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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

October 31, 2011

The President

The White House

Washington, DC 20500

Dear Mr. President:

On behalf of the National Council on Disability (NCD), I am pleased to submit the 

enclosed report, National Disability Policy: A Progress Report. In this report, NCD 

assesses the current state of people with disabilities in America and how emerging 

trends and government policies are impacting the quality of their lives. The report offers 

a broad range of recommendations for reforms designed to enhance the independence 

and self-sufficiency of people with disabilities.

Over the past year, NCD has been actively engaged with our stakeholders across the 

country. NCD sponsored a variety of opportunities to bring stakeholders and other 

partners together to exchange information, build collaborations, and develop solutions 

to long-standing and emerging challenges. Based on what we learned from this 

extensive community engagement, as well as a review of the most recent national 

disability data, we found that vast disparities exist between people with and without

disabilities in the United States. Overall, people with disabilities have lower rates of 

employment, lower annual earnings, lower educational attainment and achievement; 

lack adequate access to housing, transportation, technology, and health care; and are

more likely to live in poverty. Furthermore, the current economic downturn is having a 

disproportionate negative impact on people with disabilities, and national trend data 

indicate a decline in many aspects of their quality of life. 

NCD also identified a number of recent advances in public policy that, when fully 

implemented, will have the potential to improve aspects of quality of life for people with 

disabilities. Some examples include:

 Improved access to health care and health insurance under the Affordable Care Act;

 Increased access to federal employment opportunities as a result of the 

Executive Order on increasing federal employment of people with disabilities;

 Increased public awareness of the need for home- and community-based care 

instead of institutional care that has resulted from advocacy efforts by the 

disability community; and
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 Increased community participation as a result of upcoming regulations of the 

Americans with Disabilities Act (ADA) to improve access to leisure and recreation 

facilities and public rights-of-way, as well as upcoming regulations from the 

Federal Communications Commission to improve access to television and video 

programming.

A strong federal commitment to the implementation and enforcement of these efforts will 

be critical to their success. Still, we acknowledge that these are difficult economic times.

As a result, we have taken care to include both short- and long-term priorities within our 

report. Some of our recommendations—such as ending the institutional bias in 

Medicaid—are long-standing priorities of the disability community, which we urge the 

federal government to recommit itself to in the years to come. Others—such as ensuring 

that people with disabilities are included in federal programs related to health 

disparities—are policy measures that can be addressed in the very near term through 

swift and effective executive action. Even during a time of economic hardship, we must 

continue to strive to keep our promises to Americans with disabilities. Furthermore, 

given that spending on working-age people with disabilities constitutes 12 percent of 

federal spending, the quality and effectiveness of disability programs must remain a 

critical area of emphasis for the federal government.

Much more is needed to reverse the downward trends in the indicators of quality of life 

for people with disabilities and to eliminate the many disparities between people with 

and without disabilities. First, in addition to the changes recommended in this report, 

safeguards are needed to ensure that, as our nation‘s leaders consider ways to further 

reduce the federal deficit and to stimulate the economy, any adopted changes do not 

leave people with disabilities even further behind. Second, coordination and 

collaboration must be emphasized greater across federal disability programs to ensure 

uniform application of the overarching goals of the ADA—full participation, equal 

opportunity, independent living, and economic self-sufficiency for people with 

disabilities.

NCD stands ready to work with the administration and Congress to identify opportunities 

to improve our nation‘s disability policy and to enhance the quality of life, independence, 

and full inclusion of people with disabilities into all aspects of society.

Sincerely,

Dr. Jonathan M. Young, Ph.D.

Chairman

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

the U.S. Senate and the Speaker of the House of Representatives.)
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National Council on Disability Members and Staff

Members

Jonathan M. Young, Ph.D., Chair

Fernando M. Torres-Gil, Ph.D., Vice Chair

Gary Blumenthal

Chester A. Finn

Sara Gelser

Marylyn Howe

Janice Lehrer-Stein

Lonnie Moore

Ari Ne‘eman

Dongwoo Joseph (―Joe‖) Pak, MBA

Carol Jean Reynolds

Clyde E. Terry

Linda Wetters

Pamela Young-Holmes

Staff

Aaron Bishop, Executive Director

Stacey S. Brown, Staff Assistant

Julie Carroll, Senior Attorney Advisor

Lawrence Carter-Long, Public Affairs Specialist

Joan M. Durocher, General Counsel & Director of Policy

Lisa Grubb, Confidential Special Assistant / Coordinator of Administration

Geraldine-Drake Hawkins, Ph.D., Senior Policy Analyst

Carla Nelson, Administrative Specialist

Ken Pezzella, Financial Analyst

Robyn Powell, Attorney Advisor

Mark Seifarth, Legislative Affairs Specialist

Anne Sommers, Director of Legislative Affairs & Outreach
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Acknowledgments

The National Council on Disability (NCD) thanks Sue Swenson, the Deputy Assistant 

Secretary for the Office of Special Education and Rehabilitation Services and, at the 

time, Acting Director for the National Institute on Disability and Rehabilitation Research 

(NIDRR). NCD collaborated with NIDRR, updated and used selected trend data from an 

unpublished report, Indicators of the State of Disability, written by Doris Werwie, PhD, 

and Scott Sargrad. NCD also thanks Natalia Pane and Dahlia Shaewitz at the American 

Institutes for Research for their assistance in assembling the data for this report.
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Table of Contents

EXECUTIVE SUMMARY ................................................................................................ 7

INTRODUCTION............................................................................................................. 9

Purpose........................................................................................................................... 9

Community Engagement............................................................................................... 10

CHAPTER 1: COMMUNITY LIVING............................................................................. 13

Access to Home- and Community-Based Services: There‘s No Place Like Home ....... 13

Housing......................................................................................................................... 16

Healthy Living................................................................................................................ 19

Transportation ............................................................................................................... 23

State of Emergency Management and Disability........................................................... 24

Access to Technology: The Case for a Technology Bill of Rights ................................. 27

Voting............................................................................................................................ 30

Unequal Parental Rights: The Eugenics Movement Back Door? .................................. 31

Military Families with Disabilities: Closing the Medicaid Portability Gap........................ 32

CHAPTER 2: LEARNING............................................................................................. 35

Education and Lifelong Learning................................................................................... 35

Early Intervention .......................................................................................................... 42

Youth and Transition ..................................................................................................... 44

Postsecondary Education.............................................................................................. 44

Bullying and Students with Disabilities .......................................................................... 46

Community Reentry of Inmates with Disabilities ........................................................... 49

CHAPTER 3: EARNING ............................................................................................... 51

Employment .................................................................................................................. 51

Financial Status............................................................................................................. 56

CONCLUSION .............................................................................................................. 59

APPENDIX A: DISABILITY TABLES........................................................................... 61

ENDNOTES .................................................................................................................. 65
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Executive Summary

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

current state of people with disabilities in America. Findings are based on information 

gathered through a variety of events with NCD stakeholders; the most recent figures 

from an extensive set of national data indicators measuring the quality of life of people 

with disabilities in the United States; and recent studies and reports from NCD. 

These indicators reveal vast disparities between people with and without disabilities in 

the United States. Overall, people with disabilities have lower employment rates, lower 

annual earnings, lower educational attainment and achievement; lack adequate access 

to housing, transportation, technology, and health care; and are more likely to live in 

poverty.

These disparities have persisted over time, despite substantial federal and state 

investments in programs and services for people with disabilities, as well as a number 

of disability rights protections provided in legislation, regulations, and public policies.

Moreover, in recent years many of the disparities between people with and without 

disabilities have increased. In too many aspects of living, learning, and earning, more 

people with disabilities are falling behind. The economic downturn is having a 

particularly detrimental effect on people with disabilities. Since 2008, job loss among 

people with disabilities has far exceeded that of people without disabilities. Median 

earnings for people with disabilities dropped 7 percent from 2008-2009. The number of 

people applying for Social Security Disability Insurance benefits is on the rise. More 

people with disabilities are on waiting lists for home- and community-based services.

The percentage of young people in the nursing home population is increasing. Disability 

discrimination is on the rise in housing, employment, and air travel. Too many students 

with disabilities are still being segregated and are experiencing poor education 

achievement outcomes. These are alarming trends that, if not reversed soon, will result 

in substantial financial and human costs to our society.
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We are at a critical juncture in our nation‘s disability policy. As our nation‘s leaders focus 

on how to reduce the federal deficit and rescue the declining economy, spending on 

disability programs will come under greater scrutiny. We must review the nation‘s 

approach to disability policy and make comprehensive changes to ensure that these 

programs are aligned with the overarching goals of the Americans with Disabilities Act—

full participation, equal opportunity, independent living, and economic self-sufficiency.

Long-term fiscal stability depends, in part, on providing people with disabilities with 

meaningful opportunities to contribute to our collective well-being and on eliminating 

outdated policies that trap people with disabilities in poverty and dependency, such as 

Social Security work disincentives, the institutional bias in Medicaid, and barriers to an 

inclusive education.

This report contains many recommendations for improving the quality of life of people 

with disabilities. Given that the comprehensive reform of our nation‘s approach to 

disability policy will be a long-term process, immediate priority should be given to the 

recommendations that will lead to better education outcomes and increased 

employment and independent living opportunities for people with disabilities.
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Introduction

Purpose

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

15 members appointed by the President of the United States and confirmed by the 

U.S. Senate. NCD recommends policies, programs, practices, and procedures that 

guarantee equal opportunity for all individuals with disabilities, regardless of the nature 

or severity of the disability, and that empower individuals with disabilities to achieve 

economic self-sufficiency, independent living, and inclusion and integration into all 

aspects of society.

In preparation for writing this annual progress report, NCD reviewed the current state of 

people with disabilities in the United States. This report is based on information 

gathered through a variety of NCD stakeholder events; the most recent figures from an 

extensive set of national data indicators measuring the quality of life of people with 

disabilities in the United States; and recent NCD studies and reports. The national data 

indicators cover several aspects of living, learning, and earning, including community 

participation, housing, health, transportation, technology, education, employment, and 

financial status.

In general, these indicators reveal vast disparities between people with and without 

disabilities in the United States. Overall, people with disabilities have lower rates of 

employment, annual earnings, educational attainment, and achievement; lack sufficient 

access to housing, transportation, and health care; and are more likely to live in poverty.

As this report was being written, our nation‘s leaders passed legislation to raise the debt 

ceiling to avoid an economic catastrophe. This legislation created a 12-member special 

congressional committee tasked with identifying sources of additional and significant 

deficit reductions. This is a critical juncture in our nation‘s disability policy. Historically, 

discussions about deficit reductions have painted people with disabilities with a broad 

brush and have resulted in sweeping slashes to services and supports without regard to 
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the detrimental, real-life effects of those cuts on the ability of people with disabilities to 

live, learn, and earn and to contribute to our nation‘s economy. 

This report offers fiscally responsible recommendations that promote the independence 

and self-sufficiency of people with disabilities. Long-term fiscal stability depends, in part, 

on providing people with disabilities with meaningful opportunities to contribute to our 

collective well-being and on eliminating outdated policies that trap people with 

disabilities in poverty and dependency.

Community Engagement

Coming together is a beginning, keeping together is progress, and 

working together is success. 

—Henry Ford

In 2010, NCD implemented new, targeted ways to engage with stakeholders and collect 

timely and relevant suggestions for agency actions going forward. NCD also initiated 

steps to connect stakeholders with one another for the exchange of information, 

collaboration, and the development of solutions to emerging and long-standing 

challenges. We began by conducting the first-ever National Summit on Disability Policy, 

in observance of the 20th anniversary of the Americans with Disabilities Act (ADA), to 

launch a national dialogue on disability policies and programs for the 21st century. More 

than 500 people from U.S. territories, tribal entities, 48 states, and one foreign country 

gathered at the multiday summit to identify emerging opportunities to improve outcomes 

in living, learning, and earning for people with disabilities. Participants stressed the need 

for greater collaboration across federal agencies to improve the flexibility and 

coordination of vital programs and services.

NCD‘s commitment to community engagement is guided by a conviction that the 

greatest progress in the quality of life for people with disabilities will come from effective 

coordination and collaboration. NCD has developed a new strategic plan under the 

leadership of Chairman Young, with the theme ―Living, Learning, and Earning.‖ Instead 
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of thinking about housing, employment, health, or transportation in isolation, we will 

examine how these essential elements of life influence one another. With the 

international legal framework embracing these interconnections through the adoption of 

the Convention on the Rights of Persons with Disabilities, it is more important than ever 

to examine this nation‘s progress. 

NCD addresses these issues by asking: How do we develop fully accessible 

communities for our children, parents, coworkers, and friends who have disabilities? 

How do we approach learning more holistically, and take it from a traditional K–12 

framework to incorporate the entire span of an individual‘s lifelong learning process? 

How do we enhance earning opportunities so that the ADA‘s goal of economic selfsufficiency is achieved? How do we make all the pieces fit successfully together? 
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CHAPTER 1: Community Living

Satisfaction with community living throughout the lifespan 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, the failure to 

coordinate various elements of inclusion means missing out on opportunities to live, 

learn, and earn. 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. 

On May 5 and 6, 2011, NCD hosted a ―Living Forum‖ in Portland, Oregon, focused on 

community living systems change. At the end of the forum, NCD hosted a town hall and 

invited members of the public to share their disability policy priorities and concerns. 

Common themes included person-centered planning; the need for more prevention and 

early intervention services, more accessible, affordable integrated housing, and better 

transition services for youth with disabilities; and the need to redirect scarce public 

resources away from expensive institutions to community-based supports and services.

Access to Home- and Community-Based Services: There’s No Place 

Like Home

No disability policy is in greater need of reform than the antiquated Medicaid rules that 

favor institutional settings over home- and community-based services (HCBS). States 

receiving federal Medicaid funds are required to cover nursing home services, whereas 

home- and community-based services are optional. In FY 2009, 57 percent of Medicaid 

long-term care (LTC) dollars was directed toward institutional care. The remaining 43

percent was spent on ―home health and personal care,‖ which includes HCBS waivers. 

This long-standing institutional bias persists, despite the strong preference of seniors 

and people with disabilities to live and receive services in their homes.1
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TABLE 1.

