an accessible communications and technology environment
with its efforts in Internet telephony and voice description. NCD
challenges the Disability Rights Office to work with the disability
community to push the commission further in this cause.
3. Research and International Developments
A $23 million request by the Administration for technology
initiatives for the National Institute on Disability and Rehabilitation
Research--$8 million for initiatives in information technology and
telecommunications, and $15 million for grants to states for alternative
loan financing programs--was reduced by Congress to $5 million and
$4 million respectively. NCD commends the Administration for
recognizing the need for increased funding in technology research
and making technology affordable to all individuals with disabilities,
and encourages Congress to meet the President's recommended funding
levels.
Progress in international technology access policy
included the Irish and Portuguese governments issuing requirements
that all government websites must be accessible to persons with
disabilities. The World Economic Development Congress publication
"World Markets in 2000" selected the web accessibility article "The
Growing Digital Divide in Access for People with Disabilities: Overcoming
Barriers to Participation" for distribution at their World Bank
International Monetary Fund (IMF) Summit and to government cabinets
around the world. The article was developed for the first U.S. conference
on the impact of the digital economy, convened by President Clinton.
N. INTERNATIONAL
ISSUES The year 1999 witnessed several important
successes for people with disabilities around the world. On March
1, the International Treaty to Ban Landmines became international
law, having been ratified by 40 countries in just eight months.
The treaty is a critical step in eliminating landmines; landmines
continue to create physical impairments among people worldwide.
In July, the Organization of American States ratified the Inter-American
Convention on the Elimination of All Forms of Discrimination against
Persons with Disabilities. The U.S. Agency for International Development
(USAID) issued its first year self-assessment of its policy to integrate
disability concerns into all development activities of the agency.
The World Bank extended its look at economic development and the
need to incorporate strategies to serve populations with disabilities.
However, a 1991 General Accounting Office report entitled "Assistance
to Disabled Persons in Developing Countries" characterizes U.S.
assistance as "sporadic." As of 1999, this assessment remains accurate.
1. World Bank
In a recent review of poverty and disability commissioned
by the World Bank, the author concludes: "Disabled people have lower
education and income levels than the rest of the population. They
are more likely to have incomes below poverty level than the nondisabled
population, and they are less likely to have savings and other assets_
The links between poverty in disability go two ways--not only does
disability add to the risk of poverty, but conditions of poverty
add to the risk of disability." The impact of this relationship
is apparent in every development sector.
The Bank is developing and extending its products
and services to help its clients meet this development challenge.
There is a growing portfolio of Bank projects that include persons
with disabilities. Increasing the quality of such projects is a
high priority and will be accomplished through the collection of
information on good practice in development assistance for disabled
persons and distribution of this information in supports for project
design. The Bank will continue to strengthen its efforts in partnership
with clients and other organizations to build and disseminate good
practices in order to help countries achieve the goals of access,
inclusion, and poverty reduction of persons with disabilities.
NCD encourages the World Bank to ensure that all
assistance is developed and delivered in a manner that ensures full
participation and accessibility by all people with disabilities
in the geographic region served by the aid or assistance.
2. U.S. Department of State
Last year, NCD encouraged the Department of State
to take steps to ensure that all aspects of U.S. foreign policy
and assistance recognize the human rights and civil rights of all
people with disabilities, by ensuring compliance with the Architectural
Barriers Act, Section 504 of the Rehabilitation Act, and ADA in
U.S. embassies, consular offices, missions, and other U.S.-owned
or -leased property abroad. Progress in this area includes the completion
of the survey of U.S. embassies and residences and the establishment
of accessibility to these facilities as among the five priorities
for renovation and new construction. Affirmative action in hiring
practices by the Department of State has seen increases in the placement
of individuals with disabilities in positions from internships up
to Foreign Service Officers. Much more remains in the completion
of self-evaluations in all U.S. government agencies active abroad,
as mandated by Section 504 of the Rehabilitation Act.
Also last year, NCD encouraged the Department of State
and USAID to ensure that all foreign aid and assistance is developed
and delivered in a manner that ensures full participation and accessibility
by all people with disabilities and their families in the geographic
region served by the aid or assistance. The State Department has
yet to issue a policy statement to that effect, though negotiations
continue.
