National Council on Disability

September 18, 2012

National Disability Policy: 

A Progress Report
National Council on Disability

1331 F Street, NW, Suite 850

Washington, DC 20004

National Disability Policy: A Progress Report

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

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

September 18, 2012

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.

Letter of Transmittal

September 18, 2012

The President 

The White House 

Washington, DC 20500 

Dear Mr. President: 

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 

The National Council on Disability (NCD) is charged with developing an annual report 

on the nation’s progress in achieving our national disability policy goals: equality of 

opportunity, independent living, full participation and economic self-sufficiency for an 

estimated 54 million Americans with disabilities. This is a daunting task. Virtually every 

foreign and domestic policy issue has—or should have—a disability angle. Our 

engagements in military conflicts, overseas diplomatic efforts, budget decisions, 

infrastructure development, enforcement activities, education, health care, employment, 

transportation, telecommunications, and emergency preparedness policies all have 

direct and indirect impacts on Americans with disabilities—irrespective of whether 

decision-makers are aware the far-reaching effects of their daily decisions on people 

with disabilities. 

NCD’s National Disability Policy: A Progress Report fulfills our mandate by highlighting 

recent achievements that show significant progress on disability policy and identifying 

areas where action is acutely needed. As charged by statute, this report serves not 

merely as a report on NCD’s efforts or even of the federal government, but rather on 

significant developments across the nation. While the report focuses on the period 

between September 2011 and June 2012, we also seek to contextualize recent 

developments to illustrate progress and how progress is often agonizingly elusive. The 

material in this report is based on our engagement with stakeholders, actions among 

federal agencies and Congress, and NCD’s own policy projects. 

With last year’s report, NCD began identifying and evaluating national data sets as a 

tool to assess progress with more precision and enable tracking over time. 

Unfortunately, there are few updates to those data sets available today. With this year’s 

report, NCD provides a high-level, interim policy assessment under the thematic 

organizing framework NCD adopted in 2010: Living, Learning and Earning. NCD 

adopted these three themes to emphasize that people with disabilities want what all 

Americans want: to live free and full lives in communities of their choosing, to learn in 
2 

Sincerely, 

Jonathan M. Young

Chairman 

(The same letter of transmittal was sent to the President Pro Tempore of the 

U.S. Senate and the Speaker of the House of Representatives.)

ways that enrich their lives and enable them to reach their potential, and to provide for 

themselves and their families. 

A central theme in this report is NCD’s conviction that achieving long-term fiscal stability 

requires eliminating outdated and costly policies that trap Americans with disabilities in 

cycles of poverty and dependency, and cultivating meaningful opportunities for these 

and all Americans to contribute to our nation’s collective well-being. This effort depends 

on finding ways to integrate and coordinate the delivery of necessary supports and 

services across federal departments, agencies, programs and policies. Unfortunately, 

lack of authority and lack of focused effort often conspire to perpetuate fragmentation 

and prevent real progress. This report seeks to identify some of the important progress 

and challenges in coordinating disability policy and promoting the independence and 

self-sufficiency of Americans with disabilities. 

NCD has appreciated the opportunity to work with your Administration and Congress in 

furthering the goals of the ADA. We are pleased to report that we are making progress, 

yet sobered by the magnitude of the tasks that lie ahead. While we recognize that there 

are extreme pressures to curtail the federal budget, we hope your Administration and 

the Congress will join us in recognizing we must continue to expand opportunities for 

people with disabilities to contribute to their fullest potential. Failure to do so not only 

jeopardizes the lives of people with disabilities; it also threatens our national recovery. 

NCD is a tiny agency with a huge mission, but we are ready to do our part in helping to 

make the promises of the ADA a reality. 
3 

National Council on Disability Members and Staff

Members

Jonathan M. Young, PhD, JD, Chair

Janice Lehrer-Stein, Vice Chair

Gary Blumenthal

Chester A. Finn

Sara Gelser

Marylyn Howe

Matan Koch

Lonnie Moore

Ari Ne’eman

Stephanie Orlando

Dongwoo Joseph (“Joe”) Pak, MBA

Clyde E. Terry

Fernando M. Torres-Gil, PhD

Linda Wetters

Pamela Young-Holmes

Staff

Aaron Bishop, Executive Director

Joan Durocher, General Counsel & Director of Policy

Anne Sommers, Director of Legislative Affairs & Outreach

Stacey S. Brown, Staff Assistant

Julie Carroll, Senior Attorney Advisor

Lawrence Carter-Long, Public Affairs Specialist

Lisa Grubb, Confidential Special Assistant/Coordinator of Administration

Gerrie-Drake Hawkins, PhD, Senior Policy Analyst

Carla Nelson, Administrative Specialist

Robyn Powell, Attorney Advisor

Mark Seifarth, Legislative Affairs Specialist
4 

Contents

Letter of Transmittal...................................................................................................... 1

National Council on Disability Members and Staff..................................................... 3

Report Introduction....................................................................................................... 7

CHAPTER 1. Community Living................................................................................. 9

Introduction ............................................................................................. 9

Americans with Disabilities Act (and Amendments) ................................ 9

ADA Standards for Accessible Design ............................................ 9

Project Civic Access...................................................................... 10

Other ADA Enforcement ............................................................... 12

Olmstead Enforcement ................................................................. 14

Recommendations ........................................................................ 15

Developmental Disabilities Assistance and Bill of Rights Act

(DD Act) ........................................................................................ 16

Recommendations ........................................................................ 19

Section 504 of the Rehabilitation Act .................................................... 20

Accessible Currency ..................................................................... 20

Recommendations ........................................................................ 21

Housing................................................................................................. 21

Supportive Housing....................................................................... 22

Housing Discrimination ................................................................. 23

Recommendations ........................................................................ 25

Home- and Community-Based Services and Supports ......................... 26

CMS Works to Define Community Living ...................................... 26

Community First Choice Option .................................................... 28

Recommendations ........................................................................ 29

Healthy Living........................................................................................ 30

Health Care Disparities ................................................................. 30

Insuring People with Preexisting Conditions ................................. 31

Disability Research ....................................................................... 32

Medicaid Managed Care............................................................... 33

Recommendations ........................................................................ 34

Military Health Care............................................................................... 36

Active Duty Care for Exceptional Family Members (EFM) ............ 36

Veterans’ Mental Health Needs..................................................... 36
5 

Life Transition Challenges............................................................. 38

Recommendations ........................................................................ 39

Emergency Management ...................................................................... 40

Recommendations ........................................................................ 41

Parenting Rights.................................................................................... 42

Recommendations ........................................................................ 44

Transportation....................................................................................... 44

Ground Transportation .................................................................. 45

Public Rights-of-Way..................................................................... 47

Air Travel....................................................................................... 47

Other Transportation Accessibility Challenges.............................. 48

Recommendations ........................................................................ 49

United Nations Convention on the Rights of Persons with 

Disabilities (CRPD) ....................................................................... 49

Recommendations ........................................................................ 51

CHAPTER 2. Learning............................................................................................... 53

Introduction ........................................................................................... 53

NCD’s Experts Symposium and Town Hall on Education Reform......... 53

Education Reforms................................................................................ 54

Common Core State Standards .................................................... 54

Recommendations ............................................................ 57

Charter Schools ............................................................................ 57

Recommendations ............................................................ 59

Vouchers....................................................................................... 60

Recommendations ............................................................ 61

Elementary and Secondary Education Act (ESEA)............................... 62

No Child Left Behind Waivers ....................................................... 62

Recommendations ............................................................ 62

Addressing Disparities in Underserved Populations...................... 63

Bullying Prevention ....................................................................... 64

Recommendations ............................................................ 65

Seclusion, Restraints, and Aversives ............................................ 66

Recommendations ............................................................ 68

Youth Transitions .......................................................................... 68

Recommendations ............................................................ 69
6 

CHAPTER 3. Earning................................................................................................. 73

Introduction ........................................................................................... 73

Employment Discrimination Claims....................................................... 73

Impact of the Recession........................................................................ 74

Social Security Disability Programs....................................................... 74

Recommendations ........................................................................ 75

Employment Disparities among Subgroups .......................................... 75

Workforce Investment Act ..................................................................... 76

Recommendations ........................................................................ 77

Federal Hiring Initiative ......................................................................... 78

Recommendations ........................................................................ 78

Federal Employment of Veterans with Disabilities ................................ 79

Recommendations ........................................................................ 80

Federal Contractors and Subcontractors Hiring Workers with 

Disabilities..................................................................................... 80

Recommendations ........................................................................ 81

Veterans................................................................................................ 81

Veterans with Disabilities’ Unemployment Figures........................ 81

Congressional and Executive Branch Action ................................ 82

Recommendations ........................................................................ 84

Mental Health Impact on Earning and Economics among 

Veterans............................................................................ 84

Conclusion ............................................................................................ 85

Endnotes...................................................................................................................... 87

Higher Education Act ............................................................................ 70

Accessible Instructional Materials ................................................. 70

Recommendations ............................................................ 70

Inclusion of Students with Intellectual Disabilities in

Higher Education .............................................................. 71

Recommendations ............................................................ 71
7 

Report Introduction

This annual progress report by the National Council on Disability (NCD) provides a 

glimpse at the current state of people with disabilities in the United States. This report 

covers the period of summer 2011 through spring 2012 by issue area, and reviews toplevel policy developments affecting people with disabilities, including key federal actions 

and state trends. The report notes progress where it has occurred and provides further 

recommendations where necessary. The material in this report comes from NCD 

stakeholders, federal agencies, and information gathered during NCD policy projects.

The report is organized into three chapters based on the broad policy themes by which 

NCD has organized its work since the summer of 2010—living, learning, and earning—

the thought behind which is that all people, including people with disabilities, have the 

same fundamental wants and needs—to live, to learn, and to earn. Woven throughout 

each themed chapter is an examination of the impact of the current recession and slow 

recovery on the lives of people with disabilities, and the unique as well as shared 

experiences facing military service members and veterans of all wars. Each chapter 

also contains several lists of recommendations for specific actions, primarily for 

Congress and the Administration. Many of these recommendations emphasize 

enforcement of existing laws, as well as revisions to policies and practices intended to 

improve living, learning, and earning opportunities for people with disabilities. 

In Chapter One: Community Living, NCD examines to what extent people with 

disabilities are included in all aspects of community living—including housing, health 

care, emergency management, raising families, and transportation. In Chapter Two: 

Learning, NCD begins to consider the impacts of education reforms on students with 

disabilities; the effect of No Child Left Behind (NCLB) waivers now and in the future; 

bullying prevention; and the elimination of aversives, seclusion, and restraints. In 

Chapter Three: Earning, NCD considers the reauthorization of the Workforce 
8 

Investment Act; employment disparities among subgroups of people with disabilities; 

and unemployment gaps among people with and without disabilities. 
9 

CHAPTER 1.Community Living 

Introduction

Satisfaction with community living depends on having personal choices, access to 

places and information, and the safety and freedom to fully participate in community life. 

As millions of people with disabilities know, failure to coordinate various elements of 

inclusion means missing out on opportunities to live, learn, and earn in the United 

States of America. Successful community living occurs when people have 

independence, safety and security, freedom of mobility, freedom of communication, 

affordable and accessible housing and transportation, and access to health care and 

long-term services and supports. It occurs when citizens with disabilities are involved in 

all aspects of community planning and implementation, including emergency 

preparedness. 

Americans with Disabilities Act (and Amendments)

ADA Standards for Accessible Design 

On March 15, 2012, the U.S. Department of Justice (DOJ) announced that regulations 

based on revised 2010 Americans with Disabilities Act (ADA) Standards for Accessible 

Design had gone into effect.1 The 2010 Standards, which underwent extensive review 

and numerous open comment periods over more than 10 years, set requirements for 

built-in elements at public facilities, including but not limited to courtrooms and detention 

facilities, amusement rides, and swimming pools and play areas. The Standards also 

clarify requirements for accessible and companion seating at stadiums and other 

assembly areas, distribution of accessible hotel rooms among different classes of hotel 

rooms provided, overlap between wheelchair accessible rooms and rooms with 

communication features, and reach ranges and toilet room dimensions. The new 
10

Standards have been widely heralded by people with disabilities as a significant step 

toward realizing the promises of the ADA.

However, the continued challenges in realizing the promises of the ADA were also 

evident in a controversy surrounding one element of the new Standards: the 

requirement that owners and operators of public swimming pools must acquire and 

maintain bolted-down mechanical chair lifts. Although the proposed requirements were

long in the making, announced in 2010 with compliance scheduled originally for March 

15, 2012,2 and despite the fact that DOJ provided what appeared to be sufficient 

clarification to the proposed swimming pool regulations, owners and operators objected 

to the proposed rule before it went into effect. Initially, DOJ extended the deadline for 

compliance to May 21, 2012, to respond to this objection. This action raised concerns 

among disability advocates that swimming pool owners and operators would seek to set 

aside the new requirement. Indeed, measures were introduced in Congress that would 

substantially modify the proposed requirement.3 However, on May 24, 2012, DOJ 

released two technical assistance documents as part of its effort to continue to educate 

covered entities about their obligations under the 2010 Standards. DOJ also announced 

that the final rule would go into effect with no change to its requirements, but with an 

additional extension for compliance to January 31, 2013.

4

 

Project Civic Access

Launched in August 1999, Project Civic Access is a DOJ initiative to remove barriers 

across local governments. In 2011, the Disability Rights Section of DOJ’s Civil Rights 

Division reached settlement agreements across the United States to ensure compliance 

with the ADA. DOJ also developed technical assistance materials on Title II and Title III 

of the ADA, including accessible entry and exit requirements for swimming pools and 

spas, revised ADA requirements on ticket sales, and revised ADA requirements 

regarding service animals, to assist other localities in reaching this goal. 
11

Title II of the ADA specifically prohibits discrimination on the basis of disability by public 

entities. From June 28, 2011, through February 8, 2012, the following municipalities 

reached agreements with DOJ to meet the requirements of the ADA by removing 

physical and communication barriers that prevent people with disabilities from 

participating fully in civic life in their communities: 

● February 8, 2012 – Humboldt, Kansas, agreed to make physical modifications to 

facilities, improve access to sidewalks, upgrade the telephone relay service, post 

notices, improve Web access, and ensure emergency management services, 

among other improvements.

● November 22, 2011 – Upshur County, Texas, agreed to appoint an ADA 

coordinator, make physical modifications to facilities, improve sidewalk access, 

post notices, improve Web access, and ensure emergency management 

services, among other improvements. 

● September 28, 2011 – Warrenton, Virginia, agreed to survey facilities and 

programs to ensure ADA compliance, make physical modifications to facilities,

improve access to sidewalks, install signs, and improve Web access, among 

other improvements. 

● August 29, 2011 – The Puerto Rico Department of Justice agreed to pay $45,000 

to an employee denied a reasonable accommodation. It also agreed to provide 

training to employees on the requirements of the ADA, and adopt policies to 

ensure that it does not require employees with disabilities to attend meetings at, 

or be relocated to, an inaccessible location. 

● August 16, 2011 – The Maryland National Capital Park and Planning 

Commission and Montgomery County, Maryland, agreed to a wide-ranging series 

of accommodations to improve access for people with disabilities. 
12

● July 26, 2011 – Madison, Indiana, Daviess County, Kentucky, and Norfolk 

County, Massachusetts, agreed to make physical modifications to public facilities

and improve access to parking, entrances, assembly areas, and restrooms. 

Improvements in effective communication (e.g., Web site and telephone 

communications), grievance procedures, polling places, emergency management 

procedures and policies, and sidewalks were also agreed on. 

● June 28, 2011 – Van Buren County, Arkansas, agreed to improve the 

accessibility of sidewalks, transportation stops, and pedestrian crossings; make 

physical modifications to facilities; improve access to sidewalks; upgrade the 

telephone relay service; post notices; improve Web access; and ensure 

emergency management services, among other improvements.

Other ADA Enforcement

In addition to the enforcement activities of Project Civic Access, in the past year, DOJ 

and courts around the nation reached agreements or filed suit to ensure access for 

Americans with disabilities. These cases included the following: 

● On March 30, 2012, DOJ announced a settlement with Trinity Regional Medical 

Center in Fort Dodge, Iowa, regarding allegations of a failure to provide 

appropriate auxiliary aids and services, including sign language interpreters, to 

patients who are deaf, resulting in confusion, a lack of understanding of medical 

instructions, and long waits. The settlement included a civil penalty, provision of 

training to hospital staff regarding the requirements of the ADA, and the adoption 

of policies and procedures to ensure prompt provision of auxiliary aids and 

services in the future for patients who are deaf or hard of hearing or their 

companions.5

● On March 20, 2012, DOJ announced a settlement with Mountain Valley, 

Pennsylvania, Midget Football League following allegations that the league 
refused to allow a seven-year-old boy with ocular albinism to play football in the 

league with a helmet with a tinted visor as an accommodation. Conditions of the 

settlement include the requirement that the league develop and implement a 

disability rights policy, train league officials on the ADA requirements, and grant 

reasonable accommodations.6

● On February 1, 2012, DOJ announced a settlement with Henry Ford Health 

System in Ferndale, Michigan, regarding allegations of the system’s failure to 

provide auxiliary aids and services to enable a patient who is deaf (and visiting 

family members who are deaf) at an inpatient psychiatric facility to communicate 

effectively with health care providers. The settlement requires staff training on 

ADA requirements; development and adoption of policies and procedures 

regarding the provision of auxiliary aids and services; and appointment of a 

corporate ADA administrator and ADA facilitators at each hospital, clinic, and 

health center.7

● On June 28, 2011, DOJ announced that it reached a settlement agreement with 

Beach Babies Learning Center, LLC, in Old Saybrook, Connecticut. The 

agreement resolves allegations the center terminated the enrollment of a twoyear-old child because the child has autism.8

 

● On June 24, 2011, a U.S. District Court jury in Fort Myers found that 7-Eleven 

violated the Florida Civil Rights Act and the ADA when it fired Jim Soliday, an 

employee who is deaf, after removing his accommodations.

9

● On May 31, 2011, DOJ reached a settlement with Wells Fargo & Company to 

ensure equal access for individuals with disabilities to Wells Fargo’s services 

nationwide, including its nearly 10,000 retail banking, brokerage, and mortgage 

stores; more than 12,000 ATMs; and telephone and Web site services.10

13
14

Olmstead Enforcement

Thirteen years ago, the U.S. Supreme Court ruled in Olmstead v. L.C. that Title II of the 

ADA prohibits the unnecessary institutionalization of people with disabilities. In the 

words of the Court, services to people with disabilities must be provided “in the most 

integrated setting possible.” As states across the country continue to struggle with 

budget shortfalls, lawmakers have often contemplated or made cuts to services that 

have imperiled the ability of people with disabilities to remain in or transition to the most 

integrated setting possible. Actualizing the promise of the Olmstead decision has 

become a major component of ADA enforcement. To quote Assistant Attorney-General 

for Civil Rights Tom Perez, “Segregating people with disabilities into institutions is as 

wrong as segregating African-American children into inferior schools.”

11

Recent Olmstead decisions include the following: 

● On April 12, 2012, DOJ filed a Statement of Interest in Lane v. Kitzhaber,

asserting that “the integration regulation prohibits the unnecessary segregation of 

persons with disabilities by public entities in non-residential settings, including 

segregated sheltered workshops.”

