The civil rights movement for people with disabilities has made substantial progress through the enactment and implementation of several pieces of landmark legislation. UCP continues to advocate for a life without limits for people with disabilities through its policy efforts.
Below is an index of some key pieces of legislation that has created meaningful change for people with disabilities and opened doors to employment, education, housing and other access to community life.
The Affordable Care Act (ACA) of 2010, known as “the Health care reform law” (P.L. 111-148, as amended by P.L. 111-152). The ACA contains numerous provisions that greatly benefit people with disabilities. The most important changes that the ACA will bring about are: Prohibiting pre-existing condition exclusions; Eliminating annual and lifetime caps; Prohibiting discrimination based on health status and disability (prevents insurers from dropping individuals when they get sick); Requiring insurers to issue and renew insurance to employers and individuals; Expanding Medicaid eligibility to cover individuals with incomes up to 133 percent of the federal poverty line (approximately $29,000 per year for a family of four); and making a number of improvements to the Medicaid program. Learn more about the ACA’s critical provisions for people with disabilities.
Rosa’s Law (P.L. 111-256) changes the terms “mental retardation” and “mentally retarded” to “intellectual disabilities” and “intellectually disabled” in federal laws regarding education, employment and certain health programs (not including Medicaid however). The statute does not alter eligibility, services or rights under these laws nor does it compel states to change their terminology, though many states have already changed their terminology.
The Frank Melville Supportive Housing Investment Act (P.L. 111-374) makes many long-overdue reforms and improvements to the Housing and Urban Development Section 811 program. Most importantly, the law authorizes and/or incentivizes more integrated models supportive housing units by funding small set-asides of Section 811 units within affordable housing developments.
The Twenty-First Century Communications and Video Accessibility Act of 2010 (P.L 111-260) will ensure that Americans with disabilities can more fully participate in society and enjoy all that new technologies have to offer–especially Internet-based and mobile services. The new law will make it easier for people who are deaf, blind or have low vision to access the Internet, smart phones, television programming and other communications and video technologies. The law will also make sure that emergency information is accessible to individuals who are blind or have low vision. In addition, $10 million per year will be allocated from the Interstate Relay Service Fund for equipment used by individuals who are deaf-blind. For more information read What S.3304 Does For Us. The Teacher Jobs and State Fiscal Relief Act of 2010 provides $16.1 billion in Medicaid funding and $10 billion in education funding that states can receive for 2011. Enactment of the law brings significant relief to advocates from across the country that had been bracing for further budget cuts to HCBS as well as special education teacher layoffs.
The Social Security Applicants Access to Representation Act of 2010 (P.L 111-142) provides for the permanent extension of the attorney fee withholding procedures to qualified non-attorney claimant representatives for the OASDI and SSI programs.
The Mathew Shepard and James Byrd Jr. Hate Crimes Prevention Act of 2009, contained in the National Defense Reauthorization Act for FY 2010 (P.L. 111-84), see section 123 stat 2835. The hate crimes law adds disability as a protected class under the Hate Crimes Act. The American Recovery and Reinvestment Act (ARRA) of 2009 (P.L. 111-5) includes billions of dollars to protect and expand disability services and benefits. Most critical were the funding increases to Medicaid, special education, early intervention and vocational rehabilitation:
• $ 87 billion for enhanced federal match for Medicaid
• $11.3 billion increase for the Individuals with Disabilities Education Act (IDEA) State Grant
• $400 million increase for the IDEA Preschool Program
• $500 million increase for the IDEA Part C Early Intervention Program
• $540 million increase for the Vocational Rehabilitation State Grant program
• $140 million increase for Independent Living Programs
The ADA Amendments Act (ADAAA) of 2008 (P.L. 110-325). The ADAAA will restore the workplace protections of the Americans with Disabilities Act of 1990, which had been eroded by several court decisions. The law redefines “major life activities” in ways that make it easier for people with intellectual, developmental and other disabilities to qualify for protections against employment discrimination under the ADA.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (contained in P.L 110-343). The parity law mandates that commercial insurers must set mental health insurance co-payments and treatment limits equal to those for coverage of physical conditions. It also bans cost-sharing requirements that only apply to mental health or substance abuse disorder benefits.