3. U.S. Agency for International Development
In its 1996 reports Foreign Policy and Disability
and Achieving Independence: The Challenge for the 21st Century,
NCD made several recommendations to USAID on creating a disability
development policy with measurable goals and timelines. In September
1997 USAID issued a policy promoting inclusion of people with disabilities
in all development activities.
In December 1998, USAID issued its First Annual Report
on the progress of its new policy. The report noted minimal progress
and urged the following goals, which were immediately endorsed by
then-Administrator J. Brian Atwood:
- every mission will have a specific disability plan
by the end of calendar year 1999.
- eighty percent of missions will have at least one
contact organization in the disability community.
- there will be an increase in the involvement of
people with disabilities in USAID activities as measured by self-reporting
and a survey of activities in at least three organizations.
- training on disability and sensitivity to disability
will be a part of the regular training program for leaders and
for leadership development.
- Bureau of Program and Policy Coordination/Center
for Development Information and Evaluation will commission an
evaluation of the impact of inclusion of people with disabilities
on the overall implementation of at least one of the five USAID
strategies.
On December 3, 1999, the new Administrator, J. Brady
Anderson, issued a statement affirming his support of the USAID
Disability Policy and inclusion of people with disabilities at every
level in USAID. A second-year report is being prepared.
NCD commends USAID for initiating the policy of
involving people with disabilities in development activities, and
for its earnest and ongoing evaluation of its implementation of
that policy. NCD reiterates its recommendation to the Department
of State and USAID to ensure that all foreign aid and assistance
is developed and delivered in a manner that ensures full participation
and accessibility by all people with disabilities in the geographic
region served by the aid or assistance. Latin American organizations
serving individuals with disabilities should not be left to recover
on their own current budgets when aid to assist victims of Hurricane
Mitch was distributed.
4. Organization of American States
The Inter-American Convention for the Elimination
of All Forms of Discrimination for Reasons of Disability was adopted
by a number of member states at the first plenary session of the
Twenty-Ninth Regular Session of the Organization of American States
in Guatemala on June 7, 1999. This Convention seeks to set enforceable
and achievable standards for the equitable treatment and optimal
level of independence and quality of life of persons with disabilities
throughout the hemisphere. NCD and other disability community stakeholders
reviewed and provided comments on the draft policies and the final
Convention. The adopted Convention would enter into force following
ratification by six countries and would be in force only in those
countries that ratify it. NCD encourages the Mission to the Organization
of American States to advocate that the Convention be fully implemented
by each member state. NCD encourages Congress to adopt the Convention.
All of these recommendations are to respond to the
many challenges for persons with disabilities and those not yet
disabled that increase with each conflict, each natural disaster,
and the course of poverty. Thousands in Central America still suffer
from the aftermath of Hurricane Mitch and continuing heavy rains.
The extent of devastation caused by the civil war in Kosovo and
the war in Chechnya is still unknown. And the AIDS pandemic is changing
the face of our world.
CONCLUSION
This report reflects the large and small steps
taken by America in the last year of the 20th century to ensure
that people with disabilities enjoy the full benefits of American
citizenship and prosperity. Within these pages are the incremental
events, legal actions, legislative victories and defeats, and policy
actions for one year out of more than three decades of such activities
that make up the movement for civil and human rights and access
to society for individuals with disabilities. It began as a grassroots
movement of small groups of individuals establishing their concerns
and demands for opportunities and human rights to the greater society.
That movement has taken on the sophistication of maneuvering in
the halls of legislatures and policymakers at the local, state,
and federal levels, but much of the energy, vision, and force remains
at the grassroots.
The year 2000 brings celebration. It will mark the
25th anniversary of the passage of legislation guaranteeing free
and appropriate public education for children with disabilities
now embodied in the Individuals with Disabilities Education Act
(IDEA). Also, we will mark the first decade since the enactment
of the Americans with Disabilities Act (ADA). We have much to celebrate.