12

● On January 26, 2012, DOJ concluded an Olmstead investigation in Virginia with an

agreement that Virginia will create approximately 4,200 home- and communitybased waivers over 10 years for people who are on waiting lists for community 

services or transitioning from institutional settings. Virginia also agreed to create a 

comprehensive community crisis system with a full range of crisis services, including 

a hotline, mobile crisis teams, and crisis stabilization programs, to divert individuals 

from unnecessary institutionalization or other out-of-home placements.13

● On January 9, 2012, DOJ filed a Statement of Interest regarding a plaintiffs’ 

challenge to a 20 percent reduction in personal care services provided through 

California’s In-Home Support Services (IHSS) program. IHSS is designed to 
15

enable seniors and people with disabilities to avoid hospitalization and 

institutionalization.14

● In December 2011, DOJ issued a Findings Letter concluding that Mississippi is in 

violation of the ADA’s integration mandate to provide meaningful opportunities for 

people with disabilities to live in most integrated community settings.15

● On July 12, 2011, DOJ filed an amicus brief supporting California adults with 

physical and mental disabilities, who argued that state policies place them at 

serious risk and are actionable under the ADA.16

● On July 6, 2011, DOJ announced that it had entered into a comprehensive 

agreement with Delaware to resolve violations of the ADA within the state’s 

mental health system.17

Recommendations

NCD recommends: 

1.1 The U.S. Department of Justice should enforce the Americans with 

Disabilities Act 2010 Standards for Accessible Design, including 

regulations regarding the accessibility of swimming pools, without further 

extensions. 

1.2 DOJ should maintain and expand its efforts to ensure state compliance 

with the Supreme Court’s Olmstead v. L.C., focusing its efforts on the 

closure of institutions both large and small and advancing the ADA’s 

integration mandate and the application of the Olmstead decision in other 

types of public programs, such as employment.
16

Developmental Disabilities Assistance and Bill of Rights Act (DD Act)

In 1963, the U.S. Congress passed the Developmental Disabilities Assistance and Bill 

of Rights Act, which created an infrastructure of state developmental disability planning 

councils, the University Affiliated Centers (now known as Centers of Excellence), and 

the Protection and Advocacy system. Within these systems, much has been done to 

build both peer and family support programs. These programs have been very helpful, 

particularly in states that have closed institutions. This same type of support is important 

to create successful transitions from sheltered workshop settings to integrated 

competitive employment opportunities.

In 2011, NCD released Rising Expectations: The Developmental Disabilities Act 

Revisited, which summarized many of the key accomplishments and challenges of the 

DD system as well as considered the existing structure against a backdrop of the 

current and future social and policy environments.18 In April 2012, NCD issued a 

supplement to the Rising Expectations report, titled Exploring New Paradigms for the 

Developmental Disabilities Assistance and Bill of Rights Act, which builds on the former 

report by exploring opportunities for the expansion of the DD network infrastructure to 

fully realize the goals of the DD Act and to establish a comprehensive policy framework 

of clear, consistent objectives across federal agencies and key laws.19 The report 

makes pointed recommendations for addressing structural challenges to policy, 

program, and service coordination. These recommendations were formulated as a 

result of a comprehensive literature review of trends, developments, and challenges 

since the last DD Act reauthorization in 2000, as well as interviews and focus groups 

1.3 DOJ should consider mechanisms to expand its enforcement activities in 

the context of education, placing particular emphasis on strategic 

litigation aimed at addressing issues of segregation of students with 

disabilities in public schools, including charter schools.
17

with individual stakeholders, including self-advocates, family advocates, researchers, 

practitioners, and state and Federal Government officials.

In New Paradigms, NCD recommends restructuring the Federal Government’s response 

to disability policy to address and remove the administrative constraints on the 

Administration on Developmental Disabilities (ADD) as well as to facilitate more intuitive 

coordination of programs, services, and supports. Coincidentally, shortly before the 

release of New Paradigms, the U.S. Department of Health and Human Services (HHS) 

announced a structural reorganization that brings together several program offices that 

provide support for aging and disability communities under a newly created operating 

division called the Administration on Community Living.20 NCD is heartened that this 

newly created division assists in repositioning and elevating ADD’s status. However, 

coordination of services for populations with intellectual and developmental disabilities 

(ID/DD) that are provided outside of HHS will remain problematic until further shifts occur. 

Most notably, the newly named Administration on Intellectual and Developmental 

Disabilities (AIDD, formerly ADD) continues to lack a direct policy and funding relationship 

with key stakeholders who have developed a presence in developmental disability policy 

over the past several decades. Although AIDD is the key federal agency within HHS 

charged with encouraging and supporting the provision of services to people with 

intellectual and developmental disabilities,21 it possesses no funding or policy relationship 

with state ID/DD service-provision agencies, the primary entities responsible for 

administering services for people with ID/DD at the state level. As a result, AIDD is forced 

to pursue its systems change priorities indirectly, through influencing state DD Network 

partners, such as the Protection and Advocacy programs, or by working to influence the 

Center for Medicare and Medicaid Services. This lack of authority seriously hamstrings 

AIDD’s effectiveness in advancing the goals and values of the DD Act. 

NCD urges the creation of a direct relationship with state ID/DD agencies to enhance 

AIDD’s ability to drive meaningful change. Such a relationship could take several forms. 

Although the Medicaid program is the largest source of funding for state ID/DD 

agencies, providing AIDD with a funding stream allocated specifically for systems 
18

change grants to state ID/DD agencies would give AIDD valuable leverage to assist 

states interested in improving their service-delivery systems but requiring additional 

support to do so. Furthermore, a formula grant to state ID/DD agencies administered by 

AIDD and geared specifically at data collection activities would provide AIDD with 

valuable leverage to establish and hold states accountable for clear metrics and 

outcome measures reflecting the values of the DD Act.

Another key gap within the present DD Act programs remains the absence of a statutorily 

defined mechanism for AIDD to support self-advocacy organizations—defined as 

organizations run by people with intellectual and developmental disabilities speaking on 

their own behalf and on behalf of their communities. At the time Congress created the DD 

Act programs, the primary stakeholders within the developmental disability world were 

family members, researchers, and legal advocates. The current DD Act programs reflect 

this in their establishment of a University Center of Excellence on Developmental Disability, 

Protection and Advocacy system, and state Developmental Disability Planning Council 

within each state. However, the past several decades have seen the emergence of a new 

stakeholder group deserving of representation within the DD Act: people with intellectual 

and developmental disabilities themselves. Although the self-advocacy movement—defined 

as people with disabilities working to advance their community’s interests and speaking on 

their own behalf—is not yet sufficiently developed to allow the creation of a federally funded 

statewide entity within each state akin to the other DD Network partners, it is nonetheless 

capable and deserving of federal support and investment. Self-advocacy organizations 

have played a key role in driving systems change and connecting individuals with 

intellectual and developmental disabilities to meaningful resources regarding topics as 

diverse as benefits planning, relationships and sexuality, housing, deinstitutionalization, 

social inclusion, community recreation activities, employment, rights protection, addressing 

discrimination, postsecondary education, and a wide variety of other key topics. NCD 

believes that Congress should develop a competitive grant program under AIDD for local 

self-advocacy organizations, reflecting a similar structure to the Centers for Independent 

Living program within the Rehabilitation Services Administration, another successful model 

of federal support to organizations run by people with disabilities.
19

Recommendations

NCD recommends: 

1.4 The University Centers of Excellence on Developmental Disability, Protection 

and Advocacy programs, and Developmental Disability Councils, authorized 

under the Developmental Disabilities Assistance and Bill of Rights Act, should 

coordinate and expand efforts to support expanded peer support to both 

families and individuals with intellectual and developmental disabilities moving 

from sheltered workshop settings to integrated employment.

1.5 DD Network partners should be required to coordinate their planning through 

the establishment of a joint strategic planning process under the Administration 

on Intellectual and Developmental Disabilities’ review. This would enable AIDD 

to select particular areas of emphasis for systems change activities, which in 

turn would allow the DD Network partners to pick a particular focus area to 

coordinate around, such as building state Employment First infrastructure or 

working to eliminate ICF-MRs22 within the state.

1.6 Congress should establish a relationship between state ID/DD agencies and 

AIDD, providing AIDD with funding for data collection and systems change 

grants to state ID/DD agencies and empowering AIDD to require meaningful 

data collection from state ID/DD agencies, which would better enable AIDD to 

track progress and promote systems change supporting community 

integration at the state level.

1.7 Congress should establish a competitive grant program for local self-advocacy 

organizations, similar to the Center for Independent Living model, to be 

operated through AIDD, which could be a mechanism for both systems 

change and for encouraging greater social opportunities for people with ID/DD.
20

Section 504 of the Rehabilitation Act

Accessible Currency

On October 3, 2008, United States Court of Appeals for the District of Columbia Circuit 

Judge James Robertson issued an historic injunction against the United States 

Treasury Department. In a case brought by the American Council of the Blind and other 

advocates, Judge Robertson held that the Treasury “violated Section 504 of the 

Rehabilitation Act by failing to provide meaningful access to United States currency for 

blind and other visually impaired persons.”

23 The Treasury was ordered to take steps to 

make U.S. currency accessible to people who are blind and/or visually impaired.24 

Since that time, the U.S. Bureau of Engraving and Printing (BEP) has worked with the 

Treasury Department and DOJ to increase the accessibility of American paper currency. 

This process is ongoing, and logistical, technological, and administrative challenges 

remain to meet the court’s mandate and guarantee comprehensive and timely 

compliance. Questions remain about what the phase-out period should be for the use of 

existing currency, and how best to determine ways of maximizing accessibility during 

the transition to new tactile currency. 

In December of 2011, BEP reported two key developments: 

● In consultation with experts and stakeholders, BEP is researching the most 

practical method for rendering tactile bills of a denomination larger than $1.00. 

With periodic reporting to DOJ, BEP anticipates finalization within the near future 

of the shape and type of tactile symbol to be affixed.

● Interim computer applications (including the EyenoteTM application for Apple, a 

free download) and development and distribution of more advanced currency 

readers will help during the transition period while older inaccessible bills near a 
21

natural obsolescence. Eventually, new paper currency will include symbols and 

raised textural numbers for bills larger than $1.00.

25

Housing

In 2006, 2008, and 2010, NCD issued reports26 focused on housing policy for people 

with disabilities. In its 2006 and 2008 reports, NCD defined a “livable community” as one 

that— 

● Provides affordable, appropriate, accessible housing; 

● Ensures accessible, affordable, reliable, safe transportation; 

● Adjusts the physical environment for inclusiveness and accessibility; 

Recommendations

NCD recommends: 

1.8 The U.S. Bureau of Engraving and Printing should complete research 

and set a timetable for commencement of production of tactile currency 

within two years. 

1.9 BEP should finalize a plan for how to distribute, or support by voucher 

application the distribution of easy-to-use handheld currency readers, 

which will make existing paper currency audibly accessible. Mandatory 

biannual reports submitted by BEP to the District of Columbia Court and 

the Department of Justice should be made available to the public, other 

agencies, and interested parties.
22

● Provides work, volunteer, and education opportunities; 

● Ensures access to key health and support services; and

● Encourages participation in civic, cultural, social, and recreational activities. 

Supportive Housing

Supportive housing is a cost-effective, evidence-based approach of combining 

individualized support services with permanent, affordable rental housing to enable people 

with disabilities to live successfully in the community, consistent with the Olmstead 

decision. On January 4, 2011, President Obama signed the Frank Melville Supportive 

Housing Investment Act of 201027 into law.28 The Frank Melville Act amends the U.S. 

Department of Housing and Urban Development (HUD) Section 811 Supportive Housing 

for Persons with Disabilities program by authorizing a cost-effective demonstration program 

that could triple the number of integrated housing units created through Section 811 without 

an increase in the program’s appropriation, reducing bureaucratic barriers and improving

the program’s efficiency and cost-effectiveness, and authorizing a cost-neutral shift of fiscal 

responsibility for the Section 811-funded Mainstream Voucher program to the Housing 

Choice Voucher appropriation. The law maintains traditional funding of group homes and 

independent living complexes, while creating a new emphasis on multifamily housing to 

encourage nonprofit sponsors to set aside up to 25 percent of units in housing 

developments for Section 811 supportive housing units developed and owned by a 

nonprofit sponsor.29 It also creates a new Project Rental Assistance authority to allow HUD 

to delegate award and oversight of Section 811 operating assistance to the states that can 

fully fund the initial cost of the units and can show strong collaboration with state health and 

human service agencies to address the needs of people with disabilities more holistically.

30 

On November 16, 2011, HUD announced $749 million in housing funds under its 

Sections 202 and 811 Supportive Housing programs for very low-income people with 

disabilities and seniors, to assist nonprofits in producing accessible, affordable rental 
23

housing and facilitate supportive services. The funding enabled the start of construction 

or significant restoration of 189 housing developments in 42 states and Puerto Rico that 

will result in more than 4,800 households with people with disabilities or seniors gaining 

affordable housing with access to support services.31 

On March 28, 2012, HUD issued a Notice of Proposed Rulemaking (NPRM) to amend its 

regulations for Section 202 (Supportive Housing for the Elderly Program) and Section 811 

(Supportive Housing for Persons with Disabilities Program) to streamline requirements for 

mixed-finance developments to attract private capital and expertise to create attractive 

and affordable supportive housing developments for seniors and people with 

disabilities.32 The proposed rules also modernize Section 202 and 811 development 

regulations by allowing greater flexibility in the design of the units, extending the 

availability of capital advance funds, and making other technical corrections. The NPRM 

is the first part of a larger regulatory reform effort of the Section 202 and 811 programs 

based on the passage of the Frank Melville Act.33 An additional NPRM is expected out 

later this year. 

Housing Discrimination

In the past year, HUD announced several charges of fair housing discrimination on the 

basis of disability:

● On February 27, 2012, HUD announced that it was charging Bank of America with 

discrimination against home buyers with disabilities, in violation of the Fair Housing Act, 

for allegedly requiring borrowers who relied on disability income to qualify for loans to 

provide statements from their physicians of proof of their disabilities and continuance of 

their Social Security payments. The charge was announced in concert with work 

conducted by the Federal Financial Fraud Enforcement Task Force’s nondiscrimination 

working group. The charge was referred to DOJ for additional action.34
24

● On October 24, 2011, HUD announced charges against a Florida-based property 

owner, management company, and its employees after their refusal to 

accommodate the request of a resident with a chronic respiratory illness to move 

to a vacant apartment located between an elevator and a nonsmoking unit after a 

neighbor’s secondhand smoke had twice resulted in the tenant’s requiring

emergency medical care.35 

● On October 11, 2011, HUD announced charges against a Utah homeowner 

association, property management company, and group of condominium owners 

after refusing to accommodate a Gulf War veteran with a disability who required 

an emotional support dog. HUD alleges that illegal fees and fines were assessed 

for the presence of the service animal and that renewal of the tenant’s lease was 

refused until payment was made.36

● On October 11, 2011, HUD also announced charges against the University of 

Nebraska at Kearney and several of its employees following their refusal to 

permit a therapy dog to live in a university-owned apartment and illegally seeking 

information from a student with psychiatric disabilities regarding her treatments, 

prescribed medications, and clinical summary. As a result of the university’s 

refusal, the student had to move out of university housing and withdrew from the 

college.37

● On September 26, 2011, HUD charged the owner and manager of a Washington 

trailer park with discrimination on the basis of disability for refusing to make 

reasonable accommodations to a “no pets” policy when testers posing as 

applicants with disabilities who needed service dogs requested the 

accommodation.38

● On August 24, 2011, HUD announced charges against a housing cooperative in 

New York as well as two of its employees for their refusal to accommodate an 

emotional support animal, which had been doctor-prescribed to assist with daily
25

living for a tenant with disabilities. Following the refusal, the co-op refused to 

accept the tenant’s rent payments and attempted to evict him.39

Recommendations

NCD recommends: 

1.10 Similar to the Center for Medicare and Medicaid Services’ (CMS) 

promising practices resources, CMS and the U.S. Department of Housing

and Urban Development together should collaborate with states to 

continually highlight and widely disseminate effective plans, policies, and 

practices for coordinating housing with community living/long-term care 

supports across state systems, using a consumer-directed approach.

1.11 HUD should improve fair housing enforcement of disability rights, 

including ensuring that all agencies at the local, state, and federal levels 

follow HUD’s guidance to “affirmative further fair housing” for people with 

disabilities by reviewing and eliminating obstacles to accessible housing. 

1.12 HUD should expand accessibility features within registries, such as 

features for people with sensory (vision, hearing, tactile), developmental, 

and psychiatric disabilities; autism; and environmental sensitivities.

1.13 Congress should fund mechanisms for community-based organizations, 

such as Centers for Independent Living, Area Agencies on Aging, and 

Aging and Disability Resource Centers, to coordinate and maintain 

housing information along with community living support and program 

information, so consumers can have real choices and make informed 

decisions.
26

Home- and Community-Based Services and Supports 

CMS Works to Define Community Living 

Over the history of Medicaid Home- and Community-Based Services (HCBS), the 

Federal Government has worked consistently to incentivize the expansion of HCBS as 

an alternative to institutions and nursing homes for people with disabilities. A wide array 

of efforts have been undertaken to increase the percentage of Medicaid Long-Term 

Services and Supports (LTSS) dollars going to community-based service provision and

to decrease the percentage allocated to institutional care, including the Money Follows 

the Person (MFP) program; federal litigation to promote state compliance with the 

Olmstead decision; and substantial advocacy efforts on the part of local, state, and 

national disability rights organizations. In response to these efforts, many states have 

shifted their Medicaid spending toward HCBS and diminished their spending on 

institutional care. 

Unfortunately, in response to this shift, certain questions have emerged as to how to 

appropriately define what is and what is not HCBS service provision. Certain states and 

1.14 HUD should work in collaboration with the Department of Justice, the 

Administration on Intellectual and Developmental Disabilities, the new 

Administration on Community Living and other relevant stakeholders in 

both government and the advocacy community to restructure its 

programs to reflect consistency with the Supreme Court’s Olmstead v. 

L.C. decision and the integration mandate of the Americans with 

Disabilities Act.

1.15 HUD should step up its efforts to enforce the Fair Housing Act rights of 

people with disabilities attending colleges and universities, including 

people with intellectual disabilities in nondegree-granting programs.
27

providers have attempted to use HCBS funds for services outside the intent or purpose 

of the HCBS program, such as gated communities, disability-segregated farmsteads, or 

clustered group homes and settings on the grounds of or immediately adjacent to an 

institution or nursing home.

In April 2011, the CMS aimed to address this problem through an NPRM proposing a 

three-pronged definition of what could and could not be considered a community-based 

setting under Medicaid.40 The NPRM set out the following standard: “...HCBS settings: 

must be integrated in the community; must not be located in a building that is also a 

publicly or privately operated facility that provides institutional treatment or custodial 

care; must not be located in a building on the grounds of, or immediately adjacent to, a 

public institution; or, must not be a housing complex designed expressly around an 

individual’s diagnosis or disability, as determined by the Secretary. In addition, we 

propose that the settings must not have qualities of an institution, as determined by the 

Secretary. Such qualities may include regimented meal and sleep times, limitations on 

visitors, lack of privacy and other attributes that limit individual’s ability to engage freely 

in the community.”

41

This proposed definition received substantial feedback, both positive and negative, 

during the public comment process. As a result, CMS did not issue a final rule defining 

HCBS for the 1915(c) waiver, as it had proposed to do. Instead, the agency chose to 

revise its proposed definition of “community” (and solicit additional public comment) 

within the regulations promulgating the 1915(i) Medicaid state plan option, as 

established by the Patient Protection and Affordable Care Act (ACA). In so doing, the 

agency indicated its intention to standardize the definition of community across 1915(i), 

1915(k), and 1915(c) to ensure a uniform definition of community across every HCBS 

funding authority within the Medicaid program. The revised definition of HCBS carried 

some positive innovations, such as a requirement that states develop a quality 

assurance system utilizing individual outcome measures to monitor provider compliance 

with setting requirements and person-centered planning. However, there are also 

elements of significant concern in CMS’ new proposed definition, such as an allowance 
28

for exceptions to the setting and characteristic requirements of HCBS settings on an 

individual basis. While a flexibility-based approach may carry benefits, concerns exist as 

to the greater possibility of abuse under this model.