Medicaid Long-Term Care Dollars (billions) Spent on 

Home/Community-Based Services vs. Institutional Care, 1990–2009

1990 1995 2000 2002 2004 2006 2008 2009

Total spent on 

LTC (billions) 32 54 75 92 100 109 115 122

Total spent on

home- and 

communitybased care 

(billions) 4.16 10.80 22.5 29.44 37.00 44.69 48.30 52.46

Total spent on

institutional 

care (billions) 27.84 43.20 52.50 62.56 63.00 64.31 66.7 69.54

Source: http://www.Statehealthfacts.org.

The institutional bias in Medicaid is an unsound fiscal policy that the United States can 

ill afford in this time of fiscal crisis. HCBS can cost two-thirds to four-fifths less per 

person annually than nursing home care, depending on the geographic area.

2

Moreover, average costs for home- and community-based services are increasing at a 

slower pace than are those for institutional care.3The average cost to Medicaid for a 

person with an intellectual disability to receive services in an institutional setting in 2009 

was approximately $137,000, compared with an average of $44,000 to support the 

same person in the community.4

Begin highlighted text:

The average cost to Medicaid for a person with an intellectual 

disability to receive services in an institutional setting in 2009 

was approximately $137,000, compared with an average of 

$44,000 to support the same person in the community.

End highlighted text.

The institutional bias in Medicaid not only is fiscally irresponsible but also violates one of 

the most cherished American values—the right to live in the community. On June 21, 

2011, NCD and the Bipartisan Disabilities Caucus provided a congressional briefing on 
15

a landmark Supreme Court decision, Olmstead v. L.C.,

5

and the benefits of HCBS, 

delivered primarily under Medicaid. In Olmstead, the Supreme Court ruled that ―under 

the ADA, unnecessary institutional segregation of the disabled constitutes 

discrimination.‖

6

In recent years, the U.S. Department of Justice has focused 

enforcement efforts on requiring states to offer HCBS instead of confining people in 

institutions.7 Although many individuals have successfully transitioned to community 

settings in recent years, waiting lists for community services have grown considerably,

and many who would opt for community services are not able to obtain them.

Recent state budget crises have compounded the problem and threaten to erode the

gains made in recent years as many states short-sightedly cut home- and communitybased services in an attempt to balance their budgets. Although states are prohibited by 

the Affordable Care Act from limiting Medicaid eligibility, other state policies have 

reduced HCBS by lowering reimbursement rates to HCBS providers and reducing the 

number of approved HCBS hours per beneficiary. Additionally, the expiration of the 

enhanced Medicaid Federal Medical Assistance Percentage (FMAP) made available to 

states through the American Recovery and Reinvestment Act (ARRA) has led to state 

expenditures on HCBS dropping to pre-recession levels.

8

Many people have turned to the courts to prevent states from cutting essential homeand community-based services, given that the effect of these cuts is often a guaranteed 

path for Medicaid beneficiaries to an institutional placement, which is at odds with the 

Olmstead decision.9This is a tragic waste of scarce resources. Home- and communitybased services need federal protection that does not force people with disabilities to 

litigate in order to stay in their homes.

As Congress and the Administration grapple with the federal debt crisis, the elimination 

of the institutional bias in Medicaid is both a moral and a fiscal imperative. Data show 

that people ages 31 to 64 now make up 14 percent of the nursing home population,

10 up 

from 10 percent just a decade ago. The data do not show why this age group is entering 

nursing homes in higher numbers, but reversing this alarming trend must become a 

national priority.
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Begin highlighted text:

Data show that young people ages 31 to 64 now make up 

14 percent of the nursing home population, up from 10 percent 

just a decade ago.

End highlighted text.

NCD recommends:

1. Congress should eliminate the institutional bias in Medicaid. 

2. The Centers for Medicare and Medicaid Services (CMS) should require states to 

ensure that reductions in reimbursement rates do not create additional barriers to 

care for people with disabilities. 

3. CMS should issue a letter requiring states to notify Medicaid beneficiaries of their 

due process rights when reductions are made to home- and community-based 

services (HCBS).

4. Congress should lower the Federal Medical Assistance Percentage for 

institutional care for states that fail to meet their Olmstead obligations.

5. Congress should retain the Community Living Assistance Services and Supports 

(CLASS) Act, ensuring adequate opportunity for the U.S. Department of Health 

and Human Services to pursue changes to ensure its self-sufficiency and to 

enhance access to long-term services and supports outside of Medicaid.

6. CMS should issue regulations specifying what HCBS waiver dollars can and 

cannot be used for, ensuring that states cannot use funds allocated for HCBS for 

―gated communities‖ and other settings with ―institution-like‖ characteristics.

Housing

Efforts to enhance home- and community-based services are often impeded by the lack 

of affordable, accessible housing. It is nearly impossible for people with disabilities living 

on Supplemental Security Income (SSI) to obtain decent, safe, affordable, and 

accessible housing in the community without a permanent housing subsidy.11 Workers 

on average must earn $15 per hour over a 40-hour work week to afford a one-bedroom 

rental at the national average.12 This means that people with disabilities receiving SSI 
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would need to triple their income to afford housing—making housing out of reach for 

many. A recent government report estimated at least 43 percent of homeless adults in 

shelters—about 421,000 people—identify as a person with a disability.13

Many people with disabilities can live in the community with the right supports. A variety 

of private and nonprofit entities have used public funds to establish successful housing 

programs14 that include supportive services such as counseling, peer support, 

assistance with home buying and lending, home modifications, and personal services 

such as housekeeping, cooking, and shopping.15 These programs have enabled many 

people who once lived in group homes or institutions to move into integrated housing,

including apartments, condos, rentals, or their own homes. However, many people with 

disabilities are not eligible for supportive housing programs. Some supportive housing 

programs restrict eligibility to people who are homeless, receive certain services, or 

participate in treatment programs, which has led to complaints that these eligibility 

requirements restrict choice and independence.

Discrimination continues to be a barrier to accessible, affordable housing for people with 

disabilities. Housing discrimination complaints based on disability are the most 

frequent—30 percent higher than those based on race—and increased more than 

20 percent between 2005 and 2009 (Table 2).

Begin highlighted text:

Housing discrimination complaints based on disability are the 

most frequent—30 percent higher than those based on race—and 

increased more than 20 percent between 2005 and 2009.

End highlighted text.
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TABLE 2.

Bases of Housing Discrimination Complaints, 2005–09

2005 2006 2007 2008 2009

Disability 3,766 4,110 4,410 4,675 4,458

Race 3,472 4,043 3,750 3,669 3,203

Retaliation 452 577 588 575 654

Familial status 1,414 1,433 1,447 1,690 2,017

National origin 1,225 1,427 1,299 1,364 1,313

Sex 961 997 1,008 1,133 1,075

Religion 218 258 266 339 302

Color 142 154 173 262 251

Source: U.S. Department of Housing and Urban Development, The State Of Fair Housing Report, FY 2009

A 2005 U.S. Department of Housing and Urban Development/Urban Institute study 

found that individuals who were deaf or used a wheelchair experienced adverse 

treatment during the rental process, even at rates greater than African American and 

Hispanic renters. In addition to fewer accessible housing options, wheelchair users 

learned about fewer housing units and were more likely to have fewer opportunities to 

inspect units than those without disabilities. Individuals who were deaf and TTY users 

were refused service in 25 percent of cases and were given less information about the 

housing process when their calls were accepted.

16 Thus, as a result of discrimination, 

people with disabilities have limited access to an insufficient supply of accessible, 

affordable housing.
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NCD recommends:

1. The U.S. Department of Housing and Urban Development (HUD) should 

increase affordable, accessible, and integrated housing for people with 

disabilities.

2. HUD should increase housing vouchers for people with disabilities.

3. Congress and HUD should create a permanent home modification fund to pay for 

reasonable accommodations in private market housing. 

4. Congress should redirect federal housing and treatment funds now supporting 

institutional facilities (nursing homes, etc.) toward integrated housing options.

5. HUD should prevent the loss of accessible, publically subsidized housing through 

investment and preservation strategies.

6. Supportive housing programs should eliminate the requirement that a person be 

homeless in order to be eligible for a supportive housing unit.

7. HUD and the Substance Abuse and Mental Health Services Administration 

should collaborate to create better community-based and integrated housing 

solutions for people with psychiatric disabilities.

8. HUD should allow a phaseout of housing supports as individuals move into 

employment. 

9. 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 ―affirmatively further fair housing‖ for people with disabilities by 

reviewing and eliminating obstacles to accessible housing.

Healthy Living

The greatest barriers to healthy living for people with disabilities have been the 

inaccessibility of health care (e.g., inaccessible mammography equipment, exam tables, 

weight scales) and the discriminatory practices of health insurers, resulting in significant 

health disparities for people with disabilities.17 The ADA does not address discrimination 

in the health insurance market. However, the passage of the Affordable Care Act of 

2010 (ACA)18 began an effort to eliminate discrimination against people with disabilities 

in the health care market, which many call the ―unfinished business‖ of the ADA.19
20

Under the ACA, insurers are prohibited from denying coverage to children if that denial 

is based solely on the fact that they were born with disabilities. In 2014, all 129 million 

Americans with preexisting health conditions will be protected from insurance 

discrimination because of preexisting conditions or health status. Additionally, the ACA 

Patient‘s Bill of Rights outlaws many of the worst abuses of the insurance industry, such 

as arbitrary annual and lifetime caps on benefits, that have resulted in a denial of health 

care when people need it most.

In 2014, Medicaid will expand to cover many Americans with disabilities who do not 

qualify for coverage now. States are establishing Affordable Insurance Exchanges, 

which are new competitive marketplaces to provide better insurance options for those 

who buy individual coverage. Recently, the U.S. Department of Health and Human 

Services (HHS) proposed requirements to make every Exchange technologically 

accessible and understandable for people with disabilities—including those who rely on 

assistive technology to navigate the Internet. Additionally, the ACA calls on the U.S. 

Access Board to establish accessibility standards for medical diagnostic equipment.

Thus, if the ACA is fully implemented, it holds great promise for improved access, care,

and quality of life for people with disabilities.

Begin highlighted text:

Recently, HHS proposed requirements to make every Exchange 

technologically accessible and understandable for people with 

disabilities—including those who rely on assistive technology to 

navigate the Internet.

End highlighted text.

Some key issues remain to be addressed, however, if people with disabilities are to gain 

equal access to health care. The absence of professional training on disability 

competency for health care practitioners is one of the most significant barriers to having 

people with disabilities receive appropriate and effective health care.20 Historically, 

federally funded cultural competency projects among health professions have not 

included disability. Few professional health care training programs address disability 
21

cultural competency in their curricula. Disability cultural competency is generally not a 

requirement for medical practitioner licensing, educational institution accreditation, or 

medical education loan forgiveness. There is no standard definition of what it means to 

be ―culturally competent‖ to serve people with disabilities and there is no comprehensive 

model curriculum. The result is that people with disabilities sometimes fail to get 

appropriate care, or even avoid getting needed health care, because providers do not 

have the necessary knowledge to treat them appropriately.21

People with disabilities often do not have access to health promotion services and 

physical fitness activities. The need for healthful living and engagement in leisure and 

recreational activities is universally accepted, but it is perhaps even more essential for 

people with disabilities. A focus on physical health, nutrition, exercise, and lifestyles that 

promote vigorous engagement in society and culture can have significant benefits for 

people with physical, intellectual, or mental disabilities.22 Yet research shows that 

people with disabilities are less likely to participate in leisure time physical activities.23

Reasons cited for lower participation include lack of access to fitness facilities, 

inaccessible exercise equipment, lack of transportation, lack of adapted sports 

programs, and physical inability to exercise.24

Physical fitness has long been credited as beneficial for all Americans.25 Vigorous 

exercise for 30 minutes a day at least five times a week is recommended for adults to 

extend longevity, improve concentration, and alleviate depression.26 Musclestrengthening activity is recommended for adults at least two times a week.27 Although 

people with disabilities may need a customized form of exercise to compensate for 

specific limitations posed by the disability, many forms of competitive sport and exercise 

are available. These sports include chair yoga,28 wheelchair basketball,29 downhill and 

cross-country skiing and golfing for people who are blind or visually impaired,

30 downhill 

ski competitions for people using prosthetics,31 and the development of prosthetic limbs 

for long-distance runners,32 just to name a few.

Access to health promotion initiatives that encourage high standards of personal health 

is equally important. The percentage of people with disabilities who are obese is much 
22

higher than the percentage of obese people without disabilities (see Table A1 in 

Appendix A). The percentage of persons with disabilities who smoke is much higher 

than the percentage of people without disabilities who smoke (see Tables A2a and A2b

in Appendix A). The dangers represented by these percentages should be addressed 

through a public health education campaign.

Americans with disabilities have long desired to participate fully in all aspects of 

recreation and culture. Proposed ADA regulations33 and the recently enacted 21st 

Century Communications and Video Accessibility Act34 should greatly increase 

opportunities for disabled Americans to engage in social events such as concerts,

leisure activities, and television and Internet programming. However, accessibility and 

implementation continue to be slow and inconsistent. Further attention is necessary to 

ensure that people with disabilities are included in leisure and recreation, from youth 

sports leagues to concerts, lectures, and education to senior activities.

NCD recommends:

1. The U.S. Department of Health and Human Services (HHS) should fund a 

comprehensive project to develop and disseminate model curricula for medical 

and health professions on disability cultural competency.

2. HHS and the Centers for Disease Control and Prevention should conduct a 

national public awareness campaign focusing on the benefits of fitness and 

healthful lifestyles for people with disabilities and the need to make leisure and 

recreational activities accessible and inclusive.

