The Impact of the 

Americans with Disabilities Act: 

Assessing the Progress Toward 

Achieving the Goals of the ADA

National Council on Disability 

July 26, 2007
National Council on Disability 

1331 F Street, NW, Suite 850 

Washington, DC 20004 

The Impact of the Americans with Disabilities Act: Assessing the Progress Toward 

Achieving the Goals of the ADA 

This report is also available in alternative formats and on the award-winning National Council 

on Disability (NCD) Web site (www.ncd.gov). 

Publication date: July 26, 2007 

202-272-2004 Voice 

202-272-2074 TTY 

202-272-2022 Fax 

The views contained in this report do not necessarily represent those of the Administration as 

this and all NCD documents are not subject to the A-19 executive branch review process.
 National Council on Disability 

An independent federal agency making recommendations to the President and Congress 

to enhance the quality of life for all Americans with disabilities and their families. 

1331 F Street, NW  Suite 850  Washington, DC 20004 

202-272-2004 Voice  202-272-2074 TTY  202-272-2022 Fax  www.ncd.gov 

1 

Letter of Transmittal 

July 26, 2007 

The President 

The White House 

Washington, DC 20500 

Dear Mr. President: 

The National Council on Disability (NCD) is charged with gathering information about the 

implementation, effectiveness, and impact of the Americans with Disabilities Act (ADA). In 

keeping with this requirement, I submit this new report, entitled The Impact of the Americans 

with Disabilities Act: Assessing the Progress Toward Achieving the Goals of the ADA, which 

addresses many of the goals of your New Freedom Initiative pertaining to community 

integration, participation, and enhancement of the independence of people with disabilities at 

home, at work, and throughout the course of their daily lives. 

The purpose of the ADA is “to provide a clear and comprehensive national mandate for the 

elimination of discrimination against individuals with disabilities.” This report describes a twoyear retrospective study and review of the impact the ADA has had on the lives of Americans 

with disabilities over the past sixteen years, with particular focus on the four major goals of the 

ADA—equality of opportunity, full participation, independent living, and economic selfsufficiency. NCD consulted disability experts and ADA stakeholders from around the country 

through interviews, public forums, and focus groups, and analyzed existing data and information 

sources to gather information about the impact of the ADA. The findings are encouraging but far 

from complete. 

The provisions of the ADA addressing architectural, transportation, and communication 

accessibility have changed the face of American society in numerous concrete ways, enhancing 

the independence, full participation, inclusion, and equality of opportunity for Americans with 

disabilities. Americans with disabilities report having greater access to goods and services from 

businesses, state and local governments, and their local communities. People with mobility 

impairments have experienced substantial improvements in physical access to transportation, 

businesses and government agencies. As workers, people with disabilities are more likely to 

receive accommodations and less likely to be terminated due to their disabilities. However, 

obtaining employment remains difficult for people with visible and severe disabilities. 

Disparities still exist in access to health insurance, health care, and financial assets for people 

with disabilities, as compared to people without disabilities. Access to information, particularly 
the Internet, is inconsistent, at best, for people who are visually impaired. Progress toward the 

goal of economic self-sufficiency appears to be the goal having the least success. 

The ADA impact report contains recommendations for addressing the barriers that are preventing 

full achievement of the overarching goals of the ADA, and NCD remains committed to working 

with the Administration, Congress, and the public to achieve the promise of the ADA for all 

Americans—the elimination of disability-based discrimination in all aspects of society. 

Sincerely, 

John R. Vaughn 

Chairperson

2
3 

National Council on Disability Members and Staff 

Members 

John R. Vaughn, Chairperson 

Patricia Pound, First Vice Chairperson 

Glenn Anderson, Ph.D., Second Vice Chairperson 

Milton Aponte, J.D. 

Victoria Ray Carlson 

Chad Colley 

Robert R. Davila, Ph.D. 

Graham Hill 

Young Woo Kang, Ph.D. 

Kathleen Martinez 

Lisa Mattheiss 

Anne M. Rader 

Marco Rodriguez 

Cynthia Wainscott 

Linda Wetters 

Staff 

Michael C. Collins, Executive Director 

Martin Gould, Ed.D., Director of Research and Technology 

Mark S. Quigley, Director of Communications 

Julie Carroll, Senior Attorney Advisor 

Joan M. Durocher, Senior Attorney Advisor 

Geraldine Drake Hawkins, Ph.D., Senior Program Analyst 

Pamela O’Leary, Sign Language Interpreter 

Mark E. Seifarth, Congressional Liaison 

Brenda Bratton, Executive Assistant 

Stacey S. Brown, Staff Assistant 

Carla Nelson, Secretary 

3 
4 

Acknowledgments 

The National Council on Disability wishes to express its appreciation to Patricia M. Jackson, 

Program Manager Lockheed Martin Services, Inc., Peter Blanck, Ph.D., J.D., Chair, Burton Blatt 

Institute, Syracuse University, and James Schmeling, J.D., Interim Co-Director, Law, Health 

Policy and Disability Center, University of Iowa College of Law, for conducting the ADA 

Impact Study and for drafting this report. 
5 

Table of Contents

Executive Summary........................................................................................................................ 9 

Introduction................................................................................................................................... 19 

Summary of Methodology ............................................................................................................ 23 

Perceptions of the ADA Overall................................................................................................... 25 

I. Equality of Opportunity............................................................................................................. 29 

A. Transportation.......................................................................................................................29 

1. Public Transportation........................................................................................................ 29 

a. Trains............................................................................................................................. 31 

i. ADA Requirements ................................................................................................... 31 

ii. Relevant Data ........................................................................................................... 31 

(a). Light Rail and Commuter Rail ........................................................................... 32 

(b). Amtrak................................................................................................................ 35 

b. Buses............................................................................................................................. 35 

i. ADA Requirements ................................................................................................... 35 

ii. Relevant Data ........................................................................................................... 36 

c. Paratransit Services ....................................................................................................... 37 

i. ADA Requirements ................................................................................................... 37 

ii. Relevant Data ........................................................................................................... 37 

d. Input from People with Disabilities .............................................................................. 38 

2. Private Transportation....................................................................................................... 39 

a. Private Over-the-Road Bus Service .............................................................................. 39 

b. Taxis.............................................................................................................................. 40 

i. ADA Requirements ................................................................................................... 40 

ii. Relevant Data ........................................................................................................... 40 

iii. Input from People with Disabilities......................................................................... 41 

3. Recommendations – Transportation ................................................................................. 41 

B. Sidewalks and Curb Ramps ..................................................................................................41 

1. Sidewalks .......................................................................................................................... 42 

a. ADA Requirements....................................................................................................... 42 

b. Relevant Data................................................................................................................ 42 

2. Curb Ramps ...................................................................................................................... 42 

a. ADA Requirements....................................................................................................... 42 

b. Relevant Data................................................................................................................ 43 

c. Input from People with Disabilities .............................................................................. 44 

3. Recommendations – Sidewalks and Curb Ramps ............................................................ 44 

C. Places of Public Accommodation .........................................................................................45 

1. Physical Accessibility for People with Mobility Impairments ......................................... 45 

a. ADA Requirements....................................................................................................... 45 

b. Relevant Data................................................................................................................ 45 

c. Input from People with Disabilities .............................................................................. 49 

2. Access for People with Vision, Hearing, and Speech Disabilities.................................... 52 

a. ADA Requirements....................................................................................................... 52 

b. Relevant Data................................................................................................................ 52 
6 

c. Input from People with Disabilities .............................................................................. 52 

3. Recommendations – Places of Public Accommodations.................................................. 53 

D. Accessibility of Telecommunications...................................................................................54 

1. ADA Requirements........................................................................................................... 54 

2. Relevant Data.................................................................................................................... 55 

3. Input from People with Disabilities .................................................................................. 57 

4. Recommendations – Accessibility of Telecommunications ............................................. 58 

II. Full Participation...................................................................................................................... 59 

A. State and Local Government Services ..................................................................................59 

1. ADA Requirements........................................................................................................... 59 

2. Relevant Data.................................................................................................................... 60 

3. Input from People with Disabilities .................................................................................. 63 

4. Recommendations – State and Local Government Services ............................................ 64 

B. Voting....................................................................................................................................65 

1. ADA Requirements........................................................................................................... 65 

2. Relevant Data.................................................................................................................... 66 

3. Input from People with Disabilities .................................................................................. 70 

C. Other Forms of Civic Participation.......................................................................................70 

D. Recommendations – Full Participation.................................................................................71 

III. Independent Living ................................................................................................................. 73 

A. Community Integration.........................................................................................................73 

1. ADA Requirements........................................................................................................... 73 

2. Relevant Data.................................................................................................................... 74 

a. Federal Olmstead Initiatives ......................................................................................... 74 

i. Department of Health and Human Services (HHS)................................................... 74 

ii. Department of Justice (DOJ) .................................................................................... 74 

iii. Department of Labor (DOL) ................................................................................... 75 

b. State Olmstead Initiatives ............................................................................................. 76 

3. Input from People with Disabilities .................................................................................. 80 

B. Recommendations – Independent Living..............................................................................82 

IV. Economic Self-Sufficiency..................................................................................................... 83 

A. Financial Assets and Insurance.............................................................................................83 

1. Financial Assets ................................................................................................................ 83 

2. Health Insurance ............................................................................................................... 85 

B. Higher Education ..................................................................................................................85 

1. ADA Requirements........................................................................................................... 85 

2. Relevant Data.................................................................................................................... 86 

3. Input from People with Disabilities .................................................................................. 88 

C. Employment ..........................................................................................................................89 

1. Hiring ................................................................................................................................ 89 

a. ADA Requirements....................................................................................................... 89 

b. Relevant Data................................................................................................................ 89 

c. Input from Employers ................................................................................................... 92 

d. Input from People with Disabilities .............................................................................. 93 

2. Reasonable Accommodation and Promotion.................................................................... 95 

a. ADA Requirements....................................................................................................... 95 
7 

b. Relevant Data................................................................................................................ 95 

c. Input from People with Disabilities and Employers ..................................................... 99 

3. Lawsuits .......................................................................................................................... 101 

D. Recommendations – Economic Self-Sufficiency ...............................................................102 

Summary of Findings.................................................................................................................. 105 

Summary of Recommendations.................................................................................................. 107 

Conclusion .................................................................................................................................. 113 

Appendix A: Blue Ribbon Panel................................................................................................. 115 

Appendix B: Methodology ......................................................................................................... 117 

Appendix C: Mission of the National Council on Disability...................................................... 121 

Endnotes...................................................................................................................................... 125 
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9 

Executive Summary 

Sixteen years after the Americans with Disabilities Act (ADA) was signed into law on July 26, 

1990, by President George H. W. Bush, the law is having a meaningfully positive impact on the 

lives of people with disabilities. Many people with disabilities credit the ADA with improving 

their lives. As consumers, Americans with disabilities have greater access to goods and services 

from businesses, state and local governments, and their local communities. Service animals for 

people with vision and other impairments are more accepted than ever before. In addition, 

greater availability of relatively inexpensive assistive technology has helped people with vision 

and hearing impairments overcome information and communication barriers to all forms of 

community participation. People with mobility impairments have experienced substantial 

improvements in physical access to transportation, businesses and government agencies. As 

workers, people with disabilities are more likely to receive accommodations and less likely to be 

terminated due to their disabilities. 

Many people with disabilities, employers, and businesses, however, still do not understand major 

provisions of the ADA, particularly the employment provisions. The ADA is a civil rights law—

requiring equal opportunity for individuals with disabilities, with broad coverage and setting 

clear, consistent, and enforceable standards prohibiting discrimination on the basis of disability. 

Title I of the ADA prohibits discrimination in employment. It does not provide for accessible 

housing, transportation to the work site, rehabilitation services, job training, job placement, or 

any form of affirmative action for people with disabilities. It does not address work 

disincentives, such as Social Security rules that make people with disabilities who work 

ineligible for Medicaid, the only form of insurance that provides the kind of services most people 

with disabilities need to function independently, nor does it require employers to provide the 

kind of insurance coverage people with disabilities need. While the ADA requires existing 

transportation services to become accessible, it does not provide transportation for people with 

disabilities to get to work if they work or live where there is no public transportation. To 

determine the impact of Title I, one must look at the degree to which employment discrimination 

against individuals with disabilities has decreased. One cannot measure the success of Title I 
10 

solely by the employment rate of people with disabilities unless all other barriers to work are 

eliminated. 

Many Americans with disabilities remain frustrated that disability discrimination has not been 

eliminated, despite ADA implementation. People with disabilities reported the ADA has not 

been fully enforced; the barriers they face remain primarily attitudinal. Additionally, there is a 

growing backlash against disability rights and the ADA. The lack of national consistency of 

access makes it difficult for people with disabilities to carry out daily activities, and access to 

public transportation, particularly in rural areas, remains a serious problem. Although, once on 

the job, accommodations are easier to obtain, people with visible disabilities do not appear to be 

significantly more likely to be hired than before the ADA, and some argue that they are having 

more difficulty getting hired than before. 

Regarding the attainment of the four major goals of the ADA—equality of opportunity, full 

participation, independent living, and economic self-sufficiency—the results are encouraging but 

far from complete. By virtue of greater availability of physical and communications access, 

accessible transportation, and education and workplace accommodations, people with disabilities 

have more opportunities to pursue their interests than before the ADA and are seizing those 

opportunities. Community participation has increased passively, by virtue of greater access, and 

actively, through greater efforts by businesses, employers, and governments to reach people with 

disabilities and encourage participation. Options for independent living have improved for 

people with disabilities since the ADA was passed, particularly since an important Supreme 

Court decision, Olmstead v. L.C., which requires community integration. However, outdated 

government restrictions, budget priorities, and medical attitudes are slowing progress. Economic 

self-sufficiency appears to be the goal having the least success. While many Americans with 

disabilities are experiencing improvements in quality of life, some people with disabilities 

remain disenfranchised. 

This retrospective study and review provides a snapshot of the impact the ADA has had on the 

lives of Americans with disabilities over the past sixteen years. Specifically: 
11 

• Most people with disabilities perceive improvements in their quality of life and many attribute 

those improvements to the ADA; 

• A majority of people with disabilities surveyed by a Harris Poll perceived significant 

improvements in public facility access and public attitudes; 

• Public transit systems in the United States have made significant progress in becoming more 

accessible, especially to wheelchair users. Private transportation companies lag behind. People 

in rural areas continue to be underserved by public transportation, and, as a result, participate 

less in all aspects of community living; 

• A significant number of curb ramps have been installed and sidewalks have been made more 

accessible in some areas, but full access to public rights-of-way lags behind that of other 

facilities and there are no regulations for public rights-of-way access; 

• People with physical disabilities have seen steady, although inconsistent, progress in access to 

public accommodations, including restaurants, theaters, stores, museums, Web sites, and 

government services. People with sensory or communication disabilities were less likely to 

report experiencing progress in access to public accommodations;

• The ADA has brought about significant improvements in access to telecommunications. 

Telephone relay services are being used to a greater degree, and changes in technology are 

making usage easier. However, some businesses are reluctant to use these technologies; 

• The percentage of Americans with disabilities voting in 2004 increased dramatically from 

prior years;

• The education gap between people with disabilities and people without disabilities is 

shrinking, and people with disabilities are attending postsecondary institutions in greater 

numbers. Educational supports and services for students with disabilities now are available at 

most of the nation’s postsecondary institutions; 

• Many employees with disabilities are experiencing less discrimination on the job. However, 

people with visible and severe disabilities continue to experience discrimination in hiring;

• There is no clear evidence that Americans with disabilities are becoming economically selfsufficient; 
12 

• There is a surprising absence of ongoing, systematic data collection about the ADA, and the 

result is significant knowledge gaps about the impact of the ADA. 

Based on these findings, this report recommends: 

• Federal agencies should fund and implement state-by-state surveys of people with disabilities, 

based on the N.O.D./Harris Surveys using statistically significant survey populations and 

distinguishing among rural and urban communities, communities of diverse cultures, and 

high, middle, and low income communities. 

Equality of Opportunity – Transportation 

• Congress should expand accessibility requirements for rail services beyond key stations; 

• The Department of Transportation should conduct extensive training and outreach for public 

transit providers regarding maintenance and stop announcements; 

• The Department of Transportation should work with state and local governments and taxi 

providers to develop and publicize effective incentives for private taxi providers to offer 

accessible vehicles; 

• The Department of Transportation should conduct extensive training and outreach for public 

and private transportation services regarding service animals and increase high-profile 

enforcement actions by the Departments of Justice and Transportation; 

• The Department of Transportation should work with paratransit providers, state and local 

governments, transportation experts, and representatives of disability and aging communities 

to explore paratransit options such as more subscription service, more flexible services, and 

other ideas to close the expectation gap and increase usability of paratransit for riders with 

disabilities; 

• The Department of Transportation should study and test options for providing transportation 

services to people with disabilities in rural areas. 
13 

Equality of Opportunity – Sidewalks and Curb Ramps 

• The Department of Justice should promulgate ADA regulations for public rights-of-way as 

soon as possible;

• The Department of Transportation should increase funding for sidewalk access and curb ramp 

installation; 

• The Department of Justice should develop and disseminate guidelines for the prioritization of 

curb ramp installations, so the most needed and useful curb ramps are installed first. 

Equality of Opportunity – Public Accommodations 

• The National Institute on Disability and Rehabilitation Research (NIDRR) should conduct a 

survey of businesses, perhaps through the chambers of commerce or small business 

associations, to determine the degree to which businesses have instituted readily achievable 

barrier removal efforts, and provide guidance to Congress on adequately funding the 

Department of Justice to enforce this part of the statute; 

• The Department of Justice, NIDRR, and the Department of Labor should provide expert, 

individualized, low-cost technical assistance and consulting to small businesses. The ADA 

and IT Centers and local offices of the National Disability Rights Network are possible 

agencies to carry out this effort; 

• The Department of Justice should expand its Project Civic Access to increase enforcement in 

local areas by reviewing businesses in identified localities;

• Congress should require states to submit their building codes for access certification by the 

DOJ; 

• The U.S. Access Board and Department of Justice should continue coordination with model 

building code agencies; 

• The Department of Justice should increase enforcement and education regarding how to serve 

customers with visual and hearing impairments, particularly as it pertains to Web access and 

use of TTYs and relay services; 
14 

• Congress should require Web sites of places of public accommodations and commercial 

facilities to comply with federal Web accessibility standards; 

• The Department of Justice and NIDRR should develop technical assistance materials 

regarding what people with disabilities and businesses should expect of existing buildings of 

various sizes years after passage of the ADA. 

Equality of Opportunity – Accessibility of Telecommunications 

• The Department of Justice should publish information for businesses about how 

Telecommunications Relay Services work, how to use the service, and the legal obligation to 

use it. The ADA and IT Centers could be funded to provide this information; 

• The Federal Communications Commission should establish standards to encourage the 

continued development of Video Relay Services. 

Full Participation – State and Local Government Services 

• The Department of Justice and other federal agencies should focus on enforcing the ADA 

obligations of government agencies; 

• Federal agencies should use initiatives such as Project Civic Access to increase ADA 

compliance at the state and local levels; 

• The Department of Justice should use targeted, high-profile litigation on particularly 

important issues, such as access to courts, medical care, and education to increase state and 

local ADA compliance. 

Full Participation – Voting 

• The Department of Justice should immediately implement the Help America Vote Act 

requiring installation of electronic voting equipment; 

• NIDRR should study the involvement of people with disabilities in civic opportunities, such 

as government office; 
15 

• Other non-governmental disability organizations, such as The National Organization on 

Disability and the American Association of People with Disabilities, should encourage state 

and local governments, as part of their diversity efforts, to emphasize involvement of the 

disability community and provide technical assistance to help government agencies reach out 

to people with disabilities. 

Community Integration 

• Congress should increase Medicaid support for community-based treatment settings; 

• Congress should pass and fully fund the Money Follows the Person Act1 and Medicaid 

Community-Based Attendant Services and Supports Act;2

• Congress should require states to expeditiously complete effective Olmstead plans, consistent 

with HHS guidance;

• The Department of Health and Human Services should require states to fund personal care 

services when needed to allow individuals with disabilities to remain in their community; 

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

working with state and local governments and community agencies should implement local 

initiatives to extend the integration mandate to housing, education, transportation, 

employment, and other areas affecting people with disabilities; 

• The Department of Justice should increase and target enforcement of the Civil Rights of 

Institutionalized Persons Act, requiring effective deinstitutionalization efforts and publishing 

creative and effective programs to provide community-based services; 

• The Department of Labor’s program funding home modifications should be significantly 

expanded to allow people with disabilities and the elderly to live in their communities; 

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

should work with disability communities and others to develop an overall national policy 

framework for community integration of people with disabilities; 
16 

• The Department of Health and Human Services should study systems of long-term care and 

long-term care insurance to eliminate unnecessary institutionalization of people with 

disabilities and aging people. 

Economic Self-Sufficiency 

• The Department of Education should work with colleges, universities, and public schools to 

enhance the effectiveness of supports, such as preparing students to better negotiate their 

accommodations, assisting students with coordinating and managing a variety of services 

from multiple sources, and facilitating the use of technology in education and employment; 

• The Department of Education should improve coordination of services between the 

educational system and the vocational rehabilitation system, particularly as regards funding 

for services and assistive technology; 

• Disability organizations, and research and policy centers focused on economic empowerment 

for people with disabilities should work with philanthropists and federal and state government 

agencies to improve availability of scholarship, tuition waiver, and loan repayment programs 

for students and adults with disabilities who wish to pursue higher education; 

• Congress should extend and expand the Mental Health Parity Act to ensure that people with 

mental health disabilities are able to secure treatment; 

• NIDRR should study insurance coverage issues that prevent people with disabilities from 

accessing private insurance; 

• The Equal Employment Opportunity Commission, the Department of Labor, and NIDRR 

should place immediate priority on increasing the hiring of people with disabilities. 

Sixteen years after the passage of the ADA, much has been accomplished. Yet, more needs to be 

done as this report demonstrates, especially in the areas of employment, transportation, health 

care, and education. 

The Americans with Disabilities Act Restoration Act of 2006 was introduced on September 29 to 

address aspects of the ADA narrowed by U.S. Supreme Court decisions, and which are discussed 
17 

in this report. The bill would prohibit discrimination “on the basis of a disability” and is intended 

to enable individuals utilizing the ADA to focus on the discrimination they have experienced 

rather than having to prove they fall within the intended scope of the ADA. Passage of this bill 

will promote progress in those areas remaining to be addressed, and promote the inclusion of 

people with disabilities into society. 
18 
19 

Introduction 

To the critics who complain that the ADA has not achieved total justice ... I say 

what about the Bill of Rights and the Ten Commandments? Have they achieved 

total justice? The vision of justice is an eternal long march to the Promised Land 

of the good life for all. 

– Justin Dart, Jr., “Father of the ADA”3

Today, in 2006— 

Mary Sims gets on the bus and goes to work. 

John Witherspoon talks on the telephone to a college buddy he hasn’t seen in 20 years. 

Lisa Rabinovitz tries out a new restaurant in her neighborhood. 

Jeremy Montauk takes notes during his economics professor’s lecture. 

Sylvia Mathias leads a training session on community advocacy. 

Billy Wilkinsen takes part in his town’s intramural baseball program. 

Before the Americans with Disabilities Act of 1990 (ADA), Mary Sims, who is blind, would not 

have been able to take the bus to work. Her guide dog could not accompany her unless her state 

had a disability antidiscrimination law. Without the telecommunications relay services mandated 

by the ADA, John Witherspoon, who is deaf, would have difficulty telephoning anyone. Lisa 

Rabinovitz, a wheelchair user, rarely would eat out at a new restaurant, concerned that it would 

not be physically accessible. Jeremy Montauk, who has a learning disability, likely would not 

have received accommodations to attend and succeed in college. Fearing discrimination, Sylvia 

Mathias would not have disclosed her disability and become an advocate for people with mental 

illnesses in her community. And Billy Wilkinsen, who has an intellectual disability, may not 

have been allowed to play on the town’s baseball team. 

Prior to the ADA, employment and rehabilitation programs for people with disabilities were 

modeled on outmoded and medicalized stereotypes. These long-standing views date back to the 

birth of the Civil War pension system, which linked the definition of disability to an inability to 
20 

work and established physicians as the medical gatekeepers of disability benefits.4 The medical 

model defined disabilities as individual infirmities that precluded full participation in 

employment, and society in general.5 Many individuals were institutionalized, their housing and 

treatment determined by doctors, rehabilitation professionals, psychologists, and social workers. 

Because the medical model never questioned the physical and social environment in which 

disabled people were forced to function, one designed for individuals without disabilities, it 

countenanced their segregation and economic marginalization.6

By contrast, the disability civil rights model that influenced government policy in the 1970s 

conceptualized people with disabilities as a minority group entitled to the same legal protections 

for equality that emerged from the struggles of African Americans and women. The civil rights 

model focuses on the laws and practices that subordinate disabled persons and insists that 

government must secure the equality of disabled persons by eliminating the legal, physical, 

economic, and social barriers that preclude their full involvement in society. Under the civil 

rights model, disability is not an individual’s infirmity but a social and cultural construct.7

 An 

evolving policy of inclusion fostered federal and state laws to address issues including voting 

and air travel accessibility, access to education and housing, eventually culminating with passage 

of the ADA in 1990.8 In the ADA Congress expressly recognized the minority status of disabled 

persons, finding that: 

Historically, society has tended to isolate and segregate individuals with disabilities, and, despite 

some improvements, such forms of discrimination against individuals with disabilities continue 

to be a serious and pervasive social problem; ... and that] individuals with disabilities are a 

discrete and insular minority who have been faced with restrictions and limitations, subjected to 

a history of purposeful unequal treatment, and relegated to a position of political powerlessness 

in our society ....9

To redress these wrongs, the ADA’s drafters delineated “the Nation’s proper goals regarding 

individuals with disabilities are to assure equality of opportunity, full participation, independent 

living, and economic self-sufficiency for such individuals.”10 Sixteen years after passage of the 

ADA, the long march to full equality is underway. Progress has been made, but work remains in 
21 

areas such as employment, transportation, health care, and education, as shown by national 

statistics, studies, and comments received from the public during this study. 

