National Council on Disability

Budget Justification

Fiscal Year 2023

National Council on Disability (202) 272-2004 Voice

1331 F Street, NW, Suite 850 (202) 272-2022 Fax

Washington, DC 20004

www.ncd.gov
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INTRODUCTION FROM THE CHAIRMAN

The National Council on Disability (referred to herein as the “Council”) is an independent, 

nonpartisan federal agency that provides the President, his Administration, the U.S. 

Congress and the heads of federal agencies with timely analysis and recommendations to 

advise policy development, revision, implementation, and enforcement efforts to enhance 

the quality of life for all Americans with disabilities and their families. The Council’s purview 

is illimitable, so our research pedantically considers the diverse needs of people across all 

types of disabilities throughout the United States and in our territories.

The Council presents this budget justification for fiscal year 2023, requesting a total budget 

authority of $3,905,325. These resources will be applied to the furtherance of our mission 

to advise the President, Congress, and other federal agencies regarding federal policies 

and the impact on people with disabilities.

As we present this year’s budget justification, as it was during our prior year submission, 

the challenges affecting people with disabilities throughout the country and in our territories 

remain formidable and exacerbated due to the global pandemic – a pandemic that has 

disproportionately affected the health and well-being of persons with disabilities, who 

remain vulnerable to the extreme effects of the virus given decades of neglect in 

meaningfully addressing the chronic and profound health disparities between persons with 

disabilities and those without, and decades of neglect in addressing systemic and 

pervasive barriers to accessible healthcare.

It is for those reasons that the Council’s abiding focus during Fiscal Year 2023 will remain

in large part on addressing healthcare barriers and the breadth of issues associated 

therewith. And in view of Executive Order 13990, “Protecting Public Health and the 

Environment and Restoring Science to Tackle the Climate Crisis”; and Executive Order 

14030, “Climate-Related Financial Risk” which directed agencies to take a whole-ofGovernment approach to increase resilience to the impacts of climate change and protect 

public health, NCD will focus its annual, statutorily mandated, Progress Report on 

addressing the impacts of climate change on the lives of people with disabilities. 
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Throughout all the work we undertake, we will endeavor to work closely and collaboratively 

with federal partners and legislators on commitments expressed in the President’s 

disability plan, even as we advise for greater efforts. We will continue to educate 

policymakers on the incompatibility of arcane disability programs and laws, like 

subminimum wages paid to people with disabilities, to modernize national disability goals 

and policies.

Our budget submission for Fiscal Year 2023 facilitates the Council’s ability to address 

those issues and to serve as the federal voice of people with disabilities.

Respectfully,

Andrés J. Gallegos

Chairman
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TABLE OF CONTENTS

AGENCY OVERVIEW .......................................................................5

COUNCIL STRUCTURE ....................................................................7

ORGANIZATIONAL STRUCTURE.......................................................9

PERFORMANCE.............................................................................10

OBJECTIVES, STRATEGIC RESULTS & PLANNED ACTIVITIES............11

Goal 1 – Develop new disability policy recommendations with a 

particular emphasis on issues of healthcare equity, employment, 

and the inclusion of traditionally underserved communities.

Goal 2 – Review and analyze both proposed and existing federal 

policies’ impact on people with disabilities. 

Goal 3 – Engage policymakers of both the Administration and 

Congress and respond to their requests for assistance 

accurately and efficiently.

Goal 4 – Gather information from subject matter experts and 

members of the disability community both of Washington, DC, 

and nationally, to help inform policymakers’ work.

Goal 5 – Enhance agency operational and programmatic internal 

controls to effectively service execution of statutory duties.

Goal 6 – Recruit, retain, and develop a highly qualified 

professional staff in order to effectively service execution of 

statutory duties.

CROSS-AGENCY COLLABORATION..................................................49

BUDGET..........................................................................................52

APPENDIX A. COST DISCUSSION.......................................................53

APPENDIX B. ANALYSIS OF RESOURCES...........................................54

APPENDIX C. ORGANIZATIONAL CHART.............................................62

APPENDIX D. MANAGEMENT PRIORITIES AND CHALLENGES..............63
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AGENCY OVERVIEW

Agency Mission

The mission of the National Council on Disability is to be a trusted advisor regarding 

the impact of federal policies on the lives of people with disabilities to the President, 

U.S. Congress, and other federal agencies, by developing policy recommendations; 

reviewing existing policies’ effects on the quality of life of people with disabilities; and 

by engaging policymakers and responding to their requests for assistance accurately, 

efficiently and without bias.

The National Council on Disability (NCD) is an independent, nonpartisan federal agency 

that provides the Administration and the U.S. Congress with timely analysis and 

recommendations to advise policy development, revision, implementation, and 

enforcement efforts as they have impact on the lives of people with disabilities across 

America. Our purview is not limited to a set policy area or subgroup of disabled Americans, 

so our advice is not siloed at the exclusion of others’ interests. The Council provides

advice that thoughtfully considers the diverse needs of our core constituency, which varies 

greatly by type and severity of disability. NCD is critical in preserving and strengthening the 

impact of the Americans with Disabilities Act (ADA) in our nation’s policies and programs. 

The Council is inextricably intertwined with the ADA and its history. 

First established as an advisory council within the Department of Health, Education, and 

Welfare in 1978, and then placed within the Department of Education, NCD became an 

independent federal agency in 1984. The Rehabilitation Act Amendments of 1984 (Public 

Law 98-221) transformed the National Council on Disability into an independent agency 

and required NCD to provide advice to Congress and the Administration. In 1986, NCD 

recommended enactment of an Americans with Disabilities Act (ADA) and drafted the first 

version of the bill which was introduced in the House and Senate in 1988. Since enactment 

of the ADA in 1990, NCD has continued to play a leading role in crafting disability policy, 

and advising the President, Congress and other federal agencies on disability policies, 

programs, and practices. Changes were also made to the Council’s statutory mandate by 

the Rehabilitation Act Amendments of 1992 and 1998, the Education of the Deaf Act 
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Technical Amendments of 1993, and most recently, by the Workforce Innovation 

Opportunity Act (WIOA) of 2014 (Public Law 113-128).

Upon its establishment as an independent agency, Congress charged NCD with a new 

mandate to review all existing federal policies and programs. Two years later, the Council 

delivered on that charge with its path breaking report, Toward Independence, which called 

for enactment of a federal disability civil rights law. The Council later offered the first draft 

of that civil rights law in 1988. After President George H.W. Bush signed the ADA into law,

the mission of the Council was amended to reflect the national disability policy goals now 

enshrined in the ADA. 

NCD serves a unique role among federal agencies because its mission reflects the 

breadth and diversity of the disability community itself. In its authorizing statute, the 

Council’s duties are extensive and belie the Council’s limited financial and human 

resources. In FY 2021, the Council had a $3.75 million annual appropriation to support its 

mission of gathering information and reviewing and evaluating on a continuing basis all 

“policies, programs, practices, and procedures concerning individuals with disabilities 

conducted or assisted by federal departments and agencies...,” and “all statutes and 

regulations pertaining to federal programs which assist such individuals with disabilities...” 
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COUNCIL STRUCTURE

The governing body of the Council is comprised of nine members (five presidential and 

four congressional appointees), including a Chair, whom the President designates; and a 

Vice-Chair, appointed by the Chair. Congressional appointees are appointed by each of 

the following: the Speaker of the House, the House Minority Leader, the Senate Majority 

Leader, and the Senate Minority Leader. Each council member serves a three-year term, 

with the possibility of a second term. Council members serve until a replacement 

appointment occurs; therefore, terms can extend beyond six years. 

Council members are special government employees (SGE) who live across the country 

and are restricted to serve a maximum of 130 days per year in a part-time capacity. Each

appointee brings a unique perspective informed by varied personal and professional 

experiences. Council members are people with disabilities, disability service providers, 

parents or family members of people with disabilities, or other people who have substantial 

knowledge of or experience with disability policies and programs. Council members are 

appointed to represent people with disabilities, national organizations concerned with 

disabilities, providers and administrators of services to people with disabilities, people 

engaged in conducting medical or scientific research related to disabilities, business 

concerns and labor organizations. Sixty-seven percent of the current council members are 

people with disabilities and / or parents of children with disabilities. Eighty-two percent of 

full-time staff are people with disabilities and / or parents of children with disabilities.

Every year, the Council and staff propose, and advance new policy projects based upon 

current events, national trends, respective areas of expertise, suggestions from 

policymakers, and anticipated legislative reauthorizations or regulatory activities. The 

Council deliberates and ultimately votes on upcoming priorities. In response to the vote, 

and in consideration of the Council’s budget, statements of work are developed to begin 

the process of undertaking the research approved by the Council. 

To fulfill the mission of the National Council on Disability, the Chair appoints members to 

advise on commissioned policy priorities within a committee structure. These committees 

are comprised of no more than four council members and a full-time professional staff 

member who manages the work of the project, drafts portions of policy advice based upon 

council members’ discussions and research, and who acts as a Contract Officer 
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Representative (COR), or Agreements Coordinator, for any supplemental data provided to 

a project from a contracted researcher. Once each policy project yields a final draft 

product, it is shared with the entire Council for review, discussion, refinement, and 

ultimately, a vote of approval by council members. Once approved, professional staff work 

with a professional editor on final edits and report layout before dissemination of the final 

report, including its policy recommendations to the President, Congress, other Federal 

agencies and all interested parties. 

When opportunities or circumstances warrant immediate response to proposed legislation 

or regulations, including when the Council is requested directly by policymakers for such 

input, the Council provides brief, nimble responses based upon the Council’s existing body 

of research and recommendations to ensure the needs of people with disabilities are 

discussed and included present in new legislation and policies.

The Council’s vote is required to approve the Council’s annual budget and spending plan

as well as all published research, papers, and formal opinions published in the name of the 

Council Members, except that the requirement of a vote for changes to the budget may be 

suspended consistent with the powers of the Executive Committee. Professional staff 

provides a status of funds and updates on policy projects to the Executive Committee

approximately monthly. The Council is provided updates no less than once per quarter as 

part of the quarterly business meetings of the Council.

In addition to projects that the Council votes to commence during the budget cycle, we 

continue to disseminate and advise on past work and meet with policymakers to ensure 

that our recommendations are known and understood. 

NCD is a respected resource within the Federal Government and beyond on all disability 

policy issues.
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ORGANIZATIONAL STRUCTURE

The bylaws of the Council delegate the power, authority, and responsibility to the executive 

director to supervise and direct the day-to-day business and management of the Council, 

including decision-making processes and allocation of staff resources to assist 

presidentially and congressionally appointed members in fulfilling their duty to advise on 

policy priorities that will improve the lives of all Americans with disabilities. 

A small, dedicated full-time staff located in Washington, D.C., support the work of the 

council members. The executive director is responsible for hiring technical and 

professional employees to assist the Council to carry out its duties. Such appointments 

shall be made in accordance with the provisions of Title 5 of the United States Code, 

including chapters 51 and 53; all applicable laws and regulations. (Appendix C, 

Organizational Chart)

The executive director has oversight authority and is accountable for assignment of staff 

duties; training and provision for the human resources and needs of the staff including 

reasonable accommodation, establishing staff performance standards and performing 

regular evaluations to ensure that they are met, the maintenance of staff and the member 

office policy manuals to govern the performance of all employees, supervising their 

compliance with all applicable laws and regulations, and ensuring compliance with all 

applicable legislative and regulatory requirements.

The duties of professional and contract staff include: 

• Analyzing federal laws, regulations, programs, policies, and case law precedent; and 

proposing and developing policy positions that have a national, state and international 

impact on the lives of people with disabilities;

• Monitoring congressional activity on issues critical to the disability community and 

cultivating and maintaining effective working relationships with stakeholders at the 

federal, state, and local levels; and

• Providing critical staff support and monitoring the Council's finance and accounting, 

information technology, and human resources management, as well as partnering with 

the policy and outreach teams to build strategic relationships that are critical to the 

Council's work.
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PERFORMANCE

STRATEGIC FRAMEWORK, FISCAL YEAR 2022 – 2026

The Council’s budget submission is submitted for the same fiscal year of its new five-year 

strategic plan. The updated plan seeks to reflect goals and objectives approved by the 

Office of Management and Budget and prioritized by the Council’s constituency to focus on 

the most pressing needs of the disability community in furtherance of the goals of the 

Americans with Disabilities Act; optimize operational efficiency and accountability; and 

pursue mission-critical activities consistent with the Administration’s priorities and 

directives. 

The Council evaluates its progress towards fulfillment of its goals and objectives by 

conducting program evaluations prior to implementation – formative needs evaluation, 

periodically and ad hoc; formative process evaluation; and at the end of each, summative 

outcome and impact evaluation.
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OBJECTIVES, STRATEGIC RESULTS AND PLANNED ACTIVITIES

The National Council on Disability has a unique mission among federal agencies as it is 

charged with reviewing all programs and policies across the Federal Government, not 

merely one aspect of policy affecting people across all types of disabilities or all policy 

areas affecting only one subpopulation of people with disabilities. With that unique and farreaching mission in mind, the Council’s strategic goals for FY 2022 – 2026 include the 

following:

• Goal 1 – Develop new disability policy recommendations with a particular emphasis 

on issues of healthcare equity, employment, and the inclusion of traditionally 

underserved communities.

• Goal 2 – Review and analyze both proposed and existing federal policies’ impact on 

people with disabilities.

• Goal 3 – Engage policymakers of both the Administration and Congress and 

respond to their requests for assistance accurately and efficiently.