Community First Choice Option

On April 26, 2012, HHS finalized the rule implementing the Community First Choice 

(CFC) Option of the ACA.

42 The CFC Option is a new state plan option under 

Medicaid that will allow people to receive health services and support in their 

communities more easily rather than in hospitals or institutional settings. The former 

have been shown to be more cost-effective and increase the independence and 

improve the quality of life of those in need of such services. Absent “setting” 

requirements, final regulations effective July 6, 2012, define eligibility, specify services 

that must be made available under the CFC Option, call for a self-directed model of 

service provision, and confirm that states that opt for the CFC state plan option will 

receive an additional 6 percent in Federal Medical Assistance Percentage for the 

provision of those services and supports.43 

On February 22, 2011, HHS announced $4.3 billion in new funds to help establish and 

expand community-based alternatives to institutional long-term care through increased 

funding for the MFP demonstration program and the CFC Option programs. Thirteen 

new states plus 29 already approved states will together receive more than $45 million 

in MFP grants under provisions of the ACA to start programs in their states, with a total 

of $621 million committed through 2016. In addition, HHS proposed rules to allow all 

states to access a total of $3.7 billion in increased federal funding to provide long-term 

services and supports through the CFC Option program.44
29

Recommendations

1.16 The Center for Medicare & Medicaid Services should further refine its 

definition of Home- and Community-Based Service provision in 

consultation with the disability community to differentiate HCBS more 

clearly from congregate care models, utilizing a definition that excludes 

gated communities, segregated farmsteads, clusters of group homes, 

settings that restrict personal choice and control, and other settings with 

the characteristics of an institution. CMS may wish to consider 

developing distinct definitions of HCBS for senior citizens and nonseniors 

with disabilities. 

NCD recommends: 

1.17 Congress should explore various mechanisms to further enhance the 

Federal Medicaid Assistance Percentage (FMAP) available to Home and 

Community Based Services and to reduce the FMAP for Institutional 

Services. 

1.18 Eligible states should adopt and implement the various mechanisms 

within the Affordable Care Act supporting the expansion of HCBS, 

including the Community First Choice State Option, the State Balancing 

Incentive Program and the reauthorized Money Follows the Person 

Demonstration Grants.
30

Healthy Living

Health Care Disparities

When NCD released its 2009 health care status report on people with disabilities,45

defining disability as a demographic characteristic was still a fairly radical concept, given 

that disability—particularly within the health care field—has traditionally been 

considered a medical diagnosis, rather than a demographic identifier. Through 

extensive community engagement and review of available national disability data, NCD 

found that vast disparities exist between people with and without disabilities in access to 

health care. The overall findings have seen little change since NCD’s 2009 report. 

People with disabilities tend to be in poorer health and to use health care at a 

significantly higher rate than people who do not have disabilities. They also experience 

a higher prevalence of secondary conditions and use preventive services at lower rates. 

People with disabilities experience more problems accessing health care than other 

groups, and these difficulties increase for people with the most significant disabilities 

and who are in the poorest health. The lack of access to health care has been 

associated with increased risk for secondary conditions for people with significant 

disabilities.46 Despite these persistent and long-standing problems, people with 

disabilities are still not included within the federal government’s definition of “medically 

underserved population.” 

Since the passage of the ACA in 2010, HHS and other federal agencies and groups 

have shown support for the view that disability is a demographic identifier and have 

begun to address unique health disparities among people with disabilities. For example, 

the 2011 Health Brain Trust, an annual conference sponsored by the Congressional 

Black Caucus, included disability as a diversity factor in its sessions about racial, ethnic, 

and gender health disparities.47 During that conference, HHS introduced newly formed 

teams of internal division and office leaders responsible for addressing health 

disparities, including those of people with disabilities. NCD has taken note of these 
31

efforts and is heartened by these developments. Replication and further development of 

these and similar federal efforts are critical in addressing health care disparities, 

particularly with regard to the inclusion of people with disabilities in health care data 

collection and disaggregation used to inform public policy making.

Insuring People with Preexisting Conditions 

A number of the provisions of ACA give people with disabilities great hope for improved 

access to health care and health insurance. One ACA provision most heralded within 

the disability community has been the prohibition of coverage or eligibility denial on the 

basis of preexisting medical conditions or health status. This provision went into effect 

September 23, 2010, for children and goes into effect on January 1, 2014, for adults. In 

a congressional memorandum released shortly after the passage of ACA, a House 

Energy and Commerce Committee investigation found that the four largest for-profit 

health insurance companies issued more than 600,000 denials of individual health 

insurance coverage due to preexisting conditions during the three years directly 

preceding the ACA’s passage and that the number of denials had increased significantly 

each of those years, despite a far more modest increase in enrollment applications.

48

These findings underscore the need for this particular ACA provision. 

Following passage of the ACA in 2010, 26 states brought a multi-state lawsuit against 

the Federal Government, challenging the constitutionality of the requirement that those 

who do not have health insurance must purchase it or incur a fine; and the law’s 

expansion of the Medicaid program, which was taken up by the Supreme Court. Several 

disability and aging groups filed an amicus brief with the Supreme Court in support of 

the ACA and specifically the ban on the denial of coverage for preexisting conditions.49

In one brief, amici warn that without the ability to obtain insurance, individuals with 

disabilities are at serious financial and medical risk, and that barriers to access to health 

insurance cause postponements in timely diagnosis and treatment until both are more 

expensive and less effective.50 On June 28, 2012, in a 5-4 decision, the U.S. Supreme 

Court upheld ACA. In its ruling, the Supreme Court found that the requirement that 
32

individuals must have health insurance or pay a fine was constitutional under 

Congress’s taxing authority. While also finding constitutional the expansion of the 

Medicaid program, the Court limited the enforcement of those provisions by ruling that 

the Federal Government may not remove existing funding from states that do not 

Medicaid expand eligibility. As a result, some states may elect to not expand Medicaid, 

although federal funding incentives still exist to do so. 

Disability Research51 

A growing body of evidence shows the need for patient-centered research in efforts to 

assess the relationship between particular interventions, treatments, and other forms of 

health care and the quality of life of those receiving them. In addition to questions of 

quality, efforts by the Federal Government, health professionals, and others to address, 

reduce, and/or contain public health costs must ensure that people with disabilities are 

included in planning and implementation. 

To accomplish this, federal research funders should serve as a model for private funders by 

highlighting various mechanisms to involve people with disabilities throughout the research 

process. Involving people with disabilities in the grant review process constitutes a significant 

opportunity to enhance the disability community’s role in assessing which scientifically valid 

research priorities have the greatest impact on the lived experiences of people with 

disabilities and their family members. Furthermore, the use of Community-Based 

Participatory Research/Participatory Action Research models—where the population being 

studied is involved as a full partner at each stage of the research process—poses significant 

opportunities for ensuring greater community relevance and reliability of research findings. 

Historically, NCD has called for research that disaggregates data and compares

information on people with disabilities with information on their peers without disabilities. 

Similar principles can be applied to traditional vs. nontraditional treatment options. A 

positive step forward in the health care arena is that the U.S. Food and Drug 

Administration and the Institute of Medicine at HHS highlight the importance of valid and 
33

reliable measurement of patient-reported outcomes in the evaluation of conventional 

and alternative medical products.52 Similar efforts to measure effectiveness and quality 

of various health care treatments should be undertaken in consultation and 

collaboration with the disability community.

Medicaid Managed Care

This year, NCD undertook efforts to respond to the growing shift away from fee-forservice and toward managed care payment mechanisms within the Medicaid program. 

NCD’s efforts focused on articulating implications of managed care arrangements in 

publicly financed service systems for people with disabilities and on providing guiding 

principles for enrolling people with disabilities in managed care plans.

Managed care has historically been used primarily in the context of acute care services 

for adults without disabilities. The economic recession and new demonstration authority 

within the ACA for integrating services for the dual-eligible population has led more states 

to move to adopt managed care models for people with disabilities, in the context of both 

LTSS and acute care. A number of states have successfully used managed care models 

for their Medicaid systems, including LTSS. However, additional capacity must be built to 

ensure that the needs of people with disabilities are met in managed care frameworks. 

For example, the issue of quality measurement—critical to successful managed care 

contracts—requires elaboration to ensure that indicators adopted to assess health care 

quality do not overly medicalize LTSS for people with disabilities. The National Quality 

Forum is the nonprofit entity with lead responsibility for determining the measures that 

should be recognized as national standards. Among the more than 1,500 measures 

approved to date, only a handful are connected to LTSS as opposed to traditional acute 

care—and those primarily relate to behavioral health and early childhood 

development.53 NCD believes that CMS must undertake efforts to ensure that states 

shifting to managed care models adopt safeguards to ensure that people with 

disabilities are not adversely affected. 
34

Recommendations

NCD recommends: 

1.19 The U.S. Department of Health and Human Services should ensure the 

inclusion of people with disabilities within the definition of “medically 

underserved populations,” as well as within other relevant categories 

relating to the acknowledgment of disparities in access to health care and 

equal access to research funding and related benefits aimed at 

decreasing health disparities. 

1.20 Prior to approving a state application to implement a managed care 

program, the Center for Medicare & Medicaid Services must conduct a 

state readiness assessment to determine whether the submitting state 

has in place the resources and capacity necessary to effectively 

administer and oversee the proposed managed care program, and to 

hold managed care entities accountable for their performance. The 

readiness assessment must include a review of the state’s plan and 

operational capacity, as well as the requirements set out in the contracts 

between the state and the managed care entities.

1.21 CMS should require states to commission an independent evaluation of 

their managed care programs and make the submission of the findings 

and conclusions growing out of this evaluation a condition of a state’s 

renewal request.

1.22 While federal statutes and regulations have established expectations for 

ongoing quality assessment and performance improvement programs in 

managed care settings, the tools most commonly used for monitoring 

quality in Medicaid managed care are primarily focused on acute care and 
35

are not relevant to the provision of long-term services and supports for 

people with disabilities. CMS must establish a process for ensuring that 

measurement tools that are normed on the various sub-populations 

enrolled in managed care programs encompassing LTSS can be 

employed by states to monitor performance. For example, for the 

intellectual/developmental disability population, National Core Indicators is 

a nationally recognized tool for monitoring quality of LTSS. Performance 

indicators should address key domains such as individual outcomes 

(employment, access to and participation in community life, contact with 

friends and family), participant rights, and family outcomes. CMS must 

ensure that an accessible, disability-competent quality assessment and 

performance improvement process is applied to both Medicaid-only 

managed care arrangements and managed care arrangements relating to 

the dual-eligible demonstration projects authorized under the Affordable 

Care Act. HHS should ensure that its research funding agenda does not 

curtail or exclude investigations that gather data on the impact of 

nontraditional treatment measured against traditional treatments. Choices 

among various evidence-based treatments must remain available for all 

people with physical and/or mental health care needs.

1.23 HHS, placing particular emphasis on the National Institutes of Health, 

Agency for Healthcare Research and Quality, and Health Resources and 

Services Administration, should work to ensure that its disability research 

agenda is aligned with the priorities of the disability community and 

meaningfully includes people with disabilities and the organized disability 

community at every step, from priority setting and grant review to study 

design, data collection, and interpretation of findings. The use of 

Community-Based Participatory Research/Participatory Action Research 

models and the inclusion of people with disabilities in the grant review 

process should both be prioritized toward these ends.
36

Military Health Care 

Active service members, their family members with and without disabilities, returning 

veterans, and veterans of former wars all need reliable and effective health care. 

Difficulties with navigating systems, obtaining timely referrals, and encountering 

shortages of providers, particularly in the area of mental health, can dramatically affect

those in need of services and supports. 

Active Duty Care for Exceptional Family Members (EFM)

For its 2011 report, United States Marine Corps Exceptional Family Members: How to 

Improve Access to Health Care, Special Education, and Long-Term Supports and 

Services for Family Members with Disabilities, NCD collected stories of the experiences 

of the United States Marine Corps community through focus groups and interviews with 

caretakers, family members with disabilities, and service providers at three large bases 

where many EFM families are assigned: Marine Corps Base Quantico, Camp Lejeune, 

and Camp Pendleton.

54 Active service members, their families, and service providers 

told NCD of numerous barriers to meeting health care needs. 

Specifically, EFM participants reported encountering (1) inconsistent processes across 

military locations for obtaining information about health services, (2) a lack of quality 

health care specialists, and (3) difficulty obtaining timely referrals and appointments 

near military installations. Family members with disabilities often go untreated when 

they are denied access to or are unaware of available help. EFM children often face

shortages of pediatric and mental health specialists.55 

Veterans’ Mental Health Needs 

“The statistics are sobering—18 veterans commit suicide each day with 

almost a third receiving care from the Department of Veterans Affairs (VA) 

at the time of their death.... Each month, there are 950 veterans being 
37

treated by VA who attempt suicide. What’s more, data from the U.S. 

Department of Defense indicate service members took their lives at an 

approximate rate of one every 36 hours from 2005 to 2010.” 

—Chairwoman Ann Marie Buerkle, Veterans Committee,

Subcommittee on Health, U.S. House of Representatives56

Five years have passed since the U.S. Department of Defense (DoD) sent a Mental 

Health Task Force Report to Congress in 2007. The task force based its work on the 

vision of transforming military mental health care through four goals: creating a culture 

of support for psychological health; a full continuum of excellent care; sufficient and 

appropriate resources; and visible and empowered leaders.

57 In announcing its 

subsequent corrective action plan, DoD stated, “The department is working to provide a 

comprehensive integrated system of excellence in prevention and care, to meet the 

needs of individual service members and their families throughout the military lifecycle. 

We have a strong partnership with the U.S. Department of Veterans Affairs (VA) and the 

Department of Health and Human Services (HHS) to build a safety net of care for our 

military families.”

58 However, despite plans and efforts, the accounts of unmet mental 

health needs and often devastating outcomes for veterans with disabilities continue. 

While waiting for systems change, litigation can be a viable path by which a number of 

veterans receive the mental health service benefits they require. For example, while 

fulfilling his U.S. Army role in Iraq, a single father of two was in multiple firefights, and 

his vehicle was struck by improvised explosive devices. He was told that he could no 

longer serve in the military owing to his post-traumatic stress disorder (PTSD) and was 

separated from the military with a low disability rating that denied him TRICARE 

benefits. In an historic class action settlement announced in July 2011, he and his 

children were restored their veterans’ health benefits.59 

Congress has also focused much attention on the mental health care of thousands of 

U.S. veterans and their families through a variety of hearings over the past year.60

These hearings, held in the Senate, in the House, and jointly, have highlighted several 

key problems that continue to plague the system, including long wait times for critical 
38

services and significant mental health staffing shortages.61 University researchers 

reported three years ago that a many veterans with service-connected disabilities live in 

rural communities;

62 veterans in underserved areas need professionals and facilities for 

physical and mental health care. The Rural Assistance Center reports that the primary 

barrier facing this rural veterans’ population is the geographic distance from the nearest 

VA health facility.63 In some areas, vacancies for mental health care practitioners 

serving veterans have been as high as 23 percent.64 

In April 2012, the VA announced that roughly 1,600 mental health clinicians—nurses, 

psychiatrists, psychologists, and social workers, as well as nearly 300 support staff--

would be added to the VA’s existing mental health workforce.65 NCD acknowledges 

reports of VA actions to begin this hiring, with completion targeted for the end of 2012, 

and a promise to continue assessing staff needs.66 Also in April 2012,, the VA 

announced it had also expanded its mental health services to include marriage and 

family therapists as well as licensed professional mental health counselors.67 That same 

month, Joining Forces,68 in coordination with the VA and DoD, announced a 

commitment from 150 nursing organizations and 500 nursing schools to further educate 

more than 3 million nurses on the unique health care needs of service members, 

veterans, and their families, with a specific focus on PTSD, traumatic brain injury, 

depression, and other combat-related concerns.

69 

Life Transition Challenges

Some service members transitioning to civilian status develop health care needs that 

affect daily living for them as well as their families, particularly when unmet physical and 

mental health needs surface. In March 2012, the House Veterans’ Affairs Committee’s 

Subcommittee on Disability Assistance and Memorial Affairs held a hearing to examine 

the implementation of the new Integrated Disability Evaluation System (IDES) by DoD 

and the VA. IDES was designed to aid wounded warriors and their families in the 

transition from active duty to veteran status when, as a result of physical or mental 

injuries, a service member’s duty status is at issue. Testimony at the hearing outlined 
39

ongoing problems with lengthy delays and difficulty navigating the system. IDES pilot 

programs significantly decreased the 500-day process time of the system it was 

designed to replace, but once IDES expanded to more locations, its process time 

lengthened to 500 days as well.

70 

Recommendations

NCD recommends: 

1.24 The Department of Defense and the Veterans Administration should 

develop and carry out a plan to ensure continuous availability of physical 

and mental health services for all active service members and veterans. 

The plan must ensure that people with post-traumatic stress disorder and 

traumatic brain injury, which may manifest after leaving the military, have 

ongoing access to mental health services both before and after their 

military separation. 

1.25 DoD and the VA should identify and build upon lessons learned from the 

model of training veterans to become vocational rehabilitation 

counselors, and determine effective ways to apply the principles to 

combat the staff shortages in mental health professionals.

1.26 Tricare should increase the accuracy and timeliness of information 

accuracy and timeliness of information Exceptional Family Members 

families receive from TRICARE by instructing case managers to assist 

families in accessing services, assigning TRICARE case managers to a 

larger proportion of the EFM population, and establishing multiple 

communication mechanisms, including a dedicated TRICARE telephone 

hotline (staffed 24/7) for EFM families, similar to the Medicare hotline.
40

Emergency Management

In 2011, NCD participated in two events that focused on the importance of effective 

communication with people with disabilities before, during, and after an emergency. 

First, NCD collaborated with the Federal Emergency Management Agency (FEMA) 

Office of Disability Integration and Coordination on an inclusive emergency 

preparedness conference titled “Getting Real II,” in September 2011. This conference 

highlighted promising practices in inclusive emergency management. To increase 

participation in the conference and dissemination of the information, the conference was 

webcast via a live stream online.71 In addition to the conference’s 400 attendees (who 

came from 37 states and Guam), 2,826 people viewed the webcast, with 80 percent 

coming via direct traffic and 10 percent international traffic, primarily from Japan, 

Canada, Germany, and the United Kingdom, as well as Africa. 

Also in September 2011, NCD held an all-day meeting with FEMA’s Regional Disability 

Integration Specialists (RDISs), at which the agencies discussed the current state of 

emergency management as well as access for people with disabilities. Later, in 

February 2012, NCD and FEMA’s RDISs held a follow-up conference call to discuss 

NCD’s anticipated effective communication report as well as potential for further 

collaboration between the agencies. 

The lack of enforcement of federal laws affecting people with disabilities is a significant

problem reflected in legal complaints filed. Although DOJ has not reported comparison 

data, readers can access settlement agreements resolving complaint-based 

investigations and compliance reviews online.72 For example, advocates filed a class 

action complaint against New York City for inaccessible evacuation maps, lack of plain 

language to clarify messages across levels of understanding, failure to provide sign 

language interpreters, and other allegations.73 

In addition to the aforementioned events, NCD obtained feedback from stakeholders 

regarding the nationwide November 2011 Emergency Broadcast System test.74
41

At the writing of this progress report, NCD was beginning a comprehensive report 

intended to provide cross-disability perspectives and recommendations for 

communication improvements within emergency management practices. NCD proposes 

to collect information on the experiences of people with disabilities as they relate to 

emergency-related communication; highlight best and promising practices; and 

determine recommendations for how emergency communication accessibility for people 

with disabilities can be improved. NCD is also looking at current disability laws and 

regulations as they pertain to effective communication before, during, and after 

emergencies; the enforcement of these laws and regulations; and whether further laws 

and/or regulations should be pursued. NCD hopes the information in the report will 

motivate and drive emergency planners to improve their ability to provide effective 

communication for people with disabilities,75 and their parents who also are living with 

their own disabilities. NCD anticipates concluding work on this project some time in 

2013.

