Report - 042 Ncd A Progress Report 508
Summary
National Disability Policy: A Progress Report, a report of the National Council on Disability dated October 26, 2017. The letter of transmittal to the President states that the council submits a statutorily mandated report each year, and that the 2017 edition takes poverty as its central theme. It states that the report focuses on seven factors for the economic independence of people with disabilities: education, employment, financial assistance and incentives, health care, long-term services and supports, transportation, and housing. The letter closes with the name of Clyde E. Terry, Chairperson.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
- Issuer
- Congressional materials
- Document type
- Report
- Case
- 042 Ncd A Progress Report 508
Cite this document
“Report - 042 Ncd A Progress Report 508.”
Original at ncd.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/042-ncd-a-progress-report-508/
, SHA-256 77875fe2f83491e68bdafb401e2b072ae9a695736685d49a3515bba93fdf9a14.Full text
National Disability Policy:
A Progress Report
National Council on Disability
October 26, 2017
National Council on Disability (NCD)
1331 F Street NW, Suite 850
Washington, DC 20004
National Disability Policy: A Progress Report
National Council on Disability, October 26, 2017
Celebrating 30 years as an independent federal agency
This report is also available in alternative formats. Please visit the National Council on Disability
(NCD) website (www.ncd.gov) or contact NCD to request an alternative format using the following
information:
ncd@ncd.gov Email
202-272-2004 Voice
202-272-2022 Fax
The views contained in this report do not necessarily represent those of the Administration, as this and
all NCD documents are not subject to the A-19 Executive Branch review process.
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 26, 2017
President Donald J. Trump
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Dear Mr. President:
The National Council on Disability (NCD) is pleased to present the 2017 edition of National Disability
Policy: A Progress Report. Each year, NCD submits a statutorily mandated report to the White
House and Congress to offer recommendations on new and emerging issues affecting the lives
of people with disabilities. NCD identified one central topic as the theme for the 2017 Progress
Report—poverty. The Council focused on poverty because it is the common thread that continues
to compound many of the core concerns for people with disabilities. The report focuses on seven
factors that are crucial for enhancing the economic independence of people with disabilities in
our society: education, employment, financial assistance and incentives, health care, long-term
services and supports, transportation, and housing.
NCD submits this report at a time when an increasing number of plans and initiatives to
combat poverty have been announced. Poverty among people with disabilities has reached
epidemic proportions. As a result, existing programs and policies must be revised to address the
circumstances that keep Americans with disabilities from achieving economic self-sufficiency. This
report addresses why people with disabilities are often destined to live in poverty and experience
high unemployment despite existing federal regulations and public policies that are geared toward
improving the lives of people with disabilities.
Issues reflected in the 2017 Progress Report have implications for our society as a whole. With
continuous advances in technology, health care, and education and ever-changing attitudes toward
people with disabilities in society, there has never been a better time for Americans with disabilities
to achieve economic independence. This report highlights the opportunities to improve existing
policy as well as the need for forethought to ensure that any proposed policy changes in the fight
against poverty do not inadvertently cause harm to people with disabilities but rather further our
common goal of achieving economic self-sufficiency for all.
NCD appreciates the efforts of policymakers who continue to promote policies and practices that
affect the economic self-sufficiency and independence of all people with disabilities. We invite
1331 F Street, NW ■ Suite 850 ■ Washington, DC 20004
202-272-2004 Voice ■ 202-272-2074 TTY ■ 202-272-2022 Fax ■ www.ncd.gov
Congress and the White House to continue this momentum by carefully considering the concerns and
recommendations reflected here.
Respectfully,
Clyde E. Terry
Chairperson
(The same letter of transmittal was sent to the President Pro Tempore of the U.S. Senate and the Speaker of the
U.S. House of Representatives.)
National Council on Disability Members and Staff
Members
Clyde E. Terry, Chairperson
Benro T. Ogunyipe, Vice Chairperson
Billy W. Altom
Rabia Belt
James T. Brett
Bob Brown
Daniel M. Gade
Wendy S. Harbour
Neil Romano
Staff
Vacant, Executive Director
Joan M. Durocher, General Counsel & Director of Policy
Amy Nicholas, Attorney Advisor
Amged Soliman, Attorney Advisor
Ana Torres-Davis, Attorney Advisor
Anne Sommers, Director of Legislative Affairs & Outreach
Phoebe Ball, Legislative Affairs Specialist
Lisa Grubb, Director of Operations and Administration
Stacey S. Brown, Staff Assistant
Keith Woods, Financial Management Analyst
National Disability Policy: A Progress Report 3
4 National Council on Disability
Acknowledgments
The National Council on Disability wishes to thank American Institutes for Research (AIR),
particularly Mona Kilany and her team—Kaylie Clark, Tsion Ghedamu, Rose Belanger, and Natanee
Thawesaengskulthai—as well as Nanette Goodman and Michael Morris from the National Disability
Institute, for the research conducted in developing this report. NCD also thanks those who shared their
personal experiences and offered expert input to inform this report.
National Disability Policy: A Progress Report 5
6 National Council on Disability
Contents
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Contents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Collaboration and Data Collection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Financial Assistance and Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Transportation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Acronym Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Cinda’s Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
The 2017 NCD Progress Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Chapter 1: How Public Policies, Programs, and Practices Help People
with Disabilities Achieve Economic Self-Sufficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Michael’s Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Health and Well-Being. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Financial Assistance and Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Social Security Disability Insurance (SSDI)
and Supplemental Security Income (SSI). . . . . . . . . . . . . . . . . . . . . . 38
Earned Income Tax Credit (EITC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Transportation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
National Disability Policy: A Progress Report 7
Chapter 2: Barriers to Achieving Economic Self-Sufficiency for People
with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Barriers to Adequate Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Barriers Related to the Transition to Employment . . . . . . . . . . . . . . . . . . . . 47
Barriers Related to Complex Eligibility and Enrollment Procedures . . . . . 48
Barriers Related to Program Income and Asset Limits . . . . . . . . . . . . . . . . 50
Barriers Related to Transportation in Rural Areas. . . . . . . . . . . . . . . . . . . . . 52
Barriers Related to Attitudes and Stereotypes . . . . . . . . . . . . . . . . . . . . . . . 52
Chapter 3: Emerging and Promising Practices for Achieving Economic
Self-Sufficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Financial Assistance and Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Underutilized Policies, Programs, and Practices. . . . . . . . . . . . . . . . . . . . . . 64
Chapter 4: Recommendations to Promote Economic Self-Sufficiency
for People with Disabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Collaboration and Data Collection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Financial Assistance and Incentives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Transportation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Conclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Appendix A: Focus Group Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Focus Group Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Recruitment and Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Relevant Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Lessons from Focus Group Discussions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
8 National Council on Disability
Appendix B: Policies, Poverty, and People with Disabilities . . . . . . . . . . . . . . . . . . . . . 77
Americans with Disabilities Act (ADA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Title I: Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Title II: State and Local Governments . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Title III: Public Accommodations and Commercial Facilities . . . . . . . . 78
Individuals with Disabilities Education Act (IDEA). . . . . . . . . . . . . . . . . . . . 78
Workforce Innovation and Opportunity Act (WIOA). . . . . . . . . . . . . . . . . . . 78
Supplemental Security Income (SSI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Social Security Disability Insurance (SSDI). . . . . . . . . . . . . . . . . . . . . . . . . . 80
Ticket to Work and Work Incentives Improvement Act. . . . . . . . . . . . . . . . . 80
Work Incentives Planning and Assistance (WIPA) . . . . . . . . . . . . . . . . . . . . 81
Medicaid Buy-In. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Achieving a Better Life Experience Act of 2013 (ABLE Act) . . . . . . . . . . . . . 81
Patient Protection and Affordable Care Act (ACA) . . . . . . . . . . . . . . . . . . . . 82
Appendix C: Select NCD Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
2013 and Earlier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Appendix D: Institutions of Higher Education with Transition and Postsecondary
Programs for Students with Intellectual Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Endnotes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
National Disability Policy: A Progress Report 9
10 National Council on Disability
Executive Summary
T
he National Council on Disability (NCD) self-sufficiency. Next, the report identifies and
recognizes that all Americans have describes the common barriers that perpetuate
the right to pursue lives with equal the cycle of poverty for people with disabilities.
opportunity, full community participation, The report then looks at a number of promising
independent living, and economic self-sufficiency. practices that lift people with disabilities out
However, people with disabilities live in poverty of poverty. It discusses how these practices
at more than twice the rate of people without address barriers that people with disabilities
disabilities. It is imperative that we examine the experience with the goal of improving the lives
interconnected nature of poverty and the barriers of people with disabilities. Finally, the report
that people with disabilities face in order to offers recommendations that help ensure
determine how existing programmatic structures people with disabilities are able to achieve
can be improved to better meet the needs of economic self-sufficiency.
people with disabilities. NCD has committed A summary of recommendations to promote
the 2017 Progress Report to poverty. The report economic self-sufficiency and lift people with
examines public policies, programs, and practices disabilities out of poverty follows:
across the areas of education, employment,
financial assistance and incentives, health care,
Collaboration and Data Collection
long-term services and supports, transportation,
■■ Congress should appropriate funds for
and housing, as access to each of these areas
the creation of a coordinated review of all
is necessary in order for people with disabilities
federal disability programs to enhance the
to achieve independent living and inclusion in all
efficiency and ability of existing structures to
aspects of society.
break down silos between federal agencies
The 2017 Progress Report offers insight
in order to improve the economic picture for
into how existing public policies and programs
people with disabilities.
are designed to provide economic support
for people with disabilities, but often create ❍❍ The Office of Management and Budget
barriers that impede upward mobility. The report (OMB) should direct all cabinet-level
begins with a review of how existing public federal agencies to submit their Agency
policies, programs, and practices can assist Reform Plans pertaining to their disability
people with disabilities in achieving economic programs to NCD for review.
National Disability Policy: A Progress Report 11
❍❍ All federal agencies should be directed inclusion of all students with disabilities.
to include measures of cross-agency Reauthorization should reinforce the
collaboration within their Government assertions under IDEA to provide a free
Performance and Results Act (GPRA) and appropriate education to students
performance measurement standards. with disabilities, including language to
OMB should report on measures of ensure that students with disabilities from
cross-agency collaboration in its annual diverse ethnic backgrounds and students
reports on agency performance. who exhibit challenging behaviors are not
disproportionately placed outside of the
❍❍ All federal agencies, including but
least restrictive environment.
not limited to the U.S. Departments
of Education, Labor, Health and ■■ The U.S. Department of Education (ED)
Human Services, and Housing and should issue guidelines to local education
Urban Development, should improve agencies and state education agencies on
data collection related to people the inclusion of universal design for learning
with disabilities in order to enhance (UDL) principles and recommend giving
knowledge of how people with disabilities teachers flexibility to implement UDL with
are assisted by existing programs. Data state and district curricula and lesson plans
collection should include information to promote broader integration of students
about people with disabilities who use with disabilities in the classroom.
federally funded programs to determine ■■ ED and state education agencies should
where programs can be modified and issue guidelines to local school districts
improved to promote employment and to give all students with disabilities an
economic self-sufficiency. opportunity to obtain a standard high school
diploma. The guidelines should reinforce that
■■ Congress should continue investments in
the use of alternative high school diplomas
the U.S. Census Bureau’s development
or certificates of completion should be
of the Supplemental Poverty Measure
considered a last resort for students with
and annual reports to ensure an adequate
disabilities.
assessment of how the cost of necessary
expenses that people with disabilities face ■■ ED Institute on Education Sciences should
(like medical or long-term services and fund national research that explores the
support expenses) affects their opportunities educational and employment outcomes of
and ability to achieve economic alternative high school diplomas for students
self-sufficiency. with individualized education programs
(IEPs) and Section 504 plans as well as the
Education demographic characteristics of students
■■ Congress should reauthorize the Individuals receiving these alternative diplomas.
with Disabilities Education Act (IDEA) in ■■ ED should continue funding for model
a manner that facilitates the meaningful programs like the Transition and
12 National Council on Disability
Postsecondary Programs for Students with Program to include people with disabilities
Intellectual Disabilities (TPSID) program, as a presumed socially disadvantaged
which can help reduce poverty among group to be in line with the findings in the
people with intellectual disabilities. Americans with Disabilities Act (ADA),
■■ Congress should amend the Higher which states that people with disabilities
Education Act to modify existing are disadvantaged socially, economically,
higher education financial assistance vocationally, and educationally.
program guidelines so that they are ■■ The U.S. DOL and Education should issue
adequately accessible and students with guidelines to develop partnerships across
disabilities are not penalized when a state vocational rehabilitation agencies, local
qualifying disability limits their ability to education agencies, institutes of higher
maintain a full course load or work-study education, and employers that promote
requirements as determined by campus paid internships for college graduates and
disability services programs. This should students with disabilities in postsecondary
include but not be limited to Pell grants, education as a gateway to full-time
federal work-study programs, and student employment.
loan repayment. ■■ All federal agencies should be the model
■■ The Internal Revenue Service (IRS) should in hiring, retention, and integration of
provide guidance that waives the tax debt people with disabilities in the workplace.
on student loan forgiveness for students In accordance with the U.S. Office of
with disabilities so that they do not incur a Personnel Management (OPM), all federal
tax debt from a forgiven loan. agencies should increase coordination
between their Selective Placement Program
Employment Coordinators (SPPCs). This will bridge the
■■ The U.S. Department of Labor (DOL), the gap between managers and employees
U.S. Access Board, the U.S. Department of with disabilities and enhance understanding
Justice (DOJ), and the Equal Employment of reasonable accommodations and their
Opportunity Commission (EEOC) should effect on productivity and retention of
dictate that all policies and regulations people with disabilities. To attain this goal,
related to Sections 503 and 511 of the mandatory training for human resources
Rehabilitation Act of 1973 be prioritized for staff, managers, and supervisors should be
nationwide enforcement. This includes an required.
annual report to Congress on activities and ■■ States should mandate Employment First
the impact on employment for people with initiatives to reflect stronger legislative and
disabilities. policy support of competitive integrated
■■ Congress should amend the Small employment to increase opportunities for
Business Act to expand the Small Business economic independence for youth and
Administration’s 8(a) Business Development adults with disabilities.
National Disability Policy: A Progress Report 13
Financial Assistance and Incentives Code on how states or state agencies can
establish a qualified ABLE program.
■■ Congress should expand opportunities for
people with disabilities who need to pay for ■■ Congress should pass legislation that
personal care services to benefit from tax decouples eligibility for health care benefits
deductions when medical expenses are less from eligibility for cash benefits like
than 10 percent of adjusted gross income or Supplemental Security Income (SSI) and
deductions cannot be itemized. Social Security Disability Insurance (SSDI) to
prevent people with disabilities from being
■■ Congress should approve three amendments
forced to choose between getting a job or
to the Achieving a Better Life Experience
having access to health care.
(ABLE) Act:
■■ Congress should amend the Earned
❍❍ The ABLE Financial Planning Act, which
Income Tax Credit (EITC) to lower the age
would allow 529 educational savings
of eligibility from 25 to 18 years old and
accounts to be transitioned to qualifying
increase the benefit for childless adults
people with disabilities without incurring
to provide greater incentive to work and
penalties or taxes.
advance self-sufficiency.
❍❍ The ABLE Age Adjustment Act, which
would increase the qualifying age
Health Care
threshold for eligibility for an ABLE
■■ Congress should maintain protections that
account from 26 to 46.
prohibit insurance companies from denying
❍❍ The ABLE to Work Act, which would coverage because of preexisting conditions
allow employed people with disabilities to ensure affordable health insurance
to contribute funds to an ABLE account coverage for people with disabilities.
in an amount above the $14,000 per year
■■ Congress should ensure that Medicaid
cap. Additional contributions would not
reforms, including but not limited to block
exceed the equivalent of the determined
grants or per capita caps, will be robust
federal poverty level for that year (the
enough to: a) prevent dramatic cutbacks in
maximum allowable amount was
services and prevent lower reimbursement
$26,060 in 2017).
rates for providers and limits on Medicaid
■■ All states should implement ABLE programs eligibility; and b) safeguard access to
and actively inform people with disabilities home and community-based services
and their caregivers of this legislation in waivers, which are essential to promoting
order to provide people with disabilities the independent living, employment, and
opportunity to build individual savings and economic self-sufficiency for people
invest their money in ways that will enhance with disabilities. Any increases to state
their economic self-sufficiency. flexibility through block grants or per
■■ The IRS should issue final regulations to capita caps should include meaningful
Section 529A of the Internal Revenue accountability to the Centers for Medicare
14 National Council on Disability
and Medicaid Services (CMS) to ensure varying price in any new development,
a minimum level of coverage, services, similar to Montgomery County, Maryland’s
and consistency are provided across state Moderately Priced Housing law, which
Medicaid programs. requires 12.5 to 15 percent of the total
■■ Congress should maintain Medicaid number of units in a new development
expansion for individuals whose conditions to be moderately priced. HUD should
did not meet the severity requirements for provide guidance to local communities to
disability-based Medicaid prior to passage promote greater investment in housing
of the Patient Protection and Affordable developments incorporating universal
Care Act (ACA) and those falling within the design, to ensure greater availability of
two-year waiting period before qualifying for accessible housing units, and to promote
disability-based Medicare. opportunities for aging in place.
■■ Congress should remove the 18 to 64
Transportation
age limits for buy-in options in Medicaid
■■ DOJ should issue regulations that require
to promote work among people with
privately funded transit agencies to provide
disabilities after age 65 without requiring
accessible transportation options for people
them to spend down to be eligible for
with disabilities in all communities. This
Medicaid or exclude their buy-in assets from
includes but is not limited to taxicabs and
being counted for eligibility purposes.
transportation arranged through smartphone
applications.
Housing
■■ The U.S. Department of Housing and ■■ Local municipalities should require taxicab
Urban Development (HUD) should require authorities to provide mandatory training
that all federally assisted housing units for taxicab operators about the proper ramp
follow universal design principles and deployment and securement policies and
ensure that accessible housing units are procedures so that people with mobility
in line with the percentage of people with disabilities can safely and effectively use
disabilities requesting federal housing privately funded transit options.
assistance. This goal can be achieved by ■■ Local communities should provide
increasing the percentage of required guidance that clarifies and bolsters the
new housing units that are accessible ADA nondiscrimination standards in order
for people with mobility disabilities to address issues faced by people with
and accessible for people with sensory disabilities who require assistance to use
disabilities from the current rate of transportation services because of their
5 percent and 2 percent, respectively. disability. This includes but is not limited to
■■ Local communities should enact refusal to accommodate service animals,
ordinances requiring developers to include claims of broken lifts and ramps, and late
a percentage of accessible homes of pickup or no shows.
National Disability Policy: A Progress Report 15
■■ The U.S. Department of Transportation’s ■■ Congress should place greater emphasis
(DOT) Federal Transit Administration should on funding transportation programs in rural
work with local communities so that the DOT areas to address minimal or nonexistent
ADA regulations are followed to guarantee public and privately funded accessible
that all public transit stations and bus stops transportation options for people with
are accessible. This includes but is not disabilities.
limited to ensuring the detectability of bus ■■ Neighboring paratransit agencies should
stops through tactile signage or unique bus coordinate with each other to eliminate
stop pole designs for people who are blind or the arbitrary line between paratransit
have visual impairments, and installation and jurisdictions, which would provide people
maintenance of shelters and level concrete with disabilities with increased job
pads for people with mobility disabilities. opportunities in major business hubs.
16 National Council on Disability
Acronym Glossary
ABLE Achieving a Better Life Experience Act
ACA Affordable Care Act
ADA Americans with Disabilities Act
AJC American Job Centers
BPAO Benefit Planning, Assistance, and Outreach
CDR continuing disability reviews
CWIC Community Work Incentives Coordinators
DOJ U.S. Department of Justice
DOT U.S. Department of Transportation
ED U.S. Department of Education
EEOC Equal Employment Opportunity Commission
EITC Earned Income Tax Credit
EN employment network
FPL federal poverty level
GAO Government Accountability Office
GPRA Government Performance and Results Act
HCBS home and community-based services
HUD U.S. Department of Housing and Urban Development
IDEA Individuals with Disabilities Education Act
IEP individualized education programs
IEEI Initiative for Empowerment and Economic Independence
IRS Internal Revenue Service
IRWE impairment-related work expense
MPH moderately priced housing
NCD National Council on Disability
NCI National Core Indicators
ODIC Office of Disability Integration and Coordination
OMB Office of Management and Budget
OPM U.S. Office of Personnel Management
PASS plans for achieving self-support
PHA public housing authority
RSA Rehabilitation Services Administration
SGA substantial gainful activity
SPPC Selective Placement Program Coordinator
SSA Social Security Administration
National Disability Policy: A Progress Report 17
SSI Supplemental Security Income
SSDI Social Security Disability Insurance
TANF Temporary Aid to Needy Families
TPSID Transition and Postsecondary Programs for Students with Intellectual Disabilities
TTW Ticket to Work
UDL universal design for learning
USDA U.S. Department of Agriculture
VR vocational rehabilitation
WIOA Workforce Innovation and Opportunity Act
18 National Council on Disability
[
People with disabilities make up approximately
12 percent of the U.S. working-age population;
however, they account for more than half of those
living in long-term poverty.
National Disability Policy: A Progress Report 19
20 National Council on Disability
Introduction
Background to environmental stressors.4 At the same time,
D
some current public policies and attitudes about
isability and poverty are inextricably tied
disability lead to poverty among people with
together. Poverty causes disability by
disabilities. The impact of these public policies
exacerbating physical and mental health
and attitudes is illustrated by data showing that
issues, while people with disabilities achieve
17.5 percent of people with disabilities participate
lower rates of education, employment, and
in the workforce compared to 65 percent of
financial independence, resulting in a scarcity
people without disabilities, directly resulting in
of resources. In fact, people with disabilities
higher rates of poverty for this population.5
live in poverty at more than twice the rate of
Public policies like the ADA, the IDEA, and
people without disabilities (29 percent compared
the Rehabilitation Act of 1973 (as amended) set
to 12 percent).1 While people with disabilities
standards for protecting civil rights for people
continue to seek
with disabilities so that
economic self-sufficiency,
they may enjoy the
independent living, People with disabilities make up
benefit of full access
and integration into all approximately 12 percent of the U.S.
and inclusion throughout
aspects of society, public
working-age population; however, society. However, people
policies need to better
they account for more than half of with disabilities often
meet the challenges
those living in long-term poverty. encounter significant
faced by people with
obstacles in their quest
disabilities to break the
toward these goals including physical access
link with poverty.
barriers, lack of available programs, complex
People with disabilities make up approximately
relationships between programs and eligibility
12 percent of the U.S. working-age population;2
requirements, and inaccurate perceptions of their
however, they account for more than half of
capabilities.
those living in long-term poverty.3 In addition
The complex relationship between poverty
to exacerbating poor physical or mental health,
and disability can lead to obstacles that affect
poverty can lead to disabling chronic health
people with disabilities throughout their lives.
conditions including childhood asthma, heart
For example, students with disabilities often
disease, and obesity in situations characterized
graduate from high school at rates nearly
by limited basic supports and long-term exposure
National Disability Policy: A Progress Report 21
20 percentage points lower than students purposes. Although some programs support
without disabilities.6 Postsecondary education work goals, other programs penalize people with
is important for employment, with estimates disabilities who attempt to find work by basing
indicating that 56 percent of workers need at access to housing, food, and medical care on
least some college education for their jobs.7 maintaining a very low income.