3. HHS 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.

4. HHS should work to ensure the inclusion of people with disabilities as an 

emphasis area in funding opportunities relating to health disparities, health 

professions, and other areas aimed at enhancing access to health care, 

improving the quality of care, increasing available treatment and interventions, 

and decreasing health disparities.
23

Transportation

People with disabilities are more likely than people without disabilities to report that they 

have inadequate transportation. (34 percent versus 16 percent, respectively)—a gap of 

18 percentage points.35 Transportation appears to be a greater problem in 2010 for both 

people with and without disabilities, increasing from 30 percent in 2004 to 34 percent in 

2010 for people with disabilities and from 13 percent in 2004 to 16 percent in 2010 for 

people without disabilities.36

The realities behind these statistics reveal lives severely limited by the lack of 

transportation options. Some people with disabilities who would otherwise be able to 

work cannot do so because of inadequate transportation. Others cannot shop, socialize, 

go to religious services, or even leave their homes. Some individuals with disabilities 

who need medical services are confined to institutions solely because of the lack of 

safe, reliable transportation options to get them to needed medical services.37

Transportation barriers faced by people with disabilities are not necessarily the ones 

getting the most attention in policy debates. Often, federal policymakers have focused

only on the transportation access requirements of the ADA. The ADA led to great 

improvements, but many compliance gaps remain that pose significant transportation 

problems for people with disabilities. Additionally, because the ADA merely requires that 

where public transportation is provided, it must be made accessible for people with 

disabilities, an absence of public transportation usually translates to no transportation at 

all for people with disabilities. In rural areas, people with disabilities often become 

isolated and dependent on others and are at a significant disadvantage in their 

transportation options in our automobile-dependent society.

People with disabilities also continue to have difficulties with air travel. According to the 

U.S. Department of Transportation, airlines received 21,001 disability-related complaints 

in 2010, a 23 percent increase from the previous year.38 In 2009, some 17,068 

complaints were filed (a 22 percent increase from 2008), and 14,006 complaints were 

filed in 2008.39 More than half of the complaints received in 2010 concerned the failure 
24

to provide adequate assistance to wheelchair users.

40 Additional complaints alleged 

refusal to allow boarding, denial of boarding without an attendant, security issues 

concerning the disability, aircraft inaccessibility, airport inaccessibility, disputes about 

advance notice, seating accommodations, damage to assistive device, storage or delay 

of assistive device, service animal problem, and unsatisfactory information.

Begin highlighted text:

According to the U.S. Department of Transportation, airlines 

received 21,001 disability-related complaints in 2010, a 

23 percent increase from the previous year.

End highlighted text.

As we approach the 25th anniversary of the Air Carrier Access Act (ACAA),

41 it is time 

to revisit the ACAA, and its regulations and enforcement, to determine why 

discriminatory service in this important transportation sector persists.

NCD recommends:

1. Congress should adopt flexible policies for making transportation available to 

people with disabilities beyond the public transportation system.

2. Congress should hold 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.

3. The Transportation Security Administration should work to ensure the 

accessibility of aviation security screenings for all people with disabilities, 

including wheelchair users and those with invisible disabilities.

State of Emergency Management and Disability 

With earthquakes, tsunamis, tornados, excessive heat, and beyond, 2011 has been a 

year of devastating emergencies in the United States and worldwide. Historically, the 

United States has had a poor track record in emergency preparedness for people with 

disabilities—unnecessary separation from families; loss of independence resulting in 

institutionalization; inaccessible emergency transportation, communication, housing, 
25

and medical care; and loss of life that could have been avoided. An example is a deaf 

couple in Athens, Alabama, who narrowly escaped when a tornado destroyed their 

home. With the electricity off and unable to hear the tornado or audible warnings, they 

did not have access to audible alerts that protected the hearing community.42

In the United States, national efforts to improve outcomes for people with disabilities in 

emergencies have become increasingly urgent. In response to Executive Order 13347, 

Individuals with Disabilities in Emergency Preparedness, member agencies of the 

Federal Interagency Coordinating Council on Emergency Preparedness and Individuals 

with Disabilities (ICC) coordinate on a multitude of concerns, addressing health, 

transportation, and other critical areas. The Federal Emergency Management Agency 

(FEMA) now has an Office of Disability Integration and Coordination, with staff in 

headquarters and most of its 10 regions. The U.S. Department of Justice is providing 

increased technical assistance and enforcement of civil rights laws covering disability 

access in emergency management. State, local, and tribal governments, as well as 

private entities, also are showing increased attention to these important matters, 

including implementation of the recommendations issued in August 2009 by NCD in 

Effective Emergency Management: Making Improvements for Communities and People 

with Disabilities. 

However, national efforts have been delayed and are fraught with challenges. Despite 

the integration mandate in the ADA, many efforts to integrate people with disabilities in 

emergency situations focus on separate, ―special needs‖ solutions, which lead to 

segregation, separation, and discrimination. Despite the increased activity (efforts to 

provide checklists, ―how-to‖ guides, and trainings to emergency managers, schools, 

nursing homes, and others), research-based knowledge to support these activities is 

severely lacking. NCD, the ICC, and others have repeatedly reported on this lack of 

research since as early as 2005.

43 Without strong, reliable information, our national 

efforts must depend on best guesses and good intentions rather than facts. The 

National Institute on Disability and Rehabilitation Research and several other federal 

agencies have provided funding for research and development projects, but the number 
26

of federal projects being funded and the number of participating agencies remain at 

unacceptably low levels. Federal budget concerns may lead to decreased capacity to 

fund new projects specific to emergency management and disability.

Despite the lack of evidence-based practices to inform our national efforts, some progress 

has been made in discrete areas across the nation to develop knowledge and best 

practices. For example, the Research and Training Center on Independent Living at the 

University of Kansas and the Kansas Department of Health and Environment created an 

interactive clearinghouse of best practices relevant to disaster and the health, safety, and 

disability communities. This website (http://www.disabilityprepared.ku.edu) allows 

communities to share best practices across multiple areas related to emergency 

management and allows members to communicate through social media sites. In 

September 2011, the FEMA, in collaboration with NCD, hosted the ―Getting Real II 

Conference—Promising Practices in Inclusive Emergency Management for the Whole 

Community.‖ More effort, research, and collaboration along these lines are needed across 

the nation.

Progress is impeded by the continued unacceptable ―silo‖ approach to emergency 

management and disability. Technologies, ideas, and plans continue to be developed 

for the emergency management community or the disability community, rather than 

inclusively integrating the ―whole‖ community.

44 This approach results in a national 

emergency management system resigned to playing catch up because it was not 

designed for all participants. 

Additionally, most resources address evacuating and serving people with disabilities in 

shelters. In many cases, however, people with disabilities are left behind or are advised 

to shelter in place.45 More resources are needed to assist people with disabilities in 

planning for emergencies, particularly people who stay in place during a disaster.

The Office of Disability Integration and Coordination at FEMA is working to facilitate a 

fully integrated approach. Unfortunately, this office does not have sufficient staff or 

resources to meet this critical national need.46
27

NCD recommends:

1. The President should issue an Executive Order requiring all federal agencies that 

conduct or fund research, development, or demonstration projects related to 

emergency management to 

a. develop and implement procedures to ensure the inclusion of people with 

disabilities and other access and functional needs within the scope of those 

research, development, or demonstration projects; and 

b. report annually to the President and Congress on the results of those efforts 

and key findings from the research, development, or demonstration projects. 

The Executive Order should emphasize the importance of an inclusive, 

―whole community‖ approach to research, development, and demonstration 

projects related to emergency preparedness, mitigation, response and 

recovery. 

2. Congress should pass legislation that 

a. establishes the Office of Disability Integration and Coordination (ODIC) as a 

permanent office within Federal Emergency Management Agency; 

b. authorizes funds for staff and resources in Headquarters and the 10 regional 

offices sufficient to meet national and regional needs; and 

c. charges ODIC with coordinating within the U.S. Department of Homeland 

Security and with other key stakeholders to integrate people with disabilities 

into emergency preparedness, mitigation, response, and recovery.

3. ODIC should provide training for people with disabilities on preparing for 

emergencies, including training for people with disabilities who have limited 

English proficiency.

Access to Technology: The Case for a Technology Bill of Rights

Technology and its advances provide opportunities for significant improvements in the 

quality and independence of the lives of individuals with disabilities at work and in 

education, travel, entertainment, health care, and community living. Many technological 

advances show great promise of improved accessibility. However, technology also has

the potential to create new barriers for people with disabilities when they are not 

designed with all users in mind. Given the rapid rate at which technology evolves in
28

today‘s marketplace, retrofitting is not practical or cost-efficient, and assistive 

technology vendors struggle to keep up with ever-changing mainstream technology.47

People with disabilities report difficulties in accessing and using a variety of 

technologies, including cell phones,48 consumer electronics,49 distance learning 

software,50 electronic readers,51 and home appliances.52 Yet, a variety of manufacturers 

have demonstrated that where there is a commitment to making products accessible, it 

is very feasible.53

The same is true for making websites accessible for people with disabilities. Many large 

companies have made their websites accessible for people who are blind or visually 

impaired,54 demonstrating that such access is possible.55 However, many of these 

websites do not provide captioning of audio for people who are deaf or hard-of-hearing, 

and many commercial websites remain largely inaccessible to both populations. The 

U.S. Department of Justice has yet to incorporate web access standards into ADA 

regulations, even though web accessibility standards have been in use for many years, 

both in the United States and internationally. The World Wide Web Consortium (W3C) 

first published web access standards in May 1999,56 and the U.S. Access Board 

published a federal web accessibility standard in December 2000.57

A recent Harris Poll survey revealed a significant gap between people with and without 

disabilities in the use of technology to access the Internet. (See Table A3 in Appendix 

A). People with disabilities are much less likely to use the Internet across all age 

groups. Eighty-five percent of adults without disabilities report using a computer or other 

electronic device to access the Internet from home, work, or another location, compared 

with 54 percent of adults with disabilities—a gap of 31 percent. The gap is smallest 

among youth, but a 10 percent difference still exists. The gap increases threefold 

among those 65 or older to 33 percent. Clearly, too many people with disabilities are

being left behind in this digital age.
29

Begin highlighted text:

A recent Harris Poll survey revealed a significant gap between 

people with and without disabilities in the use of technology to 

access the Internet.

End highlighted text.

Federal policy regarding technology access has been piecemeal, with technologies 

inconsistently regulated by access requirements, and only in certain settings. The ADA 

applies to ATMs and automatic fare machines.58 The Telecommunications Act59 and the 

recently enacted 21st Century Communications and Video Accessibility Act,60 apply to 

certain communications and video programming technologies and services but do not 

apply uniformly. Section 508 of the Rehabilitation Act61 applies to certain technologies, 

but only in the federal environment. Most consumer electronics and home appliances—

items that have great potential to enhance independent living and quality of life for 

people with disabilities—are not covered by any accessibility standards. Accessibility 

laws and policies are needed that are not technology- or environment-specific, but 

rather are comprehensive and function-based and remain applicable over time as 

technology evolves. As the rate at which technology evolves increases exponentially, so 

does the potential for an unbridgeable technology divide. The policies we adopt today 

will determine whether the technology of the future empowers people with disabilities to 

live, learn, and earn.
30

NCD recommends:

1. Congress should enact a comprehensive Technology Bill of Rights for people 

with disabilities to

a. clearly establish that manufacturers must create accessible user interfaces for 

all products; 

b. authorize the U.S. Access Board to establish uniform technology access 

standards; and 

c. provide for effective enforcement mechanisms. 

2. The U.S. Department of Justice should incorporate web accessibility standards 

into ADA Title III regulations.

Voting

Since the accessibility provisions of the Help America Vote Act (HAVA) were 

implemented, the number of people with disabilities who vote has increased (Table 3). 

However, recent reductions in HAVA funds may set back efforts to make polling places 

and the voting process accessible to people with disabilities because states no longer 

have the support they need to continue improvements. Additionally, as many states move 

to require voters to show photo identification, there is concern that this requirement may 

discourage some people with disabilities from voting because many people with 

disabilities do not possess a driver‘s license. Studies must be undertaken to determine 

whether there is a disproportionate negative impact on people with disabilities.

TABLE 3.

Percentage of People Voting in National Elections, 1992–2010

1992 1996 2000 2004 2010

People with disabilities 45% 33% 41% 52% 59%

People without disabilities 56% 50% 52% 56% 59%

Source: Harris Poll, selected Presidential election years.
31

Unequal Parental Rights: The Eugenics Movement Back Door? 

The right to parent is one of the most fundamental rights in the U.S. Constitution, rooted 

in the due process clause of the Fourteenth Amendment. However, those rights do not 

extend equally to people with disabilities. Although the involuntary sterilization of people 

with disabilities is relegated to the recent past, parental rights of people with disabilities 

are constantly under threat. State statutes, judicial decisions, and child welfare practices 

are sometimes based on the presumption of parental incompetence when the parent 

has a disability.62

NCD‘s ―Living Forum‖ in Portland, Oregon, focused attention on many issues facing 

parents with disabilities. A panel discussion identified numerous discriminatory state 

laws and practices carried out by child welfare agencies and family courts that have 

caused parents with disabilities to lose legal custody of their children. Bias against 

parents with disabilities influences termination of parental rights and child custody cases 

to the detriment of the rights of parents with disabilities.

63 Parents with intellectual or 

developmental disabilities and those with psychiatric disabilities face the most 

discrimination within the child welfare system, because more than 30 states include 

mental illness and developmental or intellectual disability as grounds for termination of 

parental rights.

64 To date, only 3 states (Idaho, Kansas, and Missouri) have passed laws 

specifically protecting the parenting rights of individuals with disabilities.65

There are countless devastating reports of people with disabilities who have lost their 

parental rights because of their disability. For example, in 2010, a blind couple‘s 2-day 

old daughter was placed in protective custody when the state of Kansas wrongfully 

deemed the blind parents unable to care for the child. The family was reunited after a 

57-day battle. This issue represents a critical policy concern that has not been the 

subject of serious attention from the disability policy and advocacy communities or child 

welfare officials. NCD is committed to addressing the rights of parents with disabilities 

and is conducting extensive research and meeting with stakeholders to produce a report 

on this subject.
32

NCD recommends:

1. States must eliminate statutes that include disability as grounds for termination of 

parental rights. 

2. The U.S. Department of Justice should issue guidance advising states that per 

se presumptions of parental incompetence based on disability violate the ADA 

and requiring states to ensure that parenting assessments are fully accessible to 

parents with disabilities.

3. Congress should address the disparate treatment experienced by parents with 

disabilities through legislation, including adding specific protections for parents 

with disabilities in the Adoption and Safe Families Act.

4. Government agencies such as the U.S. Department of Health and Human 

Services and the U.S. Department of Justice should maintain statistics about 

parents with disabilities and their interaction with the child welfare and court 

systems.

Military Families with Disabilities: Closing the Medicaid 

Portability Gap

NCD recently completed a study of Marine Corps families with disabilities for the U.S.

