AACCENT Act
Bill: S.2 | Sponsor: Sen. Casey, Robert P., Jr. (D-PA)
Policy area: Social Welfare

Summary:
Augmentative and Alternative Communication Centers to Establish National Training Act or the AACCENT Act
This bill requires the Department of Health and Human Services to award three grants in geographically diverse regions to establish a network of resource centers to improve access to tools, technologies, strategies, training, and other methods used to supplement or replace speech (i.e., augmentative and alternative communication) for individuals with significant expressive communication disabilities. These are communication disabilities (other than communication disabilities that are primarily visual or auditory in nature) that prevent or significantly limit an individual from understanding or being understood using spoken words, resulting in the need for or benefit from augmentative and alternative communication.

To support national training, technical assistance, and resource 
  centers, to ensure that all individuals with significant expressive 
    communication disabilities have access to the augmentative and 
alternative communication the individuals need to interact with others, 
 in order to learn, work, socialize, and take advantage of all aspects 
                     of life in the United States.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Augmentative and Alternative 
Communication Centers to Establish National Training Act'' or the 
``AACCENT Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Communication is a basic human need and fundamental 
        right, and is essential to self-determination, social 
        inclusion, and emotional and physical well-being. In enacting a 
        provision of the Americans with Disabilities Act of 1990 
        (referred to in this section as the ``ADA''), Congress 
        recognized that ``physical or mental disabilities in no way 
        diminish a person's right to fully participate in all aspects 
        of society,'' and that ``the discriminatory effects of 
        communication barriers'' are a form of discrimination.
            (2) Three decades after the passage of the ADA, Americans 
        with significant expressive communication disabilities still 
        experience discrimination in the form of communication 
        barriers, institutionalization, segregation, and relegation to 
        lesser services, programs, activities, benefits, jobs, or other 
        opportunities compared to Americans without significant 
        expressive communication disabilities.
            (3) Data about augmentative and alternative communication 
        is lacking, but it is estimated there are at least 4,000,000 
        people in the United States who cannot reliably meet their 
        daily communication needs using natural speech.
            (4) The population of individuals with significant 
        expressive communication difficulties is at substantial risk 
        for limited education, unemployment, poor health outcomes, 
        poverty, and low quality of life.
            (5) People can acquire a significant expressive 
        communication disability and need augmentative and alternative 
        communication as a result of many health and developmental 
        conditions at all stages of life.
            (6) Research indicates that individuals who belong to 
        racial or ethnic minority communities face a greater likelihood 
        of being born with or acquiring expressive communication 
        disabilities, as well as added difficulties in obtaining 
        intervention services, including augmentative and alternative 
        communication.
            (7) Individuals with significant expressive communication 
        disabilities, schools, families, employers, direct support 
        providers, health care providers, the justice system, and the 
        general public need more information about how to effectively 
        deploy, implement, and ensure continued access to robust 
        communication tools, services, and other supports for 
        individuals with significant expressive communication 
        disabilities.
            (8) The lived experiences and writings of individuals with 
        significant expressive communication disabilities demonstrate 
        the positive impact augmentative and alternative communication 
        has on their lives. These lived experiences and writings also 
        illustrate the harm that results from denying augmentative and 
        alternative communication to those who need it.
            (9) The leadership of individuals with significant 
        expressive communication disabilities is critical in crafting 
        and implementing effective policies and programs affecting 
        their lives, including policies and programs regarding 
        augmentative and alternative communication.
            (10) The freedoms of expression, and to be understood, are 
        essential to both democracy and to individual well-being. 
        Individuals with significant expressive communication 
        disabilities must be afforded equal rights, opportunities, 
        strategies, technologies, services, and other supports to 
        effectively express themselves and participate in their 
        communities and in democracy.

SEC. 3. PURPOSE.

    The purpose of this Act is to work toward eliminating the continued 
discrimination, isolation, marginalization, and denial of equal 
opportunity of individuals with significant expressive communication 
disabilities by providing for comprehensive national training, 
technical assistance, and resource centers to improve access to--
            (1) a full range of augmentative and alternative 
        communication;
            (2) equal opportunity;
            (3) awareness and implementation of relevant laws, 
        policies, and practices;
            (4) leadership and self-advocacy skills;
            (5) capacity, in the case of individuals with significant 
        expressive communication disabilities, educators, 
        professionals, and families;
            (6) national statistical data; and
            (7) societal awareness.

