Americans with Disabilities
Gil believes Americans with disabilities have the right to live independently with the same dignity and freedom afforded every other citizen. Despite the passage of the Americans with Disabilities Act (ADA) in 1990, a Congressional report revealed nearly a quarter of a million Americans are being unfairly segregated in nursing homes and the numbers are growing. In response, the bipartisan and bicameral Disability Integration Act (DIA) was introduced in the 115th Congress by Senate Minority Leader Charles Schumer (D-NY) and Congressman James Sensenbrenner (R-WI). The DIA ensures that disabled Americans have a right to live and receive services in their own homes. In Congress, Gil would vote to pass The Disability Integration Act because it prevents states and private insurers from denying people with disabilities their Constitutional right to liberty. The DIA also allows Americans with disabilities to remain in their homes, thereby keeping families together, and saves millions in federal and state dollars compared to institutionalization.
Why the ADA Isn’t Enough
The ADA, passed by Congress in 1990, was the nation’s first comprehensive civil rights law addressing the needs of people with disabilities, prohibiting discrimination in employment, public services, public accommodations, and telecommunications. In the 1999 court case Olmstead v. L.C., the Supreme Court declared the ability to live in the community is a protected civil right under the ADA and that the unnecessary institutionalizing of individuals with disabilities is in violation. However, a 2013 Senate report revealed almost a quarter of a million working-age Americans remained unfairly segregated in nursing homes, and the number of working-age Americans with disabilities confined to nursing homes is actually growing. Additionally, by 2010, only 12 states had spent more than 50 percent of Medicaid funds on community-based care instead of institutional care. This Senate report by the Health, Education, Labor & Pensions (HELP) committee recommended Congress strengthen the ADA “integration mandate” to clarify that States and private insurers cannot interfere with every American’s right to liberty by failing to provide Long-Term Services and Supports (LTSS) in the community.
The Disability Integration Act is Born
The DIA is bipartisan and bicameral legislation first introduced in the 114th Congress. Senate Minority Leader Schumer reintroduced the bill (S.910) in the 115th Congress with minor changes that strengthened the bill. Congressman Sensenbrenner, who was a cosponsor during the 114th Congress, has introduced DIA (HR.2472) in the House of Representatives.
No Denial of Services
This bill prohibits states or local governments that provide institutional placements for individuals with disabilities who need long-term assistance with daily living activities or health-related tasks and prohibits insurance providers that fund such long-term services, from denying community-based services that would enable such individuals to live in the community and lead an independent life.
States, local governments, or insurance providers may not discriminate against such individuals in the provision of community-based services by: (1) imposing prohibited eligibility criteria, cost caps, waiting lists, or payment structures; (2) failing to provide a specific community-based service; or (3) requiring an individual to receive a service in a congregate or disability-specific setting.
Emphasis on Independent Living
Community-based services must be offered to individuals with such disabilities prior to institutionalization. Institutionalized individuals must be notified regularly of community-based alternatives.
States, local governments, and public insurance providers must assess (1) transportation barriers that prevent individuals from receiving services in integrated settings, and (2) the availability of integrated employment opportunities.
The Department of Justice (DOJ) and the Department of Health and Human Services (HHS) must issue regulations requiring states, local governments, or insurance providers to offer community based long-term services to individuals with such disabilities who would otherwise qualify for institutional placement. State and local governments, in conjunction with housing agencies, must ensure sufficient availability of affordable, accessible, and integrated housing that is not a disability specific residential setting or a setting where services are tied to tenancy.
Such regulations must also require states and local governments to begin implementing a transition plan to achieve the requirements of this bill within 12 years after its enactment. For 10 years after issuance of the regulations, HHS must determine annually whether each state is complying with the transition plan. If a state is complying, HHS must increase by five percentage points the federal medical assistance percentage for a state requesting an increase for expenditures on home and community-based services furnished under the state Medicaid plan under title XIX (Medicaid) of the Social Security Act, or a waiver of such plan, that are identified as: (1) improvements to ensure accessibility or self-directed receipt of such services, (2) funding shifts from institutional settings to integrated community-based services, or (3) environmental modifications for housing targeted toward the lowest income individuals.
The bill provides for DOJ enforcement and allows civil actions by individuals subjected to, or about to be subjected to, a violation of this bill.
Wide Support for DIA
The Disability Integration Act has wide support of over 40 national groups and 38 California based organizations. It was crafted by ADAPT & the National Council on Independent Living with assistance from the Autistic Self Advocacy Network. Key supporters include:
American Association of People with Disabilities
Association of University Centers on Disabilities
Bazelon Center for Mental Health Law
Brain Injury Association of America
California Foundation for independent Living Centers
Democratic National Committee
Leadership Conference on Civil and Human Rights
Little People of America
Medicare Rights Center
National Academy of Elder Law Attorneys
National Council on Aging
National Disability Leadership Alliance
National Disability Rights Network
National Downs Syndrome Congress
National Organization of Nurses with Disabilities
Paraprofessional Healthcare Institute
Parent to Parent USA Self Advocates Becoming Empowered
The Congress of Disabled Persons Against Exploitation
United Spinal Association