Marine Corps (USMC). The requirement to move regularly, often to destinations not of 

one‘s choosing, is a constant in military life and each time entails logistical, emotional, 

and financial stressors. The results of NCD‘s USMC study reinforced that these

challenges can be significantly more arduous for families with members who have 

disabilities, especially if the families are young, the disability involved is severe, or both. 

Every time a family relocates, its members must learn about the resources available 

and the process for accessing these services. Then they must reassemble their family 

member‘s continuum of care, that is, request, coordinate, and advocate for the services 

needed.

The lack of Medicaid waiver portability, specifically, is a significant obstacle to obtaining 

and keeping long-term supports and services for such families, because there are long 

waiting lists for these waivers and new applicants start at the bottom of the waiting list 

each time the family moves to a new state. Many of the families who participated in 

NCD‘s USMC study called for a mechanism to help individuals retain Medicaid benefits 
33

when they move to a new state. One of NCD‘s recommendations from the study is for 

Congress to implement mechanisms to enable military families with disabilities to 

maintain the services they would receive under Medicaid when they move from state to 

state instead of requiring them to go to the bottom of the waiting list each time they 

relocate.

NCD recommends:

1. Congress should ensure that the health insurance available to military families 

(Tricare and ECHO) cover the same services the family would receive if enrolled 

in Medicaid.
34
35

CHAPTER 2: Learning

Education and Lifelong Learning

The federal government has established a long-standing role of helping all students 

reach challenging standards and of supporting state and local high-quality education 

efforts.66 A generation of Individuals with Disabilities Education Act (IDEA)–protected 

young adults are moving on to pursue careers and other life activities. In contrast to

previous generations, they have grown up with an expectation that school populations 

include students with a broad spectrum of abilities. Their experience is largely due to 

generations of students who have enjoyed the protections of IDEA, which guarantees 

the right to a free appropriate public education for all eligible students with disabilities. 

Students with disabilities not covered by IDEA are protected by Section 504 of the 

Rehabilitation Act of 1973 (Section 504). Before the landmark laws, children and youth 

without disabilities were welcome in public schools while their peers with disabilities 

were excluded or segregated. Segregation was the rule, not the exception. 

Although Americans celebrated the 35th anniversary of IDEA last year, many observers 

report that the law is far from delivering on its promises. Despite progress made across 

a number of educational indicators and the discontinuation of the ―proxy rule,‖

67 selfadvocates, parents, and other supporters of equal opportunity report that meaningful 

inclusion is hampered by insufficient permeation of inclusion principles into institutions.

Students with disabilities continue to face barriers to learning and achievement 

opportunities. 

Although the percentage of students with disabilities who were served more than 80

percent of the time in general classrooms increased steadily over the past 19 years, a 

closer look reveals that inclusion in the general classroom is not consistent across all 

disabilities (Table 4). Students with speech or language impairments, specific learning 

disabilities, or hearing or visual impairments are the most likely to be included in general 

classes, whereas those with intellectual disabilities or multiple disabilities are the least 

likely to be included (Table 5).
36

TABLE 4.

Percentage of Students Ages 6–21 Served under the Individuals with 

Disabilities Education Act (IDEA), Part B, by Educational 

Environment, Selected School Years, 1990–91 through 2008–09

Year

Regular 

school: 

80% or 

more

Regular 

school: 

79–40% 

Regular 

school: 

Less 

than 

40% 

Separate 

school for 

students 

with 

disability:

Public

Separate 

school for 

students 

with 

disability: 

Private

Separate 

residential 

facility: 

Public

Separate 

residential 

facility: 

Private

Parentally 

placed in 

regular 

private 

school

Homebound/ 

hospital 

placement

Correctional 

facility

90–91 33.1 36.4 25 2.9 1.3 0.6 0.3 — 0.5 —

94–95 44.8 28.5 22.4 2 1 0.5 0.3 — 0.6 —

95–96 45.7 28.5 21.5 2.1 1 0.4 0.3 — 0.5 —

96–97 46.1 28.3 21.4 2 1 0.4 0.3 — 0.5 —

97–98 46.8 28.8 20.4 1.8 1 0.4 0.3 — 0.5 —

98–99 46 29.9 20 1.8 1.1 0.4 0.3 — 0.5 —

99–00 45.9 29.8 20.3 1.9 1 0.4 0.3 — 0.5 —

00–01 46.5 29.8 19.5 1.9 1.1 0.4 0.3 — 0.5 —

01–02 48.2 28.5 19.2 1.7 1.2 0.4 0.4 — 0.4 —

02–03 48.2 28.7 19 1.7 1.2 0.3 0.4 — 0.5 —

03–04 49.9 27.7 18.5 1.7 1.1 0.3 0.4 — 0.5 —

04–05 51.9 26.5 17.6 1.8 1.2 0.3 0.3 — 0.4 —

05–06 54.2 25.1 16.7 1.8 1.2 0.3 0.3 — 0.5 —

06–07 53.7 23.7 17.6 2.9 — 0.4 — 1 0.4 0.4

07–08 56.8 22.4 15.4 3 — 0.4 — 1.1 0.4 0.4

08–09 58 21.7 15.1 3 — 0.4 — 1.1 0.4 0.4

Source: U.S. Department of Education, Institute of Education Sciences, Condition of Education, Table A-7-2, 

http://nces.ed.gov/programs/coe/tables/table-cwd-2.asp compiled from U.S. Department of Education, Office 

of Special Education Programs, Individuals with Disabilities Education Act (IDEA) database

Note: Includes children and youth in the 50 states, the District of Columbia, and the Bureau of Indian 

Education schools. Data for 2007–08 and 2008–09 do not include Vermont. Detail may not sum to totals 

because of rounding. 
37

TABLE 5.

Percentage of Students with Disabilities in Regular Schools by 

Percentage of Time in General Classes by Disability Type, 2008–09

Regular 

school: 

80% or more

Regular 

school: 

79–40%

Regular 

school: 

Less than 40% 

Intellectual disability 16.2 27.4 48.9

Multiple disabilities 13.2 16.5 46.2

Autism 36.1 18.3 35.8

Deaf-blindness 30 16.7 29.1

Orthopedic impairments 51.3 16.6 24.8

Other health impairments 60.1 24.6 24.8

Emotional disturbance 39.2 19.4 23.2

Traumatic brain injury 45 23.2 23

Developmental delay 61.8 20.6 16.2

Hearing impairments 53.3 17.2 15.8

Visual impairments 61.6 13.9 12

Specific learning disabilities 60.9 28.4 8.6

Speech or language 

impairments 86.4 5.7 4.7

Source: U.S. Department of Education, Institute of Education Sciences, Condition of Education, 

Table A-7-2, http://nces.ed.gov/programs/coe/tables/table-cwd-2.asp compiled from U.S. Department of 

Education, Office of Special Education Programs, Individuals with Disabilities Education Act (IDEA) 

database.

Note: Includes children and youth in the 50 states, the District of Columbia, and the Bureau of Indian 

Education schools. Data for 2007–08 and 2008–09 do not include Vermont. Detail may not sum to totals 

because of rounding. 

Similarly, the data on the number of students with disabilities who exit high school with a 

diploma varies by disability, as well as by state. When aggregated, the higher rates of 

graduation with a high school diploma for students with certain disabilities can mask the 

very low rates for students with other disabilities (Table 6).
38

TABLE 6.

Percentage of 14- to 21-Year-Old Students Served under IDEA, Part B, 

Who Exited School by Exit Reason and Type of Disability, 2007–08

Type of disability

Graduated 

with 

diploma

Received a 

certificate of 

attendance

Dropped 

out

Reached 

maximum 

age

Visual impairments 77% 10% 10% 2%

Hearing Impairments 70% 17% 11% 2%

Other health 

impairments 67% 10% 22% 1%

Speech or language 

impairments 67% 12% 20% 0%

Traumatic brain injury 65% 16% 15% 3%

Specific learning 

disabilities 64% 11% 24% 1%

Autism 63% 24% 7% 6%

Orthopedic impairments 62% 18% 13% 4%

Deaf-Blindness 57% 19% 9% 12%

Emotional disturbance 46% 9% 43% 1%

Multiple disabilities 46% 26% 18% 8%

Intellectual disability 38% 36% 22% 5%

Source: U.S. Department of Education, Office of Special Education Programs, Individuals with 

Disabilities Education Act (IDEA) database. Retrieved September 8, 2010, from 

https://www.ideadata.org/PartBData.asp. (This table was prepared September 2010.)

Note: Students may exit special education services because of maximum age beginning at age 18 

depending on state law or practice or order of any court. ―Dropped out‖ is defined as the total who were 

enrolled at some point in the reporting year, were not enrolled at the end of the reporting year, and did not 

exit through any of the other bases described. It includes students previously categorized as ―moved, not 

known to continue.‖ Other health impairments include having limited strength, vitality, or alertness as a 

result of chronic or acute health problems such as a heart condition, tuberculosis, rheumatic fever, 

nephritis, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes.

National data can also mask serious problems in some states. States show significant 

variation in the percentage of students with disabilities who exit with a diploma.

Minnesota and Nebraska graduate over 60 percent, whereas Nevada, Mississippi, and 

Louisiana graduate fewer than 20 percent (see Table A4 in Appendix A).

Federal public policy and resources should reflect a stronger commitment to the 

implementation of fully inclusive education practices that benefit all students, including 
39

students with disabilities. Public policies should promote students with disabilities as 

part of the general education population and not as a segregated subpopulation. 

Overwhelming evidence demonstrates that fully inclusive schools, in which students 

with disabilities are fully engaged in the general educational setting and have access to 

the general education curriculum, result in higher academic performance for both 

students with disabilities and their nondisabled peers,68 whereas the placement of 

students in segregated classrooms because of diagnosis or special needs leads to 

detrimental outcomes.69

Significant academic achievement gaps exist between students with disabilities and 

students without disabilities at the 8th grade level, as shown by scores on the National 

Assessment of Educational Progress (NAEP), which is often called the Nation‘s Report 

Card. Although mathematics scores have increased over time for all 8

th grade students, 

the significant gap (approximately 40 points) between the achievement scores of 

students with disabilities and those of students without disabilities remains relatively the 

same. Reading scores of 8th grade students also show a significant and persistent gap 

(approximately 30 points) between students with and without disabilities. The gap 

widens significantly (approximately 50 points) when the mathematics and reading 

scores of 8

th grade African American and Hispanic students with disabilities are 

compared with the scores of white students without disabilities (Tables 7 and 8). These 

data clearly indicate that progress has been meager over the years in addressing the 

academic achievement of racial and ethnic minorities with disabilities and in closing the 

wide achievement gaps between students with disabilities and students without 

disabilities.
40

TABLE 7.

NAEP Grade 8 Reading Scores by Race/Ethnicity and Disability 

Status, 2002–09

2002 2003 2005 2007 2009

All students with a disability 228 225 227 227 230

All students without a disability 268 267 266 266 267

White with a disability 237 234 236 237 240

Black with a disability 212 208 208 209 213

Hispanic with a disability 211 209 212 212 212

Asian/Pacific Islander with a disability 223 226 227 229 232

American Indian with a disability 217 210 222 214 218

White without a disability 274 274 273 274 275

Black without a disability 248 248 246 248 250

Hispanic without a disability 249 248 248 249 251

Asian/Pacific Islander without a disability 267 271 271 271 275

American Indian without a disability 256 254 255 253 258

Source: U.S. Department of Education, Institute of Education Sciences, National Center for Education 

Statistics, National Assessment of Educational Progress (NAEP), NAEP Data Explorer, July 2011

TABLE 8. 

NAEP Grade 8 Mathematics Scores by Race/Ethnicity and Disability 

Status, 2000–09 

2000 2003 2005 2007 2009

All students with a disability 230 242 245 246 249

All students without a disability 276 282 283 285 287

White with a disability 239 253 255 257 260

Black with a disability 206 219 222 226 229

Hispanic with a disability 218 228 229 231 235

Asian/Pacific Islander with a disability 251 249 249 253

American Indian with a disability 234 236 235 232

Unclassified with a disability 240 246 254 257

White without a disability 286 291 292 294 296

Black without a disability 248 256 259 263 265

Hispanic without a disability 254 262 264 267 269

Asian/Pacific Islander without a disability 288 292 297 298 302

American Indian without a disability 266 271 270 270 273

Unclassified without a disability 281 281 285 287

Source: NAEP Data Explorer, July 2011
41

These issues are likely to be exacerbated by the current economic downturn. In 2009, 

the ARRA made available $11.3 billion in IDEA Part B funding for local education 

agencies (LEAs).

70 Unfortunately, this increase in federal funding resulted in many LEAs 

reducing their local spending on special education, because the IDEA Maintenance of 

Effort provisions allow reductions in local spending to offset increases in federal 

spending. According to a Government Accountability Office report, ―This year, ... an 

estimated 44 percent of LEAs plan to use the reduced local expenditure flexibility to 

decrease local spending on students with disabilities.71 The percentages vary across 

states—from 14 percent in New York to 72 percent in Iowa. An estimated 48 percent of 

the largest LEAs planned to [reduce local funding].‖ NCD is concerned about the longterm consequences of these reductions in funding as the federal IDEA funds made 

available by ARRA run out and return to pre-ARRA levels.
42

NCD recommends:

1. The Secretary of Education should require states seeking flexibility under No 

Child Left Behind to provide a clear and compelling plan to address the 

achievement gap for students with disabilities and the segregation of students 

with disabilities from the general classroom, particularly those with low-incidence 

disabilities.

2. Congress should incorporate within the reauthorization of the Elementary and 

Secondary Education Act (ESEA) and the Individuals with Disabilities Education 

Act (IDEA) mechanisms to hold LEAs and state education agencies accountable 

for graduating students with low-incidence disabilities with a diploma and 

including such students in the general education classroom. 

3. Congress should consider including in the reauthorization of the ESEA language 

that holds LEAs accountable for the performance of students who fall into 

multiple subgroups, such as African American or Hispanic students with 

disabilities or English language learners with disabilities.

4. The Department of Education‘s Office of Special Education and Rehabilitative 

Services should issue guidance clarifying that LEAs that reduce their 

Maintenance of Effort (MOE) in violation of IDEA must use the MOE obligation of 

the last year the LEA was in compliance as the basis for their MOE obligations in 

the coming school year, rather than the amount of their local expenditures during 

the year the LEA was in violation.