NCD conducted this ADA Impact Project to review the existing information about the impact of 

the ADA, gathering input from ADA stakeholders and assessing the state of research and 

knowledge about the impact of the ADA, in an attempt to determine the extent to which the 

overarching goals of the ADA are being met. One of the important findings is a surprising 

absence of ongoing, systematic data collection about the ADA from any source. The result is 

significant knowledge gaps about many aspects of the ADA. 

Any study of the impact of the ADA must be undertaken with the recognition that full 

implementation of the ADA is not complete. The ADA calls for implementation at varying times 

and degrees, depending on factors such as when a facility is built or altered, the technical 

feasibility of certain accessibility requirements, the nature, size, and resources of covered 

entities, and the cost of modifications. For example, when a new facility is built, the ADA’s 

accessibility requirements are triggered. When a public accommodation is undertaking 

renovations or alterations of an existing facility, it must, to the “maximum extent feasible,” make 

the alterations in “such a manner” that the facility is accessible, but only to the extent that costs 

are not “disproportionate.” The overall accessibility standard under the ADA does not require 

total accessibility of all parts of buildings, nor that of all hotel rooms, parking spaces, bathrooms, 

stalls, etc., but only a reasonable number. For existing facilities not undergoing alterations, the 

ADA requires only accessibility changes that are “readily achievable,” defined to mean without 

much difficulty or expense. Additionally, transportation facilities are only required to make “key 

stations” accessible, and certain transportation providers can take up to twenty-two years from 

the date of the enactment of the ADA to make their vehicles accessible. Thus, while progress 

toward implementation may be studied, the full impact of the ADA can be evaluated only when 

the law has been implemented fully and covered entities are in compliance. 
22 
23 

Summary of Methodology 

This study gathered and synthesized information on the impact of the ADA sixteen years after its 

passage, based on the law’s four overarching goals: equality of opportunity; full participation; 

independent living; and economic self-sufficiency. NCD established a Blue Ribbon Panel, 

chaired by Dr. Peter Blanck (see Appendix A for list of members and affiliations), which defined 

each of these goals for purposes of this study. 

To assess each of these core areas, data were collected using several methods: (i) an 

environmental scan (reviewing publicly available documents and documents provided by various 

key informants), (ii) nine focus groups and five public forums, (iii) 24 individual interviews, (iv) 

112 e-mails received by NCD as a result of forum publicity, and (v) requests for comments from 

487 local and state organizations. 

Project staff also had unique access to, and analyzed the raw data from, the National 

Organization on Disability/Harris Surveys of Americans with Disabilities conducted in 1994, 

1998, 2000 and 2004, and the International Council of Disability/Harris Survey of 1986.11

More detail about the methodology used for this project is provided in Appendix B. 

Data collection on ADA compliance efforts was difficult, as many key elements are not being 

systematically tracked or recorded. For example, some requirements of Title I of the ADA 

discourage identification and tracking of employees and applicants with disabilities. Business 

groups do not track the ADA compliance efforts of private businesses. Because many 

improvements to city sidewalks and curb ramps are done as part of ongoing street repairs, it is 

difficult to determine exactly how many curb ramps are being installed. Records of adoption of, 

and progress on, transition plans are de-centralized. Multiple sources of data on various topics 

use different standards to define “disability,” “accessibility,” and other essential elements. 

Therefore, one study of the status of people with disabilities will not be readily comparable to 

another study, because the people studied often are defined differently. 
24 

The creation of original data was beyond the scope of this project. Project researchers undertook 

a comprehensive search and analysis of existing studies, data compilations, and available 

information about the impact of the ADA. The project team also tapped into the collective 

knowledge about the impact of the ADA, drawing from the experiences and expertise of ADA 

stakeholders across the nation. The findings presented in this report reflect the project team’s 

best efforts to pull together in one report what is known about the impact of the ADA at this 

time. However, one of the important findings is that there is a surprising absence of any ongoing, 

systematic data collection about the ADA from any source, and the result is significant 

knowledge gaps about many aspects of the impact of the ADA. This report contains 

recommendations to increase the information that is collected and made available to the public 

about the ADA from this point forward. 
25 

Perceptions of the ADA Overall 

Most people with disabilities who participated in the public forums, focus groups, and 

information requests report the ADA has had a significant positive effect on their lives. As one 

participant wrote: 

Have we gotten all the results we want? No. Have we made the nation entirely accessible 

and inclusive? No. Do all people with disabilities have jobs? No. Are all decisions made 

ones free of bias against persons with disabilities relative to jobs, public accommodations 

or public services? No. 

But ... more people with disabilities are out there in their communities, shopping, eating, 

attending movies, taking public transportation, going to school and working. People with 

disabilities are moving from their homes or institutions into their societies ... no, not at 

the pace which I and other advocates would like. Barriers are still many and plentiful 

from attitudes to finances to architecture ... but inch by inch they are crumbling. 

And perhaps this would have happened without the ADA, but I like to think that it is in 

large measure because of the ADA ... because people are thinking about it, people are 

talking about it. Disability is out in the open, something to be discussed, analyzed, 

considered and factored in. There aren’t many who can profess ignorance of this law and 

get away with it, even if they still do try the argument that they don’t have to be 

accessible because ‘no one with a disability comes here anyway’ as they stand at the top 

of their staircase! 

So, I do believe the ADA has had and will continue to have a profound impact on my life 

and the lives of others with disabilities. I hope that the next fifteen years see feet of 

barriers come crashing down instead of inches ... and that people with disabilities cement 

their place in history with this important civil rights law.12
26 

According to a 2000 National Organization on Disability/Harris Survey of Americans with 

Disabilities,13 more than 60 percent of people with disabilities perceived significant 

improvements in public facility access, personal quality of life, and public attitudes (see 

Table A). 

Table A: Percentage of Individuals with Disabilities Perceiving 

Quality of Life Improvements – 2000 

Access to public facilities 75% 

Quality of life 63% 

Public attitudes 63% 

Media portrayals 59% 

Public transportation 60% 

People with disabilities in advertising 56% 

Work opportunities 44% 

The majority of people with disabilities and people without disabilities, according to the 2004 

N.O.D./Harris Survey, have heard of the ADA, compared with 31 percent who had heard of 

Section 504 of the Rehabilitation Act of 1973 in the 1986 International Center for the Disabled 

Poll of Disabled Americans.14

However, most respondents to the 2004 N.O.D./Harris Survey of Americans with Disabilities did 

not credit the ADA with achieving these improvements in their lives. Only 30 percent of poll 

respondents believed the ADA had made their lives better, while 64 percent felt it had made no 

difference and 5 percent did not know if the law had made a difference.15 This contrasts with 

much higher numbers in 1986 regarding the effect of pre-ADA laws. At that time, 68 percent of 

people with disabilities felt the Rehabilitation Act of 1973, the Individuals with Disabilities 

Education Act, and other federal disability-related laws had helped them “a great deal” or 

“somewhat” and only 24 percent felt those laws had helped “not too much” or “hardly at all.”16
27 

The current level of perceived impact may reflect the disability community’s higher expectations 

of the ADA, combined with the significant delays in implementation and challenging 

employment figures. Or, it may reflect a new, better status quo. Compared with 1986, younger 

respondents in 2004 may not have much experience as adults with the pre-ADA world. 

Researchers on this project noted that some people with disabilities confused the requirements of 

a variety of laws, such as the Individuals with Disabilities Education Act, the Rehabilitation Act, 

and the Social Security, Medicare and Medicaid laws, and sometimes attributed aspects of the 

ADA to one of these laws, and vice versa. 
28 
29 

I. Equality of Opportunity 

In passing the ADA, Congress found that people with disabilities traditionally have been 

excluded from, or limited in their ability to access, goods and services in their communities and 

historically have been subjected to purposeful unequal treatment. Equality of opportunity, for 

purposes of this project, is defined as the equalization of chances for people with disabilities to 

have reliable access to transportation, and goods and services from businesses and government. 

A. Transportation 

1. Public Transportation 

Public transportation is essential to many people with disabilities. For many people with 

disabilities the use of a private automobile is not possible, either because of their disability or 

because the cost of modifying a car for accessible use is prohibitive. Without access to reliable 

public transportation, people with disabilities are severely limited in their ability to enjoy social 

and economic opportunities, live independently, and participate in their communities. 

Testimony from people with disabilities confirmed that access to public transportation is a 

central issue for people with all kinds of disabilities. Despite the widely reported progress in 

access to public transportation, people with hearing impairments report a lack of visual signage 

announcing transportation information,17 people with vision impairments report a lack of verbal 

announcements,18 people with brain injuries and cognitive impairments report a lack of clear, 

accessible information,19 and people with mobility impairments still encounter a lack of physical 

accessibility.20 

In June of 2005, the National Council on Disability issued a comprehensive report, The Current 

State of Transportation for People with Disabilities in the United States.21 In addition to the 

recommendations to federal agencies and transit system operators that NCD included in its 

transportation report, NCD echoes the sentiments of a frequent traveler with a disability who 

spoke at the Los Angeles public forum: 
30 

I have traveled 18,000 miles between Los Angeles and Bakersfield in an externship, and 

without the ADA and the Department of Transportation’s provisions, I would not have 

managed to remain independent and commute. I’ve commuted to at least five or six 

counties on a frequent basis, and it has really increased my independence. And the access 

and the paratransit systems work for me because I am a very informed person. And that’s 

what [people with disabilities] have to do. Stay informed about the ADA and know and 

exercise your rights.22

The 2004 N.O.D./Harris Survey found that 31 percent of people with disabilities reported 

inadequate access to public transportation and more than half of those people found it to be a 

major problem.23 By comparison, the 1986 ICD/Harris Survey of Disabled Americans found that 

49 percent reported that lack of access to transportation was an important reason that they did not 

socialize as much as they wanted.24 

Most individuals submitting comments and testimony indicated that the ADA has had a 

significant positive effect on public transportation,25 stating, for example, “My quality of life has 

been greatly improved since ADA .... I am able to travel and use public transportation with just 

some or little assistance .... All due to the wonderful law we call ADA.”26 Most noted that much 

remains to be done and that rural areas lag far behind urban ones.27 One commenter indicated 

that states in the South, Northern Midwest, and Central Midwest lag further behind in ADA 

compliance in transportation than Northeastern and Western states.28 Another suggested that, in 

some areas, transportation access has declined since passage of the ADA, because pre-existing 

paratransit services had larger service areas than are required under the ADA.29

Many people with disabilities, especially those in rural areas, continue not to be served by local 

transit systems, either because public transit systems are not available, or because they are 

inaccessible. 

The Economic Research Service (ERS) confirms that the lack of public transportation in rural 

areas remains a problem for people with disabilities. In its report, Rural Transportation at a 

Glance, the ERS reports that in the 1990s public transportation in rural areas increased as a result 

of federal funding priorities. However, only 10 percent of federal transportation funding went to 
31 

rural areas. The ERS found that public transportation was available in 60 percent of rural 

counties nationwide, but that many of these transportation services offered only limited service.30

ERS found that, in 2000, 23 percent of rural public transportation users had disabilities.31

In its 2005 transportation report, NCD found that people with disabilities who live in rural areas 

are still severely restricted in their ability to participate in all aspects of community life, and 

some people are even forced to live in institutions because of the lack of transportation to 

medical appointments. 

a. Trains 

i. ADA Requirements 

The ADA requires key light rail and commuter rail stations to be accessible by July 26, 1993. 

However, the ADA allows the FTA Administrator to grant extensions to July 26, 2020, for 

stations requiring extraordinarily expensive structural modifications. 

In addition to station accessibility, the ADA requires new passenger train cars purchased, leased, 

or remanufactured after 1990 to be accessible.32 The ADA also requires commuter and light rail 

trains of two or more cars to have at least one accessible car by July 1995.33 Under Title II of the 

ADA, all intercity rail (e.g. Amtrak) stations are to be accessible to people with disabilities by 

July 26, 2010.34 In addition to accessibility of stations, new cars purchased, leased, or 

remanufactured after 1990 are required to be accessible and at least one car per train is required 

to be accessible by July 26, 1995.35

ii. Relevant Data 

The National Council on Disability’s 2005 transportation study found that many transit agencies 

with fixed transportation routes fail to comply with the ADA.36 According to the study, old rail 

systems often do not have accessible stations, and riders often find elevators out of service. Other 

data indicates that rail accessibility has improved since passage of the ADA. 
32 

(a). Light Rail and Commuter Rail 

The Bureau of Transportation Statistics (BTS) reports that 22 percent of rail stations of all types 

(heavy, light, and commuter) were accessible in 1993 (553 out of 2,452).37 The BTS also reports 

that, reviewing 14 heavy rail systems, 19 commuter rail systems and 26 light rail systems, 74 

percent (1,666 out of 2,882) of rail stations of all types (heavy, light, and commuter) were 

accessible by 2004 (see Figure A).38

Figure A: Accessibility of Rail Stations – 1993 to 2004 

As of the end of 2004, of commuter rail systems in 19 regions, 58 percent of all stations were 

accessible (666 out of 1153).39 Nine areas had made all stations accessible (San Jose, CA, San 

Diego, Los Angeles, New Haven, Miami, Dallas, Ft. Worth, Seattle, Washington, DC). The 

remaining ten ranged from 29 percent to 80 percent accessible (see Figure B).40

0 

500 

1000 

1500 

2000 

2500 

3000 

1993 2004 

Inaccessible 

Stations 

Accessible 

Stations 
33 

Figure B: Accessibility of Commuter Rail Stations – 1993 to 2004 

For light rail services, the Bureau of Transportation Statistics reported that, in 2004, among 26 

providers, 82 percent of all stations were accessible (572 out of 706). Nineteen systems were 98 

percent to 100 percent accessible, while the remaining seven ranged from 2 percent to 86 percent 

accessible (see Figure C).41

1993 2004

Accessible 

Stations 

Inaccessible 

Stations 

800 

600 

400 

 200 

1000 

1400 

0

1200 
34 

Figure C: Accessibility of Light Rail Stations – 1993 to 2004 

Accessible train cars appear to have increased substantially, indicating compliance with the onecar-per-train rule. According to the American Public Transportation Association 2006 poll, 78 

percent of commuter rail vehicles were accessible and 86 percent of light rail vehicles were 

accessible (see Figure D).42

0 

100 

200 

300 

400 

500 

600 

700 

800 

900 

1993 2004

Accessible 

Stations 

Inaccessible 

Stations 
35 

Figure D: Accessible Rail Vehicles – 1994 to 2006 

(b). Amtrak 

As of 2005, Amtrak reports that 66 percent of 91 stations are physically accessible to people with 

disabilities.43 Amtrak projects that by 2010, as new stations are built and old ones renovated, 

every Amtrak station in America will be in full compliance with the ADA. All Amtrak trains 

have at least one coach car with accessible seating and an accessible restroom. Overnight trains 

offer accessible seating and restrooms in at least one coach car and an accessible bedroom in 

each sleeping car. Accessible seating includes space for a passenger using a wheelchair, a 

transfer seat and storage for the wheelchair.44

b. Buses 

i. ADA Requirements 

The ADA requires the programs and services provided in bus stations and other public 

transportation stations built before 1992 to be accessible to people with disabilities, either by 

making physical alterations to provide accessibility, or through other means.45 Newly constructed 

or altered transportation facilities must be accessible.46 The lack of a requirement to make all bus 

0%

10%

20%

30%

40%

50%

60%

70% 

80%

90%

100%

1994 1997 2006 

Year

Light Rail 

Commuter Rail 
36 

transportation facilities accessible by a certain date makes it difficult to track and assess progress 

toward achieving accessible bus transportation facilities. 

The ADA requires that buses purchased or leased after August 25, 1990, be accessible, although 

the Department of Transportation can grant waivers.47 The ADA also requires that 

communications by public entities be accessible to people with vision and hearing disabilities.48

Bus services can comply with this requirement by verbally announcing (or “calling out”) the 

names or locations of stops for people with vision disabilities, and by providing visual 

information about the stops for people who are deaf. 

ii. Relevant Data 

According to the Federal Transit Administration, bus systems increased by 67 new systems from 

1991 to 2003 and demand responsive systems increased by 111 new systems over the same 

period.49 Sixty-three percent of all buses in the United States operated by public transportation 

agencies were lift- or ramp-equipped by 1996.50 FTA has set the goal of a 100 percent accessible 

bus fleet (lift- or wheelchair ramp-equipped) by 2007.51 Interim goals moving toward that goal 

have been met, achieving 95 percent accessibility by 2004.52

According to the Federal Transit Administration’s 2003 National Transit Summaries and Trends

report, Type B (25–35 seat) bus accessibility increased from 54 percent in 1993 to 97.7 percent 

in 2003 and Type C (>35 seat) bus accessibility increased from 50.3 percent in 1993 to 99.2 

percent in 2003, and articulated bus (high-capacity, flexible center) access increased from 38 

percent in 1993 to 96.4 percent in 2003.53

The Bureau of Transportation Statistics confirms that bus access has increased significantly since 

1993. As of the end of 2004, 98.1 percent of all buses were accessible (67,454 out of 68,789).54

Similarly, an American Public Transportation Association survey indicates that, as of 2006, 97 

percent of buses are accessible.55 As recently as the end of 2005, however, the Department of 

Justice took enforcement action against the City of Detroit, Michigan, for failing to provide and 

maintain accessible buses.56 Under the consent decree, Detroit agreed to establish systems for 

promptly identifying, removing from service, and repairing buses with malfunctioning 
37 

wheelchair lifts, including daily maintenance checks and service logs for each bus. Detroit also 

agreed to retrain its drivers and mechanics to deploy wheelchair lifts and assist passengers with 

disabilities. In addition, the city agreed to obtain alternative transportation promptly when there 

are breakdowns in accessible service, implement a complaint system, appoint an ADA 

coordinator, and retain an independent auditor to assess compliance.57

Bus accessibility may be more of a reality in larger, urban areas where bus replacement happens 

more frequently. The Bureau of Transportation Statistics and American Public Transportation 

Association surveys both appear to have focused on urban areas. The Economic Research 

Service indicated that the number of rural communities served by long-distance bus service has 

declined sharply since 1982.58

Physical accessibility to buses is one component of accessibility. The 2005 NCD transportation 

study reported that many transit agencies with fixed transportation routes fail to comply with the 

ADA, even if they have accessible buses.59 The input from people with disabilities in the NCD 

transportation study was the same as the input from participants in the public forums—that some 

transit agencies still fail to announce bus stops, maintain wheelchair lifts on buses, and secure 

wheelchairs once inside the bus. 

c. Paratransit Services 

i. ADA Requirements 

Under the ADA, public entities that operate non-commuter fixed-route transportation services for 

the general public are required to provide origin-to-destination paratransit service to eligible 

individuals. This paratransit service must be comparable to the fixed-route service.60

ii. Relevant Data 

The National Council on Disability pointed out, in its Progress Report in 2003,61 that people with 

disabilities often rely on paratransit services to avoid personal health or safety challenges on 

fixed-route systems such as longer waits in extreme temperatures or safety challenges at isolated 

stops. NCD noted that people with disabilities using paratransit frequently experience long waits, 

trip delays, and missed trips (no vehicle arrives), making it difficult to rely upon paratransit for 
38 

employment, medical, and other appointments. NCD stated that the Department of 

Transportation must be vigilant in maintaining fairness and effectiveness, particularly as transit 

agencies consider offsetting the growth in paratransit demand with stricter trip-eligibility 

criteria.62

In Los Angeles County, one of the largest paratransit systems in the country, a 2005 study of 

paratransit service after litigation63 indicated that 89 percent of riders in Los Angeles were picked 

up within 20 minutes of their scheduled appointment. Comparing 11 peer paratransit systems, 

rides were stated to be “on time” (no more than 30 minutes after the appointed time) 84 percent 

to 99 percent of the time. The study indicated trips were denied to 1 percent of passengers.64 The 

Los Angeles paratransit provider’s 2004–05 annual report indicates a complaint rate of 6.59 out 

of 1000 trips.65

The Federal Transit Administration has conducted compliance reviews of numerous paratransit 

agencies and continues to find deficiencies in their policies and services. These compliance 

reviews indicate another area where the FTA’s standards for ADA compliance do not match with 

customers’ expectations. For example, the FTA considers pickups within 30 minutes after the 

scheduled pickup time to be “on time.”66 Given that the scheduled pickup time may be up to one 

hour after the requested pickup time, customers may permissibly be picked up one hour and 30 

minutes after their requested time. Because of these delays, people with disabilities have 

difficulty relying on paratransit services to meet work schedules and appointments. 

d. Input from People with Disabilities 

Input from people with disabilities in a previous research effort by NCD revealed that access to 

rail services has improved, but has not been fully achieved. In the focus groups, there were 

several individuals who mentioned bus services. A participant with a mobility disability 

indicated that accessible transportation is available in metropolitan areas but not rural areas: 

I think as far as transportation, we see quite a bit of improvement in the metro areas 

where now all of our bus system finally is accessible. I think the last accessible bus just 

came on within the last two years. So it took a tremendously long time, but you get 
39 

outside the metropolitan area anything probably 50,000 and above [in population] where 

transportation is absolutely terrible.67

The participant’s point relates to the availability of public transportation as much as it does to 

accessible transportation, because, if no public transportation is provided at all, the ADA does 

not require that accessible transportation be provided. 

Participants testified that they were concerned about the attitudes of bus drivers toward people 

with disabilities and the maintenance of accessible equipment. For example, participants 

complained that bus drivers often do not announce stops.68 A wheelchair user participating in the 

Savannah forum described how she was harassed on an Atlanta city bus for sitting on a seat with 

her wheelchair beside her in the aisle because the accessible seating area was inoperable.69

In the Los Angeles public forum, one participant stated, “Paratransit works for some, but for the 

majority of the disabled community doesn’t work at all because it’s a dumping ground for fixedroute nonaccessibility.”70

Several witnesses testified that paratransit services are inadequate because of strict eligibility 

requirements, long wait times and late pickups, and limitations on the areas served.71 However, 

several participants indicated that paratransit services had improved the quality of their lives 

significantly.72

2. Private Transportation 

a. Private Over-the-Road Bus Service 

In 1999, Greyhound began to put more accessible buses on the roads and to train Greyhound’s 

bus drivers and other workers to provide accessible bus service through the operation of lifts, 

other boarding devices, and disability awareness.73 According to a 1999 settlement reached with 

the U.S. Department of Justice, Greyhound was to guarantee lift-equipped bus service, upon 48 

hours advance notice from the passenger, to and from all of its destinations, except in a very 

limited set of circumstances, by April 1, 2000.74 All of Greyhound’s over-the-road buses are 

required to be accessible by October 28, 2012.75
40 

b. Taxis 

i. ADA Requirements 

The ADA prohibits discrimination by taxi services. Taxi services may not refuse service to 

people with disabilities or charge additional fees.76 Automobiles are not required to be 

wheelchair accessible.77 When a taxi provider purchases or leases a new vehicle that is not an 

automobile (e.g., a van), it must be accessible unless the provider can demonstrate equivalency. 

Taxi providers are not required to purchase non-automobiles.78

ii. Relevant Data 

The Community Transportation Association of America reports that some local governments 

have made efforts to increase accessibility of private taxi cabs. For example, the City of Chicago 

has passed an ordinance requiring that every fleet of more than 15 taxis must include at least one 

accessible taxi. Fleets of over 100 vehicles must have at least 2 accessible vehicles and one 

additional accessible taxi for each 100 vehicles.79 Chicago has 41 accessible taxis out of 6000 

taxis.80 The city has also instituted a centralized dispatching system for accessible vehicles.81 Los 

Angeles requires that taxi companies operate 2 percent of their fleets as accessible vehicles,82

resulting in 127 of the city’s 1,931 taxis being accessible.83 Las Vegas requires that 2 vehicles in 

every fleet be accessible, resulting in 28 accessible taxis out of 1,100.84 

According to the Community Transportation Association, some large cities appear to have no 

accessible taxis, including Philadelphia (1,600 cabs), Dallas (1,900 cabs), Detroit (1,320 cabs), 

and Seattle (850 cabs).85 A 2004 newspaper article suggests that few taxicabs in New York City 

were accessible. According to the article, only 5 of 12,000 taxicabs in New York City were 

wheelchair accessible.86 The Community Transportation Association indicates that the efforts of 

cities and taxi service providers who have committed to accessible taxi service have resulted in 

accessible taxis ranging from 2.5 percent to 6.6 percent of the taxi fleets in Las Vegas, San 

Diego, Boston, San Francisco, and Los Angeles.87

Taxi companies have been sued for discrimination against people with disabilities. Many suits 

claim that taxicabs discriminate against people with vision impairments who use service 

animals.88 Others claim taxis refuse to pick up people who use wheelchairs.89
41 

iii. Input from People with Disabilities 

One blind individual who uses a guide dog commented that, while most businesses are much 

more aware of their obligation to allow guide dogs, “Guide dog users still experience difficulties 

in getting taxi drivers to agree to transport the dog.”90

3. Recommendations – Transportation 

• Congress should expand accessibility requirements for rail services beyond key stations; 

• The Department of Transportation should conduct extensive training and outreach for public 

transit providers regarding maintenance and stop announcements; 

• The Department of Transportation should work with state and local governments and taxi 

providers to develop and publicize effective incentives for private taxi providers to offer 

accessible vehicles; 

• The Department of Transportation should conduct extensive training and outreach for public 

and private transportation services regarding service animals and increase high-profile 

enforcement actions by the Departments of Justice and Transportation; 

• The Department of Transportation should work with paratransit providers, state and local 

governments, transportation experts, and representatives of disability and aging communities 

to explore paratransit options such as more subscription service, more flexible services, and 

other ideas to close the expectation gap and increase usability of paratransit for riders with 

disabilities. One model for this work is the U.S. Access Board’s Advisory Committees, which 

bring together diverse constituencies to develop recommendations on disability-related issues; 

• The Department of Transportation should study and test options for providing transportation 

services to people with disabilities in rural areas. Again, a model similar to that used by the 

U.S. Access Board’s Advisory Committees may be useful in this effort. 

B. Sidewalks and Curb Ramps 

Accessible buildings mean little without accessible sidewalks leading to them. For people with 

mobility impairments who use public transportation, which often requires traveling from a 
42 

station, bus stop, or other drop-off point to a destination, inaccessible sidewalks can render an 

otherwise possible trip impossible. Inaccessible sidewalks also force many people to use 

paratransit services. 