• Goal 4 – Gather information from subject matter experts and members of the 

disability community both of Washington, DC, and nationally, to help inform 

policymakers’ work.

• Goal 5 – Enhance agency operational and programmatic internal controls to 

effectively service execution of statutory duties.

• Goal 6 – Recruit, retain, and develop a highly qualified professional staff in order to 

effectively service execution of statutory duties.
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GOAL 1

OBJECTIVES, STRATEGIC RESULTS AND PLANNED ACTIVITIES

GOAL 1: Develop new disability policy recommendations with a particular emphasis 

on issues of healthcare equity, employment, and the inclusion of traditionally 

underserved communities.

1. Develop recommendations that help foster healthcare equity and accessibility for 

people with disabilities in a manner consistent with self-determination through a series 

of health equity legislative proposals or a combination of executive, administrative, or 

legislative action.

2. Develop recommendations that enhance equal opportunity for people with disabilities to 

achieve economic self-sufficiency through the elimination of the Medicaid benefits cliff 

and a national Medicaid buy-in program. 

3. Provide recommendations that promote job growth for people with disabilities through 

the Small Business Administration 8(a) Business Development Program.

4. Develop recommendations to address the concerns and issues uniquely associated 

with people with disabilities within tribal communities.

5. Address the disparate treatment of citizens with disabilities residing in Puerto Rico (and 

disabled citizens in other U.S. territories) under certain federal programs in contrast to 

their counterparts residing on the mainland.
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In furtherance of Goal 1, the Council accomplished the following in FY 2021:

• Centralized accommodations for employees with disabilities – NCD provided

recommendations to both Congress and the Executive Branch aimed at fulfilling the

Federal Government’s reasonable accommodation responsibilities, in relation to the

Computer/Electronic Accommodations Program (CAP) in specific (housed under the

Department of Defense and used throughout other federal agencies). Specifically,

recommendations were made concerning funding levels and CAP’s potential

involvement with the Chief Information Officer’s Council as a means of tracking

emerging accommodations technology. NCD also expressed strong concern about the

provision of CAP’s services being cut to other federal agencies, a long-standing

accommodation still needed by many small agencies.

• Professional associations responded, accreditation standards – Following our 

recommendations to the Liaison Committee on Medical Education (LCME) that it revise 

its national medical school curriculum standards to include mandatory disability 

competency training for all medical students in the U.S., in response to the available 

data that indicate people with disabilities face difficulties in finding providers that are 

adequately trained or able to provide proper treatment to patients with disabilities, in 

Fiscal Year 2020, the LCME made modest revisions to its accreditation standards but 

also took the opportunity to revise its standards to now require that U.S. medical 

schools draft and implement nondiscrimination policies, including with respect to people 

with disabilities.

• Advised the US Department of Health and Human Services on assisted suicide, 

medical futility and quality-adjusted life years (QALYS) – We provided 

recommendations to HHS to address denial of, limiting access to, and inequitable 

access to necessary medical care, for people with disabilities and chronic conditions 

based on unjustified bases and/or disability bias.

• Advised Congressional Budget Office (CBO) about pitfalls of using QALY to 

estimate cost – In April 2021, NCD wrote to CBO to recommend that CBO use 

alternate methods to estimate the budgetary effects of any future drug pricing 

proposals. Our recommendation was based on the discriminatory design of the QALY 

method, resulting in restricting access to life-sustaining and lifesaving drugs and 
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treatments, and in recognition of the concerns that led to the prohibition of its use under 

the Affordable Care Act. It is significantly more difficult, if not impossible, to use QALYs 

in a nondiscriminatory manner. CBO responded immediately and NCD’s Chairman and 

staff met in May 2021. We provided a summary of our concerns based on our report 

and CBO’s expressed interest in exploring alternatives to the QALY when conducting 

future cost estimates of drug pricing bills.

• Advised Centers for Medicare and Medicaid, QALYs, organ transplants – We 

provided analysis concerning the ability of people with disabilities to access necessary 

healthcare and lifesaving treatments and identified actions that federal agencies can 

make to ensure nondiscrimination. NCD provided a response to a CMS published a 

Request for Information (RFI) on Health and Safety Requirements for Transplant 

Programs, Organ Procurement Organizations, and End-Stage Renal Disease Facilities. 

The RFI highlighted NCD’s report on organ transplant discrimination and asked for 

comments on the discrimination experienced by people with disabilities throughout the 

organ transplantation process.

• Advised Maryland legislature, assisted suicide – We shared the findings of our The 

Dangers of Assisted Suicide report with the Maryland legislature as they considered 

legislation that would legalize assisted suicide in the state.

• Advised Congress and the Computer/Electronic Accommodations Program 

(CAP), Reasonable accommodations for federal employees with disabilities – We 

shared our findings concerning the most efficient means of providing reasonable 

accommodations to federal employees with disabilities, including with respect to 

funding levels and emerging technologies.

• Advised the Chief Information Officer (CIO) Council, Computer/Electronic 

Accommodations Program (CAP) – We recommended to the CIO Council that they 

appoint a CAP representative to their Council to ensure the CIO Council is keeping 

pace with emerging accommodations technologies for federal employees with 

disabilities.

• Tribal coordination EO/ tribal lands toolkit – In FY21, NCD signed a memorandum 

of understanding (MOU) with the National Indian Coalition on Aging (NICOA) to update 
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NCD’s 2003 report “Understanding Disabilities and American Indian and Alaska Native 

Communities: Toolkit Guide.” The final revisions of the toolkit were submitted to NCD in 

December 2021 and NCD is reviewing the final product and will coordinate with NICOA 

for dissemination and training of its content. The Administration has reinvigorated a 

prior executive order that requires executive federal agencies confer with tribal 

communities to ensure inclusion of concerns and issues uniquely associated with tribal 

communities. NCD is working with NICOA and other entities to identify Native American 

stakeholders with disabilities with whom to confer on future NCD projects.

• Advised Senate leadership, COVID-19 legislative package – We advised the 

Senate to include provisions in its COVID-19 legislative package that promote access 

to critical home-and-community-based service systems for people with disabilities and 

those who support them during the COVID-19 outbreak.

• Advised the Department of Justice (DOJ), voting concerns – We urged the 

Department of Justice to timely remind State Board of Election Administrators of their 

responsibilities under federal law in light of changes being made due to the COVID-19 

pandemic -- that election options made available to voters during the pandemic must 

be accessible to people with disabilities.

• Advised Health & Human Services (HHS) Office of Civil Rights (OCR), COVID-19 –

We requested that the Office for Civil Rights quickly issue a notice to physicians and 

hospitals specifying the applicability of non-discrimination requirements of the 

Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and 

Section 1557 of the Affordable Care Act in making COVID-19 treatment decisions.

• Advised the White House, taskforce interpreters – We requested that the White 

House Coronavirus Taskforce use sign language interpreters during its public briefings, 

as millions of people in the U.S. who are Deaf or hard of hearing use American Sign 

Language to obtain the vital information the Taskforce provides.

• Advised Center for Medicaid Services (CMS), COVID-19 – We cautioned States’ 

usage of CMS blanket waiver’s pertaining to long-term care facilities, skilled nursing 

facilities and/or nursing facilities. We noted that CMS blanket waivers are a valuable 

tool and have been used to improve healthcare readiness and outcomes in times of 
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disaster, but that certain provisions of these waivers can also create upheaval and 

unnecessary institutionalization for persons with disabilities.

• Responded to Health and Human Services (HHS) Office of Civil Rights (OCR), 

civil rights, HIPAA, and COVID-19 – We recommended protocols for civil rights 

enforcement for healthcare discrimination against people with disabilities during the 

pandemic.

• Advised the National Governors Association (NGA), COVID-19 – We urged NGA to 

remind governors that their state crisis response protocols for administering healthcare 

and life-saving medical care to people with disabilities during the pandemic must 

adhere to federal non-discrimination laws.

• Advised Center for Medicaid Services (CMS), direct service providers – We 

requested CMS provide guidance to states on the availability of Medicaid waivers to 

retain Direct Service Providers during the COVID-19 pandemic.

• Advised congressional leadership, home- and community-based services 

(HCBS) inclusion in COVID-19 Package – We advised Congressional Leadership 

that the subsequent COVID-19 legislative package be inclusive of several critical 

home-and-community-based service system provisions that will save potentially tens of 

thousands of lives of people with disabilities and those who support them during the 

COVID-19 outbreak.

• Research and report commissioned for the Council’s annual progress report in 

support of the Administration’s priorities to focus on COVID-19 – NCD released a

report that examines the broadscale impact of COVID-19 on the lives of people with 

disabilities in healthcare, direct care services, employment, education, group homes, 

communications, transportation, and mental health. NCD also addressed 

intersectionality of race and disability in the report. 

• Issued a report in response to the need for accessible medical diagnostic 

equipment – The report identifies and examines healthcare settings or systems (i.e., 

hospitals, preferred provider organizations or networks owned by hospitals, and 

physician groups) that widely utilize accessible medical equipment and contains

information on both its qualitative and quantitative impacts on the healthcare settings 
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and the patients. It also examines two new initiatives by healthcare systems/hospitals 

aimed at increasing accessible medical equipment in their provider’s offices. The report 

also includes information on any savings that have been achieved by states that have 

enacted safe patient handling laws. The report was released on May 19th, 2021. NCD 

met with the leadership of the Agency for Healthcare Research and Quality to discuss a 

letter from NCD that recommends that AHRQ conduct a biannual survey of medical 

facilities’ accessible medical diagnostic equipment. NCD corresponded with and met 

with DOJ officials to recommend that the Department of Justice move forward with the 

regulatory process to ensure that healthcare facilities have accessible medical 

diagnostic equipment. NCD met with the leadership and staff of the Office of the 

National Coordinator for Health Information Technology (ONC) to discuss ways to 

capture disability status in electronic health records. In January, ONC informed NCD 

that it released “Draft United States Core Data for Interoperability Version 3”, which 

includes “Disability Status” as one of the new data elements being proposed to 

advance health IT for improved care, reduced inequities, and stronger public health 

reporting.

• Commissioned a study on states’ use of Quality Adjusted Life Year (QALY) 

based cost-effectiveness reports to inform Medicaid coverage for prescription 

drugs – The purpose of this report is to follow up on NCD’s report, Quality Adjusted 

Life years and the Devaluation of Life with a Disability, with regard to State’s use of 

ICER’s QALY-based cost-effectiveness reports or international drug prices to inform 

coverage of prescription drugs in their Medicaid programs. It will describe how many 

States are using ICER QALY-based cost studies or referencing international prices; 

how this information is being used, e.g., as a benchmark or cost-threshold, and if this 

has resulted in restricted access to prescription drugs. The report will gather evidence 

that that shows whether reliance on this information is delaying access to or denial of 

coverage of necessary drugs and treatments for chronic illnesses. It will also describe 

methodological alternatives to QALYs that consider patient values and preferences. It 

will make findings and make specific recommendations to Congress, federal 

government, and states to address the findings. This work will be completed in FY22.

• Began research on the need for a successful national home- and communitybased services system with permanent and adequate funding that supports a strong 
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direct care workforce and ensures states have the capacity to provide appropriate 

services to people in the community before, during and after health emergencies. It will 

make findings and recommendations to Congress and executive agencies, particularly 

the Department of Health and Human Services (HHS) and the Department of Housing 

and Urban Development (HUD), and state Medicaid agencies, and further develop the

information in NCD’s report, Deinstitutionalization: Unfinished Business (2012); NCD 

communications with Congress and the Department of Health and Human Services 

regarding institutionalization and HCBS; and the 2021 Progress Report: The 

Broadscale Impacts of Covid-19 on People with Disabilities (upcoming release 2021). 

Finally, it will propose a comprehensive plan to increase community living options with 

necessary services and supports.

• Advised the National Institute on Minority Health and Health Disparities and the 

Agency for Healthcare Research and Quality, “health disparities population”-

NCD sent a letter to the National Institute on Minority Health and Health Disparities 

(NIMHD) and the Agency for Healthcare Research and Quality (AHRQ), providing a 

summary of decades of health research on people with disabilities in support of the 

designation of people with disabilities as a “health disparity population.”

• NCD provided information to CMS’s Request for Information (RFI) on health and

safety requirements for transplant programs, organ procurement organizations, 

and end-stage renal disease facilities –The RFI highlighted NCD’s report on organ 

transplant discrimination and asked for comments on the discrimination experienced by 

people with disabilities throughout the organ transplantation process.

In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:

• Release of NCD’s Health Equity Framework – Based on research and policy 

analysis conducted in Fiscal Year 2021, in February 2022, NCD released its health 

equity framework for people with disabilities. The framework, among other 

recommendations, focuses on the four primary policy recommendations of 1) 

designating people with disabilities as a Special Medically Underserved Population 

legislatively and/or designating people with disabilities as a Health Disparities 
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Population administratively, 2) accessible medical and dental equipment, 3) improved 

data, and 4) disability clinical care and competency training of medical professionals.

• Implications of climate change on people with disabilities – In view of Executive 

Order 13990, “Protecting Public Health and the Environment and Restoring Science to 

Tackle the Climate Crisis;” and Executive Order 14030, “Climate-Related Financial 

Risk” which directed agencies to take a whole-of-Government approach to increase 

resilience to the impacts of climate change and protect public health, NCD will focus its 

annual, statutorily mandated, tool kit in 2022 on addressing the impacts of climate 

change on the lives of people with disabilities. It will seek to examine how many recent 

natural disasters and record high temperatures have resulted in lengthy or rolling power 

outages, the impact of which have imperiled the lives of people with disabilities by a 

lack of access to consistent electricity for those who rely upon it for electric-powered 

health devices for mobility, breathing, communicating, or response to medical fragility. 