Recommendations

NCD recommends: 

1.27 The U.S. Department of Justice, in collaboration with the Federal 

Communications Commission as appropriate, must increase the 

enforcement of disability laws and regulations as they pertain to effective 

communication before, during, and after emergencies for people with 

disabilities. Specifically, state and local emergency management officials 

must comply with their effective communication legal obligations. In 

addition, television broadcasters must adhere to laws and regulations 

regarding the accessibility of emergency information.
42

Parenting Rights

There are approximately nine million parents with disabilities in the United States, and that 

number is expected to grow in this century.76 Currently, many states’ child custody laws 

permit a parent’s disability to be an acceptable reason to deny custody or visitation, even in 

instances in which a parent with a disability has successfully parented for years prior to an 

ended relationship or divorce. After repeatedly hearing of these concerns from NCD 

stakeholders and receiving a thorough briefing of the topic at NCD’s regional “Living Forum” 

in Portland, Oregon, in May 2011, NCD embarked on a policy project regarding parenting 

rights of people with disabilities, which will culminate in a report later this year titled Rocking 

the Cradle: Ensuring the Rights of Parents with Disabilities and Their Children.

77

In undertaking this research project, NCD identified several areas on which to focus its 

research and policy recommendations: 

● Overcoming discriminatory presumptions—societal attitudes as well as policies, 

practices, and procedures—that people with disabilities are “unfit” to be parents; 

● Removing barriers to creating families for people with disabilities (reproductive 

health care access, including access to adoption and assisted reproductive 

technologies); 

● Educating health professionals and the general public about challenges to 

parents with disabilities and enforcement of Titles II and III of the ADA; 

● Making available parenting guidance about children with disabilities similar to 

data made available on other special populations; 

● Ensuring that child welfare systems will recognize and assume their legal duty to 

appropriately serve parents with disabilities and their families; and

● Providing funding for supports needed to serve parents with disabilities.
43

People with disabilities continue to experience significant barriers to creating a family 

that their peers without disabilities do not encounter. For example, child welfare 

agencies often do not provide parents with disabilities appropriate accommodations to 

support child rearing. Family courts also make a priori assumptions about people with 

disabilities being unable to raise children simply because of their various disabilities. 

These assumptions often result in denial of child custody and other related rights.78 

In addition, federal agencies omit letters of findings and fact sheets on Web sites that 

can serve as adoption guidance for parents with disabilities. For example, the Office for

Civil Rights at HHS provides letters of findings and agreements with state entities on the 

legal protections for prospective parents of diverse races, colors, and national origins 

seeking to adopt.79 However, it does not give similar guidance concerning the rights of 

prospective adoptive parents with disabilities. 

NCD’s anticipated 2012 publication, Rocking the Cradle: Ensuring the Rights of Parents 

with Disabilities, will seek to improve understanding and promote the rights of parents 

with disabilities and their children. Rocking the Cradle will provide a comprehensive 

review of the barriers and supports people with disabilities experience when exercising 

their fundamental right to create and maintain families. The report will highlight the 

systemic and pervasive discrimination against parents with disabilities. It will provide an 

analysis of how federal disability law and policy applies to parents with disabilities within 

the child welfare system and the family law system and the systems’ disparate 

treatment of parents with disabilities and their children. The report will also review the 

impediments prospective parents with disabilities encounter when adopting, both 

domestically and internationally, and when attempting to access reproductive 

technologies. 
44

Transportation 

“It is hereby declared to be the national policy that elderly and 

handicapped persons have the same right as other persons to utilize mass 

transportation facilities and services; that special efforts shall be made in 

the planning and design of mass transportation facilities and services so 

that the availability to elderly and handicapped persons of mass 

transportation which they can effectively utilize will be assured; and that all 

Federal programs offering assistance in the field of mass’ transportation 

(including the programs under this Act) should contain provisions 

implementing this policy.” 

—Urban Mass Transportation Act of 1970)80

Recommendations

NCD recommends: 

1.28 The U.S. Department of Justice should issue guidance to family courts 

on their legal obligations pursuant to the Americans with Disabilities Act.

Such guidance must address (1) the applicability of the ADA to custody 

and visitation proceedings, (2) the courts’ duty to provide reasonable 

accommodations to parents with disabilities, and (3) per se presumptions 

of parental incompetence based on disability that violate the ADA.

1.29 The U.S. Department of Health and Human Services and DOJ should 

gather annual data on parents with disabilities and their interaction with 

child welfare and dependency court systems. Such data must include 

(1) disability, (2) exact involvement, (3) services and reasonable 

accommodations provided, and (4) outcome.
45

Billy Altom, executive director of the Association of Programs for Rural Independent 

Living, cited the statutory language from the Urban Mass Transportation Act of 1970 

when he testified at a Senate hearing on challenges and opportunities to accessible 

transportation for people with disabilities. He said, “The above 1970 statutory language, 

establishing national transportation policy, was written 20 years before the 

1990 Americans with Disabilities Act (ADA). We need to use the 1970 Transportation 

Act’s words as a challenge and a reminder of promises to keep.”

81

Indeed, transportation continues to be one of the most critical challenges for Americans 

with disabilities. Whether to school, to the office, the gym, or the grocery store, “getting 

there” is the necessary first step to participating in activities that positively influence 

one’s quality of life. Still, for millions of Americans with disabilities, the question “How 

will I get there?” remains unanswered. There is no doubt that transportation is one of 

the most critical and cherished elements of modern independent living. Urgent attention 

and progressive campaigns to increase integrated access are critical.

Ground Transportation

Ground transportation is essential for everyone to access jobs, recreation, shopping, 

friends, and family. Consistently positive, accessible transportation experiences are 

often indicative of coordination and collaboration among passengers, public and private 

transportation providers, human service agencies, and a variety of funding sources. 

However, too often, these elements are not coordinated, and resulting barriers to 

access confound people’s efforts to find and maintain employment, social integration, 

and full participation. 

People with disabilities who move to cities may do so in part to take advantage of public 

transit; those who live in suburban, rural, or remote areas without access to public 

transportation options may face isolation. However, even for people with disabilities who 

live in urban centers, subways, buses, paratransit, taxis, and limousine services often 

require many improvements to be fully accessible. 
46

Subway construction and renovations are not routinely carried out with accessibility in 

mind. The results are new or renovated stations that fail to include necessary elevator 

access or do not extend access to the platform.82 Repeatedly, elevators in existing 

subways are closed for safety or mechanical reasons. Gaps between platforms and the 

trains may prevent passengers using wheelchairs from entering trains even if they make 

it to the platform level.

Paratransit systems continue to be riddled with problems, including overall scarcity, 

monumental delays, fare increases, driver failure to assist when needed, and service

eliminations due to budget cuts. The net result of many of these problems is at best 

significant delays for some passengers whose busy schedules are regularly 

compromised; and at worst, being left completely stranded and isolated due to 

eliminated service. 

Private urban transportation systems, including taxis and limousines, are equally 

unworkable and continue to operate without cross-coordination. People with disabilities 

who use service animals are routinely denied access altogether. While London taxis are 

100 percent accessible, the New York City (NYC) fleet of more than 13,000 taxis has

fewer than 250 accessible cabs; and but for litigation, NYC’s proposed “green” taxi fleet 

would reduce that number to zero.83 

In September 2011, the U.S. Department of Transportation (DOT) issued a final rule on 

transportation for people with disabilities at intercity, commuter, and high-speed 

passenger rail station platforms, which became effective a month later.

84 The rule 

requires that full-length, level-entry boarding be available at new or altered commuter, 

intercity, and high-speed station platforms where no tracks are shared with freight.85

However, where a station is shared with freight, the performance standards are more 

flexible. If the station cannot provide full-length level-entry boarding, the rule permits 

car-borne lifts, station-based lifts, or mini-high platforms once its plan for meeting the 

performance standard is approved by the Federal Transit Administration or Federal Rail 

Administration.86 The rule also removes the definition of a “common wheelchair” from 

the regulation, as the original concept had come to be applied to exclude certain 
47

wheelchairs even if train cars and equipment could accommodate them.87 Although the 

disability community was overall quite pleased with the positive developments in the 

final rule, many have voiced frustrations with the freight industry’s rejection of levelboarding platforms, and with questions regarding DOJ’s level of jurisdiction in enforcing 

the new provisions. 

Public Rights-of-Way 

On the 21st anniversary of the ADA, the Architectural and Transportation Barriers 

Compliance Board issued proposed guidelines for accessible public rights-of-way and 

held two hearings on the guidelines in October and December 2011, during the open 

comment period.88 The proposed guidelines address sidewalks, pedestrian signals and 

crosswalks, and other pedestrian facilities so that their design, construction, or alteration 

ensures that they are readily accessible to and usable by people with disabilities. The 

comment period for the proposed guidelines closed in February 2012. 

Air Travel 

Intercity and international travel pose equal difficulties for passengers with disabilities. 

The Air Carrier Access Act (ACAA) prohibits discrimination by domestic and foreign 

airlines against passengers with disabilities and applies across the entire flying 

experience, from reservations, boarding, and deplaning to the way mobility devices are 

handled.89 However, a lack of personnel training has contributed to ongoing 

discriminatory experiences. In fact, the number of complaints filed with the Aviation 

Consumer Protection (DOT) alleging discrimination against people with disabilities who 

are using airlines has increased in the past two years.90 Security checkpoints are often 

at a loss for how to deal with passengers with disabilities. 

In November 2011, NCD Chairman Jonathan Young presented at an ACAA 25th

anniversary event, held in collaboration with DOT and the Airline Transport Association.

Young cited evidence of progress shown through recent DOT initiatives that address 
48

issues of access for people with disabilities in U.S. airports to tickets, kiosks, and 

foreign travel.91 However, while acknowledging progress, Young told participants that 

people with disabilities continued to be at the mercy and discretion of airlines, and that 

more improvements were needed. 

Despite progress made by DOT to address areas needing improvement, people with 

disabilities continue to report frustrations with basic accommodations, access, staff 

training, broken equipment, unequal treatment, disrespect, and overall negative 

attitudes displayed by many airport employees.92 In addition, as seen in three DOT fines 

imposed on airlines to date, many of these disability-based complaints are not properly 

reported.

93

In 2011, NCD met with representatives of the Transportation Security Administration 

(TSA) to discuss concerns of air travelers with disabilities regarding security screenings.94

As a result, TSA formed an Integrated Product Team to conduct an extensive review of 

the sections of the Screening Checkpoint Standard Operating Procedures that apply to 

people with disabilities and medical conditions. Additionally, the team is collaborating with 

TSA’s Office of Technical Training on a complete redesign of the training curriculum for 

serving passengers with disabilities. NCD applauds TSA for launching the TSA Cares 

hotline for airline passengers with disabilities and special medical needs. Passengers can 

also now request a TSA official to answer airport screening questions.95

Other Transportation Accessibility Challenges

The final transportation frontier for people with disabilities lies in America’s suburbs, 

rural, and remote areas. People with disabilities who are forgotten time and again include 

Alaska Natives and some members of tribal communities on pueblos, rancherias, and 

reservations in need of viable road systems, as ground transportation, and air travel. 

More than a decade has passed since a key NCD report emphasized that inaccessibility 

of transportation is not limited to vehicular barriers. Examples include inaccessibility of 
49

print-only maps, timetables, signage, announced-only delay or detour information, and 

fare and ticket machines.96 The breadth of problems related to transportation and the 

degree to which they affect the quality of life for Americans with disabilities will require 

strong inquiry and modification. 

United Nations Convention on the Rights of Persons with Disabilities 

(CRPD) 

The CRPD was adopted as a response to the reality that while existing human rights 

conventions offer considerable potential to protect the rights of people with disabilities, 

this potential was not being realized. Around the globe, people with disabilities are still 

denied basic human rights and kept on the margins of society. 

The CRPD sets out legal obligations to promote and protect the rights of people with 

disabilities. It was created, in part, to address an overlooked development challenge.

Approximately 10 percent of the world’s population is people with disabilities (more than 

Recommendations

NCD recommends: 

1.30 Congress should conduct a hearing to examine the experiences of air 

travelers with disabilities, industry best practices, and enforcement 

activities by the U.S. Department of Transportation; and develop 

corrective actions to make nondiscrimination in air travel a reality. 

1.31 The Transportation Security Administration should enforce compliance 

with its security screening policies and procedures to ensure the 

accessibility of aviation security screenings for all people with disabilities, 

including wheelchair users and people with invisible disabilities. 
50

650 million people), approximately 80 percent of whom live in developing countries.97 The 

CRPD seeks to shift the focus away from the perception of people with disabilities as 

“objects” of charity, medical treatment, and social protection toward recognizing them as 

“subjects” with rights, who are capable of claiming those rights and making decisions about 

their lives with informed consent as engaged, valuable, and active members of society.98

As of April 2012, there have been 110 ratifications and 153 signatories to the CRPD. To 

date, there have also been 63 ratifications of the Optional Protocol, including 

90 signatories. The international disability community is embracing the new legal 

framework in the CRPD. NCD continues to recommend that when the Senate receives

the ratification package, it expeditiously consents to ratify the CRPD. The CRPD 

provides the United States with a tool to promote nondiscrimination and equality for 

people with disabilities worldwide.

In addition, the current Disability Policy of the U.S. Agency for International 

Development (USAID), drafted in 1997, is outdated and provides minimal guidance on 

how USAID programs can be made inclusive across all sectors of its development 

portfolio. A review and revision of the 1997 policy should also redouble efforts to ensure 

inclusion in all programming and provide specific, concrete, and achievable guidance to 

USAID personnel and implementing partners. An emphasis on training that reaches 

USAID personnel in Washington, as well as in missions around the world, is clearly 

needed. The development of disability indicators to enrich the monitoring and evaluation 

of USAID’s programs is likewise timely.

In June 2010, the Obama Administration created a new position, the Special Advisor on 

International Disability Rights, within the U.S. State Department (DOS) to further its 

commitment to supporting the CRPD. The purpose of the Special Advisor is to “include 

issues affecting people with disabilities across the world in all aspects of [DOS] work.”

99

NCD commends this appointment and recommends that DOS provide adequate 

resources to achieve the objectives of that office, such as providing proper staffing and 

finances for the office and promoting agency-wide coordination.
51

Recommendations

NCD recommends: 

1.32 The United States should expeditiously ratify the UN Convention on the 

Rights of Persons with Disabilities. 

1.33 The U.S. Agency for International Development should review and 

update its Disability Policy. 

1.34 USAID should provide adequate resources for the Coordinator on 

Disability and Inclusive Development. NCD recommends that USAID 

provide ample resources for the Coordinator on Disability and Inclusive 

Development to advance implementation of the USAID Disability Policy. 

USAID should provide proper staffing and finances for this work and 

should promote agency-wide coordination. Additionally, USAID should 

promote interagency coordination between this office and DOS to 

promote disability inclusion in all international diplomacy and 

development work. 

1.35 Congress should instruct USAID, the Department of State, the 

Department of Defense, as well as other U.S. agencies operating 

overseas to promote greater comparative knowledge and understanding 

of local disability law and policy frameworks, including the status of 

CRPD ratification in countries receiving foreign assistance.

1.36 DOS should provide adequate resources for the Office of the Special 

Advisor on International Disability Rights to promote disability inclusion in 

all aspects of DOS work. 
52
53

CHAPTER 2.Learning

Introduction

Students with disabilities in the 21st century face persistent barriers to a free 

appropriate public education, despite the protections in the Individuals with Disabilities 

Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973. Schools in 

which students with and without disabilities learn side by side are essential to quality 

educational outcomes for all students. Disability-specific or segregated charter schools 

for students with disabilities are contrary to the social, civic, and educational advances 

embraced by IDEA and other seminal education reforms. Education must move forward, 

and not return to the failed segregation practices of decades past. 

NCD’s Experts Symposium and Town Hall on Education Reform

In March 2012, NCD hosted an Experts Symposium titled “Raising Expectations: A 

Disability Framework for Education Reform,” in Orlando, Florida. The symposium 

brought together approximately 30 experts from general and special education to 

discuss the effect of a variety of education reforms on students with disabilities and 

assist NCD in the development of a policy toolkit that state departments of education, 

legislatures, and local school districts can use to help evaluate education reforms for

students with disabilities. Each expert participant was a part of a working group that 

delved into specific aspects of education reform. Working groups included “Common 

Core and Access to the General Curriculum,” “Vouchers and Charter Schools,” and 

“Graduation Outcomes and Assessment Tools.” 

Expert participants came from 12 states and represented a variety of perspectives, 

based on personal and professional experiences, which greatly enriched the 

discussions. Participants included current or former general education or special 

education teachers, principals, school superintendents, parents of students with 
54

disabilities, academics and researchers, assessment developers, think thank analysts, 

employees of state departments of education, and school board members. 

Representatives from the Council of State Governments, the Parent Teacher 

Association, and the U.S. Department of Education (ED) also participated. 

Directly following the Experts Symposium, NCD hosted a town hall for people with 

disabilities in the Orlando area. NCD members heard from a number of parents of 

children and adults with disabilities, who expressed a grave disconnect between 

nonprofits, school systems, and state government agencies that provide services to 

people with disabilities and their families. Some expressed dismay that budget cuts 

often disproportionately affect people with disabilities and devastate their lives, giving 

voice to a widespread belief that short-term fixes should not be pursued without serious 

evaluation of the long-term consequences. NCD also heard from several service 

providers who summarized the services and supports their organizations offer, including 

parent training, transition services, group housing, and staffing services. They also 

identified barriers that hinder service delivery. 

Education Reforms

Although significant achievement gaps persist between students with and without disabilities, 

as captured in the National Assessment of Educational Progress, disability advocates are 

quick to acknowledge the significant gains students with disabilities have made under 

NCLB/Elementary and Secondary Education Act (ESEA) due to a focus on subgroup 

accountability. As legislative and policy proposals emerge around ESEA reauthorization as 

well as assessment tools linked to the rollout of the Common Core State Standards,100

reforms and envisioned “flexibility” should never compromise subgroup accountability. 

Common Core State Standards

In June 2010, the National Governors Association Center for Best Practices and the 

Council of Chief State School Officers released the Common Core State Standards 
55

(CCSS). These are common standards for all students in English/language arts and 

math designed to align with college and career expectations; internationally 

benchmarked; evidence-based; and focused on critical thinking, problem solving, and 

collaboration. The CCS have been adopted by 46 states to date, and are set for 

implementation by 2014.101 With a greater focus on individualized learning needs, the 

CCSS include several affirmative statements on the necessity of instruction 

incorporating appropriate supports and accommodations for students with disabilities:

“The Standards should also be read as allowing for the widest possible 

range of students to participate fully from the outset and as permitting 

appropriate accommodations to ensure maximum participation of students 

with special education needs. For example, for students with disabilities 

reading should allow for the use of Braille, screen-reader technology, or 

other assistive devices, while writing should include the use of a scribe, 

computer, or speech-to-text technology. In a similar vein, speaking and 

listening should be interpreted broadly to include sign language.”

