Progress on Legislative Recommendations from Toward Independence

National Council on Disability
(formerly the National Council on the Handicapped)

A Report to the President and to the Congress of the United States, January 1988

National Council on Disability
1331 F Street, NW, Suite 1050
Washington, DC 20004-1107
202-272-2004 (Voice)
202-272-2074 (TTD)
202-272-2022 (Fax)

The views contained in this report do not necessarily represent those of the Administration, as this document has not been subject to the A-19 Executive Branch review process.

Contents

Letter of Transmittal

Description of the National Council on the Handicapped

Council and Staff Members

Acknowledgments

Executive Summary

Foreword

I. Introduction

II. Recent Data and Trends

III. Analysis of Progress Made In Specific Topic Areas Since the Publication of Toward Independence

A. Equal Opportunity Laws

The Americans With Disabilities Act of 1988--Section by Section Summary
The Americans With Disabilities Act of 1988--A Draft Bill

B. Employment
C. Disincentives to Work Under Social Security Laws
D. Prevention of Disabilities
E. Transportation
F. Housing
G. Community-Based Services For Independent Living
H. Educating Children With Disabilities
I. Personal Assistance
J. Coordination

Biographies of Members of the National Council on the Handicapped

References

(Text of identical letters sent to the President of the United States, the President of the Senate, and the Speaker of the House of Representatives)

January 29, 1988

The National Council on the handicapped is pleased to issue On the Threshold of Independence, a report describing progress made toward increasing the independence and quality of life for persons with disabilities since the Council's 1986 report, Toward Independence. On the Threshold of Independence was developed in response to a statutory mandate that the Council:

Not later than January 30, 1988, and annually thereafter, the National Council on the Handicapped shall issue a report to the President and Congress on the progress that has been made in implementing the recommendations contained in the Council's January 30, 1986, report Toward Independence. The reports issued shall present, as appropriate, available data on health, housing, employment, insurance, transportation, recreation, and education, and shall include appropriate information on the current status and trends in the status of individuals with disabilities.

(Public Law 99-506, Section 502(b))

Toward Independence assessed the status of persons with disabilities in America and the Federal laws and programs that affect them. It presented forty-five legislative remedies to identified problems, all geared toward increasing the dignity and independence of Americans with disabilities. Since the publication of Toward Independence, many doors, previously closed to persons with disabilities, have been opened. On the Threshold of Independence describes accomplishments that have been achieved in response to the recommendations in Toward Independence, and the degree to which the recommendations have been implemented.

In some instances, the Toward Independence recommendations have been the driving force behind particular legislative proposals, and the Council played a major role in the process of developing concrete statutory approaches. In other cases, the Council was but one of many voices in favor of a particular proposal that led to legislative action. In either event, the Council gratefully acknowledges that the progress has been the result of the ideas, comments, and diligent work of numerous persons with disabilities, their families, public officials, other professionals and experts, consumer and service organizations, and other interested individuals from all over the country.

Some progress has been made in each of the ten topics of Toward Independence. There have been major statutory advances in many of the topic areas, bills are pending in others, and at least some positive administrative efforts or related activities have occurred in the remainder. In all, approximately eighty percent of the recommendations have been either partially or fully accomplished.

The Council is pleased at the many ways in which the Legislative and Executive Branches of Government have responded positively to its recommendations. Yet, the significant progress that has been made does not obscure the fact that many of the major recommendations have not yet been addressed or addressed only partially- many of the doors of opportunity remain firmly shut to persons with disabilities. The Council seeks to rededicate its own efforts, and to join with the President, the Congress, and persons with disabilities and their families, to achieve the objectives of Toward Independence. Only then will Americans with disabilities escape from situations of dependence and dehumanization and cross the threshold of independence.

The Council appreciates the opportunity to continue to shape disability policy and to work toward an America in which persons with disabilities are afforded all the opportunities that our society has to offer.

Sincerely,

Sandra Swift Parrino
Chairperson

The National Council on the Handicapped is an independent Federal agency comprised of 15 members appointed by the President and confirmed by the Senate. The Council was initially established in 1978 as an advisory board within the Department of Education (Public Law 95602). The Rehabilitation Act Amendments of 1984 (Public Law 98-221) transformed the Council into an independent agency.

The current statutory mandate of the Council assigns it the following duties:

• establishing general policies for and reviewing the operation of the National Institute on Disability and Rehabilitation Research (NIDRR);
  
  
• providing advice to the Commissioner of the Rehabilitation Services Administration (RSA) on policies and conduct;
  
  
• providing ongoing advice to the President, the Congress, the RSA Commissioner, the Assistant Secretary of the Office of Special Education and Rehabilitative Services (OSERS), and the Director of NIDRR on programs authorized in the Rehabilitation Act;
  
  
• reviewing and evaluating on a continuous basis the effectiveness of all policies, programs, and activities concerning handicapped individuals conducted or assisted by Federal departments or agencies, and all statutes pertaining to Federal programs, and assessing the extent to which they provide incentives to community-based services, promote full integration, and contribute to the independence and dignity of individuals with disabilities;
  
  
• making recommendations of ways to improve research, service, administration, and the collection, dissemination, and implementation of research findings affecting handicapped persons;
  
  
• reviewing and approving standards for Independent Living programs;
  
  
• submitting an annual report with appropriate recommendations to the Congress and the President regarding the status of research affecting persons with disabilities and the activities of RSA and NIDRR;
  
  
• reviewing and approving standards for Projects with Industry programs;
  
  
• providing to the Congress, on a continuing basis advice, recommendations, and any additional information which the Council or the Congress considers appropriate; and
  
  
• issuing an annual report to the President and the Congress on the progress that has been made in implementing the recommendations contained in the Council's January 30, 1986, report, Toward Independence.

While many government agencies deal with issues and programs affecting people with disabilities, the National Council is the only Federal agency charged with addressing, analyzing, and making recommendations on issues of public policy which affect people with disabilities regardless of age, disability type, perceived employment potential, economic need, specific functional ability, status as a veteran, or other individual circumstance. The Council recognizes its unique opportunity to facilitate independent living, community integration, and employment opportunities for people with disabilities by assuring an informed and coordinated approach to addressing the concerns of persons with disabilities and eliminating barriers to their active participation in community and family life.

Members

Sandra Swift Parrino, Chairperson
John S. Erthein
Theresa L. Gardner
Marian N. Koonce
Leslie Lenkowsky, Ph.D.
Nanette Fabray MacDougall
Robert Muller
Brenda Premo
*Harry J. Sutcliffe, D. D. (Deceased 12/87)
Joni Eareckson Tada
Roxanne Vierra
A. Kent Waldrep, Jr.
Phyllis Zlotnick

Staff

Lex Frieden, Executive Director
Brenda Bratton, Secretary
Stacey Brown, Clerk Typist
Ethel Briggs, Adult Services Specialist
Robert Burgdorf Jr., Attorney/Research Specialist
Frances Curtis, Administrative Officer
Andrea Farbman, Public Affairs Specialist
Kathleen Roy, Children's Specialist
Deborah Shuck, Staff Assistant
LaVerne Chase, Fellow
D. Fay Fuller, Jr., Fellow

The Council is indebted to Andrea Farbman for coordinating, managing, and editing this report. The contributions of staff members Ethel Briggs, Robert Burgdorf Jr., Kathy Roy, and fellows LaVerne Chase and D. Ray Fuller, Jr. are greatly appreciated. Gratitude is also extended to Richard Moss for graphic design and production, Karen Premack for editorial guidance, and Unicor print plant for printing the report.