SEC. 4. DEFINITIONS.

    In this Act:
            (1) Advisory council.--The term ``advisory council'' means 
        an 11-person advisory council that--
                    (A) provides guidance, recommendations, and 
                oversight to an eligible entity;
                    (B) is comprised exclusively of individuals with 
                significant expressive communication disabilities who 
                collectively have diverse--
                            (i) educational and professional 
                        backgrounds;
                            (ii) racial, ethnic, gender, and linguistic 
                        identities;
                            (iii) disabilities, including intellectual 
                        disabilities, ages, and geographic locations;
                            (iv) levels of income; and
                            (v) forms of augmentative and alternative 
                        communication relied upon; and
                    (C) is subject to each of the following conditions:
                            (i) The initial council members shall be 
                        identified in the grant application by the 
                        partners of the eligible entity.
                            (ii) Each member of the advisory council 
                        shall be appointed for a period of 5 years.
                            (iii) The Chair and Vice Chair of the 
                        council shall be selected by the council 
                        members at the first meeting and thereafter as 
                        the council determines to be appropriate.
                            (iv) The council shall fill any vacancy in 
                        accordance with section 7(b)(8)(C).
            (2) Augmentative and alternative communication.--The term 
        ``augmentative and alternative communication'' means any tool, 
        method, technology, strategy, service, training, coaching, and 
        other support used to supplement or replace speech.
            (3) Competitive integrated employment.--The term 
        ``competitive integrated employment'' has the meaning given the 
        term in section 7 of the Rehabilitation Act of 1973 (29 U.S.C. 
        705).
            (4) Disability.--The term ``disability'' has the meaning 
        given the term in section 3 of the Americans with Disabilities 
        Act of 1990 (42 U.S.C. 12102).
            (5) Eligible entity.--The term ``eligible entity'' means a 
        partnership of at least 2 organizations--
                    (A) for which the controlling partner of the 
                partnership is a nonprofit organization headquartered 
                in the United States that vests power and authority in 
                individuals with significant expressive communication 
                disabilities in terms of management, staffing, 
                decisionmaking, operation, and provision of services;
                    (B) that includes at least one other organization 
                headquartered in the United States that is either an 
                institution of higher education or an association of 
                professional service providers or educators in the 
                field of significant expressive communication 
                disabilities;
                    (C) that has a cross-disability and cross-
                generational focus;
                    (D) that is advised by an advisory council;
                    (E) that has adopted a mission that values equal 
                opportunity and the fundamental right of communication 
                access, and operating principles that respect the 
                rights of individuals with significant expressive 
                communication disabilities to express themselves in the 
                manner of their choosing; and
                    (F) of which the organizational members, 
                collectively--
                            (i) have knowledge, experience, and 
                        capacity in conducting training, technical 
                        assistance, or knowledge dissemination related 
                        to the priority activities described in section 
                        6;
                            (ii) have experience working directly with 
                        individuals with significant expressive 
                        communication disabilities in association 
                        with--
                                    (I) early intervention programs, 
                                early childhood programs, elementary or 
                                secondary schools, or postsecondary 
                                education programs; or
                                    (II) 2 or more types of entities 
                                from among--
                                            (aa) centers for 
                                        independent living authorized 
                                        under part C of title VII of 
                                        the Rehabilitation Act of 1973 
                                        (29 U.S.C. 796f et seq.);
                                            (bb) home and community-
                                        based service providers;
                                            (cc) employers;
                                            (dd) health care providers;
                                            (ee) protection and 
                                        advocacy organizations;
                                            (ff) aging networks;
                                            (gg) caregiver 
                                        organizations; or
                                            (hh) State, Tribal, or 
                                        local government agencies; and
                            (iii) have experience developing and 
                        maintaining collaborative working relationships 
                        among disability-led advocacy organizations, 
                        institutions of higher education, professional 
                        associations, or caregiver organizations.
            (6) Evidence-based.--The term ``evidence-based'', used with 
        respect to assistance that is knowledge, a resource, training, 
        or technical assistance, means assistance--
                    (A) that demonstrates a rationale based on a high-
                quality research finding or positive evaluation that 
                such assistance is likely to improve a communication 
                outcome or other relevant outcome; and
                    (B) for which ongoing efforts are made to examine 
                the effects of the assistance.
            (7) Individual with significant expressive communication 
        disabilities.--The term ``individual with significant 
        expressive communication disabilities'' means an individual of 
        any age--
                    (A) who has 1 or more real or perceived significant 
                expressive communication disabilities and may have 
                other disabilities; and
                    (B) whose disabilities result in the need for, or 
                benefit from, augmentative and alternative 
                communication and other supports to enable the 
                individual to communicate and to aid the individual in 
                participating in 1 or more aspects of life.
            (8) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
        term in section 101(a) of the Higher Education Act of 1965 (20 
        U.S.C. 1001(a)).
            (9) National resource center.--The term ``national resource 
        center'' means a National Resource Center on Augmentative and 
        Alternative Communication referred to in section 5(a).
            (10) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (11) Significant expressive communication disability.--
                    (A) In general.--The term ``significant expressive 
                communication disability'' means any disability, 
                whether congenital, developmental, or acquired at any 
                point in life, that prevents or significantly limits an 
                individual from understanding or being understood using 
                spoken words, resulting in the individual's need for or 
                benefit from augmentative and alternative 
                communication.
                    (B) Application.--The term does not apply to an 
                individual whose primary communication disability is 
                visual or auditory in nature, but does apply to an 
                individual with a disability described in subparagraph 
                (A) who also has a visual or auditory communication 
                disability and who may communicate using sign language.
            (12) State.--The term ``State'' means the 50 States, the 
        District of Columbia, the Commonwealth of Puerto Rico, the 
        United States Virgin Islands, Guam, American Samoa, and the 
        Commonwealth of the Northern Mariana Islands.

