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History of Federal Legislation Impacting Individuals
with Disabilities
1918—The Smith-Sear
Veterans Vocational Rehabilitation Act establishes a federal vocational rehabilitation program for soldiers
with disabilities.
1920—The Fess-Smith
Civilian Vocational Rehabilitation Act creates a vocational rehabilitation program for civilians with
disabilities.
1935—Social Security Act creates a national insurance system for people who
are elderly; establishes a federal-state unemployment insurance program; grants
aid to states on a matching basis for dependent mothers and children, people
with disabilities, and people who are blind; and supports public health
services.
1950—Social Security Act
Amendments creates a public assistance
program for people who are “totally and permanently
disabled.” Each state determines
eligibility standards and assistance levels in accordance with the Act, which
provides for federal financial assistance.
1954—The Vocational
Rehabilitation Act is revised,
establishing a system of state vocational rehabilitation agencies.
1956—The Social Security
Amendments of 1956 creates the
Social Security Disability Insurance (SSDI) program for disabled workers aged
50 to 64.
1965—The Social Security
Act of 1965 establishes the Medicare
and Medicaid programs under Titles XVIII and Title XIX. The initial purpose of
Title XIX was to improve access to and the quality of medical care for all
low-income people and did not provide services solely based on disability. States were required to provide certain
services to individuals who were categorically needy; states could offer
optional services and choose to cover individuals who were medically needy.
1968—The Fair Housing Act
of 1968, Title VIII of the Civil Rights
Act of 1968, prohibits discrimination in the sale, rental and financing of
dwellings based on race, color, religion, sex or national origin. Title VIII
was amended in 1988 to include individuals with disabilities.
1970—The Developmental
Disabilities Services and Facilities Construction Amendments of 1970 gave states responsibility for planning and
implementing comprehensive services for people with severe disabilities,
calling for Developmental Disabilities Councils in each state to plan and
coordinate activities.
1972—The Social Security
Act of 1972 authorizes the
Supplemental Security Income (SSI) program, a consolidated,
federally administered cash benefits program for needy individuals and couples
who are aged, blind, or have a disability.
Children with disabilities under the age of 18, including children who
are blind, become eligible for benefits provided their disabilities are
comparable in severity to adult recipients.
1973—The Rehabilitation
Act is rewritten providing stronger
emphasis on people with severe disabilities.
The Act requires vocational rehabilitation agencies to develop an
“individualized written rehabilitation program” (IWRP) with each individual
receiving services. Section 504 of the
Act protects individuals with disabilities from discrimination in all federally
assisted programs and activities.
Sections 501 and 503 protect people with disabilities from employment
discrimination by federal agencies or federal contractors.
1974—The Housing and
Community Development Act of 1974
creates the Community Development Block Grant (CDBG) program, authorizing funds
for removal of architectural barriers and in constructing public
facilities. Urban areas are required to
prepare a Housing Assistance Plan that reflects the needs of individuals with
disabilities.
1975—The Education for
Handicapped Children Act mandates
that public schools provide students with disabilities a “free appropriate
public education” (FAPE) in the “least restrictive environment.” The Act requires educators to develop an
“individual education plan” (IEP) for each child receiving special education
services. Part B of the Act provides
federal financial assistance to states and local education agencies to meet the
mandates.
1975—The Developmental
Disabilities Assistance and Bill of Rights Act reauthorizes the Developmental Disabilities Services
and Facilities Construction Amendments of 1970 and provides formula grants to
state-based Developmental Disabilities Councils. The Act also authorizes the University
Affiliated Facilities and establishes state protection and advocacy systems to
protect the rights of individuals with developmental disabilities.
1981—The Omnibus Budget
Reconciliation Act authorizes
Medicaid to waive certain federal requirements so that states can provide
personal care and other home and community-based services to individuals who
would otherwise receive care in an institutional setting.
1982—The Tax Equity and
Fiscal Responsibility Act (TEFRA)
allows states to cover home care services under Medicaid for children with
disabilities, even when family income and resources exceeded that of the
state’s financial eligibility standards.
1984—The Rehabilitation
Act Amendments establishes the
Client Assistance Program (CAP), a formula grant program for states designed to
inform individuals with disabilities who are receiving rehabilitation services
how to access available benefits and ensure protection of individual rights
through legal, administrative or other remedies.