102

However, the CCSS have a caveat about items deemed outside their scope, while 

remaining resolute that all students must have the same opportunities to meet high 

standards:

“The Standards set grade-specific standards but do not define the 

intervention methods or materials necessary to support students who are 

well below or well above grade-level expectations. It is also beyond the 

scope of the Standards to define the full range of supports appropriate for 

English language learners and for students with special needs. At the 

same time, all students must have the opportunity to learn and meet the 

same high standards if they are to access the knowledge and skills 

necessary in their post-school lives.”

103

Since the release of the CCSS, attention has shifted to how the standards will be taught 

and assessed. In 2010, ED announced winners of the Race to the Top Assessment 
56

competitive grants to develop a “new generation of tests” in mathematics and English 

Language Arts/Literacy aligned with the CCS.

104, Winners include the Partnership for 

Assessment of Readiness for College and Careers (PARCC), a 26-state consortium

with Florida as fiscal agent and Massachusetts as board chair; and the SMARTER 

Balanced Assessment Consortium (Smarter Balanced), a 31-state consortium with 

Washington state as both fiscal agent/board chair.

105 At the time of the announcement, 

ED Secretary Arne Duncan stated that the assessments developed around the CCSS 

will be designed from the start to assess students with disabilities, rather than retrofitting 

the assessments. Following the announcement, ED officials confirmed that there will be 

no need for alternate assessments based on modified achievement standards for 

students with disabilities (commonly referred to as the “2 percent tests”); however, the 

so-called “1 percent assessment,” used with students with the most significant cognitive 

disabilities, will be aligned to the CCSS through a separate assessment development 

competition.

106 According to a May 2012 ED press release, the new assessment 

systems are on track for implementation in the 2014–15 school year.107

While having to wait to review the general assessments under development and the 

1 percent assessment yet to be developed, one disability group aptly summarized many 

of the other unresolved questions for students with disabilities this way: “Will the CCSS 

change what special educators need to know? Will the CCSS lend themselves to 

modifications for learning profiles without minimizing expectations? How will important 

access and transition skills be integrated into the teaching schedule?”

108 Although these 

and other questions persist, the CCS Initiative insists that promoting a culture of high 

expectations is a goal for all students, including those with disabilities. Accordingly, the 

CCSS Initiative states that students with disabilities may be provided additional supports 

and services, such as instructional supports based on Universal Design for Learning, 

instructional accommodations. assistive technology, and other supports and services 

that “ensure that students receive access to multiple means of learning and 

opportunities to demonstrate knowledge, but retain the rigor and high expectations of 

the Common Core State Standards.”

109
57

In April 2012, NCD participated in a Council of State Governments focus group meeting 

on “Deeper Learning”

110 to explore how instruction, assessments, accountability, teacher 

and leader effectiveness, and technology should change to increase students’ economic 

opportunities and civic engagement through education. NCD will continue to contribute to 

these and other policy discussions surrounding the CCSS as opportunities arise. 

Charter Schools 

Approximately 5,000 publicly funded, privately run charter schools across the country 

operate apart from the conventional public school system and are administered 

independently under a contract, often with a public school board. The contract typically

articulates each school’s unique mission, goals, success metrics, and modes of 

assessment.111 Charter schools are regulated and financed quite differently from state 

to state. They are afforded a great deal of autonomy in the name of innovation and 

competition, but because many operate outside a traditional framework, they are ill

equipped to serve students with disabilities, which in turn creates a loophole decried by 

many disability advocates. 

Recommendations

NCD recommends: 

2.1 The adoption of the Common Core State Standards by most states 

provides a unique opportunity to improve access to the general 

curriculum through the principles of Universal Design for Learning and 

differentiated instruction. Schools should improve meaningful access to 

the general curriculum for all students, and state and federal 

policymakers should reject policies that exempt students from 

standardized testing on the basis of their disabilities.
58

Policy discussions have begun to focus intently on whether and how well the charter 

school movement is being held accountable for students with disabilities. Accountability 

for the performance of each student with a disability is a requirement under both IDEA

and ESEA. State laws can grant charter schools flexibility in meeting state or local 

education regulations or policies, but charter schools must comply with all federal laws 

that apply to any other public school.112

However, because charter schools do not design a comprehensive plan to educate 

students with disabilities as school districts do, the Individualized Education Plan (IEP) 

of a student with a disability will likely deter that student from attending a charter school, 

which views it as an inappropriate placement because it has not been set up to

implement IEPs and serve students with disabilities.113 As a striking example of this 

phenomenon, a recent analysis of K–12 data on students with disabilities in 14 school 

districts in Florida, which represent more than three-fourths of Florida’s total charter 

enrollment, revealed the following information about students with significant disabilities 

(including students with Down syndrome, cerebral palsy, and autism):114 

● More than 86 percent of those charter schools do not serve even one student 

with a significant disability compared to more than half of school districts that do. 

● In a school district that serves more than 1,000 students with significant 

disabilities, only one was enrolled in a charter school. 

● There are no students with significant disabilities in charter schools in the 24thlargest school district in the country. 

● Most students with significant disabilities are enrolled in charter schools that 

specialize in particular disabilities.115

Since under federal law every eligible student with a disability is entitled to a free, 

appropriate public education in the least restrictive environment, publicly funded charter 

schools should not create separate or segregated schools for students with disabilities.
59

NCD recognizes a role for state policies on charter schools in the education reform 

movement, including school choice. At the same time, such schools should comply with 

federal provisions that protect the rights of children with disabilities to be educated in the least 

restrictive environment. Charter schools are public schools and bear responsibility to make a 

free, appropriate public education available to all students with disabilities. Charter schools 

need to be open and available on an equal basis to all students, without segregation. 

Recommendations

NCD recommends: 

2.2 Ensuring that students with and without disabilities will learn side by side is 

the cornerstone of inclusive, integrated education. Developing, 

emphasizing, or launching disability-specific or segregated charter schools 

for students with disabilities runs contrary to the social, civic, and 

educational advances ensured by the Individuals with Disabilities 

Education Act and other seminal education reforms. Education must move 

forward, not return to the failed segregation practices of decades past.

2.3 Congress should amend IDEA to ensure the guarantee of a free and 

appropriate public education in the least restrictive environment (LRE) for 

students with disabilities attending charter schools. In particular, Congress 

and the U.S. Department of Education should clearly communicate that 

schools oriented around specific disabilities or segregated on the basis of 

disability status violate the LRE rights of students with disabilities. 

Furthermore, IDEA must clearly mandate that the obligation to provide free 

appropriate public education, including related services and identification 

of children with disabilities, is not diminished for charter schools, including 

charter schools acting as their own local education authority.
60

Vouchers

A recent publication reported that nearly 30,000 students with disabilities in eight states 

across the country use vouchers or scholarships to attend private schools with 

programs specifically designed for children with special needs.

116 These school choice 

programs exist in Arizona, Florida, Oklahoma, and Utah, with Arizona, Florida, Georgia, 

Louisiana, North Carolina and Ohio, (Arizona and Ohio each operate two programs. .

117

Vouchers and “school choice” scholarships are a method of education finance, paid for 

by public (and sometimes private) dollars, by which families are given a tuition 

certificate to apply toward attending a participating private school. Vouchers allow 

parents maximum choice in deciding how the public money for their students’ education 

will be spent. Eligibility for vouchers depends on such things as disability, a family’s 

income level, and the failure of the home school. 

For nearly a decade, NCD has considered the effect of school vouchers on the 

experiences and outcomes of students with disabilities118 and has elevated several

areas of concern. Chief among these is that once students with disabilities use a voucher 

to attend a private school, they and their family relinquish rights under IDEA, including a 

parent’s right to participate in meetings about his or her child’s education and in hearings 

about how and whether a school is meeting a student’s educational needs. 

In addition, the dollar amount of vouchers frequently covers only a portion of costs 

associated with special education, which can leave a large amount of the private school 

tuition unaccounted for. This may have the effect of excluding lower-income families who 

may not be able to supplement remaining costs. In addition, and as recent reports continue 

to find, some private schools have policies or reputations for not accepting students with 

the most significant disabilities, which further marginalizes certain students with disabilities. 

2.4 Congress should amend the Elementary and Secondary Education Act to 

put in place clear standards for charter school authorizers.
61

Finally, there has not been a demonstrable commitment to the IDEA principle of 

accountability for results. In fact, the nation’s largest organization promoting “school 

choice” programs recently compiled data on accountability provisions in existing special 

education school vouchers programs, and the header of “academic accountability,” 

broken into “standardized assessment,” “public reporting of results,” and “independent 

evaluation,” indicated that none of the nation’s special education voucher programs had 

any public reporting of results or independent evaluation, and only two (and one with a 

caveat) had any standardized assessment.119 

Recommendations

NCD recommends: 

2.5 Some states currently offer or are considering providing publicly funded 

vouchers or scholarships to students with disabilities to help pay private 

school tuition. Receipt of public funds, vouchers, or scholarships should 

not require students with disabilities to surrender their rights under the 

Individuals with Disabilities Education Act or the Americans with 

Disabilities Act. Schools that receive public funds should be required to 

publish assessment scores, graduation rates, and other outcome data of 

students with disabilities. Vouchers should not be used to create a 

publicly financed (in whole or in part) segregated educational system for 

students with disabilities.

2.6 The U.S. Department of Education and the U.S. Department of Justice 

should issue a letter to clarify civil rights violations that may be linked to 

creating a publicly financed (in whole or in part) segregated educational 

system for students with disabilities; vouchers should not be usable for 

schools segregated on the basis of a specific disability or disability status 

more generally.
62 

Elementary and Secondary Education Act (ESEA)

No Child Left Behind Waivers

After the U.S. Department of Education (ED) announced its intention to offer waivers to 

states for key provisions of NCLB120 in return for state adoption of various college- and 

career-ready standards and teacher evaluations, NCD met with key ED leaders, including 

Secretary Arne Duncan and Assistant Secretary for Special Education and Rehabilitative 

Services Alexa Posny, as well as staff in the Senate Health Education Labor and 

Pensions Committee, to discuss the development. Following those meetings, NCD issued 

a letter to Secretary Duncan supporting “flexibility for reform” in principle, but asked ED to 

ensure that the flexibility not compromise the accountability provisions, teacher quality 

provisions, and data partitioning under which students with disabilities have made great 

strides under NCLB.121 In February 2012, ED updated “ESEA Flexibility – Review and 

Guidance”

122 available on its Web site, for states and reviewers considering waiver 

applications. NCD commends ED for sharing this information, which addresses the 

impact of proposed waivers on students with disabilities if waivers are granted. 

As of the time of the writing of this report, 11 states had been granted waivers in the first 

round of applications, and 26 additional states had submitted applications for the 

second-round consideration.123 

Recommendations

NCD recommends: 

2.7 Congress should ensure that any revisions, repeals, or amendments to 

the Elementary and Secondary Education Act refrain from removing 

safeguards provided consistently with civil rights laws such as the 
63

Addressing Disparities in Underserved Populations

A number of underserved subgroups within the population of students with disabilities 

often experience discriminatory policies and practices in compounded ways. Such 

subgroups include, but are not limited to gender, racial, ethnic, and language minorities, 

and students with disabilities in the foster care system. NCD has a long-standing policy 

of outreach to diverse people with disabilities, through forums, quarterly meetings, and 

opportunities to provide written comments. NCD has a record of extending invitations 

and receiving stakeholder input on issues affecting underserved children and youth.124 

According to a previous NCD report,125 a considerable number of children and youth in 

the foster care system have disabilities and other diverse characteristics. In November 

2011, as part of the implementation of the Fostering Connections to Success and 

Increasing Adoptions Act of 2008,126 ED and HHS convened a summit titled “Child 

Welfare, Education and the Courts: A Collaboration to Strengthen Educational 

Successes of Children and Youth in Foster Care.”

127 Its goal was to encourage 

Individuals with Disabilities Education Act, Section 504 of the 

Rehabilitation Act, and the Americans with Disabilities Act. 

2.8 Congress and the U.S. Department of Education should look to the 

ESEA reauthorization process and the ESEA Flexibility Waiver process 

as an opportunity to promote methodologies, such as Universal Design 

for Learning, that expand access to the general education curriculum for 

students with and without disabilities.

2.9 Congress should ensure that students with disabilities are fully included 

within ESEA’s accountability infrastructure, moving to eliminate the 

2 percent modified assessment category and reform the 1 percent

alternative assessment category.
64

educational stability and improve educational outcomes for children in foster care. State 

teams composed of education, child welfare, and judicial branches participated and

were charged with creating a plan for cross-system collaboration.128 

Bullying Prevention 

All students, with and without disabilities, who experience bullying are familiar with the 

negative emotional, educational, and physical consequences.129 However, students with 

disabilities are often disproportionately affected by bullying. Despite this, there is little

research and policy specifically focused on the elimination of bullying of students with 

disabilities. Much of the current data specific to bullying of students with disabilities is 

collected at the state or local level, and the picture it paints is a disturbing one of frequent 

and targeted bullying. The 10 studies that have been conducted in the United States specific 

to bullying of students with developmental disabilities all found that such students were two 

to three times more likely to be bullied than students without developmental disabilities.130 

Students with disabilities must be included on an equal basis with other protected 

classes in bullying prevention efforts undertaken as part of general education laws and 

policy initiatives.131 This includes policy discussions regarding the impending 

reauthorization of ESEA as well as bullying prevention efforts of the Health Resources 

and Services Administration and the ED Office for Civil Rights. In addition, it is necessary 

to consider utilizing the IEP process as well as IDEA’s guarantee of a free and 

appropriate public education in the least restrictive environment to strengthen and 

increase ant bullying measures.

NCD commends ED and HHS for their March 30, 2012, announcement about the 

revitalization of a collaborative Web site for bullying prevention. The enhanced Web site 

(www.stopbullying.gov) with suggested action steps was a joint agency response to the 

March 2011 White House conference on Bullying Prevention in which NCD participated 

and the September 2011 Partners in Bullying Prevention Summit. NCD is co-hosting the 

third annual Federal Partners in Bullying Prevention Summit August 6–7, 2012, spear-
65

headed by the U.S. Department of Education’s Office of Safe and Healthy Students, in 

conjunction with the departments of Justice, Health and Human Services, Defense, 

Agriculture, the Interior, the Federal Trade Commission, and the White House Initiative 

on Asian Americans and Pacific Islanders.

Recommendations

NCD recommends: 

2.10 All federal agencies should include disability in their data collection on 

bullying, victimization, violence, harassment, and hate crimes.

2.11 Congress should consider supplementing existing nondiscrimination laws, 

such as the Americans with Disabilities Act, Title IX, and the Civil Rights 

Act of 1964, with an explicit private right of action aimed at holding schools 

accountable for severe, persistent, and pervasive bullying and harassment. 

2.12 The U.S. Department of Education should include the Equal Employment 

Opportunity Commission as a critical stakeholder in federal bullying 

prevention efforts and issues surrounding workplace bullying.

2.13 The U.S. Department of Justice and the Federal Bureau of Investigation 

should work collaboratively on fighting hate crimes against people with 

disabilities in all settings. 

2.14 Congress should include in the Elementary and Secondary Education Act

reauthorization and other applicable laws and procedures a requirement 

that parents be notified when their child is either victim or perpetrator in an 

incident of bullying or harassment. 
66

Seclusion, Restraints, and Aversives

The use of seclusion, restraints, and aversives in educational settings has received 

increased national attention in recent years and rightly continues to galvanize the 

disability community. Families and local news reports frequently cite chilling accounts of 

students with disabilities being choked, confined, pinned down, or otherwise hurt by 

adults they are supposed to trust. 

While unable to determine whether allegations were wide spread, Congressional 

testimony of the U.S. Government Accountability Office (GAO) in 2009 cited hundreds 

of cases of alleged abuse and death tied to seclusion and restraint methods used on 

students in public and private schools and in treatment centers.132 The testimony also 

noted that no federal agency or other entity seems to collect information on the 

incidence of seclusion and restraint and its effects, nor do the states uniformly restrict

the practice.133 Alarmingly, thorough examination of several cases showed patterns of 

parents not being aware of nor giving consent to the practices used on their children; 

children who received these punishments not having displayed physical aggression 

prior to receiving them; and a lack of consequences for teachers who used these 

practices.134 Following the GAO report and a number of disability groups keeping 

focused attention on the topic at the federal level through reports and advocacy, 

bipartisan legislation135 was introduced in the last Congress that eventually passed the 

House but did not pass the Senate. Similar legislation has been reintroduced136 in both 

the House and the Senate in the 112th Congress. 

2.15 ED’s Office of Special Education and Rehabilitative Services should 

expand technical assistance on how to utilize the Individualized Education 

Plan to protect students with disabilities from bullying and harassment and 

effective ways to address bullying behaviors that may be linked to a 

disability.
67

Shortly after the 2009 heightened attention to the topic in Congress and elsewhere, ED 

Secretary Arne Duncan wrote the Chief State School Officers, urging them to review and 

revise or develop state policies regarding restraint and seclusion.137 A short time later, ED 

wrote the original sponsors of the legislation from the 111th Congress and shared a 

number of principles it believed Congress should consider in legislation,

138 including an 

emphasis on data collection. In March 2012, summary data captured during the 2009–

2010 academic year in ED’s Civil Rights Data Collection (CRDC) shows that while 

students with disabilities represented only 12 percent of the students in the CRDC 

sample,139 they constituted 69 percent of the students physically restrained by adults in 

their schools.140 The summary data shows that of the total 38,792 students represented 

who were subject to physical restraint, 26,766 of them, were students with disabilities.141

When the data is further parsed for demographic subpopulations, additional disparities 

emerged. For instance, while African-American students represent 21 percent of students 

with disabilities overall, they constitute 44 percent of students with disabilities subjected to 

mechanical restraints.142 Even though the more comprehensive data report had not been 

released as of the time of the writing of this report, this data clearly shows that claims of 

the incidence of seclusion and restraints and its disparate use on students with disabilities 

are not merely anecdotal, and that calls for decisive action from ED and Congress are not 

baseless. 

The use of aversive “treatments” has also gained great public attention in the past year, 

with media attention focused on the use of electric shock and other aversive techniques 

on students with disabilities by the Judge Rotenburg Center (JRC) in Canton, 

Massachusetts, a residential school for students with disabilities. NCD has a long 

history of opposition to aversive treatments143 as contrary to the letter and spirit of the 

ADA and the DD Act, and at odds with findings of mental health and developmental 

disability research.144 The use of aversive measures on people without disabilities is 

already recognized as illegal and immoral. 

The Massachusetts Department of Developmental Services recently adopted 

regulations that greatly restrict the use of intentional pain as a form of treatment, by 
68

preventing the use of contingent electric shock for new students entering JRC, but JRC 

is still permitted to use aversive treatment on students with disabilities who were 

previously admitted. NCD views the issue as one of national importance, because

students from multiple states and the District of Columbia attend JRC and are 

potentially subject to such treatment. In April 2012, NCD sent a letter to DOJ’s Disability 

Rights Section of the Civil Rights Division, urging DOJ to expedite its investigation of 

JRC and issue its findings.145 

NCD commends the Senate HELP Committee chaired by Senator Harkin for its July 

2012 public hearing on seclusion and restraint. Along with other stakeholders, NCD 

looks forward to follow-up congressional actions that promote positive behavior and 

environments for all students.146

Youth Transitions 

A 2010 policy publication, Future of Children, states that the most important markers of 

adulthood are now considered to be completing school, establishing an independent 

household, and being employed full time.147 Yet the sparse data available on people 

Recommendations

NCD recommends: 

2.16 Congress should act swiftly to pass S. 2020/H.R. 1381, the Keeping All 

Students Safe Act.

2.17 The Department of Justice should move swiftly to follow up on its open 

investigation of the Judge Rotenberg Center and work to close the 

facility, ending contingent electric shock for existing students as well as 

supporting the state’s ban on the practice for incoming students. 
69

with disabilities indicates that many of them have less success with those markers. 