SEC. 5. GRANTS.

    (a) In General.--The Secretary shall award 3 grants through an open 
competition to eligible entities, with applications approved under 
section 7, to create, maintain, and administer a network of National 
Resource Centers on Augmentative and Alternative Communication. Each 
national resource center shall be a comprehensive training, technical 
assistance, and resource center created to work toward eliminating the 
continued discrimination against, isolation of, marginalization of, and 
denial of effective communication for and equal opportunity of, 
individuals with significant expressive communication disabilities, 
through activities including the priority activities described in 
section 6.
    (b) Awards for Multiple Centers.--The Secretary shall award the 
grants for national resource centers in 3 geographically diverse 
locations, and shall designate one of the centers as the lead 
administrative center.
    (c) Lead Administrative Center.--The lead administrative center 
shall coordinate--
            (1) all activities of the centers;
            (2) specialization of priorities among the centers;
            (3) dissemination of information among the centers;
            (4) responses of the centers to the Secretary; and
            (5) ensuring that the full range of individuals with 
        significant expressive communication disabilities is served by 
        the centers.
    (d) Amount.--The Secretary shall, to the extent practicable, award 
the 3 grants in amounts that total not more than $9,000,000 per year of 
a period described in subsection (e).
    (e) Periods.--The Secretary shall award each grant for a period of 
5 years, through an open competition held initially and at the end of 
each 5-year period. An eligible entity that receives a grant under this 
section may reapply for such a grant at the end of the grant period.

SEC. 6. NATIONAL RESOURCE CENTER PRIORITY ACTIVITIES.