1986—The Education for
Handicapped Children Act is expanded
to include Part H, a formula grant program, to assist states in developing
early intervention services for infants and toddlers with disabilities.
1986—The Employment
Opportunities for Disabled Americans Act makes permanent the work incentives provision, Sections 1619 (a) and
1619 (b), of the Social Security Act, authorizing special SSI benefits and
continued Medicaid coverage for people with disabilities who are working, but
whose income exceeds “substantial gainful activity” levels. Medicaid coverage is extended to people with
disabilities who may lose SSI or Section 1619(a) benefits due to excess
earnings, but who are unable to afford health care coverage equal to coverage
under Medicaid.
1986—Protection and Advocacy
for Individuals with Mentally Illness (PAIMI), establishes a formula grant program for statewide
mental health advocacy services to be operated directly by or through contract
with the state protection and advocacy agency to protect and advocate for the
rights of people with mental illness and investigate incidents of abuse and
neglect.
1987—The Omnibus Budget
Reconciliation Act of 1987, known as
the Nursing Home Reform Act, requires states to conduct Pre-admission
Screening and Annual Resident Review (PASARR) of individuals with disabilities
(mental illness, mental retardation, developmental disabilities) prior to
admission to a nursing facility to determine if they actually need nursing
facility level of care, even if the individual is not Medicaid eligible. PASARR requires that individuals with
disabilities be provided specialized services while in a nursing facility. If nursing facility level of care is not
required but an individual requires specialized services, the state must
provide for or arrange for the specialized services in an appropriate setting.
1988—The Technology
Related Assistance for Individuals with Disabilities Act establishes grant programs to encourage the
development and distribution of assistive technology for people with
disabilities.
1988—Fair Housing
Amendments Act expands the Fair
Housing Act of 1968 to prohibit discrimination based on disability or on
familial status (presence of child under age of 18, and pregnant women);
establishes new administrative enforcement mechanisms; revises and expands
Justice Department jurisdiction to bring suit in Federal district courts. In connection with prohibitions on
discrimination against individuals with disabilities, the Act contains design
and construction accessibility provisions for certain new multifamily
dwellings.
1989—The Omnibus Budget
Reconciliation Act of 1989 (OBRA 89)
defines the Medicaid Early and Periodic Screening, Diagnostic and Treatment
(EPSDT) program, a comprehensive and preventative child health program for
individuals under the age of 21. OBRA requires that any medical necessary
health care service be provided to an EPSDT recipient even if the service is
not available under the State’s Medicaid plan for the rest of the Medicaid
population.
1990—The Americans with
Disabilities Act (ADA) affirms the
rights of citizens with disabilities and prohibiting discrimination in
employment, public services, public accommodations and services that are
operated by private entities, and telecommunications. It is wide-ranging
legislation intended to make American Society more accessible to people. While the employment provisions of the
1990—The Individuals with
Disabilities Education Act (IDEA)
reauthorizes The Education for Handicapped Children Act. The Act includes traumatic brain injury as a
disability and requires public schools to report the number of students with
TBI receiving special education and related services. IDEA also requires schools to prepare
students for transition to adulthood by incorporating a statement of needed
services into the student's individualized education program (IEP) no later
than age 16. Transition services are
defined as "a coordinated set of activities for a student, designed within
an outcome-oriented process, which promotes movement from school to post-school
activities." Post-school activities
include "post-secondary education, vocational training, integrated
employment (including supported employment), continuing and adult education,
adult services, independent living or community participation."
1992—The Rehabilitation Act
Amendments of 1992 make several
fundamental changes to the Rehabilitation Act of 1973 and the way in which
rehabilitation services are provided to Americans with disabilities through the
public vocational rehabilitation program.
Built on the foundation of the Americans with Disabilities Act, the
amendments recognize competence and choice and afford individuals with
disabilities access to the services and supports they need to live, work, and
meaningfully participate in community life.
In accordance with the law, services must be carried out in a manner
consistent with the principles of presumed ability, integration and inclusion,
full participation, meaningful and informed choice, and involvement of families
and natural supports. Title I contains a
presumption that individuals with disabilities, including those with severe
disabilities, are capable of engaging in gainful employment. Title VII
establishes standards and assurances for centers for independent living and
includes a statement of the independent living philosophy.