The Prenatally and Postnatally Diagnosed Conditions Awareness Act of 2008 (P.L. 110-374). The Act introduced the provision of scientifically sound information and support services to parents receiving a positive test diagnosis for Down syndrome or other prenatally and postnatally diagnosed conditions for their children.
The Higher Education Opportunity Act of 2008 (P.L. 110-315) enacts the most significant federal efforts to date to assist students with disabilities to access and succeed in postsecondary education programs. It includes groundbreaking provisions regarding inclusion, enrichment, socialization, independent living, and person centered planning in the development of the course of study. The law also bolsters teacher training in special education.
The National Affordable Housing Trust Fund Act of 2008 (included in P.L. 110-289) will develop 1.5 million new units of rental housing affordable to very low-income and extremely low-income households. This law creates the first new federal housing production program specifically targeted to extremely low-income households since the Section 8 Housing Choice Voucher program was created in 1974.
The Over-the-Road Bus Transportation Accessibility Act of 2008 (P.L. 110-291), gives DOT an additional tool to ensure accessibility of all buses and in particular “curbside” operators who have had a poor record of meeting ADA standards.
The Federal Railroad Safety Improvement Act of 2008 (P.L. 110-432) reauthorizes Amtrak and requires Amtrak to report to Congress how they intend meet the 2010 ADA deadline to make all their stations accessible. It also authorizes funding to help Amtrak finance the accessibility improvements.
The Genetic Information Non-Discrimination Act of 2008 (P.L 110-233) will prevent employers from engaging in discriminative practices including firing, refusing to hire, or otherwise discriminating with respect to compensation, terms, conditions or privileges of employment based on genetic information. Similarly, this bill will prohibit insurance companies, from basing eligibility determinations or adjusting premiums or contributions on the basis of genetic information.
The SSI Extension for Elderly and Disabled Refugees Act of 2008 (P.L. 110-328). The law extends SSI eligibility for elderly and disabled refugees, those who have sought asylum, and other humanitarian immigrants from seven to nine years. In addition, a provision of the bill will cover those who have already lost their SSI benefits. These individuals fled persecution or torture in countries such as Iran, Russia, Iraq, Vietnam, and Somalia and now meet the criteria for SSI eligibility based on disability or age.
The Christopher and Dana Reeve Paralysis Act contained in Title XIV of the Omnibus Public Lands Management Act of 2009 (P.L. 111-11). The Christopher and Dana Reeves Paralysis Act is the first piece of comprehensive legislation aimed at improving the lives of Americans living with paralysis. It creates new coordinated research activities through the National Institutes of Health, and focuses their efforts through collaborative scientific research into a cure for paralysis. It intends to promote enhanced rehabilitation services for paralyzed Americans no matter the cause, helping develop better equipment and technology that allows them to live full and independent lives.
U.S. Troop Readiness, Veterans Care, Katrina Recovery and Iraq Accountability Appropriations Act of 2007 (P.L 110-28) which includes a raise in the minimum wage to $7.25 over 2 years. An extension until August 31, 2011 of the Work Opportunity Tax Credit (WOTC) was also included in the law.
Family Opportunity Act of 2006 (contained in P.L. 109-171, the Deficit Reduction Act) gives states the option of allowing families with annual incomes between approximately $17,050 and $60,000 for a family of four who have children with significant disabilities (those who meet the Social Security definition of disability or have the potential to meet it) to buy into Medicaid. FOA also includes authorization and funding for Family-to-Family Health Information Centers.
