March 25, 2002 Contact: HHS Press Office
DELIVERING ON THE PROMISE - REPORT OF FEDERAL AGENCIES' ACTIONS TO ELIMINATE BARRIERS AND PROMOTE COMMUNITY INTEGRATION
Overview: In February 2001, President Bush released the New Freedom Initiative, a comprehensive plan to tear down the barriers facing people with disabilities and preventing them from participating fully in community life. As part of that initiative, the President issued Executive Order 13217, "Community-Based Alternatives for Individuals with Disabilities," June 18, 2001. The order calls upon the federal government to assist states and localities to swiftly implement the decision of the United States Supreme Court in Olmstead v. L.C. In that case, the court found that, under certain circumstances, the Americans with Disabilities Act (ADA) requires states to provide community-based services for persons with disabilities and holds that unjustified institutionalization of a person with a disability is discrimination under the ADA.
More information on the New Freedom Initiative and Executive Order 13217 is available at http://www.hhs.gov/newfreedom.
Executive Order 13217 directs six federal agencies, including the departments of Justice (DOJ), Health and Human Services (HHS), Education (ED), Labor (DOL) and Housing and Urban Development (HUD) and the Social Security Administration (SSA) to evaluate their policies, programs, statutes and regulations to determine whether any should be revised or modified to improve the availability of community-based services for qualified individuals with disabilities and to report back to the President with their findings. The departments of Transportation (DOT) and Veterans Affairs (VA) and the Office of Personnel Management (OPM), though not named in the Executive Order, also joined in the implementation effort.
Together, the participating agencies formed the Interagency Council on Community Living (ICCL) under the leadership of HHS Secretary Tommy G. Thompson. The self-evaluation process represented an unprecedented government-wide effort to identify and find ways to remove barriers to community integration. The interagency collaboration it generated will serve as a model for future interagency efforts on disability and other issues.
President Bush directed that public input would be a central component of the federal review mandated by the order. To encourage the broad participation of people with disabilities, family caregivers, providers and advocates in the public input, the ICCL sponsored a national listening session in Washington, D.C., a national teleconference, and a Federal Register notice soliciting written public comments. More than 800 individuals and organizations provided comment.
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On March 25, 2002, HHS presented President Bush with the reports of the nine agencies participating in the self-evaluation. Prior to delivering the full reports, Secretary Thompson presented the President with a preliminary report on Dec. 21, 2001. The reports will be available soon at http://www.hhs.gov/newfreedom.
FINDINGS OF THE ĎDELIVERING ON THE PROMISEí REPORTS
In their reports to the President, the participating federal agencies identified more than 400 steps to tear down barriers and improve community integration in a number of key areas. Following are a few highlighted recommendations in each of the barrier areas that were identified:
Health Care Structure and Financing: When the Medicaid program was created nearly 40 years ago, few community-based alternatives were available for people with disabilities who required health care services. Despite the expanded possibility of community alternatives available today, approximately 73 percent of Medicaid long-term care funding pays for institutional care while only 27 percent is directed toward home- and community-based services.
Housing: The lack of accessible, affordable housing continues to present a major barrier to the participation of people with disabilities in their communities and in the economic life of the nation. As more people with disabilities leave institutions for community life, this housing shortage will become more acute unless actions are taken.
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Personal Assistance, Direct Care Services and Community Workers: There is already a critical need for personal care assistants and other direct care staff to provide services to people with disabilities living in the community. The administration will work to increase the number of these workers through recruitment, training, and work-related benefits.
Caregiver and Family Support: The vast majority of direct care for people with disabilities is provided by families, friends and neighbors. However, despite the enormous contribution of family and informal caregivers to the community integration of people with disabilities, these caregivers receive little direct assistance and often face great financial and emotional pressures.
Transportation: Accessible transportation is necessary for people with disabilities to go to work, get an education, receive medical care and to have an active, inclusive role in society. Barriers to transportation include a lack of available transportation options such as public transportation and a lack of access to existing transportation services.
Employment: The dignity, responsibility and economic independence resulting from gainful employment is one of the most effective ways of enhancing self-reliance, changing attitudes, reducing dependency on public benefits and promoting community acceptance of people with disabilities.
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Education: Young people with disabilities face particular barriers to succeeding in school and going to college. Low educational attainment and confusing government programs and benefits have resulted in many young people with disabilities not making successful transitions from school to post-secondary education, employment and independent living.
Access to Technology: Assistive technological devices enable people with disabilities to live independently or reduce their need for other assistance services. Technology also provides a gateway to a wealth of information about employment opportunities, community events and educational forums and has fundamentally changed the skills and knowledge needed to fully participate in the 21st century workplace.
Accountability and Legal Compliance: There is a need for an array of activities to promote statesí compliance with the Olmstead decision, including: greater federal oversight of programs that serve people with disabilities; stronger enforcement of laws that protect the rights of people with disabilities; guidance to states on effective planning to provide services in the most integrated setting; and greater and more effective outreach to assist individuals with disabilities and their family members in understanding the ADA and Olmstead's requirements.
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Public Awareness, Outreach and Partnerships: Many people with disabilities and their families are not aware of the full range of community services that are available to them. Outreach to provide information and incorporate the views of people with disabilities and other stakeholders into federal policy will help fill this knowledge gap.
Income Supports: Cash and medical benefits can be critical to an individual's ability to live in the community. Cash benefits, often in conjunction with food stamps and housing subsidies, can provide for basic needs such as food, clothing and shelter. Medical benefits can enable someone to obtain treatment that may be critical to his or her ability to function in a community setting. Of course, work also contributes significantly to an individual's ability to thrive in a community setting.
Gathering, Assessment and Use of Data: The successful integration of people with disabilities into community settings requires consistent data collection to measure the progress of existing programs and initiatives and to determine the specific needs of people with disabilities.
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Cross-Agency Collaboration and Coordination: In order to effectively meet the needs of individuals with disabilities and to efficiently utilize federal resources, the various federal agencies that develop disability policy and provide, fund and support community-based services will communicate about and collaborate on their objectives.
Note: All HHS press releases, fact sheets and other press materials are available at www.hhs.gov/news.