In the 1986 Amendments to the Rehabilitation Act of 1973, Congress required the Council to:

...issue a report to the President and Congress on the progress that has been made in implementing the recommendations contained in the Council's January 30, 1986, report Toward Independence.

The reports issued shall present, as appropriate, available data on health, housing, employment, insurance, transportation, recreation, and education, and shall include appropriate information on the current status and trends in the status of individuals with disabilities. (Public Law 99-506, Section 502(b))

On the Threshold of Independence chronicles progress made on the forty-five legislative recommendations which were proposed in the Council's previous report, Toward Independence. Several recent studies on disability, including one from the Census Bureau and two Harris polls are also discussed.

Some significant progress has occurred in the two years since Toward Independence was published. The Council has identified some twenty-one statutory provisions consistent with its recommendations in Toward Independence that have been enacted into law. In addition, the Council is aware of eight bills that have been introduced in Congress, but not yet enacted, that would further proposals included in Toward Independence.

Of the forty-five legislative recommendations, eighty percent have been either partially or fully accomplished. Many doors to independence have been opened, others remain closed or only partially opened.

This report assesses progress made in each of the ten topic areas in Toward Independence and examines the extent to which each of the forty-five legislative recommendations have been implemented. The following is an overview of progress that has occurred.

Equal Opportunity Laws

A major achievement in this area was the development by the Council of a comprehensive legislative proposal, "The Americans with Disabilities Act of 1988," which translates the primary equal opportunity recommendations into proposed statutory language. Three other statutes- the Rehabilitation Act Amendments of 1986, the Handicapped Children's Protection Act of 1986, and the Protection and Advocacy for the Mentally Ill Individuals Act of 1986- incorporated other significant, but narrower, equal opportunity recommendations. In spite of legislative progress made, the Council remains committed to passage of its comprehensive equal opportunity proposal as an essential prerequisite to equality and independence for persons with disabilities.

Employment

In the area of employment of persons with disabilities accomplishments included passage of legislation incorporating several of the Council's major recommendations in the areas of supported employment, transition, and tax incentives for employers. The Council believes that these legislative changes represent unprecedented gains in terms of expanded employment opportunities for persons with disabilities. Additional congressional action is still needed to implement the full range of the Council's recommendations, including the establishment of model centers on employment and return-to-work programs, and elimination of the income eligibility requirement for persons with disabilities under the Job Training Partnership Act.

Disincentives to Work under Social Security Laws

Legislation passed in the 99th Congress furthered several of the Council's recommendations for the removal of barriers under the Social Security Act that discouraged persons with disabilities from seeking gainful employment. These included the Employment Opportunities for Disabled Americans Act which made the temporary provisions of Section 1619 (a) and (b) of the Social Security Act permanent and established Section 303 of the Rehabilitation Act Amendments of 1986 which required the National Institute on Disability and Rehabilitation Research to conduct a study of health insurance for persons with disabilities. The Council continues to believe that the eligibility criteria for Supplemental Security Income and Social Security Disability Insurance merit attention.

Prevention of Disabilities

The Council devoted considerable effort regarding policies and programs to prevent both primary and secondary disabilities. The Office of Disease Prevention and Health Promotion, in conjunction with the Council, convened a Federal ad hoc group on the prevention of disabilities which included a number of Federal agencies. The focus of this ad hoc group was the exchange of information between Federal agencies and the development of a national plan for the prevention of disabilities, as recommended by the Council. Funds have been sought for the development of the national plan and a small community-based grants program administered by the Centers for Disease Control. After these projects have been completed, the Office of Technology Assessment will be asked to conduct a study on the status of prevention of disabilities in America.

Transportation

In Toward Independence the Council concluded that accessible transportation is a critical component of a national policy that promotes the self-reliance and self-sufficiency of people with disabilities. The area of greatest progress has been that of air transportation with the passage of the Air Carrier Access Act of 1986. Other developments included the introduction of bills to amend the Urban Mass Transit Act and to create a national uniform system for handicapped parking. The Council affirms its commitment to improving access for persons with disabilities.

Housing

The housing legislative recommendations presented direct and indirect means for increasing the housing opportunities available to persons with disabilities. Some significant legislative proposals and administrative actions have furthered the Council's recommendations. At the same time, many of the Council's key housing recommendations have yet to receive congressional resolution and administrative implementation.

Community-Based Services for Independent Living

Centers providing independent living services have grown substantially in number, scope, and resources. Consistent with the Council's recommendation, Congress has continued to appropriate funds for independent living. The evaluation standards for independent living services developed by the Council have been endorsed by the Rehabilitation Services Administration. Tax deductions for expenses incurred by persons with disabilities have increased under the Tax Reform Act of 1986. Other Council recommendations regarding core funding and institutional bias within the Health Care Financing Administration have not been implemented.

Educating Children with Disabilities

The Education of the Handicapped Act Amendments of 1986 accomplished a primary recommendation of the Council by creating an early intervention program to serve disabled infants from birth through age two. In addition, the legislation included significant improvements in services for three- to five-year-old children with disabilities. To further implementation of its recommendation regarding standards to clarify the concept of least restrictive environment, the Council developed a draft policy statement on this issue. One activity not mentioned in Toward Independence was the Council's initiation of a third Harris poll to examine the status of education for children with disabilities. The results of the poll will be of immense value to the Council, the Congress, and others in the development of educational policy to meet the needs of children with disabilities.

Personal Assistance: Attendant Services, Readers, and Interpreters

The Council established a task force for the development of a legislative package for a comprehensive national personal assistance program and consulted with leaders in the field and numerous organizations around the country. A legislative workplan is currently being developed which recommends amendments to legislation, and includes proposals to fill service gaps in developing coordination of personal assistance services.

Coordination

The Council participated in efforts that have fostered coordination of services for people with disabilities on the Federal, State, and local levels. Examples of these efforts include participation in an ad hoe group on the prevention of disabilities, observation of the regulatory negotiation process for the Air Carrier Access Act of 1986, cosponsorship of a conference on transition with the Office of Special Education and Rehabilitative Services, and recommendations in testimony for the Education of the Handicapped Act Amendments of 1986. The Council is also exploring the work of the Advisory Council on Intergovernmental Relations to identify data being gathered regarding coordination efforts at the State and local levels.

In response to Toward Independence, President Ronald Reagan proclaimed:

I agree with the goals implicit in Toward Independence- equal opportunity and full social participation for all Americans, and I am pleased to see that your report sets forth a comprehensive agenda for progress toward these goals .... [However]The road toward full independence will not be easy.

(Reagan letter, Jan., 1986)

Toward Independence assessed the status of persons with disabilities in America and the Federal laws and programs that affect them. The report presented forty-five legislative remedies to identified problems, all geared toward increasing the dignity and independence of Americans with disabilities. Each recommendation can be viewed as a means of achieving a greater degree of independence; viewed together, the implementation of all forty-five recommendations can bring about an America in which disabled citizens are given the opportunity to be fully participating members.

Since the publication of Toward Independence in 1986, many doors, previously closed to persons with disabilities, have been opened. Some doors to opportunities have been fully opened, some have been opened halfway, some have been only cracked slightly, and still others remain tightly shut. This report describes accomplishments that have been achieved in response to the recommendations in Toward Independence, and the degree to which the recommendations have been implemented.