Improving Long-Term Care Choices Act of 2006. (contained in P.L. 109-171, the Deficit Reduction Act) gives states the option of creating home and community-based services and supports within the state Medicaid plan, without obtaining a waiver. States are permitted to allow individuals to choose to self-direct services. States must establish a more stringent eligibility standard for placement of individuals in institutions than for services in a home and community-based setting. Unfortunately, provisions added to the act before passage allows states to impose caps on services, and to establish waiting lists for the new home and community-based optional services.
Money Follows the Person Act of 2006 (contained in P.L. 109-171, the Deficit Reduction Act) provided demonstration grants to states to help individuals transition from institutions to community settings. The program provide financial incentives for states to rebalance their long term care systems and provide more cost-effective choices between institutions and the community.
Post Katrina Emergency Management Reform Act of 2006. The Act includes a provision for people with disabilities, including the appointment of a Disability Coordinator to serve as a point person for disability issues in the Department of Homeland Security and requirements for the inclusion of people with disabilities in all aspects of emergency management at all levels of government.
The Lifespan Respite Care Act of 2006 (P.L 109-442) The Act authorized $30 million in the first year and almost $300 million over five years for competitive grants for states and local bodies to increase the availability of respite care services for family caregivers of individuals with disabilities, regardless of age. The Act also promotes a coordinated system of accessible respite care at the state and federal level.
Combating Autism Act of 2006 (P.L 109-416). The Act authorizes increased funding to the National Institutes of Health and the Centers for Disease Control for education and screening and other programs for children with autism and other developmental disabilities, along with a portion to autism research.
National Institutes of Health Reform Act of 2006 restructures and limits the growth of bureaucracy at NIH and provide funds for new forms of research. The Act includes a range of changes designed to create greater transparency and accountability in how each of the 27 institutes and centers at NIH (including the National Institute on Child Health & Human Development (NICHD) allocates funding for medical research.
The Safe Accountable, Flexible, Efficient Transportation Equity Act of 2005 A Legacy for Users (SAFETEA-LU). This Act included a new program, Section 5317, authorizing $78 million in funding for transportation services for people with disabilities that goes beyond the ADA. This Act provides a higher authorization level ($112 million in FY 2006) for Section 5310, the grant program that funds local community-based organizations to provide specialized transportation services to individuals with disabilities and the elderly. The Act expired in 2009.
The Assistive Technology Act of 2004 (P.L. 108-364) reauthorized the Assistive Technology Act of 1998. Aimed at “getting more assistive technology into the hands of more consumers,” the legislation mandates state Tech Act programs to provide, with at least 60 percent of their Federal dollars, Alternative Financing and Device Loan programs and makes Demonstration Centers and Device Recycling programs discretionary. The Act authorizes a minimum level of funding to all state assistive technology programs and also authorizes resources to fund national technical assistance activities.
The Individuals with Disabilities Education Improvement Act of 2004 makes changes in Individual Education Plan (IEP) requirements, transition services and the way in which school districts identify students as having disabilities with special attention to the issue of over-identification of members of ethnic and racial minority groups. The law also encourages more early intervention referrals and makes changes in the way disciplinary actions are handled and adopts portions of the No Child Left Behind (NCLB) Act. The Act also adopts the NCLB definition of “Highly Qualified Teacher,” provides for “risk pool” programs to address high needs children with disabilities, makes changes in procedural safeguards and dispute resolution and encourages `universal design’ as defined in the Assistive Technology Act. It also has provisions for assessments of special education students under NCLB, for paperwork reduction activities and for monitoring and technical assistance to school districts and states.
The “Help America Vote Act of 2002” (HAVA) (P.L. 107-252) was passed in response to problems that occurred in the 2000 elections. The legislation impacts accessibility in every part of the voting process, including voting machines, provisional ballots, voter registration, and poll worker training. It authorized funding at the federal level for states to plan and implement voting reforms. HAVA Required a State Planning Process with representative citizen input and State plans for full disability access to voting, including one accessible voting system in every polling place by January 1, 2006.