1. Sidewalks 

a. ADA Requirements 

The ADA requires all programs, services and activities of state and local governments to be 

accessible. The concept is commonly referred to as “program access.”91 In addition, newly 

constructed or altered facilities must be fully accessible.92 Program access to existing facilities 

was required by January 26, 1995. However, some cities argued that sidewalks did not constitute 

a city program, service or activity. When the Ninth Circuit Court of Appeals dismissed this 

argument in 2002 in Barden v. City of Sacramento,

93 cities began to take seriously their 

responsibilities to provide accessible sidewalks. 

b. Relevant Data 

NCD’s 2005 transportation report found that public rights-of-way including streets, sidewalks, 

and other public infrastructures continue to be inaccessible and not in compliance with the 

ADA.94 No published reports on the degree to which sidewalks are accessible were found in our 

environmental scan. 

2. Curb Ramps 

a. ADA Requirements 

Title II regulations of the ADA required state and local governments to include in their transition 

plans, plans to install curb ramps at all existing corners by January 26, 1995 or “in any event, as 

expeditiously as possible.”95 Newly constructed or altered streets and sidewalks are also required 

to provide accessible curb ramps.96

In 1993, the Third Circuit Court of Appeals resolved the question of what constitutes an 

alteration that would trigger the requirement to install an accessible curb ramp. The court 
43 

concluded that street resurfacing constituted an alteration that would trigger the curb ramp 

obligation on adjacent sidewalks.97

b. Relevant Data 

In 2002, a representative of the city of Los Angeles announced that the city had concluded its 

ADA transition plan and had installed over 22,500 curb ramps at an average cost of $1100.98 At 

the same meeting, a city engineer for Memphis, Tennessee said in the last three years the city 

had installed over 3,000 curb ramps and was committed to installing 1,000 curb ramps a year for 

the foreseeable future.99 Smaller cities have also worked to increase sidewalk access. For 

example, Culver City, California had ramped 96 percent of its curbs by 2003 and planned to 

complete the remaining 50 by 2005.100 The U.S. Department of Justice has negotiated more than 

145 “Project Civic Access” agreements with 138 local governments ensuring accessible 

buildings, programs and services.101 These also include curb ramps. 

In contrast, the Eastern Paralyzed Veterans of America (EPVA) sued New York City under these 

regulations because, by 1994, the city had not installed curb ramps at two-thirds of its street 

corners, and had no transition plan in place. When the City finally issued a “transition plan” five 

months after EPVA brought suit, the plan did not contain a schedule for ramping its 106,000 

street corners without curb ramps. In September 2002, the city agreed to a settlement to commit 

approximately $218 million to make all of its 158,738 street corners accessible to wheelchair 

users. According to the settlement the city agreed to commit a total of $217,862,000 for 

installation of curb ramps on all of the 61,074 corners remaining to be ramped (27,747 in 

Queens; 13,008 in Staten Island; 10,710 in Brooklyn; 7,007 in the Bronx; and 2,602 in 

Manhattan).102 

Some cities object to the obligation to install curb ramps. As recently as the fall of 2005, the City 

of Riverside, New Jersey claimed it has no obligation to install curb ramps because it has fewer 

than 50 employees.103 The City of Chicago was sued over inaccessible curb ramps in 2005.104 The 

City of Sacramento, California, was sued over inaccessible sidewalks and curb ramps and 

reached a settlement in 2004 requiring the city to spend 20 percent of its annual transportation 

funds on sidewalks and curb ramps for up to 30 years.105 The City and County of Honolulu were 
44 

sued twice for failing to timely implement their transition plan for installing curb ramps, finally 

agreeing in 2001 to install 7,600 ramps by 2007.106 

In 2005, a survey of San Francisco sidewalks identified 13,430 curbs needing curb ramps at 

6,726 intersections, costing an estimated $210 million.107 The City estimated that it installed 650 

curb ramps per year.108 

Many curb ramps appear to be installed by private developers as part of their construction 

projects. In San Francisco, for example, approximately 450 curb ramps are installed annually by 

the city, while 75–90 are installed by private developers.109

These lawsuits and city reports indicate the deadlines of the ADA for installation of curb ramps 

have not been met and that curb ramps will continue to be inconsistently available for years to 

come. Lawsuits and forced settlement agreements may be essential tools for ensuring 

compliance. 

c. Input from People with Disabilities 

Input from people with disabilities about curb ramps often focused on issues of safety as well as 

access. The lack of ramps at many intersections, curb ramps that are too steep or not adjacent to 

pedestrian push buttons, lack of accessible pedestrian signals for blind pedestrians, and failure of 

municipalities to clear snow from curb ramps were sited as issues causing people with 

disabilities to make unsafe street crossings and, in some instances, forcing people to use their 

wheelchairs in the streets or gutters. 

3. Recommendations – Sidewalks and Curb Ramps 

• The Department of Justice should promulgate ADA regulations for public rights-of-way as 

soon as possible; 

• The Department of Transportation should increase funding for sidewalk access and curb ramp 

installation; 
45 

• The Department of Justice should develop and disseminate guidelines for the prioritization of 

curb ramp installations, so that the most needed and useful curb ramps are installed first. 

C. Places of Public Accommodation 

1. Physical Accessibility for People with Mobility Impairments 

a. ADA Requirements 

The ADA requires places of public accommodation to provide physical accessibility to differing 

extents based on the time of construction of the facility. Facilities existing before the effective 

date of Title III of the ADA, must have physical access barriers removed to the extent it is 

readily achievable to do so. “Readily achievable” means that the barrier removal is not too 

difficult or too expensive given the resources available to the facility’s owner.110

Facilities constructed after the effective date of the ADA must be designed and constructed to be 

fully accessible in compliance with the ADA Accessibility Guidelines.111 Alterations to existing 

facilities must comply with the ADA Accessibility Guidelines. In addition, alterations to primary 

function areas give rise to a requirement to make the path of travel serving the altered area 

accessible at a cost proportional to the cost of the original alteration. Proportional is defined as 

costing up to 20 percent of the cost of the alteration.112

b. Relevant Data 

Systematic data measuring the accessibility of public accommodations and commercial facilities 

pre-ADA does not exist and the law makes no specific provisions for tracking such information. 

However, the National Organization on Disability/Harris Surveys suggest people with 

disabilities perceive improvement in access to public facilities, including restaurants, theaters, 

stores and museums. When asked whether access to public facilities had improved, 75 percent or 

more of respondents in 1994, 1998, and 2000 reported that they had perceived improvement.113

Not surprisingly, the percentage of people with disabilities going out to restaurants regularly has 

increased from 34 percent in 1986 to 57 percent in 2004.114
46 

In interviews with major trade associations representing businesses directly impacted by the 

ADA, including the National Restaurant Association, the American Hotel and Lodging 

Association, the U.S. Chamber of Commerce and others, not one could provide information on 

the number of their members that have made their facilities more accessible to people with 

mobility impairments in the last 15 years. The response of the Building Owners and Managers 

Association (BOMA) International was typical: “BOMA wishes that it had quantifiable data to 

share with you to fulfill your specific requests. This type of data is, to our knowledge, 

unavailable. Based on the vast number of designs that are incorporated into buildings, we are 

unable, as well, to extrapolate the total amount of ADA-inspired modifications based on 

anecdotal evidence of what a few modifications may have cost.”115

In an interview with the American Institute of Architects (AIA), whose members are on the 

frontline of assisting businesses with Title III compliance, a spokesman said the AIA has no data 

on the number of accessible buildings owned or operated by private entities in the United 

States.116

The Government Accountability Office (formerly the General Accounting Office), or GAO, last 

conducted a study in 1994 on whether the ADA had improved access for people with disabilities 

to goods and services provided by businesses and state and local governments. The GAO looked 

at four issues: changes in accessibility in the 15 months after the ADA took effect, the common 

barriers still remaining, awareness of owners and managers in that same 15-month span, and the 

nature of barrier removal efforts during that time. The GAO found that accessibility for people 

with disabilities, and managers’ and owners’ awareness of the ADA, had considerably and 

steadily increased. Some significant barriers remained, however, and barrier removal efforts 

were not always consistent with the Americans with Disabilities Act Accessibility standards. 

Half of the owners and managers had not made any changes to be more ADA compliant, and had 

no immediate plans to do so.117 

According to the University of California San Francisco’s Disability Statistics Center, 12,728 

small businesses applied for tax credits for disability access improvements in 1993.118 According 

to a 2002 General Accounting Office Report on Business Tax Incentives, in 1999, about 7,199 
47 

corporations (1 out of 686) and 18,633 individuals with business affiliations (1 out of 1,570) 

filed for the disability access credit.119 The credits amounted to approximately $59 million. The 

study concluded that the disability-related tax incentives are underutilized by businesses. 

According to a 2003 study by the Society for Human Resource Management, 77 percent of 

surveyed businesses were not accessing any of the tax incentives for accessibility.120

Numerous articles have been written about the use of litigation to enforce the accessibility 

requirements of the ADA, generally focusing on the following types of “bad” behavior by 

disability attorneys and advocates: 

• Failure to notify businesses and give them a chance to make improvements before filing suit 

(or threatening to do so); 

• High demands for damages or attorneys fees; 

• Insufficient attention to whether the demanded improvements are actually carried out; 

• Threats of litigation over minor violations; 

• Insufficient assistance to business as to what needs to be corrected or how to comply; 

• Repeat lawsuits against businesses that are trying to comply; 

• Multiple lawsuits by individual plaintiffs or attorneys. 

While no comprehensive studies of lawsuits and complaints filed against places of public 

accommodation were found in our environmental scan, the U.S. Department of Justice has 

investigated and reached settlements with numerous restaurants, movie theaters, and other types 

of chains. Restaurants subject to settlement agreements with the Department include Pizza 

Hut,121 McDonald’s,122 and Burger King.123 Theaters include Regal,124 Cinemark,125 and 

Shubert,126 while AMC is involved in ongoing litigation with the Department.127

Data regarding nationwide compliance with the physical access requirements of Title III of the 

ADA is largely unavailable. Larger businesses, national chains, and new businesses have made 

significant efforts toward compliance, due in part to the incorporation of accessibility 
48 

requirements into local building codes and because of close attention paid by public and private 

enforcement agencies. As a result, people with disabilities have much more freedom to engage in 

social and business activities and are taking advantage of that freedom. Smaller businesses 

appear to face less pressure to comply. Litigation may not be an effective mechanism to force 

compliance by smaller businesses. 

The backlash by business owners against enforcement of the ADA through litigation emphasizes 

the difference in expectations between people with disabilities and business owners. People with 

disabilities have high expectations of accessibility after the ADA, while business owners are 

surprised that continued access improvements are required of them, even in the absence of a 

complaint. Despite years of ADA enforcement and wide dissemination of technical assistance 

materials, business owners remain confused about the extent of accessibility required for preexisting businesses. For example, the American Hotel and Lodging Association described the 

complexities their members face: 

It is a significant barrier to compliance with the law that the ADA is a highly detailed, yet 

highly vague law, unlike other laws and regulations. Our members know, for example, 

that under OSHA regulations, compressed air cannot be used for cleaning purposes 

except where the pressure has been reduced to less than 30 pounds per square inch and 

then only when effective chip-guarding and personal protective equipment is provided. 

Under the Hotel & Motel Fire Safety Act of 1990, our members know that if they are a 

five-story hotel and wish to receive federal travelers, they must have hard-wired smoke 

detectors and be fully sprinklered. But while these specific legal details are clear and 

helpful, this clarity is absent from much of the ADA. Our members have long been 

frustrated with the inability to get clarity in compliance with the ADA. When a hotel 

operator wants to open a new property, an architect will be hired, zoning permits will be 

obtained from the local zoning boards, operating licenses will be obtained from the 

proper local and state offices. These various boards, commissions and government 

entities will perform their duties, but at no point will anyone check for compliance with 

the ADA. There is no entity that will give an ADA certificate informing a business that 

they comply with this law.128
49 

c. Input from People with Disabilities 

The physical accessibility of private businesses was addressed by people with disabilities in the 

focus groups, public forums, and e-mail. People with mobility impairments indicated they are 

benefiting from such physical modifications as ramps, accessible parking, and more accessible 

restrooms that businesses have provided since the ADA was passed. Commenters indicated that 

much improvement has been made in access to businesses since passage of the ADA, but much 

remains to be done. One wheelchair user in Wyoming elaborated: 

My impression from ’92 or ’90 is that things have gotten more accessible. You see a lot 

more power doors. Although they’re legally not required, you always see a few more of 

those. It helps the UPS guy as well as the FedEx guy. It’s kind of what we try to sell them 

on. I think generally overall there’s an improvement in accessibility. Recently we put a 

big push on to look at all the businesses in town and we’ve run across one that was very 

accommodating; went over and above what we asked for. And we ran across another who 

just kind of thumbed their noses at us. So, we said the [heck] with it, we’ll just file 

complaints on them. Talking to this guy didn’t do any good anymore. So we still run 

across it 15 years later, and we’re still running across a lot of ignorance; really no 

awareness of the law but don’t really . . . give a rip one way or the other.129

A total of 53 commenters indicated that public accommodations and commercial facilities would 

be more accessible to more people with disabilities if enforcement mechanisms were improved. 

Several commenters expressed frustration at the process of filing complaints with government 

agencies, indicated that mediation was not an effective mechanism,130 and indicated that private 

lawsuits were not an effective means of enforcement. As one Savannah commenter explained: 

I learned of a mediation process which was conceived by USDOJ to expedite the 

resolution of ADA matters. Given the history of [my] experiences with the courts, I opted 

for the new process. I filed a complaint in 1999 against a local establishment named 

Stogie’s which was frequented by legal professionals. The barrier was a six-inch step 

which prevented my entry. After several failed attempts to discuss the matter with 

management, the case was filed with USDOJ with a specific request for mediation. After 
50 

numerous meetings and a signed conciliation agreement, the barrier remains to date—

exactly as it was when the case was filed. From my understanding, the current matter is 

wedged in an administrative bottleneck at USDOJ. My friends with mobility disabilities 

can recount many similar experiences with failed mediation which were not followed by 

enforcement. 

I have witnessed legislative attempts to weaken the ADA through legal means of a 

notification provision and judicial decisions, such as the Alabama (i.e., Garrett) 

employment decision which limited the scope of coverage. The rationale behind the 

proposed notification requirement is to give the business community a chance. Fifteen 

years later and numerous administrative and legal complaints later, I believe we have 

extended the hand of compromise only to be slapped with it. Angry—partly; 

disappointed—definitely. I consider the dream once promised growing fainter as time 

goes by.131 

Other commenters expressed similar frustrations:132

• “While the Americans with Disabilities Act has helped, there must be better enforcement and 

far higher fines to go along with it.”133

• “Either the Federal Government is going to have to have ADA people in each state with the 

power to write warning violation letters or write a federal ticket or District level ticket in a 

violation, with fines. Or the Federal Government is going to have to mandate States to enforce 

the ADA. Then if they do not, a complaint can be filed against the state.”134

• “Shopping, eating and being entertained are a fundamental part of the American way of life. 

We still have to fight to shop, eat and be entertained. That fight is generally through the 

courts. Local building officials have no jurisdiction to enforce the ADA and many states still 

do not have their own building standards for access and rely only on the ADA. Getting a local 

building official to understand that they have the responsibility and jurisdiction in the absence 

of state building codes is near impossible.”135
51 

• “I believe that in order to ensure that more buildings are built/remodeled accessible, and to 

provide a level of protection for builders, employers, business owners etc, that there should be 

some way of licensing or certifying accessibility that is mandatory on states and communities. 

For instance, perhaps require any state/community receiving Community Development Block 

Grants (CDBG) or other federal money to have its building code certified as being ADAAG 

compliant by the Federal DOJ.”136

• “In many cases, places of public accommodation are also more reactive than proactive. In 

some cases business owners are uninformed and don’t know/understand the law. In other 

cases, owners react when hit with lawsuits or complaints. Recently this has generated a lot of 

ill will because of the number of local businesses receiving threatening letters if compliance 

work is not completed in a short amount of time. Lawsuits where plaintiffs receive settlement 

money [are] upsetting local business owners who feel they are victims of extortion.”137

• “Lack of enforcement for equal access [ADA] to public accommodations and prospective 

businesses remains the single greatest need [and political and legislative avoidance] of our 

national disabled community.”138

• “One area I feel is greatly lacking is the ... enforcement of the ADA in situations where 

proprietors choose not to cooperate. Those persons have learned that the only effective 

enforcement is through costly law suits and most people are reluctant to do this. And so those 

of us who need the ADA most have learned the only ones who comply with the Americans 

with Disabilities Act are those who chose to do so. The rest can simply ignore it if they 

wish.”139

• “First of all, the problem is not the law itself; it’s a great law. The regulations are great. To 

me, it’s enforcement that’s the problem. The enforcement is predicated on the ability of the 

individual to file a complaint. The solution I think is that the Justice Department or EEOC 

needs to have more investigators that would actually go out to see if people are complying 

with the law. That would stop the horror stories. That would make employers accountable. 

That would put the teeth in the law.”140
52 

2. Access for People with Vision, Hearing, and Speech Disabilities 

a. ADA Requirements 

Title III of the ADA requires places of public accommodation to ensure that their communication 

with people with vision, hearing, and speech disabilities is as effective as their communication 

with people without disabilities.141 They accomplish this by providing auxiliary aids and services, 

such as braille, large print, taped texts, sign language interpreters, closed captioning, notes, 

assistive listening devices, and text telephone devices.142 Hotels must provide TTYs and closed 

captioned televisions.143 In addition, businesses may not exclude, surcharge, or otherwise 

discriminate against individuals with service animals.144

b. Relevant Data 

A review of the U.S. Department of Justice’s Web site indicates that businesses frequently fail to 

provide sign language interpreters to people who are deaf. The U.S. Department of Justice has 

participated in at least 11 settlements requiring hospitals and health care providers to provide 

sign language interpreters and other auxiliary aids to people who are deaf or hard of hearing.145

Private suits have repeatedly been brought against hospitals for failure to provide interpreters.146

The U.S. Department of Justice’s Web site also demonstrates that many hotels are not complying 

with their obligations to provide closed captioned televisions, TTYs, and accessible room 

notification devices.147 The Department has entered into formal settlement agreements with at 

least 16 hotels and motels involving access for people with hearing impairments. 

The Department investigated and resolved numerous complaints against restaurants, taxi 

companies, and other public accommodations over access for blind people who use service 

animals.148

c. Input from People with Disabilities 

People who are blind or visually impaired, deaf or hard of hearing, or have other communication 

disabilities were less likely to state that private businesses operating public accommodations are 

meeting their accessibility needs. Some individuals noted that businesses need to become 
53 

educated about Telephone Relay Services, saying representatives of businesses often cut short 

Relay calls. For instance: 

• “I make a lot of business calls in a week. Either I get hung up on, or they put you on hold for 

15, 20 minutes, hoping that you hang up.”149

• “Sometimes when we make a request for example, for an interpreter at a doctor’s office or 

attorney visit .... just a public accommodation, it’s very difficult. It’s hard to make that 

request and just like some others were saying, why is it so hard to make a request?”150 

Some people who are hard-of-hearing reported missing flights because public announcements in 

airports, including announcements about gate changes, are not provided visually. 

People with vision impairments reported that braille and large print were becoming more widely 

available.151 However, braille and large print materials are not reliably available and verbal 

announcements of visual information in public spaces are rarely provided.152

People with vision impairments continue to struggle to gain access to the Web sites of public 

accommodations. Because the DOJ Title III regulations do not specifically mention access to 

Web sites, people with vision impairments have been forced to file lawsuits against entities that 

refuse to make their Web sites accessible. To date, the courts have been split on this issue.153 But, 

since the implementation of Section 508 of the Rehabilitation Act,154 which requires federal 

agencies to make their Web sites accessible, people with vision impairments are frustrated that 

Title III regulations have not been updated to apply the federal Web accessibility standards to 

places of public accommodation. 

3. Recommendations – Places of Public Accommodations 

• The National Institute on Disability and Rehabilitation Research should conduct a survey of 

businesses, perhaps through the chambers of commerce or small business associations, to 

determine the degree to which businesses have instituted readily achievable barrier removal 

efforts, and provide guidance to Congress on adequately funding the Department of Justice to 

enforce this part of the statute; 
54 

• The Department of Justice and National Institute on Disability and Rehabilitation Research 

should provide expert, individualized, low-cost technical assistance and consulting to small 

businesses. The ADA and IT Centers and local offices of the National Disability Rights 

Network are possible agencies to carry out this effort; 

• The Department of Justice should expand its Project Civic Access to increase enforcement in 

local areas by reviewing businesses in identified localities;

• Congress should require states to submit their building codes for access certification by the 

DOJ; 

• The U.S. Access Board and Department of Justice should continue coordination with model 

building code agencies; 

• The Department of Justice should increase enforcement and education regarding how to serve 

customers with visual and hearing impairments, particularly as it pertains to Web access and 

use of TTYs and relay services; 

• DOJ should incorporate the Section 508 Standard for accessible Web sites into Titles II and 

III; 

• The Department of Justice and National Institute on Disability and Rehabilitation Research 

should develop technical assistance materials regarding what people with disabilities and 

businesses should expect of existing buildings of various sizes years after passage of the 

ADA. 

D. Accessibility of Telecommunications 

1. ADA Requirements 

Title IV of the ADA consists of two provisions: one requires captioning of federally funded or 

produced public service announcements; the other mandates nationwide telecommunications 

relay services (TRS). TRS is required to “provide the ability for an individual who has a hearing 

impairment or speech impairment to engage in communication by wire or radio with a hearing 

individual in a manner that is functionally equivalent to the ability of an individual who does not 
55 

have a hearing impairment or speech impairment to communicate using voice communication 

services by wire or radio.”155

Newer Internet Protocol (IP) Relay Services allow people to access TRS through the Internet, 

rather than relying on text telephones (TTYs). A deaf caller uses a computer and the Internet to 

type messages to the relay operator, who calls the call recipient and voices what the caller types. 

Video Relay Services (VRS) allow people who use sign language to communicate with the relay 

center using sign language through video equipment attached to a computer. The caller signs to 

the relay interpreter via video and the relay interpreter contacts the call recipient by telephone 

and voices what the caller signs. For individuals without computers or Internet access, deaf 

callers can use several access centers. This service may be particularly useful for people in rural 

areas, where sign language interpreters may be unavailable. VRS is funded through mandated 

contributions from all common carriers that go into a national fund administrated by the National 

Exchange Carrier Association, Inc. (“NECA”). The Federal Communications Commission 

(“FCC”) determines the rate that ensures appropriate compensation to VRS providers. 

Applicability of the ADA to these new services is not yet settled. Because the ADA encourages 

the FCC not to discourage the advancement of technology, some disability groups have argued 

that the FCC should regulate VRS to encourage further development of VRS technology and 

performance standards.156 

2. Relevant Data 

The telecommunications aspects of the ADA have had a positive effect on the ability of people 

with hearing impairments to communicate. Relay services are now widely available and usage is 

high. Telecommunications Relay Services (TRS) have been established for residents of every 

state to ensure that people with speech and/or hearing impairments have access to 

telecommunications 24 hours a day, seven days a week.157 Relay services are available by dialing 

7-1-1 or local numbers. 

The evolution of new technologies has served to increase use of relay services. However, 

businesses have not been quick to understand and use the technology. 
56 

• No reliable data exists on the average annual number of telephone relay calls prior to 

implementation of the ADA.158 However, use of all forms of relay service increased by 15 

percent (from over 180 million minutes to over 208 million minutes) from 2003 to 2004 (see 

Table B). Traditional relay service use is declining slightly (.3 percent), while Internet relay 

service is increasing (45 percent) and video relay service is increasing tremendously (210 

percent). 

Table B: Relay Service by Type, 2003–2004159

2003 minutes 2004 minutes

Traditional TRS 134,320,610 133,909,527 

IP Relay 43,559,603 63,080,942 

VRS 2,788,532 11,031,032 

Total Combined 180,668,745 208,021,501 

• Approximately 3,500 complaints were reported that alleged a violation of one or more of the 

Federal Communications Commission’s mandatory minimum standards for TRS. This 

number indicates that just over 1/100th of a percent (.01 percent) of TRS calls resulted in an 

alleged violation of required service standards. Over seventy-five percent of all complaints 

stemmed from the interaction between the calling party and the communications assistant.160 

• The National Exchange Carrier Association (NECA) is the administrator of the Interstate TRS 

Fund that compensates relay service providers for the provision of relay services. NECA 

submitted to the FCC the proposed new provider reimbursement rates, funding requirements, 

and carrier contribution factor for the Telecommunications Relay Services (TRS) Fund. For 

the period beginning on July 1, 2005, and ending on June 30, 2006, NECA is recommending a 

total funding requirement of $413.3 million, a $124 million increase from the current fund. 

NECA has recommended this increase in the size of the fund, based primarily on continuing 

significant growth in demand for IP Relay Services and Video Relay Services (VRS). 
57 

3. Input from People with Disabilities 

In the public forums, many individuals spoke favorably of relay services and several mentioned 

that technology was enhancing the service. 

• “From a hard of hearing point of view, the program obviously helps thousands and thousands 

of people. We have 600,000 pieces of equipment out there for the deaf, the hard of hearing 

and disabled. Every month we do 1.5 million conversation minutes .... Relay service helps 

people have jobs. It helps them communicate with the hearing community, be part of the 

greater world.”161

• “One of the big things I’m seeing more than ever with deaf people in our community is the 

video relay services that are being instituted now. So much more natural than having to slowly 

type out what you’re going to say, and that just naturally, the communication gap that happens 

in the timeframe of typing.”162

Almost all of the e-mail writers on the subject of relay services were enthusiastically positive. 

• “Has the ADA had an impact on the ability of people who have hearing and/or speech 

impairments to communicate by telephone? Yes. The Telephone Relay Service centers are 

making a big difference.”163

• “The [ADA has certainly benefited us when it comes to the use of relay services, yet within 

the African American Deaf Community few have access to the knowledge and technology 

needed to benefit.”164

• “My mother, 82, essentially lost her hearing by 65. It is thought it’s due to a childhood illness; 

that it progressively worsened in time. Were it not for the Americans with Disabilities Act; 

her TDD machine; MD’s Relay Service and its trained operators we, her family of 6 

daughters, 4 sons-in-law and 10 grandchildren would be at a loss.”165

Commenters said the service needs to be publicized more. 
58 

4. Recommendations – Accessibility of Telecommunications 

• The Department of Justice should publish information for businesses about how TRS works, 

how to use it, and the legal obligation to use it. The ADA and IT Centers could be funded to 

provide this information; 

• The Federal Communications Commission should establish standards to encourage the 

continued development of Video Relay Services. 
59 

II. Full Participation 

When passing the ADA, Congress found that people with disabilities traditionally have been 

relegated to a position of political and social powerlessness, by virtue of being excluded from, or 

segregated in, community activities. Full participation, for purposes of this study, is defined as 

active inclusion and integration of people with disabilities in community activities, including 

governance and citizenship.