    The priority activities of a national resource center shall be to--
            (1) increase access to and effective implementation of the 
        full range of augmentative and alternative communication for 
        all individuals with significant expressive communication 
        disabilities in the United States, regardless of age, race, 
        ethnicity, gender, gender identity, LGBTQ+ status, immigration 
        status, educational achievement, socioeconomic condition, 
        primary language, nature or severity of disability, location of 
        residence, and age of onset of the significant expressive 
        communication disability;
            (2) increase the capacity of individuals with significant 
        expressive communication disabilities, educators, professional 
        service providers, families, and direct support professionals 
        to support individuals with significant expressive 
        communication disabilities by creating and disseminating 
        evidence-based knowledge, resources, training and technical 
        assistance, and recommended practices in ensuring individuals 
        with significant expressive communication disabilities have the 
        tools and other supports necessary to exercise self-
        determination and effectively access and participate in all 
        aspects of life, including education, employment, health care, 
        and community living;
            (3) promote awareness and implementation of the laws, 
        regulations, policies, practices, procedures, and systems that 
        facilitate access to the full range of augmentative and 
        alternative communication and promote equal access and 
        opportunity for individuals with significant expressive 
        communication disabilities;
            (4) support and enhance the skills and leadership of 
        individuals with significant expressive communication 
        disabilities and their families to advocate for the rights of 
        the individuals to effective communication, education, self-
        determination, access to justice, and equal opportunity and 
        participation in all aspects of life;
            (5) support the improved collection, availability, and 
        dissemination of demographic and characteristic data, with a 
        cross-disability and cross-generational focus, regarding 
        individuals with significant expressive communication 
        disabilities in the United States, the barriers the individuals 
        experience to meaningful access to augmentative and alternative 
        communication, and the unmet communication support and other 
        needs of this population; and
            (6) increase societal awareness and knowledge about 
        individuals with significant expressive communication 
        disabilities and the importance of, need for, benefits of, and 
        rights to meaningful access to effective communication tools 
        and other supports in all aspects of community and life.

SEC. 7. APPLICATIONS.

    (a) In General.--To be qualified to receive a grant under section 
5, an eligible entity shall submit an application to the Secretary at 
such time and in such manner as the Secretary may require.
    (b) Contents.--Each such application from an eligible entity shall 
include, at a minimum, each of the following:
            (1) A description of the experience of each partner 
        organization in the entity in providing training, information, 
        advocacy, and support related to augmentative and alternative 
        communication and individuals with significant expressive 
        communication disabilities.
            (2) A description of each partner organization's experience 
        in providing training, information, advocacy, and support 
        related to augmentative and alternative communication and to 
        individuals with significant expressive communication 
        disabilities, to--
                    (A) early intervention specialists;
                    (B) elementary education, secondary education, 
                postsecondary education, and specialized instructional 
                support personnel as defined in section 8101 of the 
                Elementary and Secondary Education Act of 1965 (20 
                U.S.C. 7801);
                    (C) caregiver groups;
                    (D) providers of home and community-based services 
                for adults;
                    (E) health care providers and educators;
                    (F) employers;
                    (G) providers of services to older adults;
                    (H) law enforcement agencies, courts, offices of 
                district attorneys, and other public and private 
                security agencies and businesses;
                    (I) institutional long-term care services and 
                support providers;
                    (J) nursing home providers; and
                    (K) other stakeholders.
            (3) A description of each partner organization's experience 
        working with State, local, or Tribal government agencies in 
        providing training, information, and support related to 
        augmentative and alternative communication for full expression 
        and individuals with significant expressive communication 
        disabilities.
            (4) A description of each partner organization's prior 
        partnerships with disability-led organizations focused on 
        augmentative and alternative communication and individuals with 
        significant expressive communication disabilities.
            (5) Evidence of how the applicant satisfies the 
        requirements of section 4(5).
            (6) A description of the applicant's plan to ensure that 
        the applicant will provide training, technical assistance, and 
        information to target audiences, especially those audiences in 
        need of knowledge and access to augmentative and alternative 
        communication.
            (7) A description of the applicant's plan to implement the 
        priority activities in section 6, including how the 
        organizational members of the eligible entity will partner, 
        collaborate, and operationalize the activities.
            (8) Advisory council information, including--
                    (A) a description of the advisory council, 
                including a list of the inaugural members of the 
                advisory council;
                    (B) an assurance that the Chair and Vice Chair of 
                the advisory council will be selected by the advisory 
                council members at the first meeting of the advisory 
                council and thereafter as the council determines to be 
                appropriate; and
                    (C) an assurance that, in filling a vacancy on the 
                advisory council, the advisory council will--
                            (i) solicit nominations from the population 
                        of augmentative and alternative communication 
                        users;
                            (ii) if there is not more than 1 nominee 
                        for the vacancy, confirm the nominee as a new 
                        member; and
                            (iii) if there is more than 1 nominee for 
                        the vacancy, vote to determine the nominee to 
                        fill the vacancy and subsequently confirm the 
                        nominee.
            (9) A description of how other individuals with significant 
        expressive communication disabilities will be involved in the 
        governance and operations of the national resource center 
        involved, especially through employment of individuals with 
        significant expressive communication disabilities.
            (10) A description of how the applicant will design and 
        make training, technical assistance, and information available 
        in accessible formats, including plain language.
            (11) Assurances that the applicant, acting through the 
        national resource center, will work with the stakeholders 
        identified in section 9(d).
            (12) Assurances that the applicant, acting through the 
        national resource center, will provide the Secretary with 
        requested data and information for purposes of evaluating the 
        grant activities.