When the accomplishments of the past two years are examined in their entirety, the overall effect can be viewed as having placed persons with disabilities on the threshold of independence. For the areas in which the proposals in Toward Independence have been implemented and the doors to opportunity have been opened, the task remaining is to keep the doors open and for people with disabilities to accept the challenge of going through the doorways. For those areas in which the doors to independence are ajar, the Council hopes for further efforts to keep opening up opportunities for independence, dignity, and self sufficiency. For areas in which no progress has been made and the doors to opportunity remain shut, the Council plans to redouble its efforts, and looks to the Congress, the Administration, people with disabilities and their families, services providers, and others, to join with the Council to continue to push and knock until the doors are opened.

While President Reagan has aptly warned that -[t]he road to full independence will not be easy," some significant progress has occurred in the two years since Toward Independence was published. The Council has identified some twenty-one statutory provisions consistent with its legislative recommendations in Toward Independence that have een enacted into law (see Table 1). In addition, it is aware of eight bills that have been introduced in Congress, but not yet enacted, that would further proposals included in Toward Independence. The Council does not seek to claim for itself the credit for such laws and proposed legislation. The development of bills and the process of getting them through Congress and signed by the President is a highly collaborative process involving the skills and commitment of many individuals and organizations.

In some instances, the Toward Independence recommendations have been the driving force behind particular legislative proposals, and the Council has played a major role in the process of developing concrete statutory approaches. In other cases, the Council was but one of many voices in favor of a particular proposal that led to legislative action. In either event, the Council gratefully acknowledges that the recommendations issued in Toward Independence were the result of the ideas, comments, and advice of numerous persons with disabilities, their families, public officials, other professionals and experts, consumer and service organizations, and other interested individuals from all over the country.

The legislative recommendations contained in Toward Independence focused on ten major topic areas. Within each of these ten areas, some progress has been made since the publication of that report. There have been major statutory advances in many of the topic areas, bills are pending in others, and at least some positive administrative or related activities have occurred in the remainder. Of the forty-five specific legislative recommendations in Toward Independence, 75 percent, or thirty-four of the forty-five recommendations, have been partially accomplished, and three have been fully accomplished (see Table 2).

The Council is pleased at the many ways in which the Legislative and Executive Branches of Government have responded positively to its recommendations. Yet, the significant progress that has been made does not obscure the fact that many of the major recommendations have not yet been addressed or addressed only partially- many of the major doors of opportunity remain firmly shut to persons with disabilities. This report represents a recognition and affirmation of the progress since Toward Independence, but it also provides an assessment of how much has not been accomplished. The Council seeks to rededicate its own efforts, and to join with the President, the Congress, and persons with disabilities and their families, to achieve the objectives of Toward Independence. Only then will persons with disabilities in the United States escape from situations of dependency and dehumanization and cross the threshold of independence.

Background

On January 29, 1986, the National Council on the Handicapped released its comprehensive blueprint for disability policy in America. Toward Independence was developed in response to a 1984 congressional mandate for the Council to:

assess the extent to which Federal programs serving people with disabilities provide incentives or disincentives to the establishment of community based services for handicapped individuals, promote the full integration of such individuals in the community, in schools, and in the workplace, and contribute to the independence and dignity of such individuals. (Section 401 of the Rehabilitation Act of 1973, as amended)

In that report, the Council presented its findings, conclusions, and legislative recommendations based upon its review and assessment of Federal laws and programs, as well as input from hundreds of persons with disabilities.

• Relevant information and data were collected by:
  
  
• examining current legislation and programs;
  
  
• collecting and analyzing information about exemplary programs;
  
  
• reviewing existing analyses of Federal programs and disability issues;
  
  
• consulting with experts;
  
  
• conducting special seminars and hearings: and
  
  
• conducting forums with persons with disabilities and their families throughout the United States.

As a result, Toward Independence listed major Federal programs serving individuals with disabilities and ranked them according to expenditures, with an estimated number of persons with disabilities served. From its analysis, the Council drew three primary conclusions:

1. Approximately two-thirds of working-age persons with disabilities do not receive Social Security or other public assistance income.
   
   
2. Federal disability programs reflect an overemphasis on income support and an underemphasis on initiatives for equal opportunity, independence, prevention, and self-sufficiency.
   
   
3. More emphasis should be given to Federal programs encouraging and assisting private sector efforts to promote opportunities and independence for individuals with disabilities.

The Council also analyzed Federal spending on disability. "Our nation's current annual Federal expenditure on disability benefits and programs exceeds $60 billion" (p. 2). Further examination of that estimate revealed that the combined spending for Fiscal Year 1986 for the education of handicapped children and vocational rehabilitation totaled less than $3 billion, or less than five percent of the total dollars spent on disability. This startling underemphasis of spending on programs and services oriented toward the goals of independence and self-reliance caused the Council to target its legislative recommendations on more fiscally responsible approaches which emphasize productivity and self-determination.

The forty-five legislative recommendations in Toward Independence focused on ten major topic areas of particular importance to persons with disabilities. These ten topics were discussed extensively in a 600page Appendix to the report. In order to review the major recommendations from the topic areas, a brief synopsis follows.

Recommendations from Toward Independence

Based on testimony and comments from hundreds of people with disabilities, parents, and others, the most pervasive and recurrent problem faced by disabled persons appeared to be unfair and unnecessary discrimination.

...[W]hatever the limitations associated with particular disabilities, people with disabilities have been saying for years that their major obstacles are not inherent in their disabilities, but arise from barriers that have been imposed externally and unnecessarily. (p. 1)

Equal Opportunity Law

The Council recommended the enactment of a comprehensive law requiring equal opportunity for individuals with disabilities, with broad coverage and setting clear, consistent, and enforceable standards prohibiting discrimination on the basis of handicap.

Employment

To increase employment among people with disabilities- a drastically unemployed and underemployed segment of the population- the Council recommended several legislative changes, concerning the transition from school to work, supported employment, private sector initiatives, job training, job development, and placement.

Disincentives to Work Under Social Security Laws

The Council outlined several ways in which provisions of existing Social Security laws- Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medicaid, and Medicare- serve to discourage and penalize people with disabilities if they seek to become employed and self supporting. In response to these work disincentives, the Council recommended corrective amendments to the problematic provisions.

Prevention of Disabilities

To promote the prevention of disabilities and to assure that individuals having disabilities do not experience unnecessary secondary disabilities, the Council recommended that the Federal Government mount a national program for the prevention of disabilities.

Transportation

The Council recommended amendments to transportation legislation to achieve the Nation's established policy that "disabled people have the same right to use public transportation as nondisabled persons." Proposals related to urban mass transit, air transportation, intercity and interstate buses, private vehicles, and research.

Housing

To permit people with disabilities an opportunity to obtain appropriate housing, which is an important prerequisite to obtaining employment, living independently, and avoiding costly institutionalization, the Council made several recommendations designed to prohibit housing discrimination and to promote increased appropriate and accessible housing for persons with disabilities.

Community-Based Services for Independent Living

To achieve productivity and independence, people with disabilities require a range of support services according to the nature and degree of their disabilities. The Council proposed a variety of measures, including amendments and funding support under Parts A and B of Title VII of the Rehabilitation Act, to promote the availability of community based services for independent living.

Educating Children with Disabilities

The Council made legislative recommendations regarding educational opportunities for children with disabilities. These recommendations responded to: the need for special education and related services during infancy; the need to educate children with special needs in regular

education facilities: and the need to assess progress made since the enactment of the Education for All Handicapped Children Act.