It will also evaluate the local, state, and federal response to people with disabilities’ 

needs in such instances, and how communities rebuild after sustaining damage and 

whether the community is made inclusive during those rebuilding efforts, to help ensure 

full participation and access for people with disabilities. 

• Follow-Up to our Medicaid Oral Health Project – The Council has made impressive 

strides in the area of oral healthcare equity for people with intellectual and 

developmental disabilities and will continue its focus in this area in Fiscal Year 2022 

with a project focused on the benefits of an increase in the reimbursement rate from 

Medicaid to ensure dentists that they will be appropriately compensated and 

incentivized in treating patients with intellectual and developmental disabilities.

• Tax policy and employee misclassification – NCD will examine the legal 

implications of the IRS’ longstanding categorical exclusion of people with disabilities 

working in congregate settings from the meaning of “employment” under tax policy. 

Other federal agencies and many state unemployment statutes have adopted the IRS’ 

exclusion to determine that people with disabilities working in congregate settings are 

not “employees” and therefore not entitled to employment protections or benefits. NCD 

will use the findings from this policy project to assist the IRS in considering 

amendments to its policies to make them consistent with current disability policy.
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• Federal employment programs – NCD will inventory federal disability employment 

programs to determine the number of programs and their effectiveness in helping 

people with disabilities gain competitive integrated employment, with the goal of making 

recommendations for improvement.

• Voting Rights – NCD is in the process of collecting data on States’ voting rights laws 

that may impact a voter with a disability’s ability to cast a vote. The data collected will 

be used to draft correspondence highlighting disability stakeholder concerns.

• NCD will release its Tribal coordination EO/ tribal lands toolkit – NCD, in 

collaboration with the National Indian Coalition on Aging (NICOA), will release its 

updated disability policy toolkit for American Indian and Alaska Native Communities. 

GOAL 2

OBJECTIVES, STRATEGIC RESULTS and PLANNED ACTIVITIES

GOAL 2: Provide perspectives and analysis on existing federal policies’ impact on 

people with disabilities.

1. Provide findings and recommendations regarding disaster and healthcare emergency 

relief planning and responses with respect to the rights of people with disabilities.

2. Provide recommendations concerning proposed policies of healthcare equity.

3. Provide recommendations concerning proposed policies of pandemic preparedness,

including how home and community-based services HCBS have been impacted.

4. Provide analysis and recommendations concerning economic opportunities for people 

with disabilities.

5. Provide recommendations concerning an increase in the oral health Medicaid 

reimbursement rate for people with intellectual and developmental disabilities as a 

means of saving costs long-term.

6. Provide recommendations concerning civil rights enforcement. 
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In addition to the projects that the Council approves for commencement of work and 

dissemination in Fiscal Year 2023, the Council continues to disseminate its work and meet 

with policymakers regarding its existing reports and position letters that address proposed 

and existing legislation. For example, in FY21, due to high profile pop culture news, some 

policymakers contacted NCD out of concern about the legal implications of guardianship 

and/or conservatorship proceedings on people with disabilities, and NCD responded to 

their queries on the basis of our research findings and recommendations in our 2018 

Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination for 

People with Disabilities report. As another example, as Congress has continued to pursue 

the goal of lowering prescription drug prices, our 2019 report, Quality-Adjusted Life Years 

and the Devaluation of Life with a Disability, which outlines concerns with the use of 

QALY-based value assessments, have routinely been brought to policymakers’ attention. 

Additionally, we weigh in with our federal colleagues on disability-related regulatory 

proposals that impact people with disabilities when they arise; and with congressional staff 

on general legislative proposals that impact people with disabilities, as well as disabilityspecific legislation that is introduced.

In furtherance of Goal 2, the Council accomplished the following in FY 2021:

• Released AbilityOne report – This report took an in-depth look at the AbilityOne

Commission to determine whether it promotes Congress’ goal of improving 

employment opportunities for people who are blind or have significant disabilities and 

presented its findings and recommendations to disability stakeholders at an 898 Panel 

Briefing on December 4, 2020. The 898 panel was created out of Section 898 of the 

National Defense Authorization Act for Fiscal Year 2017. It directed the Secretary of 

Defense to establish a “Panel on Department of Defense and AbilityOne Contracting 

Oversight, Accountability and Integrity.” Subcommittees were created to inform the 898 

Panel on recommendations from research and discussion with stakeholders on how to 

improve the AbilityOne program.

• Medicaid dental coverage for people with intellectual and developmental

disabilities – NCD conducted research into whether the provision of oral health care

coverage for people with intellectual and developmental disabilities is cost effective

policy vis-à-vis the money ultimately spent on preventable operations and chronic

health conditions, and in emergency rooms, due to untreated dental problems, aside
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from being good preventative services policy and consistent with the objectives of the

Americans with Disabilities Act and Rehabilitation Act. Approximately 60 percent of

people in the United States with intellectual and developmental disabilities, and many

people with other non-I/DD disabilities, rely on Medicaid for their health insurance

coverage and Medicaid’s reimbursement doesn’t always suffice. The research for this

report concluded in Fiscal Year 2021.

• Released fact sheet, voting rights for people with disabilities – We published a fact 

sheet outlining established voting rights for people with disabilities on our website’s 

resources page. 

• Disparate treatment of residents with disabilities in Puerto Rico under various 

federal programs – We finalized our examination of the disparate treatment people 

with disabilities receive under various federal programs based solely on their residency 

in Puerto Rico and the effect of the island’s commonwealth status upon persons with 

disabilities. Puerto Rico is the largest and most populous territory of the United States. 

U.S. citizenship was extended to all persons born on Puerto Rico since 1917 and in 

1952 it became a Commonwealth. This report studies the impact of the island’s 

commonwealth status on the approximately 716,000 persons with disabilities residing 

on the island. The report will examine the disparate treatment of persons with 

disabilities residing on the island in their participation in Medicare, Medicaid, SNAP, 

SSI and other programs as compared to persons with disabilities residing on the 

mainland, programs that they would be entitled to participate in full (assuming they 

meet the programs’ eligibility requirements) if they resided anywhere on the mainland. 

The report also examines the effect of the Jones Act, which requires all goods imported 

into Puerto Rico be carried on American-flagged vessels, on the costs of disability 

specific durable medical equipment and other supplies. NCD recently concluded its 

research, and the report is slated for May 2022 release.

• Legislation reintroduced, designating the ID/DD population as medically 

underserved – Consistent with our recommendation, and with our assistance in 

drafting the originally submitted legislative language, bipartisan legislation was 

reintroduced in Congress for the 2019-2020 session (and then again for the 2021-2022 

session) that would improve the delivery of medical and dental care to people with 

ID/DD. Under the Healthcare Expansion and Accessibility for Developmentally Disabled 
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and Underserved Population (HEADs UP) Act, the Public Health Service Act would be 

revised to designate people with ID/DD as a medically underserved population, thereby 

granting people with ID/DD access to the programs and resources of the National 

Health Service Corps (as is the case for the homeless, residents of public housing, and 

migrant workers).

• Advised Congress and the President on COVID-19 relief legislation – On January 

12 and February 1, 2021, NCD advised Congress and the President to include 

provisions in COVID relief legislation pertaining to home- and community-based 

services; Money Follows the Person reauthorization and funding; assisting families with 

paid leave who are home from work to provide caregiving; and provision of personal 

protective equipment for family and professional caregivers.

• Advised HHS to proceed with Section 504 RFI and rulemaking – On February 22, 

2021, NCD advised HHS to proceed with regulatory activity related to the RFI regarding 

Section 504 of the Rehabilitation Act, “Discrimination on the Basis of Disability in 

Critical Health and Human Services Programs or Activities.” OCR is currently

developing a Notice of Proposed Rulemaking (NPRM) to amend its Section 504 

regulations that would heavily incorporate or closely mirror the topics in NCD’s reports.

• Offered advice to Rehabilitation Services Administration regarding competitive 

integrated employment Frequently Asked Questions – On April 9 and April 26,

2021, NCD offered policy advice to RSA to assist them in developing guidance to 

clarify the Vocational Rehabilitation (VR) program’s criterion for an “integrated 

employment location” and improve VR program participants’ ability to exercise informed 

choice.

• Advised the Congressional Budget Office (CBO) and Congress of concerns 

related to use of the QALY in H.R. 3 – On April 7, 2021, NCD expressed concerns to 

CBO regarding their reliance on the quality-adjusted life year (QALY) to estimate the 

budgetary effects of H.R.3, the Elijah E. Cummings Lower Drug Costs Now Act, given 

the QALY’s discriminatory effect on people with disabilities. On April 29, 2021, NCD 

wrote to House committees with jurisdiction over H.R. 3, to urge policymakers not to 

rely on foreign drug prices set in reliance on QALY, a cost-effectiveness measure that 
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devalues the lives of people with disabilities and chronic illnesses, when pursuing 

legislative solutions to high drug prices.

• Held a bipartisan, bicameral AbilityOne Hill briefing to discuss recommendations 

from NCD’s recent report – On January 26th, 2021, NCD discussed transparency, 

oversight, and compliance concerns about the AbilityOne program with House and 

Senate Appropriations committee staff by providing a briefing on NCD’s Policies from 

the Past in a Modern Era: The Unintended Consequences of the AbilityOne Program & 

Section 14(c) report, released in October 2020. NCD discussed the findings and 

recommendations from its report to phase-out the program and phase-in a new 

contracting requirement under Section 503 to transition people with disabilities into 

competitive integrated employment. AbilityOne published a NPRM to accelerate the 

end of the usage of 14(c) certificates and in the AbilityOne quarterly meeting AbilityOne 

stated it is implementing new requirements for the individual employment evaluation 

(IEE) process. Both of these changes were recommended in NCD’s report.

• Conducted outreach to numerous House and Senate offices throughout the year 

to discuss upcoming legislative priorities that may require NCD’s assistance and 

planning – As House and Senate offices were developing their legislative priorities for 

the 117th Congress, NCD met with staffers to discuss how NCD can assist with 

developing or reviewing legislative ideas for policies that affect people with disabilities. 

• Provided recommendations to House and Senate offices of provisions to be 

included in the Transformation to Competitive Integrated Employment Act –

House and Senate members expressed intent to introduce a bill that intends to phase 

out Section 14(c) of the Fair Labor Standards Act while making transition grants 

available to states, providers, and experts to provide technical assistance. NCD has 

participated in discussions to recommend that the bill text be consistent with findings 

and recommendations to Congress from NCD’s 2012 and 2018 reports on the topic.

• Hosted congressional briefings on NCD’s AbilityOne report – NCD offered a series 

of four briefings to congressional staff in October 2020 regarding NCD’s Policies from 

the Past in a Modern Era: The Unintended Consequences of the AbilityOne Program & 

Section 14(c) report. As requested, NCD offered briefings on the same report to the 

House and Senate Appropriations Committees in March 2021 and conducted two 
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member-level briefings on the report in March and April for a Member of the House of 

Representatives and his staff.

• Recommended further regulatory action on HHS OCR’s Request for Information 

(RFI) regarding Section 504 of the Rehabilitation Act, “Discrimination on the 

Basis of Disability in Critical Health and Human Services Programs or Activities” 

(RIN: 0945-AA15) – NCD urged then Acting Secretary Norris Cochran to take further 

regulatory action on the RFI. NCD had extensive briefing sessions with HHS’s Office of 

Civil Rights (OCR) about its research in these areas, which it relied on in the 

development of the RFI. NCD’s research brought attention during the coronavirus 

pandemic to how crisis standards of care may discriminate against individuals with 

disabilities which OCR relied on in its enforcement and technical assistance. 

• Held a three-part briefing series with congressional staff to discuss NCD’s 2012 

and 2018 reports and recommendations to phase-out Section 14(c) of the Fair 

Labor Standards Act -- Upon specific request from a member of Congress who chairs 

a relevant committee, NCD held a briefing with congressional offices to discuss its past 

findings and recommendations to phase out Section 14(c) of the Fair Labor Standards 

Act while phasing in systems change that will support people with disabilities in 

competitive integrated employment. This request came as a result of NCD’s

discussions with committee staff about the need to remove the 83-year-old exception to 

wage protections for people with disabilities, which is wholly inconsistent with current 

disability policy and prohibits workers from transitioning into competitive integrated 

employment. Read NCD’s 2012 and 2018 recommendations to Congress.

• Submitted a statement for the record for a Senate hearing held on March 23, 

2021, titled, “Why Does the US Pay the Highest Prices in the World for 

Prescription Drugs?” – Members of the Senate Health, Education, Labor, and 

Pensions, Subcommittee on Primary Health and Retirement Security held a hearing to 

discuss the cost of prescription drugs and focused on three bills that intend to 

substantially reduce prescription drug prices and save the federal government money. 

Those bills discussed were the Prescription Drug Price Relief Act, which would cut 

prescription drug prices in half by pegging the price of medicine in the United States to 

median price in five major countries, Canada, United Kingdom, France, Germany and 

Japan; the Medicare Drug Price Negotiation Act, which would direct the Secretary of 
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Health and Human Services to negotiate lower prices for prescription drugs on the 

Medicare Part D; and the Affordable and Safe Prescription Drug Importation Act, which 

would allow patients, pharmacists and wholesalers to legally purchase safe, low cost 

medicine from Canada and other major countries. NCD’s statement highlighted 

concerns outlined in its 2019 report on the quality adjusted life year (QALY) about 

adopting foreign drug prices that rely on the QALY, a cost-effectiveness measure that 

devalues the lives of people with chronic illnesses and limits their access to highly 

effective drugs and treatments and warned. NCD’s statement made several 

recommendations that included avoiding legislation that would require HHS to cover 

only the most cost-effective drugs and treatments or impose restrictions on less costeffective treatments. 