These milestones present an opportunity to reinvigorate
federal enforcement of disability rights laws so that more Americans
with disabilities and their families can realize the dream of equal
access to full participation in American society. We must commit
the leadership and resources to enforce our civil and human rights
laws to make sure that protections in law are protections in fact.
NCD will do so by releasing two more parts of their "Unequal Under
the Law" series on enforcement of IDEA and the ADA.
At the same time, we should heed the words of Disabled
Peoples' International during the International Day of Disabled
Persons at the United Nations on December 3rd:
As we approach the new millennium, we must reflect
on the issues affecting the lives of one of the largest groups
among the poorest, and the serious conditions in which the majority
of people with disabilities still live, even in the most industrialized
countries today. We have raised awareness about poverty and disability,
lack of health care services, lack of education and vocational
training, and many other issues that are the consequences of lack
of accessibility and social integration. We have raised awareness
about human rights violations and the atrocities committed to
persons with disabilities in areas of civil unrest.
The year 2000 must mark the time America and the world
come to full stride in the race to provide access to opportunities
to individuals with disabilities to take part in their communities
on an equal level with others. No longer will we tolerate the immense
economic and social costs of keeping 54 million Americans, and a
significant portion of the world population, at the margins of society.
No longer will we tolerate segregated education for individuals
with disabilities or anything less than the highest quality education
for all children
This coming year we admit the reality that access
to jobs by workers or potential workers with disabilities is not
happening. The Federal Government and states must implement a groundswell
of new education and habilitation/rehabilitation strategies to ensure
that the overwhelming majority of the next generation of individuals
with disabilities participates in the prosperity of work, and not
mere survival on income maintenance programs.
This coming year we provide a continuum of long-term
care services to ensure that nursing home or other institutional
care is not the "default solution." Access and adequate support
to live where they choose is fundamental to individuals with disabilities
to exercise their civil, political, social, religious, and cultural
rights in society.
This coming year we ensure that the new world economy,
an economy already defined by technology, is also defined as an
economy with the ability to unlock the potential of individuals
with disabilities. Worldwide accessible technology is imperative.
Let this new millennium mark a realignment of commitment
from government, private sectors, and society to support the enormous
energy of the grassroots movement for civil and human rights and
access to society for individuals with disabilities.
APPENDIX
MISSION OF THE NATIONAL COUNCIL
ON DISABILITY
Overview and Purpose
NCD is an independent federal agency with 15 members
appointed by the President of the United States and confirmed by
the U.S. Senate.
The overall purpose of NCD is to promote policies,
programs, practices, and procedures that guarantee equal opportunity
for all individuals with disabilities, regardless of the nature
or severity of the disability; and to empower individuals with disabilities
to achieve economic self-sufficiency, independent living, and inclusion
and integration into all aspects of society.
Specific Duties
The current statutory mandate of NCD includes the
following:
- Reviewing and evaluating, on a continuing basis,
policies, programs, practices, and procedures concerning individuals
with disabilities conducted or assisted by federal departments
and agencies, including programs established or assisted under
the Rehabilitation Act of 1973, as amended, or under the Developmental
Disabilities Assistance and Bill of Rights Act; as well as all
statutes and regulations pertaining to federal programs that assist
such individuals with disabilities, in order to assess the effectiveness
of such policies, programs, practices, procedures, statutes, and
regulations in meeting the needs of individuals with disabilities.
- Reviewing and evaluating, on a continuing basis,
new and emerging disability policy issues affecting individuals
with disabilities at the federal, state, and local levels and
in the private sector, including the need for and coordination
of adult services, access to personal assistance services, school
reform efforts and the impact of such efforts on individuals with
disabilities, access to health care, and policies that act as
disincentives for individuals to seek and retain employment.
- Making recommendations to the President, Congress,
the secretary of education, the director of the National Institute
on Disability and Rehabilitation Research, and other officials
of federal agencies about ways to better promote equal opportunity,
economic self-sufficiency, independent living, and inclusion and
integration into all aspects of society for Americans with disabilities.
- Providing Congress, on a continuing basis, with
advice, recommendations, legislative proposals, and any additional
information that NCD or Congress deems appropriate.
- Gathering information about the implementation,
effectiveness, and impact of the Americans with Disabilities Act
of 1990 (42 U.S.C. 12101 et seq.).