A. State and Local Government Services 

1. ADA Requirements 

Title II of the ADA applies to “services, programs, and activities” of public entities.166 Title II 

prohibits discrimination on the basis of disability and requires: (a) making reasonable 

modifications to policies, practices, and procedures; (b) administering services, programs, or 

activities in the most integrated setting appropriate to the needs of qualified people with 

disabilities; (c) modifications to facilities to achieve program access; (d) ensuring that 

communications with people with disabilities are as effective as communications with people 

without disabilities, and (e) accommodations in transportation. Effective communication is 

achieved by providing auxiliary aids and services to people with vision, speech, and hearing 

disabilities.167

Government programs in existing buildings must achieve “program accessibility.” This means 

the program, when viewed in its entirety, must be accessible to people with disabilities.168

Program accessibility may be achieved by making physical changes to facilities or by a 

combination of other means (e.g., moving programs upon request, providing service through 

other means, etc.). To achieve program accessibility, state and local governments with 50 or 

more employees were required to engage in a self-evaluation of their facilities and a transition 

plan to make their programs accessible. Any structural modifications called for by the transition 

plans were to be completed by January 26, 1995.169
60 

New construction and alterations must be fully accessible in accordance with the ADA 

Accessibility Guidelines.170

2. Relevant Data 

In 1995, Condrey & Brudney surveyed municipal government personnel administrators in U.S. 

cities with a population of 50,000 or more. Their sample size was 334 and their response rate 

was 63 percent. Over 90 percent of the respondents had obtained literature on the ADA, 

participated in an ADA seminar, and appointed an ADA coordinator. Over 80 percent of their 

respondents had studied the ADA regulations, conferred with the city attorney, carried out the 

self-evaluation, and evaluated their job descriptions. Discussions with a labor lawyer were held 

by 42.5 percent of the respondents and discussions with an ADA consultant were held by 35.9 

percent. The Job Accommodation Network was consulted for assistance by 21.6 percent. In over 

80 percent facilities were made accessible and in over 70 percent of the local governments there 

had been ADA workshops.171

Pfeiffer and Finn in 1995 conducted a study of compliance with the ADA by state, territorial, and 

local governments. This study surveyed local governments separately from states and territories 

and included small as well as larger local governments. In the survey of local governments, over 

840 jurisdictions responded. Just over 65 percent of local governments answered they had ADA 

and/or Section 504 coordinators, and the study concluded: “The most important finding of the 

present study is that the existence of an ADA coordinator on the local government level has a 

considerable impact. A person to oversee the necessary activities and to deal with complaints (in 

various ways) increases the implementation activities on the local level.”172

Pfeiffer and Finn found that states were likely to be in greater compliance with the ADA. “Over 

three quarters of the state and territorial governments have completed their [ADA compliance] 

self evaluations and almost 85 percent say that their agencies have transition plans. Attention is 

being paid to the requirements of the ADA: 97.8 percent of the states and territories reported that 

sign language interpreters are provided upon request. Over 90 percent had changed questions on 

their employment applications, provided material in alternative format, and changed locations for 

interviews. A reasonable accommodation had been provided by 87 percent of the states and 
61 

territories. There is considerable ADA implementation activity on the state and territorial 

level.”173

To promote Title II compliance at the local level, the Department of Justice (DOJ) operates 

“Project Civic Access,” a wide-ranging effort to ensure that counties, cities, towns, and villages 

comply with the ADA by eliminating physical and communication barriers that prevent people 

with disabilities from participating fully in community life. DOJ has conducted reviews in 50 

states, as well as Puerto Rico and the District of Columbia, and is posting the agreements to help 

additional communities come into compliance with the Act. DOJ states it has negotiated 145 

Project Civic Access agreements with 138 local governments ensuring accessible buildings, 

programs and services.174

Examples of issues specifically addressed by the Department of Justice’s Project Civic Access 

settlements include: 

• Physical modifications of facilities to improve accessibility. Facilities include city and town 

halls; police and fire stations and sheriff departments; courthouses; centers for health care 

delivery, childcare, teen and senior activities, conventions, and recreation; animal shelters; 

libraries; baseball stadiums; parks (including ice skating rinks, public pools, playgrounds, ball 

fields and bleachers, band shells and gazebos). The agreements secure the following: 

○ Accessible parking 

○ Accessible routes into and through the facilities 

○ Accessible rest rooms, drinking fountains, and telephones 

○ Accessible service counters and concession stands, or the provision of services at 

alternate, accessible locations 

○ Accessible bathing facilities at public pools 

• Physical modifications to polling places and/or the provision of curbside or absentee balloting. 

• Permanent and conspicuous notice to the community of their ADA rights and the 

government’s ADA obligations. 
62 

• Establishment of an ADA grievance procedure where none existed in communities employing 

more than 50 people. 

• Establishment of delivery systems and time frames for providing auxiliary aids and services. 

• Installation of assistive listening systems in assembly areas (e.g., legislative chambers, court 

rooms, municipal auditoriums). 

• Strengthening of 9-1-1 emergency services through the acquisition of additional text 

telephones (TTYs) to achieve a 1:1 ratio of TTYs and answering positions, training to 

recognize “silent calls,” and accountability through performance evaluations and discipline of 

employees. 

• Improvements in telephone communication between the government and citizens with hearing 

or speech impairments through the acquisition of additional TTY’s and/or utilization of the 

state relay service, official publication of TTY/relay numbers, and training of employees. 

• Adoption of procedures for relocating inaccessible activities to accessible locations upon 

request (e.g., City and Town Council meetings, municipal and county court proceedings).175

One particular area of concern is access to the judicial system. As a fundamental American right, 

access to court proceedings should be a top priority. Yet state and local courts have been slow to 

improve physical access and to provide auxiliary aids. From 1994 to 2004, the Department of 

Justice reached settlement agreements involving courthouses in 58 cases. The Department 

reached informal agreements with 57 courts.176 These cases primarily involved physical access 

issues and provision of sign language interpreters and other auxiliary aids for people with 

hearing disabilities. The Department of Justice recently reported on progress using litigation and 

informal agreements, as well as other work undertaken by the department in their report “Access 

for All: Five Years of Progress, A Report from the Department of Justice on Enforcement of the 

Americans with Disabilities Act.”177

Major lawsuit filings indicate that state and local courts still are not fully accessible, 15 years 

after passage of the ADA. Courthouses have been the subject of several lawsuits, including 

Tennessee v. Lane,

178 Miles v. Los Angeles,179 and others. In California, the Chief Justice 

acknowledges that 75 percent of the state’s courthouses are not accessible to people with 
63 

physical disabilities.180 Other states, such as Oregon and Arizona, began conducting accessibility 

surveys in 2003–2004.181

Recognizing the need for access to courts, the U.S. Access Board has issued accessibility 

guidelines for courthouses and has convened an Advisory Committee to provide technical 

assistance on courthouse accessibility.182 However, the delay between issuance of guidelines by 

the Access Board and adoption of those guidelines as enforceable standards by the Department 

of Justice encourages courts to delay compliance for fear that they would waste effort 

implementing outdated guidelines. 

Another possible reason for the delay in compliance is the belief that state and local governments 

cannot be held liable for monetary damages for failing to make their facilities accessible. The 

Supreme Court in University of Alabama v. Garrett found that state governments could not be 

held liable for monetary damages for violations of the employment provisions of the ADA, based 

on the doctrine of sovereign immunity.183 States have also raised the Sovereign Immunity 

defense in ADA actions involving Title II, which covers access to state and local government 

programs and facilities. The Supreme Court in Tennessee v. Lane found that, at least for court 

facilities, money damages is available against states.184 However, states’ liability for money 

damages for failure to comply in other areas remains unclear and may be contributing to delays 

in compliance. 

Although local, as opposed to state, governments are not protected by sovereign immunity the 

courts have imposed limitations on their liability for damages under the ADA. Courts require a 

showing of intentional discrimination for monetary damages to be available.185 Lacking the 

incentive of monetary liability for noncompliance, local governments may be moving more 

slowly than they otherwise would. 

3. Input from People with Disabilities 

In the focus groups, some participants confused the provision of accommodations in educational 

settings required by Section 504 of the Rehabilitation Act of 1973, as amended, and the 

Individuals with Disabilities Education Act with Title II of the ADA. There was similar 
64 

confusion with Medicare, Medicaid, and other services that do not come within the scope of the 

ADA. The lack of services in these areas was identified in the focus groups and often incorrectly 

attributed to lack of ADA enforcement. Comments from forums and e-mail were mixed 

regarding accessibility of government services under the ADA. 46 percent of respondents 

expressed negative opinions on the accessibility of government services, while 45 percent were 

positive. The need for greater ADA enforcement for better access to state and local government 

services was cited by participants numerous times. 

• “The improvement in this area is Tremendous!! Anyone who says otherwise is not 

remembering how it was. Curb ramps, accessible building entrances and moving around 

inside, transportation, sidewalks, paths of travel, the list goes on and on and on.”186

• “Government agencies are by far the worst in compliance. Getting to and from their physical 

offices can be a nightmare. They choose to build or locate sites that are inaccessible for 

varieties of reasons not the least of which is public transportation and parking/path of travel. 

Of particular note are those government offices in rural areas.”187

• “Pennsylvania has been especially good about meeting the ADA accessibility 

requirements .... I wish facilities at Federal sites were as reliable.”188

• “There are still places I cannot go. Council Chambers are one. You cannot hear them speak. 

Even with microphones. Public events—cannot hear the speaker.”189

• “I would say this is the most changed and improved area of all. The agency personnel 

generally are more educated about disabilities and the buildings are much more accessible 

than private entities.”190

4. Recommendations – State and Local Government Services 

• The Department of Justice and other federal agencies should focus on enforcing the ADA 

obligations of government agencies; 

• Federal agencies should use initiatives such as Project Civic Access to increase ADA 

compliance at the state and local levels; 
65 

• The Department of Justice should use targeted, high-profile litigation on particularly 

important issues, such as access to courts, medical care, and education to increase state and 

local ADA compliance. 

B. Voting 

1. ADA Requirements 

Two pre-ADA laws addressed the access issues of voting for people with disabilities. The Voting 

Rights Act of 1965 (VRA) provides that any voter requiring assistance to vote “by reason of 

blindness, disability, or inability to read or write may be given assistance by a person of the 

voter’s choice ....”191 The Voting Accessibility for the Elderly and Handicapped Act of 1984 

(VAEHA) requires that political subdivisions responsible for conducting elections ensure that all 

polling places for federal elections are accessible to elderly voters and voters with disabilities. 

Title II of the ADA and its implementing regulations require that people with disabilities have 

access to basic public programs, including the right to vote. However, it does not strictly require 

that polling place sites be accessible. Instead, as with all state and local government programs, 

the program of voting, as a whole, must be accessible. Such program access can be accomplished 

in a variety of ways, including curbside voting for people with mobility impairments at 

inaccessible polling places, and assisted voting for people with vision impairments.192 

During the 2004 election, the U.S. Department of Justice implemented new policies to protect 

the rights of voters with disabilities, including publishing a 39-page “ADA Checklist for 

Accessible Polling Places” and, for the first time, deploying election monitors trained to assess 

the accessibility of polling places.193 

The Help America Vote Act of 2002 (HAVA) provides states with federal monies to update their 

voting process, including funds for the purchase of accessible voting machines and removal of 

the systemic and physical barriers that have denied people with disabilities their constitutional 

right to vote. At least one electronic voting machine, which must be fully accessible for people 

with visual impairments, was required in each polling place by January 1, 2006.194
66 

2. Relevant Data 

All states have provisions (in the form of statutes, regulations, or policies) that specifically 

address voting by people with disabilities. These provisions vary greatly, as do county practices 

for assuring voting accessibility. For example, while some counties cite accessibility as a specific 

criterion used in selecting polling places, others do not. All states provide for one or more 

alternative voting methods or accommodations that may facilitate voting by people with 

disabilities whose assigned polling places are inaccessible. For instance, all states have 

provisions allowing voters with disabilities to vote absentee without requiring notary or medical 

certification requirements, although the deadlines and methods (such as by mail or in person) for 

absentee voting vary among states. In addition, many states, but not all, have laws or policies that 

provide for other accommodations and alternatives for voting on or before Election Day—such 

as reassignment to a polling place that is accessible, curbside voting, or early voting.195

In 2001, a General Accounting Office (now the Government Accountability Office) study of 

polling places in the United States estimated that, from the parking area to the voting room, 16 

percent of all polling places in the contiguous United States had no potential impediments, 56 

percent had one or more potential impediments but offered curbside voting, and 28 percent had 

one or more potential impediments and did not offer curbside voting. Such potential 

impediments primarily affected people with mobility impairments and occurred most often on 

the route from the parking area to the building or at the entrance to the polling place, with more 

than half of all polling places having impediments in these areas. Inside the polling place, the 

types and arrangement of voting equipment used posed challenges for people with mobility, 

vision, or dexterity impairments. To facilitate voting inside the voting room, polling places 

generally provided accommodations, such as voter assistance, magnifying devices, and voting 

instructions or sample ballots in large print. However, none of the polling places visited by the 

GAO had special ballots or voting equipment adapted for blind voters.196

A 2004 Massachusetts survey indicated that 60 percent of its polling sites did not meet HAVA 

requirements. 197 A Missouri survey found that 70–80 percent of urban polling places were 

accessible, while only 10 percent of rural ones were accessible.198 A 2003 Florida survey 

revealed that 54 percent of polling places were accessible.199 Six percent of polling places in 
67 

Utah were inaccessible, according to a 2004 survey.200 Ninety-four percent of polling places in 

Indiana were found to be inaccessible.201 In Los Angeles County, accessibility of polling places 

substantially improved since passage of the ADA, rising from 70 percent accessible in 1986 to 

98 percent accessible in 2001. 

Substantial barriers to independent voting remain for people with vision impairments. Paper 

ballots require people with vision impairments to rely on third parties for assistance in voting, 

thus undermining the independence and confidentiality of their votes. The Help America Vote 

Act (HAVA) intended to address this problem by requiring electronic voting machines to be 

available at every polling place in federal elections by January 2006. According to the American 

Association of People with Disabilities, in 2004 about 80 percent of polling places nationwide 

were not fully accessible in accordance with HAVA standards.202 Although states are steadily 

adopting electronic voting, controversies over the security of electronic voting have delayed 

approval, purchase, and implementation of electronic voting systems.203

Compared to prior years, the percentage of Americans with disabilities who voted in 2004 

increased dramatically. According to the N.O.D./Harris Surveys, voting by Americans with 

disabilities has increased steadily over the last three presidential election cycles, and the gap 

between those with disabilities and those without disabilities who voted is decreasing (see 

Figure E). In 1996, 31 percent of adults with disabilities voted in the presidential election, 

compared to 49 percent of all adults voting. In 2000, 41 percent of Americans with disabilities 

voted compared to 51 percent of all adults. In 2004, turnout among likely voters with disabilities 

was estimated by Harris to be 52 percent, while, according to the Census, 64 percent of people 

without disabilities voted. 
68 

Figure E: Voting Practices of Americans with Disabilities 

31%

41% 49% 51% 52%

64%

0%

25%

50%

75%

100%

1996 2000 2004

Election Year

Adults with disabilities All adults

• According to the American Association of People with Disabilities, voting participation 

ranged from 31 percent in Georgia to 55 percent in Minnesota in the 2000 elections (see 

Table C).204 

Table C: Percentage of People with Disabilities Voting by State in 2000 

State 

% of People with 

Disabilities Voting State 

% of People with 

Disabilities Voting 

Alabama 40% Montana 49.2% 

Alaska 53.1% Nebraska 45.2% 

Arizona 33.8% Nevada 35% 

Arkansas 38.2% New Hampshire 50% 

California 35.3% New Jersey 40.8% 

Colorado 45.5% New Mexico 37.9% 
69 

State 

% of People with 

Disabilities Voting State 

% of People with 

Disabilities Voting 

Connecticut 46.7% New York 40.3% 

Delaware 46.7% North Carolina 40.2% 

DC 39.3% North Dakota 48.3% 

Florida 40.5% Ohio 44.6% 

Georgia 30.5% Oklahoma 39% 

Hawaii 32.4% Oregon 48.5% 

Idaho 43.6% Pennsylvania 43% 

Illinois 42.2% Rhode Island 43.4% 

Indiana 43.6% South Carolina 37.3% 

Iowa 48.6% South Dakota 46.6% 

Kansas 43.3% Tennessee 39.4% 

Kentucky 41.3% Texas 34.5% 

Louisiana 43.4% Utah 42.1% 

Maine 53.8% Vermont 51.2% 

Maryland 41.3% Virginia 42.4% 
70 

State 

% of People with 

Disabilities Voting State 

% of People with 

Disabilities Voting 

Massachusetts 46.1% Washington 45.5% 

Michigan 46% West Virginia 36.6% 

Minnesota 55% Wisconsin 52.9% 

Mississippi 38.9% Wyoming 47.8% 

Missouri 46% 

Perhaps recognizing the increased participation of individuals with disabilities, individuals 

running for election have been more visibly responsive to the concerns of the disability 

community. For example, in 2004, both Presidential candidates took public positions on 

disability issues—President George W. Bush’s New Freedom Initiative and Senator John Kerry’s 

Disability Policy Platform.205 State-level election candidates have also publicized positions on 

disability issues.206

3. Input from People with Disabilities 

In the discussion about accessible voting, one participant said: “We participated in a program 

called “Count Us In,” where our polling places of today were visited and rated and none of them 

passed 100 percent. But the polling place workers were helpful and tried to do what they 

could.”207

C. Other Forms of Civic Participation 

No data were found in our environmental scan about rates of participation by people with 

disabilities in other forms of civic activities, such as serving in public office, participating in 

government advisory committees, or performing community service. 
71 

Most states have a disability commission to advise on disability policy issues208 and people with 

disabilities serve on these commissions. 

D. Recommendations – Full Participation 

• The Department of Justice should immediately implement the Help America Vote Act 

requiring installation of electronic voting equipment; 

• The National Institute on Disability and Rehabilitation Research should study and publish the 

involvement of people with disabilities in civic opportunities, such as government office; 

• The National Organization on Disability should encourage state and local governments to 

emphasize involvement of the disability community as part of their diversity efforts and 

provide technical assistance to help government agencies reach out to people with disabilities. 
72 
73 

III. Independent Living 

People with disabilities traditionally have been subject to governmental, medical, and family 

control in their most central life decisions, including where and with whom to live. Independent 

living, for purposes of this study, is defined as control by people with disabilities over their own 

lives, including availability of acceptable choices of housing and health care and lack of undue 

control by others in life decisions. An important aspect of independent living is the availability of 

services in integrated community-based settings. 

A. Community Integration 

1. ADA Requirements 

In July 1999, the Supreme Court issued the Olmstead v. L.C. decision.209 The Court’s decision in 

that case challenged state governments to provide people with disabilities with communitybased, rather than institutional, services. The Olmstead decision interpreted Title II and its 

implementing regulations, requiring states to administer their services, programs, and activities 

“in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” 

The Court found that unjustified institutionalization constituted discrimination under Title II of 

the ADA. The Court found that the cost of providing services in community-based, rather than 

institutional, settings was not a defense to the obligation except when the state could show that, 

in the allocation of available resources, immediate relief for a particular individual would be 

inequitable to the other individuals under the state’s care.210 Since the Court’s Olmstead

decision, lower courts interpreting the decision have been reluctant to insert themselves into the 

administration of health care services. Community-based health care, mental health, and housing 

services are increasing slowly in response to the Olmstead decision. Courts have accepted as 

legitimate slow movements by the states toward community-based care. 

In July 2001, President George W. Bush issued an Executive Order providing guidance on the 

implementation of the Olmstead decision and allocated over $120 million in grants in 2001–2002 

to increase community-based integration for people with disabilities.211 
74 

2. Relevant Data 

a. Federal Olmstead Initiatives 

On March 25, 2002, the U.S. Department of Health and Human Services (HHS) submitted to the 

President a report entitled Delivering on the Promise.212 The report summarized agency activities 

that support Olmstead’s goal of community integration, identified barriers in government 

programs that are impeding full implementation of Olmstead, and proposed more than 400 

solutions aimed at removing these barriers.213 According to a 2004 Progress Report on the 

President’s New Freedom Initiative, the following federal activities are specifically related to 

promoting de-institutionalization:214

i. Department of Health and Human Services (HHS) 

In October 2002, HHS established the Office on Disability to address the coordination of 

disability policies and programs across HHS agencies. HHS’s Centers for Medicare and 

Medicaid Services (CMS) had awarded nearly $200 million since 2001 under the Real Choice 

Systems Change Grants for Community Living, which has the goal of enabling people with 

disabilities to reside in their communities and participate more fully in community life. Since 

2003, CMS funded $12 million in demonstration grants to improve the direct service community 

workforce, which enables state and community-based providers to test new strategies for 

recruiting, training, and retaining direct service workers. 

Since 2001, HHS’s Administration on Aging supported family caregivers through the National 

Family Caregiver Support Program with over $400 million to states and tribal governments to 

develop multi-faceted systems of support to extend the caregiving efforts of families, friends, 

and neighbors. 

ii. Department of Justice (DOJ) 

DOJ evaluates residential placements, in each investigation of healthcare facilities, under the 

Civil Rights of Institutionalized Persons Act (CRIPA) in light of the ADA’s requirement that 

services be provided to residents in the most integrated setting appropriate to their needs. DOJ 

has issued letters of finding citing violations of Olmstead involving four facilities for people with 
75 

developmental disabilities, six nursing homes, and the children’s unit of a psychiatric hospital. 

DOJ has worked with officials in several states to help states and other jurisdictions provide 

community-based services to people who are currently residing in publicly-operated institutions. 

iii. Department of Labor (DOL) 

In September 2003, the Department of Labor’s Office of Disability Employment Policy, and its 

Center for Faith-Based and Community Initiatives, awarded $500,000 to eight recipients to 

provide home modifications as a means of expanding the community integration of people with 

disabilities, particularly those seeking employment. 

In 2005, the President’s proposed federal expenditures to promote community integration 

initiative included: 

• $1.75 billion through fiscal year (FY) 2009 for the “Money Follows the Individual 

Rebalancing Demonstration,” with $350 million targeted for FY 2005. This demonstration 

would assist states in re-balancing long-term care systems to support cost-effective choices 

between institutional and community options, including financing Medicaid services for 

individuals who move from institutions to the community; 

• $327 million through FY 2009, with $18 million for FY 2005, to fund three demonstrations 

that promote home and community-based care alternatives. Two of the demonstrations 

provide respite care services for caregivers of adults with disabilities or long-term illness, and 

children with substantial disabilities. Another demonstration provides community-based care 

alternatives for children who are currently residing in psychiatric residential treatment 

facilities; 

• $102 million through FY 2009, with $17 million in FY 2005, to continue Medicaid eligibility 

for spouses of people with disabilities who return to work. Under current law, people with 

disabilities might be discouraged from returning to work because the income they earn could 

jeopardize their spouse’s Medicaid eligibility. This proposal would extend to the spouse the 

same Medicaid coverage protection now offered to the worker with a disability; 
76 

• $40 million to continue the Real Choice Systems Change Grants Program, including nearly $3 

million to continue the demonstration program being administered by CMS to promote the 

recruiting, training, and retention of direct service workers.215

Federal Medicaid spending on home and community-based waiver services has grown 

exponentially, from 37 percent in 1992 to 66 percent in 2001. In 1992, 15 percent of all longterm care spending went to home and community-based care waiver benefits, while by 2002 that 

figure had risen to 30 percent.216

While the Federal Government’s commitment to these new initiatives has been welcomed in the 

disability community, it has been criticized on two counts: (1) a lack of an overall national policy 

framework for community integration of people with disabilities, and (2) inadequate stimulation 

of change in the long-term care system to eliminate unnecessary institutionalization of people 

with disabilities.217 

b. State Olmstead Initiatives 

The Supreme Court suggested that states demonstrate compliance with the Olmstead decision by 

producing formal plans for increasing community integration. Olmstead directs states to make 

“reasonable modifications” in programs and activities. Modifications that would “fundamentally 

alter” the nature of services, programs or activities are not required. As a result, the Federal 

Government encourages states to plan for reforms not only in the health arena, but also in 

transportation, housing, education and other social supports that can help people with disabilities 

live in the community. 

Because Medicaid is the primary funding source for long-term care and covers a large number of 

people with disabilities, many states focused their initial efforts on how Olmstead affects 

Medicaid budgets. More than 35 percent of all Medicaid spending goes to long-term care 

services. Institutions get the lion’s share, about 71 percent in 2001. Many refer to this lopsided 

distribution as the “institutional bias.” Medicaid waivers are necessary to allow services in the 

home and in communities. Although every state has a variety of waivers to provide communitybased services,218 the majority of funds continues to be directed at nursing homes or other 
77 

institutional settings.219 Every state also allows home health care in at least some 

circumstances.220 However, 20 states do not cover personal care services.221

As of 2004, 29 states had issued Olmstead-related plans or reports. Many of these plans rely on 

Medicaid community service options, in combination with resources from other programs, to 

achieve the types of community programs that make it possible for people with disabilities to 

live and work in their own communities.222

The definition of an Olmstead plan is not clear-cut and states have developed alternative 

approaches to Olmstead planning.223 Some states have developed specific strategies for 

implementation over a number of years. Others identified key priorities for immediate action. 