• Submitted a statement for the record for the House hearing titled, “Lessons 

Learned: Charting the Path to Educational Equity Post-COVID-19” – Members of 

the House Committee on Education & Labor, Subcommittee on Early Childhood, 

Elementary, and Secondary Education held a hearing on the effects of COVID-19 on 

the education and those most affected by school closures. Representative Andy Levin 

included NCD’s statement applauding the subcommittee for providing additional 

Individuals with Disabilities Education Act funding in the American Rescue Plan of 

2021, which President Biden signed into law on March 11, 2021, as part of his remarks. 

Read NCD's Statement for the Record. 

• NCD’s report on organ transplant discrimination against people with disabilities 

was entered into the records for the House Committee on Oversight and Reform,

Subcommittee on Economic and Consumer Policy’s hearing on May 4, 2021 titled, 

“The Urgent Need to Reform the Organ Transplantation System to Secure More 

Organs for Waiting Ailing and Dying Patients.” Committee members examined ways to

reform the Organ Procurement Organizations (OPO) system, distribute more organs to 

waiting patients, address the inequities in organ donation process, and minimize waste 

and abuse. The Committee entered NCD's Organ Transplant Discrimination report into 

the hearing record. 

• NCD’s report on guardianship was prominently discussed at a Senate Judiciary 

Subcommittee hearing. One of the invited witnesses had been a member of NCD’s 
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research team and derived her testimony from the agency’s seminal 2018 report on 

guardianship. 

• NCD’s QALY report was entered into the House Committee on Energy and 

Commerce, Subcommittee on Health hearing titled, "Negotiating a Better Deal: 

Legislation to Lower the Cost of Prescription Drugs" on May 4, 2021. Committee 

members evaluated whether the Secretary of Health and Humans Services should 

negotiate the prices of prescription drugs to make prescription drugs more affordable, 

prevent price hikes, and promote innovation in the development of new drugs. Full 

Committee Ranking Member McMorris Rogers mentioned NCD’s concerns about 

Quality-Adjusted Life Years (QALYs) in her opening remarks. Khrystal Davis, a hearing 

witness and Rare Disease Caregiver & Patient Advocate, referenced NCD’s QALYs 

report in her oral and written testimony stating that the QALY assessment would 

prioritize treatment to a non-disabled population with a longer theoretical life 

expectancy, and otherwise perfect health, over a population with a disability or chronic 

condition. 

• Provided technical assistance to Senate offices for emergency preparedness 

legislation – NCD provided assistance consistent with its report, Preserving Our 

Freedom: Ending Institutionalization of People with Disabilities During and After 

Disasters, regarding possible legislation to improve preparedness for emergencies. 

NCD’s suggestions focused on how to ensure non-disruption of HCBS services, that 

people with disabilities are accounted for in the Public Health Strategy plan and how to 

improve data collection.

• NCD provided recommendations to congressional staff regarding the SBA – NCD 

has coordinated with congressional staff to note what SBA needs to provide to improve 

access for people with disabilities. NCD specifically has requested and continues to 

request that SBA add people with disabilities to SBA’s 8(a) presumed group list.

• NCD provided recommendations to CMS regarding complex rehabilitation 

technology – NCD met with the Deputy Administrator and Director of Center for 

Medicare in September 2021 to request that CMS reconsider the national coverage 

determination that power seat elevation, power standing, balancing and other features 

permitting wheelchairs to drive up and down steep inclines, over wide variety of terrain, 
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and climb up and down stairs, are not considered a medical necessity and therefore not 

considered covered complex rehabilitation technology for Medicare beneficiaries.

In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:

• QALY state use – NCD is following its 2019 report on the quality adjusted life year 

with research focused on States’ use of the Institute for Clinical and Economic 

Review (ICER) QALY-based cost-effectiveness reports, or international drug prices, 

to inform coverage decisions for prescription drugs in their Medicaid programs. It

will also describe methodological alternatives to QALYs that consider patient values

and preferences.

• FEMA / NCD federal working group – A federal working group was created by

FEMA in coordination with NCD to work on more comprehensive emergency

management guidance among multiple federal agencies. NCD will continue to serve

on this group throughout FY22.

• Examination of nation’s HCBS prior to and during the pandemic – In the 

context of the deaths of many people with I/DD living in congregate settings during 

the pandemic, NCD is examining the state of the nation’s HCBS that contributed to 

the inability of residents with I/DD to transition to lesser-density community housing 

options. To that end, NCD has conducted numerous listening sessions with federal 

and non-federal stakeholders focusing on ways to meet the current and future need 

for community living options for people with disabilities, break barriers to community 

integration for institutionalized individuals, increase accessible and affordable 

housing, and strengthen the direct care workforce.

• NCD will continue to provide written and verbal testimony at federal and state 

hearings on topics that NCD has made pointed recommendations to policymakers 

about. 

• NCD released a report on Medicaid dental coverage for people with

intellectual and developmental disabilities (I/DD) – NCD concluded its research

into this topic in Fiscal Year 2021 and released its report to Congress and the

President and his Administration in March 2022, in which NCD advised that
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increasing Medicaid oral healthcare for people with I/DD is cost effective policy with

a modest return on investment for most states. 

• NCD released its annual progress report focused on the impact of COVID-19 

on people with disabilities – NCD provided policymakers a comprehensive look at 

the unique impacts the pandemic has had on people with disabilities in school, 

work, healthcare, and community life. 

• Advised HHS with Section 504 rulemaking. NCD followed up on previous 

advisement by providing HHS with further information from NCD’s bioethics report 

series, accessible medical diagnostic equipment report, and information concerning 

disability clinical care and competency training for healthcare professionals for use 

in the development of their Section 504 rulemaking.

GOAL 3

OBJECTIVES, STRATEGIC RESULTS and PLANNED ACTIVITIES

GOAL 3: Engage policymakers of both the Administration and Congress and 

respond to their requests for assistance accurately and efficiently.

1. Provide timely disability policy briefings for members of the Administration and Hill 

staff.

2. Provide timely written briefing materials to congressional leadership and members 

of the Administration on policy priorities of the disability community.

3. Increase the time NCD staff and appointed Council members dedicate to direct 

engagement of congressional and Administration policymakers with NCD’s policy 

advice.

In Fiscal Year 2021, we responded to congressional requests for policy assistance; met

with and offered briefings to congressional and committee offices regarding our newly 

released policy research; engaged with congressional and agency offices regarding their 

own priority areas that have implications for Americans with disabilities; and engaged

media on topics on which we have completed research, made recommendations and 

provided advice to policymakers.

In furtherance of Goal 3, the Council accomplished the following in FY 2021:
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• Advised National Governors Association (NGA), vaccine allocation and data 

Collection – On February 9, 2021, NCD advised NGA regarding priority vaccine 

allocation for people with disabilities based upon national data regarding the 

disproportionate impact of COVID on people with disabilities, and made 

recommendations regarding data collection related to the pandemic.

• National Conference of State Legislatures (NCSL), vaccine allocation – NCD put 

together issue points (with a reference to NCD’s related letter) for the National 

Conference of State Legislatures as part of NCD’s efforts of encouraging vaccine 

equity through states’ COVID-19 vaccine allocation. NCSL drafted an article for its 

newsletter based on the issue points NCD provided.

• Autonomous vehicle technology – In early 2021, NCD met with staff of the U.S.

Access Board to share NCD autonomous vehicles work and contacts in advance of

their webinar series.

• Federal Emergency Management Agency (FEMA) stakeholder calls – NCD met

with representatives from FEMA’s individual assistance (IA) Division to discuss the

public assistance (PA) and IA division of FEMA stakeholder calls to inform regional

disability integration specialists, state and local emergency management personnel and

the disability community on its updated guidance and requirements for personal

assistant services at shelters. We also participated in the first discussion which was

held on March 30, 2021. The policy changes and subsequent stakeholder calls were

conducted as follow up to NCD’s moderated roundtable discussions with FEMA and

disability stakeholders. NCD also met with representatives from FEMA’s Individual

Assistance Division and disability stakeholders to discuss the status of FEMA’s

personal assistant services guide. This guide was created following the NCD facilitated

roundtable discussions with FEMA and the disability community. It provides guidance

to the states to ensure that independent living centers receive reimbursement for

services rendered before, during, and after emergencies. NCD coordinated roundtable

discussion with FEMA, CMS, HHS ACL, ASPR, DHS, CRCL, DOJ and HUD. In

response to the roundtable, FEMA and NCD coordinated to implement a Federal

Advisory Committee (FAC) to develop a guide for stakeholders that will describe in

detail available federal programs and how to access those programs and receive

reimbursement if needed. The FAC is meeting monthly.
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• Education equity – NCD issued a statement for the record to the House Education 

and Labor Committee regarding education equity post-pandemic based upon our 

research that was underway for our 2021 progress report focused on COVID-19’s 

impact on people with disabilities.

• Bioethics / Quality Adjusted Life Year (QALY) – NCD sent a letter to CMS regarding 

its Most Favored Nation Model Interim Final Rule. The letter describes concerns that 

the model will reduce the availability of needed prescription drugs to older persons with 

chronic illnesses and imports drug prices from nations that use the QALY – a method of 

pricing healthcare treatments that assigns a lower value to the lives of people with 

disabilities. 

• Meeting with Office of Management and Budget (OMB), IDEA funding report –

NCD met with our OMB examiner to discuss NCD’s recommendations in Broken 

Promises: The Underfunding of IDEA to inform the development of the President’s 

Fiscal Year 2023 Budget. NCD followed up with our researchers and provided more 

recent information to supplement what NCD shared during the call. 

• AbilityOne report – NCD presented the findings and recommendations from NCD’s 

report: Policies from the Past in a Modern Era: The Unintended Consequences of the 

AbilityOne Program to disability stakeholders at an 898 Panel Briefing on December 4, 

2020. The 898 panel was created out of Section 898 of the National Defense 

Authorization Act for Fiscal Year 2017. It directed the Secretary of Defense to establish 

a “Panel on Department of Defense and AbilityOne Contracting Oversight, 

Accountability and Integrity.” Subcommittees were created to inform the 898 Panel on 

recommendations from research and discussion with stakeholders on how to improve 

the AbilityOne program.

• Multi-Agency task force on increasing employment of people with disabilities –

NCD participated in the last meeting held on December 18, 2020. The group discussed 

a possible employer summit for 2021 as a way to bring non-governmental employers 

together with government agencies that have pipelines to employees with disabilities. 

NCD’s 2020 Progress Report was discussed regarding employer engagement, and 

SSA was very interested in this as a way to introduce non-government employers to 

the Ticket to Work Program. SSA asked NCD to connect them to leadership of the 
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Valuable 500, a company highlighted in the NCD 2020 Progress Report comprised of 

companies that have pledged to hire people with disabilities, and NCD did so.

• COVID-19 Relief Legislation – In January 2021, NCD issued a letter to the Biden 

Administration regarding inclusion of provisions and funding in Congress’ next COVID19 legislative package. 

• Interim rule concerning vehicle modifications in light of COVID-19 – In December,

2020, NCD sent a letter to the National Highway and Traffic Safety Administrator 

concerning implementing as an interim rule Supplemental Notice of Proposed 

Rulemaking: “Make Inoperative Exemptions; Vehicle Modifications to Accommodate 

People with Disabilities” [49 CFR Part 595, Docket No. NHTSA-2016-0031, RIN 2127-

AL67, 85 FR 84281, Document Number: 2020-28648], in light of the COVID pandemic 

and the risk of using public transportation at present.

• DOD Computer/Electronic Accommodations Program (CAP) – The Department of

Defense (DOD) announced it will no longer allow CAP to assist with providing

reasonable accommodations to other federal agencies as it has done for many years.

In November 2020, NCD wrote to DOD regarding this matter asking that this budget cut

be delayed for one year while efforts begin to request additional funds for an allencompassing federal employees centralized accommodations fund.

• Electoral Access/OSCE – The Organization for Security and Cooperation in Europe 

(Office for Democratic Institutions and Human Rights) has deployed a Limited Election 

Observation Mission for the upcoming November 3 General Elections. The mission 

officially began its operations on September 29, 2020, and is composed of a team of 15 

international election experts based in Washington, D.C. NCD met with the 

representatives to discuss NCD’s HAVA report and election accessibility issues. 

• Administration on Community Living (ACL) – NCD meets monthly with staff across 

ACL to discuss NCD’s anticipated and recent engagements across HHS as well as 

learn of ACL’s current areas of focus. 

• Health Care Accessibility Workgroup Meeting – NCD participated in a virtual

meeting of the Federal Health Care Accessibility for People with Disabilities Workgroup

(formerly referred to as the “Federal Partners Group”). These meetings provide an
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excellent opportunity to exchange information and foster collaboration between our

federal partners on the work that is being done in this area. The group’s scope has

widened to encompass physical, communication and programmatic health care

accessibility for people with mobility, sensory and intellectual/developmental

disabilities. NCD updated the group on NCD’s project examining the oral healthcare

Medicaid reimbursement rate for people with I/DD.

• Technical assistance provided to congressional offices regarding crisis 

standards of care – In view of our 2019 bioethics report series, several congressional 

offices asked NCD for assistance in understanding and responding to the concerns of 

the disability community regarding COVID-19 crisis standards of care that many states 

have readied for use in anticipation of potential medical rationing. We assisted a group 

of bipartisan, bicameral offices over many months to that end. 