Personal Assistance: Attendant Services, Readers, and Interpreters

Because of the critical importance of such services in fostering independence and avoiding expensive institutionalization, the Council recommended a national commitment to developing a quality system of attendant services, readers, and interpreters.

Coordination

The Council recommended that all Federal and federally supported disability-related programs be authorized and required to develop a joint plan for the systematic coordination of services and benefits.

Dissemination and Response to Toward Independence

Reactions to Toward Independence were overwhelmingly positive. Some of the highest accolades were expressed in a letter from President Reagan (a replica of the letter appears on page 5). In addition to sending copies to the White House and to all members of the Senate and House of Representatives, the Council released Toward Independence at two Washington press conferences.

Media Coverage

One of the factors that increased the visibility of Toward Independence was the simultaneous release of an unprecedented nationwide Harris poll that examined the perceptions of persons with disabilities (for details on the poll, see: -Recent Data and '&ends"). Toward Independence and the Harris poll were covered on the front page of USA Today, as well as in articles in many local papers across the country. Television coverage included interviews with Chairperson Sandra Swift Parrino on "Today in New York City" and "Live at Five" on station WPLG in Miami, Florida. And radio broadcasts were generated from as far away as Seattle, Washington, St. Louis, Missouri, and Miami, Florida. Based on a request from the Voice of America, the Council and Toward Independence were featured on a radio program broadcast in the Peoples Republic of China.

The disability community also openly embraced Toward Independence. Publications such as the Disability Rag and various newsletters ran articles emphasizing the comprehensiveness and depth of the report's recommendations.

THE WHITE HOUSE
WASHINGTON
January 29, 1986

Dear Mrs. Parrino:

Thank you for Toward Independence, the special report of the National Council on the Handicapped.

I congratulate the members and staff of the Council on the completion of this report, and I commend the many individuals from all of the fifty states who donated their time, their talents, and their economic resources to produce this special testament to the spirit of independence. Their contributions demonstrate the vitality of our democratic process and the commitment of the American people to the principles of independence and opportunity for all.

I agree with the goals implicit in Toward Independence -equal opportunity and full social participation for all Americans, and I am pleased to see that your report sets forth a comprehensive agenda for progress toward these goals. My Administration will study your report and cooperate with the Council, with the Congress, and with disabled Americans and their supporters to refine and develop these proposals.

The road toward full independence will not be easy. It will require the efforts of individuals, families, and communities as well as partnership between the private sector and all levels of government. You can be assured of my complete cooperation as we work together to make the American dream a reality for all our people.

Sincerely,

[Signature: Ronald Reagan]

The Honorable Sandra S. Parrino
Chairperson
National Council on the Handicapped
123 Marlborough Road
Briarcliff Manor, New York 10510

Visibility on Capitol Hill

Opportunity for close scrutiny came when the National Council on the Handicapped appeared before the House and Senate Committees on Appropriations to review the Council's Fiscal Year 1987 Budget request. Both Committees queried Council Chairperson Sandra Swift Parrino and Executive Director Lex Frieden about the report's recommendations and plans for implementation.

Senator Lowell Weicker opened the Council's 1986 appropriation hearing by congratulating the Council for its accomplishments and remarking about the uniqueness of the Council: "I think really, so many of these national councils are a lot of show and don't do anything. I think you are terribly blessed .... You have a great outfit here." Later in the hearing Senator Weicker added:

...I want to thank you for everything that you are doing: for the report Toward Independence. I think it is a magnificent piece of work, the Harris poll, with the professionalism that you are bringing with the Council to where the Council's voice is listened to by everybody, and for the courage in cutting across all partisan and philosophical bounds in order to achieve the result of those you serve, which is what it is all about. (p. 805)

Senator Weicker asked Chairperson Parrino to summarize Toward Independence and describe how the Council planned to follow up and monitor each of the forty-five recommendations. Mrs. Parrino detailed the Council's workplan and implementation strategies.

On the House side, Congressmen William Natcher, Silvio Conte, and Carl Pursell further explored the recommendations of Toward Independence. In responding to a question from Congressman Pursell, Executive Director Frieden commented on the major themes of the report:

There are two principal themes that run through this report. One of those deals with equal opportunity .... The second predominant theme relates to independence for people with disabilities. We believe community-based programs that facilitate independence for people with disabilities are the most cost-effective means of providing disabled people the opportunity to make choices about their own lives. (p. 443)

In addition to being a topic for discussion during the Council's appropriations hearings, a number of legislators integrated recommendations from Toward Independence into their own speeches and comments on disability-related legislation. For example, in his remarks on the Employment Opportunities for Disabled Americans Act, Congressman Steve Bartlett used Toward Independence to underscore the importance of employment opportunities for persons with disabilities.

Toward Independence Featured at Conferences

In the course of the two years since the publication of Toward Independence, the report has been used repeatedly as the centerpiece for conferences, meetings, and forums. Organizations such as the Paralyzed Veterans of America, the National Easter Seal Society, and the National Council for Independent Living have all employed the report as a tool from which to generate discussion about disability policy.

Follow-up Report Mandated by Congress

Subsequent to the report, Congress reauthorized the Rehabilitation Act of 1973 in the Rehabilitation Act Amendments of 1986. In the Amendments, Congress required the Council to report on progress that had been made on the recommendations in Toward Independence.

Section 502 of the Rehabilitation Act Amendments of 1986 states:

(b)(1) Not later than January 30, 1988, and annually thereafter, the National Council on the Handicapped shall issue a report to the President and Congress on the progress that has been made in implementing the recommendations contained in the Council's January 30, 1986, report Toward Independence.

(2) The reports issued pursuant to paragraph (1) shall present, as appropriate, available data on health, housing, employment, insurance, transportation, recreation, and education, and shall include appropriate information on the current status and trends in the status of individuals with disabilities.

Thus, the intent of this followup report is to chronicle progress made on each of the forty-five legislative recommendations proposed in Toward Independence. For the purpose of this report, progress includes the convening of important meetings and conferences, the initiation of correspondence, and the development of legislation and regulations. Progress was realized not solely by the Council, but also by disability organizations, service providers, government agencies, individuals, and others. The period covered by this report is February 1, 1986, through November 18, 1987.

Accurate statistical data in the area of disability are imperative for policy-makers and others. As reported in Toward Independence, existing studies have been fraught with problems. Since the publication of Toward Independence, however, a number of significant studies have been conducted.

The Census Bureau issued an important study of functional limitations in December 1986. Entitled "Disability, Functional Limitation, and Health Insurance Coverage: 1984/85," the report presents data drawn from the Bureau's Survey of Income and Program Participation, conducted in May through August of 1984.

In the report, researchers found that one out of five non-institutionalized residents aged 15 and over- some 37.3 million persons- has difficulty performing one or more basic physical activities. The activities included seeing, hearing, speaking, walking, using stairs, lifting or carrying, getting around outside, getting around inside, and getting into or out of bed. Some 13.5 million persons said that they not only had difficulty, but could not perform the activity specified or could not do it without help.

Among the findings of the study:

• Some 12.8 million people, or 7.1 percent of the population studied, had trouble seeing words and letters in ordinary newsprint, even with glasses or contact lenses. Approximately 1.7 million could not see words and letters at all.
  
  
• About 7.7 million people had trouble hearing a normal conversation, and 500,000 were unable to hear such a conversation.
  
  
• Some 2.5 million people had a problem having their speech understood by others.
  