Still others set out broad policy recommendations. Many plans anticipate frequent 

amendments.224

Some states have displayed little specific strategic work in this area. One study reports three state 

strategies to address Olmstead compliance: legislative action (policy and budgetary mechanisms 

for moving money around the system); market-based approaches (consumer information to 

enable choice and create demand for Home and Community-Based Services (HCBS)); and fiscal 

and programmatic linkages (e.g., improving coordination between services and increasing HCBS 

capacity).225 

The focus of state plans has been to: 

• Help people make the transition from institutions into the community; 

• Promote affordable and accessible housing; 

• Improve the recruitment and retention of direct care workers; 

• Provide information and referral as well as family-centered assessments; 

• Allow funding to follow the individual rather than the providers; 

• Reduce the waiting lists for home and community-based services; 

• Increase employment opportunities for people with disabilities; 
78 

• Enhance data collection activities and systems; 

• Increase accessible transportation options; 

• Ensure quality of care based on outcomes.226

NCD’s 2003 Olmstead Report found, in part, the following regarding state plans: 

• Plans do not consistently provide for opportunities for life in the most integrated setting as 

people with disabilities define “the most integrated setting”; 

• The majority of states have not planned to identify or provide community placement to all 

institutionalized persons who do not oppose community placement; 

• Few plans identify systemic barriers to community placement or state action steps to remove 

them and few plans contain timelines and targets for community placement; 

• State budgets often do not reflect Olmstead planning goals.227 

Medicaid coverage of nursing home services is mandatory. However, coverage of most 

community-based services is optional. To address this institutional bias, states such as Texas are 

allowing funds that are devoted to the care of institutional residents to follow them into the 

community.228 Specifically, sources in 25 states—Arizona, Arkansas, Connecticut, Delaware, 

Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Louisiana, Maryland, Massachusetts, 

Michigan, Minnesota, Mississippi, North Dakota, Ohio, Pennsylvania, Rhode Island, South 

Carolina, Texas, Utah, Washington and Wisconsin—described efforts to shift more people from 

nursing homes and “intermediate care facilities for the mentally retarded” (ICF/MRs) into the 

community or to divert people from unnecessary institutional placements during the hospital 

discharge planning process.229

Many of these states are helping people make the transition by giving allowances to fund the 

move and housing fees and by providing assistance through case managers. Florida is 

implementing three pilot nursing home transition programs with the goal of moving 1,200 people 

during FY 2003–2004 and allowing Medicaid funding to follow the person. Pennsylvania is 

developing a three-county pilot project to streamline Medicaid waiver eligibility to divert people 
79 

from nursing homes. Wisconsin received a systems change grant to move about 200 people with 

developmental disabilities out of institutions.230

According to a report by the National Conference of State Legislatures, since 2001, state budget 

restrictions have delayed implementation of Olmstead efforts. Although community-based 

services are estimated to be less costly than institutional services in the long term, during the 

transition from institution to community-based programs, expansion of services is required. 

Thus, without adequate additional funding, and facing overall budget shortfalls, states have not 

succeeded in implementing their Olmstead plans. As a result, numerous lawsuits have been filed 

to enforce Olmstead obligations.231

However, progress has been made. In April 2005, there were 16,094 nursing homes in the United 

States, down from 16,516 in December 2002. The U.S. Department of Health and Human 

Services reports that nearly 1.399 million people were in nursing homes in the first quarter of 

2006, and over 297,000 (21 percent) of them expressed a preference to live in the community.232

This number is down from the fourth quarter of 2002, when 1.43 million people were in nursing 

homes.233

Only six years have passed since the Olmstead decision requiring states to emphasize community 

integration. As of 2002, the Government Accountability Office estimated that there were at 

minimum 1.8 million people with disabilities being served in institutional settings, including 

1.6 million individuals in nursing facilities, 106,000 individuals in institutions for people with 

developmental disabilities, and 57,000 individuals in state and local facilities for individuals with 

mental illness.234 Since the Olmstead decision, state and Federal Government agencies have been 

changing their systems to facilitate community integration. The effects of these changes have not 

yet resulted in substantial numbers of people with disabilities leaving institutions, and courts 

have not been willing to push states to move more quickly. However, the Olmstead decision 

holds great promise for people with disabilities, particularly those with mental illness or 

intellectual disabilities, who want to become more integrated into their local communities. 
80 

3. Input from People with Disabilities 

Survey respondents indicated that Olmstead has not yet been effectively implemented to a degree 

sufficient to meet the needs of people with disabilities. The Bazelon Center for Mental Health 

Law issued this statement on the fifth anniversary of the Olmstead decision: 

• “While many Americans with disabilities have made progress since the Olmstead ruling, 

people with mental illnesses have been largely left behind in efforts to implement the 

decision. Most states are enacting Olmstead reforms at a snail’s pace, defying the spirit of the 

ruling and preventing Americans with mental illnesses from participating in their 

communities. 

• Rhetoric has far outstripped action to promote community services for people with mental 

illnesses. States are quick to trumpet their limited efforts to implement Olmstead, but these 

have produced little actual movement of people with mental illnesses into integrated 

community settings. 

• Budget pressures have closed psychiatric hospitals across the country, but few appropriate 

community services have been adequately funded to help people with mental illnesses live 

successfully in the community. Instead, states have ‘transinstitutionalized’ people with mental 

illnesses to settings as outmoded, isolating and inappropriate as the facilities they were meant 

to replace. Increasing numbers of people with psychiatric disabilities now find themselves in 

large board and care homes, ‘adult homes,’ nursing homes, and other institution-like settings. 

Thousands wind up in jail or prison because chronically underfunded community mental 

health systems fail to provide meaningful support. 

• Where real progress has occurred, it is largely because states have been sued. Five years after 

Olmstead and 14 years after enactment of the Americans with Disabilities Act, litigation 

should be unnecessary. Yet it remains the single most effective way to combat the persistent 

segregation of people with mental illnesses.”235

Olmstead was discussed extensively in the Savannah public forum, which was attended by 

advocates who are involved daily in promoting Olmstead implementation. One was the lead 

attorney for “L.C.” in Olmstead v. L.C. These participants suggested that many people with 
81 

disabilities, particularly those with developmental disabilities or mental illness, are not benefiting 

from Olmstead. 

I don’t mean to say that lots of people aren’t moving out of institutions into the 

community; they are. And I don’t mean to say that we’re stuck in the legal sense because 

we’re definitely moving toward a better development of legal rights in this country for 

people with disabilities. 

But I do mean to say that the people I encounter on a daily basis are, if not in as bad a 

shape—they may in some cases be in worse shape because staffing is bad, treatment is 

bad, professionals are not particularly competent in many cases, and there’s a very 

limited understanding among institutional staff, still, about the rights of the people they 

are serving. There is very little understanding that they have a right to apply for all these 

community-based services. The institutional staff doesn’t know that. They have no 

clue.236

These advocates endorsed the “Money Follows the Person” concept, which has been proposed in 

the Senate by Sen. Tom Harkin (D-IA) and as a budgeted demonstration project by the Bush 

Administration. Under this bill, the Medicaid money paid by states and the Federal Government 

would follow a person with a disability from an institution into the community. The legislation 

would provide 100 percent federal reimbursement for the community services that individuals 

need during the first year after they move out of a nursing home or similar facility. After that 

first year, individuals would remain in the community, and states would receive their regular 

Medicaid match for their services. 

The breakdown of the community-based programs is due to not enough money being 

attached to be able to develop real supports that are going to give people the services they 

need .... Maybe attaching the money to the individual will expedite those things. When a 

person has money they get a service, so maybe that’s the key, to make sure that each 

individual has enough funding to be able to meet their needs in a person-centered way. 

That’s an idea to think about, and something that would work a lot better if you started 

doing something like that, rather than setting up granting agencies all over the place, 
82 

where they don’t meet the needs of the individual, but they meet the needs of the 

system.237

B. Recommendations – Independent Living 

• Congress should increase Medicaid support for community-based treatment settings; 

• Congress should pass and fully fund the Money Follows the Person Act;238 and Medicaid 

Community-Based Attendant Services and Supports Act;239

• Congress should require states to expeditiously complete effective Olmstead plans, consistent 

with HHS guidance;

• The Department of Health and Human Services should require states to fund personal care 

services when needed to allow a person with a disability to remain in their community;

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

working with state and local governments and community agencies should implement local 

initiatives to extend the integration mandate to housing, education, transportation, 

employment, and other areas affecting people with disabilities; 

• The Department of Justice should increase and target enforcement of the Civil Rights of 

Institutionalized Persons Act on requiring effective deinstitutionalization efforts and 

publishing creative and effective programs to provide community-based services; 

• The Department of Labor’s program funding home modifications should be significantly 

expanded to allow people with disabilities and the elderly to live in their communities; 

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

should work with disability communities and others to develop an overall national policy 

framework for community integration of people with disabilities; 

• The Department of Health and Human Services should study systems of long-term care and 

long-term care insurance to eliminate unnecessary institutionalization of people with 

disabilities and aging people. 
83 

IV. Economic Self-Sufficiency 

People with disabilities traditionally have relied on government benefits and charity for survival, 

and Congress found, when passing the ADA, that as a group, people with disabilities occupy an 

inferior status in our society, and are severely disadvantaged socially, vocationally, 

economically, and educationally. Economic self-sufficiency, for purposes of this study, is 

defined as financial security for people with disabilities, which is achieved by education, 

employment, and asset accumulation. Availability of appropriate health care and insurance 

coverage are additional aspects of economic self-sufficiency. 

There is no direct evidence to suggest that Americans with disabilities are becoming more 

economically self-sufficient. Improvements in areas such as education, reasonable 

accommodations on the job, and improvements in access to public transportation, factors that 

might be expected to contribute to economic self-sufficiency in the long run, give some reason 

for optimism, and warrant further study. The education gap between people with disabilities and 

people without disabilities is shrinking and people with disabilities are attending postsecondary 

institutions in record numbers, but their graduation rates lag behind their counterparts without 

disabilities. Educational supports and services for students with disabilities are now available at 

most of the nation’s 3,000 postsecondary institutions. There is evidence that people with 

disabilities are experiencing less discrimination on the job, but they are not experiencing 

increases in hiring. People with disabilities rarely win ADA employment discrimination cases. 

The percentage of people with disabilities living in poverty has not decreased since passage of 

the ADA—a disappointing finding that many attribute to Social Security rules that trap people 

into living at poverty levels in order to retain essential medical supports and services.240 

A. Financial Assets and Insurance 

1. Financial Assets 

NCD was unable to discover a comprehensive and reliable source of information on the financial 

assets of people with disabilities. However, as research at the Burton Blatt Institute 

(http://bbi.syr.edu) and by others shows, it is generally understood that limited access to financial 
84 

assets is one of the challenges facing many Americans with disabilities. Additionally, significant 

disparities exist between the financial resources of people with disabilities and people without 

disabilities. 

In 2006, the U.S. Bureau of the Census data indicated that approximately one in every five 

Americans with a disability (19 percent) live in poverty, three times the percentage of people 

without disabilities living in poverty.241 Twenty-six percent of Americans with severe disabilities 

live in poverty.242 The 2000 N.O.D./Harris Survey of Americans with Disabilities indicated 28 

percent of people with severe disabilities lived in poverty, as compared to 8.3 percent of people 

with no disability.243 In 1990, before implementation of the ADA, 19 percent of people with 

disabilities lived in poverty—exactly the same percentage as in 2006. 

NCD currently has a financial incentives study underway that will investigate the extent to which 

people with disabilities have access to financial assets, such as savings, investments, and loans, 

the disparity between the financial assets of people with disabilities and people without 

disabilities, and the costs and availability of health insurance coverage and benefits for people 

with disabilities. NCD believes that this Financial Incentives study will provide much-needed 

information for the development of strategies to improve economic self-sufficiency for people 

with disabilities.244 

Banks and financial institutions have responded to pressure to make their services accessible to 

people with disabilities. Numerous lawsuits and structured settlement negotiations have resulted 

in Citibank, Wells Fargo, Bank of America, Fleet Bank, Sovereign Bank, Citizens Bank, 

Chase/Bank One, First Union Bank (now Wachovia), Union Bank of California, Washington 

Mutual, and LaSalle Bank installing talking ATMs, providing statements in accessible formats, 

and increasing accessibility of their Web sites to screen readers for people with vision 

impairments. American Express has also agreed to provide statements and other written 

materials in braille and other formats for credit card customers.245 Current estimates indicate that 

over 50,000 talking ATMs are available at banks across the country.246
85 

2. Health Insurance 

Who receives health care services and how much service is obtained depends on one’s health 

care coverage, or health insurance, which is, unfortunately for people with disabilities, 

intertwined with employment. Either an individual is able to work full-time at one employer long 

enough to qualify for employer-based health insurance (EBHI), or an individual must be assessed 

as totally unable to work, thereby qualifying for public health coverage. Those between these 

two extremes, where people with disabilities are likely to find themselves, have difficulty 

obtaining health coverage, threatening their access to health care, risking a deterioration of their 

health conditions, and further limiting their ability to work. Almost one of every five working 

age people with disabilities lacks health insurance. Even people with disabilities who are 

employed are less likely to have health insurance than workers without disabilities. Among fulltime employees, for example, 65 percent of those with disabilities had EBHI, compared to 74 

percent of those without disabilities.247

People with disabilities and people without disabilities are equally likely to be covered by some 

form of health insurance (88 percent – 91 percent).248 However, most of the people with 

disabilities covered (56 percent) are covered by Medicaid or Medicare, while most people 

without disabilities are covered by private insurance (78 percent). These differences in the 

sources of coverage are significant and may explain why people with disabilities are significantly 

more likely to go without needed medical care than people without disabilities (18 percent versus 

7 percent). 

B. Higher Education 

1. ADA Requirements 

Postsecondary schools must ensure that the programs they offer, including extracurricular 

activities and avenues of communication, are accessible to students with disabilities. State 

colleges and universities must ensure “program access”249 under Title II, while private colleges 

must ensure readily achievable barrier removal under Title III.250 Under both titles of the ADA, 

such access is to be supported through the provision of “reasonable modifications” to policies, 

practices and procedures251 and “auxiliary aids and services.”252 
86 

Academic adjustments may include classroom and testing modifications, such as extra time on 

examinations, provision of materials in alternative formats, and ensuring physical accessibility of 

classrooms and labs. Auxiliary aids and services include practices that create access to 

information for people with sensory impairments, such as providing sign language interpreters 

for students who are deaf and readers for students who are blind. 

2. Relevant Data 

The education gap between people with disabilities and people without disabilities is shrinking 

and people with disabilities are attending postsecondary institutions in record numbers. Although 

people with disabilities remain twice as likely to drop out of high school as people without 

disabilities (21 percent versus 10 percent),253 the number of postsecondary students reporting a 

disability has increased dramatically since the passage of the ADA.254 The proportion of firsttime, full-time students with disabilities attending colleges and universities tripled between 1978 

and 1994, from 2.6 percent to 9.2 percent.255 By 1998, the full range of students with disabilities 

(i.e., part-time students and students enrolled in graduate programs) had risen to 10.5 percent of 

the postsecondary student population.256 

In a 2000 report, the National Council on Disability stated that as many as 17 percent of all 

students attending higher education programs in the United States were identified as having a 

disability. Learning disabilities are the most common type of disability reported by college 

students. Further, more than one-half of all the students with disabilities who enroll in 

postsecondary education completed their program of study. Within five years of starting 

postsecondary education, 41 percent of students with disabilities reported they had earned a 

degree or credential, and another 12 percent remained enrolled in their course of study.257

The 2004 N.O.D./Harris Survey confirms that people with disabilities are participating in higher 

education at higher rates than before the ADA (see Figure F). 40 percent of people with 

disabilities received some college or a degree (compared to 52 percent of people without 

disabilities) in 2004. In 1986, only 29 percent of people with disabilities were attempting college 

(compared to 48 percent of people without disabilities). Thus, the gap between people with 

disabilities and people without disabilities attending college has narrowed from 19 percentage 
87 

points to 12 percentage points. However, people with disabilities are earning degrees at the same 

rate (14 percent) as in 1986.258

While people with disabilities are now enjoying greater access to education than before the 

ADA, there has been some decrease in the percentage attending college (from 49 percent 

attending at least some college in 1998 to 40 percent in 2004). This tracks a similar decrease in 

college attendance among people without disabilities.

Figure F: College Attendance of People With and Without Disabilities 

Major higher education testing agencies have been sued over testing accommodations for people 

with disabilities and, as a result, have improved the provision of accommodations. In 2001, in 

response to a lawsuit, the Educational Testing Service, which administers the GRE, SAT, 

GMAT, and other tests, agreed to stop “flagging” tests taken with accommodations.259 In 2002, 

the U.S. Department of Justice reached a settlement agreement with the Law School Admissions 

Council to ensure provision of accommodations on the LSAT for students with physical and 

communication disabilities.260 These changes among the “gatekeepers” to higher education have 

allowed more students with disabilities to pursue undergraduate and advanced degrees. 

0%

10%

20%

30%

40%

50%

60%

1986 2000

People with 

Disabilities

People without 

Disabilities 
88 

Though variable in quantity and quality, educational supports and services for students with 

disabilities are now available at most of the nation’s 3000 postsecondary institutions.261 A recent 

decision by the Ninth Circuit Court of Appeals may have made it more difficult for students with 

learning disabilities to obtain accommodations in higher education. In Wong v. Regents of the 

University of California,262 the court found that a student with a learning impairment who was 

seeking accommodations in medical school was not “substantially limited” in the major life 

activity of learning and, therefore, was not protected by the ADA. The court found that, although 

he had been identified as having a learning disability as a child, because the student had 

succeeded in school (both with and without accommodations), he was not substantially limited in 

learning as compared to most people in the general population in their activities of daily living. 

The court found that the standard was not to compare the student’s learning ability to other 

students in school, but to compare it to what most people do in their daily activities. Because the 

student in this case was able to read and learn as well as most people need to in their daily living 

activities, although not as well as a medical student needs to, he was considered to not be 

protected by the ADA.263

This interpretation of the ADA may be making it difficult for students with learning disabilities 

to obtain accommodations in higher education, because their success in education may be 

evidence against them and because the abilities required for success in higher education will not 

be the standard of comparison for determining substantial limitation. 

3. Input from People with Disabilities 

Testimony from people with disabilities repeatedly emphasized the positive impact of greater 

access to higher education.264

I am blind since age twelve, born 1949. I graduated from our local, Labette Community 

College with honors in 2004. ADA very much helped to make it possible. First I was 

encouraged by state workers from Social Security Disability Services of Kansas. My 

instructors at the college were aware of ADA and its rules and provided needed reading 

for me, a blind person. The college was accessible, elevator, ramps, handicapped rest 

rooms, and teachers to read my exams or provide visuals and tutoring.265
89 

C. Employment 

The effects of the ADA on employment can be assessed on two levels: Hiring and On-the-Job 

Accommodations. The ADA’s effects on these two areas differ substantially. 

1. Hiring 

a. ADA Requirements 

Title I of the ADA prohibits disability discrimination in hiring and application processes.266 Thus, 

employers may not reject qualified applicants because of their disabilities or their need for 

reasonable accommodations and may not adopt qualification standards that unnecessarily 

exclude people with disabilities.267

b. Relevant Data 

According to the 2004 N.O.D./Harris Survey, just over one-third (35 percent) of people ages 18–

64 with disabilities are employed compared to more than three-quarters of those without 

disabilities.268 These figures have not changed from those reported in the comparable 1986 

poll.269 In fact, the percentage of people with disabilities who were working dropped from 1994 

to 2000 to as low as 29 percent.270 Additionally, the 2004 poll showed that people with 

disabilities are nearly three times as likely as people without disabilities (26 percent versus 9 

percent) to have a household income of $15,000 or less.271 In 1986, 50 percent of people had a 

household income of $15,000 or less (compared to 25 percent of people without disabilities). 

Some researchers have gone so far as to suggest that the ADA caused employment declines for 

people with disabilities, but this conclusion has not been supported by empirical study.272 Our 

environmental scan suggests that employment rates for people with disabilities have been mixed 

since the passage of the ADA. One author argues that: 

A closer look at the employment measures suggests that the overall rate of employment 

may not be the best measure of job opportunities, because it includes many people 

unlikely to acquire jobs regardless of any improvement in employer attitudes or 

workplace accessibility. A larger proportion of working-age adults with disabilities are 
90 

not oriented toward participation in the labor force, either because they consider 

themselves unable to work or because they are engaged in other activities. That 

proportion has been growing—a disturbing development requiring closer scrutiny. But, 

when we leave this group [out of] statistics—when we consider only those people with 

disabilities who are able and available to work—we obtain what we believe to be a truer 

indication of changes in employer practices with regard to workers and job applicants 

with disabilities. When we do so, the picture brightens considerably. We find that 

employment opportunities improved significantly for people with disabilities—or, at 

least, for some people with disabilities—during the decade following the passage of the 

ADA.273

In an ADA Hearing before the Subcommittee on the Constitution of the House Committee on the 

Judiciary on September 13, 2006, Professor Robert Burgdorf Jr., a leading ADA scholar, posited 

that, because Supreme Court decisions have so restricted the use of Title I of the ADA, it is 

impossible to know whether it would be effective, if ever implemented, in improving 

employment opportunities for people with disabilities. 

The ADA is a civil rights law. Even if implemented, the employment provisions of the ADA do 

not have the ability to eliminate the deep structural barriers to employment that people with 

disabilities face: 

The ADA’s antidiscrimination requirement can prevent an employer from refusing to hire 

a qualified person simply because the person has a disability, and the ADA’s 

accommodation requirement can force the employer to make some changes in facilities or 

job tasks to enable individuals with disabilities to perform particular jobs. But those 

mandates do not require the employer to provide in-home personal-assistance service or 

transportation to enable an individual with a disability to get to work, nor do they require 

the employer to provide the individual with health insurance coverage that is as adequate 

as he or she can receive through Medicaid. The solutions to these problems require more 

than simply mandating that individual employers cease discriminating and provide 
91 

accommodations; they require more direct and sustained government interventions such 

as the public funding and provision of benefits.274

Unfortunately, there is a paucity of data on many questions regarding the employment of people 

with disabilities. NCD has an initiative underway to address the vacuum of research-based 

evidence and practices on the employment problems facing people with disabilities. NCD 

currently is conducting an “Employment Study” that will include an assertive and systematic 

review of both public and private policies and initiatives aimed at understanding the causes of 

underemployment and unemployment of people with disabilities and improving the employment 

of people with disabilities.

Incentives for employing people with disabilities warrant further study. For example, the Work 

Opportunity Tax Credit is a tax credit available to employers who employ people with 

disabilities and other disadvantaged groups. It does not appear that employers are taking 

advantage of this credit by hiring people with disabilities. In 1999, approximately 1 out of 790 

and 1 out of 3,450 individuals with business affiliations reported the Work Opportunity Tax 

Credit on their returns, accounting for approximately $254 million.275 The Department of Justice 

sent newsletters on tax incentives to over seven million businesses in 2002–2003.276

Nevertheless, a 2003 study by the Society of Human Resource Management found that only 16 

percent of surveyed businesses had ever used the Work Opportunity Tax Credit.277

A 2003 survey of 501 employers found that one-fourth (26 percent) of employers said that their 

company employs at least one worker with a mental or physical disability.278 

Research on corporate culture and disability indicates that “researchers, policymakers, business 

leaders, and the disability community must engage in meaningful dialogue about the examination 

of disability rights law and policy in general, and the implications of the Americans with 

Disabilities Act (ADA) of 1990 for people with disabilities and their families and employers in 

particular.”279 They must also be cognizant of who Title I covers, particularly given the changing 

coverage as a result of various Supreme Court decisions. 
92 

A 2003 survey of 501 employers found that 49 percent of employers have made recruiting and 

interviewing locations accessible, but only 12 percent have changed the format of job 

applications to make them more accessible, or changed the tests or evaluations used in hiring or 

promotion. In all instances, larger firms are more likely than smaller firms to have made changes 

to their business practices to accommodate and recruit workers with disabilities.280

A 2004 N.O.D./Harris Survey confirms that people with disabilities continue to have difficulty 

breaking into the job market. Although the frequency of other types of job discrimination 

decreased from 1994 to 2004, the frequency of being denied a job interview remained stable. In 

1994, approximately 29 percent of respondents who had experienced job discrimination reported 

being denied an interview because of their disability or health problem. In 2004, 27 percent 

reported being denied an interview.281 

Although people with disabilities are seeking higher education, they do not appear to be 

benefiting from that education in terms of greater employment opportunities. The 2004 

N.O.D./Harris Survey indicates that higher education does not correlate to employment for 

people with disabilities to the degree that it does for people without disabilities. Thus, while 82 

percent of people without disabilities who have college degrees are employed full- or part-time, 

only 54 percent of college graduates with disabilities are employed. To some extent, this may 

reflect higher ages of respondents with disabilities, 17 percent of whom were retired, as 

compared to 3 percent of respondents without disabilities who were retired.282 Education among 

people with disabilities also does not appear to correlate to higher income levels. 50 percent of 

college graduates with disabilities earned $50,000 or less per year, while only 28 percent of 

graduates without disabilities earned $50,000 or less. At the $50,000–$75,000 range, the 

percentage of graduates with and without disabilities was approximately equal (23 percent – 24 

percent). Graduates with disabilities were much less likely to be earning at the higher levels 

(>$75,000) than graduates without disabilities (16 percent versus 38 percent).283

c. Input from Employers 

Employers reported that businesses generally do not track the number of their employees with 

disabilities.284 Because of the ADA prohibitions on pre-employment and post-employment 
93 

inquiries into disability, and the requirements of confidentiality of disability-related information, 

employers are discouraged, if not actually prohibited, from collecting and reporting such 

information. This makes it difficult to assess the progress of people with disabilities in 

employment, particularly of those who are successfully employed. It is likely that this fact is 

skewing the data on employment of people with disabilities, as employed people with disabilities 

are less likely to have the time to participate in surveys, forums, and meetings about disability 

and employment. Moreover, this inability to count and brag about hiring people with disabilities 

may be counterproductive to the goal of increasing employment. 

Employers consistently commented that they had made significant changes to their employment 

application processes to make them more accessible to people with disabilities.285 They also 

commented that the vagueness of the definitions of “person with a disability” and “reasonable 

accommodation” made compliance more difficult than it should be.286

d. Input from People with Disabilities 

In the focus groups, public forums and e-mail responses, nearly half of those who addressed 

employment concerns suggested they had been discriminated against by employers. Across the 

board, the discrimination was believed to occur at the hiring stage. People with disabilities 

believed they had been turned down for jobs because of employers’ attitudes toward 

disabilities—an action difficult to prove in an employment discrimination case. 

