Thirty-one years ago today, when the Americans with Disabilities Act (ADA) became law, I wonder how many Americans knew how transformative this law would be.
Thanks to the American Disabilities Act, if you are blind and have a service dog, a bus driver cannot refuse to allow your dog with you on the bus. A person who uses a wheelchair can visit public parks or their local bank and expect to have the same access as people without disabilities. Most people with intellectual, developmental and mental health challenges now receive needed services and supports in the community, not in institutions. Reasonable accommodations and elimination of discriminatory hiring practices have opened workplaces, and many people with and without disabilities are routinely working side by side. Curb cuts and ramps on sidewalks are now common.
Before the ADA, individuals with disabilities experienced discrimination in so many aspects of their lives, with no legal recourse in many situations. The ADA changed all of that.
The ADA is a far-reaching piece of civil rights legislation, and it has become a model for the rest of the world. It prohibits discrimination by local and state governments; provides accessibility standards for privately owned businesses and commercial facilities; ensures equal access to health care, social services, transportation, and telecommunications; and protects against discrimination in the workplace. The ADA generally asserts that people with disabilities have the same rights to partake in American life as anyone else, including the right to live, work, and participate as valued members of their community.
But while the ADA guarantees the rights of people with disabilities to live in the community, it cannot guarantee the availability of the supports people need to do so. This paradox has led to catastrophic consequences during the pandemic, as people who live in institutions faced dramatically higher rates of infection and death. By every measure – from the risks of COVID-19 itself, to its economic consequences, to the isolation and hardships faced as a result of physical distancing – the costs of the pandemic have been amplified for people with disabilities.
COVID-19 illuminated the work that remains to make our country inclusive and accessible for everyone. This is where our work at the Department of Health and Human Service (HHS) comes in.
Today, HHS and the Department of Justice jointly published guidance on how disability nondiscrimination laws apply to people with "long COVID" who may be newly covered because of the impact of the COVID-19 infection. The guidance discusses when long COVID may be considered a disability under the ADA and other federal civil rights laws. The guidance, along with a directory of resources available through programs funded by the Administration for Community Living (ACL), was shared this morning by the White House as part of a comprehensive package of resources for people with disabilities, including those with long COVID and other post-COVID conditions.
Upholding the rights of people with disabilities during the COVID-19 pandemic has been one of our top priorities since President Biden took office. Earlier guidance from HHS' Office for Civil Rights (OCR) addressed how federal nondiscrimination laws apply to vaccination programs, support persons during hospitalization, and address crisis standards of care, and OCR continues to enforce compliance with important civil rights laws including the ADA, as well as Section 504 and Section 1557, to ensure non-discrimination during COVID-19 and beyond. In addition, HHS provided nearly $100 million to ensure equal access to vaccines for people with disabilities, and ACL launched the Disability Information and Access Line (DIAL), which connects people with disabilities to vaccine information and services to meet a range of needs.
COVID-19 has created a national urgency to expand and strengthen our home and community-based services (HCBS) system, and we are seizing this opportunity. The Centers for Medicare & Medicaid Services is working with states to take full advantage of a significant increase in federal funding for Medicaid HCBS provided through the American Rescue Plan.
We also are working with the Department of Housing and Urban Development (HUD) to increase access to affordable, accessible housing and voluntary services – those chosen by the person receiving them – to support community living. This partnership will advance key priorities of the Biden-Harris Administration, including addressing homelessness, expanding HCBS, and addressing the institutional bias in America's long-term care system.
President Biden has also proposed $400 billion to expand HCBS, strengthen the direct care workforce, and support family caregivers. And this is all in addition to the Affordable Care Act's (ACA) Medicaid expansion, which has increased health coverage among people with disabilities and has been a lifesaver for many who do not qualify for Medicaid.
As part of the Administration's commitment to advancing equity, we are also working to address the health disparities experienced by people with disabilities. The prevalence of disability and access to needed services and supports differs across different racial and ethnic groups and across geography, and HHS is committed to mitigating the additional barriers faced by disabled people who are also members of other underserved communities. We have begun this crucial work through the President's COVID-19 Health Equity Task Force and the broadened scope of the HHS Health Disparities Council, both of which have an intersectional focus that explicitly includes disability.
As we celebrate the 31st anniversary of the signing of the ADA into law, it is a time to look back at what once was, celebrate what now is, and look forward to what can be.
I started my career in the mid-1980s as a legal aid attorney working with the Commonwealth of Massachusetts' Protection and Advocacy program, where I assisted people with mental health challenges transitioning from institutions to the community. One of my last acts as Attorney General of California was to establish the Bureau of Disability Rights at the California Department of Justice to ensure that the rights of people with disabilities are advanced. Now as HHS Secretary, I am honored to continue that work at the federal level, and to recommit myself to the ADA and advancing its core aims.