5. The Secretary of Education should establish an internal work group, including the 

Office of Postsecondary Education, the Office of Vocational and Adult Education, 

the Office of Special Education and Rehabilitative Services, the National Institute 

of Disability Rehabilitation Research, the Office on Title I of the Elementary and 

Secondary Education Act, the Office on Drug Free and Safe Schools, and other 

entities, to share available data; obtain public input, including perspectives from 

young adults living with disabilities; and identify problems and promising 

practices for ensuring that students with disabilities can access academic 

curricula and all school activities available to their peers without disabilities.

Early Intervention

The Infants and Toddlers with Disabilities Program was created under IDEA Part C in 

1986 to enhance the development of infants and toddlers with disabilities, minimize 

potential developmental delay, and reduce education costs by minimizing the need for 

special education services as children with disabilities reach school age. A substantial 
43

body of evidence demonstrates the effectiveness of early intervention services. A 

national longitudinal study of early intervention services found that the benefits for 

infants and toddlers receiving early intervention services included increased motor, 

social, and cognitive functioning; acquisition of age-appropriate skills; and reduced 

negative impact of their disabilities.72 Studies also demonstrate improvements in 

reasoning, problem-solving, and communication skills.73

The demand for early intervention services has skyrocketed, while federal funding has 

remained stagnant. Many children with behavioral or developmental disabilities are 

missing vital opportunities for early detection and intervention. In the United States, 17 

percent of children have a developmental or behavioral disability such 

as autism, intellectual disabilities, and attention-deficit/hyperactivity disorder.74 However, 

less than 50 percent of these children are identified as having a problem before starting 

school, by which time significant delays may have already occurred and opportunities 

for treatment have been missed.75

Diagnoses of autism spectrum disorders have increased significantly in the last decade 

and are expected to continue to increase as more children are screened early in life.

The number of students with autism seeking IDEA services increased 500 percent

between 1997 and 2007.76 Early Intervention programs are the first line of care for most

poor children with autism, and professionals predict that these programs will not have 

the capacity to address the increasing demand for autism services.77

In recent years, the Leadership Education in Neurodevelopmental and Other Related 

Disabilities programs have significantly increased professional capacity to diagnose and 

treat children with autism and other developmental disabilities through clinical and 

community-based research and training activities.78 However, given the expected 

growth in the demand for these services and the shortage of professionals who can 

provide these services, federal efforts to build capacity in this field will be needed for 

some time to come. 
44

NCD recommends:

1. Congress should extend funding for the Leadership Education in 

Neurodevelopmental and Other Related Disabilities programs at current levels.

2. The Office of Special Education and Rehabilitation Services should provide 

technical assistance to assist states in delivering Part C Early Intervention 

Services in the most integrated setting.

Youth and Transition

All students deserve meaningful next steps at the end of their formal education. Too 

often, individual transition planning and implementation activities fail to meet 

Congressional intent under IDEA and the Higher Education Act.79 High school 

graduation rates for students with disabilities remain a fraction of those of the general 

student population.80

Receiving early transition services is critical to the future success of all youth in 

preparation for adulthood, including individuals with significant disabilities. Planning for 

transition should begin as early as possible. Evidence-based research has documented 

that youth with disabilities who are educated in inclusive settings, are exposed to work 

experience and career exploration, and participate in a paid work experience while in 

school have better postsecondary and employment outcomes.81

Postsecondary Education

Overall, the percentage of students with disabilities who pursue higher education has 

steadily increased. Postsecondary enrollment increased among most categories of 

individuals with disabilities; the average group increase was more than 20 percentage 

points from 2003 to 2009 (Table 9). 
45

TABLE 9.

Enrollment of Individuals with Disabilities in Postsecondary 

Education at Any Institution, by Disability Type, 2003–09

2003 2005 2007 2009

Total 27.2% 42.2% 51.7% 57.0%

Learning Disability 29.5% 45.2% 58.1% 63.3%

Emotional Disturbance 19.3% 30.7% 42.3% 51.3%

Speech Impairment 36.5% 53.8% 58.9% 65.2%

Hearing Impairment 57.5% 69.7% 68.2% 72.9%

Visual Impairment 63.6% 70.6% 65.2% 66.7%

Autism 40.4% 49.7% 33.1% 37.9%

Mental Retardation 11.0% 23.9% 26.6% 27.9%

Deaf/Blindness 47.7% 40.9% 51.2%

Multiple Disabilities 19.0% 32.8% 24.8% 28.4%

Orthopedic Impairment 32.2% 51.2% 54.1% 58.9%

Traumatic Brain Injury 23.4% 51.0% 53.8% 59.5%

Other Health Impairment 33.4% 53.0% 55.6% 64.1%

Source: Years 2-5 NLTS data, compiled from http://www.nlts2.org/data_tables.

Nearly 28 percent of the general population of people 25 years of age and older have 

completed college,82 but people with disabilities complete college at half that rate. 

Increased efforts are needed to close the gap between people with and without 

disabilities.
46

NCD recommends:

1. Congress should consider enhancing the role of postsecondary outcomes in the 

accountability infrastructure of the Elementary and Secondary Education Act and 

the State Performance Plan indicators of the Individuals with Disabilities 

Education Act.

2. The Department of Education should issue further guidance to colleges and 

universities on meeting the accommodation needs of underserved disability 

categories in higher education settings as well as on meeting the accommodation 

needs of students with disabilities in undergraduate, graduate, and professional 

education.

3. Congress and the Administration should charge key federal agencies responsible 

for policies and programs that shape education and lifelong learning to establish 

a national task force that will identify barriers to accessing the general education 

curriculum, earning a regular high school diploma, and entering and completing 

postsecondary education, and establish meaningful short and long term goals 

and actions to set forth examples of attainable paths to gainful employment and 

that will assist cross-agency coordination of federally funded services and 

supports. 

4. Congress and the Administration should require the Secretaries of the 

U.S. Departments of Education, Labor, Transportation, Health and Human 

Services, Justice, and Homeland Security to obtain input from state and local 

stakeholders; develop federal guidance based on findings, including promising 

practices; and prepare an annual report to Congress on challenges and 

progress.

Bullying and Students with Disabilities

Although the body of literature on bullies and victims is substantial, relatively little 

attention has focused on how this problem relates specifically to children and youth with 

disabilities. Research indicates a severe problem facing many students with disabilities.

Students with disabilities, visible or otherwise, are subject to more bullying than

students without disabilities.83 Bullying is frequently a direct result of a student‘s 

disability.84 Students with disabilities are disproportionately likely to face peer rejection, 

a significant risk factor for victimization.85 Many students with disabilities have difficulty 

with social skills, either as a core trait of their disability or as a result of social isolation 

that results from segregated environments or peer rejection. Such students may be at 
47

particular risk for bullying and victimization. Research confirms that such victimization 

exists across a broad range of students, including students with physical, 

developmental, intellectual, emotional, and sensory disabilities, among others.86

In April 2010, in Oklahoma, a 14-year-old boy with developmental disabilities was 

hospitalized after being forced to drink hand sanitizer.87 Further investigation revealed 

the bullies had been poisoning the boy for months.

Although some consideration has been given to bullying with regard to relevant civil 

rights laws, including Section 504 and the ADA, until recently, little attention has been 

given in the context of IDEA. This is significant because schools have specific 

obligations under IDEA to provide students with disabilities with a free appropriate 

public education in the least restrictive environment. These obligations were aptly 

expressed by Assistant Attorney General Thomas Perez of the Justice Department‘s 

Civil Rights Division and Assistant Secretary Russlynn Ali of the Department of 

Education‘s Office for Civil Rights: ―All students have a right to go to school without 

fearing harassment from their peers . . .and schools have a responsibility to ensure 

students can exercise that right. If children aren‘t safe, then children can‘t learn.‖88

On October 25, 2010, the Office for Civil Rights of the Department of Education issued 

a letter89 that described the legal obligations of education institutions nationwide to 

protect the civil rights of students with disabilities along with other identified student 

victims of bullying, while maintaining a safe learning environment. In March 2011, NCD 

provided a briefing paper on bullying for the White House Conference on Bullying 

Prevention, in response to a request from the Department of Education.90 NCD‘s paper 

asserted that negligence on the part of a school district in adequately addressing 

bullying behavior against students with disabilities constitutes a denial of such students‘ 

rights to a free appropriate public education in the least restrictive environment under 

IDEA. Since that time, federal case law has further defined schools‘ responsibilities to 

students with disabilities who are victims of bullying, citing NCD‘s briefing paper as part 

of its justification. On April 25, 2011, a federal court ruled that schools cannot turn their 

back on bullying perpetrated on disabled students and may face severe legal 
48

consequences for failing to address harassment about which it knows or reasonably 

should know. According to the court, the rule to be applied is as follows: When 

responding to bullying incidents, which may affect the opportunities of a special 

education student to obtain an appropriate education, a school must take prompt and 

appropriate action. It must investigate if the harassment is reported to have occurred. If 

harassment is found to have occurred, the school must take appropriate steps to 

prevent it in the future. These duties of a school exist even if the misconduct is covered 

by its anti-bullying policy and regardless of whether the student has complained, asked 

the school to take action, or identified the harassment as a form of discrimination.91

A school‘s failure to act against bullying represents a failure to ensure the right to a free 

appropriate public education and meaningful educational benefit in the least restrictive 

environment for students with disabilities. When bullying forces a student with a 

disability from an integrated educational setting into a more restrictive placement, such 

as a classroom only for students with disabilities or a change of schools, a free 

appropriate public education and meaningful educational benefit in the least restrictive 

environment are compromised or absent. 

Begin highlighted text:

A school’s failure to act against bullying represents a failure to 

ensure the right to a free appropriate public education in the 

least restrictive environment for students with disabilities.

End highlighted text.

NCD recommends:

1. The U.S. Department of Education Office for Civil Rights should issue a new 

Dear Colleague letter affirming that bullying constitutes a denial of a student‘s 

right to be educated in the least restrictive environment and outlining the school‘s 

obligations set forth in federal case law since the October 2010 Dear Colleague 

letter.
49

Community Reentry of Inmates with Disabilities

Students with disabilities make up a significant portion of youth in the juvenile justice 

system. Some studies show that up to 85 percent of children in juvenile detention 

facilities have disabilities that make them eligible for special education services, yet only 

37 percent receive services while in school.92 This failure to adequately address the 

needs of students with disabilities, particularly at-risk students, creates what has been 

termed ―the school-to-prison pipeline.‖

93

In 2005, 56 percent of state prisoners, 45 percent of federal prisoners, and 64 percent 

of jail inmates were people with mental health problems.94 Approximately74 percent of 

state prisoners and 76 percent of jail inmates with mental health problems also had 

substance dependence or abuse.95

It is estimated that inmates with developmental disabilities make up approximately 3 to 

9 percent of the prison population.96 Approximately 5.7 percent of state inmates have a 

hearing impairment, 8.3 percent reported a vision impairment, and 11.9 percent 

reported a physical impairment.97 Also, 1 percent of the prison population have a vision 

or mobility disability or are deaf or hard-of-hearing.

Inmates with psychiatric and developmental disabilities are often placed with the 

general inmate population. They are a vulnerable group, subject to bullying and

manipulation. Adjustment to prison life can be difficult, and they can find themselves in 

dangerous and threatening situations. The prison experiences often exacerbate their 

disabilities. 

Access to disability-related supports and services upon release from prison can make 

the difference for a person with a disability hoping to successfully reenter the 

community. Many federal and state policies require that Supplemental Security Income 

(SSI) and Medicaid be terminated while a person is in prison. Leaving prison with a 

major mental or physical disability without health insurance and no funds for medication 

can only worsen these conditions. Transition planning for successful reentry into the 
50

community for inmates with disabilities is of paramount importance for successfully 

addressing impediments to successful reentry.

Many of the challenges faced by inmates returning to the community were addressed in 

The Second Chance Act of 2008 (SCA),

98 which was designed to improve outcomes for 

people returning to communities from prisons and jails. This pioneering legislation 

authorizes federal grants to government agencies and nonprofit organizations to provide 

employment assistance, substance abuse treatment, housing, family programming, 

mentoring, victims support, and other services that can help reduce recidivism.

However, programs under the SCA are funded through discretionary grants and 

therefore are subject to termination if the SCA is not reauthorized or funded by 

Congress. Transitioning inmates with disabilities need a more consistent and reliable 

safety net to safeguard their access to disability-related supports and services when 

returning to the community.

NCD recommends:

1. The U.S. Department of Justice should require correction facilities to create a 

prerelease assessment and individualized reentry plan for all inmates with 

disabilities, including a needs assessment and assistance in arranging for health 

care and medications, reinstitution of SSI and Medicaid benefits, special 

education services for those returning to school, vocational services, and 

accessible housing.
51

CHAPTER 3: Earning

Employment

The current economic realities contribute to a bleak picture for persons with disabilities 

who are qualified for, capable of, and interested in gainful employment. They face 

obstacles in accessing employment training, finding employment that matches their 

skills and abilities, and, once hired, maintaining employment in a difficult job market. 

Additionally, little progress has been made to reduce fears that employment may lead to 

a permanent loss of services provided through necessary benefit programs such as 

Medicaid, Medicare, or veterans‘ disability payments.

Too many students with disabilities drop out of public education, severely limiting their 

opportunities to find jobs and achieve self-sufficiency. Of youth ages 14 to 21 who were 

served under IDEA Part B in the 2004–05 school year, 54 percent graduated with a 

standard diploma, 28 percent dropped out, 15 percent received a certificate of 

attendance, and just over 1 percent reached the maximum age to stay in school; More 

current data for the 2009 school year indicate no major changes.

Students with disabilities often leave public education lacking the basic skills required 

for work or for additional training. Specific skill-building programs, as well as the soft 

skills such as job interviewing, are sacrificed in the quest to maintain requisite academic 

achievement levels. As a result, students with disabilities may not get advice on career 

opportunities and often are steered away from college programs that counselors may 

feel are not appropriate for them.

Although students with disabilities are enrolling in postsecondary education in 

increasing numbers, entry levels are well below those of their nondisabled peers, and 

they often report an inability to secure employment in the field in which they were 

trained.
52

Once they enter the job market, people with disabilities encounter a whole new set of 

difficulties. Stigma and discrimination limit opportunities for aspiring workers with 

disabilities. Some employers assume that certain tasks cannot be accomplished by the 

applicant. NCD‘s stakeholders consistently list discrimination as one of the primary 

barriers keeping them out of the workforce. The majority think that discrimination occurs

at the hiring stage. People with disabilities believe that they have been turned down for 

jobs because of employers‘ attitudes toward disabilities.