Yet only 55 percent of students with disabilities Similarly, some existing policies may interact
enroll in postsecondary education, compared with needed public services in ways that
with 62 percent of students without disabilities, perpetuate a cycle of poverty among people with
while students with disabilities graduate from disabilities. The lack of health insurance coverage,
postsecondary schools at a rate of 38 percent long-term supports and services, and reliable
compared to a 41 percent graduation rate for the transportation can hinder participation in the labor
general population.8 Disparities are compounded force, thus disconnecting people with disabilities
for people with disabilities who are from diverse from the primary strategy (i.e., employment) that
backgrounds. For example, only 50.6 percent is most effective in combating poverty.12 Policies
of African Americans with disabilities enroll in intended to economically support people with
postsecondary education disabilities must consider
within six years of high both the opportunities
More than 65 percent of the
school graduation.9 and barriers to public
Even after obtaining a
17.9 million working-age adults with assistance so that
postsecondary education, disabilities participate in at least effective and improved
people with disabilities one safety net or income support programs can be put
earn 38 percent less program... into place to create a
than their peers without better path to economic
disabilities.10 self-sufficiency. This is imperative if people with
Established public programs seek to address disabilities are to achieve independent living and
the challenges of poverty and disability. More inclusion in all aspects of society.
than 65 percent of the 17.9 million working-age To fully understand how to modify existing
adults with disabilities participate in at least one programs and create new ones that can
safety net or income support program such as address the disability-poverty link, it is helpful
SSI, SSDI, Medicaid, Medicare, Supplemental to understand the history of poverty measures
Nutrition Assistance Program (SNAP), or and how these measures affect supports for
Temporary Assistance for Needy Families (TANF), people with disabilities. The official measure of
and many participate in multiple programs.11 poverty in the United States was developed in
They may also get job search support from the 1960s. It estimates poverty rates by looking
the vocational rehabilitation system, the DOL’s at an individual’s or a family’s cash income from
Office of Workforce Investment, or their state’s wages, salaries, or Social Security benefits or
developmental disabilities or mental health interest. The amount of cash income that people
systems. However, these programs are not well have is then used to calculate the poverty line.
integrated with each other and may work at cross Specifically, the poverty line is based on the
22 National Council on Disability
minimum level of cash resources people would
need to meet their basic needs. In the official
poverty measure, basic needs are measured by
a formula that calculates three times the cost
of a minimum diet in 1963, adjusted for current
prices.13 In 2016, the poverty line for a family of
four was $24,300.14 This definition of poverty
is used most often to determine eligibility for
participation in public programs.
However, Cinda’s story highlights how
the basic needs for people with disabilities
go beyond what is covered in the official U.S.
definition of poverty. In addition, the official
U.S. definition of poverty does not account
for geographic differences in the cost of food,
Cinda’s Story
What kind of supports do people with disabilities need to achieve economic self-
sufficiency? Consider this example:
Cinda, 55, has been quadriplegic since birth. She lives in Alexandria, Virginia. She currently
works part-time with a contracting firm to conduct training and makes $36,000 per year.
Cinda uses a power wheelchair to get around and has a personal care assistant to help with
her daily living needs. Her power wheelchair costs $30,000 and needs to be replaced every
four to five years. Additionally, ongoing needed repairs to her power wheelchair cost $1,900
per year. She is currently uninsured, so she pays for all her wheelchair repairs out of pocket.
She does not qualify for Medicaid because her income is too high. She also pays $500 per
month for a family member to serve as her personal care attendant. Cinda completed three
years of college, but she was unable to finish college because she frequently missed classes
because of her personal care attendants showing up late or not showing up at all. She
received $700 per month in SSI from age 14 to 32, but her SSI payments stopped as soon as
she began earning a living wage. Additional costs for Cinda include $60 to $80 per month for
public transportation and $1,560 per month in rent, which she only can afford with help from
her church. She does not live in an accessible apartment because it would cost an extra $500
per month. Cinda has never had a savings account because her day-to-day costs related to
her disability regularly exceed her income.
National Disability Policy: A Progress Report 23
housing, or utilities or the value of public development of the supplemental poverty
benefits. As a result, an interagency technical measure and annual report to ensure an
working group that includes the U.S. Census adequate assessment of how the cost
Bureau and the Bureau of Labor Statistics of necessary expenses that people with
developed a supplemental poverty measure.15 disabilities face (like medical or long-term
The working group defined poverty as the lack services and support expenses) affects their
of economic resources for the consumption opportunities and ability to achieve economic
of basic needs. This supplemental poverty self-sufficiency. People with disabilities tend
measure considers the value of cash income to have higher unmet basic needs than people
from all sources plus the value of nutritional without disabilities. Basic needs include
assistance, subsidized housing, and home adequate education, health care, long-term
energy assistance. The supplemental poverty services and supports, technology, housing,
measure subtracts expenses like income taxes, and transportation. People with disabilities may
Social Security payroll need medications, home
taxes, child care and other health care, personal care
work-related expenses,
[T]he basic needs for people attendants, and assistive
child support payments to with disabilities go beyond what technologies. A new
another household, and is covered in the official U.S. definition of poverty could
contributions toward the definition of poverty. A new help highlight the financial
out-of-pocket costs for challenges facing people
definition of poverty could
medical care and health with disabilities and
help highlight the financial
insurance premiums. influence changes in policy.
Unfortunately, neither challenges facing people with Changes to the definition of
poverty definition addresses disabilities and influence poverty in existing policies
the additional costs changes in policy. could give people with
associated with having disabilities a better chance
a disability as described in Cinda’s story, such of having enough resources to achieve economic
as medical care, accessible transportation, self-sufficiency.
home modifications, and personal assistants. For people with disabilities, poverty affects
One recent study estimated that 40 percent all areas of life from access to education,
of people with disabilities experience material employment, health care, and long-term services
hardship because of the extra costs of living with and supports to housing and transportation.
a disability.16 Such material hardship means that To provide people with disabilities with every
many people with disabilities cannot meet daily opportunity to achieve economic self-sufficiency
living expenses, do not experience sustained and independence requires an understanding
food security, are unable to get needed medical of the interconnected nature of poverty and the
care, or live in housing that is below acceptable barriers that people with disabilities experience
housing quality standards.17 across these areas. There is an urgent need to
NCD recommends that Congress continue look at which policies and practices work and
investment in the U.S. Census Bureau’s which do not and how existing programmatic
24 National Council on Disability
structures can be improved to better meet the with disabilities and advocates who have direct
needs of people with disabilities. experience with both the challenges of poverty
and opportunities for economic self-sufficiency.
The 2017 NCD Progress Report Uses for the report include:
NCD affirms the need to reorient public policies
■■ Providing insight and guidance to federal
and programs in order to dismantle the poverty
policymakers on reauthorizing existing
trap associated with disability and public program
legislation and initiating and supporting new
participation. This need is reflected throughout
legislation.
this report, which focuses on how existing public
policies and programs are designed to help ■■ Giving federal policymakers a deeper
people with disabilities achieve economic self- understanding of the challenges people with
sufficiency but often create barriers that impede disabilities face while also clarifying and
upward mobility for this population. reversing stereotypes and misinformation
The 2017 Progress Report benefited from about people with disabilities.
the input of people with disabilities who have ■■ Providing ideas and opportunities to federal
experience with the policies and programs that
policymakers, employers, and people with
provide economic support. NCD solicited these
disabilities to initiate new policies or amend
perspectives through focus groups with people
existing policies to increase the number of
with a variety of disabilities. Select responses
people with disabilities in the workplace,
from focus group participants appear throughout
leading to economic self-sufficiency for this
the report to illustrate the effects of poverty
population.
and disability. A synthesis of the focus group
discussions appears in Appendix A. Appendix B includes an overview of select
The 2017 Progress Report updates the policies and programs and the way they apply
Administration and Congress on policy to poverty and disability throughout the 2017
issues related to people with disabilities and Progress Report. Appendix C contains select
those related to poverty. NCD expects the 2017 NCD resources that address the topics discussed
Progress Report also to be relevant to people in this report.
National Disability Policy: A Progress Report 25
26 National Council on Disability
Chapter 1: How Public Policies, Programs, and
Practices Help People with Disabilities Achieve
Economic Self-Sufficiency
T
his chapter illustrates the importance of professions reached 70 percent.18 In other
public policies, programs, and practices words, the statistics have reversed. Access
in helping people with disabilities achieve to quality education is more important than
economic self-sufficiency across education, ever. People with disabilities often need
employment, health care, financial assistance accommodations and services to access
and incentives, housing, and transportation. the same level of education as their peers
Addressing all of the aspects that drive poverty without disabilities and to be prepared for
and disability extends beyond the reach of this higher education and the workforce. When
report; instead, the topics covered here are accommodations and services are effective,
intended to help illustrate how existing public people with disabilities can use their education
policies, programs, and practices can assist to achieve gainful employment and economic
people with disabilities. NCD’s website contains self-sufficiency, thus avoiding poverty.
a comprehensive list of topic areas that readers Several pieces of legislation prohibit
can reference for more information about discrimination and address the disability-related
economic self-sufficiency and poverty among needs of students. The IDEA (P.L. 108-446)
people with disabilities. Appendix B contains an mandates that students with disabilities who
overview of select legislation and how it relates attend public schools receive a free appropriate
to economic self-sufficiency. public education in local schools with nondisabled
peers to the maximum extent possible,
Education with needed accommodations and services.
People with disabilities can work if the proper However, the reauthorization of IDEA has been
supports and accommodations are in place. delayed and it has never been fully funded. To
In today’s world, an effective education is continue protecting the rights of students with
also essential for preparing people with disabilities, NCD recommends that Congress
disabilities for jobs. Sixty years ago, 73 percent make reauthorization of IDEA a priority.
of jobs in the United States were classified In addition to IDEA, the ADA and Section
as “unskilled,” requiring no more than a high 504 of the Rehabilitation Act of 1973 prohibit
school diploma. By 2002, the number of discrimination against people with disabilities in
jobs that were defined as “skilled” jobs or educational settings, including private schools
National Disability Policy: A Progress Report 27
Michael’s Story
What kind of supports do people with disabilities need to achieve economic self-
sufficiency? Consider this example:
Michael, 57, has a degenerative eye condition and has been visually impaired since childhood.
He lives in Baltimore, Maryland. Michael completed three years of college with support
from Pell grants and financial aid but left college because of insufficient funding. He took
disability retirement from a 20-year career with the Federal Bureau of Investigation in 2011
and currently hosts an independent radio talk show. Michael made $85,000 per year in
his Federal Government job. After his disability retirement, he depleted his saving while
waiting nine months for his SSDI application to be approved. His current monthly income
is $3,135 per month after taxes and paying for health care ($2,088 from SSDI and $1,047
from disability retirement). Michael uses software to magnify and read documents on the
computer ($500–$600 initial purchase, $100 for software upgrades), a CCTV magnifier
($1,700 bought used, but usually $3,400 brand new), a note taker (hardware, $2,500), ID
Mate bar code reader ($600 refurbished), and a color identifier ($200). He purchased these
devices on his own or with help from the Maryland Division of Rehabilitation Services. At
home, family members helped him identify appliances to show start or stop buttons or
numbers so he can do daily household tasks on his own. Michael uses paratransit services
to get around within Baltimore. If he needs to travel outside of Baltimore, he takes taxicabs,
Uber, or has a family member drive because the paratransit system does not take him across
counties. Michael owns his own condo and pays $953 per month for mortgage payments
and condo fees. Michael has a checking account, and he tries to save a few hundred dollars
per month to build up his savings again.
and postsecondary education settings. There in the general education classroom as possible
are also many state laws that reinforce and gives students with disabilities access to the
strengthen federal disability antidiscrimination general curriculum while holding them to the
laws in education. same standard as students without disabilities.
Public policy has already made a significant This approach better prepares students with
impact on the education of students with disabilities for success in future postsecondary
disabilities. For example, the number of students education and work, and also prepares students
with disabilities who spend 80 percent or without disabilities to expect the inclusion of
more of their time inside a general education people with disabilities in the community and
classroom has been rising over time. From 1989
19
workforce.
to 2013, the percentage rose from 32 percent Another strategy designed to help students
to nearly 62 percent. Spending as much time
20
with disabilities achieve educational success
28 National Council on Disability
is the multiple diploma option. States are on Education Sciences fund more research
responsible for determining the types of to better understand how multiple diploma
diplomas that are available to students. They have options affect students’ inclusion in schools
experimented with a variety of diploma options, and their ability to find gainful employment
including honors diplomas, standard diplomas, after graduation.
certificates of completion, special education The evolution of technology and its use in
diplomas, and others. Most states offer diploma
21
the classroom has been especially beneficial for
options to students completing less rigorous students with disabilities. Technology has allowed
coursework or students with disabilities who are teachers to customize classroom materials
unable to complete the standard coursework, to meet the unique needs of students with
even with accommodations. Multiple diploma disabilities. For example, electronic textbooks
options may provide another path to graduation that are compatible with screen-readers make
and reduce drop-out rates for these students. The it easier for a student who may be blind or have
multiple diploma option may also allow states to low vision to be independent in the classroom.
maintain high standards for the standard diploma One focus group participant who was blind
while also allowing students with less ability to throughout his childhood said that when he was
graduate. However, NCD recommends that
22
in school, he would often have his mother or
the U.S. Department of Education Institute sisters sit with him and read him his textbooks.
National Disability Policy: A Progress Report 29
With digital textbooks, students today do not disabilities to pursue postsecondary education.
have the same limitations or dependencies. In 2012, the most recent year for which data
Making course materials such as syllabi, reading is available, 11.1 percent of undergraduate
lists, and assignments available in an electronic students who were enrolled in postsecondary
format is an easy way to customize these institutions had a disability (Exhibit 1.1). Although
materials for students who require different types the number of students with disabilities in
of access.23 This also prepares students with postsecondary programs remains low compared
disabilities for the continued use of technology, with the number of students without disabilities,
assistive and otherwise, that they will use this data underscore the importance of
throughout their education and careers. supportive educational policies at the national
The transition from high school to and state level, as the educational attainment
postsecondary education, training, or work is a of students with disabilities at the high school
critical time in which schools can provide support and community college levels is now equivalent
for students with disabilities. Transition planning to or greater than the levels of peers without
services provided by schools may address many disabilities.
paths and opportunities, including transitioning As students with disabilities move into higher
to college and other postsecondary education education, cost becomes a factor in whether they
settings, career and technical education can pursue a postsecondary degree and enter the
programs, vocational rehabilitation services labor market with competitive skills. Pell grants
(when needed), supported living arrangements, and other federal aid programs have played a
or behavioral health services.24 major role in expanding access to postsecondary
Although IDEA mandates transition planning education for all students, including people with
services for all students with an IEP (i.e., disabilities.27 The federal work-study program
students with disabilities), local communities provides part-time jobs for any undergraduate
and businesses can also play an important role or graduate student who has financial need,
by offering summer employment, internships, including students with disabilities, who can earn
service learning, and part-time work. These money to help with their education expenses.
opportunities can help students with disabilities On average, undergraduate students earn $2,400
gain work experience and experience advocating per academic year in wages.28 Also, under the
for their own needs and accommodations in the Federal Supplemental Educational Opportunity
workplace.25 For some students with disabilities, Grant program, any student with financial
services that help them acquire daily living need can apply for grants between $100 and
skills are also a central part of transitioning $4,000 a year to support additional educational
from high school and beyond, but skills like expenses. The amount of the award depends
using transportation, working with money, and on their financial need, the amount of other
following a schedule can all be acquired in work aid they receive, and the availability of school
settings within the community. funds.29 All federal work-study opportunities
Public policies and programs have also must be accessible to students with disabilities.
resulted in more opportunities for students with However, there is no available data that provides
30 National Council on Disability
Exhibit 1.1. Postsecondary Education by Disability Status and Select Characteristics
Selected Student Characteristics Students Without
Students with Disabilities
(as of 2012 Unless Otherwise Stated) Disabilities
Percentage of students 11% 89%
Educational attainment*
■■ High school diploma 34% 25%
■■ Some college or associate’s degree 32% 32%
■■ Bachelor’s degree or higher 14% 33%
Sex
■■ Male 11% 89%
■■ Female 11% 89%
Race/ethnicity
■■ White 11.1% 89%
■■ African American 12.2% 88%
■■ Hispanic 10.4% 90%
■■ Asian 8.0% 92%
Veteran 20.6% 79%
Sources: Data from Snyder et al. (2016); Erickson et al. (2017).26
*Based on 2015 data for noninstitutionalized persons aged 21 to 64 years from Erickson et al. (2017).
a breakdown of students with and without disabilities are not penalized if they cannot
disabilities who participate in these programs. maintain a full course load.
NCD recommends that the U.S. Department Students with intellectual disabilities have
of Education collect data on the participation traditionally been excluded from postsecondary
of students with and without disabilities in education opportunities. One promising
these programs. Furthermore, many students initiative that is addressing the needs of
with disabilities do not know how to disclose students with intellectual disabilities is the
disability-related expenses to financial aid TPSID program. TPSID, which is funded by
officers, which means that these expenses are ED, provides grants to institutions of higher
not considered when determining financial aid education for model comprehensive transition
packages. Many financial aid options also require and postsecondary programs for students
students to attend school full time, although with intellectual disabilities. Through these
some disabilities make this difficult. NCD programs, students with intellectual disabilities
recommends that Congress amend the Higher learn academic, career, and independent living
Education Act to modify financial assistance skills while auditing classes on university
program guidelines so that students with campuses. Between 2012 and 2015, the
National Disability Policy: A Progress Report 31
program expanded to 45 colleges and desire and willingness to work, only 32 percent
universities and has served 1,379 students with of working-age people with disabilities are
intellectual disabilities across 24 states (see employed compared with 73 percent of those
Appendix D for a list of participating colleges without disabilities. This employment rate varies
and universities). The TPSID program offers by disability type. For example, 52 percent
structured academic advising and curriculum of people with hearing impairments and
for students with intellectual disabilities. While 24 percent of people with ambulatory difficulties
in the program, many students with intellectual are employed.33 For people with intellectual
disabilities at certain institutions have access disabilities, the disparity in employment
to paid internships and participate in career participation is even more dramatic. Data from
development activities. After leaving their the National Core Indicators (NCI) project
college-based programs, 36 percent of the suggests that in 2014–2015, only 15 percent of
students secured paid jobs, of which 89 percent working-age adults who were supported by state
paid minimum wage or higher.30 To ensure the intellectual disability agencies and who lived in
quality of these programs, Think College, a the community were employed in a paid job in
project of the Institute for Community Inclusion the community.34
at the University of For people with
Massachusetts Boston, disabilities, barriers to
[O]nly 32 percent of working-
provides support, joining the labor force
coordination, training, age people with disabilities are include the belief that
and evaluation services employed compared with 73 percent employment is not
to TPSID grantees of those without disabilities. a viable option given
and others.31 TPSID their disability or fear of
is an example of a disability-specific program losing public benefits like SSDI, SSI, or enhanced
that can help reduce poverty and increase disability compensation (unemployability benefits)
opportunities for students with disabilities to available to some veterans. Many simply give up
obtain jobs.32 Therefore, NCD recommends after unsuccessfully searching for a job; for this
that the U.S. Department of Education reason, this population is often referred to as
continue funding for model programs like “discouraged workers.” For those that do persist,
TPSID to provide students with disabilities their employment options are often limited to
with the opportunity to attain economic jobs with low pay, few or no benefits, and no
independence. career opportunities.36
Job training and job placement services can
Employment help to address the employment disparities for
Employment is the most direct and cost-effective people with disabilities. In 2010, the Government
way to empower all individuals, including those Accountability Office (GAO) identified 45 federal
with disabilities, to achieve independence programs that supported employment for
and economic self-sufficiency. Although many people with disabilities.37 Although some of
adults and youth with disabilities have the the policies and programs serve people with
32 National Council on Disability
Exhibit 1.2. Employment Rate of Working-Age Adults (18–64), by Disability Status
and Selected Socioeconomic Characteristics
Selected Student
With Disabilities Without Disabilities
Characteristics
Total 32% 73%
Sex
■■ Male 34% 78%
■■ Female 31% 69%
Race/Ethnicity
■■ White 34% 76%
■■ African American 24% 66%
■■ Hispanic 34% 71%
■■ Asian 38% 71%
Veteran 35% 77%
Source: Data from U.S. Census Bureau (2015).35
disabilities exclusively, others serve a broader often face multiple barriers to employment and
population. GAO concluded that the number of economic advancement.38
programs resulted in a fragmented system of The Workforce Innovation and Opportunity
services. Others described the system similarly: Act (WIOA) (P.L. 113-128) reaffirmed the role
“The current national approach involves various of a customer-focused, one-stop delivery
agencies administering system for job seekers
multiple funding streams ... [T]he Government Accountability and expanded the
at a federal, state, and responsibility of the
Office (GAO) identified 45 federal
local level. Each service system to serve job
delivery system was
programs that supported seekers with disabilities.
created in response employment for people with WIOA was designed to
to varying public disabilities... GAO concluded that increase access to and
policy priorities and is the number of programs resulted in opportunities for the
governed by separate employment, education,
a fragmented system of services.
federal statutes and training, and support
regulations. Each system has a specific set of services that people with disabilities need to
rules to determine eligibility for services and succeed in the labor market.
support, define scope of services, and allocate The workforce system made up of
resources. No single source of funding or approximately 3,000 One-Stop Centers (also
resource is able to respond effectively to all the known as American Job Centers) brings
diverse needs of people with disabilities who resources from multiple agencies under one
National Disability Policy: A Progress Report 33
roof. As a result, One-Stop Centers are well- is competitive employment, defined as full-time
positioned to address the fragmentation of or part-time employment for at least 90 days,
employment services and to serve people with during which the individual is compensated at or
disabilities who may have multiple barriers to above the minimum wage. However, VR agencies
employment. In 2014, the system served 494,413 do not often consider longer term outcomes
people with disabilities. WIOA includes provisions or whether the job provides a sustainable
specifically designed to enhance opportunities income given individual client characteristics.
for job seekers with disabilities. In addition to NCD recommends that the U.S. Department
specific antidiscrimination language included of Education’s Rehabilitation Services
in Section 188 that prohibits the exclusion of Administration collect data on long-term
job seekers with disabilities from full access to outcomes and income levels of clients they
services, WIOA specifies that: (1) local workforce serve. In evaluating the VR system for SSI/SSDI
development boards must ensure that there are beneficiaries, GAO found that earnings increased
sufficient service providers in the local area with for many Social Security beneficiaries. However,
expertise in assisting people with disabilities few earned above the set monthly amount that
with their career and is based on the nature
training needs; (2) state of a person’s disability
workforce development WIOA has specifically focused on (i.e., substantial gainful
boards must develop youth with disabilities by requiring activity).42
strategies to support that 15 percent of VR funds be spent Recent changes
career pathways for on this population. enacted under Title IV
people with disabilities to of the WIOA of 2014
enter and retain employment; and (3) the general seek to bolster the VR system by strengthening
workforce system has an obligation to serve the alignment of core state agencies, such as
youth with disabilities. VR, labor, and adult education agencies, and
WIOA legislation also provides guidance advocating for partnerships with other state
to the vocational rehabilitation (VR) system, human services agencies, local workforce
which is funded by the Rehabilitation Services investment boards, and employers.43 WIOA has
Administration (RSA) in the ED. State VR specifically focused on youth with disabilities
agencies receive funding from RSA and state by requiring that 15 percent of VR funds be
governments and serve as one of the largest spent on this population. Overall, strengthening
state–federal partnerships, offering employment the alignment of public service agencies and
services and supports for people with disabilities businesses increases the opportunities for
with nearly 506,000 annual applicants.39 In fiscal transition-age youth and emphasizes competitive
year 2016, expenditures for the program were integrated employment. NCD will be issuing a
$3.2 billion.40 report with more detailed recommendations
Although the VR system is effective for at about pre-employment transition services in the
least some clients,41 the level of effectiveness fall of 2017.