The No Child Left Behind Act of 2001(NCLB) is a sweeping reform of the Elementary and Secondary Education Act (ESEA) which sets deadlines for states to expand the scope and frequency of student testing, revamp their accountability systems and guarantee that every teacher is qualified in their subject area. NCLB requires states to make demonstrable annual progress in raising the percentage of students proficient in reading and math, and in narrowing the test-score gap between advantaged and disadvantaged students. At the same time, the new law increases funding in several areas, including K-3 reading programs and before- and after-school programs, and provides states with greater flexibility to use federal funds. It is based on four basic principles: stronger accountability for results, increased flexibility and local control, expanded options for parents, and an emphasis on teaching methods that have been proven to work.
The Traumatic Brain Injury Act of 1996 is amended and reauthorized as Title XIII of the Children’s Health Act of 2000. The Act authorizes funding to the Centers for Disease Control and Prevention (CDC) to expand state surveillance and national education and prevention; to the National Institutes of Health to carry out applied research related to cognitive disorders and neurobehavioral consequences; and to the Health Resources and Services Administration for state capacity building grants. The Amendments of 2000 also authorize funding for state protection and advocacy services to provide legal advocacy for people with traumatic brain injuries (PATBI).
The Ticket to Work and Work Incentives Improvement Act creates options for states and individuals with disabilities to get jobs and keep their heath insurance. The goal is to also reduce individuals with disabilities’ dependence on cash benefits, such as SSI and SSDI. Specifically, the Act sought to provide health care, employment preparation, placement services, Medicaid coverage and the option of maintaining Medicare coverage while working. Title II expands availability of health care services. States are given the option of providing Medicaid coverage for people with disabilities who would qualify for SSI, if not for income, or who are working and have a “medically determinable impairment”, or allow individuals to “buy in” to Medicaid coverage.
The Workforce Investment Act of 1998 (Title III) (P.L. 105-220) amends the Wagner-Peyser Act to require that Employment Service/Job Service activities become part of the “One-Stop” system and establishes a national employment statistics initiative. It establishes a temporary “Twenty-First Century Workforce Commission” to study issues relating to the information technology workforce in the United States. The Act is based on the “One-Stop” concept where information about and access to a wide array of job training, education, and employment services is available for customers at a single neighborhood location.
The Amendments to The Individuals with Disabilities Education Act (IDEA) shifts the focus from providing children with disabilities access to an education to improving results for all children in the education system. Prior to 1997, the law did not include a regular education teacher as a required member of the Individualized Education Plan (IEP) team. The new law mandates that a regular education teacher, to the extent appropriate, participate in the development, review and revision of the IEP of the child. The law also strengthens the role of parents in educational planning and decision making on behalf of their children and required a statement of transition service be prepared and included in the IEP by age 14.
The Traumatic Brain Injury Act authorizes funding to the Health Resources and Services Administration for grants to states for the purpose of carrying out demonstration projects to improve access to health and other services regarding traumatic brain injury; to the Centers for Disease Control and Prevention to carry out projects to reduce the incidence of TBI; to the National Institutes of Health to conduct basic and applied research regarding TBI; and to the National Center for Medical Rehabilitation Research, within the National Institute for Child Health and Human Development, to conduct a national consensus conference on managing traumatic brain injury and related rehabilitation concerns.
The Technology-Related Assistance for Individuals with Disabilities Act The Act is expanded and includes funding for protection & advocacy agencies for the assistive technology program to assist individuals with disabilities in accessing assistive technology devices and assistive technology services through legal representation and self-advocacy training.
Rehabilitation Act Amendments of 1993 mandates Centers for Independent Living to provide four “independent living core services” along with any of the other optional independent living services specified in the amendments. The four core services are: information and referral, independent living skills training, peer support, and individual and systems advocacy. The Act also establishes the PAIR Program, Protection and Advocacy for Individual Rights, to protect and advocate for the legal and human rights of persons with disabilities.