According to the Equal Employment Opportunity Commission, disability discrimination 

charges rose in 2010 by about 17 percent to 25,165 claims (Tables 10a and 10b).

99

Overall, the agency received nearly 100,000 claims during the 2010 fiscal year, a 

7 percent increase and the highest number in its 45-year history.100 While some increase 

might be expected after passage of the Americans with Disabilities Amendments Act in 

2009, the upward trend in disability discrimination charges was evident before that time.

ADA charges are up 42 percent since 2007. In comparison, race, sex, and age charges 

are up 18, 17, and 22 percent, respectively, over the same time period. 

Begin highlighted text:

According to the Equal Employment Opportunity Commission, 

disability discrimination charges rose in 2010 by about 

17 percent to 25,165 claims.

End highlighted text.

TABLE 10A.

Number of Charges toward the Americans with Disabilities Act of 

1990, 1997–2003

1997 1998 1999 2000 2001 2002 2003

ADA charges 18,108 17,806 17,007 15,864 16,470 15,964 15,377

Source: EEOC, http://www.eeoc.gov/eeoc/statistics/enforcement/charges.cfm. 
53

TABLE 10B.

Number of Charges toward the Americans with Disabilities Act of 

1990, 2004–10

2004 2005 2006 2007 2008 2009 2010

ADA charges 15,376 14,893 15,575 17,734 19,453 21,451 25,165

Source: EEOC, http://www.eeoc.gov/eeoc/statistics/enforcement/charges.cfm

Discrimination continues to be a substantial problem for many job seekers and workers 

with disabilities. We must renew our commitment to education and enforcement to 

increase the recognition of the talented workforce of people with disabilities and to rid

workplaces of disability discrimination.

Given the current economic environment, and the historically low rate of employment of 

people with disabilities, it is imperative that the federal government become a model 

employer of people with disabilities. During the past year, since the 2010 Executive Order 

on increasing employment of people with disabilities,101 the federal government has 

increased recruitment opportunities for people with disabilities. Data are not yet available 

to evaluate the success of this latest initiative. In the past, obstacles at the hiring level and 

reluctance by hiring managers have contributed to the low federal employment rate of 

people with disabilities. Less than 1 percent of the federal workforce is made up of 

individuals with targeted disabilities (see Table A5 in Appendix A). Moreover, individuals 

with targeted disabilities are clustered within the lower federal pay grades (Table 11). 
54

TABLE 11.

Number of Federal Employees with Targeted Disabilities by Type and 

Federal Pay Grade, 2009

Disability by Type

GSR-1 

to 5

GSR-5 

to 10

GSR-10 

to 15

Senior Pay and Senior 

Executive Service

Mental Illness 978 1,291 1,147 12

Deafness 602 714 510 2

Partial Paralysis 481 684 967 17

Mental Retardation 437 111 13 1

Convulsive Disorders 377 671 767 11

Blindness 376 768 844 22

Complete Paralysis 159 282 465 15

Missing Extremities 103 238 375 10

Distortion of Limb/Spine 73 163 162 4

Source: EEOC‘s Annual Report on the Federal Workforce, 2009. See 

http://www.eeoc.gov/federal/reports/fsp2009/appendix4.cfm, Table 6.

Note: The EEOC defines ―targeted disabilities‖ as: Hearing impairments, Vision impairments, Missing 

extremities, Partial paralysis, Complete paralysis, Other impairments including convulsive disorder (e.g., 

epilepsy), mental retardation, mental or emotional illness, and sever distortion of limbs and or spine (e.g., 

dwarfism, kyphosis)

NCD stakeholders have commented on the lack of knowledge at the state and local 

levels about the new federal initiative to increase hiring of people with disabilities, even 

though the vast majority of federal jobs are not located within the nation‘s capital. 

People with disabilities have been disproportionately harmed by the recent downturn in 

the economy. Data from the Current Population Survey indicates that between October 

2008 and June 2011, job loss among workers with disabilities far exceeded that of 

workers without disabilities, with the proportion of employed U.S. workers identified as 

having disabilities declining by 9 percent.102 Many laid-off workers with disabilities 

entered the Social Security Disability Insurance rolls.103

In addition, the labor force participation of people with disabilities lags behind that of 

people without disabilities. The most recent data, released in July 2011 by the 

Department of Labor‘s Bureau of Labor Statistics, shows that only 32.8 percent of 
55

working age people (ages 16 to 64) with disabilities are actually in the U.S. workforce. 

By comparison, the participation rate for people reporting no disabilities is 77.2 percent.

Moreover, disabled workers‘ income is on average one-third less than the income of 

their nondisabled coworkers.

Few federal programs are designed to directly provide vocational services, including job 

placement, for individuals with disabilities. Of the total $429 billion in state and federal 

spending on supports and services for working-age people with disabilities in 2008, 

some 95 percent went toward health care and income maintenance, with only part of 

the remaining 5 percent allocated to improving employment and economic 

independence.104

The Rehabilitation Services Administration, the Ticket to Work program of the Social 

Security Administration, the One Stop Career Centers of the Department of Labor‘s 

Employment and Training Administration, and the Vocational Rehabilitation and 

Counseling program of the Department of Veterans Affairs all are struggling to

accomplish their goals, as unemployment rates have hit double digits in many states 

and are perilously close in others. As state and local programs grapple with budget 

deficits, they have reduced state funding with the result that federal fund matches are 

not being used in states where people with disabilities need them most urgently. Waiting 

lists, staff reductions, lack of clear performance outcomes, and lack of collaboration 

among federal agencies serving people with disabilities have resulted in the loss of 

important job training and placement services across the nation. 

A further focus on community-based, integrated employment could improve 

employment levels. Too many people with disabilities are relegated to sheltered 

workshops, making below minimum wage. Demonstration projects should be directed to 

better identify best practices and models for proper assessment and placement geared 

toward community-based employment. 

Fear of a loss of benefits is another barrier to employment for people with disabilities.

Social Security and Medicaid beneficiaries, in particular, fear losing income supports, 
56

housing assistance, or Medicaid, which covers many long-term services needed for 

people with disabilities to live independently—services not typically covered by private 

health insurance. People who acquire a disability while working often must stop working 

to obtain necessary disability-related supports and services.105 Our public policies 

should support work, not impede it.

NCD recommends:

1. The Office of Disability Employment Policy (ODEP) should conduct an 

information awareness campaign to dispel myths about disability and educate 

employers about the benefits of hiring employees with disabilities through a 

variety of media outlets, involving the disability and business communities in the 

process of developing the campaign.

2. Ways to make reasonable accommodation expertise and assistance more readily 

available in the workplace should be explored, instead of limiting these services 

to those seemingly unable to work or those with a significant disability.

3. Congress should legislate a universal Medicaid buy-in option for people with 

disabilities who work.

4. The Rehabilitation Services Administration should develop technical assistance 

tools to help state and local governments better understand, communicate, and 

disseminate information on federal initiatives to increase federal employment of 

people with disabilities.

5. The Department of Labor should support innovative ways for employers to 

provide leadership in the design and implementation of employment programs.

6. ODEP and the Employment Equal Opportunity Commission should work together 

to update and reissue resources and guidance relating to the rights of employees 

with disabilities in light of new regulations implementing the ADA Amendments 

Act of 2008. Emphasis should be placed both on the new populations that may 

be covered as a result of the broader definition of disability under this Act and on 

any unique accommodation needs that newly covered populations may possess.

Financial Status

Since 1981, the income gap among households with and without a person with a work 

limitation (the Current Population Survey definition of ―disability‖) has grown steadily, 

from a difference of about $19,000 in 1980 (in 2008 dollars) to nearly $28,000 in 2008.106
57

Median earnings for people with disabilities dropped 7 percent from 2008 to 2009, 2 

percentage points more than the drop for persons without disabilities (5 percent). (See 

Tables 12a, 12b, 12c, and 12d). The number of people with disabilities living in poverty 

remains nearly three times the number of people without disabilities Table 13).

TABLE 12A.

Median Household Income among Households with Individuals with 

and without a Work Limitation, 1980–88

1980 1981 1982 1983 1984 1985 1986 1987 1988

No person 

with work 

limitations 

in house 51,500 50,500 50,100 49,900 51,500 52,800 55,000 55,700 56,100

Person 

with work 

limitations 

in house 32,300 31,900 31,800 31,300 31,900 32,200 32,000 32,700 31,500

TABLE 12B.

Median Household Income among Households with Individuals with 

and without a Work Limitation, 1989–97

1989 1990 1991 1992 1993 1994 1995 1996 1997

No person 

with work 

limitations 

in house 57,100 55,900 55,400 55,600 55,300 56,100 57,500 58,600 59,500

Person 

with work 

limitations 

in house 33,500 32,900 32,800 30,700 31,000 31,600 32,400 31,800 32,200
58

TABLE 12C.

Median Household Income among Households with Individuals with 

and without a Work Limitation, 1998–2006

1998 1999 2000 2001 2002 2003 2004 2005 2006

No person 

with work 

limitations 

in house 61,700 63,300 63,400 62,600 61,700 61,300 61,300 61,300 61,900

Person 

with work 

limitations 

in house 32,700 34,600 33,200 33,300 32,200 32,600 31,700 32,400 32,400

TABLE 12D.

Median Household Income among Households with Individuals with 

and without a Work Limitation, 2007–08

2007 2008

No person with work limitations in house 62,300 62,200

Person with work limitations in house 32,100 32,500

Source: Data are from the Current Population Survey and reflect the number of persons with a work 

limitation, which was based on this question: ―[D]oes anyone in this household have a health problem or 

disability which prevents them from working or which limits the kind or amount of work they can do?‖

TABLE 13.

Percentage of People Ages 18–64 with and without a Work Limitation 

Who Lived in Families with Incomes below Poverty, 2008–00

2008 2007 2006 2005 2004 2003 2002 2001 2000

With a work 

limitation 28.1 28.6 28 28 27.8 28 28.2 26.8 27

Without a work 

limitation 10 9.2 9.2 9.4 9.7 9.2 9 8.5 7.9

Source: Data are from the Current Population Survey and reflect the number of persons with a work 

limitation, which was based on this question: ―[D]oes anyone in this household have a health problem or 

disability which prevents them from working or which limits the kind or amount of work they can do?‖
59

Conclusion

In living, learning, and earning, more people with disabilities are falling behind. Disability 

discrimination is on the rise in housing, employment, and air travel. Thirty-five years 

after passage of federal civil rights legislation for students with disabilities, too many 

students are still being segregated and are experiencing poor achievement outcomes.

The economic downturn is having a particularly detrimental effect on people with 

disabilities. Legislation alone does not lead to better outcomes for people with 

disabilities. The effective implementation and enforcement of disability rights requires 

federal oversight through ongoing monitoring and evaluation and cross-silo 

collaborations to ensure the uniform application of the overarching goals of the ADA—

full participation, equal opportunity, independent living, and economic self-sufficiency—

to all disability policies and programs. 
60
61

APPENDIX A: Disability Tables

TABLE A1.

Percentage of People Who Are Obese by Disability Status, 

Selected Years 1991–2006

1991-1994 2002 2006

No disability 23 28 32

Any disability 30 41 39

Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC

TABLE A2A.

Percentage of People Who Use Cigarettes by Disability Status, 

1998–2002

1998 1999 2000 2001 2002

No disability 23 22 22 21 21

Any disability 32 32 31 32 32

Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC

TABLE A2B.

Percentage of People Who Use Cigarettes by Disability Status, 

2003–08

2003 2004 2005 2006 2007 2008

No disability 20 20 20 20 18 19

Any disability 31 28 30 30 31 31

Source: Behavioral Risk Factor Surveillance System (BRFSS), CDC

TABLE A3.

Percentage of People Who Responded “Yes” to “Do you personally 

use a computer or some other electronic device, such as a cell phone, 

to access the Internet or World Wide Web from home, work or 

another location?”

Age 18–29 30–44 45–64 65+

People with disabilities 82 63 61 37

People without disabilities 92 87 82 70

Source: Harris Poll, 2010
62

TABLE A4.

Percentage of Total Students Ages 14 through 21 with Disabilities 

Served under IDEA, Part B, Who Exited Special Education, by 

Exit Reason and State, 2008–09

Graduated 

with diploma

Received a 

certificate Dropped out

Reached 

maximum age

Minnesota 68% 8% 0%

Nebraska 61% 1% 12% 2%

Massachusetts 59% 3% 18% 3%

Hawaii 57% 1% 2% 10%

Connecticut 56% 1% 14% 2%

New Jersey 55% 13% 1%

Pennsylvania 55% 0% 7% 0%

New Hampshire 53% 4% 15% 1%

Maine 52% 1% 17% 1%

Wisconsin 51% 2% 14% 1%

Missouri 49% 0% 16% 1%

Iowa 47% 2% 20% 1%

West Virginia 47% 6% 18% 0%

Montana 45% 1% 15% 0%

New Mexico 45% 15% 10%

Puerto Rico 45% 5% 25% 0%

Utah 44% 5% 14% 1%

Oklahoma 43% 12% 0%

Arizona 42% 11% 0%

District of 

Columbia 42% 7% 46%

Kansas 42% 13% 1%

Kentucky 41% 5% 11% 0%

Illinois 40% 0% 10% 1%

South Dakota 40% 10% 1%

North Dakota 39% 16% 2%

Arkansas 38% 1% 8% 0%

Washington 38% 2% 15%

Maryland 37% 6% 15% 1%

Michigan 37% 1% 18%

North Carolina 35% 5% 19% 0%
63

Graduated 

with diploma

Received a 

certificate Dropped out

Reached 

maximum age

Rhode Island 35% 1% 11% 2%

Tennessee 35% 11% 7% 0%

Alaska 33% 9% 20% 1%

Indiana 32% 7% 15% 0%

Texas 32% 21% 14% 0%

Colorado 30% 2% 17% 1%

New York 30% 12% 14% 1%

Delaware 28% 3% 16%

Virginia 28% 23% 9% 0%

Ohio 27% 20% 7% 4%

Wyoming 27% 3% 18%

South Carolina 26% 1% 33% 3%

Oregon 25% 12% 13% 3%

Florida 24% 12% 12%

Georgia 24% 19% 17%

California 23% 11% 11% 1%

Idaho 23% 17% 11% 2%

Alabama 22% 30% 8% 5%

Louisiana 19% 20% 31% 0%

Mississippi 18% 46% 10% 1%

Nevada 17% 21% 21% 1%

Vermont*

Source: 618 Part B Data, calculations made from numbers in Table 4-1. Retrieved August 2011 from 

http://www.ideadata.org.