varies by state, client characteristics, and the Self-employment is another viable option for
definition of “effective.” VR’s primary outcome people with disabilities to earn an income that
34 National Council on Disability
can lift them out of poverty. Self-employment Health and Well-Being
provides flexibility through customized work
People with disabilities are not a homogenous
requirements and settings that meet the needs
group. With varying types of disabilities, their
of the person with a disability. Self-employment
needs for health care and support services to
is an especially valuable option for rural residents address medical concerns are wide ranging.
with disabilities who face additional barriers to Historically, health insurance in the United States
employment through limited transportation and has been primarily tied to employment, which
a narrower range of competitive employment limits the availability of health care for people
options.44 with disabilities who are not employed or who
The availability and accessibility of support have little or no benefits through their work. In
for entrepreneurs with disabilities who wish addition, working-age people with disabilities
to establish small businesses varies and relies have higher expenditures than people without
on a mix of resources. The Small Business disabilities and experience higher out-of-pocket
Administration’s 8(a) Business Development costs.46 The kinds of long-term services and
program provides a vehicle through which supports that enable people with disabilities to
federal agencies can work and fully participate
use set-asides and sole in society are generally
NCD recommends that Congress
source awards to small expensive and almost
businesses owned and amend the Small Business Act to
never covered through
controlled by individuals include disability as one of the private health insurance
certified as socially presumed socially disadvantaged policies. This serves as
and economically groups. a catch-22 for people
disadvantaged.45 The with disabilities who
8(a) Business Development program is have significant health care issues: if they are
geared toward African Americans, Hispanic not receiving health care services, then they
Americans, Asian Pacific Americans, Native cannot work, and if they do not have jobs, then
Americans, and Subcontinent Asian Americans they cannot access or afford health care. For
presumed to be socially disadvantaged. some, the only way they can access the health
However, people with disabilities need care services they need is through Medicaid,
to show through a preponderance of the which is tied to having a low income. Again, the
evidence that they are socially disadvantaged challenges are interconnected as both health care
because of their disability. The absence of and employment are essential for people with
disability as a presumed group in the 8(a) disabilities to attain economic self-sufficiency and
program limits this important program for maintain their independence.
small business owners with disabilities. NCD For millions of people with disabilities,
recommends that Congress amend the Medicaid and Medicare are essential health
Small Business Act to include disability as insurance programs. Medicaid serves low-
one of the presumed socially disadvantaged income children, seniors, adults, and people
groups. with disabilities; it is funded at both the federal
National Disability Policy: A Progress Report 35
be complicated and can leave individuals
“Everything is about cost . . . all of the impoverished in order to qualify for Medicaid.
things that we have talked about, there has Medicare is the federal health insurance
always been a cost issue involved. And it program for seniors and people with disabilities.
costs twice as much for us to live as it does Those who receive SSDI benefits are eligible
anybody else.” for Medicare. To qualify for SSDI and Medicare,
people with disabilities under the age of 65
—Focus Group Participant
must not be able to participate in “substantial
gainful activity” because of a medical condition
for a period of at least 12 months and must be
and state level. There are more people with on SSDI for 24 months before they are eligible
disabilities on Medicaid than are privately insured for Medicare.49 In addition, Medicare provides
and, in comparison with people with private limited access to durable medical equipment and
insurance, those receiving Medicaid are more does not provide long-term care services that
likely to report fair or poor health and are unable are often critical for people with disabilities to
to work or have a limited ability to work because maintain their independence. (For more detailed
of their health.47 As of fiscal year 2011, 10 million analysis of Medicaid and Medicare policies, see
adults and children with disabilities were covered Appendix C for NCD’s work in this area.)
by Medicaid. Although the share of adults with There are many cases in which people with
disabilities accounts for 12 percent of Medicaid disabilities are still not able to afford health
enrollment, they account for 36 percent of care coverage or receive all the services they
Medicaid spending, largely because of higher need with Medicare alone. These individuals
health care and long-term services and support may be eligible for assistance from their state’s
needs.48 Medicaid program. People who are dually
The path to Medicaid coverage for eligible for Medicare and Medicaid often have
people with disabilities is through SSI. In higher medical costs and needs. In fiscal year
addition, people who are deemed “medically 2010, about 9.6 million Americans were covered
needy” but who have countable income under both Medicare and Medicaid. People
and nonexempt property (e.g., cash, bank with disabilities under the age of 65 constituted
accounts, and stocks) that disqualify them 40 percent (3.9 million) of these dual eligible
from Medicaid may be considered for health beneficiaries. However, 60 percent of Medicaid’s
coverage by “spending down.” The spend- adult enrollees with disabilities were not eligible
down process involves deducting medical for Medicare coverage and a number of these
expenses from the individual’s countable enrollees were still in the two-year waiting
income until they reach the eligible income period to receive Medicare based on their SSDI
level for Medicaid. Once they “spend down” eligibility.50
to the eligibility level, the individual’s medical The existing eligibility criteria for SSDI and
bills will be covered for a set three or six SSI may force people with disabilities to choose
month period. However, this process can between getting a job and taking care of their health.
36 National Council on Disability
NCD recommends that Congress decouple with no waiting list or caps;53 however, the 2012
eligibility for health care benefits from Supreme Court decision in National Federation of
eligibility for cash benefits like SSI and Independent Business (NFIB) v. Sebelius decided
SSDI. (For more information, see Appendix C, that states were not mandated to expand
which provides a link to NCD’s report, Securing Medicaid coverage.54 As a result, 18 states
the Social Contract: Reforming Social Security opted not to expand the program. Recent data
Disability.) This is a disincentive to work, and it shows that people with disabilities in Medicaid
can be addressed through changes to federal expansion states are more likely to be employed
policy. For example, prior to passage of the versus people living in non-Medicaid expansion
ACA, people with disabilities were more likely states.55 NCD recommends maintaining
to be uninsured even if they were employed, the Medicaid expansion for individuals
with only 22 percent of people with disabilities whose conditions did not meet the severity
having private insurance coverage compared requirements for pre-ACA disability-based
with 70 percent of people without disabilities.51 Medicaid, as well as for those falling within
The ACA created new ways for working-age the two-year waiting period before qualifying
adults to obtain public for disability-based
assistance for health Medicare. NCD
Recent data shows that people with
care coverage and also also recommends
disabilities in Medicaid expansion
prohibited discrimination maintaining protections
based on disability. The states are more likely to be that prohibit insurance
ACA expanded Medicaid employed versus people living in companies from
eligibility for working- non-Medicaid expansion states. denying coverage
age adults with incomes because of preexisting
up to 138 percent of the federal poverty level conditions. (See Appendix C for more
(FPL) and provides subsidies for people with information about NCD’s analysis of current
incomes up to 400 percent of the FPL to buy health reform plans.)
health insurance on a state health insurance Long-term services and supports are another
exchange. It also changed the enrollment rules vital aspect of health care for people with
to make eligibility determinations much easier.52 disabilities, and advances in medical knowledge
The expansion of Medicaid eligibility up to and technology have allowed this population to
138 percent of the FPL allowed more people live more independently with these services.
in poverty, including those with disabilities, to This is important for an aging population as
work more and gain an income without being data shows that, between the ages of 40
penalized by losing their health care benefits. and 50, almost one in 10 people will have a
This change provides a stronger start toward disability that may require long-term services
financial independence for people with disabilities and supports.56 Many people with disabilities are
while allowing them to retain their health care able to access these services through Medicaid
coverage. Under the current system, Medicaid home and community-based services (HCBS)
guarantees federal matching dollars to states waivers. These waivers allow states to provide
National Disability Policy: A Progress Report 37
nonmedical services such as personal care people with disabilities, many of whom rely on
services and habilitation services. Without these this safety net system and who have, on average,
HCBS services, many beneficiaries would be at higher health care costs and long-term support
risk of becoming institutionalized in a nursing needs. NCD recommends that any changes to
home or hospital facility. NCD recommends that federal and state funding for Medicaid should
Congress expand opportunities for people consider how to safeguard health care for
with disabilities who need to pay for personal this population.59 (See Appendix C for more
care services in order to benefit from tax information about NCD’s analysis of current
deductions. The ACA also gives states the option health reform plans.)
to include home and community-based services
as part of their benefits instead of providing Financial Assistance and Incentives
them through a waiver. HCBS waivers can cover Social Security Disability Insurance
important services such as case management, (SSDI) and Supplemental Security
personal care, adult day health services, Income (SSI)
habilitation, and respite care, which often are In addition to serving as an entry point for federal
not available through private insurance plans. health insurance (i.e., Medicare and Medicaid),
The kinds of HCBS services states offer varies SSDI and SSI provide essential cash supports for
greatly, with 17 states offering targeted HCBS more than 13 million Americans with disabilities
services to those at risk of future institutional and their families.60 These programs offer financial
care, 32 states offering personal care services, support to help cover living expenses and other
and eight states offering Community First Choice costs when individuals are “unable to work due
attendant care services and supports.57 These to severe physical and/or mental limitations.”
services support people with disabilities in their Although the average benefit is modest, without
home and/or community instead of in institutional it, many individuals and families would be in
settings. deep financial distress. Both programs provide
Current health care reform discussions will cash payments to engage in “substantial gainful
have a greater impact on people with disabilities activity” because of one or more severe physical
than any other group because of the major role or mental impairments that are expected to
both Medicaid and Medicare play in covering last at least a year or result in death. In 2017,
their health care costs. Per capita caps would substantial gainful activity was defined as the
reduce the amount that states receive from ability to earn $1,170 per month ($1,950 per
the Federal Government for Medicaid and, in month for blind individuals).
many cases, states would reduce the amount In 2015, 8.9 million SSDI beneficiaries received
of the state’s share of spending on Medicaid. an average of $1,166 per month or less than
The proposed per capita caps are estimated to $14,000 per year—marginally above the poverty
reduce federal Medicaid support by $149 billion guideline for individuals living alone ($11,771 in
by 2026 to states that would have used the 2015).61 Although this seems like a small sum, the
funding to support Medicaid programs.58 These program provides crucial economic support for
reductions would have a significant impact on people with disabilities. Approximately 80 percent
38 National Council on Disability
The disability determination process is often
“No one enjoys having to be on one of those so long and daunting that, after becoming
programs [SSDI or SSI]. And yet, it is a vital eligible, beneficiaries begin to believe that they
survival tool.” cannot work and they fear running afoul of the
complicated rules and losing their benefits. In
—Focus Group Participant
discussions with stakeholders, the situation has
been described as follows: “We teach a group of
people that they cannot work and cannot build
of beneficiaries get at least half of their income assets and that they shouldn’t even try.”
from the SSDI program, while 36 percent of
beneficiaries rely on SSDI benefits as their sole Earned Income Tax Credit (EITC)
source of income.62 Estimates suggest that SSDI The EITC is the largest cash assistance program
pulled 2.7 million households out of poverty in in the United States. For the general U.S.
2015 (calculation based on Bailey and Hemmeter population, the EITC has become the centerpiece
(2015).63 In that same year, 4.9 million working-age of antipoverty initiatives. In 2016, 27 million
SSI beneficiaries received an average of $561 per eligible workers and families received more than
month.64 Estimates suggest that SSI payments $67 billion in the form of reduced taxes and tax
pulled one million households out of extreme refunds. Speaker Paul Ryan’s antipoverty plan
poverty, yet most remain recommends increasing
within 150 percent of the EITC.67
Estimates suggest that SSI payments
the poverty threshold Although more
(calculation based on
pulled one million households out than 10 percent of
Bailey and Hemmeter, of extreme poverty, yet most remain working-age adults
2015).65 The Social within 150 percent of the poverty with disabilities take
Security Administration threshold. advantage of the tax
(SSA) publishes program credit,68 the structure
statistics about the characteristics of SSI and of the EITC does not serve the needs of low-
SSDI beneficiaries by age, sex, and type of income people with disabilities as well as it
disability. However, SSA discontinued publication serves low-income people without disabilities.
of beneficiary characteristic by race for the SSI In 2012, adults with disabilities were nearly
program after 2002 and after 2009 for the SSDI equally as likely to claim the EITC as those
program largely because of the challenge of without disabilities, but they received a much
collecting race information when Social Security lower average benefit. The average annual tax
numbers are assigned.66 credit benefit for people without disabilities
Despite the importance of SSI and SSDI was $2,072, while the average for people
in providing a safety net for people with with disabilities was $1,301, and more than
disabilities, these programs can keep people 60 percent of people with disabilities received
in poverty or near poverty by setting up low less than $500 from the EITC benefit.69 This
expectations and perverse economic incentives. disparity is the result of a mismatch between
National Disability Policy: A Progress Report 39
the structure of the program and two important mobility) that affect individuals, families, and
socioeconomic characteristics of people with communities.71 However, current federal
disabilities: (1) being older and (2) having no housing assistance programs are substantially
qualifying children. The EITC is designed to underfunded, and only one in four income-
reduce poverty, especially childhood poverty, eligible families receive any form of housing
and discourage the use of welfare programs assistance.
such as TANF. As a result, the EITC offers a Several programs available through HUD
much larger benefit for workers with “qualifying provide rental assistance for low-income
children” than for those with either no children households. These programs serve approximately
or children who are older than 19. Because 90 percent of the five million low-income
people with disabilities tend to be older and households receiving federal rental assistance.
are less likely to have qualifying children, The median annual income for households
the EITC has limited benefits for them. receiving federal rental assistance from the three
NCD recommends primary HUD programs is
increasing the EITC for $13,500.
The median annual income for
individuals and families HUD housing
without qualifying households receiving federal rental programs are operated
children to help low- assistance from the three primary through local public
income workers HUD programs is $13,500. housing authorities
with disabilities lift (PHAs). Two of the three
themselves out of poverty. primary HUD programs provide funding for
multifamily, apartment complex-, or house-based
Housing rental units. Project-Based Section 8 is a voucher
Housing is one of the largest budgetary program in which rental units for low-income
expenditures for most households and is households are included in an apartment house
strongly linked to overall health and well-being. or development that is privately owned. Private
Housing also serves as a mechanism for companies and development corporations can
accumulating personal wealth. Access to apply for subsidies in the form of tax credits or
stable, safe, appropriate, and affordable other cost-offsets when they include a certain
housing can provide the foundation for the number of units in their developments that
layers of activities and services necessary are designated as affordable. In addition to the
to promote health, educational attainment, offsets for including affordable units, developers
employment, economic mobility, and improved can receive contracts for ongoing monthly rental
quality of life for low-income individuals or assistance subsidies. Another HUD program is
households, including people with disabilities.70 the Housing Choice Voucher Program, which
An integrated policy approach to housing and consists of buildings or housing developments
service provision is thought to reduce the cost that are HUD-owned or operated. Individuals or
of addressing multiple needs and challenges households that are eligible and awarded federal
(e.g., poverty, health care utilization, economic rental assistance funds are then assigned to
40 National Council on Disability
people with significant and long-term disabilities
“I can’t afford to live in accessible housing. with the stipulation that no more than 25 percent
It costs up to $500 more. I have to use a of units in properties funded through Section
regular apartment and use a bench to use 811 be set aside for people with disabilities,
the bathroom.” which seeks to expand the supply of long-term
affordable, integrated housing. In 2011, the Frank
—Focus Group Participant
Melville Act statutes were amended and HUD
developed guidance for housing authorities
to address turnover of Section 811 as well as
a specific rental subsidized unit in a specific Section 8 vouchers. The guidance focused on
HUD-owned building. Renters are assigned ensuring that the Section 811 and Section 8
a unit (1-, 2-, or 3-bedroom) in one of these vouchers would continue to be made available
buildings based on family composition and to people with disabilities and not awarded
HUD guidelines. People with disabilities may on a first-come, first-served basis. By 2013,
also qualify for housing choice vouchers. These 13 state housing finance agencies received
vouchers are portable in that eligible renter funding from HUD for the development of 3,006
households can use them to find housing in housing units.73
any unit that meets HUD occupancy standards The U.S. Department of Agriculture (USDA)
where the property landlord agrees to accept the also provides housing assistance through its
voucher and comply with HUD standards and Rural Development program. This program
regulations. funds housing and rental assistance programs
HUD also offers Section 811 funds, which for rural and farmworker households. In 2016,
are targeted to both develop and then subsidize approximately 46 million Americans lived in
rental units that specifically address the needs rural areas. The USDA Rural Development
of low-income people with disabilities who program was established in the 1990 farm
require additional supports and services to live bill amending the previous Farm and Rural
independently in the community. Prior to 2010, Development Act of 1972. The program
Section 811 housing was not working as needed focuses on the needs of rural areas, particularly
for people with disabilities because it was impoverished and remote communities,
creating fewer than 1,000 new housing units through various initiatives that are targeted
per year.72 toward strengthening rural communities. USDA
The Frank Melville Supportive Housing Rural Development’s low-interest home repair
Investment Act of 2010, signed into law in 2011, loans and grants enable seniors and people
served to reform the Section 811 program. In with disabilities to remove health and safety
the long term, the law will fund the development hazards, perform necessary repairs, improve
of thousands of permanent supportive housing or modernize a home, make homes accessible
units integrated within affordable housing for people with disabilities, or make homes
properties each year. Further, the law supports more energy efficient so these very-low-income
and promotes a community integration model for families use less of their income on utility
National Disability Policy: A Progress Report 41
bills, allowing them to live independently and/ Transportation
or age in place. USDA Rural Development has
Accessible transportation options, including
also developed collaborations across 19 other
accessible buses, ADA complementary
federal agencies to target high-poverty tribal
paratransit (paratransit), taxicabs, and railway
communities, both urban and rural. These
systems provide people with disabilities with
collaborations address housing, education,
opportunities to participate in employment,
health care, and other critical needs for tribal
education, health care, housing, and other
communities.
community activities. The passage of the ADA led
The HUD and USDA rental and housing
to major improvements in transit systems across
assistance programs help lift low-income
the United States. Nationwide, approximately
households out of poverty, including the
6,800 agencies provide bus and rail services or
approximately 1.1 million households that have
other modes of transportation.78
an adult between the ages of 18 and 62 with
Title II of the ADA prohibits discrimination
a disability and approximately 73,000 veterans
based on disability in public transportation
with disabilities that
services such as city
receive housing or rental
buses and public
assistance benefits. In There is growing evidence that
rail (e.g., subways,
addition, the programs access to decent, stable, affordable
commuter trains, and so
reduce homelessness housing may be the platform or forth). Under the ADA, all
and housing instability
intersection for better outcomes new fixed-route vehicles
among vulnerable
in economic mobility, educational used in public transit
families.74 There is
must be accessible. In
growing evidence that attainment, and quality of life,
addition, existing rail
access to decent, stable, including better physical and mental
stations that were altered
affordable housing health. after the passage of
may be the platform or
the ADA must be made
intersection for better outcomes in economic
accessible if technically feasible and all new
mobility, educational attainment, and quality of
rail stations and facilities must be accessible.
life, including better physical and mental health.75
Paratransit (on-demand, door-to-door) services
Housing plays a substantial role in improving
are required for noncommuter fixed-route bus or
outcomes at all levels from the individual to
rail services.79
the community at large. As first noted in our
With the enactment of the ADA, accessible
2010 “The State of housing in America in the
transportation options for people with disabilities
21st Century” report,76 NCD recommends
using fixed-route transportation, including public
the implementation of integrated housing
buses and rail systems, have increased. Bus
policies, which can be critically instrumental
service has also improved. For example, low-
in addressing the economic well-being
floor buses with ramps, floor markings, and
of the increasing number of low-income
other design features, such as additional grab
households.77
bars, audible stop announcements when more
42 National Council on Disability
than one route is served at the same location,
larger destination signs, and monitors that show
upcoming stops have significantly bolstered bus
accessibility.80 Paratransit transportation is often
provided by minibuses and door-to-door shared
rides upon request for eligible people with
disabilities who cannot use fixed-route services.
Although the use of paratransit among people
with disabilities has increased consistently in
the past 20 years, a 2009 analysis of ridership
from seven selected systems showed that,
on average, fixed-route ridership by people
with disabilities was higher than paratransit
ridership.81 Use of public transit is increasing
and playing a major role in providing increased
independence and mobility to people with
disabilities. One concern regarding paratransit
service is DOT’s ADA regulations for passenger
pickup. According to these standards, paratransit
service is only provided within a three-quarter-
mile radius of a fixed-route bus stop, to be
comparable to fixed-route transit. This limitation
places a burden on people with disabilities who
depend on paratransit service and may cause Las Vegas, San Francisco, Seattle, and Portland
them to have difficulty finding employment as have made improvements to their accessible
well as access to the community.82 taxicab programs.83 For example, a settlement
Private transportation agreement in New
is another important York City is expected
[A] 2009 analysis of ridership from
alternative that provides to phase in wheelchair-
people with disabilities
seven selected systems showed that, accessible taxicabs, via
with greater flexibility on average, fixed-route ridership by attrition of old vehicles,
and independence than people with disabilities was higher so that, by 2020,
public transportation. than paratransit ridership. 50 percent of taxicabs
This is particularly true for will be accessible to
people with disabilities who live in areas where people who use wheelchairs and scooters.84
public transit is unavailable or inaccessible. Many Although, as the option of using taxicabs
people with disabilities who cannot drive or afford increases, greater attention is needed for training
a car use taxicab services. Furthermore, some taxicab operators about ramp deployment and
cities such as New York City, Chicago, Boston, securement procedures. NCD recommends
National Disability Policy: A Progress Report 43
local municipalities require taxicab authorities Areas (Section 5311).86 These activities provide
to provide mandatory training for taxicab funding to states for transportation to and from
operators on these issues so that people with jobs for low-income people and people who
mobility disabilities can safely and effectively receive government assistance, as well as people
use privately funded transit options. with disabilities. In addition, grants from the
However, access to affordable and accessible Enhanced Mobility for Seniors and Individuals
transportation can be especially challenging for with Disabilities program (Section 5310) enable
people with disabilities states to support private
living in rural areas. [A] settlement agreement in New nonprofit groups in
Grants from the Federal providing transportation
York City is expected to phase in
Transit Administration to people with disabilities
wheelchair-accessible taxicabs, via
provide funding to create and seniors when
or enhance local public attrition of old vehicles, so that, by public transportation is
transit systems, which can 2020, 50 percent of taxicabs will insufficient, inappropriate,
be useful for people with be accessible to people who use or unavailable to meet
disabilities, particularly the needs of these
wheelchairs and scooters.
in rural communities. For populations.87 These
example, Job Access and Reverse Commute federally funded grant programs play a major role
activities are eligible for funding under the in engendering more opportunities for people
Urbanized Area Formula Funding program with disabilities to access employment and
(Section 5307)85 and Formula Grants for Rural achieve economic self-sufficiency.