• Advised Treasury Secretary and Internal Revenue Service (IRS) Commissioner

on CARES Act Payments – NCD shared concerns and advice regarding the IRS’s

deadlines for recipients of federal benefits with qualifying dependents to submit 

additional information to the IRS non-filer portal and regarding the mechanism by which 

individuals are currently constrained to submit this information.

• Advised the Department of Health and Human Services (HHS) on individuals with 

disabilities and disasters – NCD is serving on the HHS National Advisory Committee 

on Individuals with Disabilities and Disasters. The NACIDD will evaluate issues and 

programs and provide findings, advice, and recommendations to support and enhance 

all hazards public health and medical preparedness, response activities, and recovery 

related to meeting the unique needs of individuals with disabilities. The NACIDD will 

advise the Secretary of Health and Human Services on actions HHS can take before, 

during, and after disasters and emergencies to meet the unique needs of individuals 

with disabilities.

• AbilityOne Report congressional briefings – NCD offered a series of four briefings 

to congressional staff in October 2020 regarding NCD’s Policies from the Past in a 

Modern Era: The Unintended Consequences of the AbilityOne Program & Section 14(c)

report. As requested, NCD offered briefings on the same report to the House and 

Senate Appropriations Committees in March 2021 and conducted two member-level 
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briefings on the report in March and April for a Member of the House of 

Representatives and his staff.

• Subminimum Wage congressional briefings – Upon request, in February 2021, 

NCD offered a series of three briefings to staff of the House Education and Labor 

Committee regarding subminimum wage employment with respect to its history, wages, 

and employment settings. 

• Technical review and advice on proposed legislation, letters, etc. – NCD provided 

technical review and advice on proposed legislation, congressional letters, proposed 

GAO study requests, and related matters to numerous congressional offices throughout 

FY21, including but not limited to efforts to harmonize the Americans with Disabilities 

Act with the Affordable Care Act; interest in addressing the emerging needs of 

individuals with “long COVID” regarding its impact on workplace accommodations and 

eligibility for Social Security; interest in studying the prevalence of people with 

disabilities within federal contract employment; interest in ensuring the rights of parents 

with disabilities in child welfare cases; and interest in creating alternatives to the use of 

the quality adjusted life year measure in the context of efforts to reduce drug prices. 

NCD also assisted with drafting letters from congressional offices urging HHS to 

provide clarification that states’ Crisis Standards of Care policies must not authorize 

any form of disability discrimination as well as clarify that the liability immunity 

provisions of HHS’ Declaration pursuant to the President’s Declaration Under the 

Public Readiness and Emergency Preparedness Act for Medical Countermeasures 

Against COVID–19 did not change healthcare professionals’ obligations under laws 

and regulations that prohibit discrimination on the basis of race, color, national origin, 

disability, age, sex, and exercise of conscience and religion. 

• Media engagement – NCD’s work is routinely highlighted in national media and

industry publications, and we regularly receive media inquiries for comment and

information on current policies and events related to people with disabilities and to our

most recent report releases. A small sampling of our media mentions in Fiscal Year

2021 include the following:

o NCD’s received consistent media coverage referencing our FY 2020 bioethics

and disability report series (particularly with respect to medical futility and
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quality-adjusted life years reports) throughout the pandemic. National and local

media highlighted NCD’s reports as legislation was introduced in several states

on assisted suicide and organ transplant discrimination. Medical rationing

continued to be a prevalent news topic due to the COVID-19 vaccine framework,

with medical discrimination and crisis standards of care stories featured in The

Hill, Huffington Post, The Federalist, and numerous other online publications

referencing the NCD reports.

o NCD was heavily referenced in relation to the 31st anniversary of the signing of

the Americans with Disabilities Act in local, national and international media.

NCD coordinated with White House planners on the July 26, 2021, anniversary

event hosted by the President and Vice President, and attended by the NCD

Chairman.

o Media coverage of our letters to policymakers regarding topics such as medical

rationing and the need for sign language interpreters at White House COVID-19

briefings continued to garner follow-up queries and coverage from CNN, NPR,

Yahoo, Washington Post and Examiner, New York Times and Post, and others.

Coverage of other government agencies’ policy announcements often included

reference to NCD’s letters or reports.

o NCD conducted a press event for its AbilityOne Report. Articles followed in 

Government Executive, Federal News Network, and Disability Scoop.

o NCD produced a video from the webcast May 20, 2021 briefing for the release of 

the Enforceable Accessible Medical Equipment Standards: A Necessary Means 

to Address the Health Care Needs of People with Mobility Disabilities report. The 

briefing on the report, which 498 people registered for, included an interagency 

lineup from NCD; Access Board; HHS Office for Civil Rights; DOJ Civil Rights 

Division, Disability Rights Section; and non-governmental organizations.

o NCD concluded in Fiscal Year 2021 a national radio tour during National 

Disability Employment Month, with 15 radio interviews highlighting employment 

of people with disabilities, subminimum wage discrimination, and enhancing 

competitive integrated employment opportunities consistent with the goals of the 

ADA.
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o NCD’s Chairman participated in several webcast digital media presentations and 

discussions regarding policy topics impacting people with disabilities, including 

accessible dental care, employment and health equity. He also joined or 

provided pre-recorded video keynotes to several organizations’ annual 

conferences about NCD’s advice to policymakers.

o A Washington Post feature story on experiences with FEMA referenced NCD’s 

report on institutionalization after natural disasters. The story was run on six 

outlets and had a reach of 59.7M.

o NCD’s Chairman authored an article regarding health equity published in the 

blog of prestigious medical journal Health Affairs on misperceptions of people 

with disabilities and the impact on their quality of care.

o NCD supported national media including PBS, Yahoo News, Daily, Beast,

BuzzFeed News, Christian Science Monitor, Disability Scoop, Atlantic, CNN,

Forbes, New York Times, Washington Post and others for data queries and

relevant contacts on stories that were disability-related. For FY 2021, NCD had

over 2,800 media placements.

o NCD supported congressional queries regarding optimal ways to message about

conservatorship in media coverage of the topic. Media widely referenced NCD's

report on guardianship, citing estimates that at least 1.3 million Americans are

under guardianship or conservatorship orders. Notably, Yahoo ran a plain

language version of one of their articles, which again referenced NCD’s reports,

and had a reach of 64.9 million.

o NCD’s current and former Chairmen were interviewed and quoted extensively

during FY 2021 from our press releases regarding our findings and

recommendations from a variety of reports released in previous fiscal years,

including topics of bioethics, guardianship and subminimum wage that NPR, The

Daily Beast, the Atlantic, BBC, and many other media outlets covered.

o NCD social media accounts collectively reached 62,000 followers in FY 2021, 

with an estimated 1.2M reach from NCD initiated posts.
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• Other Engagement

In addition to its traditional and primary advisees, throughout each year, we are 

commonly engaged with requests for assistance from other groups and interested 

parties as well. A small sampling of these interactions for Fiscal Year 2021 follows:

o Follow-up on NCD’s Sexual Assault on College Campuses report – NCD 

met with the leadership of PAVE (Promoting Awareness/Victim Empowerment), 

a sexual violence survival organization, about NCD’s report addressing sexual 

assault on college campuses. NCD presented on the report at a January 2021

PAVE meeting during their lunch and learn series. 

o Disability Policy Series – NCD gave a lecture virtually at Florida State

University in spring 2021 on disability policy and evolution.

o Wireless RERC Virtual State of Technology Forum – NCD presented on

NCD’s technology recommendations at the 2021 forum in March. NCD also

assisted the Wireless RERC in informing our constituents of the RERC’s survey

seeking people with disabilities and older adults for their survey on access to

COVID-19 information.

o LEADERs Summit on Accessible Healthcare - NCD participated in the 

LEADERs Summit: Working Together to Advance Equitable Healthcare for 

Persons with Disabilities, on October 19th and November 9th. The Summit was 

part of a two-year project at the University of Colorado Anschutz Medical 

Campus funded by the Patient Centered Outcomes Research Institute. The 

purpose of the Summit was to discuss a variety of issues impacting equal 

access to health care for people with disabilities and to develop proposed 

solutions, and a path forward, to address disability healthcare disparities. Sixty 

participants from a variety of disciplines participated in robust discussions.

o Progress Report 2020 – NCD presented to the Virginia Ability Forum in 

October 2020. The forum is focused on NCD’s employment recommendations 

from our 2020 Progress Report and presenters focused on employer 

engagement, entrepreneurships and the Small Business Administration, and 

countering disincentives to employment. 
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o Dentistry - On October 2, 2020, the Chairman of NCD keynoted at the NYU 

Dentistry Virtual Symposium, Achieving Health Equity through Access for All 

with Disabilities (AHEAD). The AHEAD symposium, which coincided with the 

30th anniversary of the Americans with Disabilities Act, brought together experts 

in the areas of health care advocacy, access, and funding at the state and 

federal levels for people with disabilities. 

o ADA – On October 23, 2020, NCD presented on a panel discussing disability 

rights and access to justice at the Equal Justice Works conference, with a 

particular focus on access to justice issues through the lens of the 30th 

anniversary of the ADA.

o Amtrak – NCD continues to meet with Amtrak and disability representatives on 

Amtrak’s recent settlement agreement with DOJ that attempts to address DOJ’s 

findings of disability discrimination in violation of the ADA. Under the agreement, 

Amtrak will fix inaccessible stations and pay $2.25 million to victims hurt by its 

inaccessible stations. 

o Showcasing U.S. federal disability rights leadership for international 

delegations – Prior to the pandemic, staff and Council Members met with 

representatives from many countries to discuss U.S. federal disability civil rights 

laws (which many nations desire to study and replicate) and the structure and 

role of the Council as an independent federal advisory body regarding disability 

policy. Many countries have signed and ratified the Convention on the Rights of 

Persons with Disabilities and thus are seeking information from the United 

States on how best to implement, given our long history with the Americans with 

Disabilities Act and other disability laws. While it is difficult to gauge specific 

outcomes from these meetings, the most frequent subject of discussion is how 

to create their own “National Council on Disability,” what structure of government 

is required; how to achieve the right make-up; and how to ensure it can be 

effective in its role as a government advisor. While these meetings lessened 

during the pandemic, we expect them to resume once travel restrictions lift.

o Liaison Committee on Medical Education (LCME) – NCD engaged the LCME 

requesting and advising that its accreditation standards be revised in compliance 
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with the Americans with Disabilities Act. The LCME subsequently took action by 

providing a few modest adjustments to its accreditation standards while also 

taking the opportunity to revise its standards with respect to disability 

accommodations and thus will now require that all medical schools in the U.S.

draft and implement non-discrimination policies. 

o NCD continue to work with sponsoring offices of legislation based on our

report recommendations, presently including the SECURE Act (sexual assault 

on college campus legislation), the HEADS Up Act (dental care of people with 

I/DD), a House concurrent resolution regarding the dangers of assisted suicide, 

H.R. 3373 (seeking to establish the Office of International Disability Rights within 

the U.S. Department of State), \ autonomous vehicle legislation, Keeping All 

Students Safe Act. the Charlotte Woodward Organ Transplant Discrimination 

Prevention Act (to prohibit the discrimination of people with disabilities receiving 

organ transplants), and the Transformation to Competitive Integrated 

Employment Act (to phase out Section 14(c) of the Fair Labor Standards Act).

o NCD continues to provide written briefing materials to congressional 

leadership and members of the Administration. In advance of congressional 

hearings regarding a topic of priority concern for the disability community, we

often provide written briefing materials to committee members, including key 

findings and recommendations from our body of research, as well as suggested 

questions for witnesses. We also suggest hearing topics and witnesses to 

House and Senate committees based on our latest research findings and on 

pressing matters of concern to Americans with disabilities and regularly receive 

requests for review of proposed witnesses. 

o NCD continues to meet with House and Senate offices regularly to discuss 

concerns from people with disabilities throughout the nation and provide them 

with technical assistance and advice regarding proposed legislation, draft letters, 

GAO study requests, Hill sign-on letters, and other policy-related materials. 

• In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:
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o NCD will focus on providing briefings on its health equity framework for 

congressional staff in committees of jurisdiction, individual congressional offices 

indicating interest, and federal agencies with responsibility over areas identified 

in the framework.

o NCD will continue responding to requests for specific subject matter briefings 

and technical assistance and research for bill text development, convening 

stakeholders, and responding to constituent inquiries from individual, committee, 

and leadership offices as well as from colleagues from within the administration.

GOAL 4

OBJECTIVES, STRATEGIC RESULTS and PLANNED ACTIVITIES

GOAL 4: Gather information from subject matter experts and members of the 

disability community both of Washington, DC, and nationally, to help inform 

policymakers’ work.

1. Engage the disability community beyond Washington, DC and solicit their views 

regarding timely policy matters including but not limited to issues of healthcare 

equity, employment, and the inclusion of traditionally underserved communities.

2. Deliberate and purposeful outreach to disability communities within tribal 

communities.

3. Deliberate and purposeful outreach to disability communities in United States’ 

territories.

4. Deliberate and purposeful outreach to the community of disabled veterans.

5. Provide opportunities for the disability community to provide input to policymakers 

on disabilities issues prior to policy decision-making.

6. Develop information gathering partnerships to generate effective intelligence for 

policymakers to use in weighing issues.