During a decade-long longitudinal study (1999–2009), the high school dropout rate 

remained high across all youth, including students with disabilities. However, the 

percentage of high school dropouts in 2009 among 16- to 24-year-olds with disabilities 

was twice as large (15.5 percent) as that of their peers without disabilities 

(7.8 percent).148 Because the markers of establishing an independent household and 

being employed full time seem conjoined, NCD’s recommendation to blend federal

funds for coordinated service delivery, first introduced in 2010, warrants restatement.149 

Recommendations

NCD recommends: 

2.18 Congress should authorize and mandate the development and 

implementation of coordinated serve delivery approaches specifically 

targeted to transitioning youth with disabilities that are based on 

“blending” of funds (e.g., Vocational Rehabilitation, other Workforce 

Investment Act programs, special education, postsecondary education, 

Veterans Administration, Social Security Administration, and other 

appropriate funding agencies).

2.19 Congress should pass the TEAM (Transitioning toward Excellence, 

Achievement and Mobility) Acts (H.R. 602, 603, and 604) aimed at 

developing a comprehensive national infrastructure to support the 

transition of youth with significant disabilities.
70

Higher Education Act

Accessible Instructional Materials 

In 2011, NCD served on the National Commission on Accessible Instructional 

Materials for Postsecondary Students with Disabilities (AIM). Per the Higher 

Education Act (reauthorized in 2008), ED convened the body and served as lead 

agency.150 The AIM Commission’s charge was to study the state of accessible 

materials for students with disabilities in postsecondary education and make 

recommendations to the ED secretary and the relevant authorizing committees in 

Congress. The AIM Commission’s December 2011 report offers pointed 

considerations for improving access to and distribution of instructional materials in 

accessible formats.151

Recommendations

NCD recommends: 

2.20 Congress should authorize the United States Access Board to establish 

guidelines for accessible instructional materials that will be used by 

government, in the private sector, and in postsecondary academic 

settings. 

2.21 Congress should consider incentives to accelerate innovation in 

accessibility by publishers and producers of course materials, hardware, 

and software by offering support and inducements for the production, 

sale, and consumption of accessible instructional materials and delivery 

systems.
71

Inclusion of Students with Intellectual Disabilities in Higher Education 

NCD applauds the ED and HHS-funded initiatives now under the umbrella of “Think 

College” to assist students with intellectual disabilities and their families around the 

country. Think College began as a demonstration project and has expanded its work in 

areas of research, training and technical assistance, and information dissemination.152

The collaborative efforts bring together four initiative that support people with intellectual 

disabilities in gaining access and succeeding in inclusive postsecondary education (e.g., 

two-year or four-year college, vocational training) institutions.153 

2.22 NCD supports the Accessible Instructional Materials Commission’s 

recommendations for federally sponsored projects and programs to help 

postsecondary faculty and staff become educated about the delivery of 

high-quality accessible instructional materials to meet the needs of 

students with disabilities in postsecondary settings.

Recommendations

NCD recommends: 

2.23 The U.S. Department of Education, Office of Civil Rights should expand 

enforcement, guidance, and technical assistance activities aimed at 

securing the rights of students with disabilities in higher education, 

placing emphasis on students with disabilities whose protections were 

restored by the Americans with Disabilities Amendments Act.

2.24 Congress and ED should maintain and expand funding for inclusive 

higher education programs for students with intellectual disabilities.
72
73

CHAPTER 3.Earning 

Introduction

More than two decades after the passage of the ADA, the unemployment rate for 

Americans with disabilities stubbornly remains nearly double that of people without 

disabilities, while their rate of labor force participation has continued to be abysmally 

low. The latest figures from the Bureau of Labor Statistics (BLS) show that labor force 

participation for workers with disabilities was 20.3 percent, while the total for workers 

without disabilities was 69.1 percent—more than three times higher.

154 As of April 2012,

the unemployment rate for people with disabilities was 12.5 percent, versus 7.6 percent 

for those without disabilities.155 

Clearly, much more work is needed to realize the goals of the ADA regarding 

employment for people with disabilities. People with disabilities, particularly those with 

the most significant disabilities, need flexible supports to enter the workforce and thrive 

at the same level as peers without disabilities. Furthermore, it is imperative that more 

consideration be given not just to increasing the employment of people with disabilities, 

but also to promoting quality employment in terms of wages, mobility, and settings. 

Employment Discrimination Claims

NCD commends the Equal Employment Opportunity Commission (EEOC) for 

demonstrating commitment to vigorous enforcement of the ADA, as amended. The 

agency reports filing and resolving 80 enforcement suits with ADA claims in fiscal year 

(FY) 2011, to ensure fair and equal treatment of all people with disabilities in the 

workplace.156 In light of the ADA Amendments Act (ADAAA), discrimination claims 

brought by people with disabilities are now substantially more likely to focus on whether 

or not discrimination occurred, rather than whether or not the person bringing the claim 

qualifies as a person with a disability. Thus, both EEOC and private litigants are able to 
74

conduct more enforcement activities aimed at previously underserved groups of people 

with disabilities, such as people on the autism spectrum, people with traumatic brain 

injury, and other groups with less visible disabilities who may have struggled to “prove” 

themselves as disabled prior to the ADAAA.

Impact of the Recession

Although states are increasingly reporting a steady and slow return to fiscal stability, many 

had to cut critical supports and services relied upon by people with disabilities. Some 

2012 state budgets, most of which went into effect in July 2011, included cuts to health care 

for people with disabilities, to personal attendant services hours, to state cash assistance for 

people with disabilities, to transportation services, and to affordable housing programs.

Although many of the cuts may not appear to affect employment, many services are critical 

supports that people with disabilities rely on to become or remain taxpayers.

157 

Social Security Disability Programs

The Social Security Administration (SSA) has important, long-established work incentives 

that allow Supplemental Security Income and Social Security Disability Insurance

beneficiaries to earn income without risking loss of benefits while working toward a future 

occupational goal or maintaining self-employment and small business ownership. However, 

agency personnel and service provider agency staff, as well as beneficiaries, remain 

relatively unfamiliar with the Plans for Achieving Self-Support program and the Benefits, 

Planning, Assistance and Outreach program. For these programs to have any widespread or 

lasting impact, SSA should embark on a major public awareness, outreach, education, and 

technical assistance campaign. In addition, these programs preclude savings for 

nonemployment-related purposes and are perceived as being complex and bureaucratic. 

Thus, although SSA has taken steps to improve its return-to-work services through the 

provision of work incentives, these efforts are hampered by the underlying program rules that 

were designed for people assumed to be permanently retired and people who were viewed 

as unable or unlikely to work in the future. 
75

Employment Disparities among Subgroups

The disability community has long pointed out the many benefits of employment—work 

enhances skills such as communication, socialization, academics, physical health, and 

community skills; it factors into how one is perceived by society; it promotes economic 

well-being; it leads to greater opportunity for upward mobility; and it contributes to 

greater self-esteem.158 Yet for many subgroups of people with disabilities, even more so 

than the group as a whole, those benefits of employment are rarely experienced. Eight 

out of ten people with intellectual and developmental disabilities are not in the labor 

market,

159 and only 15 percent of those with a psychiatric disability are.160

The Administration has focused recently on the employment of people with targeted 

disabilities. NCD commends EEOC for its efforts to call attention to unmet needs in 

employment among people with mental disabilities. EEOC hosted a meeting on March 

15, 2011 focused on people with intellectual disabilities and psychiatric disabilities.161

Recommendations

NCD recommends: 

3.1 Congress should direct the Social Security Administration, the Center for 

Medicare & Medicaid Services, the U.S. Department of Housing and 

Urban Development, and the U.S. Department of Labor’s Employment 

and Training Administration to develop and implement an expanded, 

integrated benefits planning and assistance program that coordinates 

resources and oversight across several agencies, enabling beneficiaries, 

including those transitioning out of sheltered workshops, to access 

benefits planning services within multiple federal systems. SSA should 

also make changes to the existing system to improve the accuracy and 

quality of services provided to individual beneficiaries.
76

Unfortunately, the definition of targeted disability has not been revised for a 

considerable time and is in need of updating to reflect emerging disability categories.

NCD partnered with the U.S. Department of Labor (DOL), Office of Disability 

Employment Policy (ODEP) in preparation for its August 2011 “Add Us In”

162 national 

forum, to help frame the “Culture and Identity” session. Add Us In is an ODEP initiative 

to develop strategies to increase employment of people with disabilities within small 

businesses, which are at the heart of economic growth. The national event brought 

together people with disabilities from diverse racial, ethnic, and gender groups to create 

a blueprint for disability hiring in the small business sector. They discussed the national 

implications of Add Us In and supported the creation of the national network necessary 

for collaboration, dissemination, and implementation of successful policies and 

practices. Focus areas also included cultural and linguistic competence within 

employment systems to address a variety of targeted business and populations.

Workforce Investment Act

The Workforce Investment Act (WIA) of 1998163 was designed to provide a streamlined 

system of assistance that integrates many employment and training programs through a 

one-stop delivery system for employers and job seekers, including job seekers with 

disabilities. WIA is unique in its capacity to serve people with disabilities who desire 

employment assistance, both in terms of overcoming common barriers to employment and

promoting promising strategies, and improving service delivery to workers with disabilities.

A vote on the reauthorization of WIA was scheduled for August 2011 but was postponed 

indefinitely. Draft legislation and introduced bills on reauthorization have been 

discussed in both chambers of the 112th Congress, but at the time of the writing of this 

report, there is no clear timeline to move the legislation forward. WIA may not be 

addressed again until the 113th Congress. 
77

The delay was partly caused by disagreements over a provision of the bill that would 

regulate when people with disabilities could work for less than the federal minimum 

wage. Some disability advocacy groups assert that the provision would protect a system 

of sheltered workshops that they fear lacks sufficient oversight and does not promote

the desired outcome of competitive job training and integrated employment. NCD has 

conducted site visits around the country to get a detailed understanding of how 

employment programs work best and to identify the difficulties faced by workers with 

disabilities in gaining competitive integrated employment. 

Recommendations

NCD recommends: 

3.2 As part of reauthorization of the Workforce Investment Act, Congress 

should ensure the following: 

● Accessibility plans for all one-stop job delivery systems should meet 

requirements for vigorous and proactive enforcement of the 

antidiscrimination and accessibility requirements as established by the 

U.S. Department of Labor.

● Accessibility plans should have measurable goals, timeframes, and 

methods for achieving and maintaining physical, communication, and 

program access.

● State and local Workforce Investment Boards should develop plans with the 

participation of people with disabilities, with meaningful documentation of 

their involvement throughout the planning process and an account of how 

their comments and recommendations were incorporated into final plans.
78

Federal Hiring Initiative

Executive Order (EO) 13548 that challenges the Federal Government to lead by example 

in improving the employment of people with disabilities, was signed and went into effect 

on July 26, 2010, the 20th anniversary of the ADA.

164 With the order, the President 

challenged federal departments not only to hire individuals with disabilities, but also to 

increase the rate at which workers with disabilities are retained and to advance specific 

benchmarks to be met over the course of five years.165 On January 6, 2012, United 

States Customs and Border Protection became the first federal agency to establish a 

formal alliance with the DOL ODEP to advance opportunities for workers with 

disabilities.166 

3.3 Congress should establish an enhanced match for supported employment 

services in integrated employment settings within the Medicaid program.

Recommendations

NCD recommends: 

3.4 All federal agencies need to increase hiring of employees with disabilities 

in accordance with Executive Order 13548. All Federal Government 

agencies need to develop and enact measurable outcome systems and 

ensure meaningful enforcement of stated goals. 

3.5 The National Institute on Disability and Rehabilitation Research should 

solicit input on the importance of research and development of metadesign applications as part of its focus on universal design for all 

government-funded projects. 
79

Federal Employment of Veterans with Disabilities

Notwithstanding recognition of the efforts identified in this report, much work remains to 

be done across the Federal Government for returning veterans. In 2009, President 

Obama issued EO 13518, “Employment of Veterans in the Federal Government,” which 

created the Veterans Employment Initiative to recruit, train, and retain veterans as civilian 

employees in the Federal Government, and contained several specific provisions to assist 

veterans with disabilities.167 When President Obama signed federal legislation in 

November 2011, tax credits were granted to companies that hire unemployed veterans.

168

Although this is a positive temporary incentive, permanent solutions are needed. 

Preliminary data available at the time of the writing of this report shows disappointing 

detailed figures, despite an increase of 4.5 percentage points for veteran federal hires in 

the first half of FY 2011 compared with the same period in FY 2010.169 One in three new 

Federal Government hires in the first half of FY 2011 was a veteran.170 However, that 

data is not disaggregated to indicate how many of the new hires were veterans with 

disabilities. 

3.6 The Office of Personnel Management, working in collaboration with the 

Equal Employment Opportunity Commission, should revise the definition 

of “targeted disability” categories to reflect current needs and priorities 

and to incorporate disability categories whose underrepresentation in the 

workforce has become evident more recently, such as people on the 

autism spectrum and people with other developmental disabilities.
80

Federal Contractors and Subcontractors Hiring Workers with Disabilities

Section 503 of the Rehabilitation Act of 1973 prohibits discrimination against people 

with disabilities and requires employers with federal contracts or subcontracts that 

exceed $10,000 to take affirmative action to hire, retain, and promote qualified 

individuals with disabilities.171 All covered contractors and subcontractors must also 

include a specific equal opportunity clause in each of their nonexempt contracts and 

subcontracts.172 This law is enforced by the Employment Standards Administration’s 

Office of Federal Contract Compliance Programs (OFCCP) within the DOL.

173

On February 6, 2012, NCD sent a letter to Debra Carr, director, Division of Policy, Planning 

and Program Development at OFCCP. The letter supports modernization of 

Section 503 regulations, the 7 percent target goal established for federal contractors, and 

the incorporation of disability categories into the Final Rule so the disability community can 

benefit fully from its new affirmative action. At that time, NCD also asked that subcontractors 

in sheltered workshop settings not be counted toward a contractor’s affirmative action 

obligations under Section 503, even if such workshops are considered training programs. 

This is vital so that the goals of competitive integrated employment are met.

Recommendations

NCD recommends: 

3.7 Congress should make permanent the tax breaks for businesses that hire 

veterans.

3.8 The President should assign a Cabinet-level head or designee to 

coordinate veterans disability policy efforts across federal agencies to 

increase the hiring of veterans with disabilities who need appropriate 

supports and services.
81

Veterans

“Economic opportunity for today’s war-fighters is a national imperative that 

continues to demand the kind of decisive action we saw with last year’s 

[2011] passage of the VOW to Hire Heroes Act. Recent unemployment 

numbers indicate that veterans of the current conflicts [Iraq and 

Afghanistan] remain unemployed at a higher rate than their civilian 

counterparts, with young veterans and female veterans experiencing 

unemployment rates well over twice the national average.” (Ryan M. 

Gallucci, Deputy Director, National Legislative Service, Veterans of 

Foreign Wars of the United States)174

Veterans with Disabilities’ Unemployment Figures

The available unemployment data for all veterans was compiled and reported by the 

Bureau of Labor Statistics (BLS). At the writing of this report, the BLS data reported in 

Recommendations

NCD recommends: 

3.9 In the interest of the goals of competitive integrated employment, 

subcontractors in sheltered workshop settings should not be counted toward 

a contractor’s affirmative action obligations under Section 503 of the 

Rehabilitation Act, even if such workshops are considered training 

programs.

3.10 The Office of Federal Contract Compliance Programs should establish a 

hiring subgoal for federal contractors to hire people within a targeted 

disability category as part of their Section 503 affirmative action obligations.
82

2010, 175 2011, and 2012 specifically separates unemployment rates for veterans with 

disabilities from the overall veterans’ data. A pattern shows unemployment rates are 

higher for veterans with service connected disabilities than for the general population of 

veterans across various wars. For example, among the 1.4 million veterans disabled in 

World War II, the Korean War, and the Vietnam era, 28.8 percent were in the labor force 

in August 2009, compared with 37.0 percent of veterans from these periods who did not 

have a service-connected disability. The August 2011 unemployment rate for veterans

with a service-connected disability was 8.5 percent compared to 7.9 percent for 

veterans with no disability.176 Gulf War-era II veterans with a disability had a 

12.1 percent rate of unemployment which was higher than the 9.5 percent for those 

without a disability. While the BLS reports show that there is no statistical significance in 

the figures, the differences for some veterans and their families are real and meaningful. 

Congressional and Executive Branch Action

What is being done to remedy the situation? Generally, oversight responsibilities can 

make a difference for all veterans, and NCD acknowledges ongoing congressional and 

federal agency work to address some of the unique needs of veterans with disabilities.

Full and subcommittee hearings on various laws have provided information on what is 

needed for a seamless transition from military service to civilian life. NCD calls attention 

to several actions affecting disability compensation, vocational rehabilitation, and 

education that are linked to employment and earning. NCD applauds the positive 

congressional action in passing the Veterans Opportunity to Work Act of 2011. Among 

its provisions are the following: 

1. Retraining assistance for certain 35- to 60-year-old veterans; 

2. Revised guidelines for the Transition Assistance Program regarding counseling, 

employment, and training services, including required participation; 

3. Modifications to the transition of veterans to civilian employment;
83

4. Improvements in providing information to veterans about their rights under the 

Uniformed Services Employment and Reemployment Rights Act—in many 

cases, the outcomes are seen in the enhanced employment options for service 

members who lost jobs due to the downturn in U.S. economy or to a serviceconnected disability; and 

5. Other matters affecting earning/economics for veterans with disabilities, such as 

home financing and pension limits for veterans residing in nursing homes paid 

through Medicaid. Each provision also calls for specific evaluation or assessment 

and reports to Congress of how the components are working to benefit veterans. 

November 2012 will mark three years since Executive Branch leaders were directed to 

carry out President Obama’s Executive Order on Employment of Veterans in the 

Federal Government (EO 13518). The order also established a Council on Veterans 

Employment co-chaired by the secretaries of Labor and Veterans Affairs and the 

director of the Office of Personnel Management as vice chair. 

While NCD recognizes several initiatives aimed at combatting the high unemployment 

of veterans in general, greater attention will need to be given the outcomes for veterans 

with disabilities. Among those initiatives are: (1) the November 2011 executive action 

taken by President Obama and the related action by DOL and the VA , including an 

online Veteran’s Gold Card entitles post-9/11 veterans to free career counseling at any 

DOL career center for six months; (2) the Mil2Feds launched in May 2011 (putting it into 

the previous fiscal year), as the first and much-needed military occupation to federal 

occupation translator which matches veterans’ military occupations to a civilian jobs 

database;

177 (3) changes in the National Defense Authorization Act (NDAA) to allow 

participation in apprenticeships and internships that support transition to the civilian 

world.178 However, not all units are located near abundant federal opportunities; and (4)

DOL’s for reassessment of its employment workshop for military personnel transitioning 

from active duty to civilian employment opportunities and commends the collaborative 

efforts of DoD, the VA, DOL, and the Department of Homeland Security to improve 

transition outcomes for service members, including people with disabilities.179 
84

“Our veterans have made sacrifices on behalf of the nation, and I ask all 

employers to renew their commitment to veterans, because the best way 

to honor our veterans is to employ them. No veteran should have to fight 

for a job at home after fighting to protect our nation.” 

—Secretary of Labor Hilda L. Solis, March 20, 2012)180

A related Department-level initiative is DOL’s “Hiring Vets Toolkit,”181 designed to assist 

and educate employers who have made the proactive decision to include transitioning 

service members, veterans, and wounded warriors in their recruitment and hiring 

initiatives. Key elements for employers include information on how to (1) create a 

culturally sensitive new hire orientation plan, (2) understand their responsibilities under 

the ADA, (3) consider disclosure concerns, and (4) know where to obtain free, one-onone guidance on job accommodations.