SEC. 8. AWARD PRIORITY.

    In awarding grants for activities described in this Act, the 
Secretary shall give priority to an eligible entity with at least 1 
partner organization that--
            (1) demonstrates a minimum of 3 years of experience 
        providing training and technical assistance and disseminating 
        information related to augmentative and alternative 
        communication and individuals with significant expressive 
        communication disabilities, and being otherwise engaged in the 
        priority activities described in section 6;
            (2) demonstrates that individuals with significant 
        expressive communication disabilities and those who use 
        augmentative and alternative communication are purposefully 
        involved in the governance and operation of the organization, 
        especially through their employment in service, delivery, and 
        leadership positions;
            (3) demonstrates the ability to collaborate with disability 
        self-advocacy, education, direct service, health care, 
        employment, aging, caregiver, and housing organizations, 
        whether the organizations are public agencies or private 
        entities; and
            (4) demonstrates expertise in promoting accessibility and 
        the use of universal design (the latter as defined in section 
        103 of the Higher Education Act of 1965 (20 U.S.C. 1003)) in 
        providing training and technical assistance, and information 
        dissemination.

SEC. 9. USE OF FUNDS.

    (a) In General.--An eligible entity that receives a grant under 
section 5 shall use the grant funds to manage and carry out the 
priority activities described in section 6, activities described in 
this section, and any additional activities approved by the Secretary.
    (b) Coordination With Federal Programs.--The work of a national 
resource center shall link to current and future policy and activities 
undertaken throughout the Federal Government in relation to self-
advocacy, supported decisionmaking, person-centered planning, community 
living, and competitive integrated employment for individuals with 
disabilities and particularly for individuals with the most significant 
expressive communication disabilities, for the purpose of increasing--
            (1) success and self-determination in life;
            (2) the provision of inclusive early intervention services, 
        elementary education, secondary education, and postsecondary 
        education programs;
            (3) competitive integrated employment;
            (4) health, wellness, and personal safety;
            (5) economic security;
            (6) civic engagement;
            (7) community integration; and
            (8) improvement in other aspects of life.
    (c) Information Dissemination.--Notwithstanding the priority 
activities described in section 6, a national resource center shall 
ensure information and other resources about augmentative and 
alternative communication and individuals with significant expressive 
communication disabilities are made available as appropriate to--
            (1) individuals with significant expressive communication 
        disabilities and their families;
            (2) institutions of higher education;
            (3) State, Tribal, and local educational agencies;
            (4) law enforcement agencies, courts, offices of district 
        attorneys, and other public and private security agencies and 
        businesses;
            (5) national, State, regional, Tribal, and local employers, 
        to enable businesses to hire into competitive integrated 
        employment more individuals who use augmentative and 
        alternative communication;
            (6) national, State, Tribal, and local government agencies 
        that provide services and other supports to individuals with 
        significant expressive communication disabilities, including 
        agencies responsible for emergency preparedness, employment 
        support, and vocational rehabilitation, agencies responsible 
        for State programs under the Assistive Technology Act of 1988 
        (29 U.S.C. 3001 et seq.), agencies responsible for State 
        alternative financing programs, State agencies responsible for 
        the Medicaid program under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.), and the agencies overseeing the 
        provision of home and community-based services;
            (7) national and local disability and aging advocacy 
        organizations, including disability self-advocacy 
        organizations;
            (8) family support organizations, including the parent 
        training and information centers supported under section 671 of 
        the Individuals with Disabilities Education Act (20 U.S.C. 
        1471);
            (9) centers for independent living and Statewide 
        Independent Living Councils authorized by title VII of the 