Develop information gathering partnerships to generate effective intelligence for 

policymakers to use in weighing issues. In Fiscal Year 2021, in service of its policy 

development cycle, NCD staff and Council members continued outreach efforts to national 

organizations, individual constituents, academics, disability coalitions; and disability 

conferences, all of which informed the research projects as well as helped steer the 
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direction of policy priorities the Council set for the next fiscal year. For every one of our

reports released throughout Fiscal Year 2021, our research involved engagement of 

people with disabilities from across the country in the form of focus groups, interviews, and 

advisory councils. In each report, we highlighted and summarized those interactions to

elevate first-hand experiences of people with disabilities to the attention of policymakers. 

In Fiscal Year 2021, we entered into cooperative agreements with subject matter experts 

to assist with nearly all our research endeavors to ensure that the information provided to 

policymakers was current, relevant, and accurate. These agreements are at times with 

organizations that have specialized expertise in certain policy areas, and at other times 

with academic institutions or research groups.

NCD was tasked in Fiscal Year 2018 by language in the House Appropriations Committee 

Report with responsibilities to conduct information sessions across the country regarding 

the Achieving a Better Life Experience (ABLE) Act and for interagency coordination so that 

federal agencies are providing information and guidance consistent with the legislation, 

and following several years of regular interagency coordination meetings and related 

follow-up, NCD will continue to monitor opportunities to strategically address these topics 

going forward. 

In furtherance of Goal 4, the Council accomplished the following in FY 2021:

• Disability community nonprofit meetings – In connection with NCD’s leadership 

change in FY21, NCD has met with leadership of dozens of disability nonprofits in 

FY21 to discuss their organizational policy priorities and ensure that their 

constituencies’ concerns are considered and reflected in the work of the Council. As 

the result of one such meeting with the Veterans Task Force of the Consortium for 

Citizens with Disabilities (CCD), NCD made mid-project additions of material to its 2021 

progress report, to ensure that the experiences of veterans with disabilities during the 

pandemic were captured.

• Addition of language in cooperative agreements – In response to Executive Order 

13985, “Advancing Racial Equity and Support for Underserved Communities Through 

the Federal Government,” NCD amended its cooperative agreement requirements 

language, which had read “NCD wants to ensure there is stakeholder involvement in 
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the findings and recommendations. The inclusion of people with disabilities must be 

integral to the planning, development, and execution of this project. At least one section 

of the report should focus on stakeholder input, but input should be integrated 

throughout,” to further add, “NCD wants to ensure there is stakeholder involvement in 

the findings and recommendations. The inclusion of people with disabilities, including 

people with disabilities who are multiply marginalized (black, indigenous, people of 

color, LGBTQ, e.g.), must be integral to the planning, development, and execution of 

this project. At least one section of the report should focus on stakeholder input, but 

input should be integrated throughout.” We believe this will further assist NCD’s ability 

to reflect advice to policymakers that is inclusive of the breadth of diversity of the 

disability community constituency.

• Health equity convening – In May 2021, NCD hosted a health equity convening, 

inviting a premiere list of disability health research and disparities experts from around 

the country to discuss NCD’s desire to create a comprehensive proposal to ensure 

health equity for persons with disabilities. Among NCD’s top priorities in relation to 

health equity for people with disabilities include, but are not limited to, Medically 

Underserved Population designation (MUPs), increased data collection, disability 

competency training of medical professionals, and accessible medical equipment for 

people with disabilities.

• Opportunities for public input – NCD continues to engage opportunities for the 

Council to hear directly from members of the public; meet regularly with international 

delegations when requested; and provide regular disability policy briefings for members 

of the Administration and congressional staff. We continually receive public comment 

via all social media platforms our website as well as to our designated public comment 

email account.

• Examining and updating agency website and listserv – NCD is in the process of 

examining and updating our official government website and email listserv to facilitate 

regular communication with advisees and the general public regarding our activities 

and policy recommendations and enhance accessibility and ease of use.
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• Strategic plan – Throughout FY21, we worked on updating our five-year strategic plan 

that begins in Fiscal Year 2022. On Aug. 3, 2021, NCD held a virtual forum to solicit 

feedback on the draft plan.

• Deliberate and purposeful outreach to people with disabilities in tribal 

communities – NCD entered into a Memorandum of Understanding with National 

Indian Coalition on Aging (NICOA) to update NCD’s 2003 American Indian and Alaskan 

Native Understanding Disabilities in American Indian and Alaska Native Communities

Toolkit Guide. NCD identified stakeholders from American Indian and Alaska Native 

communities to consult with tribal officials in the development of federal policies that 

have tribal implications. 

• Deliberate and purposeful outreach to people with disabilities in U.S. territories –

NCD researched and finalized a report titled Disparate Treatment of Puerto Rican 

Residents in Federal Programs, slated for release in May 2022, that highlights the 

disparities between federal programs offered to U.S. citizens with disabilities living on 

the mainland versus those living in Puerto Rico.

• NCD continued to host virtual quarterly Council meetings with increased public 

participation. Due to the virtual environment, NCD’s quarterly Council meetings 

featured state disability policy highlights without incurring expenses associated with 

invited speaker travel. The virtual meetings were attended by gradually increasing 

numbers of people across the country, and topically targeted public comment periods 

helped provide valuable information for NCD’s ongoing research endeavors.

In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:

• In February 2022, NCD hosted a health equity stakeholder call with nearly 600 

attendees. The virtual Zoom webinar attracted over 1,000 registrants who were 

interested in learning more about NCD’s Health Equity Framework. NCD edited the 

recorded webinar and remediated it for accessibility, posting it online for additional 

views.

• In January 2022, NCD presented at a well-attended US Access Board webinar on 

health equity of approximately 500 attendees. NCD discussed our report on 

accessible medical and diagnostic equipment.
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• NCD will continue to utilize listening sessions and stakeholder engagements in its 

research that draws upon expertise and perspectives from diverse cross-sections of the 

community.

• NCD will host a town hall style listening session with members of the disability 

community from the U.S. territories (Guam, American Samoa, North Mariana Islands, 

and the U.S. Virgin Islands).

• NCD will finalize and release its updated Understanding Disabilities in American Indian 

and Alaska Native Communities Toolkit Guide.

• NCD will finalize and release its report on the disparate treatment of people with 

disabilities in Puerto Rico.

GOAL 5

OBJECTIVES, STRATEGIC RESULTS and PLANNED ACTIVITIES

GOAL 5: Enhance agency operational and programmatic internal controls to 

effectively service execution of statutory duties.

1. Enhance planning and evaluation of all agency projects to ensure continual 

improvements.

2. Ensure compliance with financial regulatory and reporting requirements.

3. Regularly evaluate and as needed update internal policies and procedures to ensure 

federal compliance, improved efficiencies, and internal controls.

Since Fiscal Year 2017 and throughout Fiscal Year 2021, the Council has worked 

collaboratively with the Department of Homeland Security to implement EINSTEIN and 

other mandated cybersecurity requirements. We have complied with all mandated 

requirements to the maximum extent that our budget has allowed. 

In furtherance of Goal 5, the Council accomplished the following in FY 2021:

• Special Government Employee (SGE) – In Fiscal Year 2021, NCD enhanced the 

reporting requirement for Council Members to ensure compliance with the restriction to 

serve a maximum of 130 days per year.
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• Trusted Internet Connection (TIC) – In response to the security assessment and 

authorization (SA&A) accomplished in Fiscal Year 2019, the Council worked diligently 

to evaluate and implement mandated cyber security requirements to comply with the 

Office of Management and Budget's (OMB) Trusted Internet Connection (TIC) 

Initiative. In Fiscal Year 2020, we completed this requirement are now operating with 

TIC 3.0.

• Managed Trusted Internet Protocol Service (MTIPS) – MTIPS was required to allow 

U.S. Federal agencies to physically and logically connect to the public Internet and 

other external connections. We implemented Managed Trusted Internet Protocol 

Service (MTIPS) in Fiscal Year 2020. 

• Plan of Action and Milestones (POAM’s) – The Council has worked cross fiscal 

years with three vendors to ensure our IT infrastructure was secure and we were 

moving toward compliance with all regulatory requirements. We advanced this 

requirement and now receive live updates in response to ongoing evaluation and 

implementation of cyber security mandates. In Fiscal Year 2021 and Fiscal Year 2022, 

we will continue to plan actions and milestones (POA&M) to track and fix security 

vulnerabilities as we strive to comply with all cybersecurity mandates.

• OpenFISMA – In Fiscal Year 2019, the Council implemented OpenFISMA which 

provided a Web-based centralized repository to manage and track vulnerability 

reporting and remediation activities. In Fiscal Year 2020 and ongoing we will continue 

to oversee the compliance processes. The Council has now advanced to 

OpenFISMA++.

• Authorization to Operate (ATO) – Beginning in Fiscal Year 2019, we began work on 

obtaining an ATO to explicitly accept the risk to agency operations. At present, we 

have obtained an interim ATO. We continue to operate under a temporary ATO. 

Currently, we are researching software options in support of our ATO. Contingent 

upon funding, the ATO will be completed no later than Fiscal Year 2023.

• SharePoint – In Fiscal Year 2019, the Council created a SharePoint platform to 

increase transparency, communication and implement additional cybersecurity 

mandates. The platform was in development in Fiscal Year 2020, which will continue 
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throughout Fiscal Year 2021 with routine upgrades. This platform, once fully 

developed, will assist NCD in complying with the National Archives Records 

Administration (NARA) requirements for agencies to transition to electronic filing by 

December 2022. 

• Updates to EEOC Policies and Procedures – Pursuant to 29 C.F.R. § 1614.102(e), 

Equal Employment Opportunity Commission (EEOC) provided technical assistance to 

make minor modifications to the Council’s Sexual and Nonsexual Harassment policy, 

which EEOC confirmed in Fiscal Year 2021 remains in compliance. 

• Updates to Financial Policies and Procedures – NCD is committed to continual 

updates to internal policies and procedures. In Fiscal Year 2020, the Council updated 

and approved NCD’s Financial Policy and Procedures. In Fiscal Year 2021, NCD has 

enhanced our internal financial reports to ensure effective oversight and management 

of our financial services provider. 

• National Archives and Records Administration (NARA), Management Federal 

Records Modernization Initiative (FERMI) – The M-19-21 directive issued by NARA 

requires federal agencies to transition to electronic documents by December 31, 2022. 

. This includes legacy content. After this time, NARA will no longer accept permanent 

or temporary records from agencies in non-electronic format. We have been working 

diligently to meet this deadline by implementing functions in the SharePoint platform 

and moving exclusively to cloud storage. This government-wide initiative has allowed 

the agency to transfer our paper documents to the Federal Records Center, designate 

a Senior Agency Official and Agency Records Officer for records management which

include training, scheduling records, workflows, and retention periods. The ongoing 

process for digitization will require maximum staff resources. M-19-21 reinforces our 

commitment to digital government and recognizes the process our agency has made 

in managing electronic records electronically for full compliance by Fiscal Year 2022. 

• Voice Over IP (VoIP) – In Fiscal Year 2020, the Council implemented Voice Over IP 

(VoIP) for internet and phone service. However due to working in a telework posture, 

the roll out was incomplete as of the close of Fiscal Year 2020. Since that time, a 

vendor has been selected and all VoIP equipment is in the NCD office awaiting 

phased reentry for completion of rollout
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• Equipment Refresh – The Council’s computer equipment was scheduled to refresh in 

Fiscal Year 2020. Due to COVID-19 and the agency moving to a maximum telework 

environment, the refresh was delayed to Fiscal Year 2022. To assist with the telework 

environment, all telework employees were issued work cell phones. In Fiscal Year 

2022, the Council refreshed equipment needs for FTEs and provided laptops and 

docking stations. 

• Financial Audit – The Accountability for Tax Dollars Act requirement for an annual

preparation and audit of financial statements of smaller agencies was exempted by

OMB in recognition of our stewardship. This continues to result in a biennial cost

savings for the Council. The Council absorbed the cost of completing an audit for

Fiscal Year 2020 and Fiscal Year 2021 in Fiscal Year 2021. We will continue to seek

approval from OMB for an annual exemption. If granted, NCD will recognize savings in

our Fiscal Year 2022 budget.

• Continuity of Operations (COOP) & Transition Planning – The Council will

continue to focus on our Continuity of Operations Plan (COOP) to protect and secure 

the integrity of the Council and to preserve the work that is critical to the mission of the 

Council. Additionally, as a result of COVID we will continue to focus on return-to-work

transition planning for safety and security of our employees. 

In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:

• NCD will work with EEOC to receive technical assistance and update and ensure 

compliance with all federal EEO regulations.

• NCD will conclude its biennial financial audit.

GOAL 6

OBJECTIVES, STRATEGIC RESULTS and PLANNED ACTIVITIES

GOAL 6: Recruit, retain, and develop a highly qualified professional staff in order to 

effectively service execution of statutory duties.
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1. Engage in a human capital management assessment to evaluate staffing and consider 

opportunities for workforce optimization.

2. Enhance new staff, members, and intern orientation materials and process.

3. Encourage staff to conduct SWOT (strengths, weaknesses, opportunities, and threats) 

analyses as a means of identifying professional development opportunities and 

enhancing performance.

In Fiscal Year 2021, we experienced the turnover of five council members and in late 

January, had a new Chairman designated by President Biden who appointed a new 

executive director from within NCD’s existing staff. 

In furtherance of Goal 6, the Council accomplished the following in FY 2021:

• Continued to enhance procedures to onboard new staff and members by providing an 

agency-wide orientation. The orientation process includes all staff and is continually 

reviewed for accuracy and updates. In response to staff continuing to operate in a 

telework posture, the Council successfully offered its first virtual orientation for five 

new council members. NCD will continue this practice for new staff, council members, 

and interns. 