  
• About 19.2 million people had difficulty walking a quarter of a mile, including 8 million who reported that they were unable to walk that far.
  
  
• Some 18.1 million people had trouble walking up a flight of stairs without resting, and 5.2 million could not do so on their own.
  
  
• About 18.2 million persons had trouble lifting or carrying something as heavy as a full bag of groceries, and 17.8 million of them could not do so.
  
  
• Some 6 million individuals had trouble getting around outside the home, and 3.6 million of them could not do so on their own.
  
  
• Approximately 2.5 million people had trouble getting around inside the home, and 1.2 million were unable to do so without help.
  
  
• Some 2.1 million people had difficulty getting into or out of bed, and 1.2 million of them could not do so on their own.
  
  
• Of those who had trouble performing at least one function, 21.8 million were under age 65 and 15.5 million were 65 and over. The totals for those completely unable to perform an activity or who needed help were 6 million under age 65 and 7.5 million 65 and over.

One of the data sources employed in the development of Toward Independence was the Digest of Data on Persons with Disabilities, prepared by Mathematica Policy Research, Inc. under contract to the Congressional Research Service of the Library of Congress. The information in the Digest has been supplemented by two reports prepared by the Human Services Research Institute and issued by the National Institute on Disability and Rehabilitation Research. The Summary of Data on Handicapped Children and Youth (1985) compiles data from various sources regarding the incidence and prevalence of disability in children.

Among the statistical highlights contained in the report are estimates that 4.2 percent of all children under age twenty-one have a chronic activity limitation, and that about one-fourth of 1 percent of children under age seventeen need help in activities such as walking, going outside, dressing, eating and using the toilet. The Compilation of Statistical Sources on Adult Disability (1986) provides a bibliography containing profiles of major national data files. It is designed to serve as a reference for researchers, administrators, and practitioners looking for statistical information on adult impairments. The Compilation describes thirty data files, some of which contain two or more related surveys.

Several publications have made projections regarding the population with disabilities. These include two publications of the Menninger Foundation, A Population Model of Working Age Disabled Individuals (1985) and The Relationship Between Age and Physical Disability Among Workers: Implications for the Future (1986), and a book chapter by H.R. Vachon, III, entitled "Inventing a Future for Individuals with Work Disabilities" (1986). All three sources provide estimates of the size and characteristics of the population with disabilities through the year 2000 and beyond. Among a variety of other observations and findings, these publications verify two major premises of Toward Independencethat disabilities correlate with aging, and that the proportion of the population with disabilities will increase significantly during the next several decades.

Harris Polls

Clearly, the two Harris poll studies initiated by the Council also made important and unique contributions to the disability community. The idea for the first Harris poll evolved during the initial phases of Toward Independence. Several Council members expressed frustration at the lack of adequate data regarding the status, needs, and opinions of Americans with disabilities. One Council member suggested a nationwide survey of persons with disabilities.

A short time later, working in conjunction with the Council, the International Center for the Disabled commissioned such a study from the well-known survey research firm of Louis Harris and Associates. The survey, entitled "Bringing Disabled Americans into the Mainstream," was the first major national survey to study the attitudes and experiences of people with disabilities. As the Harris agency correctly acknowledges:

Census Bureau and other government agencies have measured the incidence and prevalence of disability in the general population, and the number of disabled people in and out of the labor force ... But no substantial nationwide survey has sought to learn the impact of disability; what disabled people think about being disabled; and what they think must be done to enable them to participate fully in the life of the nation (p. i).

The Council decided that it needed to know the answers to such questions before it could address the needs of disabled persons and effectively set disability policy in America.

Sample

One unique aspect of the Harris poll was its use of a nationwide random sample. Harris researchers telephoned 12,500 households to obtain 1,000 respondents who met at least one of the definitional criteria (which will be discussed in the next section). The sample represented non-institutionalized disabled persons aged sixteen and over who lived in households with telephones. V%Then a disabled person was unavailable for an interview, or unable to be interviewed, a proxy was chosen as the respondent. About seventeen percent of the interviews were conducted with pro2des.

Issue of Definition

Toward Independence points out that the issue of defining disability is not simple. "Most existing studies of the disabled population employ one of two major approaches, each of which has its own shortcomings and limitations" (p. 3). The health conditions approach stresses conditions or limitations which impair health or interfere with normal functioning. This approach is best exemplified in surveys conducted by the National Center for Health Statistics. On the other hand, the work disability approach focuses on factors that prevent individuals from working or limit their ability to work. Data collected by the Social Security Administration exemplify this type of definitional approach.

Knowing the limitations of these approaches, Harris sought to solve the problem by using a third approach. For purposes of the Harris survey, a person was defined as being disabled if:

• He or she had a disability or health problem that prevented them from participating fully in work, school, or other activities.
  
  
• He or she said that he or she had a physical disability, a seeing, a hearing, or speech impairment, an emotional or mental disability, or a learning disability.
  
  
• He or she considered himself or herself disabled, or said that other people would consider him or her disabled. (p. iii)

In a Council report on the Federal Government implications of the Harris survey (to be published in 1988), strong support was given to the application of this approach:

The Harris ... approach should be considered as a starting point or conceptual model in the development by Federal agencies of more adequate instruments and studies... In particular, the Bureau of Census should consider the definitional approach in the Harris survey for reformulating questions on disability for the decennial Census...."

Numbers and Types of People with Disabilities

Another issue discussed in Toward Independence was the number of people with disabilities in the U.S. Various estimates place the number between twenty million and fifty million, with thirty-five or thirty-six million being the most commonly used figures. Based on the Harris data, it was estimated that the incidence of disability was 15 percent and that the number of Americans aged sixteen and over was between twenty-seven and twenty-eight million (p. 123). Although the Harris survey did not use people under age sixteen in the survey, it found the overall incidence for this group to be 1.5 percent or about three million. This figure is drastically lower than other estimates of the number of children with disabilities, and appears to reflect an undercount. According to the Harris figures, the disabled population is between thirty and thirty-one million. When the number of disabled persons in institutions is considered, along with those in households without telephones or in households in which Telecommunication Devices for the Deaf are used exclusively, and when the undercount of children with disabilities is considered, the figure of thirty-five or thirty-six million is roughly validated.

Another complex question to answer, and one that is somewhat dependent on which definitional approach is selected, relates to the types of disabilities. Toward Independence provided data with a variety of classifications and categories from such sources as the National Center for Health Statistics, the National Institute of Mental Health, and the Office of Special Education and Rehabilitative Services.

Harris data revealed that 44 percent of respondents stated that they had a physical disability, 13 percent had sensory impairments (visual, hearing, speech, and/or language), 6 percent had a mental disability (mental retardation or mental illness), -and 32 percent had other serious health impairments (heart disease, respiratory disease, etc.) Thirty-two percent of the Harris sample considered themselves multiply disabled, while the remainder did not. Finally, with regard to the severity of disability, 45 percent considered themselves to be slightly or moderately disabled and 52 percent considered themselves to be somewhat or very severely disabled.

Age

Based on Census data, Toward Independence confirmed what many have observed: the incidence of disability increases dramatically with age. Harris data showed that "58 percent of people with disabilities were 55 years of age or older, and 71 percent were 45 or older. In contrast, only 16 percent of disabled people were between the ages of 16 and 34. Twelve percent were in the 35-44 age range" (p. 15).

Income

Numerous studies have confirmed the correlation between disability and poverty. Toward Independence drew from 1980 Census figures on income levels of those with work disabilities. Some 20.1 percent of the persons reporting a work disability had family incomes below the poverty threshold. That figure was more than double the 1980 Census rate of 9.1 percent for the general population.