The Rehabilitation Act Amendments of 1992 make several fundamental changes to the Rehabilitation Act of 1973 and the way in which rehabilitation services are provided to Americans with disabilities through the public vocational rehabilitation program. Built on the foundation of the Americans with Disabilities Act, the amendments recognize competence and choice and afford individuals with disabilities access to the services and supports they need to live, work, and meaningfully participate in community life. In accordance with the law, services must be carried out in a manner consistent with the principles of presumed ability, integration and inclusion, full participation, meaningful and informed choice, and involvement of families and natural supports. Title I contains a presumption that individuals with disabilities, including those with severe disabilities, are capable of engaging in gainful employment. Title VII establishes standards and assurances for centers for independent living and includes a statement of the independent living philosophy.
The Individuals with Disabilities Education Act (IDEA) reauthorizes The Education for Handicapped Children Act. The Act includes traumatic brain injury as a disability and requires public schools to report the number of students with TBI receiving special education and related services. IDEA also requires schools to prepare students for transition to adulthood by incorporating a statement of needed services into the student’s individualized education program (IEP) no later than age 16. Transition services are defined as “a coordinated set of activities for a student, designed within an outcome-oriented process, which promotes movement from school to post-school activities.” Post-school activities include “post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living or community participation.”
The Americans with Disabilities Act (ADA) affirms the rights of citizens with disabilities by prohibiting discrimination in employment, public services, public accommodations and services operated by private entities, and telecommunications. It is wide-ranging legislation intended to make American society accessible to people with disabilities. While the employment provisions of the ADA apply to employers of fifteen employees or more, state and local governments are covered regardless of size.
The Omnibus Budget Reconciliation Act of 1989 (OBRA 89) defines the Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT) program, a comprehensive and preventative child health program for individuals under the age of 21. OBRA requires that any medically necessary health care service be provided to an EPSDT recipient even if the service is not available under the State’s Medicaid plan for the rest of the Medicaid population.
The Technology Related Assistance for Individuals with Disabilities Act establishes grant programs to encourage the development and distribution of assistive technology for people with disabilities.
Fair Housing Amendments Act expands the Fair Housing Act of 1968 to prohibit discrimination based on disability or on familial status (presence of child under age of 18, and pregnant women); establishes new administrative enforcement mechanisms; revises and expands Justice Department jurisdiction to bring suit in Federal district courts. In connection with prohibitions on discrimination against individuals with disabilities, the Act contains design and construction accessibility provisions for certain new multifamily dwellings.
The Omnibus Budget Reconciliation Act of 1987, known as the Nursing Home Reform Act, requires states to conduct Pre-admission Screening and Resident Review (PASRR) of individuals with disabilities (mental illness, intellectual disabilities, developmental disabilities) prior to admission to a nursing facility to determine if they actually need nursing facility level of care, even if the individual is not Medicaid eligible. PASRR requires that individuals with disabilities be provided specialized services while in a nursing facility. If nursing facility level of care is not required but an individual requires specialized services, the state must provide for or arrange for the specialized services in an appropriate setting.
The Education for Handicapped Children Act is expanded to include Part H, a formula grant program, to assist states in developing early intervention services for infants and toddlers with disabilities.
The Employment Opportunities for Disabled Americans Act makes permanent the work incentives provision, Sections 1619 (a) and 1619 (b), of the Social Security Act, authorizing special SSI benefits and continued Medicaid coverage for people with disabilities who are working, but whose income exceeds “substantial gainful activity” levels. Medicaid coverage is extended to people with disabilities who may lose SSI or Section 1619(a) benefits due to excess earnings, but who are unable to afford health care coverage equal to coverage under Medicaid.