• Continued to enhance swearing in opportunities for newly appointed council members 

by providing a remote event. The swearing in process is continually reviewed for 

efficiency, inclusion opportunities and improvements. In response to the agency

operating in a telework posture, the Council successfully conducted virtual swearing in 

ceremonies for five new council members. NCD employs staff who is a licensed notary 

public who helps facilitate remote and in-person swearing in ceremonies. 

• In response to COVID, and in support of retaining, and developing highly qualified 

professional staff, employees participated in virtual trainings. To ensure compliance 

with annual ethics training requirements, we continue to partner with the U.S. 

Department of Education, Office of the General Counsel, Ethics Division and have 

provided members and staff ethics training annually in conjunction with new member 

orientation and videoconference Council meetings. 

• The Council continually reviews and revises administrative policies and financial 

procedures to ensure risk is mitigated. In Fiscal Year 2021, the Council continued to 
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respond to guidance on return on work plans, developed its reentry plan in accordance 

with OMB and OPM guidance, and extended work schedule flexibilities to NCD staff to 

help ensure mission of the Council is achieved during the pandemic.

In Fiscal Year 2022, NCD will prioritize work in the following areas of focus:

• NCD will develop and roll out several new or updated administrative policies regarding 

work schedules in light of phased reentry. 

• NCD will continue to seek opportunities to onboard interns, including interns from 

underserved communities, including students with disabilities. 
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CROSS-AGENCY COLLABORATIONS

NCD’s policy advisement is often directed at other federal agencies, and it is vital that we 

maintain open communication and relationships with agencies across the government in 

furtherance of our research to policymakers and to also help close key feedback loops for 

agencies, by assisting them in hearing from people with disabilities across the country. 

Fostering such cross-agency relationships supports our strategic objective to develop 

policy recommendations and encourage collaboration. With each policy project, we share 

our recommendations in advance with the agencies we are examining to ensure technical 

accuracy and strives to follow up with the same agencies in assessing their

implementation of our recommendations. The Council regularly engages with many other 

federal agencies. Please note the many cross-agency collaborations we have previously 

highlighted in Goal 3. In addition to those, many others include:

• Government Accountability Office – We met with the GAO to discuss the 

accessibility of airports. GAO is beginning a new engagement examining airport 

accessibility for passengers with disabilities in response to the congressional 

mandate in Section 431 of the FAA Reauthorization Act of 2018. In the course of 

this work, GAO plans to explore: (1) Airport accessibility best practices designed to 

improve wayfinding, amenities, and passenger care for passengers with disabilities; 

(2) Air carrier and airport training policies related to prohibiting discrimination and 

assisting passengers with disabilities; and (3) The extent to which airport 

accessibility best practices exceed legal requirements outlined in key disabilityrelated legislation. We also met with GAO’s Senior Analyst for Education, 

Workforce, and Income Security to discuss our education work, specifically our work 

on school climate issues like bullying and the school to prison pipeline. GAO also 

recently issued its school accessibility report, which notes that two thirds of U.S. 

school districts facilities have barriers to physical access for people with disabilities. 

The Council was interviewed for the report.

• Food & Drug Administration, Health and Human Services Administration, 

Centers for Medicaid and Medicare, and the Department of Justice –We met 

with the FDA, HHS Office of Civil Rights, DOJ’s Disability Rights Section, and the 
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Centers for Medicaid and Medicare to provide recommendation concerning 

bioethics and healthcare for people with disabilities. 

• Offices and Divisions across US Department of Health and Human Services –

NCD has met with numerous offices and divisions from across HHS regarding

information linked to NCD’s health equity framework. Meetings have included CMS,

ACL, CDC, NIDLRR, the Surgeon General’s Office, ASPE, NIH, and OCR.

• FEMA – We facilitated several joint roundtable meetings with FEMA and the 

disability community. These meetings are assisting us in gathering data on the 

impact of COVID-19 on FEMA, state and local resources and discerning best 

practices - with future plans to provide guidance and recommended policy change 

to improve outcomes of people with disabilities during and after disasters amidst the 

COVID-19 pandemic and beyond. FEMA’s Office of Disability Integration and 

Coordination has assumed the role as facilitator and plans to continue the 

roundtable discussions on a monthly basis. NCD further coordinated roundtable 

discussion with FEMA, CMS, HHS ACL, ASPR, DHS, CRCL, DOJ and HUD to 

discuss FEMA policies and reimbursements to assist people with disabilities before, 

during and after disasters. In response to the roundtable, FEMA and NCD 

coordinated to implement a Federal Advisory Committee (FAC) to develop a guide 

for stakeholders that will describe in detail available federal programs and how to 

access those programs and receive reimbursement if needed. The FAC is meeting 

monthly.

• Administration on Community Living – NCD holds monthly standing calls with 

leadership from ACL to update one another on agency work and near-horizon 

projects.

• US Access Board - NCD holds monthly standing calls with leadership from the US 

Access Board to update one another on agency work and near-horizon projects.

• Domestic Policy Council (DPC) Interagency Workgroup on Disability – NCD 

meets regularly with members of the Domestic Policy Interagency Workgroup on 

Disability and its related subcommittees regarding a range of issues identified as 

agenda items by the Director of Disability Policy at the DPC. 
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• Interagency Disability Senior Leadership Meetings – NCD has continued to 

participate in Interagency Disability Senior Leadership group meetings to exchange 

information about the activities of various federal agencies as it pertains to disability 

policy.

• Small Agency Council (SAC) Executive Committee, Partnership with General 

Services Administration (GSA) Work Group – NCD staff are members of the 

SAC Executive Committee which is charged with reviewing and providing 

advisement on activities within GSA’s Office of Administrative Services and Human 

Resources Line of Business, Office of Customer & Stakeholder Engagement. Office 

of Analytics, Performance & Improvement and GSA’s Management Through 

COVID-19.

• Congressional Budget Office – NCD met with CBO to discuss concerns regarding 

their reliance on the quality adjusted life year (QALY) in estimating costs. NCD

provided a summary of concerns based on our report and CBO’s expressed interest 

in exploring alternatives to the QALY when conducting future cost estimates of drug 

pricing bills.

• US Department of State - NCD’s policy team met with U.S. Special Advisor in 

International Disability Rights with the State Department. NCD discussed its current 

projects and how they intersect with the State Department’s interests. NCD is 

engaging the State Department on several projects, including the 2022 progress 

report on climate change.
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NATIONAL COUNCIL ON DISABILITY BUDGET

Cost Discussion (Appendix A)

DESCRIPTION FY2021

 

FY2022 Budget 

Request FY2023 

BUDGET TOTAL 3,350,000 3,750,000 3,850,000

PERSONNEL 1,963,862 2,147,857 2,274,846

TRAVEL 292,000 85,000 145,000

RENT, UTILITIES AND 

COMMUNICATIONS

317,600 283,451 352,000

PROGRAM, RESEARCH AND 

PRINTING

170,000 345,000 240,000

TRAINING AND PROFESSIONAL 

ASSOCIATIONS

30,000 28,950 27,500

AUDIT 41,404 0 42,500

PAYROLL, ACCOUNTING AND HR 

SERVICES

122,500 158,000 235,000

SUPPORT CONTRACT SERVICES 130,000 279,642 260,500

INFORMATION TECHNOLOGY 173,934 319,800 165,904

PAYMENTS TO FEDERAL AGENCIES 9,000 4,800 6,750

SUPPLIES, SUBSCRIPTIONS AND 

MATERIALS

66,200 60,000 61,500

ANTI-DEFICIENCY 33,500 37,500 38,500
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APPENDIX A

Cost Discussion

NCD is committed to fulfil its mission of advising the President, Congress, and other 

federal agencies regarding federal policies’ impact on people with disabilities in a costeffective manner.

• The Council presents a budget of $3,850,000 for Fiscal Year 2023.

• The Council’s appropriated budget for Fiscal Year 2022 is $3,750,000.

In Fiscal Year 2023, NCD remains committed to delivering mission critical outcomes while

streamlining our operational expenses wherever possible as a means of optimizing our 

appropriation toward expenses directly connected to research and advice activities. In so 

doing, NCD judiciously utilizes taxpayer dollars in support of the national priority to reduce 

deficits.
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APPENDIX B

Analysis of Resources

PERSONNEL

FY 2022 $2,147,857

FY 2023 $2,274,846

• Our Fiscal Year 2022 budget supports 9 Council members and 11 staff (FTEs), and 

regularly scheduled performance increases per OPM policy and associated 

benefits. If NCD receives the requested appropriation for Fiscal Year 2022, we will 

move forward with supporting our slated number of FTEs during FY 2022 with a 

term not to exceed (NTE) hire. The NTE hire will assist with the work of the 

Legislative Affairs and Outreach (LAO) team while the LAO Director supports the 

agency by serving in the administratively determined (AD) appointment as the 

Executive Director. It is anticipated that the LAO director role will be resumed 

following the termination of the AD appointment, at which time NCD will support 12 

FTEs. 

• Our Fiscal Year 2023 budget supports 9 Council members and 13 staff (FTEs), 

regularly scheduled performance increases per OPM policy and associated 

benefits. The increase in FTEs is in support of the mission critical work of the 

agency. 

Recruiting and retaining full-time federal employees is critical to fulfillment of the Council’s 

mission. 

TRAVEL

FY 2022 $85,000

FY 2023 $145,000

• For Fiscal Year 2022, in anticipation of ongoing travel restrictions as a result of 

COVID-19, and budget restraints NCD reduced the travel budget to support two inperson Council meetings. In support of return-to-work strategies, NCD will adjust 

travel costs consistent with COVID-19 guidance. 
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• For Fiscal Year 2023, NCD budgeted for three in-person Council meetings. Prepandemic, NCD’s practice was to conduct four statutorily required meetings inperson to maximize public input toward policy priorities. Consistent with the aim of

return-to-work strategies and budget restrictions, our budget request supports three 

in-person Council meetings during Fiscal Year 2023. 

The largest portion of the Council’s travel budget is devoted to the cost of fulfilling our

statutory requirement to conduct public meetings no less than four times each year. All 

Council members, staff, in conjunction with policy development or engagement activities to 

gather or provide expert information, invited guests. 

Additionally, the Council convenes policy forums to educate attendees on policy 

recommendations. On these occasions, if necessary and based upon availability of funds 

we pay travel to subject matter experts.

All travel is processing in accordance with federal per diem regulations. 

RENT, UTILITIES AND COMMUNICATIONS

FY 2022 $283,451

FY 2023 $352,000

We renewed our lease with the General Services Administration pre-pandemic. Effective 

October 1, 2021, for 15 years through September 30, 2031. We secured an accessible 

space and negotiated a reduced cost by entering a 15-year agreement. The ability to 

remain at the current location, which is accessible for people with disabilities by three 

major Metro rail lines and Metro bus was the primary motivation for renewing the existing 

lease. The agency will receive rent abatements for months 1 through 6 in the amount of 

$132,889.38, thus producing a one-time reduction in rental costs for FY 22.

With the majority of staff being people with disabilities, and as the federal voice to 

policymakers of the over 61 million Americans with a wide variety of disabilities, we also 

utilize several communication methods to facilitate the work of members and staff, as well 

as to engage with stakeholders. 
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PROGRAM, RESEARCH AND PRINTING

FY 2022 $345,000

FY 2023 $240,000

• For FY 2022, our budget will support policy projects related to fulfilling the mission 

of the Council. 

• For FY 2023, our budget will support policy projects related to fulfilling the mission 

of the Council.

While NCD’s costs relative to editing and printing have and will remain modest due to 

reliance on several Government Publishing Office (GPO) federal programs that negotiate 

the best prices for government customers, NCD intends to slightly increase its funding of 

program and research activities in FY 2022. In view of information NCD has received 

during extensive and ongoing stakeholder engagements in FY 2021 with the disability 

community, this budget allocation will enable NCD to contract for supplemental subject 

matter expertise and data in relation to envisioned policy projects to advise policy makers 

in the Administration and Congress in the areas of disability health equity, Medicaid 

portability, , voting rights of people with disabilities in light of recent state developments, as 

well as follow-on work in relation to our bioethics series of reports from 2019 - with 

particular focus on the Quality-Adjusted Life Years (QALY) report. The Council voted to 

prioritize three additional areas of focus in FY 22 and FY 23, noted earlier in the 

justification in more detail: 

• follow up to our Medicaid reimbursement report;

• tax policy implications on people with disabilities; and 

• and a federal employment program inventory. 

In FY 22, we are slated to complete our recently commissioned work on how to improve 

home and community-based services in light of what we’ve learned during the pandemic,

and states use of Quality Adjusted Life Year (QALY) Based Cost-Effectiveness Reports to 

Inform Medicaid Coverage for Prescription Drugs, following up on NCD’s report, Quality 

Adjusted Life years and the Devaluation of Life with a Disability. 
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AUDIT

FY 2022 $ 0

FY 2023 $42,500

As part of our reform plan and allowed per the Accountability for Tax Dollars Act 

requirement for an annual preparation and audit of financial statements of smaller 

agencies, we have been exempted by OMB for an annual audit in recognition of the 

stewardship we have presented through ongoing unqualified audits. 

NCD was exempted from conducting an annual audit by OMB beginning in Fiscal Year 

2018, and in place of an annual audit, a biennial independent financial audit is conducted 

utilizing an outside vendor to conduct a two-year financial audit of our internal operations. 