44 National Council on Disability
Chapter 2: Barriers to Achieving Economic
Self-Sufficiency for People with Disabilities
A
s discussed in Chapter 1, a variety further limit their employment options.89 Children
of policies and programs exist to from diverse racial backgrounds, specifically
economically support people with African American, Hispanic, and American
disabilities. However, achieving economic self- Indian children, including those from low-
sufficiency is not without its challenges. Many income communities and those who are English
public policies were developed during a time language learners, are overrepresented in special
when it was assumed that people with disabilities education programs.90
could not work and therefore needed permanent The challenges that students with disabilities
assistance from federal, state, and local public experience in obtaining an education are
agencies. This has led to the unintended compounded for those who also grow up
consequence of creating dependence on public in poverty. Common challenges of poverty
programs for many people with disabilities. include trauma, hunger, and family difficulties,
This chapter reviews the common barriers that which can lead to behavioral problems in
perpetuate the cycle of poverty for people with school or create ongoing health conditions and
disabilities. These include barriers to education, disabilities. Children with disabilities growing up
labor force participation, and health benefits as in these adverse circumstances face additional
well as an ongoing battle against stereotypes that obstacles because schools have limited funding
limit the potential of these citizens. for programs that could provide services and
resources to support these children.91 Parents
Barriers to Adequate Education living in poverty and struggling to meet the
Setting people with disabilities on the path to economic needs of their families often have little
achieving economic self-sufficiency in adulthood time to adequately meet all of the additional
requires a strong foundation of knowledge and needs of a child with a disability.92 In addition,
skills that must be laid in school. Currently, there they are required to navigate a complex health
are at least six million students with disabilities in system, find time to address school-related
the United States, but the high school graduation issues, and serve as a strong advocate for their
rate for students with disabilities is 63.1 percent child’s needs. Parents may turn to charter schools
nationwide compared with an 82.3 percent or private schools to ensure their children get
graduation rate for students without disabilities.88 the education and supports needed. NCD is
Drop-out rates among students with disabilities undertaking a study of school choice in the fall
National Disability Policy: A Progress Report 45
to better meet the needs of students with
disabilities who are at risk for the school-to-prison
pipeline.93 (For more information, see Appendix C
for a link to NCD’s report, Breaking the School-to-
Prison Pipeline for Students with Disabilities.)
In addition, restrictive, segregated special
education placement often leads to a larger
number of students with disabilities being
awarded alternative high school diplomas.
Pursuing an alternative diploma track is a decision
that needs to be carefully considered, as it
can impede adequate preparation for higher
education and employment because alternative
diplomas are awarded for completion of less
of 2017 with an anticipated release date of 2018. rigorous academic coursework. As a result,
(For more information, see Appendix C for a employers and institutions of higher education do
link to NCD’s 2003 report, School Vouchers and not view them as equal to standard high school
Students with Disabilities.) diplomas.94 As many as 85 percent of students
The special education systems’ segregation in special education are capable of meeting the
of children with disabilities often leads to poorer same educational standards as other students
outcomes for students with disabilities than for when given the right type of instruction, access,
their peers without disabilities. One example and supports required by IDEA.95 Unnecessary
is the school-to-prison placement into an
pipeline, which refers to alternative diploma track
Unnecessary placement into an
policies and practices has a lasting impact on
that push children out alternative diploma track has a future economic self-
of classrooms and into lasting impact on future economic sufficiency for students
the juvenile and criminal self-sufficiency for students with with disabilities. Because
justice systems. Students disabilities. children from diverse
with disabilities and racial backgrounds are
students from diverse racial backgrounds with overrepresented in special education, they are
disabilities in particular are disproportionately more likely to earn alternative diplomas and suffer
affected by these policies. Data shows that the lasting consequences of fewer employment
some states suspend and expel students with and educational opportunities. Therefore, NCD
disabilities who have IEPs at more than twice recommends that the U.S. Department of
the rate of students without disabilities, including Education issue guidelines that gives students
28 percent of all African American students with disabilities the opportunity to obtain a
with disabilities. Improvements to the special standard high school diploma and only use
education enforcement systems are needed alternative diplomas as a last resort.
46 National Council on Disability
The DOL recommends that IEP teams graduation goals (e.g., education, training, or
begin to investigate graduation options no employment). In practice, transition planning for
later than middle school because this decision students with disabilities is often inadequate.
will determine the courses that students with Preparing students without disabilities for skills
disabilities take in both middle school and high development and economic independence
school. The IEP team must also ensure that the often includes early opportunities such as
core course of study is consistent with students’ job shadowing, internships, part-time jobs,
goals after high school graduation. NCD echoes and volunteer work. However, students
this recommendation. Students with disabilities with disabilities are less likely to have these
should be meaningfully involved in the opportunities, which sets them further behind
development and planning of their IEP goals their peers when they enter the competitive job
to ensure that these goals accurately reflect market and postsecondary application process.97
their capabilities and Being from a diverse
keep future educational racial background has
The Common Core Standards
and employment a further impact on
forbid students who graduate with
opportunities open to entering the competitive
them.96 To ensure that alternative high school diplomas or job market—while
only students with the trade and career program degrees the employment rate
most significant cognitive from obtaining federal Pell grants for white youth with
disabilities are put on disabilities is 34 percent,
and federal scholarships.
an alternative diploma it is only 24 percent
track, the Every Student Succeeds Act of 2015 for African American youth with disabilities
requires that parents provide informed consent to (Exhibit 1.2).98
and understand the implications of an alternative To ensure full participation in postsecondary
diploma track. It also requires states to establish education, students with disabilities, particularly
clear guidelines about placement in an alternative those in poverty, often need federal student
track and to be more transparent about the aid. However, they face challenges in obtaining
process of alternative testing. financial support from federal resources including
Pell grants, Federal Supplemental Educational
Barriers Related to the Transition Opportunity Grants, and federal work-study
to Employment programs.99 The Common Core Standards forbid
Moving students with disabilities into the right students who graduate with alternative high
career path, which may include postsecondary school diplomas or trade and career program
education, training, or work, is key to ensuring degrees from obtaining federal Pell grants and
that they have access to opportunities federal scholarships. This limits federal financial
that will lead to financial success and self- aid to those students with disabilities who
sufficiency. IDEA mandates that transition receive standard high school diplomas and
planning be provided for all students with an GEDs. As noted in our 2015 briefing paper on the
IEP and this includes concrete post-high school reauthorization of the Higher Education Act,100
National Disability Policy: A Progress Report 47
NCD recommends that the U.S. Department Veterans with mental health issues or other
of Education revise guidelines to allow disabilities resulting from their deployments face
students who graduate with alternative high unique challenges in higher education. Many
school diplomas or trade and career program veterans enter institutions of higher education
degrees to be eligible to obtain federal Pell to improve their ability to work. However,
grants and federal scholarships if they meet they enroll in college with physical wounds,
all other qualifications for financial support posttraumatic stress disorder, depression,
from federal sources. anxiety, and traumatic brain injuries, which
As noted earlier, students with disabilities require accessibility and accommodations on
are often tracked into alternative diploma campus and in classrooms.104 As a result of their
programs, which limits their options for entry injuries, veterans may find themselves struggling
into postsecondary education, including with problems related to attention, concentration,
eligibility for federal financial aid. Students are processing new information, and other cognitive
also often required to take a full course load as functions central to obtaining a quality education.
a condition of receiving financial aid; however, Many veterans do not use the traditional services
some students with that institutions of higher
disabilities are unable During the crucial time immediately education provide to
to meet this condition. students with disabilities.
after the onset of disability, when
As a result, students Colleges and universities
with disabilities who
they may still have some attachment need to engage with
cannot obtain federal to the labor force, the current veterans in ways that are
financial aid are left to [Social Security] system encourages more in tune with their
figure out how to pay applicants not to work, which often needs and work with
for college or vocational the U.S. Department
leads to poverty.
training programs; like of Veterans Affairs to
most students, they frequently take out private communicate with veterans about disability
loans to pay for postsecondary education or services.105 Veterans need unique attention to
vocational training, even though these loans have ensure they can complete school successfully.
higher interest rates than federal student loans (For more information, see Appendix C,
and no grace periods, which federal student which provides a link to NCD’s report, Mental
loans provide.101 In 2014, student loans totaled Health on College Campuses: Investments,
$1.4 billion.102 Recent action by the ED has led Accommodations Needed to Address Student
to student loan debt forgiveness for qualified Needs.)
students with disabilities; however, at this
time, debt forgiveness does not include a tax Barriers Related to Complex
waiver.103 Thus, students with disabilities may Eligibility and Enrollment Procedures
end up paying taxes on loans that they no longer When people apply for disability insurance
owe. NCD recommends that the IRS provide benefits through SSDI, they must demonstrate
guidelines that waive taxes on student loan to the SSA that they cannot work. However, a
forgiveness for students with disabilities. significant portion of people with disabilities can
48 National Council on Disability
and want to work as long as they have adequate as part of its continuing disability reviews
health care and long-term support services, (CDRs). Those who show medical improvement
reasonable accommodations, and sometimes, through a CDR could face the prospect of losing
additional training. Support in the form of cash their benefits. Throughout the application and
assistance from SSDI or SSI helps people benefit process, SSA disability participants
with disabilities attain or maintain a reasonable must continually prove an inability to perform
standard of living. However, due to the “all or substantial gainful activity (SGA) or risk losing
nothing” requirement of the SSA, people with their benefits.107
disabilities are faced with choosing between Eligibility for SSDI and SSI benefits is
working or receiving needed cash, medical, and interconnected with health care and long-
other in-kind support. If they choose to work, term services and supports, which are also
then they often find themselves in low-paying important for people with disabilities to maintain
jobs with little or no benefits.106 If they select their independence. SSDI beneficiaries qualify
needed benefits, they cannot work and are often for Medicare after 24 months of enrollment.
faced with the further challenge of navigating People with disabilities with limited income and
a complex system to assets (e.g., cash, bank
obtain needed supports. [HCBS] services are often necessary accounts, stocks, U.S.
The disability savings bonds, land,
for people with disabilities to
determination process, vehicles, or personal
which determines SSDI
successfully attain and maintain property) can also qualify
and SSI eligibility, has employment; however, [they] … for SSI and therefore
multiple steps and can are generally not available from qualify for Medicaid.
often be lengthy. During private insurance plans and are too Through Medicaid HCBS
the SSDI application waivers under Section
expensive to afford out of pocket.
and appeals processes, 1915(c) of the Social
people with disabilities do not receive any Security Act, people with disabilities can access
income support or medical benefits. They services such as case management, personal
must disconnect from the workforce to obtain care, adult day health services, habilitation, and
financial assistance. During the crucial time respite care. Medicaid services provide important
immediately after the onset of disability, when additional supports for people with disabilities
they may still have some attachment to the labor by allowing them to remain independent in their
force, the current system encourages applicants homes and/or communities instead of forcing
not to work, which often leads to poverty. them into institutional settings. These services
In fact, the application process can take are often necessary for people with disabilities
many months or even years while people to successfully attain and maintain employment;
with disabilities provide medical information however, the services available under HCBS
to prove their inability to work. After people waivers are generally not available from private
with disabilities qualify for SSDI benefits, they insurance plans and are too expensive to afford
must continue to meet strict disability eligibility out of pocket. As a result, people with disabilities
requirements, which SSA periodically reassesses frequently stop working in order to maintain the
National Disability Policy: A Progress Report 49
low income levels that are required by SSI, SSDI, expenses. (For more information about the ABLE
Medicare, and Medicaid to ensure they received Act, see Appendix B.)
much-needed benefits. The complexities of public benefits programs
are exacerbated by concerns and confusion
Barriers Related to Program Income about paying back those benefits. SSI benefits
and Asset Limits are adjusted based on earnings; however,
Eligibility for SSI and SSDI is based on the the adjustments are often delayed by several
inability to earn an income which is referred to months because the level of benefits are
as SGA. In 2017, SGA was $1,170 per month adjusted retroactively. If SSA determines that a
for nonblind beneficiaries and $1,950 for blind person received an overpayment, beneficiaries
beneficiaries. SSDI beneficiaries who earn above must reimburse SSA for the overpaid amount.
SGA can lose all of their SSDI cash benefits. Unfortunately, the agency can take months or
Several work incentive programs exist to reduce years to determine the necessary adjustments
or forestall the risk of losing cash benefits. For to SSI benefits and will continue to overpay the
example, beneficiaries can earn an unlimited beneficiary. The need to pay back overpayments
amount for nine months during a “trial work can lead to financial turmoil and reinforce the idea
period” without losing benefits. Nevertheless, that any kind of work can lead to more harm than
SSDI beneficiaries face a “cash cliff” where good for people with disabilities.
earnings that exceed the SGA level result in the Work incentives such as expedited
loss of the full amount of the cash benefit. The reinstatement, trial work periods, extended
loss of SSDI income for people with disabilities periods of eligibility, and continuation of
may be greater than their earnings and result in a Medicare coverage can help people with
situation where they have insufficient income to disabilities on SSDI reduce the risk of losing
cover all of their expenses. benefits. In addition, SSI recipients can use
SSI beneficiaries face a different penalty when incentives such as the earned income exclusion,
their incomes rise. Specifically, after earnings impairment-related work expense (IRWE), plans
reach $65 per month, SSI benefits are reduced for achieving self-support (PASS), and continued
by one dollar for every two dollars of additional Medicaid eligibility (1619b) (see Appendix B
earnings. In addition to penalizing people with for more information.). Through the Ticket to
disabilities who want to work, eligibility for SSI
requires that people with disabilities have very
limited assets. Personal savings and assets “He’s almost forced into poverty. For every
enable people to weather financial shocks and extra dollar of income he gets, he seems
emergencies and make long-term investments to lose a benefit. If that happens, he’s
that will help them in the long term. Prior essentially in the same spot. He can never
to passage of the ABLE Act in 2014, people better his condition.”
with disabilities receiving these benefits were
—Parent of Focus Group Participant
significantly limited in what they could save for
emergencies or even large disability-related
50 National Council on Disability
Work Program, the SSA funds work incentives with SSA, Centers for Medicare and Medicaid
planning and assistance projects in each state. Services, and Department of Labor programs.
Community work incentive coordinators provide Housing is another significant cost factor for
in-depth counseling about benefits and the people with disabilities that requires thoughtful
effect of work on those benefits to people with public policy. HUD takes a more flexible approach
disabilities using the work incentives. The SSA’s than other agencies when it comes to income
Protection and Advocacy for Beneficiaries of requirements for people with disabilities to
Social Security programs in each state build maintain eligibility for program support, such
on these services by providing additional help as HUD housing or rental assistance programs.
with accessing supports that will facilitate In general, a person’s household income
work. Despite these supports, the rules for must be at 50 percent or below of the area
these incentives are complicated and many median income. People with disabilities who
beneficiaries have reported difficulty accessing rely on SSI or SSDI income may also be eligible
high-quality information about these projects. for housing assistance under the Section 811
Among the 328,000 SSI recipients who work, Supportive Housing Program. These options
only 821 have PASS plans that enable them to reduce the barriers to adequate low-cost housing.
set aside money for items or services needed Also, household income and asset limits for
to achieve a specific employment goal without HUD housing assistance programs are more
that money counting against their asset limit. generous than those for SSI and other assistance
Only 3,188 use the IRWE, which allows them programs. For people with disabilities who have
to deduct the out-of-pocket costs of certain either not been previously employed or who have
expenses from the amount of earnings SSA uses been out of the workforce for at least a year,
to calculate the SSI benefit.108 there are HUD programs designed specifically
Overall, individuals whose ability to work to help incentivize work and the move toward
may be limited or fluctuate over time face a economic self-sufficiency. These federal rental
complicated system where they must calculate assistance programs build in room for the
whether their long-term earnings can cover their household income to increase within certain
loss of benefits. Some beneficiaries are put in a parameters.
difficult position where, if they work and earn too In addition, HUD does not place limits
much, they may lose the long-term care supports on assets for people who receive support
they need to work. Others face the stark from housing or rental assistance programs.
option of full dependency on needed benefits Households can have bank accounts, and only
without the option of financial independence. the interest from a savings, checking, or other
NCD recommends the President establish account counts toward income. HUD also has
collaboration by federal agencies in forming a disability assistance allowance for additional
an interagency work group to propose rule costs that exceeds 3 percent of the household
changes in federal benefit programs and income. These costs can include paying for
reduce work disincentives linked to federal personal care attendant services, a wheelchair,
program conflicts. This effort should begin and assistive technology. For an expense to be
National Disability Policy: A Progress Report 51
allowable, it must help people with disabilities funds are allocated to serve rural communities.111
work or free another member of the household This means that there is minimal or nonexistent
to work. Anticipated medical expenses in transportation services in many rural areas.
combination with any disability assistance NCD recommends that Congress place
allowance exceeding 3 percent of the household greater emphasis on federally funded grant
income can also be considered allowable.109 programs for rural areas to address publicly
The differences in both income and asset limits and privately funded accessible transportation
across programs from federal agencies such options for people with disabilities.
as HUD and SSA create a complex system that Providing transportation to people with
people with disabilities must navigate to obtain disabilities in rural areas is often complicated by
these much needed services. small populations and long distances between
communities, which make it difficult for rural
Barriers Related to Transportation areas to provide services such as fixed-route or
in Rural Areas ADA paratransit services. Additionally, a lack of
Lack of transportation options for people with coordination between services in rural areas is
disabilities in rural areas creates serious, ongoing a significant problem for people with disabilities
barriers to employment, living in these areas. For
accessible health care, [O]nly 6 percent of federal transit example, transportation
and full participation in funds are allocated to serve rural that stops at a county
society for this population. line is an artificial barrier
communities.
According to the 2010 that limits employment
Census, 19 percent of the U.S. population lives in opportunities for people with disabilities.
rural areas,110 but only 6 percent of federal transit NCD recommends that states and counties
increase coordination between jurisdictions
in rural areas and regional transit planning
“If you have a paratransit system that authorities to overcome these barriers.
operates in just one county within your state,
Barriers Related to Attitudes
that is going to narrow the opportunities for
and Stereotypes
somebody with a disability to go look for a
job. You don’t have any kind of connection The ADA represented a major shift in social
between the counties and paratransit policy by focusing on integrating people with
systems, because each county might have disabilities into the workforce and moving them
their own paratransit system, but they might away from dependence on disability benefits.
not be linked together. If I have to go to a However, 27 years after its passage, people with
job 30 minutes from my house I can’t do it disabilities still face many outdated attitudes and
because I can’t drive.” stereotypes. For example, some believe that
people with disabilities cannot live independently
—Focus Group Participant
or contribute meaningfully to the workforce or
their communities.112
52 National Council on Disability
Starting in childhood, family and teacher
expectations play an important role in the
academic achievement of all children, regardless
of abilities or disabilities.113 One of the best
ways that educators and families can help
children with disabilities succeed is to set
high standards.114 The success of students
with disabilities can be negatively impacted
if their teachers do not feel that they should
play a central role in their education. Research
shows that teachers who see themselves as
responsible for the success of all students
regardless of ability engaged in more prolonged
interactions with students with special
educational needs than teachers who regard
support staff (i.e., teacher aides) as having
primarily responsibility for students with access to assistive technology can impede
disabilities.115 Families of Hispanic students with postsecondary achievement and success as well
disabilities are less likely than those of peers to as economic self-sufficiency among students
have home-based education-related activities. with disabilities.
African American students with disabilities have Employer attitudes often limit job
families that are more likely to be involved at opportunities. Despite the fact that these
home than white students with disabilities, but myths have been debunked, some employers
they are less likely to believe that people
attend IEP meetings and with disabilities lack the
One of the best ways that educators
be involved at school.116 necessary knowledge
At the university level,
and families can help children with and skills to work, are
faculty sometimes do disabilities succeed is to set high less productive, or can
not have an adequate standards. only do light, repetitive,
understanding of the and simple jobs.
specific needs of students with disabilities. They may also believe that accommodations
Faculty may question the nature of reasonable are expensive or that workers’ compensation
accommodations and whether students insurance and health care costs will increase.119
with disabilities need accommodations at Federal agencies can be the model for hiring and
all and doubt their own ability to effectively integration as a way to exemplify the capabilities
teach students with disabilities.117 In addition, of people with disabilities. NCD recommends
some universities do not provide adequate that all federal agencies increase coordination
accommodations and assistive devices.118 Poor with their SPPCs to improve understanding of
attitudes, lack of understanding, and inadequate reasonable accommodations and their effect
National Disability Policy: A Progress Report 53
on productivity and retention of people with related habilitation and rehabilitation services to
disabilities in the workplace. people with disabilities.122 Although the Centers
Earning a living wage can serve as a for Medicare and Medicaid Services specifies
road out of poverty. Currently, an estimated that sheltered workshops should only be used
228,600 people with intellectual/developmental as a time-limited service, one study found
disabilities and other significant disabilities that only five percent of sheltered workshop
work for subminimum wage under special employees left to take a job in the community.123
certificates issued by the DOL Wage and Some suggest that sheltered workshops are a
Hour Division.120 critical component of
These certificates are employment systems
Currently, an estimated 228,600
allowed under Section because they provide
14(c) of the Fair Labor
people with intellectual/ people with significant
Standards Act, which developmental disabilities and disabilities who may
permits employers to other significant disabilities work for have no other options
pay wages less than the subminimum wage… with the option to work.
federal minimum wage However, sheltered work
to workers who have disabilities that affect has not been shown to be effective in moving
productive capacity. The DOL’s definition of people with disabilities to an integrated work
which disabilities may affect productive capacity environment.124
includes blindness, mental illness, intellectual NCD believes that no person with a
disability, cerebral palsy, alcoholism, and drug disability should be discriminated against in an
addiction. Paying people with disabilities employment setting by receiving less than the
subminimum wage minimum wage available
serves to perpetuate the to all other citizens.