- Advising the President, Congress, the commissioner
of the Rehabilitation Services Administration, the assistant secretary
for Special Education and Rehabilitative Services within the Department
of Education, and the director of the National Institute on Disability
and Rehabilitation Research on the development of the programs
to be carried out under the Rehabilitation Act of 1973, as amended.
- Providing advice to the commissioner of the Rehabilitation
Services Administration with respect to the policies and conduct
of the administration.
- Making recommendations to the director of the National
Institute on Disability and Rehabilitation Research on ways to
improve research, service, administration, and the collection,
- dissemination, and implementation of research findings
affecting persons with disabilities.
- Providing advice regarding priorities for the activities
of the Interagency Disability Coordinating Council and reviewing
the recommendations of this council for legislative and administrative
changes to ensure that such recommendations are consistent with
NCD's purpose of promoting the full integration, independence,
and productivity of individuals with disabilities.
Preparing and submitting to the President and Congress
an annual report titled National Disability Policy: A Progress
Report.
International
In 1995, NCD was designated by the Department of State
to be the U.S. government's official contact point for disability
issues. Specifically, NCD interacts with the special rapporteur
of the United Nations Commission for Social Development on disability
matters.
Consumers Served and Current Activities
While many government agencies deal with issues and
programs affecting people with disabilities, NCD is the only federal
agency charged with addressing, analyzing, and making recommendations
on issues of public policy that affect people with disabilities
regardless of age, disability type, perceived employment potential,
economic need, specific functional ability, status as a veteran,
or other individual circumstance. NCD recognizes its unique opportunity
to facilitate independent living, community integration, and employment
opportunities for people with disabilities by ensuring an informed
and coordinated approach to addressing the concerns of persons with
disabilities and eliminating barriers to their active participation
in community and family life.
NCD plays a major role in developing disability policy
in America. In fact, it was NCD that originally proposed what eventually
became the ADA. NCD's present list of key issues includes improving
personal assistance services, promoting health care reform, including
students with disabilities in high-quality programs in typical neighborhood
schools, promoting equal employment and community housing opportunities,
monitoring the implementation of ADA, improving assistive technology,
and ensuring that those persons with disabilities who are members
of minority groups fully participate in society.
Statutory History
NCD was initially established in 1978 as an advisory
board within the Department of Education (Public Law 95-602). The
Rehabilitation Act Amendments of 1984 (Public Law 98-221) transformed
NCD into an independent agency.
1
The three questions on disability were evolved from a concerted
interagency effort of the Federal Government. Quoted from Kathryn
J. Maney, Partnership and Stakeholders Branch, Census 2000, U.S.
Census Bureau, U.S. Department of Commerce.
2 Cited in the Presidential
Task Force on Employment of Adults with Disabilities, Re-Charting
the Course: If Not Now, When? Printed November 15, 1999, and prepared
with the assistance of Health Systems Research, Inc. A copy of this
report can be found at www.dol.gov.
3 See the National Council
on Disability report, National Disability Policy: A Progress Report
to the 105th Congress, February 16, 1999. This report can be found
at NCD's website www.ncd.gov.
4 A paper prepared by
the Georgetown Federal Legislation Clinic for the Consortium for
Citizens with Disabilities. The paper is titled Principles for Health
Information Privacy Legislation [no date provided]. For more information,
contact Jeff Crowley, NAPWA, at 202-898-0414.
5 See Singer, Peter,
Practical Ethics [2nd edition]. Cambridge University Press, Cambridge,
England, 1998, and also the fact sheet from the Center on Disability
and Health by Bob Griss, Washington, DC, 1999; and the New Yorker
magazine article titled "The Dangerous Philosopher" by Michael Specter,
September 6, 1999.
6 The executive summary
of Lift Every Voice: Modernizing Disability Policies and Programs
to Serve a Diverse Nation can be found at NCD's website www.ncd.gov/newsroom/publications/1999/lift_report.htm.
7 For more information,
a fact sheet, and questions and answers about the Work Incentives
Improvement Act of 1999, go to the Social Security Administration's
website at www.ssa.gov.
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