        Rehabilitation Act of 1973 (29 U.S.C. 796 et seq.);
            (10) network partners, including the State Councils on 
        Developmental Disabilities described in section 125 of the 
        Developmental Disabilities Assistance and Bill of Rights Act of 
        2000 (42 U.S.C. 15025), the protection and advocacy systems 
        described in section 143 of that Act (42 U.S.C. 15043), and 
        University Centers for Excellence in Developmental Disabilities 
        Education, Research, and Services supported under subtitle D of 
        title I of that Act (42 U.S.C. 15061 et seq.), participating in 
        activities under that Act (42 U.S.C. 15001 et seq.);
            (11) State agencies and area agencies on aging, entities 
        carrying out long-term care ombudsman programs, and other 
        entities funded under the Older Americans Act of 1965 (42 
        U.S.C. 3001 et seq.);
            (12) health care providers and educators, health care 
        advocacy organizations, nursing home providers, and 
        institutional long-term care facilities;
            (13) professional organizations and organizations that 
        certify preservice training programs; and
            (14) other groups and entities as identified by the 
        eligible entity and the advisory council of the eligible 
        entity.
    (d) Stakeholder Collaboration.--A national resource center shall 
collaborate with--
            (1) organizations of individuals with significant 
        expressive communication disabilities;
            (2) disability organizations;
            (3) entities carrying out State assistive technology 
        programs and State alternative financing programs;
            (4) State, Tribal, and local educational agencies;
            (5) the councils, systems, and university centers described 
        in subsection (c)(10);
            (6) entities carrying out national, State, Tribal and 
        Native Hawaiian, and local programs authorized by the Older 
        Americans Act of 1965;
            (7) the federally funded Rehabilitation Engineering 
        Research Center on Augmentative and Alternative Communication;
            (8) State agencies responsible for vocational 
        rehabilitation programs, as defined in section 3 of the 
        Workforce Innovation and Opportunity Act (29 U.S.C. 3102);
            (9) professional associations whose members come in contact 
        with and support individuals who may use augmentative and 
        alternative communication;
            (10) local boards, as defined in section 3 of the Workforce 
        Innovation and Opportunity Act (29 U.S.C. 3102); and
            (11) other State, regional, Tribal, and local entities with 
        the ability to provide support for individuals who need and use 
        augmentative and alternative communication.

SEC. 10. ANNUAL REPORT.

    An eligible entity that receives a grant under section 5 to support 
a national resource center shall annually prepare and submit to the 
Secretary, the Secretary of Education, and the relevant subcommittees 
of the Committee on Health, Education, Labor, and Pensions of the 
Senate, the Special Committee on Aging of the Senate, and the Committee 
on Education and Labor of the House of Representatives, the 
Subcommittee on Labor, Health and Human Services, Education, and 
Related Agencies of the Committee on Appropriations of the Senate, and 
the Subcommittee on Labor, Health and Human Services, Education, and 
Related Agencies of the Committee on Appropriations of the House of 
Representatives a report containing, consistent with criteria 
established by the Secretary, information on--
            (1) activities conducted by the national resource center to 
        achieve the purpose of this Act;
            (2) collaboration by the national resource center with 
        other entities to achieve the purposes of this Act;
            (3) barriers to and strategies for equitable access to 
        augmentative and alternative communication and other supports 
        for individuals who belong to racial, ethnic, and linguistic 
        minority communities and face a greater likelihood of being 
        born with or acquiring significant expressive communication 
        disabilities as well as added difficulties in obtaining 
        effective augmentative and alternative communication;
            (4) identified gaps in available demographic and 
        characteristic data on individuals with significant expressive 
        communication disabilities in the United States; and
            (5) the unmet needs of individuals with significant 
        expressive communication disabilities, from diverse 
        backgrounds, in the United States and policy recommendations to 
        address such unmet needs.

SEC. 11. AUTHORIZATION OF APPROPRIATIONS.

    There is authorized to be appropriated to carry out this Act 
$9,000,000 for each of fiscal years 2023 through 2027.
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