Mental Health Impact on Earning and Economics among Veterans

Attention to mental health is sometimes considered the final frontier in health care, but 

public awareness about the needs and growing number of veterans with unseen 

disabilities reached a new level in 2011. In March 2012, Wounded Warrior Project 

(WWP) President Dawn Halfaker told a joint session of the House and Senate Veterans’ 

Recommendations

NCD recommends: 

3.11 The secretaries of various service components (U.S. Armed Forces) 

should analyze the requirements for making internships available at state 

and local agencies. This would promote and support wellness 

opportunities for transitioning service members in wounded warrior units, 

including in rural and less populous areas of the United States. 
85

Affairs committees, a survey revealed that 78 percent of warriors self-identified as 

having a mental health condition, 51 percent reported having experienced a traumatic 

brain injury, and one in three reported that mental health issues made it difficult for them 

to obtain employment or hold jobs. WWP’s information shows that PTSD and other 

invisible wounds can affect a warrior’s readjustment in many ways—impairing health 

and well-being, compounding the challenges of obtaining employment, and limiting 

earning capacity.182 

The good intention of congressional actions to increase hiring of veterans sometimes is 

overshadowed by disjointed implementation efforts. Veterans are often unaware of 

available resources. Unemployment rates for veterans with and without disabilities 

remain higher than those of the general population. Attention to the impact of mental 

health issues on employment is needed. Federal agencies have made some progress, 

but can improve coordination to simplify information provided to service members and 

their families before and during transition from military to civilian living. 

NCD commends DoD for supporting legislation extending through December 31, 2014, 

Section 1631 (b) (1) of the National Defense Authorization Act. Extending this benefit to 

service members with disabilities while they are still members of the Armed Forces 

helps them identify training requirements and resources needed to achieve their 

rehabilitation and employment goals. DoD continued its collaborative partnership with 

DOL’s Veterans Employment and Training Service. 

Conclusion

The long-term fiscal stability of the United States of America depends, in part, on 

ensuring that Americans with disabilities have meaningful opportunities to contribute to 

our collective well-being and on eliminating outdated policies that keep people in cycles 

of poverty and dependency. The Federal Government must find ways to integrate the 

delivery of necessary supports and services across agencies to ensure effective 

coordination and collaboration that meet individual needs and agency goals. 
86

Effective implementation and enforcement of the ADA requires thorough, sustained 

monitoring, evaluation, and interagency collaborations to ensure that full civic and social 

participation, equal opportunity, independent living, and economic self-sufficiency are 

achievable for all Americans, including those with disabilities.
87

Endnotes

1 U.S. Department of Justice, “Justice Department’s 2010 ADA Standards for Accessible 

Design Go into Effect” (March 15, 2012).

2 U.S. Department of Justice, Revised ADA Regulations Implementing Title II and Title 

III (updated May 21, 2012). http://www.ada.gov/regs2010/ADAregs2010.htm. 

3 H.R. 4256, 112th Congress (2012).

4 U.S. Department of Justice, “Justice Department Issues Further Guidance on 

Accessibility Requirements for Existing Swimming Pools at Hotels and Other Public 

Accommodations” (May 24, 2012). http://www.justice.gov/opa/pr/2012/May/12-crt673.html. 

5 U.S. Department of Justice, “Justice Department Reaches Americans with Disabilities 

Act Settlement with Trinity Health Systems in Iowa” (March 30, 2012). 

http://www.justice.gov/opa/pr/2012/March/12-crt-404.html. 

6 U.S. Department of Justice, “Justice Department Settles with Mountain Valley, Pa., 

Midget Football League Under the Americans with Disabilities Act” (March 20, 2012). 

http://www.justice.gov/opa/pr/2012/March/12-crt-345.html. 

7 U.S. Department of Justice, “Justice Department Settles Americans with Disabilities 

Act Lawsuit with Michigan’s Henry Ford Health System” (February 1, 2012). 

http://www.justice.gov/opa/pr/2012/February/12-crt-149.html. 

8 U.S. Department of Justice, “Justice Department Reaches Settlement with Connecticut 

Early Learning Center to Ensure Equal Opportunity for Children with Autism” (June 28, 

2011). http://www.justice.gov/opa/pr/2011/June/11-crt-849.html. 

9 Swift, Aisling, “Deaf 7-Eleven manager who was fired awarded $934,000 in 

discrimination suit,” Marco Eagle (June 24, 2011). http://www.marconews.com/news/

2011/jun/24/former-7-eleven-manager-awarded-934k-discriminatio/. 

10 U.S. Department of Justice, “Justice Department Reaches Americans with Disabilities 

Act Settlement with Wells Fargo” (May 31, 2011). http://www.justice.gov/opa/pr/2011/

May/11-crt-703.html. 

11 U.S. Department of Justice, “Remarks of Assistant Attorney General for Civil Rights 

Thomas E. Perez at His Installation Ceremony” (November 13, 2009). 

http://www.justice.gov/crt/speeches/perez_installation_speech.php. 

12 Statement of Interest of the United States of America in Support of Plaintiffs regarding 

Defendants’ Motion to Dismiss, Filed April 20, 2012, Case No. 3:12-cv-00138-ST.
88

13 U.S. Department of Justice, Office of Civil Rights, “Justice Department Obtains 

Comprehensive ADA Agreement Regarding the Commonwealth of Virginia’s 

Developmental Disabilities System” (January 26, 2012). 

http://www.justice.gov/opa/pr/2012/January/12-crt-111.html. 

14 Settlement information for Esther Darling et. al. v. Toby Douglas, Director of California 

Department of Health Care Services (formerly Brantley v. Maxwell-Jolly and Cota v. 

Maxwell-Jolly), Disability Rights California. http://www.disabilityrightsca.org/advocacy/

Darling-v-Douglas/index.html. 

15 U.S. Department of Justice, Civil Rights Division, Letter to State of Mississippi re: 

United States’ Investigation of the State of Mississippi’s Service System for Persons 

with Mental Illness and Developmental Disabilities (December 22, 2011). 

http://www.justice.gov/crt/about/spl/documents/miss_findletter_12-22-11.pdf. 

16 U.S. Department of Justice, Civil Rights Division, Statement of Interest of the United 

States of America, Darling, et al Plaintiffs v. State of California (Filed July 12, 2011). 

http://www.ada.gov/olmstead/documents/darling_soi.pdf. 

17 U.S. Department of Justice, Civil Rights Division, “Justice Department Obtains 

Comprehensive Agreement Regarding the State of Delaware’s Mental Health System” 

(July 6, 2011). http://www.justice.gov/opa/pr/2011/July/11-crt-881.html. 

18 National Council on Disability, Rising Expectations: The Developmental Disabilities 

Act Revisited (2011). 

19 National Council on Disability, Exploring New Paradigms for the Developmental 

Disabilities and Bill of Rights Act (2012). 

20 U.S. Department of Health and Human Services, “A Statement from Secretary 

Sebelius on the Administration for Community Living” (April 16, 2012). 

http://www.hhs.gov/news/press/2012pres/04/20120416a.html. 

21 Federal Register, “Statement of Organization, Functions, and Delegations of 

Authority; Administration for Community Living” (April 18, 2012). 

http://www.gpo.gov/fdsys/pkg/FR-2012-04-18/pdf/2012-9238.pdf. 

22 Intermediate Care Facility for the Mentally Retarded (ICF-MR)

23 American Council of the Blind, et al v. Henry M. Paulson, Jr., Secretary of the 

Treasury, Order and Judgment, United States District Court for the District of Columbia, 

Order and Judgment, Case 1:02-cv-00864-JR, Document 96, Filed October 3, 2008. 

http://moneyfactory.gov/images/order_injunction.pdf. 

24 Ibid.

25 U.S. Department of Treasury, Bureau of Engraving and Printing, “EyeNote® App 

Overview” http://www.eyenote.gov. 
89

26 National Council on Disability, Livable Communities for Adults with Disabilities (2006); 

Inclusive Livable Communities for People with Psychiatric Disabilities (2008); The State 

of Housing in America in the 21st Century: A Disability Perspective (2010).

27 Frank Melville Supportive Housing Investment Act of 2010, P.L. 111-374 (2011).

28 NCD recommended Congress pass this legislation, in its report titled The State of 

Housing in America in the 21st Century: A Disability Perspective (2010).

29 U.S. Department of Housing and Urban Development, Office of Multifamily Housing 

Program, “The Frank Melville Supportive Housing Investment Act: Section 811’s New 

‘Project Rental Assistance (PRA)’ Authority” (2011), Powerpoint presentation given by 

Carol Galante, Deputy Assistant Secretary. http://portal.hud.gov/hudportal/documents/

huddoc?id=HUPRAPresentation041411.pdf. 

30 Ibid. 

31 U.S. Department of Housing and Urban Development, “Obama Administration

Announces $749 Million to Fund Housing for Very Low-Income Seniors and Persons 

with Disabilities” (November 16, 2011). http://portal.hud.gov/hudportal/HUD?src=/

press/press_releases_media_advisories/2011/HUDNo.11-266. 

32 Streamlining Requirements Governing the Use of Funding for Supportive Housing for 

the Elderly and Persons With Disabilities Programs, Proposed Rule, 77 Fed. Reg. 

18723-18731 (March 28, 2012) (to be codified at 24 CFR pt. 891).

33 Ibid. 

34 U.S. Department of Housing and Urban Development, “HUD Charges Bank of 

America with Discriminating against Homebuyers with Disabilities” (February 27, 2012). 

http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/

2012/HUDNo.12-036. 

35 U.S. Department of Housing and Urban Development, “HUD Charges Florida 

Property Owner, Managers with Disability Discrimination” (October 14, 2011). 

http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/

2011/HUDNo.11-251. 

36 U.S. Department of Housing and Urban Development, “HUD Charges Utah 

Homeowner Association, Condo Owners with Discriminating against Veteran with a 

Disability” (October 11, 2011). http://portal.hud.gov/hudportal/HUD?src=/press/

press_releases_media_advisories/2011/HUDNo.11-249. 

37 U.S. Department of Housing and Urban Development, “HUD Charges University of 

Nebraska at Kearney with Discriminating against Student with Disabilities” (October 11, 

2011). http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_

advisories/2011/HUDNo.11-248. 
90

38 U.S. Department of Housing and Urban Development, “HUD Charges Washington 

State Property Owner with Disability Discrimination” (September 26, 2011). 

http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/

2011/HUDNo.11-232. 

39 U.S. Department of Housing and Urban Development, “HUD Charges New York CoOp and Two of Its Employees with Discriminating against Tenant with Disabilities” 

(August 24, 2011). http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_

media_advisories/2011/HUDNo.11-175. 

40 Home and Community Based Services: Waivers (CMS-2296-P), 76 Fed. Reg. 21311-

21317 (April 15, 2011) (42 C.F.R. Pt. 441). 

41 Ibid. 

42 U.S. Department of Health and Human Services, “HHS Announces New Affordable 

Care Act Options for Community-Based Care” (April 26, 2012). http://www.hhs.gov/

news/press/2012pres/04/20120426a.html. 

43 Medicaid Program; Community First Choice Option, Final Rule, 77 Fed. Reg. 26828-

26903 (May 7, 2012) (to be codified at 42 CFR Part 441). 

44 U.S. Department of Health and Human Services, “Affordable Care Act Supports 

States in Strengthening Community Living” (February 22, 2011). 

http://www.hhs.gov/news/press/2011pres/02/20110222b.html. 

45 National Council on Disability, The Current State of Health Care for People with 

Disabilities (2009).

46 Ibid.

47 Congressional Black Caucus Health Braintrust, 8th Annual Summit on Health 

Disparities, April 11–12, 2011. http://www.nmqf.org/2011SummitAgenda.pdf. 

48 U.S. House of Representatives Committee on Energy and Commerce, 111th Cong., 

Memorandum: “Coverage Denials for Pre-Existing Conditions in the Individual Health 

Insurance Market” (October 12, 2010).

49 American Association of People with Disabilities, “Florida v. HHS - Amicus Brief of 

American Association of People with Disabilities et al.” (2011). Patient Protection and 

Affordable Care Act Litigation. Paper 127. http://digitalcommons.law.scu.edu/aca/127; 

American Association for Retired Persons, “Florida v. HHS - Amicus Brief of AARP” 

(2011). Patient Protection and Affordable Care Act Litigation. Paper 125. 

http://digitalcommons.law.scu.edu/aca/125. 

50 American Association of People with Disabilities, “Florida v. HHS - Amicus Brief of 

American Association of People with Disabilities et al.” (2011). Patient Protection and 

Affordable Care Act Litigation. Paper 127. http://digitalcommons.law.scu.edu/aca/127. 
91

51 Comparative Effectiveness Research (CER) provides information about options for 

clinicians, patients, and people who cannot or choose not to access the health care 

system. Policy makers and public health professionals also use CER information to 

address prevention, translation of new discoveries into better health outcomes for 

Americans, acceleration of beneficial innovations, and delivery of the right treatment to 

the right patient at the right time. U.S. Department of Health and Human Services, 

Report to the President and the Congress on Comparative Effectiveness Research

(2009). http://www.hhs.gov/recovery/programs/cer/cerannualrpt.pdf. 

52 Sox, HC, et al., Comparative effectiveness research: Challenges for medical journals. 

April 27, 2010 http://www.ncbi.nlm.nih.gov/pubmed/21833926.

53 National Council on Disability, “Analysis and Recommendations for the 

Implementation of Managed Care in Medicaid and Medicare Programs for People with 

Disabilities” (2012). http://www.ncd.gov/publications/2012/CMSFebruary272012/. 

54 National Council on Disability, United States Marine Corps Exceptional Family 

Members: How to Improve Access to Health Care, Special Education, and Long-Term 

Supports and Services for Family Members with Disabilities (2011). 

55 Ibid.

56 Opening Statement of Hon. Ann Marie Buerkle, Chairwoman, Subcommittee on 

Health, “Understanding and Preventing Veteran Suicide,” Hearing of the Committee on 

Veterans’ Affairs, U.S. House of Representatives (December 2, 2011). 

57 Department of Defense Health Board, Task Force on Mental Health, An Achievable 

Vision: Report of the Department of Defense Task Force on Mental Health (2007). 

http://www.health.mil/dhb/mhtf/mhtf-report-final.pdf. 

58 U.S. Department of Defense, “DoD Receives Mental Heal Task Force Results” (June 

15, 2007). http://www.defense.gov/releases/release.aspx?releaseid=11015. 

59 Lawyers Serving Warriors, “National Veterans Legal Services Program Reaches 

Historic Class Action Settlement Victory for Iraq & Afghanistan veterans with PTSD: 

Military Agrees to Lifetime Health Benefits or Increased PTSD Disability Rating for 

Thousands of Vets” (July 29, 2011). http://www.lawyersservingwarriors.com/news_

releases-11-0729.html. 

60 “VA Mental Health Care: Addressing Wait Times and Access to Care,” Hearing of the 

U.S. Senate Committee on Veterans’ Affairs (November 30, 2011); “VA Mental Health 

Care: Closing the Gaps,” Hearing of the U.S. Senate Committee on Veterans’ Affairs 

(July 14, 2011); “VA Mental Health Care Staffing: Ensuring Quality and Quantity,” 

Hearing of the U.S. House of Representatives Committee on Veterans’ Affairs (May 8, 

2012); “Understanding and Preventing Veteran Suicide,” Hearing of the U.S. House of 

Representatives Committee on Veterans’ Affairs (December 2, 2011); “Building Bridges 

between VA and Community Organizations to Support Veterans and Families,” Hearing 
92

of the U.S. House of Representatives Committee on Veterans’ Affairs Subcommittee on 

Health (February 27, 2012).

61 Opening Statement of Chairwoman Patty Murray, “VA Mental Health Care: Closing 

the Gaps,” Hearing of the U.S. Senate Committee on Veterans’ Affairs (July 14, 2011). 

http://www.gpo.gov/fdsys/pkg/CHRG-112shrg67505/pdf/CHRG-112shrg67505.pdf. 

62 American Psychological Association, “FY2011 Congressional Appropriations 

Request: Strengthen the Graduate Psychology Education Program” (under P.L. 105-

392 Section 755(b)(1)(J)). http://www.apa.org/about/gr/education/advocacy/2010/gpe2011.aspx.

63 Madler, A., Knudson, A, Heady, H, Resource webpage for “Returning Soldier and 

Veteran Health,” Rural Assistance Center. http://www.raconline.org/topics/veterans/. 

64 U.S. House of Representatives, House Committee on Veterans’ Affairs, “Miller: 

‘These Are Wounds That Cannot Wait’” (April 19, 2012). http://veterans.house.gov/

press-release/miller-%E2%80%9Cthese-are-wounds-that-cannot-wait%E2%80%9D. 

65 U.S. Veterans Affairs, “VA to Increase Mental Health Staff by 1,900” (April 19, 2012). 

http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2302. 

66 American Psychological Association, “Psychologists are in demand as VA boosts 

mental health workforce” (June 26, 2012). http://www.apa.org/pubs/newsletters/access/

2012/06-26/psychologists-in-demand.aspx. 

67 U.S. Veterans Affairs, “VA Adding Family Therapists and Mental Health Counselors to 

Workforce” (April 24, 2012). http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2303. 

68 Joining Forces is a national initiative of the Administration that seeks to draw together 

all sectors of society to support service members and their families. See “About Joining 

Forces” at http://www.whitehouse.gov/joiningforces/about. 

69 The White House, Office of the First Lady, “America’s Nurses Join Forces with the 

First Lady and Dr. Biden to support Veterans and Military Families” (April 11, 2012). 

http://www.whitehouse.gov/the-press-office/2012/04/11/americas-nurses-join-forcesfirst-lady-and-dr-biden-support-veterans-and. 

70 U.S. House of Representatives, House Committee on Veterans’ Affairs, “System 

Failing America’s Wounded Warriors” (March 28, 2012). http://veterans.house.gov/

press-release/system-failing-america%E2%80%99s-wounded-warriors. 

71 Federal Emergency Management Agency, Office of Disability Integration and 

Coordination, Archived Video of “Getting Real II: Promising Practices in Inclusive 

Emergency Management for the Whole Community” (September 12, 2011). 

http://gettingreal-ii.webcaston.tv/vod/11-09-12-grii-p-roth.php. 
93

72 U.S. Department of Homeland Security Office for Civil Rights and Civil Liberties, 

Interagency Coordinating Council on Emergency Preparedness and Individuals with 

Disabilities, “Individuals with Disabilities in Emergency Preparedness: 2009 Annual 

Report to the President” (2009). http://www.dhs.gov/xlibrary/assets/crcl-icc-annualreport-2009.pdf. 

73 Brooklyn Center for Independence of the Disabled, Center for Independence of the 

Disabled, New York, and Tania Morales v. Michael R. Bloomberg and the City of New 

York, 11 CIV 6690 (Received September 26, 2011). 

74 Nationwide Emergency Alert System Post-Test Information 

http://www.fema.gov/emergency/ipaws/eas_info.shtm - 1. 

75 National Council on Disability, “Solicitation Notice” (February 2012).

76 Resource webpage for “Services for Parents with Disabilities,” The National Center 

for Parents with Disabilities and their Families. http://www.lookingglass.org/services/

local-services/services-for-parents-with-disabilities. 

77 National Council on Disability, Rocking the Cradle: Ensuring the Rights of Parents 

with Disabilities and Their Children (anticipated publication in 2012).

78 For summary information on this topic, see NCD’s 2011 Progress Report, section 

titled “Unequal Parent Rights: The Eugenics Movement Back Door?” 

http://www.ncd.gov/progress_reports/Oct312011 - _Toc304437145. 