If the ADA has improved employment opportunities I would like to see the evidence. In 

my experience seeking employment with a visible disability I found employers 

uncomfortable with my situation. Although I was well-qualified for the positions I was 

never able to get past the initial interview nor was there any level of follow-up on the part 

of the companies. I believe that employers view the ADA as adversarial to their role.287 

This view is consistent with the data indicating that hiring of people with disabilities has not 

increased since passage of the ADA. The hiring stage of the employment process is the most 

difficult to address under the ADA, as an applicant with a disability will rarely be told the 
94 

reasons he or she was not hired. Employers, who are discouraged by the ADA from counting 

employees with disabilities, cannot effectively publicize any positive hiring efforts they make. 

Financial incentives for hiring people with disabilities have not been sufficient incentive to 

improve hiring of people with disabilities. NCD’s ongoing Financial Incentives Study is 

investigating this issue. Although many government programs are directed at improving the 

employment rates of people with disabilities (e.g., health care, education, vocational 

rehabilitation, transportation subsidies, housing, and other areas) either directly, indirectly, or 

through specialized services, resources or environmental access, little is known about the extent, 

utilization, or impact that these financial incentives have on the everyday lives of people with 

disabilities. Financial incentives can be in many forms, including tax credits (e.g., for employees 

with disability-related work expenses or for employers) or the removal of disincentives to work. 

Financial incentives may be directed at people with disabilities who are seeking employment, for 

employees with disabilities, and for employers who hire people with disabilities; this will be 

considered along with some non-tax incentives for daily living that are of particular interest to 

people with disabilities. While many financial incentives have traditionally focused on 

improving employment, NCD will look at financial incentives in the broader context of selfsufficiency and integration into the larger society. 

The Financial Incentives Study will: 

• Identify factors that influence the use of financial incentives by employers, employees, and 

potential employees who are people with disabilities; 

• Assess what is needed to increase the use of incentives and/or create new incentives; 

• Examine the potential role of financial incentives with respect to aspects of living that affect 

obtaining and maintaining meaningful employment (e.g., affordable and accessible assistive 

technology, housing, transportation, health care, personal assistance, and other supports); 

• Analyze the different approaches to financial incentives in selected states; 

• Prepare a cost-benefit economic analysis model for employers. 
95 

2. Reasonable Accommodation and Promotion 

a. ADA Requirements 

Title I of the ADA requires employers to make reasonable accommodations to the known 

physical or mental disabilities of employees.288 Reasonable accommodations can include making 

facilities accessible to employees with disabilities, job restructuring, reassignment to vacant 

positions, modification or acquisition of accessible equipment, adjustment of training materials, 

provision of interpreters and readers, and other accommodations.289

b. Relevant Data 

It appears that, once a person with a disability is hired, he or she is less likely to experience 

employment discrimination and is more likely to receive reasonable accommodations, if needed, 

than before the ADA. The ADA has similar positive effects for people who acquire their 

disabilities while they are employed. 

According to a 1995 Harris Survey of employers, 80 percent of executives of large companies 

reported that the cost of accommodating people with disabilities had increased only a little or not 

at all. Only seven percent reported a large increase. Sixty-six percent of the executives reported 

no increase in litigation, and only 14 percent saw “a little” increase. The number of companies 

that had actually made accommodations had increased. In a 1986 survey of employers, Harris 

found that 51 percent of corporations surveyed had made some accommodations.290 In 1995, the 

figure had risen to 81 percent.291

In the 2003 Harris Survey of 501 employers, which included small employers, only 40 percent 

provided training of any kind to their employees regarding working with or providing 

accommodations to people with disabilities. Further, only 34 percent of companies with 5–24 

workers provided training to their employees in this area. Fifty-two percent of larger companies 

employing more than 25 workers provided training.292

Little empirical evidence is available to understand employers’ decisions to provide 

accommodations. One line of study explores employee and employer factors associated with 

decisions to accommodate. The analyses are based on nationwide data from interviews with 
96 

employers who contacted the Job Accommodation Network (JAN) concerning workplace 

accommodations.293 The data was derived from more than 1,000 interviews that took place 

between 2004 and 2005 with employers who consulted JAN regarding employee 

accommodations. The majority of interviews concerned accommodating a current employee. 

More than three-fourths (82.4 percent) of these consultations focused on retaining an employee 

and an additional 1.8 percent concerned promoting a current employee.294 Accommodation 

inquiries about job applicants made up a small percentage of the sample (4.6 percent), as did 

inquiries about hiring new employees (1.6 percent).295 A few inquiries involved company-wide 

issues. For more than half of the consultations, workplace accommodations were made 

subsequent to the consultation with JAN. Of the 540 employers who provided feedback, 

accommodations had been made (or were pending implementation) in 55.2 percent of the 

consultations.296 The most common reason reported for not making an accommodation involved 

a determination by the company that it was not required under the ADA or any other law (58.5 

percent).297

Accommodations were most likely to be made for employees who were considered to have a 

substantial limitation of a major life activity. Accommodations were made in 61.2 percent of the 

402 consultations for employees with substantial limitations.298 Accommodations were made in 

42.6 percent of cases for employees whom the employer considered not to have a substantial 

limitation.299 Whether an accommodation was made was significantly related to the employer’s 

ratings of the employee’s ability to work with accommodations.300

The researchers also analyzed employer reports of costs and benefits associated with providing 

the accommodations. Cost and benefit data were available only in those situations in which the 

employer had decided to provide the accommodation. Of the respondents who made an 

accommodation, 226 were able to provide the actual or estimated direct cost of the 

accommodation.301

Forty-nine percent of the accommodations made had no cost. Almost all employers reported that 

providing the accommodation benefited the company by allowing it to retain (91.6 percent) 

and/or promote (11.3 percent) a qualified employee.302 Other direct benefits reported included 
97 

eliminating the cost of training a new employee (59.5 percent), saving on worker’s compensation 

or insurance costs (43.0 percent), increasing the accommodated worker’s productivity (76.7 

percent), improving the accommodated worker’s attendance (53.3 percent), and increasing the 

diversity of the company (41.4 percent).303

The study’s core findings include: (1) Current employees with substantial limitations of major 

life activities are substantially more likely to receive accommodations, compared to those 

without substantial limitations; (2) Employers are more likely to provide accommodations for 

employees whose work-related limitations are mitigated by effective accommodations; 

(3) Accommodations for employees without substantial limitations cost less than those provided 

to employees with substantial limitations; and (4) Overall, accommodation costs are low and 

benefits are relatively high.304

According to the 2004 N.O.D./Harris Survey, fewer people with disabilities are experiencing onthe-job employment discrimination (see Figure G). A major purpose of the ADA is to eliminate 

discrimination against people with disabilities in employment. In 2004, fewer respondents with 

disabilities, who were working full- or part-time, reported experiencing employment 

discrimination than in 1986, and there was an even greater decrease in people with disabilities 

reporting employment discrimination than in 1998. In 1986, for instance, 28.2 percent of Harris 

Poll respondents with disabilities who were employed reported that they had encountered job 

discrimination because of their disability or health problem. In 1998, one third (32.8 percent) of 

those surveyed reported experiencing job discrimination and this rate fell substantially by 2004 

to 22.1 percent. 
98 

28.2 28.5 32.8

22.1

0

25

50

1986 1994 1998 2004

Survey Year

Percent

Figure G: Harris Poll Respondents with Disabilities Working Full- or Part-Time Who 

Report Experiencing Employment Discrimination 

In regard to promoting employees with disabilities, the Harris surveys have found that 

respondents in 2004 were less likely to have been denied a promotion than in earlier years. More 

than one in four (24.6 percent) respondents in 1994 who had experienced job discrimination 

reported being denied a promotion because of their disability. By 2004, this had been reduced to 

less than one in five (16.7 percent) (see Table D).305

Table D: Type of Employment Discrimination Due to Disability 

Percentage of Employed Participants 

Type of Employment Discrimination 1994 1998 2004 

Refused an interview 28.8% 23.7% 26.9% 

Refused a job 61.4% 59.3% 30.8% 

Denied a promotion 24.6% 29.3% 16.7% 

Given less responsibility than co-workers 37.3% 39.0% 14.1% 

Paid less than co-workers 18.6% 32.8% 12.8% 

Denied health insurance 23.3% 31.7% 3.8% 

Denied other work related benefits 22.4% 23.3% 6.4% 
99 

Compared to their 1994 cohorts, 2004 employed respondents were significantly less likely to 

have been refused a job, given less responsibility than co-workers, or been denied health 

insurance or other work benefits because of their disability. In 1994, 61.4 percent of respondents 

who had experienced job discrimination reported being denied a job because of their disability. 

In 2004, only 30.8 percent reported having been denied a job. In 1994, more than two out of 

three respondents (37.3 percent) who had experienced job discrimination reported that they had 

been given less responsibility than their co-workers. Significantly fewer similar respondents in 

2004, 14.1 percent, reported this experience. In 1994, of participants who had experienced job 

discrimination, 23.3 percent reported being denied health insurance, and 22.4 percent reported 

being denied other work-related benefits. In 2004, only 3.8 percent were denied health insurance, 

and 6.4 percent were denied other work-related benefits. 

c. Input from People with Disabilities and Employers 

One company noted they had made changes in their policies as a result of the ADA, even though 

they had been viewing it as a diversity issue for 30 years prior to the ADA. They noted that the 

ADA brought more disability to the forefront as a key initiative for managers, hiring, 

conversation in the company, and for employees. That company indicated that it had great 

impact on their organization or culture based on the breadth and intent of the ADA, and that the 

ADA brought things to the next level of consciousness, that next step of diversity or affirmative 

action in some people’s organization. And, they noted it gave access to potential hiring of 

individuals that maybe they had not considered to the same degree before and it obviously 

changed directions and areas of recruiting individuals. 

Another employer said, in general, they believed the Act had a positive influence on their 

organization, allowing them to develop credibility with employees in responding to requests for 

accommodations, reinforcing from their advertising that they complied both with the letter and 

the spirit of the law. They indicated it gave them an opportunity to display that, in fact, that’s the 

way they operate their business, that it’s a positive any time that they can display our 

commitments to employees and give something to reinforce other messages about commitment 

to employees. 
100 

One employer discussed accommodations that involve some type of technology or access 

accommodation, and shared that they had set up a team at their headquarters for assistive 

technology that works on technical or access accommodations of the organization. They set that 

team up to insure that technology accommodations were compatible with their other technology 

platforms, because local managers didn’t have sufficient information to incorporate seamlessly 

with their existing technology platform. They found as a result that they received much better 

pricing and much more accommodation for future technology changes, noting also that the 

process works very smoothly, and that it’s very responsive to their technology accommodation 

needs. 

One company indicated they have a localized accommodation process, but a centralized appeal 

process if accommodations are denied, to ensure people consistently receive the accommodations 

they need and are entitled to under the law. Two employers indicated they have teams to assess 

accommodation needs and determine the best way to meet the request for reasonable 

accommodations after an assessment of the individual, job, environment, and other factors 

related to that individual’s ability to do the job in the work location. 

One employer stated that of the reasonable accommodation requests she receives, “probably 70 

percent of the requests I see, the person isn’t actually disabled.”306 Another equated reasonable 

accommodation with preferential treatment.307

In our focus groups with people with disabilities, one individual discussed making a request for a 

reasonable accommodation, which he received after putting the request in a letter.308 Another 

participant said that he knew a person who had received extensive accommodations, which he 

believes she would not have gotten without the ADA.309

The majority of public forum participants with disabilities who made comments about reasonable 

accommodations said employers were not doing enough to provide them. E-mail writers were 

more evenly split, with 51 percent saying they had received an accommodation from an 

employer. 
101 

3. Lawsuits 

Private lawsuits under Title I of the ADA are rarely decided in favor of people with disabilities. 

The scholarship on Title I ADA court cases is voluminous. Our environmental scan found that 

the overwhelming majority of articles, 79 percent, were pessimistic or negative about the impact 

of Title I of the ADA on the employment prospects of people with disabilities. Three main 

reasons are given by scholars for the law’s perceived failure: adverse rulings by the Supreme 

Court as well as by many lower courts; the limits of antidiscrimination law in changing the 

broader problems faced by people with disabilities; and the limitations of the “accommodation 

mandate.”310 

Many scholars say the restrictive Supreme Court ADA decisions make it harder for people with 

disabilities to prove that they have disabilities, bolster the defenses that can be used by those 

accused of discrimination, and limit the damages and legal costs that can be collected by those 

whose complaints are upheld.311 The National Council on Disability issued a report in 2003 

cataloguing the Court’s negative impact on lower court decisions.312 In December 2004, NCD 

published Righting the ADA, which analyzed the Supreme Court’s ADA decisions severely 

restricting the ADA protections available to applicants and employees with disabilities.313 This 

Report includes draft legislative language which would restore ADA protections for people with 

disabilities who experience employment discrimination. 

The American Bar Association has conducted a number of studies on Title I ADA court cases 

and most recently (2003) found that in 97.3 percent of Title I cases, the employer won.314 The 

Equal Employment Opportunity Commission (EEOC), which enforces Title I, reports that in FY 

2004 the agency received 15,376 charges of disability discrimination, resolved 16,949 disability 

discrimination charges and recovered $47.7 million in monetary benefits for charging parties and 

other aggrieved individuals (not including monetary benefits obtained through litigation). These 

rates have dropped during the last several years. For instance, in FY 1998, EEOC resolved 

23,324 charges, and recovered $53.7 in monetary benefits.315 These drop-offs in recent years 

could be attributed to people with disabilities experiencing less discrimination by employers, the 

discouragement of filings because employers normally win Title I cases, the narrowing of the 

ADA by the courts, or to a combination of the three factors. 
102 

Some scholars argue that these figures regarding the success (or lack thereof) of disability 

employment lawsuits are not reflective of the actual impact of the ADA. The vast majority of 

claims are resolved prior to any litigation and, people with disabilities appear to have been more 

successful at obtaining reasonable accommodations and fair treatment on the job than before the 

ADA.316

D. Recommendations – Economic Self-Sufficiency 

• The Department of Education should work with colleges, universities, and public schools to 

enhance the effectiveness of supports, such as preparing students to better negotiate their 

supports and services, assisting students with coordinating and managing supports and 

services, and facilitating the use of technology in education and employment; 

• The Department of Education should improve coordination of services between the 

educational system and the vocational rehabilitation system, particularly as regards funding 

for services and assistive technology; 

• Disability organizations, and research and policy centers focused on economic empowerment 

for people with disabilities such as the Burton Blatt Institute, should work with philanthropists 

and federal and state government agencies to improve availability of scholarship, tuition 

waiver, and loan repayment programs for students and adults with disabilities who wish to 

pursue higher education; 

• Congress should extend and expand the Mental Health Parity Act to ensure that people with 

mental health disabilities are able to secure treatment; 

• The National Institute on Disability and Rehabilitation and Research should study insurance 

coverage issues that prevent people with disabilities from accessing private insurance; 

• The Equal Employment Opportunity Commission, the Department of Labor, and National 

Institute on Disability and Rehabilitation and Research should place immediate priority on 

increasing the hiring of people with disabilities, through: 

○ Study the reasons employers are not hiring people with disabilities; 

○ Conduct confidential surveys of hiring practices; 
103 

○ Improve job placement services for people with disabilities and programs to assist 

employers to recruit individuals with disabilities; 

○ Improve positive incentives and tax breaks for hiring people with disabilities; 

○ Eliminate Social Security and Medicaid regulations that discourage people with 

disabilities from working; 

○ Assistance with research and purchase of accessible equipment; 

○ DOJ and EEOC should conduct testing of business hiring practices to identify 

discriminatory hiring practices and pursue enforcement actions. 
104 
105 

Summary of Findings 

Most people with disabilities who participated in the public forums, focus groups, and 

information requests report the ADA has had a significant positive impact on their lives. This 

was also true of the participants in the 2004 Harris Survey, in response to which most people 

with disabilities reported improvement in quality of life since passage of the ADA. According to 

the 2000 Harris Poll of Americans with Disabilities, more than 60 percent of people with 

disabilities perceived significant improvements in public facility access, personal quality of life, 

and public attitudes. 

The most significant improvements appear to have occurred in telecommunications, 

transportation, and access to public accommodations. However, the lack of access to information 

resulted in the perception by many people who are blind or visually impaired that the ADA was 

not achieving its goals. 

People with disabilities have mixed perceptions about the improvement of accessibility to state 

and local governments, and the absence of any ongoing tracking of access improvements by state 

and local governments makes it difficult to assess progress in this area. While access to public 

transportation, public sidewalks, and voting has increased, due in part to the active enforcement 

efforts of DOJ, independent living remains elusive for many because of the slow progress of 

governments in shifting from an institutional bias to home and community-based health care. 

Strides are being made in access to, and participation in, higher education for people with 

disabilities. However, people with disabilities lag behind their nondisabled peers in graduation 

rates and post-college job success. 

While some gains are seen in employment, particularly for people who become disabled while 

already in a job, obtaining a job when one has a visible disability remains difficult, and the 

percentage of people with disabilities living in poverty virtually is the same as before the ADA 

was implemented. Significant disparities exist in access to health insurance and health care for 

people with disabilities, as compared to people without disabilities—even when comparing 
106 

workers with disabilities and workers without disabilities. While little data exist on the financial 

assets of people with disabilities, economic self-sufficiency remains elusive for too many people 

with disabilities. 
107 

Summary of Recommendations 

Based on these findings, this report makes the following recommendations: 

General Recommendations 

Federal agencies should fund and implement state-by-state surveys of people with 

disabilities, based on the N.O.D./Harris Surveys using statistically significant survey 

populations and distinguishing among rural and urban communities, minority 

communities, and high, middle, and low income communities. 

Equality of Opportunity – Transportation 

• Congress should expand accessibility requirements for rail services beyond key stations; 

• The Department of Transportation should conduct extensive training and outreach for public 

transit providers regarding maintenance and stop announcements; 

• The Department of Transportation should work with state and local governments and taxi 

providers to develop and publicize effective incentives for private taxi providers to offer 

accessible vehicles; 

• The Department of Transportation should conduct extensive training and outreach for public 

and private transportation services regarding service animals and increase high-profile 

enforcement actions by the Departments of Justice and Transportation; 

• The Department of Transportation should work with paratransit providers, state and local 

governments, transportation experts, and representatives of disability and aging communities 

to explore paratransit options such as more subscription service, more flexible services, and 

other ideas to close the expectation gap and increase usability of paratransit for riders with 

disabilities; 

• The Department of Transportation should study and test options for providing transportation 

services to people with disabilities in rural areas. 
108 

Equality of Opportunity – Sidewalks and Curb Ramps 

• The Department of Justice should promulgate ADA regulations for public rights-of-way as 

soon as possible; 

• The Department of Transportation should increase funding for making public rights-of-way 

accessible, including sidewalk access, curb ramp installation, and accessible street crossings; 

• The Department of Justice should develop and disseminate guidelines for the prioritization of 

curb ramp installations, so that the most needed and useful curb ramps are installed first. 

Equality of Opportunity – Public Accommodations 

• The National Institute on Disability and Rehabilitation Research should conduct a survey of 

businesses, perhaps through the chambers of commerce or small business associations, to 

determine the degree to which businesses have instituted readily achievable barrier removal 

efforts, and provide guidance to Congress on adequately funding the Department of Justice to 

enforce this part of the statute; 

• The Department of Justice and National Institute on Disability and Rehabilitation Research 

should provide expert, individualized, low-cost technical assistance and consulting to small 

businesses. The ADA and IT Centers and local offices of the National Disability Rights 

Network are possible agencies to carry out this effort; 

• The Department of Justice should expand its Project Civic Access to increase enforcement in 

local areas by reviewing businesses in identified localities; 

• Congress should require states to submit their building codes for access certification by the 

DOJ; 

• The U.S. Access Board and Department of Justice should continue coordination with model 

building code agencies; 

• The Department of Justice should increase enforcement and education regarding how to serve 

customers with visual and hearing impairments, particularly as it pertains to Web access and 

use of TTYs and relay services; 
109 

• DOJ should require Web sites of places of public accommodations and commercial facilities 

to comply with federal Web accessibility standards; 

• The Department of Justice and National Institute on Disability and Rehabilitation Research 

should develop technical assistance materials regarding what people with disabilities and 

businesses should expect of existing buildings of various sizes years after passage of the 

ADA. 

Equality of Opportunity – Accessibility of Telecommunications 

• The Department of Justice should publish information for businesses about how TRS works, 

how to use it, and the legal obligation to use it. The ADA and IT Centers could be funded to 

provide this information; 

• The Federal Communications Commission should establish standards to encourage the 

continued development of Video Relay Services. 

Full Participation – State and Local Government Services 

• The Department of Justice and other federal agencies should focus on enforcing the ADA 

obligations of government agencies; 

• Federal agencies should use initiatives such as Project Civic Access to increase ADA 

compliance at the state and local levels; 

• The Department of Justice should use targeted, high-profile litigation on particularly 

important issues, such as access to courts, medical care, and education to increase state and 

local ADA compliance. 

Full Participation – Voting 

• The Department of Justice should immediately implement the Help America Vote Act 

requiring installation of electronic voting equipment; 
110 

• The National Institute on Disability and Rehabilitation Research should study and publish the 

involvement of people with disabilities in civic opportunities, such as government office; 

• The National Organization on Disability should encourage state and local governments to 

emphasize involvement of the disability community as part of their diversity efforts and 

provide technical assistance to help government agencies reach out to people with disabilities. 

Community Integration 

• Congress should increase Medicaid support for community-based treatment settings; 

• Congress should pass and fully fund the Money Follows the Person Act;317 and Medicaid 

Community-Based Attendant Services and Supports Act;318

• Congress should require states to expeditiously complete effective Olmstead plans, consistent 

with HHS guidance;

• The Department of Health and Human Services should require states to fund personal care 

services when needed to allow a person with a disability to remain in their community;

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

working with state and local governments and community agencies should implement local 

initiatives to extend the integration mandate to housing, education, transportation, 

employment, and other areas affecting people with disabilities; 

• The Department of Justice should increase and target enforcement of the Civil Rights of 

Institutionalized Persons Act on requiring effective deinstitutionalization efforts and 

publishing creative and effective programs to provide community-based services; 

• The Department of Labor’s program funding home modifications should be significantly 

expanded to allow people with disabilities and the elderly to live in their communities; 

• The Departments of Health and Human Services, Education, Transportation, Housing and 

Urban Development, Justice, and Labor, and Equal Employment Opportunity Commission, 

should work with disability communities and others to develop an overall national policy 

framework for community integration of people with disabilities; 
111 

• The Department of Health and Human Services should study systems of long-term care and 

long-term care insurance to eliminate unnecessary institutionalization of people with 

disabilities and aging people. 

Economic Self-Sufficiency 

• The Department of Education should work with colleges, universities, and public schools to 

enhance the effectiveness of supports, such as preparing students to better negotiate their 

supports and services, assisting students with coordinating and managing supports and 

services, and facilitating the use of technology in education and employment; 

• The Department of Education should improve coordination of services between the 

educational system and the vocational rehabilitation system, particularly as regards funding 

for services and assistive technology; 

• Disability organizations should work with philanthropists and federal and state government 

agencies to improve availability of scholarship, tuition waiver, and loan repayment programs 

for students and adults with disabilities who wish to pursue higher education; 

• Congress should extend and expand the Mental Health Parity Act to ensure that people with 

mental health disabilities are able to secure treatment; 

• The National Institute on Disability and Rehabilitation Research should study insurance 

coverage issues that prevent people with disabilities from accessing private insurance; 

• The Equal Employment Opportunity Commission and National Institute on Disability and 

Rehabilitation Research should place immediate priority on increasing the hiring of people 

with disabilities. 
112 
113 

Conclusion 

The Americans with Disabilities Act has fulfilled much of its promise. Today’s world is a better 

place for many people with disabilities because of the ADA. People with disabilities have greater 

access to the goods and services provided by their local communities, businesses, and states and 

municipalities than they did before 1990. Public transit systems are more accessible to people 

with disabilities, although problems remain for rural residents with disabilities, paratransit users, 

and bus riders with visual impairments. The telecommunications title of the ADA has been 

invaluable in connecting people with hearing and/or speech impairments with the hearing world. 

More and more young people with disabilities are going to college than before the ADA, which 

may be the best solution to the high unemployment and low income rates in the disability 

community. 

The Olmstead decision, when fully implemented, could go a long way to promoting the goals of 

full participation and independent living for people with disabilities, especially those with mental 

illnesses or cognitive disabilities. Time and again, people in the focus groups, interviews and 

public forums, and through e-mail told us that funding, understanding, and enforcement were the 

keys to making the ADA work better. There are yet many miles and a long march to go before 

the full promise of the ADA will be realized. But there is no doubt this country is on the road to 

that vision of justice that Justin Dart and thousands of other Americans with disabilities started 

us on 16 years ago. 
114 
115 

Appendix A: Blue Ribbon Panel 

• Chair of Blue Ribbon Panel—Peter Blanck, Chairman, The Burton Blatt Institute, and 

University Professor, Syracuse University 

Panel Members 

• Paul Baker, Director of Research Center for Advanced Communications, Georgia Institute of 

Technology 

• Robert Herman, Advocacy Attorney, Paralyzed Veterans of America 

• Eve Hill, Executive Director, Disability Rights Legal Center, and Visiting Associate Professor 

of Law, Loyola Marymount University 

• Carmen Jones, Founder and President, Solutions Marketing Group 

• Doug Kruse, Professor of Human Resource Management, Rutgers University, and Research 

Associate, National Bureau of Economic Research 

• Ken McGill, Director, Office of Employment Support Programs, Social Security 

Administration 

• Steve Mendelsohn, Executive Director, Project Rebirth 

• Ken Nakata, Director of Disability Initiatives and Government Compliance, BayFirst 

Solutions 

• Lisa Schur, Assistant Professor of Labor Studies and Employment Relations, Rutgers 

University 

• Michael Stein, Cabell Research Professor of Law, College of William & Mary 
116 
117 

Appendix B: Methodology 

Environmental Scans 

A comprehensive environmental scan was completed to collect documents discussing the impact, 

positive or negative, that the ADA has had on the lives of people with disabilities and on the 

greater society. The project researchers gathered approximately 500 documents from a range of 

sources. The documents collected included journal articles from the social science and legal 

disciplines, settlement agreements from the Department of Justice’s Web site, case law 

summaries, e-mails from NCD’s “Call for Comments,” transcripts from public forums held in 

five locations around the United States, and targeted interviews with key federal agency officials 

and nonprofit organization affiliates. The data collected was periodically updated and a coding 

scheme was developed to categorize the nature and content of data sources. 