The Harris survey confirmed the great disparity between the incomes of those with disabilities and those in the general population. According to Harris, half of all disabled persons surveyed had incomes of $15,000 or less. Among non-disabled Americans, just over a quarter had incomes in that bracket.

Harris highlights the alarming rate of poverty among older disabled persons. "Fully one in three (32%) of disabled persons aged 65 and over report a household income of $7,500 or less. Six out of ten elderly disabled persons report a household income of $15,000 or less" (p. 23).

Poverty also correlates with severity of disability. Using the Harris definition of disability, both those who are the most severely disabled and those who stated that their activities are the most limited have the lowest family incomes.

Education

The Harris poll examined the education levels of persons with disabilities. "Forty percent of all disabled persons aged 16 and over did not finish high school. This proportion is nearly three times higher than in the non-disabled population, where only 15% of adults aged 18 and over have less than a high school education" (p. 23).

Future studies are needed to determine of the impact of the Education of All Handicapped Children Act, Public Law 94-142. As the Harris report comments: "These data provide no measure of the impact of the Education Act of 1975 [sic], since only a small minority of the sample were educated since its passage" (p. 88). Thus, at the urging of the Council, a third Harris poll surveying parents of children with disabilities, disabled children themselves, and educators, is being conducted and will be released in 1988 (see also "Educating Children with Disabilities").

Statistics from the first poll on college education, although not surprising, are also disconcerting. Only 29 percent of disabled persons have had some college or at least a four-year degree, compared with 48 percent of the non-disabled population.

Employment

Census figures on individuals with work disabilities used in Toward Independence revealed that only 32 percent of working age persons with disabilities had jobs at the time of the 1980 Census (p. 22). Data from the first Harris poll confirmed those figures. The chapter describing the employment status of disabled persons was entitled "Working or Not Working: The Great Divide." The H"s report remarks:

Not working is perhaps the truest definition of what it means to be disabled in this country. Two-thirds of all disabled Americans between age 16 and 64 are not working. Only one in four work full-time, and another 10% work part-time. No other demographic group under 65 of any size has such a small proportion working. (p. 47)

Even though the number of persons with disabilities not working is so large, one optimistic finding is that of the persons with disabilities who are not working, two-thirds say that they would like to work. As the Harris report declares, "This finding - that most non-working persons want to work- is one of the most important and challenging findings in the survey. The challenge is how society can effect policies and programs which will bring these people into the working mainstream" 50).

Barriers preventing the employment of persons with disabilities are significant. V%Then asked by Harris to comment on barriers respondents identified being limited by their own disabilities or their need for medical treatment and therapy. They also mentioned employers' attitudes, lack of appropriate jobs, insufficient education and training, lack of accessible transportation, and lack of necessary equipment or devices.

Based on data from the first Harris poll, and the conclusion that the employment picture needed more in-depth study, a second Harris poll was conducted which focused on employers' perceptions of disabled employees. Although this second study is discussed more fully in the Employment topic paper, a few relevant points are summarized here to supplement the overall status of employment of persons with disabilities.

Disabled employees received very high marks from employers. "Overwhelming majorities of managers give disabled employees a good or excellent rating on their overall job performance" (p. 7). The myth that the cost involved in hiring disabled people is high was dispelled by a 75 percent majority of managers who said that the average cost of hiring a disabled person is about the same as the cost of employing a non-disabled person (p. 9).

Managers appear to be aware of the discrimination faced by disabled employees. "A three-fourths majority of managers feel that disabled people often encounter discrimination from employers" (p. 12).

Although the study poi-trays disabled persons as being a strong, untapped resource, it also points out that the employment of disabled persons is not likely to increase because:

• Most managers think their company is already doing enough to employ disabled people and should not make greater efforts to do so.
  
  
• Most employers believe that the shortage of disabled job applicants with appropriate qualifications is a major barrier to their employing of more disabled people.
  
  
• Employers give the hiring of disabled people a lower priority than the hiring of people from minority groups and the elderly. And disabled people are the least likely to be viewed as an excellent source of employees. (p. 16)

Harris concludes that efforts to increase the employment of disabled people will require an increase in the number of qualified job applicants and employers giving the hiring of disabled persons a higher priority (p. 16).

Social Life and Leisure

The Harris survey provided important new data regarding the limited independence of people with disabilities in regard to social life and leisure experiences. Harris researchers included questions on social life and leisure patterns for which they had comparable data on the nondisabled population. They discovered a group of people who are extremely isolated and simply do not get out and pursue as many activities as non-disabled persons.

Over half of those surveyed said that their disability prevents them from getting around, attending cultural or sports events, or socializing with friends outside their home as much as they would like. The more severely disabled the individual, the more these statistics increase.

Almost 80 percent of very severely disabled persons do not get around in the ways mentioned.

Harris researchers found significantly lower participation rates among disabled persons for specific activities:

• Nearly two-thirds of all disabled Americans never went to a movie in the past year. In the full adult population, only 22% said that they had not gone to a movie in the past year.
  
  
• Three-fourths of all disabled persons did not see live theater or a live music performance in the past year. Among all adults, about 4 out of 10 had not done so.
  
  
• Two-thirds of all disabled persons never went to a sports event in the past year, compared to 50% of all adults.
  
  
• Disabled people are three times more likely than are non-disabled people to never eat in restaurants. Only 34 percent of disabled people eat at a restaurant once a week or more, compared to 58% majority of non-disabled people. (p. 3)

Traditional leisure pursuits are not the only activities limited for disabled persons. Those social activities associated with daily living and community life are also affected. For example, 13 percent of disabled persons never go to a grocery store, compared to 2 percent of the general public (p. 3). Only 36 percent of disabled persons participate actively in community, religious, volunteer or recreational groups, as compared to 60 percent of non-disabled persons.

Because of the isolated and nonparticipatory status of persons with disabilities in leisure activities, it is clear that this area is one that merits further investigation and policy development. The complex interactions between leisure and schooling, leisure and work, and leisure and health also need to be examined.

Emerging Political Constituency

Disabled voters have gained increasing attention from candidates. Most recently, efforts are being made to make polling places accessible to persons with disabilities. Of course, these efforts have even more importance in 1988, a Presidential election year.

The Harris researchers explored the degree to which persons with disabilities felt a common unity. An overwhelming majority, 75 percent, of Americans with disabilities reported that they felt some sense of common identity with other people with disabilities (p. 110). Furthermore, the Harris report notes, "the strength of identification varies little among disabled people of all ages, those who have been disabled all or only part of their lives, and among those who are moderately or severely disabled" (p. 110).

In analyzing this phenomenon, the Harris report remarks:

These results show clear signs of an emerging group consciousness. Many other findings in the survey indicate that most disabled person view their disability as their own problem. But these attitudinal data suggest that the common experience of not working and facing limitations in physical and social activities, affects how disabled persons relate to, and perceive, other disabled people. (p. 110)

In a Council report on the Federal policy implications of the Harris poll, further analysis is offered: "...[Persons with disabilities are an emerging political constituency whose views and objectives will become an increasingly important aspect of American politics and program administration" (p. 24).