*Data for 2007–08 and 2008–09 do not include Vermont. 
64

TABLE A5.

Percentage of the Federal Workforce by Selected Characteristics, 

2000–09

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Hispanic or 

Latino 6.81 6.94 7.1 7.22 7.46 7.61 7.68 7.79 7.94 7.9

Black or 

African 

American 18.76 18.74 18.63 18.56 18.18 18.29 18.36 18.43 18.3 18.03

Asian 5.22 5.32 5.45 5.54 5.79 5.94 5.89 5.95 5.87 5.84

American 

Indian 

Alaska 

Native 1.44 1.48 1.5 1.5 1.67 1.67 1.68 1.65 1.64 1.65

Individuals 

with 

Targeted 

Disabilities 1.12 1.1 1.07 1.05 0.99 0.96 0.94 0.92 0.88 0.88

Source: EEOC‘s Annual Report on the Federal Workforce, 2009, Table 1; see 

http://www.eeoc.gov/federal/reports/fsp2009/appendix4.cfm. Definition of targeted disabilities from the 

EEOC: ―To assist agencies in focusing this effort on severe disabilities that have historically been used to 

exclude qualified individuals from employment, the federal government has identified certain  ̳targeted 

disabilities‘ for special emphasis in affirmative action programs. The  ̳targeted disabilities,‘ which were last 

listed on the Office of Personnel Management (OPM) Standard Form (SF) 256 in 1987, include: 

deafness; blindness; missing extremities; partial paralysis; complete paralysis; convulsive disorders; 

mental retardation; mental illness; and distortion of limb and/or spine. EEOC tracks statistics on the 

employment by federal agencies of people with these targeted disabilities because their unemployment 

and under-employment rates are so high. Tracking employment statistics for this population allows 

federal agencies to better monitor their own efforts at becoming and remaining model employers.‖
65

Endnotes

1

―Declaration for Independence: A Call to Transform Health and Long-Term Services 

for Seniors and People with Disabilities‖ (2009), National Advisory Board on Improving 

Health Care Services for Seniors and People with Disabilities, 

http://www.declarationforindependence.org. 

2

―Medicaid Managed Care Penetration Rates and Expansion Enrollment by State: 

Penetration Rates as of December 31, 2004,‖ Centers for Medicare and Medicaid 

Services, https://www.cms.gov/MedicaidDataSourcesGenInfo/downloads/

09December31f.pdf.

3

―Five Good Reasons States Shouldn‘t Cut Home and Community-Based Services in 

Medicaid‖ (July 2010), Families USA, http://familiesusa2.org/assets/pdfs/long-termcare/Five-Good-Reasons.pdf.

4

―Modernize Medicaid to Better Support People with Disabilities,‖ Sen. Tom Harkin and 

Rep. Cathy McMorris Rodgers (June 30, 2011), http://thehill.com/blogs/congressblog/healthcare/169259-modernize-medicaid-to-better-support-people-with-disabilities.

5 Olmstead v. L.C., 527 U.S. 581 (1999).

6 Olmstead v. L.C., 527 U.S. 581 (1999).

7

―Olmstead: Community Integration for Everyone‖ (June 22, 2011), U.S. Department of 

Justice, http://www.ada.gov/olmstead/index.htm.

8 Sheryl A. Larson and K. Charlie Lakin, ―Expenditure Patterns for ICF/MR and HCBS 

Long-Term Supports for Persons with Intellectual or Developmental Disabilities: Fiscal 

Years 2004–2009, With Projections to Fiscal Year 2012,‖ Intellectual and 

Developmental Disabilities 48, no. 6 (December 2010): 480–84. 

http://www.aaiddjournals.org/doi/pdf/10.1352/1934-9556-48.6.480.

9 Brantley v. Maxwell-Jolly, Cota v. Maxwell-Jolly, 656 F. Supp. 2d 1161 (N. Dist Calif., 

2009) (http://scholar.google.com/scholar_case?case=10938590498249398271&hl

=en&as_sdt=2&as_vis=1&oi=scholarr) (preliminary injunctions granted to stop cuts to 

adult day health care; V.L. v. Wagner, 669 F. Supp. 2d 1106 - 2009

(http://scholar.google.com/scholar_case?case=17767386997275142134&hl=en&as_sdt

=2&as_vis=1&oi=scholarr) - Dist. Court, ND California 2009) (preliminary injunction 

granted to stop cuts to in-home support services; Marlo M. v. Cansler, 679 F. Supp. 2d 

635 (E.D.N.C. 2010) (preliminary injunction granted to stop cuts to home- and 

community-based services for people with mental illness and intellectual disabilities); 

Crabtree v. Goetz, No. 3:08-0930 (M.D. Tenn.) (preliminary injunction granted to stop 

cuts to Tennessee in-home services keeping people out of nursing homes); Peter B. v. 

Sanford, (Dist Court D SC 2011) (preliminary injunction granted to stop cuts to home 

care services); Clinton L., et al. v. Cansler, et al. – 10-CV-00123 – (M.D. NC 2010)

(individuals with developmental disabilities and mental illness challenged the state‘s 

proposed reductions in reimbursement rates for in-home services that will have the 

effect of eliminating providers that offer medically necessary services that enable 

individuals to successfully reside in the community and will place them at risk of 
66

institutionalization); Pitts v. Greenstein – 10-CV-635 – (M.D. LA 2010) (a group of four 

individuals with disabilities who receive and depend on Medicaid Personal Care 

Services (PCS) to remain in the community and to prevent hospitalization and 

institutionalization filed suit to prevent the state of Louisiana from reducing the 

maximum number of PCS hours available each week); Hiltibran v. Levy – 10-CV-4185 –

(W.D. MO 2010) (individuals who need incontinence supplies to live in the community 

filed a Motion for Preliminary Injunction, requesting that the Court order the state to 

provide the Medicaid-funded incontinence supplies to individuals who need those 

supplies to prevent their placement in nursing facilities); Darling v. Douglas – 09-CV3798 – (N.D. CA 2009) (formerly Cota v. Maxwell-Jolly) (plaintiffs challenged the 

manner in which the state plans to eliminate the Adult Day Health Care (ADHC) service, 

which enables elderly individuals and individuals with physical and mental disabilities to 

live in the community and avoid hospitalization and institutionalization); Oster et al. v. 

Wagner – 09-17581 – (9th Cir. 2009) (plaintiffs challenged the state‘s alterations to its 

In-Home Support Services Program because the proposed changes to eligibility criteria 

would force individuals into institutions); Napper v. County of Sacramento – 10-CV01119 – (E.D. CA 2010) (individuals with mental illness brought suit against the County 

of Sacramento for failing to provide adequate community-based services, which placed 

them at risk of institutionalization); Cruz v. Dudek – 1:10-CV-23048 – (S.D. FL 2010)

(Luis Cruz and Nigel de la Torre successfully sought a preliminary injunction enjoining 

the state of Florida from denying them the home- and community-based services 

available under its Traumatic Brain Injury/Spinal Cord Injury Medicaid Waiver); Knipp v. 

Perdue – 10-CV-2850 – (N.D. GA 2010) (plaintiffs challenged the state‘s plan to 

eliminate services for individuals with mental illness without offering sufficient alternative 

support services that are necessary to prevent plaintiffs‘ hospitalization and 

institutionalization); Ball v. Rodgers, Dist. Court D. Arizona, 2010 (permanent injunction 

granted requiring Arizona to provide home care services to keep people out of 

institutions)

10 ―A New Nursing Home Population: The Young‖ (December 9, 2010), Joseph Shapiro, 

http://www.npr.org/2010/12/09/131912529/a-new-nursing-home-population-the-young.

11 Emily Cooper, Ann O‘Hara, and Andrew Zovistoski, The Housing Crisis for People 

with Disabilities (Boston: Technical Assistance Collaborative, 2011). 

http://www.aucd.org/docs/policy/PricedOut2010.pdf.

12 Cooper, O‘Hara, and Zovistoski, The Housing Crisis for People with Disabilities. 

13 U.S. Department of Housing and Urban Development, The 2008 Annual Homeless 

Assessment Report (Washington, DC: U.S. Department of Housing and Urban 

Development, Office of Community Planning and Development, 2009). (This does not 

include homeless children with disabilities in shelters or the estimated 282,000 people 

homeless each night living on the streets, in abandoned buildings, or elsewhere not 

intended for human habitation.)

14

―The State of Housing in the 21st Century: A Disability Perspective‖ (January, 2010), 

National Council on Disability, 

http://www.ncd.gov/publications/2010/Jan192010#_Toc1122.

15

―The State of Housing in the 21st Century: A Disability Perspective,‖ chap. 5.
67

16 Austin Turner et al., Discrimination against Persons with Disabilities: Barriers at Every 

Step (Washington, DC: U.S. Department of Housing and Urban Development, 2005).

17

―The Current State of Health Care for People with Disabilities‖ (September 30, 2009), 

National Council on Disability, http://www.ncd.gov/publications/2009/Sept302009.

18 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 

(2010); Health Care and Education Reconciliation Act, Pub. L. No. 111-152, 124 Stat. 

1029 (2010).

19 Hon. Kathleen Sebelius, Secretary, U.S. Department of Health and Human Services, 

Remarks as prepared for delivery for the Americans with Disabilities Act 21st 

Anniversary (July 26, 2011), 

http://www.hhs.gov/secretary/about/speeches/sp20110726.html.

20 The Current State of Health Care for People with Disabilities. 

21 The Current State of Health Care for People with Disabilities. 

22 E. Hall, Living Well! The Benefits of Leisure for People with Disabilities (Bloomington, 

IN: Indiana University-Bloomington, National Center on Accessibility, 

2005). http:///www.ncaonline.org.

23 Hall, Living Well! 

24 The Current State of Health Care for People with Disabilities. 

25

―Physical Activity for Everyone: The Benefits of Physical Activity,‖ Centers for Disease 

Control and Prevention, http://www.cdc.gov/physicalactivity/everyone/health/index.html.

26

―Physical Activity for Everyone.‖

27

―Physical Activity for Everyone.‖

28

―Chair Yoga Is Accessible for All,‖ Lori Batcheler, http://www.disaboom.com/adaptivefitness/chair-yoga-is-accessible-for-all

29 National Wheelchair Basketball Association, http://www.nwba.org/.

30 Recreation for the Blind, http://www.99main.com/~charlief/vi/recreation.html.

31 Community Resources for People with Disabilities, 

http://www.adaptiveadventures.org.

32

―Five Steps for Introducing Running to Lower-Limb Amputees,‖ Robert Gailey, 

http://www.amputee-coalition.org/military-instep/introducing-running-lower-limb.html.

33 Americans with Disabilities Act Title II Regulations: Part 35 Nondiscrimination on the 

Basis of Disability in State and Local Government Services, updated March 29, 2011, 

http://www.ada.gov/regs2010/titleII_2010/titleII_2010_regulations.htm; Americans with 

Disabilities Act Title III Regulations: Part 36 Nondiscrimination on the Basis of Disability 

in Public Accommodations and Commercial Facilities, updated April 1, 2011, 

http://www.ada.gov/regs2010/titleIII_2010/titleIII_2010_regulations.htm.
68

34 Twenty-First Century Communications and Video Accessibility Act of 2010, Pub. L .

No. 111-260, 124 Stat. 2752 (2010), http://hraunfoss.fcc.gov/edocs_public/attachmatch/

DOC-303939A1.doc.

35

―Survey of Americans with Disabilities‖ (2010), Kessler Foundation and National 

Organization on Disability, http://www.2010disabilitysurveys.org/pdfs/surveyresults.pdf.

36

―Survey of Americans with Disabilities.‖

37 ―The Current State of Transportation for People with Disabilities in the United States‖ 

(June 13, 2005), National Council on Disability, 

http://www.ncd.gov/publications/2005/06132005.

38 U.S. Department of Transportation, Aviation Consumer Protection and Enforcement, 

Annual Report on Disability-Related Air Travel Complaints (Washington, DC: U.S. 

Department of Transportation, 2011), 4.

39 U.S. Department of Transportation, Aviation Consumer Protection and Enforcement, 

Annual Report on Disability-Related Air Travel Complaints (Washington, DC: U.S. 

Department of Transportation, 2009).

40 U.S. Department of Transportation, Aviation Consumer Protection and Enforcement, 

Annual Report on Disability-Related Air Travel Complaints (Washington, DC: U.S. 

Department of Transportation, 2011), 3-4.

41 Air Carrier Access Act, Pub. L. No. 99-435, 100 Stat. 1080 (1986).

42

―Deaf Couple Describe Weathering Alabama Tornado‖ (May 6, 2011), Blair Shiff, 

http://www.9news.com/rss/story.aspx?storyid=197177.

43 National Council on Disability, Saving Lives: Including People with Disabilities in 

Emergency Planning (Washington, DC: National Council on Disability, 2005), 

http://www.ncd.gov/publications/2005/04152005; U.S. Department of Homeland 

Security, Individuals with Disabilities in Emergency Preparedness: Executive Order 

13347, Annual Report (Washington, DC: U.S. Department of Homeland Security, 2005), 

http://www.dhs.gov/xabout/structure/gc_1266873528670.shtm#3; U.S. Department of 

Homeland Security, Individuals with Disabilities in Emergency Preparedness Executive 

Order 13347: Progress Report July 2005 – September 2006 (Washington, DC: U.S. 

Department of Homeland Security, 2006), 

http://www.dhs.gov/xabout/structure/gc_1266873528670.shtm#3; U.S. Department of 

Education, Emergency Management Research and People with Disabilities: A Resource 

Guide (Washington, DC: U.S. Department of Education, 2008). 

http://www.ed.gov/rschstat/research/pubs; National Council on Disability, Effective 

Emergency Management: Making Improvements for Communities and People with 

Disabilities (Washington, DC: National Council on Disability, 2009). 

http://www.ncd.gov/publications/2009/Aug122009.