Although [CMS] specifies that
belief that people with NCD also recognizes
disabilities cannot work
sheltered workshops should only be that eliminating all
in the same kinds of used as a time-limited service, one of the Section 14(c)
jobs as people without study found that only five percent of certificates would
disabilities. sheltered workshop employees left jeopardize the security
Most people currently of many people who are
to take a job in the community.
working under Section currently involved with
14(c) subminimum wage certificates are working the program. Therefore, as we first noted in our
in sheltered workshops (also called community 2012 report on the topic,125 NCD recommends
rehabilitation programs or work centers). These a transformation strategy to phase out the
are segregated facilities that exclusively or 14(c) model in favor of one of empowerment
primarily employ people with disabilities.121 and self-determination. (See Appendix C for a
Sheltered workshops typically receive public link to NCD’s Report on Subminimum Wage and
funding, including federal funding through Supported Employment, with more information
Medicaid and VR, to provide employment- about the transformation strategy.)126
54 National Council on Disability
In recent years, several government agencies their buses to pick up people with disabilities,
have sought to limit the use of subminimum paratransit staff do not provide friendly customer
wages. Under Section 511 of the Rehabilitation service and may fail to respond to complaints,
Act of 1973, a series of steps must be taken and paratransit drivers lack respect for users of
before an individual under the age of 24 can their services and transit agencies often use
be placed in a job paying less than minimum punitive cancellation policies for people with
wage. Section 511 also prohibits schools from disabilities.128 NCD recommends that DOT
contracting with subminimum wage providers. Federal Transit Administration work with
WIOA established the Advisory Committee on local communities to provide guidance that
Increasing Competitive Integrated Employment clarifies and bolsters ADA nondiscrimination
for Individuals with Disabilities. The advisory standards. This will address issues faced by
committee made recommendations to Congress people with disabilities and ensure accessibility
on how to strengthen competitive integrated of all public transportation options.
employment opportunities for individuals with Although the ADA prohibits discrimination
intellectual or developmental disabilities or by private entities, companies that provide
other individuals with smartphone
significant disabilities. transportation
Although the ADA prohibits
Finally, the Department applications have failed
discrimination by private entities,
of Justice entered into to provide accessible
settlement agreements companies that provide smartphone services for people with
with Rhode Island and transportation applications have disabilities. For example,
Oregon to address the failed to provide accessible services a recent lawsuit claims
rights of people with for people with disabilities. that the UberX service,
disabilities to receive which is basic door-
state-funded employment and daytime services to-door service, inhibits access to people with
in the broader community, rather than in mobility limitations.129 In Washington, DC, Uber
segregated sheltered workshops and facility- users with mobility limitations can use Taxi WAV,
based day programs.127 NCD recommends which hails a DC cab, but some reports find that
that all federal agency annual reports to wait times are longer and fares are higher with
Congress regarding Section 503 and 511 this service.130 NCD recommends that DOJ
of the Rehabilitation Act of 1973 include issue regulations for privately funded transit
information on enforcement activities and to provide accessible transportation options
the impact of employment on people with for people with disabilities. It is important to
disabilities. overcome the attitudinal and physical barriers that
Attitudes and stereotypes about people with people with disabilities face when it comes to
disabilities also create barriers for this population accessible transportation. Reliable transportation
when it comes to using fixed-route public transit is necessary for people with disabilities to be able
providers, paratransit, and private transportation to hold a job and reach the goal of economic self-
providers. For example, bus drivers may not stop sufficiency.
National Disability Policy: A Progress Report 55
Many of the same attitudinal barriers affect people with disabilities face when trying to
people with disabilities who are looking for secure housing include refusal of calls made by
accessible housing. Deaf and Hard of Hearing or for TTY users, refusal to allow inspection of
have reported experiencing adverse treatment rental units, and housing managers or landlords
in approximately half (49.5 percent) of their failing to provide information regarding available
attempts to secure a rental unit and wheelchair units or requirements for completing a rental
users were reported to have experienced application. Being an active and independent
adverse treatment in approximately one-third member of the community requires that people
(32.3 percent) of their attempts to secure rental with disabilities can secure accessible housing
housing.131 Some of the adverse experiences free of discrimination and stereotypes.
56 National Council on Disability
Chapter 3: Emerging and Promising Practices
for Achieving Economic Self-Sufficiency
N
CD recognizes that there have been a invest in accommodations in the workplace. It
number of efforts to address the barriers prepares students by building skills, confidence,
described in this report that prevent and a work history that better enables them
people with disabilities from achieving economic to find full-time employment after college. The
self-sufficiency. This chapter focuses on policies, program is committed to creating a rigorous,
programs, and practices that demonstrate real-world experience for their students, through
promise in lifting people with disabilities out of a 40-hour work week (with flexibility for students
poverty by addressing barriers that people with who cannot do a full-time internship), high work
disabilities experience. These ideas provide a standards, and pay equal to their peers, at about
basis for the development of future policies that $15 per hour. The students must apply to and
can further support the achievement of economic qualify for the internship, and if they are not
self-sufficiency for people with disabilities. quite ready, the program offers guidance on how
they can improve their application. The program
Education is also effective at influencing the perspectives
Students with disabilities often do not have the of employers, supervisors, and peers about
same access to internship and work experience working with someone who has a disability.
opportunities as other students during high Through the internship program, employers
school and college. NCD notes some promising learn that accommodations are often much more
initiatives and recommends that model programs doable and less costly than expected and their
be duplicated or tested as potential ways to preconceived ideas about what people with
increase the economic prospects for people disabilities are capable of accomplishing are
with disabilities. For example, the Initiative for challenged and transformed.132 In the coming
Empowerment and Economic Independence years, IEEI hopes to increase the number of
(IEEI) at Eskenazi Health in Indiana is a rigorous interns it employs and to continue working with
internship program for college students with employers to educate them about working with
physical and sensory disabilities. The program people with disabilities, establishing a center and
seeks to remove the barriers that normally website to serve as resources for connecting
prevent students with disabilities from pursuing individuals and companies, and expanding their
gainful employment, such as logistical issues program for implementation at other sites in
with transportation and employer reluctance to the United States. NCD recommends the
National Disability Policy: A Progress Report 57
receive academic and social support. Although
TPSID has made similar programs possible at
other universities, they should continue to be
developed and made available to more students
with intellectual disabilities.
UDL is a set of principles to guide curriculum
design to meet the needs of diverse students.
Curricula designed under the UDL framework
are more flexible and can accommodate learning
differences that exist among students by adjusting
to each student’s strengths and needs. Students
with disabilities can benefit from UDL-based
curriculum because it is more capable of meeting
their needs from day one in the classroom,
and fewer special supports may be required
for each child. For example, UDL classrooms
can present information in visual, auditory, or
interactive ways rather than only relying on
textbooks. UDL can be applied to assessments
(formative and summative) as well, allowing
students the opportunity to show what they have
learned through a variety of methods including
tests, presentations, group projects, and other
development of partnerships across evaluative activities. Perhaps most importantly,
vocational rehabilitation agencies, local UDL works because it keeps students with
education agencies, institutes of higher disabilities and those without disabilities in the
education, and employers to promote similar classroom together, which benefits all students
internship opportunities for students with socially and educationally. However, to date, UDL
disabilities. is more widely used within special education
Similar to TPSID programs, the InclusiveU classrooms than general education classrooms.133
program at Syracuse University supports One study of five high-performing schools
students with intellectual disabilities who may in Texas highlights the use of UDL practices
otherwise not have access to postsecondary to improve education for students in poverty,
education. InclusiveU is a flexible program including those with disabilities.134 In these
individualized to each student. Students with schools, the focus was on fully integrating
intellectual disabilities audit classes and receive students with disabilities into the regular
a certificate of completion from InclusiveU. education program and embracing the idea that
Participating students can also be matched up all students can be academically successful
with a Syracuse University student mentor to when the talents and experiences of teachers
58 National Council on Disability
are put to their best use. Regular communication system around the child in addition to the child-
between faculty and administrators across centered components of the behavior.136 Their
teaching areas made this program work as it four-pronged approach is central to the success
provided opportunities for teachers to learn of the program as it takes a comprehensive view
from one another. This created an environment to treatment and intervention to help children
where teaching strategies were adjusted to each with behavior problems that result from living in
student’s needs and teachers collaborated with poverty. Another example is a preschool social
colleagues to identify solutions to barriers and and emotional learning intervention that is part
participate in schoolwide intervention strategies of the Foundations of Learning demonstration.
for all students. These schools focused on a The intervention improved the ability of preschool
culture of student-centered learning where teachers to address children’s behavior problems
separate special education services (e.g., those and had positive outcomes on teacher practices
outside the general when they worked with
education classroom), Broader use of these types of UDL students with behavioral
although valued and problems. It also resulted
and inclusion practices can help
supported, were in lower levels of
students with disabilities succeed in
considered a referral of conflictual interactions
last resort. The results school and improve their chances among children and
from the Texas study for attending college or accessing a higher level of
showed that students other career opportunities after they engagement in classroom
with disabilities could activities.137 These local-
graduate.
meet or surpass high level demonstrations
standards in state assessments.135 Broader use can be valuable for informing policy changes that
of these types of UDL and inclusion practices can will positively affect the educational outcomes of
help students with disabilities succeed in school students with disabilities.
and improve their chances for attending college In addition to school-based approaches
or accessing other career opportunities after they to addressing the needs of students with
graduate. NCD recommends that ED issue disabilities, professional development
guidelines on the inclusion of UDL principles opportunities geared toward preparing teachers
to promote integration of students with to work with students with disabilities have
disabilities in the classroom. shown promise. Some of these approaches
The Center for Attachment and Family include supporting general education teachers in
Development in Decatur, Alabama, is another their efforts to effectively instruct students with
example of promising educational practices that disabilities in their general classrooms.138 In one
address the social and emotional learning needs example, teachers used problem-solving teams
of students with disabilities living in poverty. This that focused on teachers providing social support,
Center aims to improve the behavior of children learning new instructional approaches, obtaining
and encourage functional behavior that helps practical help with problems, and improving
children succeed by addressing the community practice through reflection.
National Disability Policy: A Progress Report 59
Financial Assistance and Incentives account counting against the $2,000 resource
limit of SSI. Funds in the account can be used
Another challenge for people with disabilities
tax free to purchase qualified disability expenses
who receive public assistance is to stay within
the asset limits (capped at just $2,000 total under such as housing, food, transportation, medical
SSI). The recent ABLE Act of 2013 addresses this care, education, employment support, legal
barrier and promotes economic independence fees, health and wellness services, assistive
and self-sufficiency among people with technology, financial management, and other
disabilities. The ABLE Act amends Section 529 expenses that increase the beneficiary’s health,
of the Internal Revenue Code, which establishes independence, and quality of life. However, NCD
tax-free savings accounts for qualified individuals recommends that Congress approve the ABLE
to save money to pay for qualified disability to Work Act to allow people with disabilities
expenses. Under the who are employed
ABLE Act, each state to contribute funds
Funds in the [ABLE] account can be
develops and operates above the $14,000
used tax free to purchase qualified per year cap to an
its own ABLE program.
Individuals are limited
disability expenses such as housing, ABLE account (the
to one account and the food, transportation, medical care, maximum allowable
individual must have a education, employment support, amount is $26,060
qualified disability that in 2017). People with
legal fees, health and wellness
occurred prior to the disabilities who establish
services, assistive technology,
age of 26, meaning ABLE accounts but
financial management, and other do not receive SSI are
either they must be
eligible for SSI or have a expenses… allowed to save up to the
permanent disability with amount permitted in each
marked and severe functional limitations. NCD state’s 529 education savings plan to pay
recommends that Congress approve the ABLE for qualified disability expenses. The limits
Age Adjustment Act to increase the qualifying for state 529 education savings plans range
age limit for an ABLE account to occurring from $260,000 to $550,000 depending on
prior to their 46th birthday. ABLE accounts the state. NCD recommends that Congress
can function as both savings accounts and approve the ABLE Financial Planning Act to
investment accounts for people with disabilities allow 529 educational savings accounts to
with differing allocations based on risk tolerance. be transitioned to qualifying people with
To incentivize the use of these accounts, some disabilities without incurring penalties
states provide a tax deduction for state taxpayer or taxes.
contributions to an ABLE account. Currently, 18 states have ABLE programs
Consistent with federal gift tax law, $14,000 and 28 states are developing their programs.
per year from all sources may be deposited into NCD recommends that all states implement
ABLE accounts. Additionally, each individual may ABLE programs and actively inform people
save up to $100,000 without the amount in the with disabilities and their caregivers of this
60 National Council on Disability
important new legislation. In addition, the IRS services provided under HCBS waivers are
should issue final regulations to Section 529A considered a time-limited service while services
of the Internal Revenue Code on how states that support work in the community are long
can establish a qualified ABLE program. The term. DOJ reached settlement agreements in
ABLE Act allows people with disabilities to build 2014 and 2015 with Rhode Island and Oregon
individual savings and invest their money in ways to promote integrated employment.141 Finally,
that will enhance their self-sufficiency. WIOA established the Advisory Committee on
Increasing Competitive Integrated Employment
Employment for Individuals with Disabilities to advise the
NCD is a strong proponent of employment U.S. Secretary of Labor on ways to increase
that pays a competitive wage to people with competitive integrated employment and improve
disabilities. Work is the first and preferred the use and oversight of 14(c) certificates.142
outcome in the provision of publicly funded WIOA promotes a focus on transition-age
services for all working-age youth, moving people
people with disabilities, [I]n many states to date, with disabilities into
regardless of their level of Employment First initiatives have postsecondary training,
disability. As of January education, and employment
resulted in proclamations rather
2017, 46 states have opportunities as early as
than binding mandates.
undertaken some activity possible.
to support employment for their citizens with States have followed this trend by
disabilities, and 32 states have passed legislation, implementing an Employment First model,
issued Executive Orders, or established policy which requires federal, state, and local agencies
directives to promote competitive integrated to modify their policies and funding structures
employment.139 to promote integrated employment. At the
Importantly, work for people with disabilities same time, VR service providers must retool
should be in jobs that pay a competitive and retrain their staff to provide supports geared
wage and offer adequate benefits and toward integrated rather than segregated
accommodations. This includes moving employment. Recognizing this challenge,
people from sheltered workshops and other DOL’s Office of Disability Employment Policy
segregated settings to integrated employment provides technical assistance to cross-agency
and completely removing subminimum wage teams of state government leaders through
jobs. These ideas have been supported through its Employment First State Leadership Mentor
federal policies and resulted in improved Program. However, in many states to date,
practices in the disability field. In 2001, RSA Employment First initiatives have resulted in
prohibited placement in sheltered workshops or proclamations rather than binding mandates.143
other segregated settings from counting as an NCD recommends that states mandate
employment outcome for purposes of the VR the development of Employment First
program.140 In 2011, the Centers for Medicare and initiatives to reflect stronger legislative and
Medicaid Services specified that prevocational policy support for competitive integrated
National Disability Policy: A Progress Report 61
employment opportunities, which will Universal design for housing makes homes
increase opportunities for economic easier for people to use throughout their lifetime,
independence for youth and adults with supporting independent living and aging in place
disabilities. for everyone. Homes are built with adaptable or
adjustable features and have products that are
Housing universally usable and commonly available.145 The
People with and without disabilities want to Fairfax County, Virginia, Board of Supervisors is
be part of a safe, integrated, and inclusive an example of a community-based group that has
community, where they can live independently made a commitment to supporting housing that
with reasonable access to educational will benefit all residents. The Board of Supervisors
institutions, jobs, and services. Communities created the Fairfax County Coalition on Housing
need to promote investments in infrastructure and Universal Design, which is a public-private
and developments that include diverse yet partnership between contractors, remodelers,
integrated housing and transportation that will interior designers, occupational and physical
allow access to jobs, schools, and stores to therapists, area agencies on aging, advocates
promote economic opportunity for all residents. for older adults and people with disabilities, and
In some communities, there is a move toward Fairfax County government representatives.146
using collaborative The coalition promotes the
partnerships that include incorporation of universal
[N]ew homes that are built with
federal, state, local, private, design features into new
and nonprofit organizations universal design in mind can be single family homes and
to address the needs of built at a cost similar to that of encourages the Multiple
people with disabilities along other new homes. Listing Services Database
with the needs of the entire to include information about
community.144 There are a number of promising universal design features in homes for sale.147
programs and practices that address the need The National Association of the Remodeling
for affordable housing for low-income individuals Industry and the National Association of Home
and families across the United States, including Builders also offer certifications to support the
people with disabilities. integration of universal design concepts into
Universal design for housing has been used residential construction.148 Despite this example,
in home construction since the 1980s. It seeks universal design for housing has not been widely
to create accessible and barrier-free housing and adopted in the design community (e.g., among
exceeds the minimum legislated specifications designers and builders) because it is perceived
for accessible and barrier-free housing. as a design solely for people with disabilities or
Accessibility and usability is a goal of design as cost-prohibitive. However, new homes that are
from the start. One of the main concepts behind built with universal design in mind can be built
universal design is that it includes features that at a cost similar to that of other new homes.149
help people with disabilities live independently In addition, universal design allows people to
but are also useful to people without disabilities. age in place and potentially reduces the need
62 National Council on Disability
for community services and nursing home care. “rooted” in the community.152 Anchor institutions
NCD recommends that HUD require that all collaborate on issues such as affordable housing,
federally assisted housing units are designed job training and job creation, investment in
following universal design principles and that transportation, and supporting small businesses
local communities support greater investment and businesses owned by people from diverse
in housing developments incorporating racial backgrounds. These efforts are geared
universal design. toward all residents but can support people
Affordable housing should be available to with disabilities to live independently and fully
all people regardless of disability or income. In participate in their community.
Montgomery County, Maryland, the Moderately Similarly, the Sustainable Communities
Priced Housing (MPH) Law passed in 1974 Initiative is an interagency partnership between
addressed the need for affordable housing HUD, DOT, and the Environmental Protection
among Montgomery County, Maryland, Agency that is implemented by the HUD Office of
residents. The law requires that 12.5 to Economic Resilience. The initiative encompasses
15 percent of the total number of units in any two competitive grant programs: (1) the
new development with 20 or more units include Sustainable Communities Regional Planning
”moderately priced dwelling units,” and that Grant Program, and (2) the Community Challenge
40 percent of the moderately priced units be Grant Program.153 The goals of the initiative are
made available to housing agencies for families to address environmental, social, and economic
with low and moderate income.150 Between 1974 challenges faced by regions and communities in
and 2004, 11,000 affordable housing units were a time of growing need and tightening budgets
built in Montgomery County because of the at all levels. In recent years, communities around
MPH law.151 Policies like this should be expanded the country have taken a new collaborative
to include requirements for affordable, accessible approach to community planning, recognizing
housing in new communities so that there is that they need to have a broader understanding
an adequate supply of affordable, accessible of the needs of in the community when making
housing available to people with disabilities. NCD future infrastructure investments.
recommends that local communities pass In 2010, the Federal Emergency Management
ordinances like the MPH law that, along with Agency created the Office of Disability
affordability guidelines, include requirements Integration and Coordination (ODIC) in an effort
for accessible housing in new developments. to improve access to emergency preparedness
The Democracy Collaborative supports information and ensure that the needs of
collaborative efforts to address economic and people with disabilities are met in times of
health disparities in economically struggling emergencies. People with disabilities experience
metropolitan areas through the Anchor Institution a variety of challenges during an emergency,
Initiative. Anchor institutions are defined as including accessible transportation during an
universities, hospitals, public utilities, municipal evacuation, maintaining their independence in
governments, foundations, and faith-based a shelter, finding accessible housing if theirs
institutions—all organizations or entities that are has been destroyed, and accessing services
National Disability Policy: A Progress Report 63
to enable them to return to work.154 Although agreement with SSA to provide employment and
ODIC has improved the outcomes of people other services to people with disabilities. People
with disabilities before, during, and after with disabilities in the TTW program are given a
an emergency, people with disabilities and “ticket” that allows them to contact any EN in
emergency managers need to build on existing their area or nationally to find the services and
emergency management efforts to foster supports that meet their needs. For a ticket to
inclusive disaster planning and fully accessible be activated, the person with a disability must
disaster services. It is imperative that people engage an EN or VR agency for services. SSA
with disabilities are included in the development then provides payments to the EN based on
and implementation of these initiatives to ensure specific employment milestones or outcomes.
that their accessible and affordable housing and Despite providing people with disabilities
transportation needs are fully considered and with additional choices for employment support
addressed. providers, TTW and related programs have had
a limited effect on the employment outcomes
Underutilized Policies, Programs, of SSDI beneficiaries.155 As of 2013, of the
and Practices 13.5 million tickets issued by SSA, 316,575 (or
In addition to the promising policies and approximately 2.3 percent) of the tickets issued
programs described previously, there are were activated. Of all tickets in use, 87 percent
existing programs that could be effective if were assigned to state VR agencies rather than
they were implemented other ENs. Through the
fully. Programs like the TTW program, 23,785
As of 2013, of the 13.5 million
SSA’s Ticket to Work SSDI beneficiaries
tickets issued by SSA, 316,575
(TTW) program and the were placed in a job or
Medicaid Buy-In programs (or approximately 2.3 percent) of supported on a job by an
were created to promote the tickets issued were activated. EN, and 7,835 were able
employment for people to earn enough income
with disabilities while recognizing the importance to leave SSDI.156 Two of the reasons for low
of maintaining health benefits. However, both participation in TTW to date are confusion about
programs are currently underutilized by people how TTW works and concerns about losing SSDI
with disabilities. benefits. In addition, ENs only receive payments
Established in 1999, the SSA’s TTW program if the employment outcome is at the SGA level,
is a voluntary program designed to promote which may result in ENs only selecting to work
employment among SSI and SSDI beneficiaries with clients who need the least amount of
and reduce their dependence on benefits. assistance.157
TTW expands people with disabilities’ choice The legislation that created the TTW program
of employment support providers beyond also created the Medicaid Buy-In program, which
VR and other public providers. Nonprofit, for- provides additional Medicaid eligibility options for
profit, and government agencies can become people with disabilities whose income is higher
an employment network (EN) by entering an than the allowable substantial gainful activity
64 National Council on Disability
levels. Currently, 45 states offer a Medicaid Buy- participants. Also, from 2010 to 2011, the average
in program for people with disabilities who do earnings among Medicaid Buy-In enrollees were
not qualify for Medicaid through SSI eligibility. $9,135 per year.158
This program encourages These examples
people with disabilities 45 states offer a Medicaid Buy-in show that continued
to seek or return to support from the Federal
program for people with disabilities
employment without Government to remove
fear of losing health
who do not qualify for Medicaid barriers to employment
care benefits such as through SSI eligibility… [F]rom 2010 for people with
personal care attendants. to 2011, the average earnings among disabilities is needed.
From 2010 to 2011, the Medicaid Buy-In enrollees were People with disabilities
Medicaid Buy-In program can achieve economic
$9,135 per year.
grew 10 percent to a self-sufficiency with the
total of 192,946 enrollees nationally; however, necessary accommodations across education,
the size of Medicaid Buy-In programs varies employment, financial assistance and incentives,
significantly across states. The number of health care, long-term services and supports,
enrollees in each state ranges from 50 to 20,000 transportation, and housing.
National Disability Policy: A Progress Report 65
66 National Council on Disability
Chapter 4: Recommendations to Promote Economic
Self-Sufficiency for People with Disabilities
A
ll Americans have the right to lead lives people with disabilities, but many programs hinder
with equal opportunity, full community the ability of people with disabilities to achieve this
participation, independent living, and goal. NCD proposes the following recommendations
economic self-sufficiency. A variety of federal to help ensure that people with disabilities are able
policies and programs provide economic support for to achieve economic self-sufficiency:
Collaboration and Data Collection
1. Congress should appropriate funds for the creation of a coordinated review of all federal
disability programs to enhance the efficiency and ability of existing structures to break
down silos between federal agencies in order to improve the economic picture for people
with disabilities.
a. OMB should direct all cabinet-level federal agencies to submit their Agency Reform
Plans pertaining to their disability programs to NCD for review.
b. All federal agencies should be directed to include measures of cross-agency collaboration
within their GPRA performance measurement standards. OMB should report on
measures of cross-agency collaboration in its annual reports on agency performance.
c. All federal agencies, including but not limited to the U.S. Departments of Education,
Labor, Health and Human Services, and Housing and Urban Development, should
improve data collection related to people with disabilities in order to enhance
knowledge on how people with disabilities are assisted by existing programs. Data
collection should include information about people with disabilities who use federally
funded programs to determine where programs can be modified and improved to
promote employment and economic self-sufficiency.