79 U.S. Department of Health and Human Services, Office for Civil Rights, Webpage of 

case summaries for adoption and foster care, “Summary of Selected Complaint 

Investigations and Resolution Agreements.” http://www.hhs.gov/ocr/civilrights/

activities/examples/adoption/. 

80 Urban Mass Transportation Act of 1970, P.L. 91-453 (1970).

81 “The Americans with Disabilities Act and Accessible Transportation: Challenges and 

Opportunities,” Hearing of the U.S. Senate Health, Education, Labor and Pensions 

Committee (November 17, 2011).

82 Sherbert, Erin, “Central Subway Station Could Force Disabled to Hike Half a Mile,” SF 

Weekly (February 15, 2011). http://blogs.sfweekly.com/thesnitch/2011/02/

central_subway_station.php. 

83 Donahue, Pete, “Wheelchair Taxi Tussle,” New York Daily News (May 10, 2012). 

http://articles.nydailynews.com/2012-05-10/news/31644906_1_tlc-chairman-davidyassky-assemblyman-micah-kellner-wheelchair-accessible-vehicles. 

84 Transportation for Individuals with Disabilities at Intercity, Commuter, and High Speed 

Passenger Railroad Station Platforms; Miscellaneous Amendments, Final Rule, 76 Fed. 

Reg. 57924-57939 (September 19, 2011). (49 CFR pts. 37 and 38).
94

85 U.S. Department of Transportation, Summary of Major Points of DOT ADA Final Rule 

10/19/2011. http://www.fta.dot.gov/documents/ADA_Final_Rule_one_pager_9-28-11.pdf. 

86 Ibid. 

87 Ibid. 

88 Accessibility Guidelines for Pedestrian Facilities in the Public Right-of-Way, Proposed 

Rule, 76 Fed. Reg. 75844-75845 (July 26, 2011) (to be codified at 36 CFR pt. 1190).

89 U.S. Department of Transportation Aviation Consumer Protection Division, “ 

Passengers with Disabilities” (Accessed July 16, 2012). http://airconsumer.ost.dot.gov/

publications/disabled.htm. 

90 National Council on Disability, National Disability Policy: A Progress Report 2011

(2011). 

91 The U.S. Department of Transportation projects the summer of 2012 for final rules on 

new regulatory provisions related to air travel and service animal relief areas, closed 

captioning of televisions, audio-visual displays that mirror the new requirements 

applicable to airlines set forth in the amended 14 CFR Part 382, reorganizing the 

provision in 49 CFR Part 27 regarding lifts used to transfer passengers with disabilities 

to and from the tarmac.

92 Ibid.

93 Heasley, Shaun, “Airline Fined $100K Over Disability Complaints,” Disability Scoop

(January 30, 2012). http://www.disabilityscoop.com/2012/01/30/airline-fined-spirit/14874/. 

94 National Council on Disability, Letter to TSA Administrator John Pistole Regarding 

Security Screenings (April 5, 2012). http://www.ncd.gov/publications/2011/April52011. 

95 Diament, Michelle, “TSA Rolls out Helpline for Travelers with Special Needs,” 

Disability Scoop (January 4, 2012). http://www.disabilityscoop.com/2012/01/04/tsahelpline/14707/print/. 

96 National Council on Disability, The Current State of Transportation for People with 

Disabilities in the United States (2005). 

97 World Health Organization and the World Bank, Summary: World Report on Disability

(2011), p.7–8.

98 Convention the Rights of Persons with Disabilities, GA Res 61/106, UN Doc A/RES/

61/106 (December 13, 2006). http://www.un.org/News/Press/docs/2006/ga10554.doc.htm. 

99 United States Department of State, “Conversations with America” (February 17, 

2011). http://www.state.gov/r/pa/pl/cwa/156916.htm. 
95

100 “The Common Core State Standards Initiative is a state-led effort coordinated by the 

National Governors Association Center for Best Practices (NGA Center) and the 

Council of Chief State School Officers (CCSSO). The standards were developed in 

collaboration with teachers, school administrators, and experts, to provide a clear and 

consistent framework to prepare our children for college and the workforce.” Common 

Core State Standards Initiative Website, “About the Standards” 

http://www.corestandards.org/about-the-standards. 

101 Toppo, Greg, “Common Core standards drive wedge in education circles,” USA 

Today (May 1, 2012). 

102 Common Core State Standards Initiative, “Common Core State Standards for 

English Language Arts & Literacy in History/Social Studies, Science, and Technical 

Subjects,” p.6.

103 Common Core State Standards Initiative, “Common Core State Standards for 

Mathematics,” p.4.

104 U.S. Department of Education, “U.S. Secretary of Education Duncan Announces 

Winners of Competition to Improve Student Assessments” (September 2, 2010). 

http://www.ed.gov/news/press-releases/us-secretary-education-duncan-announceswinners-competition-improve-student-asse. 

105 Partnership for Assessment of Readiness for College and Careers go back to ed.gov 

and find source

106 Samuels, Christina, “New Common Core Tests to Shelve ‘Modified Achievement 

Standards,’” Education Week (September 2, 2010).

107 U.S. Department of Education, “State-led Development of New Assessments Moves 

into High Gear State and Teacher Teams to Help Develop Sample Questions,” (May 4, 

2012). http://www.ed.gov/news/press-releases/state-led-development-newassessments-moves-high-gear-state-and-teacher-teams-he. 

108 CEC Today, “CCS impact on special education.” http://www.cec.sped.org/AM/

Template.cfm?Section=CEC_Today1&TEMPLATE=/CM/ContentDisplay.cfm&

CONTENTID=15269. 

109 Common Core State Standards Initiative, “Application to Students with Disabilities.” 

http://www.corestandards.org/assets/application-to-students-with-disabilities.pdf. 

110 The concept of “deeper learning” has also been referred to as “21st Century skills” as 

well as “college- and career-readiness.” No matter the chosen descriptor, the reference 

is to development of critical thinking and problem-solving skills, as well as effective 

communication and collaboration skills. 

111 Council of Parent Attorneys and Advocates (COPAA), “Charter Schools and 

Students with Disabilities: Preliminary Analysis of the Legal Issues and Areas of 
96

Concern” (2012). http://www.copaa.org/wp-content/uploads/2012/01/Charter-Schoolsand-Students-with-DisabilitiesFINAL.pdf. 

112 Ahearn, Eileen, “Synthesis of two reports on critical issues for special education in 

charter schools,” inForum. Project Forum, National Association of State Directors of 

Special Education (2008). http://projectforum.org/docs/Synthesisof2ReportsonCritical

IssuesforSpEdinCharterSchool.pdf. 

113 O’Connor, John, and Gonzales, Sarah, “No Choice: Florida Charter Schools Failing 

to Serve Students with Disabilities,” State Impact (a project of National Public Radio) 

(December 14, 2011). http://stateimpact.npr.org/florida/tag/no-choice/. 

114 Ibid. 

115 Ibid.

116 Alliance for School Choice, “The Promise of Special Needs Scholarships” (2012). 

http://s3.amazonaws.com/assets.allianceforschoolchoice.com/admin_assets/uploads/

98/Promise%20of%20Special%20Needs%20Scholarships.pdf. 

117 Ibid. 

118 National Council on Disability, “School Vouchers and Students with Disabilities,” 

Policy Paper (April 15, 2003). 

119 Alliance for School Choice, “The Promise of Special Needs Scholarships” (2012). 

http://s3.amazonaws.com/assets.allianceforschoolchoice.com/admin_assets/uploads/

98/Promise%20of%20Special%20Needs%20Scholarships.pdf. 

120 U.S. Department of Education, Letter from Secretary Arne Duncan to Chief State 

School Officers Regarding NCLB Flexibility (September 23, 2011). 

http://www2.ed.gov/policy/gen/guid/secletter/110923.html. 

121 National Council on Disability, Letter to Secretary Duncan Regarding Forthcoming 

NCLB Waivers (September 19, 2011). http://www.ncd.gov/publications/

2011/September192011. 

122 U.S. Department of Education, Webinar: “ESEA Flexibility: Updated Request and 

Review Guidance” (February 14, 2012). http://www2.ed.gov/policy/eseaflex/webinar2012-02-14.pdf. 

123 U.S. Department of Education, “ESEA Flexibility” (accessed May 9, 2012). 

http://www.ed.gov/esea/flexibility. 

124 National Council on Disability, “Limited English Proficiency Plan 2011 Update Re: 

Executive Order 13166” (January 7, 2011). http://www.ncd.gov/publications/

2011/LEP2011. See Background section, paragraphs 2 through 4, p.1.
97

125 National Council on Disability, Youth with Disabilities in the Foster Care System: 

Barriers to Success and Proposed Policy Solutions (2008).

126 Fostering Connections to Success and Increasing Adoptions Act of 2008, P.L. 110-

351 (2008). 

127 U.S. Department of Education. “National Meeting on Improving Educational Stability 

for Children in Foster Care” webpage, http://www.ed.gov/oese/foster-care. 

128 Program Booklet of the “Child Welfare, Education and the Courts: A Collaboration to 

Strengthen Educational Successes of Children and Youth in Foster Care” summit (2011). 

http://www.nrcpfc.org/education_summit/meeting_materials/CB%20Program.pdf. 

129 Center for Safe Schools, “Bullying Prevention” webpage, 

http://www.safeschools.info/bullying-prevention. 

130 Marshall, Catherine A., et al (editors), Disabilities: Insights from across Fields and 

around the World, Praeger Publishers (2009).

131 StopBullying.gov, “Bullying and Youth with Disabilities and Special Health Needs” 

http://www.stopbullying.gov/at-risk/groups/special-needs/index.html. 

132 U.S. Government Accountability Office, Testimony before the Committee on 

Education and Labor, House of Representatives, “Seclusions and Restraints: Selected 

Cases of Death and Abuse at Public and Private Schools and Treatment Centers” GAO09-719T. http://www.gao.gov/new.items/d09719t.pdf. 

133 Ibid. 

134 Ibid. 

135 “Preventing Harmful Restraint and Seclusion in Schools Act” (H.R. 4247 – 111th

Congress).

136 “Keeping All Students Safe Act” (S. 2020, H.R. 1381 –112th Congress)

137 Letter from U.S. Department of Education Secretary Arne Duncan to Chief State 

School Officers regarding use of seclusion and restraint in schools (July 31, 2009). 

http://www2.ed.gov/policy/elsec/guid/secletter/090731.html. 

138 Letter from U.S. Department of Education Secretary Arne Duncan to Chairman 

Christopher J. Dodd, Chairman George Miller, and Representative Cathy McMorris 

Rodgers regarding legislation to limit the use of seclusion and restraints in schools 

(December 8, 2009). http://www2.ed.gov/policy/gen/guid/secletter/091211.html. 

139 The data collection came from a survey of more than 72,000 schools, representative 

of 85 percent of the nation’s students. Diament, Michelle, “Feds: Students with 

Disabilities Most Often Restrained,” Disability Scoop (March 7, 2012).
98

140 U.S. Department of Education, Office for Civil Rights, “Civil Rights Data Collection” 

(March 2012). http://www2.ed.gov/about/offices/list/ocr/docs/crdc-2012-data-summary.pdf. 

141 Ibid. 

142 Ibid.

143 National Council on Disability, From Privileges to Rights: People Labeled with 

Psychiatric Disabilities Speak for Themselves (2002).

144 The President’s New Freedom Commission on Mental Health, Achieving the 

Promise Transforming Mental Health Care in America (2003); U.S. Department of 

Health and Human Services, Substance Abuse & Mental Health Services 

Administration, “Seclusion and Restraint: Statement of the Problem and SAMHSA’s 

Response” (May 2003). http://www.samhsa.gov/seclusion/sr_handout.aspx. 

145 National Council on Disability, Letter to Allison Nichol, Chief, Civil Rights Division 

Disability Rights Section, U.S. Department of Justice (April 12, 2012). 

http://www.ncd.gov/publications/2012/DOJApril132012/. 

146 U.S. Senate Committee on Health, Education, Labor, and Pensions, “Full Committee 

Hearing - Beyond Seclusion and Restraint: Creating Positive Learning Environments for 

All Students” (July 12, 2012). http://www.help.senate.gov/hearings/hearing/

?id=28ddbd0d-5056-9502-5dea-7197eb6434c8. 

147 An evaluative report emphasizes need to strengthen existing social institutions and 

create new ones to reflect more accurately the realities of a longer and more complex 

passage into adult life. Settersten, R. A., and Ray, B., “What’s Going on with Young 

People Today? The Long and Twisted Path to Adulthood,” Transition to Adulthood, 20:1 

(Spring 2010), The Brookings Institution and Princeton University, 

http://www.futureofchildren.org/futureofchildren/publications/journals/article/index.xml?

journalid=72&articleid=519. 

148 U.S. Department of Education, “Trends in High School Dropout and Completion 

Rates in the United States: 1972–2009” compendium report (2012). 

149 National Council on Disability, Transitioning Youth: Workforce Investment Act 

Reauthorization (March 2010). http://www.ncd.gov/publications/2010/03232010-1. 

150 One NCD Council member served on this commission, which brought together a 

virtual think tank of government leaders, representatives from the publishing industry, 

individuals with print disabilities, representatives from two- and four-year institutions of 

higher education, and leaders in accessible technology. 

151 The Advisory Commission on Accessible Instructional Materials (AIM) released its 

report on disparities in postsecondary education learning materials for students with 

disabilities on December 6, 2011.
99

152 Institute for Community Inclusion at the University of Massachusetts Boston, “Think 

College! College Options for People with Intellectual Disabilities.” 

http://test2.thinkcollege.net/index.php?option=com_content&view=article&id=34

&Itemid=39. 

153 Institute for Community Inclusion at the University of Massachusetts Boston “Think 

College Initiatives”(Accessed July 15, 2012). http://test2.thinkcollege.net/index.php?

option=com_content&view=article&id=60&Itemid=70. 

154 Bureau of Labor Statistics, “Table A-6. Employment status of the civilian population 

by sex, age, and disability status, not seasonally adjusted” (April 2012). 

http://www.bls.gov/news.release/empsit.t06.htm. 

155 Ibid. 

156 U.S. Equal Employment Opportunity Commission, “EEOC Litigation Statistics, 

FY 1997 through FY 2011.” http://www.eeoc.gov/eeoc/statistics/enforcement/

litigation.cfm. 

157 Center on Budget and Policy Priorities, “State Budget Cuts in the New Fiscal Year 

Are Unnecessarily Harmful” (July 28, 2011). http://www.cbpp.org/files/7-26-11sfp.pdf; 

Center on Budget and Policy Priorities, “An Update on State Budget Cuts” (February 9, 

2011). http://www.cbpp.org/files/3-13-08sfp.pdf. 

158 Wehman, Paul H., “Employment for persons with disabilities: Where are we now and 

where do we need to go?” Journal of Vocational Rehabilitation, 35 (2011) 145–151.

159 Written Testimony, William E. Kiernan, Ph.D., Director, Institute for Community

Inclusion, University Center on Developmental Disabilities, University of Massachusetts 

Boston and Children’s Hospital Boston, Meeting of the U.S. Equal Employment 

Opportunity Commission, “Employment of People with Mental Disabilities” (March 15, 

2011). http://www1.eeoc.gov//eeoc/meetings/3-15-11/kiernan.cfm?renderforprint=1. 

160 Ibid. 

161 Meeting of the U.S. Equal Employment Opportunity Commission, “Employment of 

People with Mental Disabilities” (March 15, 2011). http://www.eeoc.gov/eeoc/meetings/

3-15-11/index.cfm; and Introduction http://www.dol.gov/odep/addusin/. 

162 U.S. Department of Labor, Office of Disability Employment Policy, Introduction 

webpage for the Add Us In initiative, http://www.dol.gov/odep/Addusin/. 

163 Workforce Investment Act, Pub.L. 105-220, 112 Stat. 936, 29 U.S.C. § 2801, et seq.

164 The White House, Executive Order 13548, “Increasing Federal Employment of 

Individuals with Disabilities” (July 26, 2010). http://www.whitehouse.gov/the-pressoffice/executive-order-increasing-federal-employment-individuals-with-disabilities. 
100

165 Ibid. 

166 U.S. Department of Labor, Disability Employment Policy Resources: U.S. Customs 

and Border Protection Alliance involves outreach, communication, training, education, 

technical assistance and promoting dialogue on employment: 

https://www.dol.gov/odep/alliances/USCBP.htm. 

167 The White House, Executive Order 13518, “Employment of Veterans in the Federal 

Government” (November 9, 2009). http://www.whitehouse.gov/the-press-office/

executive-order-veterans-employment-initiative. 

168 The White House, “Fact Sheet: Returning Heroes and Wounded Warriors Tax 

Credits (November 21, 2011). http://www.whitehouse.gov/the-press-office/

2011/11/21/fact-sheet-returning-heroes-and-wounded-warrior-tax-credits. 

169 U.S. Office of Personnel Management, “ Highest Percentage of Veterans Hired by 

the Federal Government in Over 20 Years” (December 13, 2011). 

http://www.opm.gov/news/highest-percentage-of-veterans-hired-by-the-federalgovernment-in-over-20-years,1743.aspx. 

170 U.S. Office of Personnel Management, “Veterans Employment Council Presents 

Progress Since 2009” (June 30, 2011). http://main.opm.gov/news/veteransemployment-council-presents-progress-since-2009,1677.aspx. 

171 U.S. Department of Labor, Compliance Assistance by Law – The Rehabilitation Act 

of 1973, Section 503, http://www.dol.gov/compliance/laws/comp-rehab.htm. 

172 Ibid. 

173 Ibid. 

174 Statement of Ryan M. Gallucci, Deputy Director, National Legislative Service, 

Veterans of Foreign Wars of the United States, Hearing Before the Veteran’s Affairs 

Subcommittee on Economic Opportunity, U.S. House of Representative (March 8, 2012). 

http://www.vfw.org/VFW-in-DC/Congressional-Testimony/HVAC-EO-Bill-Hearing/. 

175 U.S. Department of Labor, Bureau of Labor Statistics, Disabled Veterans and the 

Labor Force (March 17, 2010). http://www.bls.gov/opub/ted/2010/ted_20100317.htm. 

176 BLS news Release: U.S. Department of Labor, Bureau or Labor Statistics 

Employment Situation of Veterans --- 2011 (March 20, 2012). 

http://www.bls.gov/news.release/pdf/vet.pdf. 

177 Bloomberg BusinessWeek, “Obama Said to Plan ‘Gold Card’ to Help Veterans Find 

Employment.” http://www.businessweek.com/news/2011-11-11/obama-said-to-plangold-card-to-help-veterans-find-employment.html. 
101

178 Warrior Care Blog. Operation War Fighter Overview. 

http://warriorcare.dodlive.mil/wounded-warrior-resources/operation/warfighter/. 

179 Assistant Secretary of Labor for Vets Raymond Jefferson’s Testimony before the 

Subcommittee on Economic Opportunity Committee on Veterans Affairs, U.S. House of 

Representatives (July 29, 2009). http://www.dol.gov/_sec/media/congress/

20100729_Jefferson.htm. 

180 News Release Statement by Secretary of Labor Hilda L. Solis on unemployment 

among veterans (March 3, 2012). http://www.dol.gov/opa/media/press/vets/

VETS20120535.htm. 

181 VETS News Release: US Department of Labor launches Veterans Hiring Toolkit for 

employers (October 28, 2010). http://www.dol.gov/opa/media/press/vets/

VETS20101503.htm. 

182 Testimony of Dawn Halfaker, Wounded Warrior Project, before the Committees on 

Veterans Affairs of the Senate and House of Representatives (March 21, 2012). 

http://www.woundedwarriorproject.org/media/175354/wwp_policy_agenda_testimony_

svac_hvac_3-21-12.pdf.