44 Caring for Special Needs during Disasters: What’s Being Done for Vulnerable 

Populations? Before the Subcommittee on Emergency Communications, Preparedness 

and Response Homeland Security Committee, U.S. House of Representatives (2010) 

(testimony of Jonathan M. Young, Ph.D., J.D.), 

http://www.ncd.gov/newsroom/Testimony/2010/HS_Subcomm_Young_Testimony_FINAL.
69

45

―Disability in Conflict and Emergencies Fact Sheet,‖ The Atlas Alliance, 

http://www.cbm.org/article/downloads/71140/Fact_sheet_Disability_in_Conflict_and_Em

ergencies.pdf.

46 See discussion during Caring for Special Needs during Disasters: What’s Being Done 

for Vulnerable Populations? Subcommittee on Emergency Communications, 

Preparedness and Response Homeland Security Committee, U.S. House of 

Representatives, June 15, 2010.

47 National Council on Disability, Over the Horizon: Potential Impact of Emerging Trends 

in Information and Communication Technology on Disability Policy and Practice

(Washington, DC: National Council on Disability, 2006), 

http://www.ncd.gov/publications/2006/Dec262006#_Toc151518474.

48 ―People with Vision Loss Can‘t Use Most Cell Phones. It‘s Time to Change That,‖ 

American Foundation for the Blind, 

http://www.afb.org/blog/blog_comments.asp?TopicID=3002#content. 

49

―AAPD Recommendations for Accessible Technology Research‖ (July 25, 2008), 

American Association of People with Disabilities, 

http://www.aapd.com/site/c.pvI1IkNWJqE/b.5607495/k.33DD/AAPD_Recommendations

_for_Accessible_Technology_Research.htm.

50

―Distance Learning,‖ Sheryl Burgstahler, 

http://www.washington.edu/doit/Faculty/Strategies/Academic/Distancelearning/.

51

―Inaccessible E-Book Reader Program Challenged‖ (February 23, 2011), Coalition of 

Organizations for Accessible Technology, http://www.coataccess.org/node/9967.

52

―Access in the Kitchen: An Update on Home Appliances‖ (January 2007), Brad 

Hodges, http://www.afb.org/afbpress/pub.asp?DocID=aw080104.

53 Achieving the Promise of the Americans with Disabilities Act in the Digital Age: 

Current Issues, Challenges, and Opportunities, Before the Committee on the Judiciary, 

Subcommittee on the Constitution, Civil Rights, and Civil Liberties, U.S. House of 

Representatives (2010) (testimony of Daniel F. Goldstein), 

http://www.browngold.com/?s=news&ss=86. 

54 Achieving the Promise of the Americans with Disabilities Act in the Digital Age. (Some 

examples include AOL, Target, Amazon, Audible, Major League Baseball, CVS, Radio 

Shack, Rite Aid, Staples, Ramada Hotels, Priceline.)

55 Achieving the Promise of the Americans with Disabilities Act in the Digital Age.

56 http://www.w3.org/WAI/intro/wcag.php. 

57 http://www.access-board.gov/sec508/standards.htm.

58

―2010 ADA Standards for Accessible Design, Sec. 220,‖ U.S. Department of Justice, 

http://www.ada.gov/regs2010/2010ADAStandards/2010ADAstandards.htm.

59 Telecommunications Act of 1996, 47 U.S.C. §§ 153, 255 (applies to the 

telecommunications functions of telephones, cell phones, pay phones, pagers, fax 

machines, computers with modems, and telephone company switching equipment). 
70

60 Twenty-First Century Communications and Video Accessibility Act of 2010, Pub. L.

No. 111-260, 124 Stat. 2751 (2010), 

http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-303939A1.doc.

61 Section 508 of the Rehabilitation Act, as amended, 29 U.S.C. 794(d) (applies to 

electronic and information technology of federal departments and agencies).

62 Vanessa Voltz, ―A Matter of Choice: Women with Disabilities, Sterilization, and 

Reproductive Autonomy in the Twenty-First Century,‖ Women’s Rights Law Reporter 

203 (Summer 2006).

63 Megan Kirshbaum, Daniel O. Taube, and Rosalind Lasian Baer, ―Parents with 

Disabilities: Problems in Family Court Practice,‖ Journal of the Center for Families, 

Children & the Courts 4 (2003): 27–43.

64 Elizabeth Lightfoot, The Inclusion of Disability as Grounds for Termination of Parental 

Rights in State Codes: Policy Research Brief (Minneapolis, MN: Research and Training 

Center on Community Living, 2006).

65 E. Callow, K. Buckland, and S. Jones, The Disability Movement and a New Focus on 

Legislating Protection for Children in Families with Parental Disability (Berkeley: 

Through the Looking Glass, 2008); Amy De La Hunt, ―A Victory for Parents with 

Disabilities in Missouri,‖ St. Louis Kids Magazine (2011), 

http://www.stlouiskidsmagazine.com/story/victory-parents-disabilities-missouri.

66

―Federal Education Legislation Enacted in 1994: An Evaluation of Implementation and 

Impact Executive Summary,‖ U.S. Department of Education, Office of the Under 

Secretary, Planning and Evaluation Service, accessed July 19, 2011, 

http://www2.ed.gov/offices/OUS/PES/1994legislation.html. 

67 States without appropriate alternate assessments had been allowed, for purposes of 

determining adequate yearly progress (AYP), to use a proxy, counting as proficient the 

scores of that 2 percent of students, regardless of how they actually performed. See ―All 

Means All,‖ http://www2.ed.gov/about/offices/list/osers/news.html.

68 Jennifer Catz and Pat Mirenda, ―Including Students with Developmental Disabilities in 

General Education Classrooms: Educational Benefits,‖ International Journal of Special 

Education 17, no. 2 (2002): 14–24. 

69 Catz and Mirenda, ―Including Students with Developmental Disabilities in General 

Education Classrooms.‖

70 http://www2.ed.gov/policy/gen/leg/recovery/factsheet/idea.html.

71

―Recovery Act: Status of States‘ and Localities‘ Use of Funds and Efforts to Ensure 

Accountability (GAO 10-231)‖ (2009), Government Accountability Office, 

http://www.gao.gov/products/GAO-10-231.

72 U.S. Department of Education, Office of Special Education Programs, Part C 

SPP/APR 2011 indicator analyses (FFY 2009-2010) (Washington, DC: U.S. Department 

of Education, forthcoming). 
71

73

―Outcomes for Children Served through IDEA‘s Early Childhood Programs,‖ Early 

Childhood Outcomes Center, 

http://www.fpg.unc.edu/~eco/assets/pdfs/outcomesforchildrenfinal.pdf.

74 Centers for Disease Control and Prevention, 2011. http://www.cdc.gov.

75 Centers for Disease Control and Prevention, 2011. http://www.cdc.gov.

76 Kate McKenna, ―Confronting the Autism Epidemic,‖ Harvard Education Letter 23, no. 

5 (September/October, 2007). 

http://webcache.googleusercontent.com/search?q=cache:FVh7cHRHfjwJ:www.hepg.or

g/hel/article/219+ed.gov+early+intervention+demand+need+for&cd=14&hl=en&ct=clnk&

gl=us.

77 Marissa D. Wise, Alison A. Little, Jamie Bruce Holliman, Paul H. Wise, and Jason C. 

Wang, ―Can State Early Intervention Programs Meet the Increased Demand of Children 

Suspected of Having Autism Spectrum Disorders?‖ Journal of Developmental and 

Behavioral Pediatrics 31, no. 6 (2010): 469–76. 

http://journals.lww.com/jrnldbp/Abstract/2010/07000/Can_State_Early_Intervention_Pro

grams_Meet_the.2.aspx.

78

―Report to Congress on Activities Related to Autism Spectrum Disorder and Other 

Developmental Disabilities under the Combating Autism Act of 2006,‖ U.S. Department 

of Health and Human Services, Interagency Autism Coordinating Committee, 

http://iacc.hhs.gov/reports/reports-to-congress/FY2006-2009/index.shtml.

79 ―Transition and Postsecondary Programs for Students with Intellectual Disabilities: 

Legislation, Regulations, and Guidance,‖ U.S. Department of Education, 

http://www2.ed.gov/programs/tpsid/legislation.html.

80 U.S. Census Bureau‘s 2005-2009 American Community Survey data estimate that 

84.6 percent of the country‘s general population of people 25 years and over completed 

high school. 

81 Robert E. Cimera, ―The Cost-Trends of Supported Employment Versus Sheltered 

Employment,‖ Journal of Vocational Rehabilitation 28, no. 1 (2008): 15–20.

82 Cimera, ―The Cost-Trends of Supported Employment Versus Sheltered Employment.‖ 

83 Bonnie B. Carter and Vicky G. Spencer, ―The Fear Factor: Bullying and Students with

Disabilities,‖ International Journal of Special Education 21, no. 1 (2006): 11–23. 

Retrieved December 18, 2010, from http://www.forockids.org/PDF Docs/Bullying.pdf.

84 Whitney I. Smith et al., ―Bullying and Children with Special Educational Needs,‖ in 

School Bullying: Insights and Perspectives, ed. P. K. Smith and S. Sharp (London: 

Routledge, 1994).

85 M. Martlew and J. Hodson (1991). Children with Mild Learning Difficulties in an 

Integrated and in a Special School: Comparisons of Behaviour, Teasing and Teachers‘ 

Attitudes, British Journal of Educational Psychology, 61: 355–72. 

86 A. Siebecker, S. Swearer, and J. Lieske, ―Risky Business: Bullying and Students with 

Disabilities‖ (poster presented at the annual meeting of the National Association of 

School Psychologists, Atlanta, GA, March 2005). Retrieved December 21, 2010, 
72

http://www.targetbully.com/uploads/NASP2005.Siebecker.ppt; Anthony Petrosino, 

Sarah Guckenburg, Jill DeVoe, and Thomas Hanson, What Characteristics of Bullying, 

Bullying Victims, and Schools Are Associated with Increased Reporting of Bullying to 

School Officials? (Washington, DC: U.S. Department of Education, Institute of 

Education Sciences, National Center for Education Evaluation and Regional Assistance, 

Regional Educational Laboratory Northeast and Islands, 2010). Retrieved December 

19, 2010, from http://ies.ed.gov/ncee/edlabs/regions/northeast/pdf/REL_2010092.pdf.

87 ―Dickson Mother Says Bullying Went Too Far,‖ 

http://www.kten.com/story/12298701/dickson-mother-says-bullying-went-toofar?redirected=true.

88 ―Departments of Education and Justice Reach Agreement with Owatonna, Minn., 

Public Schools to Resolve Harassment Allegations,‖ April 12, 2011, 

http://www.ed.gov/news/press-releases/departments-education-and-justice-reachagreement-owatonna-minn-public-schools-r.

89 ―Dear Colleague Letter,‖ U.S. Department of Education, Office for Civil Rights, 

http://www2.ed.gov/about/offices/list/ocr/letters/colleague-201010.html.

90 J. Young, A. Ne‘eman, and S. Gelser, Briefing Paper: Bullying and Students with 

Disabilities (Washington, DC: National Council on Disability, 2011). Written for the White 

House Conference on Bullying Prevention.

91 L.K. v. New York City Dept. of Education, 10 CV 00752 (S.D. N.Y.).

92 ―SPLC Launches School to Prison Reform Project to Help At-Risk Children Get 

Special Education Services, Avoid Incarceration‘‘ (2007), Southern Poverty Law Center, 

http://www.splcenter.org/get-informed/news/splc-launches-school-to-prison-reformproject-to-help-at-risk-children-get-special. 

93 ―SPLC Launches School to Prison Reform Project.‖

94 Doris J. James and Lauren E. Glaze, Bureau of Justice Statistics Special Report: 

Mental Health Problems of Prison and Jail Inmates (Washington, DC: U.S. Department 

of Justice, 2006).

95 James and Glaze, Bureau of Justice Statistics Special Report.

96 Jean Stewart and Marta Russell, ―Disablement, Prison, and Historical Segregation,‖ 

Monthly Review 53, no. 3 (2001). http://monthlyreview.org/2001/07/01/disablementprison-and-historical-segregation.

97 Jessie L. Krienert, Martha L. Henderson, and Donna V. Vandiver, ―Inmates with 

Physical Disabilities: Establishing a Knowledge Base,‖ Southwest Journal of Criminal 

Justice 1, no. 1 (2003): 13–23.

98 Second Chance Act of 2007: Community Safety Through Recidivism Prevention, Pub. 

L. No. 110-199, 122 Stat. 657 (2007).

99 U.S. Equal Employment Opportunity Commission, Americans with Disabilities Act of 

1990 (ADA) Charges (Washington, DC: U.S. Equal Employment Opportunity 

Commission, 2011).
73

100 U.S. Equal Employment Opportunity Commission, Americans with Disabilities Act of 

1990 (ADA) Charges.

101 Exec. Order No. 13548, ―Increasing Federal Employment of Individuals with 

Disabilities,‖ Fed. Reg. 75 FR 45039 (July 30, 2010). http://www.whitehouse.gov/thepress-office/executive-order-increasing-federal-employment-individuals-with-disabilities. 

102 U.S. Department of Labor, Bureau of Labor Statistics, Current Population Survey, 

Employment Situation: 2011 (Washington, DC: U.S. Department of Labor, Bureau of 

Labor Statistics, 2011).

103 David Stapleton and Gina Livermore, Costs, Cuts, and Consequences: Charting a 

New Course for Working-Age People with Disabilities (Princeton, NJ: Mathematica 

Policy Research, Center for Studying Disability Policy, 2010). 

http://links.mkt3889.com/ctt?kn=2&ms=MTkzNTUyNwS2&r=MTYzMDM4NDY4MQS2.

104 Stapleton and Livermore, Costs, Cuts, and Consequences.

105 Jody Schimmel and David C. Stapleton, ―Disability Benefits Suspended or 

Terminated Because of Work,‖ Social Security Bulletin 71, no. 3 (2011); see 34 CFR § 

361.36 (federal regulation governing who must receive vocational rehabilitation 

services).

106 U.S. Census Bureau, Current Population Survey (Washington, DC: U.S. Census 

Bureau).
74