2. Congress should continue investments in the U.S. Census Bureau’s development of the
Supplemental Poverty Measure and annual reports to ensure an adequate assessment
of how the cost of necessary expenses that people with disabilities face (like medical or
long-term services and support expenses) affect their opportunities and ability to achieve
economic self-sufficiency.
National Disability Policy: A Progress Report 67
Education
1. Congress should reauthorize the IDEA in a manner that facilitates the meaningful inclusion
of all students with disabilities. Reauthorization should reinforce the assertions under
IDEA to provide a free and appropriate education to students with disabilities, including
language, to ensure that students with disabilities from diverse racial backgrounds and
students who exhibit challenging behaviors are not disproportionately placed outside of
the least restrictive environment.
2. ED should issue guidelines to local education agencies and state education agencies on
the inclusion of UDL principles and recommend giving teachers flexibility to implement
UDL with state and district curricula and lesson plans to promote broader integration
of students with disabilities in the classroom. (See Chapter 3, for more information
about UDL.)
3. ED and state education agencies should issue guidelines to local school districts to give
all students with disabilities an opportunity to obtain a standard high school diploma. The
guidelines should reinforce that the use of alternative high school diplomas or certificates
of completion should be considered a last resort for students with disabilities.
4. ED Institute on Education Sciences should fund national research that explores the
educational and employment outcomes of alternative high school diplomas for students
with IEPs and Section 504 plans, as well as the demographic characteristics of students
receiving these alternative diplomas.
5. ED should continue funding for model programs like the TPSID program, which can help
reduce poverty among people with intellectual disabilities.
6. Congress should amend the Higher Education Act to modify existing higher education
financial assistance program guidelines so that they are adequately accessible and
students with disabilities are not penalized when a qualifying disability limits their ability
to maintain a full course load or work study requirements as determined by campus
disability services programs. This should include but not be limited to Pell grants, federal
work-study programs, and student loan repayment.
7. The IRS should provide guidance that waives the tax debt on student loan forgiveness
for students with disabilities so that they do not incur a tax debt from a forgiven loan.
68 National Council on Disability
Employment
1. DOL, the U.S. Access Board, DOJ, and the EEOC should dictate that all policies and
regulations related to Sections 503 and 511 of the Rehabilitation Act of 1973 be prioritized
for nationwide enforcement. This includes an annual report to Congress on activities and
the impact on employment for people with disabilities.
2. Congress should amend the Small Business Act to expand the Small Business
Administration’s 8(a) Business Development Program to include people with disabilities
as a presumed socially disadvantaged group to be in line with the findings in the ADA,
which states that people with disabilities are disadvantaged socially, economically,
vocationally, and educationally.
3. DOL and ED should issue guidelines to develop partnerships across state
vocational rehabilitation agencies, local education agencies, institutes of higher
education, and employers that promote paid internships for college graduates and
students with disabilities in postsecondary education as a gateway to full-time
employment.
4. All federal agencies should be the model in hiring, retention, and integration of people
with disabilities in the workplace. In accordance with OPM, all federal agencies
should increase coordination between their SPPCs. This will bridge the gap between
managers and employees with disabilities and enhance understanding of reasonable
accommodations and their effect on productivity and retention of people with disabilities.
To attain this goal, mandatory training for human resources staff, managers, and
supervisors should be required.
5. States should mandate Employment First initiatives to reflect stronger legislative and
policy support of competitive integrated employment to increase opportunities for
economic independence for youth and adults with disabilities.
National Disability Policy: A Progress Report 69
Financial Assistance and Incentives
1. Congress should expand opportunities for people with disabilities who need to pay for
personal care services to benefit from tax deductions when medical expenses are less
than 10 percent of adjusted gross income or deductions cannot be itemized.
2. Congress should approve three amendments to the ABLE Act:
a. The ABLE Financial Planning Act, which would allow 529 educational savings accounts
to be transitioned to qualifying people with disabilities without incurring penalties or
taxes.
b. The ABLE Age Adjustment Act, which would increase the qualifying age threshold for
eligibility for an ABLE account from 26 to 46.
c. The ABLE to Work Act, which would allow employed people with disabilities to
contribute funds to an ABLE account in an amount above the $14,000 per year cap.
Additional contributions would not exceed the equivalent of the determined federal
poverty level for that year (the maximum allowable amount was $26,060 in 2017).
3. All states should implement ABLE programs and actively inform people with disabilities
and their caregivers of this legislation in order to provide people with disabilities with the
opportunity to build individual savings and invest their money in ways that will enhance
their economic self-sufficiency.
4. The IRS should issue final regulations to Section 529A of the Internal Revenue Code on
how states or state agencies can establish a qualified ABLE program.
5. Congress should pass legislation that decouples eligibility for health care benefits from
eligibility for cash benefits like SSI and SSDI to prevent people with disabilities from being
forced to choose between getting a job or having access to health care.
6. Congress should amend the EITC to lower the age of eligibility from 25 to 18 years old
and increase the benefit for childless adults to provide greater incentive to work and
advance self-sufficiency.
70 National Council on Disability
Health Care
1. Congress should maintain protections that prohibit insurance companies from denying
coverage because of preexisting conditions to ensure affordable health insurance
coverage for people with disabilities.
2. Congress should ensure that Medicaid reforms, including but not limited to block grants
or per capita caps, will be robust enough to prevent dramatic cutbacks in services and
prevent lower reimbursement rates for providers and limits on Medicaid eligibility.
Medicaid reforms should also safeguard access to home and community-based services
waivers, which are essential to promoting independent living, employment, and economic
self-sufficiency for people with disabilities. Any increases to state flexibility through block
grants or per capita caps should include meaningful accountability to the Centers for
Medicare and Medicaid Services to ensure a minimum level of coverage and services and
consistency are provided across state Medicaid programs.
3. Congress should maintain Medicaid expansion for individuals whose conditions did not
meet the severity requirements for disability-based Medicaid prior to passage of the ACA
and those falling within the two-year waiting period before qualifying for disability-based
Medicare.
4. Congress should remove the 18 to 64 age limits for buy-in options in Medicaid to promote
work among people with disabilities after age 65 without requiring them to spend down
to be eligible for Medicaid or exclude their buy-in assets from being counted for eligibility
purposes.
Housing
1. HUD should require that all federally assisted housing units follow universal design
principles and ensure that accessible housing units are in line with the percentage of
people with disabilities requesting federal housing assistance. This goal can be achieved
by increasing the percentage of required new housing units that are accessible for people
with mobility disabilities and people with sensory disabilities from the current rate of
five percent and two percent, respectively. (See Chapter 3, for more information about
universal design.)
(continued)
National Disability Policy: A Progress Report 71
Housing, continued
2. Local communities should enact ordinances requiring developers to include a percentage
of accessible homes of varying price in any new development, similar to Montgomery
County, Maryland’s MPH law, which requires 12.5 to 15 percent of the total number of
units in a new development to be moderately priced. HUD should provide guidance to
local communities to promote greater investment in housing developments incorporating
universal design and to ensure greater availability of accessible housing units and promote
opportunities for aging in place.
Transportation
1. DOJ should issue regulations that require privately funded transit agencies to provide
accessible transportation options for people with disabilities in all communities. This includes
but is not limited to taxicabs and transportation arranged through smartphone applications.
2. Local municipalities should require taxicab authorities to provide mandatory training
for taxicab operators about the proper ramp deployment and securement policies and
procedures so that people with mobility disabilities can safely and effectively use privately
funded transit options.
3. Local communities should provide guidance that clarifies and bolsters the ADA
nondiscrimination standards in order to address issues faced by people with disabilities
who require assistance to use transportation services because of their disability. This
includes but is not limited to refusal to accommodate service animals, claims of broken
lifts and ramps, and late pickup or no shows.
4. DOT’s Federal Transit Administration should work with local communities so that the DOT
ADA regulations are followed to guarantee that all public transit stations and bus stops
are accessible. This includes but is not limited to ensuring the detectability of bus stops
through tactile signage or unique bus stop pole designs for people who are blind or have
visual impairments and installation and maintenance of shelters and level concrete pads
for people with mobility disabilities.
5. Congress should place greater emphasis on funding transportation programs in rural areas
to address minimal or nonexistent public and privately funded accessible transportation
options for people with disabilities.
6. Neighboring paratransit agencies should coordinate with each other to eliminate
the arbitrary line between paratransit jurisdictions, which would provide people with
disabilities with increased job opportunities in major business hubs.
72 National Council on Disability
Conclusion
L
ike all Americans, people with disabilities review of all federal disability programs would
want equal opportunity to participate fully improve the efficiency of existing structures
in their communities, live independently, to better meet the needs of people with
and achieve economic self-sufficiency. However, disabilities. Such a review would also begin to
poverty is a significant issue for people break down the silos that often exist between
with disabilities. The 2017 Progress Report federal agencies and address the barriers often
demonstrates how established public programs caused by the interconnected nature of existing
seek to address the connection between poverty programs. This is a critical step toward improving
and disabilities across education, employment, the economic outlook for people with disabilities
financial assistance and incentives, health care, and including them in all aspects of society.
long-term services and supports, transportation, NCD encourages readers of the 2017 Progress
and housing. However, existing programs and Report to consider ways that public policies
policies often act as a barrier to needed public and programs can promote the employment
services in ways that perpetuate a cycle of of people with disabilities and be reoriented
poverty among people with disabilities. These to remove the barriers that prevent people
barriers include physical access barriers, lack with disabilities from achieving economic
of available programs, complex relationships self-sufficiency. It is essential that efforts to
between programs and eligibility requirements, address the perpetual cycle of poverty that
and inaccurate perceptions of the capabilities of people with disabilities experience focus on all
people with disabilities. The barriers people with areas of life. This includes ensuring that people
disabilities experience are often due to limited with disabilities are able to access education,
integration across existing programs, which may employment opportunities, and transportation;
work at cross purposes. afford their daily living expenses; get needed
It will take a commitment by policymakers medical care; and live in affordable, accessible
to examine existing policies and practices to housing. Reorienting existing support systems
determine which ones work to create a better toward the goal of helping people with disabilities
path to economic self-sufficiency for people with to achieve gainful employment and economic
disabilities and which ones do not. A coordinated self-sufficiency will benefit all of society.
National Disability Policy: A Progress Report 73
74 National Council on Disability
Appendix A: Focus Group Summary
Focus groups were held with 12 people with disabilities on March 6 and 7, 2017. The purpose of the
focus groups was to discuss successes and barriers to achieving financial self-sufficiency for people
with disabilities, successes and challenges faced when accessing policies and programs designed to
help people with disabilities achieve economic self-sufficiency, and suggestions for what incentives and
supports would make it easier for people with disabilities to achieve economic self-sufficiency. Quotes
and anecdotes in the 2017 Progress Report were obtained during these focus groups.
Focus Group Highlights
Recruitment and Participants
Two focus groups were held by phone with six participants in each group. Participants were recruited
through contacts at NCD and the National Disability Institute. Participants included four men and eight
women, including two parents of adult children with disabilities. Participants were from Delaware,
Maryland, Massachusetts, Minnesota, Nevada, and Washington, DC. The group included people with
physical and intellectual disabilities, as well as individuals who were blind, Deaf, and Hard of Hearing.
Participants were asked open-ended questions and invited to share their experiences related to
education, looking for a job, working, health care and health insurance, housing, and transportation,
including their experiences facing stereotypes or misunderstandings about their disability in these
arenas.
Relevant Highlights
Education. Participants reflected on their educational experiences from high school and
postsecondary or vocational training. One parent participant noted that their children with disabilities
were at a disadvantage in finding employment after high school because they had received alternative
high school diplomas. The parents noted that, because employers did not believe that an alternative
diploma was the same as a standard high school diploma, the children had a more difficult time
finding employment. Several participants described the benefits of new technology, including greater
availability of large print and audio books, which was making education easier than when they were
younger.
Income and Health Care. Participants described having trouble earning enough income to cover
all of their day-to-day living costs and the costs associated with their disabilities. Participants rely on
SSI and/or SSDI or have relied on it at some point in time. Some participants noted that they kept their
income low enough to maintain their SSDI/SSI benefits. Participants also noted that SSI can act as a
National Disability Policy: A Progress Report 75
poverty reinforcer because of the connection between SSI and SSDI and access to health care services
through Medicare and Medicaid. A number of participants noted the importance of using benefits
counselors who can explain and guide participants through eligibility, enrollment, and income and asset
requirements. Several participants noted the burden of SSI and SSDI overpayments and the important
support provided by benefits counselors to navigate the overpayment process.
Affordable Transportation and Housing. There was extensive discussion about access to
affordable transportation services and affordable, accessible housing. All participants noted difficulties
accessing reliable transportation services in order to maintain employment. Some of the difficulties
included the lack of coordination among transit services between counties, cost of transportation
services on a limited income, limited availability of bus routes, and the time costs of using paratransit
or fixed-route services (e.g., scheduling a ride, travel time, problems with on-time arrivals). In addition,
participants who had previously lived in rural communities noted that there were several challenges
unique to rural areas, including limited or no fixed-route bus service, no paratransit service, and
difficulty finding accessible transportation options. Several participants noted that they often relied on
family members or friends for transportation support because they could not afford or rely on other
services. The ability to find affordable, accessible housing near public transit was also extensively
discussed. Participants explained that accessible housing options were difficult to find. Accessible
housing options that were close to fixed-route transit options often cost significantly more than
nonaccessible housing options. As a result, participants discussed settling for affordable housing that
was not accessible and developing accommodations as needed (e.g., using benches to transfer from
wheelchair to shower).
Lessons from Focus Group Discussions
The focus groups produced several insights for NCD to consider regarding policies and practices
to support the economic self-sufficiency of people with disabilities and the availability of accurate
information and resources to help coordinate the array of services and supports they received. The
focus groups highlighted the fact that people with disabilities often relied on word of mouth, nonprofits,
and community connections to find the information they needed. The focus groups also highlighted the
connection between policies that were meant to support people with disabilities but often trap them in
poverty rather than help them escape it. In particular, people with disabilities want to be employed and
earn higher incomes, but because they often rely on health care and long-term services and supports
from Medicare and Medicaid, they maintain a lower income, which keeps them in poverty.
76 National Council on Disability
Appendix B: Policies, Poverty, and People
with Disabilities
This section provides an overview of how select legislation applies to economic self-sufficiency for
people with disabilities.
Americans with Disabilities Act (ADA)
The ADA, enacted in 1990 and amended in 2008, prohibits discrimination on the basis of disability in
employment, state and local government programs, services and activities, public accommodations,
and commercial facilities. The goal of the ADA is to ensure full participation in society for people with
disabilities by facilitating equal opportunity, independent living, and economic self-sufficiency.
Title I: Employment
Title I of the ADA prohibits discrimination against people with disabilities in employment both
before and after they are hired. Access to employment is one of the most important issues affecting
people with disabilities. Although the ADA has led to increases in accessibility and accommodations
in employment and public awareness about the capabilities of people with disabilities, there has
been little change in available employment opportunities for people with disabilities. Reasonable
accommodations are required for job applicants and employees with disabilities among employers
with more than 15 employees. However, attitudes and stereotypes about the cost of reasonable
accommodations and the abilities of people with disabilities persist.
Title II: State and Local Governments
Title II of the ADA requires that state and local governments give people with disabilities an equal
opportunity to benefit from all state programs, services, and activities (e.g., public education,
employment, transportation, health care, and social services) in compliance with regulations
determined by DOJ. Title II also prohibits discrimination against people with disabilities for public
transportation services. Under Title II, state and local governments must provide accessible buses,
subways, or commuter rails and also provide paratransit services in all areas where they operate fixed-
route bus or rail systems.
Olmstead v. L.C. (1999) was the landmark case which determined that “unjustified isolation” of
a person with a disability is a form of discrimination under Title II of the ADA. Under the decision, if
a state treatment professional determines that community placement is appropriate, then a person
National Disability Policy: A Progress Report 77
with a disability should be placed in the community, if the person with a disability chooses. This case
had a significant impact on the opportunities for people with disabilities to live and fully participate in
their communities.
Title III: Public Accommodations and Commercial Facilities
Title III of the ADA requires places of public accommodation and commercial facilities to meet
accessibility standards. All new construction as well as existing structures must conform to the
ADA Accessibility Guidelines. Existing structures must remove architectural barriers if doing so can
be accomplished easily and without significant expense. Places of public accommodation include
restaurants, hotels, shopping centers, doctor’s offices, and day care centers.
Individuals with Disabilities Education Act (IDEA)
The IDEA, enacted in 1975 (at the time called the Education for All Handicapped Children Act, or
EHA) and reauthorized in 1990 and 2004, ensures that free public education resources are allocated
to students with disabilities to meet their unique needs. IDEA ensures that students with disabilities
have the same opportunities as other students. It mandates that students with disabilities who
attend public schools receive a free appropriate public education that is tailored to their individual
needs. The Office of Special Education Programs was created to help states with the implementation
of IDEA.
Under IDEA, students in special education programs are expected to learn in the least restrictive
environment, which means they spend as much time in an integrated classroom with their peers
who do not receive special education services. Separate classes and schools are recommended only
in cases where the disability is so severe that aids and services in the general education classroom
are not adequate. How much time students with disabilities spend in general education classes will
vary based on what is most appropriate for each student. School IEP teams work to ensure the most
appropriate learning environments for each student.
Workforce Innovation and Opportunity Act (WIOA)
WIOA, signed into law in 2014, is designed to “help job seekers access employment, education,
training, and support services to succeed in the labor market and to match employers with the
skilled workers they need to compete in the global economy.” The Act reauthorizes and amends
the Workforce Investment Act (1998) and amends the Adult Education and Family Literacy Act, the
Wagner-Peyser Act, and the Rehabilitation Act of 1973.
WIOA programs operate through a network of local centers in each state called American Job
Centers (AJC), which provide youth job training, education, and employment services at a single
location. AJCs provide skills assessments, information on employment, information on training
opportunities, job search and placement assistance, up-to-date information on job vacancies, and
transition services to job seekers regardless of their disability status.
78 National Council on Disability
WIOA includes a number of improvements for job seekers with disabilities including:
1. A much larger role for public vocational rehabilitation as people with disabilities make the transition
from school to adult life;
2. Limits on the use of subminimum wage;
3. Required agreements between state VR systems and state Medicaid systems and state
intellectual and developmental disability (IDD) agencies;
4. A definition of “customized employment” in federal statute and an updated definition of
“supported employment” that includes customized employment;
5. A definition for “competitive integrated employment” as an optimal outcome;
6. Enhanced roles and requirements for the general workforce system and One-Stop Career Centers
in meeting the needs of people with disabilities; and
7. Changes in performance measures, with potentially major implications for VR.
Supplemental Security Income (SSI)
SSI is a federal supplemental income program funded by general tax revenues (not Social Security
taxes). Like SSDI, SSI provides monthly cash payments to people with disabilities where disability is
defined as the inability to engage in SGA (specifically, the inability to earn $1,170 a month in 2017 or
$1,950 for blind individuals) because of “one or more severe physical or mental impairments that are
expected to last at least a year or result in death.” Eligibility is based primarily on medical evidence.
The disability determination process can often be lengthy. During this process, applicants must provide
medical information to prove to disability evaluators or administrative law judges that they are unable to
work above SGA. SSA periodically reassesses eligibility as part of its CDRs.
SSI is a means-tested program. Thus, in addition to meeting the definition of disability, SSI recipients
must have countable income below SSI income levels and have less than $2,000 in countable assets
($3,000 per couple). The maximum benefit in 2017 is $735 ($1,103 for a couple) and this amount
is reduced based on other income and financial resources. For any earnings over $65 per month,
SSI benefits are reduced by one dollar for two dollars of additional earnings. In most states, SSI
beneficiaries also can qualify for Medicaid to pay for hospital stays, doctor bills, prescription drugs, and
other health costs. Many states also provide a supplemental payment to certain SSI beneficiaries and
some beneficiaries may also be eligible for food assistance in every state except California. In some
states, an application for SSI also serves as an application for food assistance.
SSI includes a number of work incentives designed to help beneficiaries go to work by minimizing
the risk of losing their SSI or Medicaid benefits. Under some of these incentives, SSA will exclude
some income or resources when calculating the benefit amount (such as the earned income exclusion,
the student earned income exclusion, impairment-related work expenses, and the Plan for Achieving
Self Support). Other incentives provide continued Medicaid coverage even when the beneficiary is not
receiving cash benefits (such as the Medicaid Buy-In and section 1619(b) of the Social Security Act).
National Disability Policy: A Progress Report 79
Social Security Disability Insurance (SSDI)
SSDI is funded by payroll tax contributions from workers and employers. In order to qualify for benefits,
applicants must reach insured status for Social Security by working enough during the years before
filing to have contributed a specific amount to the Social Security system through FICA taxes. The level
of benefits is based on earnings prior to the onset of the disability; SSDI does not consider assets
or other household income. SSDI benefits are subject to a five-month waiting period, which means
that SSDI applicants must wait five months after the onset of their disability to receive cash benefits.
Most SSDI beneficiaries are eligible for Medicare after a two-year waiting period. Like SSI, disability
is defined as the inability to engage in “substantial gainful activity” because of “one or more severe
physical or mental impairments that are expected to last at least a year or result in death.”
Ticket to Work and Work Incentives Improvement Act
The Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106–170) was designed to
expand options for employment preparation and placement services to people with disabilities so that
these individuals can reduce their dependence on cash benefit programs. The Act was also designed
to enable beneficiaries to maintain access to health care even if they no longer qualify for SSI or SSDI
because their incomes exceed SGA. The ultimate goal of the program is to reduce, and whenever
possible eliminate, beneficiaries’ dependence on Social Security cash benefit programs.
The TTW is an outcome-based employment program. Eligible SSI and SSDI beneficiaries with
disabilities and those who are blind receive a “ticket” they may use to obtain vocational rehabilitation,
employment, or other support services from an approved EN or state VR agency of their choice.
The TTW program is voluntary for beneficiaries and ENs. Because the TTW program is an outcome-
based system, Social Security provides payments to ENs only when the ticket holder attains certain
“milestones” and “outcomes” in moving toward self-supporting employment.
In addition to creating the TTW program, the Ticket to Work Act expanded access to health care by
encouraging states to allow people with disabilities to purchase Medicaid coverage that is necessary
to enable such individuals to maintain employment and to give SSDI beneficiaries the option of
maintaining Medicare coverage while working.
The Ticket to Work Act also expanded work incentives designed to reduce the risk that an individual
will lose benefits when they attempt to work. In these situations, if the work is unsuccessful, they are
left without employment or benefits. These work incentives include the option to request expedited
reinstatement of benefits without filing a new application when an individual’s Social Security or SSI
disability/blindness benefits have ended because of work activity. They also allow for the deferral of
medical continuing disability review for an individual who is “using a ticket.”
In order to ensure that beneficiaries have accurate information about the impact of employment on
their benefits, the Ticket to Work Act directed SSA to establish a community-based work incentives
planning and assistance program called the Benefit Planning, Assistance, and Outreach (BPAO)
program. The purpose of this program is to provide SSI and SSDI beneficiaries with information so they
can make informed choices about employment. The BPAO program awards cooperative agreements
80 National Council on Disability
(or grants or contracts) to community-based organizations to provide all beneficiaries with access to
benefits planning and assistance services.