The project team cataloged the reports, journal articles, books, other documents published or 

posted to relevant federal agency and non-profit organization Web sites, and the “testimony 

related documents” from NCD’s “Call for Comments,” public forums, and Blanck & Associates’ 

requests for comments and targeted interviews. 

For the testimony related documents, short submissions, such as e-mail, were entered in their 

entirety into the database. The submissions received from the “Request for Comments” were 

lengthy, and thus, abstracted and entered into the database. 

In selecting documents for collection, the primary question was “Does the document describe or 

discuss the impact of the ADA, beyond merely repeating the law in a more user friendly 

format?” 

Environmental Scan Research Steps 

1. Researchers conducted an extensive search of the Web for documents related to the ADA. 

Particular attention was given to organizations that represented stakeholders from the 

business community and their publications. 
118 

2. In addition, researchers identified an additional list of federal agencies and disability 

organizations, including stakeholders and scholars who have studied ADA implementation 

and visited their Web sites, conducting the same scan as above (see step 1). 

3. To supplement the data collection, researchers included relevant documents collected on 

two concurrent projects addressing ADA implementation that were not identified in steps 

1 or 2 above. These two projects included: 

a. A search for all empirical studies of the ADA, published between 1990–2005, in law 

and social science journals. 

b. A search for all law review and social science review articles that had been published 

regarding the ADA since December 2003 (gathered originally for the purpose of 

updating the Blanck, Hill, Siegel, & Waterstone (2004) disability law casebook319). 

4. Researchers conducted a scan for academic and other scholarly books that referenced 

“Americans with Disabilities Act” in the title. These books were located using the online 

SUMMIT catalog at Syracuse University and the Lexis and Westlaw commercial 

publication Web sites. 

5. Additionally, researchers visited the following Web sites and collected any new 

documents not identified during steps 1–3. These included: 

○ The Burton Blatt Institute Web site (publications by BBI staff).320

○ The Web sites of relevant BBI national partners.321

○ The ADA Portal – a collection of documents available from the Disability Business 

Technical Assistance Centers (DBTACs).322

○ The Social Science Research Network Web site (post-December 2003 articles).323

6. Other Notes: Disability organization Web sites were visited. Summaries of the Supreme 

Court cases decided pursuant to all Titles of the ADA were collected using the summaries 

available from Findlaw as the abstract. 
119 

7. With some relevant topics, it was difficult to distinguish the ADA impact from the impact 

of other legislation or policy decisions. This was especially true in the area of housing. For 

instance, the Olmstead community integration mandate overlaps with housing issues under 

the Fair Housing Act Amendments. 

Focus Groups 

Project staff conducted nine focus groups, seven for people with disabilities and two for 

employers. Each group consisted of fewer than ten individuals. Focus groups for people with 

disabilities were organized for the following disability populations: developmental disabilities, 

learning disabilities, psychiatric disabilities, mobility disabilities, hearing disabilities, and vision 

disabilities. The focus group for people who are deaf or hard of hearing was conducted in 

Washington, DC. All of the other focus groups were conducted by telephone and included 

individuals from all regions of the country. 

Key topics for the focus groups of people with disabilities were based on the overarching goals 

of the ADA: 

• Equality of opportunity – patterns and examples of access provided to people with disabilities 

to transportation, business, and government goods and services;

• Full participation – patterns and examples of inclusion of people with disabilities in 

community activities, including political participation;

• Independent living – patterns and examples of how individuals have been able to exercise 

control over their lives, choosing among acceptable options without undue control by others; 

• Economic self-sufficiency – patterns and examples of how people with disabilities have 

gained greater access to education and employment opportunities and related economic 

benefits. 

Key topics for employer focus groups were: 

• experiences hiring people with disabilities; 
120 

• experiences employing people with disabilities; 

• experiences providing reasonable accommodations for employees with disabilities. 

Public Forums 

Five day-long public forums were held in the following cities: Iowa City, Iowa; Los Angeles, 

California; Houston, Texas; Savannah, Georgia; and Washington, DC. Participants were people 

with disabilities, their family members, disability advocates, as well as employers and 

representatives of local, state, and federal agencies. People were asked to provide testimony 

about how the ADA had impacted their lives in terms of telecommunications access, 

transportation, education, employment opportunities, access to goods and services provided by 

state and local governments, and access to public accommodations operated by private entities. 

The publicity for the forums resulted in 112 e-mail statements from people with disabilities who 

could not attend the forums. These comments were also included in the database for analysis, 

and are reflected in the findings. 

Interviews 

One-on-one interviews were conducted with 24 individuals representing federal agencies that 

implement or enforce the ADA, as well as with officials of state and local governments, private 

and public agencies that provide services to people with disabilities, business and trade 

associations, and disability organizations whose constituencies were not represented by the focus 

groups. Questions asked of participants were related to the four broad goals of the ADA, but 

each interview focused on the unique perspective of the agency or association represented. 
121 

Appendix C: Mission of the National Council on Disability 

Overview and purpose 

The National Council on Disability (NCD) is an independent federal agency with 15 members 

appointed by the President of the United States and confirmed by the U.S. Senate. The purpose 

of NCD is to promote policies, programs, practices, and procedures that guarantee equal 

opportunity for all individuals with disabilities regardless of the nature or significance of the 

disability and to empower individuals with disabilities to achieve economic self-sufficiency, 

independent living, and inclusion and integration into all aspects of society. 

Specific duties 

The current statutory mandate of NCD includes the following: 

• Reviewing and evaluating, on a continuing basis, policies, programs, practices, and 

procedures concerning individuals with disabilities conducted or assisted by federal 

departments and agencies, including programs established or assisted under the Rehabilitation 

Act of 1973, as amended, or under the Developmental Disabilities Assistance and Bill of 

Rights Act, as well as all statutes and regulations pertaining to federal programs that assist 

such individuals with disabilities, to assess the effectiveness of such policies, programs, 

practices, procedures, statutes, and regulations in meeting the needs of individuals with 

disabilities. 

• Reviewing and evaluating, on a continuing basis, new and emerging disability policy issues 

affecting individuals with disabilities in the Federal Government, at the state and local 

government levels, and in the private sector, including the need for and coordination of adult 

services, access to personal assistance services, school reform efforts and the impact of such 

efforts on individuals with disabilities, access to health care, and policies that act as 

disincentives for individuals to seek and retain employment. 

• Making recommendations to the President, Congress, the Secretary of Education, the director 

of the National Institute on Disability and Rehabilitation Research, and other officials of 
122 

federal agencies about ways to better promote equal opportunity, economic self-sufficiency, 

independent living, and inclusion and integration into all aspects of society for Americans 

with disabilities. 

• Providing Congress, on a continuing basis, with advice, recommendations, legislative 

proposals, and any additional information that NCD or Congress deems appropriate. 

• Gathering information about the implementation, effectiveness, and impact of the Americans 

with Disabilities Act of 1990 (ADA) (42 U.S.C. § 12101 et seq.). 

• Advising the President, Congress, the commissioner of the Rehabilitation Services 

Administration, the assistant secretary for Special Education and Rehabilitative Services 

within the Department of Education, and the director of the National Institute on Disability 

and Rehabilitation Research on the development of the programs to be carried out under the 

Rehabilitation Act of 1973, as amended. 

• Providing advice to the commissioner of the Rehabilitation Services Administration with 

respect to the policies and conduct of the administration. 

• Making recommendations to the director of the National Institute on Disability and 

Rehabilitation Research on ways to improve research, service, administration, and the 

collection, dissemination, and implementation of research findings affecting people with 

disabilities. 

• Providing advice regarding priorities for the activities of the Interagency Disability 

Coordinating Council and reviewing the recommendations of this council for legislative and 

administrative changes to ensure that such recommendations are consistent with NCD’s 

purpose of promoting the full integration, independence, and productivity of individuals 

with disabilities. 

Preparing and submitting to the President and Congress an annual report titled National 

Disability Policy: A Progress Report. 
123 

International 

In 1995, NCD was designated by the Department of State to be the U.S. government’s official 

contact point for disability issues. Specifically, NCD interacts with the special rapporteur of the 

United Nations Commission for Social Development on disability matters. 

Consumers served and current activities 

Although many government agencies deal with issues and programs affecting people with 

disabilities, NCD is the only federal agency charged with addressing, analyzing, and making 

recommendations on issues of public policy that affect people with disabilities regardless of age, 

disability type, perceived employment potential, economic need, specific functional ability, 

veteran status, or other individual circumstance. NCD recognizes its unique opportunity to 

facilitate independent living, community integration, and employment opportunities for people 

with disabilities by ensuring an informed and coordinated approach to addressing the concerns of 

people with disabilities and eliminating barriers to their active participation in community and 

family life. 

NCD plays a major role in developing disability policy in America. In fact, NCD originally 

proposed what eventually became ADA. NCD’s present list of key issues includes improving 

personal assistance services, promoting health care reform, including students with disabilities in 

high-quality programs in typical neighborhood schools, promoting equal employment and 

community housing opportunities, monitoring the implementation of ADA, improving assistive 

technology, and ensuring that people with disabilities who are members of diverse cultures fully 

participate in society. 

Statutory history 

NCD was established in 1978 as an advisory board within the Department of Education (P.L. 95-

602). The Rehabilitation Act Amendments of 1984 (P.L. 98-221) transformed NCD into an 

independent agency. 
124 
125 

Endnotes 

 

1

 Money Follows the Person Act of 2005, H.R. 3063, 109th Cong. (1 Sess. 2006). 

2

 H.R. 910, 109th Cong. 3

 Okla. Disability Law Ctr., Justin Dart at ADA Eleventh Anniversary, Protection & Advocacy, Sept. 2001, at

http://home.flash.net/~odlcokc/9-01nl.htm. 

4

 See Peter Blanck & Michael Millender, Before Disability Civil Rights: Civil War Pensions and the Politics of 

Disability in America, 52 Ala. L. Rev. 1 (2000) (referenced throughout this section); see also Matthew Sanders, 

History of Civil War Pension Laws, in R.W. Fogel, Public Use Tape on the Aging of Veterans of the Union Army: 

Surgeons’ Certificates, 1860-1940: Data User’s Manual 213 (1999). 5

 Sanders, supra note 4. For an overview, see also Peter Blanck et al., Disability Civil Rights Law and Policy (2004). 6

 Harlan Hahn, Accommodations and the ADA: Unreasonable Bias or Biased Reasoning?, Berkeley Journal of 

Employment and Labor Law, 21 Berkeley J. Emp. & Lab. L. 166 (2000). 

7

 K. D. Seelman, Employment of individuals with disabilities: Opportunities and challenges: The best of times/the 

worst of times (July 17, 2000. Paper presented at Employment and Disability Policy Summer Institute, Cornell 

University, Ithaca, NY; Richard K. Scotch & Kay Schriner, Disability as Human Variation: Implications for Policy, 

549 Annals Am. Acad. Pol. & Soc. Sci. 148 (1997). 8 Nat’l Council Disability (NCD, 1996). Achieving independence: The challenge for the 21st century: A decade of 

progress in disability policy: Setting an agenda for the future. Washington, D.C.: National Council on Disability. 9

 42 U.S.C. § 12101(a)(2), 42 U.S.C. § 12101(a)(7) (2000). 

10 Id. § 12101(a)(8). 11 Prior to the ADA, the International Center for the Disabled (ICD) contracted with Louis Harris and Associates in 

1986 to survey Americans with disabilities about their lives and the obstacles they faced. Louis Harris and 

Associates conducted telephone interviews with 1000 individuals aged 16 and over. Post-ADA, the National 

Organization on Disability (N.O.D.) contracted with Louis Harris and Associates to complete similar national 

surveys of approximately 1000 individuals with disabilities in 1994, 1998, 2000 and 2004. Although the surveys 

differed somewhat over time, many questions remained the same and, for others, structured response “foils” could 

be used to create similar questions. The findings herein are the first time these survey questions and data were 

reviewed across time. Two of these questions focus directly on the ADA—awareness of the ADA, and its perceived 

impact. The other questions serve as indicators of ADA influences (e.g., experiences of job discrimination). 

12 NCD E-mail Call for Comments, submitted comments on May 10, 2005. 13 Nat’l Org. Disability, 2000 National Organization on Disability/Harris Survey of Americans with Disabilities tbl. 

22C (2000) [hereinafter N.O.D. 2000], http://www.N.O.D..org/index.cfm?fuseaction=Page.viewPage&pageID=31.

. 14 Nat’l Org. Disability, 2004 National Organization on Disability/Harris Survey of Americans with Disabilities 88 

(2004) [hereinafter N.O.D. 2004], http://www.N.O.D..org/index.cfm?fuseaction=Page.viewPage&pageID=31; Nat’l 

Org. Disability, 1986 National Organization on Disability/Harris Survey of Disabled Americans 20 

(1986) [hereinafter N.O.D. 1986], http://www.N.O.D..org/index.cfm?fuseaction=Page.viewPage&pageID=31. 15 N.O.D. 2004, supra note 14, at tbl. 10A. 16 N.O.D. 1986, supra note 14, at tbl. 5. 17 NCD E-mail Call for Comments, submitted comments in 2005. 18 NCD E-mail Call for Comments, submitted comments on April 29, 2005. 19 Id. 20 Bernard Barker, People First of Georgia, Georgia Public Forum, April 13, 2005; Theresa Brenner, Savannah 

Association for the Blind, Georgia Public Forum, April 13, 2005; Bart Brophy, LIFE, Inc., Georgia Public Forum, 

April 13, 2005; Kate Gainer, GDA Consulting Group in Atlanta, Georgia Public Forum, April 13, 2005; NCD 

E-mail Call for Comments, submitted comments on May 6, 2005; Interview on March 9, 2005; Jean Idarosa, 

Chatham Area Transit, Georgia Public Forum, April 13, 2005; Terri Lance, Advocate with United Cerebral Palsy of 

Los Angeles, Ventura, and Santa Barbara Counties, California Public Forum, March 29, 2005; Blanck & Associates 

Mailing, submitted comments on May 11, 2006; Berlin Vargas, California Public Forum, March 29, 2005. 
126 

 

21 Nat’l Council Disability, The Current State of Transportation for People with Disabilities in the United States

(2005), http://www.ncd.gov/newsroom/publications/2005/current_state.htm. 22 Gwendolyn Hall Ross, California Public Forum, March 29, 2005. 23 N.O.D. 2004, supra note 14, at 67. 24 N.O.D. 1986, supra note 14, at tbl. 28. 25 NCD E-mail Call for Comments, submitted comments on April 28, 2005; NCD E-mail Call for Comments, 

submitted comments on May 10, 2005; NCD E-mail Call for Comments, submitted comments on May 11, 2005. 

26 NCD E-mail Call for Comments, submitted comments in 2005. 27 Brenner, supra note 20; Brophy, supra note 20; NCD E-mail Call for Comments, supra note 20. 28 NCD E-mail Call for Comments, supra note 17. 29 NCD E-mail Call for Comments, submitted comments on May 5, 2005. 30 Econ. Res. Serv., U.S. Dep’t Agric., Rural Transportation at a Glance (2005), 

http://www.ers.usda.gov/publications/AIB795/AIB795_lowres.pdf. 31 Id. at 4. 32 49 C.F.R. § 37.79–83 (2005). 33 Id. § 37.93. 34 Id. § 37.55. 35 Id. § 37.93. 36 Nat’l Council Disability, supra note 21. 37 Bureau Transp. Statistics, U.S. Dep’t Transp., ADA—Accessible Rail Transit Stations by Agency tbl. 1-9 

(Feb. 2006), http://www.bts.gov/publications/national_transportation_statistics/html/table_01_09.html. 38 Commuter rail systems included in the report are San Jose, CA; San Diego, CA; San Francisco, CA; Los Angeles, 

CA; New Haven, CT; Miami, FL; Chicago, IL (2 systems); Boston, MA; Baltimore, MD; New York, NY (3 

systems); the state of Pennsylvania; Philadelphia, PA; Dallas, TX; Ft. Worth, TX; Washington, DC; Seattle, WA. 

Light rail systems included in the report are: Los Angeles County, CA; San Francisco, CA; Washington, DC; 

Sacramento, CA; San Diego, CA; San Jose, CA; Denver, CO; Tampa-St. Petersburg, FL; New Orleans, LA; Boston, 

MA; Baltimore, MD; Detroit, MI; St. Louis, MO; Newark, NJ; Buffalo, NY; Cleveland, OH; Portland, OR; 

Pittsburg, PA; Philadelphia, PA; Memphis, TN; Dallas, TX; Galveston, TX; Houston, TX; Salt Lake City, UT; 

Seattle, WA (2 systems); Kenosha, WI. 

39 Bureau Transp. Statistics, supra note 37. 40 Id. 41 Id. 42 Am. Pub. Transp. Ass’n, Accessible Vehicles by Mode (2006), https://www.apta.com/research/stats/vehicles/ 

vehacc.cfm. 

43 E-mail received on June 8, 2005; Spina Bifida Ass’n of Am., Travel With a Disability: Easier than Ever (2001), 

http://www.sbaa.org/site/PageServer?pagename=ASB_travel. 44 Spina Bifida Ass’n. Am., supra note 43. 45 49 C.F.R. § 37.61 (2005) (public transportation programs and activities in existing facilities). 46 Id. § 37.41–43 (construction of transportation facilities by public entities). 47 Id. § 37.71–75. 48 Id. § 35.160. 49 Fed. Transit Auth., U.S. Dep’t Transp., 2003 National Transit Summaries and Trends (2003), 

http://www.ntdprogram.com/NTD/NTST/2003/PDFFiles/2003%20National%20Transit%20Summaries%20and%20

Trends%20(NTST).pdf. 

50 Fed. Transit Auth., U.S. Dep’t of Transp., Strategic Plan, Strategic Goal Two: Mobility and Access tbl. 2 (Aug. 

15, 2003) available at http://www.fta.dot.gov/transit_data_info/reports_publications/publications/strategic_plan/ 

8898_8914_ENG_HTML.htm. 
127 

 

51 Fed. Highway Admin., U.S. Dep’t Transp., Transportation Accessibility—Departmental Performance Measures 

and Goals, Highway Trust Fund Financial Report for Fiscal Year 2004, (June 30, 2005), available at 

http://www.fhwa.dot.gov/reports/htffy04/mda_06_09.htm. 52 Id. 53 Fed. Transit Auth., supra note 49. 54 Bureau Transp. Statistics, National Transportation Statistics, at P15 (Feb. 2006), 

http://www.bts.gov/publications/national_transportation_statistics/excel/table_01_08.xls. 55 Am. Pub. Transp. Ass’n, Accessible Vehicles by Mode, 2006, https://www.apta.com/research/stats/ 

vehicles/vehacc.cfm. 

56 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice October–December 2005, issue no. 4, http://www.ada.gov/octdec05.htm. 57 Id. 58 Econ. Res. Serv., U.S. Dep’t Agric., Rural Transportation at a Glance (Jan. 2005), available at 

http://www.ers.usda.gov/publications/AIB795/AIB795_lowres.pdf. 59 Nat’l Council Disability, supra note 21. 60 49 C.F.R. §§ 37.121 (2005). 61 Nat’l Council Disability, National Disability Policy: A Progress Report (December 2001-December 2002) 

http://www.ncd.gov/newsroom/publications/2003/progressreport_final.htm. 62 Nat’l Council Disability, Id. 63 Flores v. Access Servs. Inc., SACV 03-820 JVS (Anx) (S.D. Cal. 2004), http://www.asila.org/_pdf/ 

Agenda169.doc. 

64 Access Servs., Performance Evaluation of Access Paratransit, First Annual Report, Access Services (2005), 

http://www.asila.org/_pdf/FILE_pdf__20050908_083730.pdf. 

65 Access Servs., Access Services Annual Report 2004 – 05 (2005), http://www.asila.org/_files/ 

FILE_pdf__20050126_143056.pdf. 

66 See Gary Pub. Transp., Compliance Review Report, Gary, IN, at 16 (Nov. 2005), 

http://www.fta.dot.gov/documents/GPTC_Final_Report_051121.doc; Letter of Findings Regarding Access Services 

Inc., Los Angeles, CA (Oct. 2000), http://www.fta.dot.gov/transit_data_info/transit_info_for/ 

riders_with_disabilities/ada_information/letters_of_finding/10122_10145_ENG_HTML.htm. 67 Focus Group Participant, Feb. 28, 2005. 68 NCD E-mail Call for Comments, supra note 18; NCD E-mail Call for Comments, supra note 17. 69 Gainer, supra note 20. 70 David Wilder, Los Angeles Public Forum, Mar. 29, 2005. 71 Barker, supra note 20; Brenner, supra note 20; Blanck and Associates Mailing, submitted comments on May 19, 

2006; Amy Tangkeatkomjar, Georgia Public Forum, Apr. 13, 2005; Maggie Zepeda, Goodwill Industries, California 

Public Forum, Mar. 29, 2005. 

72 NCD E-mail Call for Comments, supra note 25; NCD E-mail Call for Comments, supra note 25. 73 U.S. Dep’t Justice, Settlement Agreement under the Americans with Disabilities Act between the United States of 

America and Greyhound Lines, Inc. (1999) http://www.usdoj.gov/crt/ada/greyhnd.htm. Attempts to interview a 

Greyhound official for this study were not successful.

74 Id. 75 U.S. Dep’t of Justice, Guide for Passengers: Accessible Bus Service Under the Greyhound Agreement (1999), 

http://www.usdoj.gov/crt/ada/greyfact.htm. 76 49 C.F.R. § 37.29(c) (2005). 77 Id. § 37.29(b). 78 Id. 79 Hal Morgan, Taxicab, Limousine and Paratransit Association, Accessible Taxicabs, 

http://www.ctaa.org/pubs/taxi.asp. 

80 Id. 
128 

 

81 Id. 82 Id. 83 Id. 84 Id. 85 Id. 86 Andy Humm, 12,000 NYC Taxis; Five Are Accessible, Gotham Gazette, May 2004, 

http://www.gothamgazette.com/article//20040507/3/970. 87 Morgan, supra note 79. 88 Handy v. LATaxi Cooperative, CV-99-2172-SVW (Central Dist. Cal. 1999) (Los Angeles taxis and guide dog 

users); Press Release, Memphis Ctr. Indep. Living, Individual Asserts Civil Rights in Federal Court (Apr. 20, 1998), 

http://www.mcil.org/mcil/news/newsr19.htm (Memphis taxis and guide dog users). 89 Wheelchair Users Take Taxi Fight to Federal Court, KUTV.com, Mar. 5, 2006, 

http://kutv.com/topstories/local_story_064192404.html (Utah taxis refusing to pick up wheelchair users). 90 Marj Schneider, Georgia Public Forum, Apr. 13, 2005. 91 28 C.F.R. § 35.149–150 (2005). 92 Id. § 35.151. 93 Barden v. City of Sacramento, 225 F.3d 1073 (9th Cir. 2002). 94 Nat’l Council Disability, The Current State of Transportation for People with Disabilities in the United States, 

(2005), http://www.ncd.gov/newsroom/publications/2005/current_state.htm. 95 28 C.F.R. § 35.150(d)(2). 96 Id. § 35.151(e). 97 Kinney v. Yerusalim, 9 F.3d 1067 (3d Cir. 1993). 98 Mitch Pomerantz, ADA compliance officer for the City of Los Angeles, Testimony given at U.S. Access Board 

Regional Meeting, Portland, Oregon, June 23, 2002. 

99 John Cameron, City Civil Design Engineer City of Memphis, Tennessee, Testimony given at U.S. Access Board 

Regional Meeting, Portland, Oregon, June 23, 2002. 

100 Culver City Pub. Works Dep’t, Sidewalk Corners Ramp Up (July 2003), 

http://www.culvercity.org/uploads/reports/July2003PWNews.pdf. 101 U.S. Dep’t Justice, Enforcing the ADA, (Jan.–Mar. 2006), http://www.ada.gov/statrpt.htm. 102 Donna Fredericksen, E. Paralyzed Veterans Am., City Will Make 158 Thousand Street Corners Accessible to 

Wheelchair Users (Sept. 12, 2002). 103 Civil Rights Div., supra note 56. 104 Disabled Chicagoans Sue over Curb Ramps, ABC News (Oct. 4, 2005), 

http://abcnews.go.com/US/LegalCenter/wireStory?id=1182184&CMP=OTC-RSSFeeds0312. 105 Dep’t Pub. Works, City & County S.F., Proposed $208 Million G.O. Bond for Street Resurfacing, Pedestrian 

Safety & Access Improvements (Apr. 2005), http://www.ci.sf.ca.us/site/uploadedfiles/sfdpw/director/ 

2005%20Street%20Bond%20Report-Rev.pdf. 

106 David Waite, City Promises Quicker Action on Wheelchair Ramps, Honolulu Advertiser, Oct. 26, 2001, 

http://the.honoluluadvertiser.com/article/2001/Oct/26/ln/ln11a.html. 

107 Dep’t Pub. Works, supra note 105. 108 Id. 109 Id. 110 28 C.F.R. § 36.304 (2005). 111 Id. §36.401. 112 Id. §36.402–403. 113 N.O.D. 2000, supra note 13, at tbl. 22C. 114 N.O.D. 2004, supra note 14, at exhibit 3; N.O.D. 1986, supra note 14, at 38. 115 NCD E-mail Call for Comments, submitted comments on Apr. 27, 2005. 116 Interview on Apr. 8, 2005. 
129 

 

117 U.S. Gen. Accounting Office, Americans with Disabilities Act, Effects of the Law on Access to Goods and 

Services (June 1994). 118 Stephen Kaye, Disability Statistics Abstract, No 21, H (May 1998), http://dsc.ucsf.edu/publication.php 

?pub_id=7. 

119 U.S. Gen. Accounting Office, Business Tax Incentives: Incentives to Employ Workers with Disabilities Receive 

Limited Use and Have an Uncertain Impact GA0-03-39, at 18 (Dec. 2002), http://www.gao.gov/ 

new.items/d0339.pdf. 

