I 
116TH CONGRESS 
1ST SESSION 
H. R. 555 
To prohibit discrimination against individuals with disabilities who need long- 
term services and supports, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 15, 2019 
Mr. SENSENBRENNER (for himself, Mr. DOGGETT, Ms. NORTON, Mr. WELCH, 
Mr. FITZPATRICK, Mr. CONNOLLY, Ms. TITUS, Mr. SERRANO, Mr. 
MORELLE, Mr. ESPAILLAT, Ms. DEAN, Mr. SUOZZI, Mr. CARBAJAL, Mr. 
BRENDAN F. BOYLE of Pennsylvania, Mr. MCGOVERN, Mr. KATKO, Mr. 
PERLMUTTER, Mr. DELGADO, Mr. HIGGINS of New York, Ms. MATSUI, 
Ms. WASSERMAN SCHULTZ, Ms. OCASIO-CORTEZ, Ms. DELAURO, Ms. 
DEGETTE, Mr. RASKIN, Ms. BARRAGA´N, Mr. CUMMINGS, Mr. LANGEVIN, 
Ms. SCHAKOWSKY, Miss RICE of New York, Mr. RUPPERSBERGER, Ms. 
STEFANIK, Ms. BONAMICI, Mr. CROW, Mr. ENGEL, Mr. TIPTON, Mr. 
PETERSON, Mr. CASTRO of Texas, Mrs. LAWRENCE, Mr. NEGUSE, and 
Mr. BRINDISI) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on the Judiciary, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To prohibit discrimination against individuals with disabil-
ities who need long-term services and supports, and for 
other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Disability Integration 
Act of 2019’’. 
SEC. 2. FINDINGS AND PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
(1) In enacting the Americans with Disabilities 
Act of 1990 (referred to in this Act as the ‘‘ADA’’), 
Congress— 
(A) recognized that ‘‘historically, society 
has tended to isolate and segregate individuals 
with disabilities, and, despite some improve-
ments, such forms of discrimination against in-
dividuals with disabilities continue to be a seri-
ous and pervasive social problem’’; and 
(B) intended that the ADA assure ‘‘full 
participation’’ and ‘‘independent living’’ for in-
dividuals with disabilities by addressing ‘‘dis-
crimination against individuals with disabilities 
[that] persists in critical areas’’, including insti-
tutionalization. 
(2) While Congress expected that the ADA’s in-
tegration mandate would be interpreted in a manner 
that ensures that individuals who are eligible for in-
stitutional placement are able to exercise a right to 
community-based long-term services and supports, 
that expectation has not been fulfilled. 
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(3) The holdings of the Supreme Court in 
Olmstead v. L.C., 527 U.S. 581 (1999), and com-
panion cases, have clearly articulated that individ-
uals with disabilities have a civil right under the 
ADA to participate in society as equal citizens. How-
ever, many States still do not provide sufficient com-
munity-based long-term services and supports to in-
dividuals with disabilities to end segregation in insti-
tutions. 
(4) The right to live in the community is nec-
essary for the exercise of the civil rights that the 
ADA was intended to secure for all individuals with 
disabilities. The lack of adequate community-based 
services and supports has imperiled the civil rights 
of all individuals with disabilities, and has under-
mined the very promise of the ADA. It is, therefore, 
necessary to recognize in statute a robust and fully 
articulated right to community living. 
(5) States, with a few exceptions, continue to 
approach decisions regarding long-term services and 
supports from social welfare and budgetary perspec-
tives, but for the promise of the ADA to be fully re-
alized, States must approach these decisions from a 
civil rights perspective. 
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(6) States have not consistently planned to en-
sure sufficient services and supports for individuals 
with disabilities, including those with the most sig-
nificant disabilities, to enable individuals with dis-
abilities to live in the most integrated setting. As a 
result, many individuals with disabilities who reside 
in institutions are prevented from residing in the 
community and individuals with disabilities who are 
not in institutions find themselves at risk of institu-
tional placement. 
(7) The continuing existence of unfair and un-
necessary institutionalization denies individuals with 
disabilities the opportunity to live and participate on 
an equal basis in the community and costs the 
United States billions of dollars in unnecessary 
spending related to perpetuating dependency and 
unnecessary confinement. 
(b) PURPOSES.—The purposes of this Act are— 
(1) to clarify and strengthen the ADA’s inte-
gration mandate in a manner that accelerates State 
compliance; 
(2) to clarify that every individual who is eligi-
ble for long-term services and supports has a feder-
ally protected right to be meaningfully integrated 
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into that individual’s community and receive commu-
nity-based long-term services and supports; 
(3) to ensure that States provide long-term 
services and supports to individuals with disabilities 
in a manner that allows individuals with disabilities 
to live in the most integrated setting, including the 
individual’s own home, have maximum control over 
their services and supports, and ensure that long- 
term services and supports are provided in a manner 
that allows individuals with disabilities to lead an 
independent life; 
(4) to establish a comprehensive State planning 
requirement that includes enforceable, measurable 
objectives that are designed to transition individuals 
with all types of disabilities at all ages out of institu-
tions and into the most integrated setting; and 
(5) to establish a requirement for clear and uni-
form annual public reporting by States that includes 
reporting about— 
(A) the number of individuals with disabil-
ities who are served in the community and the 
number who are served in institutions; and 
(B) the number of individuals with disabil-
ities who have transitioned from an institution 
to a community-based living situation, and the 
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(i) STATE
REPORT.—As a condition 
for the receipt of a payment based on an 
increase described in subparagraph (B) 
with respect to amounts to be expended by 
the State for medical assistance consisting 
of home and community-based services de-
scribed in subparagraph (B), the State 
shall report to the Secretary, for the re-
porting year, the amount of funds ex-
pended by the State for home and commu-
nity-based services (as defined in subpara-
graph (E)(ii)) in that year. The State shall 
make the report in a format developed or 
approved by the Secretary. 
(ii) REDUCTION IN PAYMENT IF FAIL-
URE
TO
MAINTAIN
EFFORT.—If 
the 
amount reported under clause (i) by a 
State with respect to a reporting year is 
less than the amount reported under clause 
(i) with respect to the previous fiscal year 
or fiscal year 2019, whichever was the 
greater reported amount, the Secretary 
shall provide for a reduction in the pay-
ment to the State based on the increase. 
(E) DEFINITIONS.—In this paragraph: 
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