Work Incentives Planning and Assistance (WIPA)
The WIPA program grew out of the BPAO program, established through the Ticket to Work and Work
Incentives Improvement Act of 1999 to provide funding to community-based organizations to educate
SSDI and SSI beneficiaries about the benefits and work incentives available to them. SSA funds
83 WIPA projects that provide information and benefits planning to enable beneficiaries with disabilities
to make informed choices about work. The primary objective of the WIPA initiative is to assist SSA
beneficiaries with transitioning from dependence on public benefits to paid employment and greater
economic self-sufficiency.
WIPA projects hire and train Community Work Incentives Coordinators (CWICs) to provide in-depth
counseling to SSI and SSDI beneficiaries about benefits and the effect of work on those benefits. All
WIPA services are free. In addition, the CWICs conduct outreach efforts to SSI and SSDI beneficiaries
(and their families) who are potentially eligible to participate in federal or state work incentives
programs and work in cooperation with federal, state, and private agencies and nonprofit organizations
that serve SSI and SSDI beneficiaries with disabilities.
Medicaid Buy-In
The Ticket to Work Act also created the Medicaid Buy-In program, which offers Medicaid coverage to
people with disabilities whose income is higher than the allowable substantial gainful activity levels.
The purpose of the Medicaid Buy-In program is to allow people with disabilities to purchase Medicaid
coverage while still being able to work. The eligibility requirements and benefits for this optional
Medicaid program vary across states. Most states review employment status, disability status, income,
and resources to determine Medicaid Buy-In eligibility. Some states require people who are eligible for
the Medicaid Buy-In to pay a monthly premium or other cost-sharing charges, which are typically set on
a sliding fee scale based on income. Many buy-in programs charge a state-specific premium and have
copayments that are higher than traditional Medicaid.
Achieving a Better Life Experience Act of 2013 (ABLE Act)
The ABLE Act, which was signed into law on December 19, 2014, is designed to improve the financial
stability of persons with disabilities by authorizing tax-advantaged savings accounts, known as ABLE
accounts, for youth and adults with disabilities. The law recognizes that many individuals and their
families depend on a wide variety of means-tested public benefits for income, health care, and food
and housing assistance. Eligibility for many of these benefits requires applicants to have few assets.
Thus, to remain eligible for these programs, an individual must remain poor.
ABLE account funds and distributions for qualified disability-related expenses are not taken into
consideration when determining eligibility for federally funded means-tested benefits, including SSI
and Medicaid. According to language in the ABLE Act, an ABLE account will, with private savings,
National Disability Policy: A Progress Report 81
“secure funding for disability-related expenses on behalf of designated beneficiaries with disabilities
that will supplement, but not supplant, benefits provided through private insurance, Medicaid, SSI, the
beneficiary’s employment, and other sources.”
These accounts are similar in construction to college savings accounts; both are included in Section
529 of the IRS Code. Assets in ABLE accounts can be used to cover any “qualified disability expense”
including housing, transportation, support services, and any other expense reasonably related to a
disability.
Under the ABLE Act, eligibility is limited to individuals with significant disabilities for whom the
onset of disability occurred before the age of 26. Individuals who meet age criteria and are already
receiving benefits under SSI and/or SSDI are automatically eligible to establish an ABLE account. Those
who do not receive SSI and/or SSDI but still meet the age of onset disability requirement may establish
eligibility by obtaining a letter from a licensed physician certifying that they meet Social Security’s
definition of disability and criteria regarding significant functional limitations.
ABLE accounts must be opened through individual state-sponsored ABLE account programs. In
order for a state to sponsor an ABLE program, it must enact state-level enabling legislation. Most,
but not all, state-sponsored ABLE programs are open to people living outside those states, as long
as they are otherwise eligible for an ABLE account. As of May 2017, 22 states have established ABLE
programs.
Any person may contribute to an ABLE account for an eligible beneficiary including family members,
friends, or the person with a disability. An ABLE account may not receive annual contributions
exceeding the annual gift-tax exemption ($14,000 in 2015). A state must also ensure that aggregate
contributions to an ABLE account do not exceed the state-based limits for 529 accounts.
Patient Protection and Affordable Care Act (ACA)
The ACA, which was signed into law in 2010, requires hospitals and primary care physicians to shift
their focus to better health outcomes and lower costs and enhance the distribution and accessibility
of their professional practices. Among the provisions in ACA is the creation of essential health benefits
required as part of private insurance coverage. ACA Sections 1302(b)(4)(B) and (C) define essential
health benefits and indicate that providers shall “not make coverage decisions . . . or design benefits in
ways that discriminate against matching dollars with no waiting list or caps. In National Federation of
Independent Business (NFIB) v. Sebelius, the Supreme Court decided that states were not mandated
to expand Medicaid coverage.
82 National Council on Disability
Appendix C: Select NCD Resources
2017
■■ Mental Health on College Campuses: Investments, Accommodations Needed to Address Student
Needs, 2017, https://ncd.gov/publications/2017/mental-health-college-campuses-investments-
accommodations-needed-address-student
■■ NCD Comments to Department of Education Regarding Mandatory Civil Rights Data Collection,
2017, https://ncd.gov/publications/2017/ncd-comments-education-mandatory-civil-rights-data-
collection
■■ NCD Letter to CMS Administrator Verma Regarding Medicaid HCBS Settings Rule, 2017, https://
ncd.gov/publications/2017/ncd-letter-cms-hcbs-settings-rule
■■ NCD Letter to CMS Administrator Verma Requesting Meeting Regarding Medicaid Policy, 2017,
https://ncd.gov/publications/2017/letter-cms-requesting-meeting-on-medicaid
2016
■■ NCD Letter to Treasury Regarding Tax Debt of Discharged Loans of Borrowers with Disabilities,
2016, https://ncd.gov/publications/2016/ncd-letter-treasury-tax-debt
■■ The Impact of the Affordable Care Act on People with Disabilities: A 2015 Status Report, 2016,
https://ncd.gov/publications/2016/impact-affordable-care-act-people-disabilities-2015-status-report
2015
■■ NCD Letter to Small Business Administration regarding Its 8a Program, 2015, https://ncd.gov/
publications/2015/ncd-letter-small-business-administration
■■ Home and Community-Based Services: Creating Systems for Success at Home, at Work and in
the Community, 2015, https://ncd.gov/publications/2015/02242015
■■ Securing the Social Contract: Reforming Social Security Disability, 2015, http://www.ncd.gov/
publications/2015/01292015/
■■ Breaking the School-to-Prison Pipeline for Students with Disabilities, 2015, https://ncd.gov/
publications/2015/06182015
■■ Transportation Update: Where We’ve Gone and What We’ve Learned, 2015, http://www.ncd.gov/
publications/2015/05042015/
National Disability Policy: A Progress Report 83
2013 and Earlier
■■ A Medicaid Block Grant Program: Implications for People with Disabilities, 2013, https://ncd.gov/
publications/2013/05222013
■■ NCD Urges HUD to Issue Olmstead Guidance, 2013, http://www.ncd.gov/publications/2013/
05212013/
■■ National Council on Disability Report on Subminimum Wage and Supported Employment, 2012,
https://ncd.gov/publications/2012/August232012
■■ The State of Housing in America in the 21st Century: A Disability Perspective, 2010, http://www.
ncd.gov/publications/2010/Jan192010
■■ Topical Brief: Transitioning Youth, 2010, https://ncd.gov/publications/2010/03232010-1
■■ Topical Brief: Workforce Investment Infrastructure, 2010, https://ncd.gov/publications/2010/
03232010-3
■■ Topical Brief: One-Stop Career Centers, 2010, https://ncd.gov/publications/2010/03232010-5
■■ Workforce Infrastructure in Support of People with Disabilities: Matching Human Resources to
Service Needs, 2010, https://ncd.gov/publications/2010/Jan202010
■■ Effective Emergency Management: Making Improvements for Communities and People with
Disabilities, 2009, https://ncd.gov/publications/2009/Aug122009
■■ People with Disabilities and Emergency Management, 2008, https://ncd.gov/publications/2008/
08082008
■■ Issues in Creating Livable Communities for People with Disabilities: Proceedings of the Panel,
2007, http://www.ncd.gov/publications/2007/Oct12007
■■ Creating Livable Communities, 2006, http://www.ncd.gov/publications/2006/Oct312006
■■ School Vouchers and Students with Disabilities, 2003, https://ncd.gov/publications/2003/
April152003
84 National Council on Disability
Appendix D: Institutions of Higher Education with
Transition and Postsecondary Programs for Students
with Intellectual Disabilities
This appendix includes a list of institutions of higher education that have TPSID.*
Albany Technical College
Appalachian State University
Bergen Community College
Borough of Manhattan Community College
California State University, Fresno
College of Staten Island
Colorado State University
Columbus State University
East Georgia State College
Florida International University
Florida State College at Jacksonville
Georgia State University
Georgia State University (consortium)
Highline College
Hostos Community College
Jacksonville State University
Kingsborough Community College
Lipscomb University
Marietta College
Mercyhurst University
Millersville University
Minot State University
Ohio State University
Ohio State University (consortium)
Penn State Harrisburg
Pennsylvania Inclusive Higher Education Consortium
Portland State University
Queens College
National Disability Policy: A Progress Report 85
Rhode Island College
Spokane Community College
Syracuse University
The College of New Jersey (partner site)
University of Alabama
University of Central Florida
University of Central Florida (consortium)
University of Cincinnati
University of Georgia
University of Hawaii
University of Kansas
University of Memphis
University of Missouri Kansas City
University of Rochester (consortium)
University of South Alabama
University of South Florida
University of Toledo
University of West Georgia
Utah State University
Vanderbilt University
*Source: More information about TPSID programs can be found at http://www.thinkcollege.net/. The list of
Institutes was retrieved from http://www.thinkcollege.net/images/stories/Cohort_2_TPSID.pdf
86 National Council on Disability
Endnotes
1 Peiyun, She, and Gina A. Livermore. 2008. “Long-Term Poverty and Disability Among Working-Age Adults.”
Journal of Disability Policy Studies 19(4): 244–256. http://journals.sagepub.com/doi/abs/10.1177/
1044207308314954
2 Brucker, Debra L., Andrew J. Houtenville, and Eric A. Lauer. 2016. “Using Sensory, Functional, and Activity
Limitation Data to Estimate Employment Outcomes for Working-Age Persons with Disabilities in the United
States.” Journal of Disability Policy Studies 27(3): 131–137.
3 Peiyun and Livermore, “Long-Term Poverty and Disability.”
4 Lustig, Daniel C., and David R. Strauser. 2007. “Causal Relationships Between Poverty and Disability.”
Rehabilitation Counseling Bulletin 50(4): 194–202. http://journals.sagepub.com/doi/abs/10.1177/
00343552070500040101.
5 U.S. Senate Committee on Health, Education, Labor, & Pensions. 2014. Fulfilling the Promise: Overcoming
Persistent Barriers to Economic Self-Sufficiency for People with Disabilities. Washington, DC: U.S. Senate
HELP Committee. https://www.help.senate.gov/imo/media/doc/HELP%20Committee%20Disability%20
and%20Poverty%20Report.pdf.
6 Sanford, Christopher, et al. 2011. The Post-High School Outcomes of Young Adults with Disabilities up to 6
Years after High School: Key Findings from the National Longitudinal Transition Study-2 (NTLS2) (NCSER 2011-
3004). Menlo Park, CA: SRI International.
7 Carnevale, Anthony P., and Richard A. Fry. 2000. Crossing the Great Divide: Can We Achieve Equity When
Generation Y Goes to College? Princeton, NJ: Educational Testing Service.
8 Sanford et al., Post-High School Outcomes.
9 Ibid.
10 Yin, Michelle, and Dahlia Shaewitz. 2015. One Size Does Not Fit All: A New Look at the Labor Force
Participation of People with Disabilities. Washington, DC: American Institutes for Research. http://www.air.org/
sites/default/files/downloads/report/Labor-Force-Participation-People-with-Disabilities-Yin-Sept-2015.pdf.
11 Houtenville, Andrew J., and Debra L. Brucker. 2014. “Participation in Safety-Net Programs and the Utilization
of Employment Services Among Working-Age Persons with Disabilities.” Journal of Disability Policy Studies
25(2): 91–105.
12 Houtenville and Brucker, “Participation in Safety-Net Programs”; Goodman, Nanette, and Michael Morris.
2015. Financing Transition Services When Everyone Is the “Payer of Last Resort.” Durham, NC: Employment
Policy and Measurement Rehabilitation Research and Training Center.
13 U.S. Census Bureau. 2014. “Measuring America: How Census Measures Poverty.” https://www.census.gov/
library/visualizations/2014/demo/poverty_measure-how.html. (Accessed March 26, 2017.)
14 Office of the Assistant Secretary for Planning and Evaluation. 2016. “Computations for the 2016 Annual
Update of the HHS Poverty Guidelines for the 48 Contiguous States and the District of Columbia.” https://
aspe.hhs.gov/computations-2016-poverty-guidelines. (Accessed March 26, 2017.)
15 Renwick, Trudi, and Liana Fox. 2016. “The Supplemental Poverty Measure: 2015.” In Current Population
Reports, P60-258. Washington, DC: U.S. Census Bureau, U.S. Government Publishing Office. https://www.
census.gov/content/dam/Census/library/publications/2016/demo/p60-258.pdf.
16 Rivera Drew, Julia A. 2015. “Disability, Poverty, and Material Hardship since the Passage of the ADA.”
Disability Studies Quarterly 35(3): 4947.
National Disability Policy: A Progress Report 87
17 Rivera Drew, “Disability, Poverty, and Material Hardship.”
18 National Collaborative on Workforce and Disability for Youth. 2009. “Graduation Requirements and Diploma
Options for Students with Disabilities: What Families and Advocates Need to Know.” InfoBrief 22. https://
www.dol.gov/odep/ietoolkit/publications/375.pdf.
19 National Center for Education Statistics. 2013. “Indicator 13: Children and Youth with Disabilities,” in “Chapter
2: Participation in Education.” In The Condition of Education 2013, edited by Susan Aud. Washington, DC: U.S.
Department of Education, National Center for Education Statistics. https://nces.ed.gov/programs/coe/pdf/
Indicator_CGG/COE_CGG_2013_01.pdf.
20 National Center for Education Statistics, U.S. Department of Education. 2016. “The Condition of Education
2016.” https://nces.ed.gov/programs/coe/indicator_cgg.asp. (Last modified May, 2016).
21 National Collaborative on Workforce and Disability for Youth, “Graduation Requirements”; National Center for
Education Statistics, “Condition for Education 2016.”
22 National Center on Educational Outcomes. 2017. “Graduation Requirements for Students with Disabilities:
Ensuring Meaningful Diplomas for All Students.” https://www.achieve.org/files/Achieve%20-%20
NCEO%20-%20Graduation%20Requirements%2013Nov2013.pdf. (Accessed June 7, 2017.)
23 DO-IT (Disabilities, Opportunities, Internetworking, and Technology). 2012. “Working Together: K–12 Teachers
and Students with Disabilities.” University of Washington. http://www.washington.edu/doit/sites/default/files/
atoms/files/Working-Together-K12-Teachers-Students-Disabilities.pdf.
24 Cameto, Renee, Phyllis Levine, and Mary Wagner. 2004. Transition Planning for Students with Disabilities:
A Special Topic Report of Findings from the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA:
SRI International.
25 Hoover, Ariel. 2016. “The Role of the Community in Transition to the Adult World for Students with
Disabilities.” American Secondary Education 44(2): 21.
26 Snyder, Thomas D., Cristobal de Brey, and Sally A. Dillow. 2016. Digest of Education Statistics 2014 (NCES
2016-006). Washington, DC: National Center for Education Statistics, Institute of Education Sciences, U.S.
Department of Education, 482, table 311.10. Erickson, William, Camille G. Lee, and Sarah von Schrader. 2016.
“Disability Statistics from the American Community Survey (ACS).” Cornell University, K. Lisa Yang and Hock
E. Tan Institute on Employment and Disability. http://www.disabilitystatistics.org/.
27 Umbricht, Mark R. 2016. “Helping Low-Income and Middle-Income Students: Pell Grants and the Higher
Education Act.” In Special Issue 2016: Reauthorization of the Higher Education Act, edited by Mark Umbricht,
special issue. Higher Education in Review 1: 24–33. Brown, Jessica. “How Financial Aid for Students with
Disabilities Works.” HowStuffWorks. http://money.howstuffworks.com/personal-finance/college-planning/
financial-aid/financial-aid-disabled-students4.htm. (Accessed March 23, 2017.)
28 Radwin, David, Jennifer Wine, Peter Siegel, Michael Bryan, and Tracy Hunt-White. 2013. 2011–12 National
Postsecondary Student Aid Study (NPSAS:12): Student Financial Aid Estimates for 2011–12, NCES 2013-165.
Washington, DC: National Center for Education Statistics, Institute of Education Sciences. https://nces.ed.gov/
pubs2013/2013165.pdf
29 Federal Student Aid. n.d. “A Federal Supplemental Educational Opportunity Grant (FSEOG) Is a Grant for
Undergraduate Students with Exceptional Financial Need.” U.S. Department of Education. https://studentaid.
ed.gov/sa/types/grants-scholarships/fseog. (Accessed May 15, 2017.)
30 Association of University Centers on Disabilities. 2015. “Transition Programs for Students with Intellectual
Disability (TPSID) Model Demonstrations & TPSID National Coordinating Center (NCC) 2015).” https://www.
aucd.org/docs/policy/appropriations/TPSID_FY15_Brief.pdf. (Accessed March 20, 2017.)
31 National Coordinating Center. n.d. “Think College.” Institute for Community Inclusion, University of
Massachusetts Boston. http://www.thinkcollege.net/about-us/think-college-grant-projects/national-
coordinating-center. (Accessed April 5, 2017.); Federal Student Aid. n.d. “Students with Intellectual Disabilities
May Be Able to Get Certain Types of Federal Student Aid.” U.S. Department of Education. https://studentaid.
ed.gov/sa/eligibility/intellectual-disabilities. (Last modified February 7, 2017, accessed April 5, 2017.)
88 National Council on Disability
32 Association of University Centers on Disabilities, “Transition Programs for Students.”
33 Yin and Shaewitz, One Size Does Not Fit All; Erickson et al., “Disability Statistics.”
34 Hiersteiner, Dorothy, et al. 2016. Working in the Community: The Status and Outcomes of People with
Intellectual and Developmental Disabilities in Integrated Employment—Update 2, NCI Data Brief. Cambridge,
MA: Human Services Research Institute.
35 U.S. Census Bureau. 2016. “2015 American Community Survey (ACS) 1-Year Public Use Microdata Samples.”
https://www.census.gov/programs-surveys/acs/data/pums.html. (Accessed May 30, 2016.)
36 Yin and Shaewitz, One Size Does Not Fit All.
37 U.S. Government Accountability Office (GAO). 2012. Employment for People with Disabilities: Little Is Known
About the Effectiveness of Fragmented and Overlapping Programs. Washington, DC: U.S. Government
Accountability Office. http://www.gao.gov/assets/600/592074.pdf.
38 Mils, Lisa, and Michael Morris. 2013. “Making Collaboration Real: Building a Progressive Vision for a Policy and
Service Delivery Framework That Promotes the Effective Leveraging of Resources to Improve Employment
and Socioeconomic Advancement of Youth and Adults with Disabilities.” LEAD Center. http://www.leadcenter.
org/resources/report-brief/2013-lead-center-policy-roundtable-report-making-collaboration-real.
39 Lauer, Eric A., and Andrew J. Houtenville. 2017. Annual Disability Statistics Compendium: 2016. Durham, NH:
University of New Hampshire, Institute on Disability.
40 U.S. Department of Education. 2017. Rehabilitation Services and Disability Research: Fiscal Year 2017 Budget
Request. Washington, DC: U.S. Department of Education. https://www2.ed.gov/about/overview/budget/
budget17/justifications/i-rehab.pdf
41 Dutta, Alo, et al. 2008. “Vocational Rehabilitation Services and Employment Outcomes for People with
Disabilities: A United States Study.” Journal of Occupational Rehabilitation 18(4): 326.
42 U.S. Government Accountability Office. Vocational Rehabilitation: Earnings Increased for Many SSA
Beneficiaries after Completing VR Services, but Few Earned Enough to Leave SSA’s Disability Rolls (GAO-07-
332). Washington, DC: U.S. Government Accountability Office.
43 National Center on Leadership for the Employment and Economic Advancement of People with Disabilities.
2016. “Summary Description of FINAL RULES Implementing Title I (State VR Program), Title VI (State
Supported Employment Services Program), and Section 511 (Limitations on Use of Subminimum Wage) of the
Rehabilitation Act, as amended by Title IV OF WIOA.” LEAD Center Policy Brief. http://leadcenter.org/system/
files/resource/downloadable_version/wioa-rehab-act-final-rule-aug.pdf.
44 Ipsen, Catherine, and Grant Swicegood. 2017. “Rural and Urban Vocational Rehabilitation Self-Employment
Outcomes.” Journal of Vocational Rehabilitation 46(1): 97–105.
45 Minority Business Development Agency, U.S. Department of Commerce. n.d. “What Is the 8(a) Business
Development Program?” https://www.mbda.gov/news/blog/2012/03/what-8a-business-development-
program?page=2. (Accessed June 7, 2017.)
46 Pumkam, Chaiporn, et al. 2013. “Health Care Expenditures Among Working-Age Adults with Physical
Disabilities: Variations by Disability Spans.” Disability and Health Journal 6(4): 287–296; Burns,
Marguerite, Nilay Shah, and Maureen Smith. 2010. “Why Some Disabled Adults in Medicaid Face
Large Out-of-Pocket Expenses.” Health Affairs (Millwood) 29(8): 1517–1522. Musumeci, MaryBeth,
and Julia Foutz. 2017. “Medicaid Restructuring Under the American Health Care Act and Nonelderly
Adults with Disabilities.” The Henry J. Kaiser Family Foundation. http://kff.org/medicaid/issue-brief/
medicaid-restructuring-under-the-american-health-care-act-and-nonelderly-adults-with-disabilities/.
47 Young, Katherine, et al. 2013. Medicaid’s Role for Dual Eligible Beneficiaries. Menlo Park, CA: The
Henry J. Kaiser Family Foundation, The Kaiser Commission on Medicaid and the Uninsured. https://
kaiserfamilyfoundation.files.wordpress.com/2013/08/7846-04-medicaids-role-for-dual-eligible-beneficiaries.pdf.
48 Musumeci, MaryBeth, and Katherine Young. 2017. “State Variation in Medicaid Per Enrollee Spending
for Seniors and People with Disabilities.” The Henry J. Kaiser Family Foundation. http://kff.org/medicaid/
issue-brief/state-variation-in-medicaid-per-enrollee-spending-for-seniors-and-people-with-disabilities/.
National Disability Policy: A Progress Report 89
49 U.S. Social Security Administration, “Federally Administered Payments,” SSI Annual Statistical Report (U.S.
Social Security Administration, Office of Retirement and Disability Policy, 2015). https://www.ssa.gov/policy/
docs/statcomps/ssi_asr/2015/sect02.html.