Endorsement of Nondiscrimination Law

A central theme of Toward Independence was the enactment of a comprehensive law requiring equal opportunity for persons with disabilities. As an emerging political constituency, the views of people with disabilities regarding such a law are important. The Harris survey found strong support for legal protection against discrimination on the basis of disability:

When it comes to how disabled persons should be treated under the law, a near consensus emerges. Three out of every four (75%) disabled persons believe that civil rights laws that protect minorities against discrimination should also protect them. (p. 112)

it is also clear from the survey that disabled Americans strongly endorse efforts by the Federal Government to enhance the lives of persons with disabilities. "A two-thirds majority of disabled Americans think that federal laws passed since the late 1960's to give better opportunities to disabled Americans have helped a great deal or somewhat" (p. 1).

Disabled Americans are not alone in their belief that they should be protected from discrimination by law. All four manager groups in the second Harris poll on employment were asked if the civil rights laws that cover minorities against discrimination should also cover disabled persons. "Majorities of top managers, EEO managers, line managers, and small business managers think they should" (p. 25). Both Harris polls have demonstrated support for equal opportunity legislation that would protect people with disabilities from discrimination.

A major obstacle to achieving the societal goals of equal opportunity and full participation of individuals with disabilities is the problem of discrimination. Discrimination consists of the unnecessary and unfair deprivation of an opportunity because of some characteristic of a person. It is the antithesis of equal opportunity. The severity and pervasiveness of discrimination against people with disabilities is well-documented. (Appendix to Toward Independence, p. A-3)

Existing nondiscrimination laws, such as Section 504 of the Rehabilitation Act of 1973, are extremely important and have engendered much progress. In an overall context, however, our Nation's laws provide inadequate protection from discrimination for people with disabilities. Current statutes are not comparable in their scope of protection against discrimination to those afforded racial, ethnic, and religious minorities and women under civil rights laws.

The National Council on the Handicapped believes that equality of opportunity is a bedrock right in our society, and that discrimination against people because of their disabilities is an unacceptable denial of that right. Such discrimination is not only an affront to the dignity of the individual involved, but it undermines Federal programs that attempt to promote the independence and self-sufficiency of persons with disabilities. Discrimination is a significant reason why many people with disabilities are trapped in situations of dependency- dependency which costs our Nation dearly, both in lost potential productivity and in dollars spent for support programs.

President Reagan has declared:

Our Nation's commitment to equal protection of the laws will have little meaning if we deny such protection to those who have not been blessed with the same physical or mental gifts we too often take for granted. I support Federal laws prohibiting discrimination against the handicapped, and remain determined that such laws be vigorously enforced.

(President Reagan, 1982)

To address the problem of discrimination against persons with disabilities, the Council has advocated comprehensive equal opportunity protection for persons with disabilities. In the Toward Independence topic paper on "Equal Opportunity Laws," the Council examined the current status of disability-related nondiscrimination laws and identified large gaps in coverage, shortcomings and inconsistencies in interpretation and application, and deficiencies in enforcement. To correct these problems, the Council recommended a series of legislative improvements. Chief among these is the enactment of a comprehensive equal opportunity statute providing clear standards of nondiscrimination, with broad coverage paralleling laws prohibiting discrimination on the basis of race, sex, religion, and national origin.

There have been some significant, albeit limited, legislative advances achieving some of the Council's equal opportunity proposals. But the major efforts, especially regarding the enactment of a comprehensive equal opportunity statute, have only recently begun to gain momentum.

Recommendations from Toward Independence

In Toward Independence, the Council made ten legislative recommendations regarding equal opportunity laws for persons with disabilities. Five of these recommendations were directly concerned with the enactment of a comprehensive law prohibiting discrimination against persons with disabilities. The Council has tentatively entitled this draft legislative proposal "The Americans with Disabilities Act of 1988." The other five recommendations called for additional legislative enactments and amendments to increase legal guarantees of equal opportunity for persons with disabilities.

Comprehensive Equal Opportunity Statute

1. Congress should enact a comprehensive law requiring equal opportunity for Individuals with disabilities, with broad coverage and setting clear, consistent, and enforceable standards prohibiting discrimination on the basis of handicap.

Accomplishments

The foregoing is the first legislative recommendation in Toward Independence. Its primacy in the proposals presented to Congress and the President reflects the Council's view that protection from discrimination is a baseline necessity, and one that is not being adequately addressed in the existing statutes and legal precedents. In forums with citizens with disabilities across the Nation, the Council has heard over and over that discrimination is the number one problem faced by individuals with disabilities.

"Bringing Disabled Americans into the Mainstream," a nationwide poll conducted in 1986 by Louis Harris and Associates, underscores the conclusion that discrimination is a problem that people with disabilities frequently experience. Respondents identified a variety of types of discrimination they had experienced, including workplace discrimination, denials of life and health insurance, denials of educational opportunities, lack of access to public buildings and public bathrooms, the absence of accessible transportation, and various forms of social rejection (others shying away or feeling sorry for them). One-fourth of those interviewed said that they personally had encountered job discrimination because of their disabilities. Forty-seven percent of those individuals who were not employed or employed less than full-time listed as an important reason why they were not working that employers would not recognize that they were capable of doing a full-time job. In a subsequent Harris poll of employers (1987), three-fourths of managers of businesses reported that people with disabilities "often encounter job discrimination from employers."

The first Harris poll found great support among individuals with disabilities for legal protection against discrimination on the basis of disability. Its survey report declared:

When it comes to how disabled persons should be treated under the law, a near consensus emerges. Three out of every four (75%) disabled persons believe that civil rights laws that protect minorities against discrimination should also protect them. Only 17% disagree. (p 112)

Such strong support for legal protection from discrimination corroborates the Council's priority for the enactment of a comprehensive equal opportunity law.

While the first recommendation in Toward Independence is a call for Congress to enact a comprehensive statute guaranteeing equal opportunities for persons with disabilities, the second through the fifth recommendations give more detail as to the content of such a law. The second recommendation describes the broad scope of statutory coverage that the proposed law should encompass. The third recommendation proposes that the law should include a definition of discrimination and standards for applying it. Recommendation number four discusses enforcement mechanisms and regulations that should be issued under the proposed law. The fifth recommendation deals with guidelines for accessibility, and the role of the Architectural and Transportation Barriers Compliance Board under the comprehensive statute. All of these recommendations would be satisfied by the enactment of a single piece of legislation- the comprehensive equal opportunity law with the features proposed by the Council.

There have been some narrow, but significant, legislative advances in the direction of the Council's equal opportunity initiative. In Toward Independence, the Council noted that the Supreme Court's decision in Atascadero State Hospital v. Scanlon (473 U.S. 234 (1985)) recognized States' immunity from suits in the Federal courts to enforce nondiscrimination requirements. This situation was corrected with the enactment of the Rehabilitation Act Amendments of 1986 (Public Law 99-506). Section 1003 of that Act provides that States may not invoke immunity under the Eleventh Amendment if they are charged with discrimination on the basis of handicap in violation of Section 504 of the Rehabilitation Act.

The Council also recommended the correction of certain problems with the provisions regarding terms of office of members of the Architectural and Transportation Barriers Compliance Board under section 502 of the Rehabilitation Act of 1973 (Toward Independence, p. 21, and Appendix, p. A-31). The wording of the statute regarding the appointment of succeeding members to the Board and the commencement of the successors' appointments had led to unfilled vacancies on the Board. The Council proposed that the terms of office provisions of Section 502 follow the approach taken in most other governmental boards and stipulate that members are to serve until their successors have been appointed and are ready to serve. This correction was made with the enactment of Section 60 1 (a) (3) of the Rehabilitation Act Amendments of 1986 (Public Law 99-506), which amended Section 502 to change the language in accordance with the Council's recommendation. The application of nondiscrimination requirements to airlines has been clarified by the Air Carrier Access Act of 1986 (Public Law 99435), which prohibits discrimination on the basis of handicap by all air carriers. (The Air Carrier Access Act is discussed more extensively in this report in the section dealing with Transportation.)