This first biennial audit occurred in FY 2019 for FY 2018 and FY 2019 and concluded with 

no findings. The audit for FY 2020 and FY 2021 utilized Fiscal Year 2021 funds and is not 

set to reoccur again until Fiscal Year 2023 with Fiscal Year 2023 funds at an estimated 

obligation of $42,500 for an independent audit of NCD’s financials for Fiscal Years 2022 

and 2023 simultaneously. The audit reviews the Council's internal control over financial 

reporting in compliance with OMB audit guidance for expressing an opinion on financial 

statements in line with the Council’s annual Performance and Accountability Report.

PAYROLL, ACCOUNTING AND HR SERVICES

FY 2022 $158,000

FY 2023 $235,000

• For FY 2022, an increase in costs associated with our vendors is reflected in the 

budget accordingly. 

• For FY 2023, we budgeted for increase of 60% in our overall Accounting and 

Payroll services and adjusted the budget accordingly. NCD is pursuing a transition 

in service providers to better meet the needs of the agency. 

We contract with the General Services Administration (GSA) Commissions and Boards 

(CABS) human resource services and Office of the Chief Financial Officer (OCFO) for 

payroll, accounting, and HR services. Through these interagency agreements, we receive 
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support to complete payroll, accounting, and human resource services. Our agreements 

also position NCD to utilize adhoc services such as legal consultation, human relations 

support, and other services as identified. We do not have the resources to employ full-time 

staff with expertise in all areas the agency requires. With oversight and support of 

professional FTEs, these service level agreements facilitate smooth operations and assists 

in fulfilling federal requirements. 

SUPPORT CONTRACT SERVICES

FY 2022 $279,642

FY 2023 $260,500

• For FY 2022, our contractual services budget is based upon the needs and 

accommodations of the Council, staff, and members.

• For FY 2023, our contractual services budget is based upon the needs and 

accommodations of the Council, staff, and members.

Many of the staff and Council members are people with a variety of disabilities. We provide 

accommodations for employees with disabilities during work hours and at meetings and

events for participants as requested. In FY 2020, we contracted with a part-time personal 

services contractor, which we have maintained, to provide personal attendant assistance 

to staff, council members and guests. 

INFORMATION TECHNOLOGY (IT)

FY 2022 $319,800

FY 2023 $165,904

• For FY 2022, additional funding is necessary for NCD to move toward full and 

ongoing compliance with IT and cybersecurity mandates. In Fiscal Year 2022, we 

plan to focus on implementing the following mandates:

o Manage NCD's risk management framework for security compliance using 

Open Fisma +. The risk management framework describes how an agency 

must access, monitor, and respond to risk;
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o Upload and monitor our agency Plans of Actions and Milestones (POAM's), 

review and respond to the risk of classified and low, medium, or high and 

guide the agency toward compliance;

o Support and upkeep on SharePoint;

o Communicate on secured phone lines that are IP based;

o Provide ongoing security for the agency by maintaining MTIPS to address 

high level federal requirements with a secure connection to the public 

internet in full compliance with OMB's Trusted Internet Connection (TIC); and

o Employ or contract with a Cyber Security Specialist to write policies, 

procedures, and standards following OMB & DHS Directives in addition to 

providing ongoing support and compliance with cybersecurity mandates.

• For FY 2023, NCD will continue to move toward full and ongoing compliance with IT 

and cybersecurity mandates.

As a small agency, we secure outside support to assist in meeting the Council’s IT and 

cybersecurity requirements. Expenses began increasing in FY 2018 and have continued to 

represent a significant amount of the Council’s appropriation. Additional expenses are a 

result of new and ongoing federal requirements such as the EINSTEIN cybersecurity 

initiative, and implementation of TIC 3.0 and OpenFisma++, to name a few. These costs

are ongoing to ensure compliance with all cybersecurity and FISMA mandates, and to 

assist in the security and protection of all Government networks. 
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PAYMENTS TO FEDERAL AGENCIES

FY 2022 $ 4,800

FY 2023 $ 6,750

Costs are relative to the anticipated needs of the Council during each fiscal year in addition 

to the Council’s decision to utilize fee-for-service expertise. 

As a small agency, we secure services through interagency agreements with other federal 

agencies for technical functions such as job postings, procurements, and security services, 

to name a few. Under the oversight of professional staff, utilizing interagency agreements 

in this way assists us in fulfilling federal requirements by providing subject matter 

expertise.

SUPPLIES, SUBSCRIPTIONS AND MATERIALS

FY 2022 $ 60,000

FY 2023 $ 61,500

Costs are relative to the anticipated needs of the Council during each fiscal year. 

The Council utilizes professional periodicals, subscriptions, technical publications, and 

services to stay informed of policy developments, conduct legal and other research, and 

access federal directories in furtherance of its mission. These resources are essential is

assisting staff to fulfill mission critical work for the Council. 

As a micro agency, NCD is a good steward of federal funds and utilizes a very small 

budget for office supplies, furniture and general supplies each year. In FY22, we anticipate 

the costs of supplies to increase as we support our employees in a maximum telework 

environment. Furniture needs are expected to decrease due to working in a maximum 

telework environment. 
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ANTI-DEFICIENCY 

FY 2022 $ 37,500

FY 2023 $ 38,500

The Council reserves one percent of our annual appropriated budget for unanticipated 

expenses and to ensure the Council does not exceed available funds. 
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APPENDIX C

Organizational Chart

Council Chair

Executive Director

Director of Legislative 

Affairs & Outreach

(duties temp assumed by 

Executive Director)

Director of Operations & 

Administration

General Counsel

& Director of Policy

Senior AttorneyAdvisor

Staff Assistant

Financial 

Management Analyst

Legislative Affairs 

Specialist 

Public Affairs 

Specialist

Senior AttorneyAdvisor

Senior AttorneyAdvisor

Special Assistant

(Contractor)

IT/Cybersecurity 

Specialist

(Part-time Contractor)

Administrative 

Support Specialist

Administrative 

Personal Attendant 

(Part-time Contractor)

Council Members

Legislative Affairs 

Advisor

(Contractor)
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APPENDIX D

MAJOR MANAGEMENT PRIORITIES AND CHALLENGES

Costs of Implementing Federal Cybersecurity Requirements

We have continued to enhance our cybersecurity program and have entered into a 

Memorandum of Agreement (MOA) with the Department of Homeland Security (DHS) and 

the Department of Defense (DOD) to secure America’s cyber networks. We also entered a 

MOA with the DHS, Office of Cybersecurity and Communications to ensure the 

deployment of EINSTEIN Cybersecurity capabilities. We have been participating in the 

deployment of EINSTEIN Intrusion Prevention Security Services (IPSS) on our networks 

for network security purposes, to look for network traffic indicating known or suspected 

malicious cyber activity. NCD continues to make strides to improve our cybersecurity 

posture by utilizing initiatives in the Federal Government such as the Continuous 

Diagnostics and Mitigation (CDM) program Federal Government cybersecurity initiative led 

by the Department of Homeland Security (DHS) and the Cybersecurity and Infrastructure 

Security Agency (CISA). 

In FY 2023, the total budget needed to implement improvements to the efficiency and 

effectiveness of our operations in the area of cybersecurity is summarized below. 

Activity FY23 Description 

Open Fisma + Software $ 6,000.00 

Open Fisma + is a workflow-based

security management tool that aids in 

meeting compliance requirements. The 

tool tracks, manages, and monitor 

agency Plans of Actions and Milestones 

(POAMs) for security findings and 

control weaknesses. 

Open Fisma + cyber work $ 35,000.00 

Manages NCD's risk management 

framework for security compliance using 

Open Fisma +. The risk management 

framework describes how an agency 

access, monitor and respond to risk. A 

contractor uploads and monitors all of 

our agency Plans of Actions and 

Milestones (POAM's) and informs the 

agency on risks identified and the 

classification as low, medium, or high, 
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followed by guiding the agency in order 

to become compliant.

SharePoint Maintenance $ 22,800.00 

Support and Upkeep of SharePoint

(NARA compliance)

VOIP $ 3,000.00 

Operational purpose to communicate on 

a secured phone line that are IP based. 

Managed Trusted 

Internet Protocol Services 

(MTIPS) $ 33,332.00

MTIPS provides security for agencies 

online traffic and addresses high level 

federal requirements with a secure 

connection to the public internet in full 

compliance with OMB's Trusted Internet 

Connection (TIC). 

ATO (Authority to 

Operate) $ 60,000.00 

Authority to operate on Government 

network which needs to be updated 

every 12 months. 

Virtual CISO $ 100,000.00 

Cyber Security Staff or Contractor to

write required policies, procedures, and 

standard in additional to providing 

support by following OMB & DHS 

directives & mandates.

Audit $ 12,000.00 

Audit for CIO Fisma Metrics and the 

Agency Report to OMB/DHS via 

CyberScope 

Security Assessment & 

Authorization $ 35,000.00 

System Security Plan (SSP) will reveal 

what system(s) are in place and what 

support is needed. This will also cover 

penetration testing which is an ethical 

hacker that connects to your network in 

an attempt to obtain passwords. Once 

the test is done, the agency will know 

what to improve. A risk assessment will 

also be completed on our network.

Total Cost $ 307,132.00
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MAJOR MANAGEMENT PRIORITIES & CHALLENGES (continued)

Costs of developing a workforce for the 21st Century

Management’s major priorities for the National Council on Disability for Fiscal Year 2023

are to:

1. Thoughtfully assess agency workforce, workload, and workflow against the any 

applicable executive orders and OMB guidance;

2. Pursue ongoing review and updates to our internal control policies and procedures; 

3. Continue compliance with mandated cybersecurity protocols, as the budget allows; 

and

4. Hire, train, develop, and retain an exceptional workforce, with a priority on hiring 

people with disabilities.

An enduring management challenge is how best to approach the allocation of the Council’s 

limited financial and human resources. The Council has been operating with eleven fulltime staff and nine Council members, who balance their service to the Council with their 

own full-time careers. Given the breadth of our mission, the scope of our engagement, 

policy development, and collaborative activities are often limited by the lack of workforce. 

Our modest budget and small workforce necessitate balancing and prioritizing stakeholder 

needs with available resources. 

Related to the allocation of resources, maintaining a continuity of workforce is both a 

management priority and challenge. Unlike a larger agency that can withstand numerous 

vacancies without immediate implication to mission accomplishment or the operational 

integrity of the Council, in an agency of our size, even a single vacancy can create a 

palpable effect on the Council. Additionally, with the extent of discrete responsibilities 

every federal agency faces, regardless of size, individual employees may be the sole 

individual responsible for and knowledgeable of how to complete tasks. This necessarily 

creates risk for which the Council must account for and control. Therefore, continuity of 

leadership, employee retention, professional development, and cross-training among 

employees are always priorities of management as are persisting in efforts to seek 

opportunities to strengthen and add to the number of staff.

We establish and maintain effective internal control and financial management systems 

that meet the objective of the Federal Manager's Financial Integrity Act. Based upon the 
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results of the independent auditor’s biennial report, we can provide reasonable assurance 

that our internal control over the effectiveness and efficiency of operations and compliance 

with applicable laws and regulations is operating effectively and no material weaknesses 

were found in the design or operation of the internal controls.

NCD publishes several full-length reports every year, in addition to advising and 

responding to multiple requests on various topics. In Fiscal Year 2021, we released three

full-length reports. Most research projects involve outside contractual assistance. These 

full-length reports are fulsome research endeavors that entail a broad scope of policy 

consideration, and/or address an emerging topic or technology that we urge policymakers 

to consider. While we will continue to fulfill our mandate to serve policymakers and 

respond to the disability community’s interests and publish annual research/policy reports, 

we are also an agency with operational requirements in addition to ever greater needs in 

the disability community to fulfill. 

STAFFING NEEDS TO SUPPORT THE MISSION OF THE COUNCIL

Since the inception of NCD and its original statutory charge to review and advise on laws 

and policies impacting people with disabilities, numerous amendments to existing civil 

rights laws as well as the passage of new laws has vastly expanded the scope of our work, 

and yet, the workforce of the Council has remained level for many years. However, the 

number of appointed council members decreased as a result of the Workforce Innovation 

and Opportunity Act.. The reduction in appointees also represented a reduction in the 

amount of professional experts who could bring their respective areas of expertise to bear 

on behalf of the Council’s work.

Given our charge to review and advise on existing and proposed laws and policies and the 

growing number of laws and policies for people across all types of disabilities, regardless 

of age or severity of disability, it has become a far more difficult task for the Council to 

service the mission of the Council with level staffing. To be timely and responsive to our 

advisees, the workload for existing staff has continually increased, with several staff 

completing assignments that equal the workload of multiple positions. Any loss in funding 

directly impacts the mission critical work of the Council.

Despite our small size, NCD must comply with requirements placed on much greaterresourced agencies. The financial demands of mandated requirements have the potential 
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to compromise NCD’s ability to complete the work that is critical to the mission of the 

Council, the Federal Government, and the disability community. To ensure the safety and 

security of the government’s network, the demand for resources to support the mandated 

requirements for compliance are ongoing for the foreseeable future. 

Based upon our FY 2023 request and cybersecurity requirements, we will utilize a portion 

of the increase in appropriations to help shore up the workforce needs of the Council

related to the mission-critical policy research and advisement work of the Council through 

contractual services and/or not to exceed (NTE) term appointments. The need is acute, 

particularly during a time of critical focus on the needs of a burgeoning aging population 

and new scores of people experiencing “long-COVID,” who will require multi-disciplinary 

policy solutions. We recognize that it is likely to be a modest initial investment in a much 

larger need than we currently have resources to accommodate. Accordingly, we will 

endeavor to invest more funding into efforts to hire, train and retain the Council’s existing 

workforce in future fiscal years as budget and guidance allows.

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