50 Young, Medicaid’s Role for Dual Eligible Beneficiaries.
51 Levy, Alice R., Brian K. Bruen, and Leighton C. Ku. 2013. “The Potential Employment Impact of Health Reform
on Working-Age Adults with Disabilities.” Journal of Disability Policy Studies 24(2): 102–112.
52 Sowers, Mary, Henry Claypool, and MaryBeth Musumeci. 2016. Streamlining Medicaid Home and
Community-Based Services: Key Policy Questions. Menlo Park, CA: The Henry J. Kaiser Family Foundation.
http://kff.org/medicaid/issue-brief/streamlining-medicaid-home-and-community-based-services-key-policy-
questions/.
53 Musumeci and Foutz, “Medicaid Restructuring.”
54 National Federation of Independent Business (NFIB) v. Sebelius, 132 S. Ct. 2566 (2012).
55 Hall, Jean P., et al. 2017. “Effect of Medicaid Expansion on Workforce Participation for People with Disabilities.”
American Journal of Public Health 107(2): 262–264.
56 Sowers et al., Streamlining Medicaid.
57 Musumeci and Young, “State Variation in Medicaid.”
58 Congressional Budget Office. 2017. “Detail of Spending and Enrollment for Medicaid for CBO’s January
2017 Baseline.” https://www.cbo.gov/sites/default/files/recurringdata/51301-2017-01-medicaid.pdf. (Accessed
May 30, 2017.)
59 O’Malley Watts, Molly, Elizabeth Cornachione, and MaryBeth Musumeci. 2016. “Medicaid Financial Eligibility
for Seniors and People with Disabilities in 2015.” The Kaiser Commission on Medicaid and the Uninsured.
http://files.kff.org/attachment/report-medicaid-financial-eligibility-for-seniors-and-people-with-disabilities-in-2015.
60 U.S. Social Security Administration, “Federally Administered Payments.”
61 Ibid.
62 Bailey, Michelle Stegman, and Jeffrey Hemmeter. 2015. “Characteristics of Noninstitutionalized DI and SSI
Program Participants, 2013 Update.” In Research and Statistics Note No. 2015-02. Washington, DC: U.S. Social
Security Administration, Office of Retirement and Disability Policy. https://www.ssa.gov/policy/docs/rsnotes/
rsn2015-02.html.
63 Bailey and Hemmeter, “Characteristics of Noninstitutionalized DI.”
64 U.S. Social Security Administration, “Federally Administered Payments.”
65 Bailey and Hemmeter, “Characteristics of Noninstitutionalized DI.”
66 Martin, Patricia P. 2016. “Why Researchers Now Rely on Surveys for Race Data on OASDI and SSI Programs:
A Comparison of Four Major Surveys.” In Research and Statistics Note No. 2016-01. Washington, DC: U.S.
Social Security Administration, Office of Retirement and Disability Policy. https://www.ssa.gov/policy/docs/
rsnotes/rsn2016-01.html.
67 Ryan, Paul, Speaker of the House of Representatives. 2016. A Better Way: Our Vision for a Confident America,
video. https://abetterway.speaker.gov/. (Accessed April 5, 2017.)
68 Goodman, Nanette, Michael Morris, and Debra L. Brucker. 2013. Use of the Earned Income Tax Credit Among
People with Disabilities. Durham, NH: University of New Hampshire, Institute on Disability. http://scholars.
unh.edu/cgi/viewcontent.cgi?article=1066&context=iod
69 Ibid.
70 Public and Affordable Housing Research Corporation. 2016. Housing Is a Foundation: 2016 PAHRS Report.
Cheshire, CT: HAI Group. https://www.novoco.com/sites/default/files/atoms/files/pahrc_2016_housing_
report_080216.pdf; National Low Income Housing Coalition. 2017. A Place to Call Home: The Case for
Increased Federal Investments in Affordable Housing. Washington, DC: Campaign for Housing and
Community Development Funding.
71 John D. and Catherine T. MacArthur Foundation. 2016. “How Housing Matters in Chicago Conference:
White Paper.” https://www.macfound.org/media/files/How_Housing_Matters_in_Chicago_Conference_White_
Paper1.pdf.
90 National Council on Disability
72 Technical Assistance Collaborative. 2011. “Frank Melville Supportive Housing Investment Act of 2010:
Reforms to HUD’s Section 811 Program Enacted.” https://www.ncsha.org/system/files/resources/TAC_
Summary_1.7.11.pdf
73 Schaak, Gina, and Lisa Sloane. 2016. “Section 811 Supportive Housing for Persons with Disabilities Program.”
2015 Advocates’ Guide. Washington, DC: National Low Income Housing Coalition. http://nlihc.org/sites/default/
files/Sec4.10_Section-811_2015.pdf.
74 Center on Budget and Policy Priorities. 2016. Chart Book: Rental Assistance Reduces Hardship, Promotes
Children’s Long-Term Success. Washington, DC: Center on Budget and Policy Priorities. http://www.cbpp.org/
sites/default/files/atoms/files/7-5-16hous-chartbook.pdf.
75 Center on Budget and Policy Priorities, Chart Book; John D. and Catherine T. MacArthur Foundation, “How
Housing Matters in Chicago Conference: White Paper.”
76 National Council on Disability. 2010. “The State of Housing in America in the 21st Century: A Disability
Perspective.” https://ncd.gov/publications/2010/Jan192010/. (Accessed August 30, 2017).
77 Blumenthal, Pamela, and John McGinty. 2015. Housing Policy Levers to Promote Economic
Mobility. Washington, DC: The Urban Institute. http://www.urban.org/research/publication/
housing-policy-levers-promote-economic-mobility.
78 American Public Transportation Association Transit Board Members & Board Support Seminar. 2014. Enabling
and Promoting the Use of Fixed-Route Transit by People with Disabilities. Cleveland, OH: APTA. http://www.
apta.com/resources/statistics/Documents/FactBook/2016-APTA-Fact-Book.pdf.
79 American Association of People with Disabilities. “Transportation Equity,” AAPD Transportation website. http://
www.aapd.com/our-focus/transportation/. (Accessed May 30, 2017.)
80 American Association of People with Disabilities, “Transportation Equity.”
81 Transportation Research Board. 2014. “Current Use of Fixed-Route Transit Services by People with
Disabilities.” In TCRP Research Brief, TCRP Report 163: Strategy Guide to Enable and Promote the Use
of Fixed-Route Transit by People with Disabilities. Washington, DC: Transportation Research Board. http://
onlinepubs.trb.org/onlinepubs/tcrp/tcrp_rpt_163IBCurrentUse.pdf. (Accessed July 14, 2017.)
82 U.S. Department of Transportation, Federal Transit Administration. 2015. FTA C 4710.1 Circular: Americans with
Disabilities Act (ADA): Guidance. Washington, DC: Federal Transit Administration. https://www.transit.dot.gov/
sites/fta.dot.gov/files/docs/Final_FTA_ADA_Circular_C_4710.1.pdf.
83 American Association of People with Disabilities, “Transportation Equity.”
84 Taxis for All Campaign v. New York City Taxi and Limousine Commission, 1:11-cv-00237-GBD (S.D.N.Y. 2014).
85 49 U.S.C. 5307.
86 49 U.S.C. 5311.
87 49 U.S.C. 5310.
88 National Center for Education Statistics, Condition of Education 2016.
89 National Collaborative on Workforce and Disability for Youth, Graduation Requirements.
90 Morgan, Paul L., et al. 2012. “Are Minority Children Disproportionately Represented in Early Intervention
and Early Childhood Special Education?” Educational Researcher 41(9): 339–351; U.S. Department
of Education. 2016. Racial and Ethnic Disparities in Special Education: A Multi-Year Disproportionality
Analysis by State, Analysis Category, and Race/Ethnicity. Washington, DC: Office of Special Education
and Rehabilitative Services, U.S. Department of Education. https://www2.ed.gov/programs/
osepidea/618-data/LEA-racial-ethnic-disparities-tables/disproportionality-analysis-by-state-analysis-
category.pdf.
91 Baker, Jane, and Deana M. Hollaway. 2009. “A Comprehensive Approach to Disruptive Behaviors in the
Classroom and Home.” International Journal on School Disaffection 6(2): 37–40.
92 Skinner, Deborah, and Thomas S. Weisner. 2007. “Sociocultural Studies of Families of Children with Intellectual
Disabilities.” Mental Retardation and Developmental Disabilities Research Reviews 13(4): 302–312.
93 National Council on Disability. 2015. Breaking the School-to-Prison Pipeline for Students with Disabilities.
Washington, DC: NCD. https://www.ncd.gov/publications/2015/06182015.
National Disability Policy: A Progress Report 91
94 National Collaborative on Workforce and Disability for Youth, Graduation Requirements.
95 Thurlow, Martha, Rachel Quenemoen, and Sheryl Lazarus. 2011. “Meeting the Needs of Special Education
Students: Recommendations for the Race-to-the-Top Consortia and States.” Minneapolis, MN: University of
Minnesota, National Center on Educational Outcomes Institute on Community Integration. https://ici.umn.
edu/index.php?products/view/385.
96 Ibid.
97 U.S. Census Bureau, 2015 American Community Survey.
98 Ibid.
99 Federal Student Aid, “Federal Supplemental Educational Opportunity Grant.”
100 National Council on Disability. 2015. “Briefing Paper: Reauthorization of the Higher Education Act
(HEA): The Implications for Increasing the Employment of People with Disabilities.” https://ncd.gov/
publications/2015/05192015. (Accessed August 30, 2017.)
101 National Council on Disability. 2015. Briefing Paper: Reauthorization of the Higher Education Act (HEA): The
Implications for Increasing the Employment of People with Disabilities. Washington, DC: NCD. http://www.
ncd.gov/publications/2015/05192015.
102 U.S. Department of Education, Federal Student Aid. 2014. Annual Report FY 2014. Washington, DC: U.S.
Department of Education. https://studentaid.ed.gov/sa/sites/default/files/FY2014_FSA_Annual_Report_508.pdf.
103 Student Debt Crisis. n.d. “Department of Ed Forgives Debt For Americans with Disabilities.” http://
studentdebtcrisis.org/dept-of-ed-disability-forgiveness/. (Accessed May 15, 2017.)
104 Church, Thomas E. 2009. “Returning Veterans on Campus with War Related Injuries and the Long Road Back
Home.” Journal of Postsecondary Education and Disability 22(1): 41–52; Rudd, David M., Jeffrey Goulding,
and Craig J. Bryan. 2011. “Student Veterans: A National Survey Exploring Psychological Symptoms and
Suicide Risk.” Professional Psychology: Research and Practice 42(5): 354–560. https://msrc.fsu.edu/system/
files/Rudd%20et%20al%202011%20Student%20veterans%20A%20national%20survey%20exploring%20
psychological%20symptoms%20and%20suicide%20risk_0.pdf.
105 Thomas E. Church, “Returning Veterans on Campus.”
106 Yin and Shaewitz, One Size Does Not Fit All.
107 Wittenburg, David, and Pamela Loprest. 2003–2007. Ability or Inability to Work: Challenges in Moving Towards
a More Work-Focused Disability Definition for Social Security Administration (SSA) Disability Programs.
Briefing Paper for the Ticket to Work & Work Incentives Advisory Panel. Washington, DC: The Urban Institute.
https://www.researchgate.net/publication/267198732_Ability_or_Inability_to_Work_Challenges_in_Moving_
Towards_a_More_Work-Focused_Disability_Definition_for_Social_Security_Administration_SSA_Disability_
Programs.
108 U.S. Social Security Administration, Office of Retirement and Disability Policy. 2015. “SSI Annual Statistical
Report, 2015.” https://www.ssa.gov/policy/docs/statcomps/ssi_asr/2015/sect07.html.
109 Technical Assistance Collaborative. n.d. “Current Priorities” http://www.tacinc.org/policy-leadership/current-
priorities. (Accessed May 30, 2017.)
110 U.S. Census Bureau. 2016. “New Census Data Show Differences Between Urban and Rural Populations.”
https://www.census.gov/newsroom/press-releases/2016/cb16-210.html.
111 National Council on Disability. 2015. “Transportation Update: Where We’ve Gone and What We’ve Learned.”
Washington, DC: NCD. https://ncd.gov/rawmedia_repository/862358ac_bfec_4afc_8cac_9a02122e231d.pdf;
Association of Programs for Rural Independent Living. 2010. “Transportation Act Reauthorization Position
Statement: Rural Transportation for People with Disabilities.” Little Rock, AR: Association of Programs for
Rural Independent Living. https://www.april-rural.org/images/stories/200911/april_transportation_position_
statementjanuary_2010.pdf. (Accessed July 14, 2017.)
112 Ju, Song, Eric Roberts, and Dalun Zhang. 2013. “Employer Attitudes Toward Workers with Disabilities:
A Review of Research in the Past Decade.” Journal of Vocational Rehabilitation 38(2): 113–123. http://content.
iospress.com/articles/journal-of-vocational-rehabilitation/jvr625.
92 National Council on Disability
113 Newman, Lynn. 2005. Family Involvement in the Educational Development of Youth with Disabilities: A Special
Topic Report of Findings from the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA: SRI
International.
114 National Collaborative on Workforce and Disability for Youth, Graduation Requirements.
115 Rix, Jonathan, et al. 2006. A Systematic Review of Interactions in Pedagogical Approaches with Reported
Outcomes for the Academic and Social Inclusion of Pupils with Special Educational Needs. London: EPPI-
Centre, Social Science Research Unit, University of London. http://eprints.soton.ac.uk/55260/.
116 Newman, Family Involvement in Educational Development.
117 L. Johnson, AdriAnne. 2006. “Students with Disabilities in Postsecondary Education: Barriers to Success and
Implications for Professionals.” VISTAS Online (American Counseling Association. https://www.counseling.org/
Resources/Library/VISTAS/vistas06_online-only/Johnson.pdf.
118 Singh, Delar K. 2003. “Students with Disabilities and Higher Education.” College Student Journal 37(3):
367–379.
119 Ju, Song, Eric Roberts, and Dalun Zhang. 2013. “Employer Attitudes Toward Workers with Disabilities:
A Review of Research in the Past Decade.” Journal of Vocational Rehabilitation 38(2): 113–123. http://content.
iospress.com/articles/journal-of-vocational-rehabilitation/jvr625; Houtenville, Andrew, and Valentini Kalargyrou.
2012. “People with Disabilities: Employers’ Perspectives on Recruitment Practices, Strategies, and Challenges
in Leisure and Hospitality.” Cornell Hospital Quarterly 53(1): 40–52. http://journals.sagepub.com/doi/
abs/10.1177/1938965511424151.
120 Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities.
2016. “Final Report to: The Honorable Thomas E. Perez, United States Secretary of Labor, the United States
Senate Committee on Health, Education, Labor and Pensions, The United States House of Representatives
Committee on Education and the Workforce.” https://www.dol.gov/odep/topics/pdf/ACICIEID_Final_
Report_9-8-16.pdf.
121 National Council on Disability. 2012. “National Council on Disability Report on Subminimum Wage and
Supported Employment.” Washington, DC: NCD.
122 ACICIEID, “Final Report.”
123 National Council on Disability, “Report on Subminimum Wage.”
124 Cimera, Robert Evert. 2011. “Does Being in Sheltered Workshops Improve the Employment Outcomes of
Supported Employees with Intellectual Disabilities?” Journal of Vocational Rehabilitation 35(1): 21–27.
125 National Council on Disability. 2012. “Report on Subminimum Wage and Supported Employment.” https://ncd.
gov/publications/2012/August232012. (Accessed August 30, 2017).
126 National Council on Disability, “Report on Subminimum Wage.”
127 U.S. Department of Justice, Office of Public Affairs. 2014. “Department of Justice Reaches Landmark
Americans with Disabilities Act Settlement Agreement with Rhode Island.” https://www.justice.gov/opa/
pr/department-justice-reaches-landmark-americans-disabilities-act-settlement-agreement-rhode; U.S.
Department of Justice, Office of Public Affairs. 2015. “Justice Department Reaches Landmark Settlement
Agreement with State of Oregon Regarding Americans with Disabilities Act.” https://www.justice.gov/opa/pr/
justice-department-reaches-landmark-settlement-agreement-state-oregon-regarding-americans.
128 National Council on Disability, “Transportation Update.”
129 Equal Rights Center v. Uber Technologies, Inc., 1:17-cv-01272 (U.S. Dist. Ct. District of Columbia June 28,
2017), https://equalrightscenter.org/wp-content/uploads/equal-rights-center-v.-uber-technologies-inc.-complaint.
pdf; Access Living of Metropolitan Chicago v. Uber Technologies, Inc., 1:16-cv-09690; Ill. Northern Dist. Ct.
Oct. 13, 2016), https://www.law360.com/cases/57ff9a753b739629f7000002.
130 Squire, Alexis L., and Gregg A. Kelley. 2017. “Equal Rights Center Files Lawsuit Against Uber for Providing
Services That Are Inaccessible to Wheelchair Riders.” https://equalrightscenter.org/press-releases/
equal-rights-center-files-lawsuit-uber-providing-services-inaccessible-wheelchair-riders/.
131 Blumenthal and McGinty, Housing Policy Levers.
National Disability Policy: A Progress Report 93
132 Initiative for Empowerment and Economic Independence (IEEI). 2017. “Case Statement”; Initiative for
Empowerment and Economic Independence (IEEI). 2017. Interview with Greg Fehribach and Kristin Hyde.
133 Canter, Lora Lee Smith, et al. 2017. “Evaluating Pedagogy and Practice of Universal Design for Learning in
Public Schools.” Exceptionality Education International 27(1): 1–16; Rao, Kavita, Sean J. Smith, and K. Alisa
Lowrey. 2017. “UDL and Intellectual Disability: What Do We Know and Where Do We Go?” Intellectual and
Developmental Disabilities 55(1): 37–47.
134 Council of Chief State School Officers and The Charles A. Dana Center at the University of Texas at Austin.
2002. Expecting Success: A Study of Five High Performing, High Poverty Schools. Washington, DC: Council
of Chief State School Officers.
135 Council of Chief State School Officers, Expecting Success.
136 Baker and Hollaway, “Comprehensive Approach to Disruptive Behaviors.”
137 Morris, Pamela, et al. 2013. “Does a Preschool Social and Emotional Learning Intervention Pay Off for
Classroom Instruction and Children’s Behavior and Academic Skills? Evidence from the Foundations of
Learning Project.” Early Education & Development 24(7): 1020–1042.
138 Williamson, Pamela, and James McLeskey. 2011. “An Investigation into the Nature of Inclusion Problem-
Solving Teams.” The Teacher Educator 46(4): 316–334.
139 Association of People Supporting Employment. 2014. Policy Research Brief: Employment First Across
the Nation: Progress on the Policy Front. Minneapolis, MN: Research and Training Center on Community
Living, Institute on Community Integration, University of Minnesota. http://www.apse.org/wp-content/
uploads/2014/01/activity.html.
140 Final Rule. 2001. “State Vocational Rehabilitation Services Program.” 34 CFR Part 361, RIN 1820-AB52. Federal
Register 66(14): 7249–7258. https://www2.ed.gov/legislation/FedRegister/finrule/2001-1/012201a.html
141 U.S. Department of Justice. 2014. “Department of Justice Reaches Landmark Settlement with Rhode Island”;
U.S. Department of Justice. 2015. “Justice Department Reaches Landmark Settlement with Oregon
142 Association of University Centers on Disabilities, “Transition Programs for Students.”
143 ACICIEID, “Final Report.”
144 U.S. Department of Housing and Urban Development. n.d. “Community Planning and Development.” https://
portal.hud.gov/hudportal/HUD?src=/program_offices/comm_planning. (Accessed March 29, 2017.)
145 Ronald L. Mace. 1998. “Universal Design in Housing.” Assistive Technology 10(1): 21–28.
146 Fairfax County Virginia. n.d. “Fairfax Building for All Committee.” http://www.fairfaxcounty.gov/universaldesign/
bfac.htm. (Accessed June 7, 2017.)
147 National Association of Home Builders. n.d. “Universal Design/Build.” https://www.nahb.org/en/learn/course-
overviews/universal-design-build.aspx. (Accessed June 7, 2017.)
148 NARI. n.d. “Universal Design Certified Professional (UDCP).” http://www.nari.org/industry/development/
certification/universal-design-certified-professional-udcp/. (Accessed June 7, 2017.)
149 Whole Building Design Guide (WBDG) Accessible Committee, Jordana L. Maisel, and Molly Ranahan. 2017.
“Beyond Accessibility to Universal Design.” Washington, D.C.: National Institute of Building Sciences, WBDG.
https://www.wbdg.org/design-objectives/accessible/beyond-accessibility-universal-design. (Accessed June 7,
2017.)
150 Montgomery County Government. n.d. “Summary of the MPDU Program and Its Requirement.” Montgomery
County, MD: Montgomery County Government. http://www.montgomerycountymd.gov/DHCA/housing/
singlefamily/mpdu/program_summary.html. (Accessed July 14, 2017.)
151 Trombka, Aron, Michael Faden, Sonya Healy, Marlene Michaelson, Ralph Wilson, and Sally Roman. 2004.
“Strengthening the Moderately Priced Dwelling Unit Program: A 30-Year Review.” In A Report to the
Montgomery County Council on Future Program and Policy Options. Rockville, MD: Montgomery County
Council. http://www.montgomerycountymd.gov/DHCA/Resources/Files/housing/singlefamily/mpdu/report_
mpdu30yearreview.pdf.
94 National Council on Disability
152 Democracy Collaborative. 2017. “Engaging with Eds, Meds, and Other Anchor Institutions to Help Them Help
Communities.” http://democracycollaborative.org/democracycollaborative/anchorinstitutions/Anchor%20
Institutions. (Accessed March 30, 2017.)
153 Bent, Elliot, et al. 2017. Better Plans for Better Places: How the Sustainable Communities Initiative Changed
the Way the Country Plans for a Prosperous and Sustainable Future. Montpelier, VT: Institute for Sustainable
Communities, Sustainable Communities Learning Network. http://betterplansbetterplaces.iscvt.org/.
(Accessed March 30, 2017.)
154 Federal Emergency Management Agency (FEMA). 2010. “2010 Getting Real: Inclusive Emergency
Management National Capacity Building Training Conference.” https://www.fema.gov/2010-getting-real-
inclusive-emergency-management-national-capacity-building-training-conference. (Accessed June 7, 2017.)
155 Blyler, Crystal, et al. 2014. Evaluation of the Ticket to Work Program: 2003–2013. Princeton, NJ: Mathematica
Policy Research, Inc.
156 Morton, William R. 2013. Ticket to Work and Self-Sufficiency Program: Overview and Current Issues.
Washington, DC: Congressional Research Service.
157 Morton, Ticket to Work.
158 Kehn, Matthew, and Jody Schimmel. 2013. Enrollment, Employment, and Earnings in the Medicaid Buy-In
Program, 2011: Final Report. Washington, DC: Mathematica Policy Research.
National Disability Policy: A Progress Report 95
National Council on Disability
1331 F Street, NW, Suite 850
Washington, DC 20004
File and source
- File
- 042_NCD_A-Progress-Report_508.pdf
- Size
- 2,247,650 bytes
- SHA-256
- 77875fe2f83491e68bdafb401e2b072ae9a695736685d49a3515bba93fdf9a14
- Original
- ncd.gov