120 Ctr. Accessible Soc’y, Employers Know Little about Tax Credits, Says Study, Apr. 29, 2003, 

http://www.accessiblesociety.org/topics/economics-employment/shrmstudy.html. 121 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice January–March 2006, issue no. 1, http://www.ada.gov/janmar06.htm. 122 Civil Rights Div., supra note 56. 123 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice April–June 2002, issue no. 2, http://www.ada.gov/aprjun02.pdf. 124 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice April–June 2005, issue no. 2, http://www.ada.gov/aprjun05prt.pdf. 125 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice October 2004–March 2005, issue no. 1 http://www.ada.gov/oct04mar05.htm. 126 Civil Rights Div., U.S. Dep’t Justice, ADA Enforcement, Enforcing the ADA: A Status Report from the 

Department of Justice July–Sept. 2003, issue no. 3, http://www.ada.gov/julsep03.htm. 127 Civil Rights Div., supra note 121. 128 Interview in 2005. 129 Focus Group Participants, on Feb. 28, 2005. 130 NCD E-mail Call for Comments, submitted comments on May 11, 2005. 131 NCD E-mail Call for Comments, submitted comments on May 5, 2005. 132 Terri Lance, United Cerebral Palsy of Los Angeles, Ventura and Santa Barbara County, California Public Forum, 

Mar. 29, 2005; Hugh Hallenberg, California Public Forum, Mar. 29, 2005. 

133 NCD E-mail Call for Comments, submitted comments on May 4, 2005. 134 NCD E-mail Call for Comments, submitted comments on May 3, 2005. 135 NCD E-mail Call for Comments, submitted comments on Apr. 30, 2005. 136 NCD E-mail Call for Comments, submitted comments on Apr. 28, 2005. 137 NCD E-mail Call for Comments, submitted comments on May 11, 2005. 138 NCD E-mail Call for Comments, supra note 130. 139 NCD E-mail Call for Comments, submitted comments on Apr. 30, 2006. 140 Gainer, supra note 20. 141 28 C.F.R. §36.303 (2005). 142 Id. 143 Id. § 36.303(d) & (e). 144 Id. § 36.302(c). 145 Civil Rights Div., U.S. Dep’t Justice, ADA Homepage, http://www.ada.gov/settlemt.htm. Settlement agreements 

between medical facilities and the United States include Greater Southeast Community Hospital, Norwegian 

American Hospital, Fairview Health Services, Parkway Hospital, Silver Hill Hospital, Ravenswood Hospital, St. 

Luke’s Hospital, Davis Hospital, Perinatal Associates, Connecticut hospitals, and Maine Medical Center. 146 Nat’l Ass’n Deaf, Deaf Child Third to Sue Maryland Hospital for Discrimination, May 1997 (Prince George’s 

Hospital Center, MD), http://www.nad.org/site/pp.asp?c=foINKQMBF&b=186212; Nat’l Ass’n Deaf, Doctors 

Agree to Provide Intepreting Services for Deaf Family Members, Nov. 1999 (Perinatal Associates, P.C., OR.), 

http://www.nad.org/site/pp.asp?c=foINKQMBF&b=178006. 

147 Civil Rights Div., supra note 145. Settlement agreements between hotels and the U.S. include agreements with 

Holiday Inn-Huntington Beach, CA; Holiday Inn-Conroe, TX; Holiday Inn-Scottsdale, AZ; Holiday Inn-Alton, IL; 
130 

 

Holiday Inn-Austin, TX; Holiday Inn-Metairie, LA; Kingston Ramada Inn; Ramada Inn-S. El Monte, CA; Holiday 

Inn-Marietta, GA; Holiday Inn-Tucson, AZ; Holiday Inn-Chateau LeMoyne, LA; Holiday Inn-Montgomery, AL; 

Holiday Inn-San Francisco, CA; Ramada Inn-Virginia Beach, VA; Holiday Inn-Independence, OH; Hotel 

Harrington. 

148 Civil Rights Div., supra note 121 (McDonalds, City Cab Co.); Civil Rights Div., supra note 122 (Broadway 

Grocery); Civil Rights Div., supra note 124 (Ramada Hotel, Dallas). 149 Curtis Humphries, Nordia Relay, California Public Forum, Mar. 29, 2005. 150 Renee Miller, Greater Los Angeles Agency on Deafness, California Public Forum, Mar. 29, 2005. 151 NCD E-mail Call for Comments, submitted comments on Apr. 29, 2005. 152 Michigan Developmental Disabilities Council, Blanck and Associates Mailing, submitted comments on June 1, 

2006; Wayne Lake, Texas Public Forum, Apr. 8, 2005; Robert Warner, SAB, Georgia Public Forum, April 13, 2005; 

Montana Independent Living Project, Blanck and Associates Mailing, submitted comments on May 2, 2006; 

153 National Federation of the Blind, Inc v. AOL Time Warner, Inc., (Civil Action No 99-12303 (D. Mass.) complaint 

filed November 16, 1999), (parties reached settlement resulting in voluntary dismissal); Hooks v. OKBridge, Inc.

(Civ. No. 99-50891, unpublished 5th Cir. August 21, 2000); Access Now Inc. v. Southwest Airlines Co., 227 F. 

Supp. 2d 1317 (S.D.Fla.) (2002). 

154 29 U.S.C. § 794d (2000). 155 47 U.S.C. § 225 (2000). 156 National Video Relay Service Coalition Comments on Speed of Answer Requirement for VRS, 

http://www.nad.org/atf/cf/{A2A94BC9-2744-4E84-852F-D8C3380D0B12}/NVRSCSpeedOfAnswerComm% 

2018%20.pdf. 

157 47 U.S.C. § 225(b). 158 In fact, since TRS services are maintained by the states, no national figures were available on the number of relay 

calls nationwide until the Federal Communications Commission (FCC), which enforces Title IV, began requiring 

states and telecommunications relay services providers to submit their annual consumer complaint log summaries in 

2002. 

159 Nat’l Exchange Carrier Ass’n, Relay Service Minutes—2003 and 2004 Actual (2005). 160 Fed. Communications Comm’n, Consumer & Governmental Affairs Bureau Reminds States and 

Telecommunications Relay Services (TRS) Providers that the Annual Summary of Consumer Complaints 

Concerning TRS Is Due Thursday, July1, 2004: Public Notice DA 04-1599 (June 2, 2004). 161 Phil Kaplan, Self Help for Hard of Hearing People, California Public Forum, Mar. 29, 2005. 162 Carol Collier, Coordinator for Services for Deaf and Hard of Hearing Students, University of Iowa, Iowa Public 

Forum, Mar. 25, 2005. 

163 NCD E-mail Call for Comments, submitted comments on May 1, 2005. 164 NCD E-mail Call for Comments, submitted comments on May 5, 2005. 165 NCD E-mail Call for Comments, submitted comments on May 2, 2005. 166 42 U.S.C. § 12132 (2000). 167 28 C.F. R. § 35.160(b)(1) (2005). 168 Id. § 35.150(a). 169 Id. § 35.150(c) & (d). 170 Id. § 35.151. 171 David Pfieffer & Joan Finn, The Americans with Disabilities Act: An Examination of Compliance by State, 

Territorial, and Local Governments in the USA, 12 Disability & Soc’y 753, 753–73 (1997). 172 Id. 173 Civil Rights Div., supra note 121. 174 U.S. Department of Justice, interviewed by e-mail on May 25, 2005. 175 Civil Rights Div., U.S. Dep’t Justice, Project Civic Access Fact Sheet, U.S. Department of Justice (Mar. 30, 

2006), http://www.usdoj.gov/crt/ada/civicfac.htm. 
131 

 

176 Court Consulting Servs. Div., Nat’l Ctr. State Courts, Enforcement Activities Under the Americans with 

Disabilities Act Title II: Programs, Services and Activities of State and Local Courts, 1994–2004 (2004), 

http://www.ncsconline.org/WC/Publications/CS_AmeDis_EnforcementSect1.pdf. 177 U.S. Dep’t Justice, Access for All: Five Years of Progress, A Report from the Department of Justice on 

Enforcement of the Americans with Disabilities Act (2006), available at http://www.usdoj.gov/crt/ada/ 

5yearadarpt/fiveyearada1.htm 

178 Tennessee v. Lane, 541 U.S. 509 (2004). 179 Miles v. County of Los Angeles, No. CV-02-03932 DT (JTLx). 180 Press Release, Judicial Council Cal., Chief Justice Urges New Judgeships, Upgraded Courthouses in California 

(Feb. 28, 2006), at 2, http://www.courtinfo.ca.gov/presscenter/newsreleases/NR20-06.PDF. 181 Associated Press, Oregon to Survey Courthouses for Accessibility for Disabled, News-Rev., Jan. 15, 2004, 

http://www.newsreview.info/apps/pbcs.dll/article?AID=/20040115/NEWS/101150023; State Bar Ariz., 2005 

Courthouse Accessibility Survey (2006), http://www.azbar.org/LegalResources/TF/2005CourthouseSurvey.cfm. 182 Courthouse Access Advisory Committee, U.S. Access Bd., Courthouse Access Advisory Committee, 

http://www.access-board.gov/caac/index.htm (last visited July 14, 2006). 183 Univ. of Ala. v. Garrett, 531 U.S. 356 (2001). 184 Tennessee v. Lane, 541 U.S. 509 (2004). 185 Ferguson v. City of Phoenix, 157 F.2d 668, 674 (9th Cir. 1998); cf. Barnes v. Gorman, 536 U.S. 181, 186–87 

(2002). 

186 ADAPT, NCD E-mail Call for Comments, submitted comments on May 3, 2005. 187 NCD E-mail Call for comments, supra note 135. 188 NCD E-mail Call for Comments, submitted comments on Apr. 29, 2005. 189 NCD E-mail Call for Comments, submitted comments on Apr. 29, 2005. 190 NCD E-mail Call for Comments, submitted comments on May 9, 2005. 191 42 U.S.C. § 1973aa-6 (2000). 192 Letter to Ms. Arlys Ward, Executive Director, City & County of Denver Election Commission, from Stewart B. 

Oneglia, Chief, Coordination & Review Section, Civil Rights Div., U.S. Dep’t Justice (Sept. 30, 1993), 

www.usdoj.gov/crt/foia/cltr103.txt. 

193 Olegario D. Cantos VII, Special Assistant to the Assistant Attorney General, Civil Rights Division, 

U.S. Department of Justice, interviewed by e-mail on May 25, 2005. 

194 Pub. L. No. 107-252, 116 Stat. 1666 (2002). 195 U.S. Gen Accounting Office, Voters with Disabilities: Access to Polling Places and Alternative Voting Methods 

GAO-02-107 (Oct. 2001), http://www.gao.gov/new.items/d02107.pdf 196 Id. 197 Elizabeth Schneider, Am. Ass’n People with Disabilities, New Machines Allow More with Disabilities to Vote—

If They Can Access the Polling Place (Nov. 18, 2004), http://www.aapd.com/dvpmain/pollaccess/ 

newmachines.html. 

198 Id.; Heather J. Carlson, Missouri Polling Places Pose Barriers for Disabled Voters, Jefferson City News Trib., 

Mar. 12, 2005, http://www.newstribune.com/articles/2005/03/12/news_state/0312050006.prt 199 Fla. Dep’t State, 2003 Report on Polling Place Accessibility Pursuant to Section 17, Chapter 2002-281 Laws of 

Florida (2004), http://election.dos.state.fl.us/reports/pdf/PollingPlaceAccess.pdf. 200 Make Voting Accessible to All, Deseret Morning News, Oct. 8, 2005, http://deseretnews.com/dn/view/ 

0,1249,615156214,00.html.

201 Survey Identifies Indiana Polling Place Accessibility Concerns, On Target, Apr. 2005, 

http://www.in.gov/gpcpd/ontarget/april05.html 

202 Schneider, supra note 197. 203 For example, New York was sued by the DOJ for its failure to comply with HAVA and still plans to offer 

electronic voting in only some of its polling places in 2006. Mark Humbert, State Files Voting Plan with Court, Apr. 

10, 2006, http://www.aapd.com/News/votingissues/060421nycompliance.htm. 
132 

 

204 Am. Ass’n People Disabilities, State Census Disability Numbers and Voting Turnout,

http://www.aapd.com/dvpmain/elreform/census.html. 205 Nat’l Org. Disability, “2004 Presidential Candidates Speak Out on Disability Issues” 

http://www.N.O.D..org/election2004.html. 206 Kansas - http://www.independenceinc.org/alerts/state_candidate_positions.htm; Rochester - 

http://mhcrochester.org/Articles/November%202005%20Newsletter.pdf; Washington - 

http://students.washington.edu/dasa/candidate-guide-2004.html. 

207 Focus Group Participant in Indiana, March 11, 2005. 208 http://www.dol.gov/odep/state/state.htm. 209 Olmstead v. L.C., 527 U.S. 581 (1999). 210 Peter Blanck, et al., Disability Civil Rights Law and Policy, at 11-14 (2004). 211 Id. at 11-16. 212 U.S. Dep’t Health & Human Servs., Delivering on the Promise—Report of Federal Agencies’ Actions to 

Eliminate Barriers and Promote Community Integration (Mar. 25, 2002), http://www.hhs.gov/news/press/ 

2002pres/20020325.html. 

213 U.S. Dep’t Health & Human Servs., Compilation of Individual Federal Agency Reports of Action to Eliminate 

Barriers and Promote Community Integration (2002), http://www.hhs.gov/newfreedom/final/. 214 White House, New Freedom Initiative: A Progress Report (2004), http://www.whitehouse.gov/infocus/ 

newfreedom/. 

215 Id. 216 Kaiser Comm’n Medicaid & Uninsured, Henry J. Kaiser Family Found., Olmstead at Five: Assessing the Impact

(June 2004), available at http://www.kff.org/medicaid/upload/Olmstead-at-Five-Assessing-the-Impact.pdf. 217 Nat’l Council Disability, Olmstead: Reclaiming Institutionalized Lives (2003), 

http://www.ncd.gov/newsroom/publications/2003/reclaimlives.htm. 218 Kaiser Comm’n Medicaid & Uninsured, Henry J. Kaiser Family Found., Medicaid Benefits: Online Database, 

Benefits by Service: Home and Community Based Services Waiver (Oct. 2004), http://www.kff.org/medicaid/ 

benefits/service.jsp?yr=2&cat=1&nt=on&sv=41&so=0&tg. 

219 Johanna M. Donlin, Moving Ahead with Olmstead: To Comply with the Americans with Disabilities Act, States 

Are Working Hard to Find Community Placements for People with Disabilities, State Legislatures, Mar. 1, 2003, at 

28. 

220 Kaiser Comm’n Medicaid & Uninsured, Henry J. Kaiser Family Found., Medicaid Benefits: Online Database, 

Benefits by Service: Home Health Services (Oct. 2004), http://www.kff.org/medicaid/benefits/service.jsp 

?yr=2&cat=1&nt=on&sv=12&so=0&tg=0. 

221 Id. 222 Dep’t Health Pol’y, George Washington Univ. Med. Ctr., Olmstead at Five: Assessing the Impact (2004), 

http://www.kff.org/medicaid/upload/Olmstead-at-Five-Assessing-the-Impact.pdf. 223 Nat’l Conference State Legislatures, The States’ Response to the Olmstead Decision: How Are States 

Complying?: A 2003 Update (Feb. 2004), http://www.ncsl.org/programs/health/forum/olmsreport.htm. 224 Id. at 7. 225 Ctrs. Medicare & Medicaid Servs., U.S, Dep’t Health & Human Servs., Money Follows the Person and 

Balancing Long-Term Care Systems: State Examples (2003), http://www.cms.hhs.gov/PromisingPractices/ 

Downloads/mfp92903.pdf. 

226 Nat’l Conference State Legislatures, supra note 2231. 227 Nat’l Council Disability, supra note 217. 228 Dep’t Health Pol’y, supra note 222, at 21. 229 Nat’l Conference State Legislatures, supra note 2231. 230 Id. 231 U.S. Gen. Accountability Office, Long-Term Care: Implications of Supreme Court’s Olmstead Decision Are Still 

Unfolding (2004), http://www.gao.gov/new.items/d011167t.pdf. 
133 

 

232 Ctrs. Medicare & Medicaid Servs., U.S. Dep’t Health & Human Servs., MDS Active Resident Count Report: 

March 31, 2006, http://www3.cms.hhs.gov/apps/mds/rescnt.asp?date=14. 233 Id. 234 U.S. Gen. Accountability Office, supra note 231. 235 Bazelon Ctr. Mental Health Law, Legal Advocate Cites Ongoing Segregation on Eve of Olmstead Anniversary, 

June 21, 2004, http://www.bazelon.org/newsroom/archive/2004/6-21-04olmstead.htm. 236 Susan Jamieson, Atlanta Legal Aid Attorney, Georgia Public Forum, April 13, 2005. 237 Yvette Hester, Georgia Protection and Advocacy for People with Mental Illnesses, Georgia Public Forum, April 

13, 2005. 

238 Money Follows the Person Act of 2005, H.R. 3063, 109th Cong. (1 Sess. 2006). 239 H.R. 910, 109th Cong. (1st Session). 240 Frank Bowe, Disability in America (2006), at http://people.hofstra.edu/faculty/frank_g_bowe/ 

disabilityNew/disablilty_exec_summary.html. 

241 U.S. Bureau of the Census (2006) (SIPP). 242 Id. 243 Robert Rudney, The Other World of Disability: Mobilizing Non-Severely Disabled Americans (Jan. 2, 2003), at 

http://www.N.O.D..org/index.cfm?fuseaction=page.viewPage&pageID=1430&N.O.D.eID=1&FeatureID=1040& 

redirected=1&CFID=10442324&CFTOKEN=98382727. 

244 Nat’l Council Disability, National Council on Disability Announces New Financial Incentives Study (Mar. 31, 

2005), at http://www.ncd.gov/newsroom/news/2005/a05-481.htm. 245 Am. Express, American Express Announces the Availability of braille and Large Print Card Statements for 

Persons with Vision Impairments (June 9, 2005), at http://home3.americanexpress.com/corp/pc/2005/braille.asp 246 E-mail from Lainey Feingold, received October 6, 2006. 247 Lisa A. Shcur, Dead End Jobs or a Path to Economic Well-Being? The Consequences of Non-Standard Work 

Among People with Disabilities, 20 Behav. Scis. & L. 601, 601–620. 248 Id. ch. 5, tbl. 5B. 249 28 C.F.R. § 35.150(a) (2005). 250 Id. § 36.304. 251 Id. §§ 35.130(b)(7), 36.302. 252 Id. §§ 35.160(b)(1); § 36.3. 253 N.O.D. 2004, supra note 14. 254 Nat’l Ctr. Educ. Statistics, U.S. Dep’t Educ., Students with Disabilities in Postsecondary Education: A Profile of 

Preparation, Participation, and Outcomes (June 1999), http://nces.ed.gov/pubs99/1999187.pdf. 255 Cathy Henderson, Am. Council Educ., College Freshmen with Disabilities: A Biennial Statistical Profile, EC 307 

573 (1999), http://eric.ed.gov/ERICDocs/data/ericdocs2/content_storage_01/0000000b/80/10/a2/d2.pdf 256 Anna H. Gajar, Postsecondary Education, in Beyond High School Transition from School to Work 385–405 (F. 

Rusch & J. Chadsey eds., 1998). 

257 Nat’l Ctr. Educ. Statistics, U.S. Dep’t Educ., An Institutional Perspective on Students with Disabilities in 

Postsecondary Education (1999), http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=1999046. 258 N.O.D. 2004, supra note 14, at 50; N.O.D. 1986, supra note 14, at tbl. 7. 259 Agency to Stop Flagging Exams of Students with Disabilities, CNNfyi.com, Feb. 8, 2001, 

http://archives.cnn.com/2001/fyi/teachers.ednews/02/08/flagged.tests.ap/. 260 U.S. Dep’t Justice, Settlement Agreement Between the United States of America and The Law School Admission 

Council, Inc. (Feb. 2, 2002), http://www.ada.gov/lsac.htm. 261 Robert Stodden, et al., Services, Supports and Accommodations for Individuals with Disabilities: An Analysis 

across Secondary Education, Postsecondary Education and Employment (unpublished manuscript, 2002). 262 379 F.3d 1097 (9th Cir. 2004). 263 Id. at 1108–10. 
134 

 

264 Focus Group Participant, on Feb. 23, 2005; Wyoming Independent Living Rehab, Focus Group Participant, on 

Feb. 28, 2005. 

265 NCD E-mail Call for Comments, submitted comments on May 3, 2005. 266 42 U.S.C. § 12112(a) (2000). For a comprehensive review, see Peter Blanck et al., Disability Civil Rights Law 

and Policy (2004). 267 Id. § 12112(b)(6). 268 N.O.D. 2004, supra note 14, at tbl. 2A. 269 N.O.D. 1986, supra note 14, at 48 & tbl. 20. 270 N.O.D. 2004, supra note 14, at tbl. 2E. 271 Id. at tbl. 3A. 272 Andrew J. Houtenville & Richard V. Burkhauser, Research Brief: Did the Employment of People with 

Disabilities Decline in the 1990s, and Was the ADA Responsible? (Aug. 2004), http://www.ilr.cornell.edu/ 

edi/publications/RB_EmpDecline.pdf. See also David C. Stapleton & Richard V. Burkhauser, The Decline in 

Employment of People with Disabilities: A Policy Puzzle (W.E. Upjohn Institute for Employment Research, 2003, 

448 pages). 

273 H. Stephen Kaye, Improved Employment Opportunities for People with Disabilities: Disability Statistics Report 

17 (U.S. Dep’t Educ. 2003). 274 Samuel R. Bagenstos, The Future of Disability Law, 114 Yale L. J. 1, 1 n.2 (2004). 275 U.S. Gen. Accounting Office, supra note 119. 276 White House, supra note 214. 277 Ctr. Accessible Soc’y, supra note 120. 278 K.A. Dixon, et al., Heldrich Ctr. Workforce Dev., Restricted Access: A Survey of Employers About People with 

Disabilities and Lowering Barriers to Work (Mar. 2003), http://www.heldrich.rutgers.edu/Resources/ 

Publication/89/WorkTrendsXIVRestrictedAccessFinalReport.pdf. 

279 Peter Blanck & Helen Schartz, Special Issue: Corporate Culture and Disability, 23 Behavioral Scis. & Law 1 

(2005). 

280 Dixon, et al., supra note 278. 281 N.O.D. 2004, supra note 14. 282 N.O.D. 2004, supra note 14, at tbl. 2C. 283 Id. at tbl. 3C 284 Xerox Corporation, Focus Group Participant, Mar. 9, 2006; Allstate Insurance Company, Focus Group 

Participant, on Mar. 9, 2005. 

285 Allstate Insurance Company, Focus Group Participant, on March 9, 2005 (Document # 999); see also notes 

accompanying supra note 284. 286 See notes accompanying supra note 285. 287 NCD E-mail Call for Comments, submitted comments on May 4, 2005. 288 42 U.S.C. § 12111(8); 29 C.F.R. pt. 1630 app, § 1630.1(c)(2). 289 42 U.S.C. § 12112(b)(5)(B). 290 N.O.D. 1986, supra note 14. 291 N.O.D. 2000, supra note 13. 292 Dixon, et al., supra note 278. 293 See Helen Schartz, DJ Hendricks, and Peter Blanck, Workplace Accommodations: Empirical Study of Current 

Employees, 75 Miss. L. J. 1 (2006); Helen Schartz, DJ Hendricks, and Peter Blanck, Workplace Accommodations: 

Evidence-Based Outcomes, Work, 15:22 (2006). 294 Id. at 2. 295 Id. 296 Id. 297 Id. 298 Id. 
135 

 

299 Schartz, et al., supra note 293. 300 Id. at 3. 301 Id. 302 Id. 303 Id. 304 Id. at 3–4. 305 Peter Blanck & Associates, Secondary Analysis of National Surveys of Americans with Disabilities (2005). 306 Employer focus group participant, Mar. 9, 2005. 307 Id. 308 Focus group participant, Mar. 4, 2005. 309 Focus group participant, Feb. 18, 2005. 310 Michael E. Waterstone, The Untold Story of the Rest of the Americans with Disabilities Act, 58 Vanderbilt L. 

Rev. 1807 (2005). 311 See generally Nat’l Council Disability, Policy Brief Series: Righting the ADA (2003), 

http://www.ncd.gov/newsroom/publications/2003/policybrief.htm. 312 Id. 313 http://www.ncd.gov/newsroom/publications/2004/righting_ada.htm 

314 ABA Special Feature, 2003 Employment Decisions Under the ADA Title I—Survey Update, 28 Mental & 

Physical Disability L. Rep. 319 (2004). 315 U.S. Equal Emp. Opportunity Comm’n, Americans with Disabilities Act of 1990 (ADA) Charges: FY 1992—FY 

2005 (2006), http://www.eeoc.gov/stats/ada-charges.html. 316 Peter D. Blanck & Mollie W. Marti, Genetic Discrimination and the Employment Provisions of the Americans 

With Disabilities Act: Emerging Legal, Empirical, and Policy Implications, 14 Behavioral Scis. & Law 411, 429 

(1996). 

317 Money Follows the Person Act of 2005, H.R. 3063, 109th Cong. (1 Sess. 2006). 318 H.R. 910, 109th Cong. 319 Peter Blanck, et al., Disability Civil Rights Law and Policy: Cases and Materials (2005). 320 Burton Blatt Inst., Publications (2006), http://bbi.syr.edu/publications/. 321 Burton Blatt Inst., Collaboration (2006), http://bbi.syr.edu/collaboration. These include: the Center for Health 

Services Research and Policy (George Washington University), the Center for Personal Assistance Services 

(University of California, San Francisco), the Center for the Study and Advancement of Disability Policy 

(Washington, D.C.), the Disability Research Institute (University of Illinois at Urbana-Champaign), the Disability 

Rights Legal Center, the Disability Statistics Center (University of California, San Francisco), the Independent 

Living Research Utilization, the Job Accommodation Network (West Virginia University), the Program for 

Disability Research (Rutgers, The State University of New Jersey), and The Institute for Rehabilitation and 

Research. 

322 ADA & IT Technical Assistance Ctrs., ADA Document Portal, at http://adaportal.org/. 323 Social Sci. Res. Network, SSRN eLibrary (2006), http://www.ssrn.com/. 
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