The Council has also noted the restrictions upon coverage of existing nondiscrimination statutes protecting people with disabilities resulting from the -program or activity" limitation (See, Toward Independence, Appendix, pp. A-8 and A-9). Pursuant to decisions of the United States Supreme Court in Grove City College v. Bell (465 U.S. 555 (1984)) and Consolidated Rail Corporation v. Darrone (465 U.S. 624 (1984)), the prohibition of discrimination under such statutes as Section 504 of the Rehabilitation Act of 1973 is limited to the specific programs or activities that are funded by Federal grant money. Under these decisions recipients of Federal financial assistance are permitted to discriminate in their other, non-federally-funded programs and activities.

A bill entitled "The Civil Rights Restoration Act of 1987" (S. 557) was introduced in the 100th Congress to remove the limitations resulting from the Grove City and Darrone decisions. In April of 1987, the Council was asked to testify before the Senate Committee on Labor and Human Resources in hearings regarding S. 557. In its testimony, the Council reaffirmed its belief in comprehensive equal opportunity protection for people with disabilities and stated its view that "an absolutely necessary first step is to return the scope of coverage of Section 504 and the other civil rights laws to their status before the Supreme Court's ruling in the Grove City case." The proposed Restoration Act has been approved by the Committee on Labor and Human Resources and is currently awaiting action on the Senate floor.

Although the statutes and pending legislation just discussed represent significant initiatives to expand or clarify nondiscrimination protection for persons with disabilities, they address only a few relatively narrow issues. The Council's primary recommendation in this area - enactment of a clear and comprehensive statute guaranteeing equal opportunities for people with disabilities- is now beginning to be the focus of legislative attention and support.

Just as the recommendations in Toward Independence were a crystallization of views expressed to the Council by numerous individuals with disabilities at the grass roots level as well as by experts and organizational representatives, the Council sought additional input and feedback in regard to the actual drafting of a comprehensive equal opportunity statute. Over the past eighteen months, the Council has engaged in numerous meetings and discussions with members of Congress, congressional staff members, officers of national organizations, grassroots consumers, and other interested parties to explore the content and wording of the statutory proposal. Based on the approach outlined in the equal opportunity recommendations in Toward Independence, augmented by the comments and advice received, the Council developed a draft of a comprehensive equal opportunity proposal entitled "The Americans with Disabilities Act of 1988."

The drafting of legislation is a developmental process that reflects negotiation, compromise, and continuous revision; the Council recognizes that the draft proposal presented on the succeeding pages is not the final version. The Council believes, however, that the draft presented herein represents a significant step toward the introduction and eventual passage of such a statute. The Council is confident that the "Americans with Disabilities Act" is representative of the need for expanded nondiscrimination protection it has heard repeatedly voiced by persons with disabilities, and is convinced that the enactment of such a statute is one key to increased independence and quality of life for persons with disabilities.

Consumer Leverage of U.S. Government

2. The law should direct the Federal Government to use its leverage as a consumer of goods and services to set standards and timelines for requiring that businesses and companies from which it purchases or rents goods, services, or facilities shall make such goods, services, and facilities accessible, available to, and usable by people with disabilities on a nondiscriminatory basis.

Accomplishments

The first five recommendations in Toward Independence concerned the enactment of the Americans with Disabilities Act and described the elements that such a law should contain. The remaining five legislative recommendations in regard to equal opportunity laws involve specific concerns that can be addressed by separate pieces of legislation or amendments.

The first of these, set out above, involves a legal mandate to require U.S. Government agencies to use their 'consumer clout" as purchasers and lessors of numerous types of services, merchandise, and facilities in order to persuade businesses they deal with to make their products and services accessible to persons with disabilities. As proposed by the Council in Toward Independence, this initiative pertains to a wide array of goods and services obtained by the Government from private companies, including conference and meeting room rentals, airline and train tickets, rental cars, hotel rooms, and office equipment.

Congress has not yet enacted legislative directives requiring the Federal Government to limit its purchases and rentals to equal access companies on an across-the-board basis.

To date, the Federal Government's purchasing power has been invoked to apply pressure for accessibility in a single but increasingly important area- electronic equipment. In February of 1986, as Congress was considering the amendments to the Rehabilitation Act of 1973 that would culminate in the Rehabilitation Act Amendments of 1986 (Public Law 99-506), the Council recommended the addition of a new section to the Act to require that all office automation equipment obtained by the Federal Government be accessible to and usable by persons with disabilities. In response to this proposal, Congress included Section 603 in the Rehabilitation Act Amendments of 1986. This provision adds a new Section 508, entitled "Electronic Equipment Accessibility," to the Rehabilitation Act of 1973. It requires the National Institute on Disability and Rehabilitation Research and the General Services Administration in consultation with the electronics industry to establish "guidelines for electronic equipment accessibility designed to insure that handicapped individuals may use electronic office equipment with or without special peripherals." After September 30, 1988, such guidelines are to be adopted by the Administrator of General Services, and complied with by Government agencies in their purchases or leases of electronic office equipment. Section 508 represents a narrow but quite significant implementation of the Council's recommendation that Government procurements of services, goods, and facilities make accessibility to persons with disabilities a condition precedent.

Discrimination in Medical Services

3. The law should apply to discrimination in medical services.

Accomplishments

This recommendation was primarily in response to the decision of the United States Court of Appeals for the Second Circuit in United States v. University Hosp., State U. of New York (729 F.2d 144 (2d Cir. 1984)), in which the court ruled that Section 504 of the Rehabilitation Act of 1973 does not apply to medical treatment. Subsequent to the publication of Toward Independence, the United States Supreme Court had occasion to review the rationale of the University Hospital decision in a separate case, Bowen v. American Hospital Association (1 06 S. Ct. 2 1 01 (1986)). The regulations regarding treatment of handicapped infants, at issue in both cases, were ultimately struck down by the Supreme Court, but not because Section 504 does not apply to medical services. On the contrary, the Court expressly ruled that "handicapped infants are entitled to 'meaningful access' to medical services provided by hospitals, and that a hospital rule or State policy denying or limiting such access would be subject to challenge under Section 504" (106 S. Ct. at p. 2111 (1986)). The Section 504 regulations regarding medical treatment of handicapped infants were invalidated because the Secretary of Health and Human Services was ruled to have overstepped the extent of his authority to address discrimination under Section 504 by providing overly intrusive procedures and failing to provide adequate documentation of the problem being addressed and of the necessity for the procedures initiated.

Currently, instances of alleged denials of medical treatment to infants with disabilities are much more likely to be dealt with under the Child Abuse Amendments of 1984 (Public Law 98-457) than under Section 504. These Amendments and the regulations issued to implement them (45 C.F.R. 1340.15) provide standards regarding the rendering of medical treatment to handicapped infants and establishing when the failure to provide treatment constitutes child abuse or neglect.

Because of the subsequent developments in legislation, regulations, and case law, the objectives underlying the Council's recommendation in regard to coverage of medical services have largely been achieved.

Bill of Rights for Persons with Disabilities

4. An enforceable Bill of Rights for Persons with Disabilities should be enacted.

Ac