1993—Rehabilitation Act
Amendments of 1993 mandates Centers
for Independent Living to provide four “independent living core services” along
with any of the other optional independent living services specified in the
amendments. The four core services are:
information and referral, independent living skills training, peer support, and
individual and systems advocacy. The Act
also establishes the PAIR Program, Protection and Advocacy Services for
Individual Rights, to protect and advocate for legal and human rights of
persons with disabilities.
1994—The
Technology-Related Assistance for Individuals with Disabilities Act is expanded and includes funding to the
National Institute on Disability and Rehabilitation Research (NIDRR) for
protection & advocacy agencies for the Assistive Technology (PAAT) Program
is to assist individuals with disabilities and their family members, guardians,
advocates and authorized representatives in accessing technology devices and
assistive technology services through case management, legal representation and
self advocacy training.
1996—The Traumatic Brain
Injury Act authorizes funding to the
Health Resources and Services Administration for grants to states for the
purpose of carrying out demonstration projects to improve access to health and
other services regarding traumatic brain injury; to the Centers for Disease
Control and Prevention to carry out projects to reduce the incidence of TBI; to
the National Institutes of Health to conduct basic and applied research
regarding TBI; and to the National Center for Medical Rehabilitation Research,
within the National Institute for Child Health and Human Development, to
conduct a national consensus conference on managing traumatic brain injury and
related rehabilitation concerns.
1997—The Amendments to
IDEA shifts the focus from providing
children with disabilities access to an education to improving results for all
children in the education system. Prior
to 1997, the law did not include a regular education teacher as a required
member of the Individualized Education Program (IEP) team. The new law mandates that a regular education
teacher, to the extent appropriate, participate in the development, review and
revision of the IEP of the child. The
law also strengthens the role of parents in educational planning and decision
making on behalf of their children and that a statement of transition service
be prepared and included in the IEP by age 14.
1998—The Workforce Investment Act
of 1998 (Title III) amends the Wagner-Peyser
Act to require that Employment Service/Job Service activities become part of
the "One-Stop" system and establishes a national employment
statistics initiative. It establishes a
temporary "Twenty-First Century Workforce Commission" to study issues
relating to the information technology workforce in the
1999—The Ticket to Work
and Work Incentives Improvement Act
creates options for states and individuals with disabilities to get jobs and
keep their heath insurance. The goal is to also reduce individuals with
disabilities' dependence on cash benefits, such as SSI and SSDI. Specifically, the Act sought to provide health care, employment
preparation, placement services, Medicaid coverage and the option of maintaining
Medicare coverage while working, and "tickets to work," which provide
access to services needed to maintain employment. Title
II expands availability of health care services. States are given the option of providing Medicaid coverage
for people with disabilities who would qualify for SSI, if not for income, or
who are working and have a "medically determinable impairment”, or allow
individuals to "buy in" to Medicaid coverage.
2000—The TBI Act of 1996 is amended and reauthorized as Title XIII of the
Children's Health Act of 2000. The Act
authorizes funding to the Centers for Disease Control and Prevention (CDC) to expand
state surveillance and national education and prevention; to the National
Institutes of Health to carry out applied research related to cognitive
disorders and neurobehavioral consequences; and to the Health Resources and
Services Administration for state capacity building grants. The Amendments of 2000 also authorize funding
for state protection and advocacy services. The Act
changes the definition of TBI by replacing the phrase "anoxia due to near
drowning" with "anoxia due to trauma."
2001—The No Child Left
Behind Act of 2001 is the most
sweeping reform of the Elementary and Secondary Education Act (ESEA) since
enactment in 1965. The legislation
redefines the federal role in K-12 education and seeks to close the achievement
gap between disadvantaged and minority students and their peers. It is based on four basic principles:
stronger accountability for results, increased flexibility and local control,
expanded options for parents, and an emphasis on teaching methods that have
been proven to work.
Susan L.
Vaughn, Chairperson of NASHIA’s Public Policy
Committee prepared this document with research and editorial assistance of
Susan H. Connors, NASHIA’s Executive Director, May
2002.
National Association
of State Head Injury Administrators
301-320-4331
www.nashia.org