Protection and Advocacy for Individuals with Mental Illness (PAIMI), establishes a formula grant program for statewide mental health advocacy services to be operated directly by or through contract with the state protection and advocacy agency to protect and advocate for the rights of people with mental illness and investigate incidents of abuse and neglect.
The Rehabilitation Act Amendments establishes the Client Assistance Program (CAP), a formula grant program for states designed to inform individuals with disabilities who are receiving rehabilitation services how to access available benefits and ensure protection of individual rights through legal, administrative or other remedies.
The Tax Equity and Fiscal Responsibility Act (TEFRA) allows states to cover home care services under Medicaid for children with disabilities, even when family income and resources exceeded that of the state’s financial eligibility standards.
The Omnibus Budget Reconciliation Act authorizes Medicaid to waive certain federal requirements so that states can provide personal care and other home and community-based services to individuals who would otherwise receive care in an institutional setting.
The Education for Handicapped Children Act mandates that public schools provide students with disabilities a “free appropriate public education” (FAPE) in the “least restrictive environment.” The Act requires educators to develop an “individual education plan” (IEP) for each child receiving special education services. Part B of the Act provides federal financial assistance to states and local education agencies to meet the mandates.
The Developmental Disabilities Assistance and Bill of Rights Act reauthorizes the Developmental Disabilities Services and Facilities Construction Amendments of 1970 and provides formula grants to state-based Developmental Disabilities Councils. The Act also authorizes the University Affiliated Facilities and establishes state protection and advocacy systems to protect the rights of individuals with developmental disabilities.
The Housing and Community Development Act of 1974 creates the Community Development Block Grant (CDBG) program, authorizing funds for removal of architectural barriers and in constructing public facilities. Urban areas are required to prepare a Housing Assistance Plan that reflects the needs of individuals with disabilities.
The Rehabilitation Act is rewritten providing stronger emphasis on people with severe disabilities. The Act requires vocational rehabilitation agencies to develop an “individualized written rehabilitation program” (IWRP) with each individual receiving services. Section 504 of the Act protects individuals with disabilities from discrimination in all federally assisted programs and activities. Sections 501 and 503 protect people with disabilities from employment discrimination by federal agencies or federal contractors.
The Social Security Act of 1972 authorizes the Supplemental Security Income (SSI) program, a consolidated, federally administered cash benefits program for needy individuals and couples who are aged, blind, or have a disability. Children with disabilities under the age of 18, including children who are blind, become eligible for benefits provided their disabilities are comparable in severity to adult recipients.
The Developmental Disabilities Services and Facilities Construction Amendments of 1970 gave states responsibility for planning and implementing comprehensive services for people with severe disabilities, calling for Developmental Disabilities Councils in each state to plan and coordinate activities.
The Social Security Act of 1965 establishes the Medicare and Medicaid programs under Titles XVIII and Title XIX. The initial purpose of Title XIX was to improve access to and the quality of medical care for all low-income people and did not provide services solely based on disability. States were required to provide certain services to individuals who were categorically needy; states could offer optional services and choose to cover individuals who were medically needy.
The Social Security Amendments of 1956 creates the Social Security Disability Insurance (SSDI) program for disabled workers aged 50 to 64.
The Vocational Rehabilitation Act is revised, establishing a system of state vocational rehabilitation agencies.
Social Security Act Amendments creates a public assistance program for people who are “totally and permanently disabled.” Each state determines eligibility standards and assistance levels in accordance with the Act, which provides for federal financial assistance.
Social Security Act creates a national insurance system for people who are elderly; establishes a federal-state unemployment insurance program; grants aid to states on a matching basis for dependent mothers and children, people with disabilities, and people who are blind; and supports public health services.
The Fess-Smith Civilian Vocational Rehabilitation Act creates a vocational rehabilitation program for civilians with disabilities.
The Smith-Sear Veterans Vocational Rehabilitation Act (also known as the Soldier’s Rehabilitation Act) establishes a federal vocational rehabilitation program for soldiers with disabilities.