"… In respect of civil rights, all citizens are equal before the law.
The humblest is the peer of the most powerful."
– John Marshall Harlan, dissenting opinion, Plessy v. Ferguson (1896)
Litigation and Legislation
In 1974, President Richard Nixon issued Executive Order 11776 reaffirming the national goal of returning about one-third of the 200,000 people with mental retardation in public institutions to community residential placements. The Justice Department was directed to strengthen the full legal rights for people with mental retardation. Amendments to the Social Security Act authorized residential care in Intermediate Care Facilities and established the Supplemental Security Income program.
Amendments to the Rehabilitation Act required that people with severe disabilities be given priority for vocational rehabilitation services; Section 504 prohibited discrimination against people with disabilities in federally funded programs.
The Developmental Disabilities Assistance and Bill of Rights Act required states to plan for community alternatives to institutionalization.
The United States District Court for the District of Minnesota, in Welsh v. Likins, held that people with mental retardation have a constitutional right to treatment in the least restrictive environment.
Dr. Elizabeth Boggs of the National Association of Retarded Citizens and Dr. Elsie Helsel of the United Cerebral Palsy Association observed how the pace of funding and programming for people with disabilities had slackened in the late 1960s. They decided a new approach was needed that addressed disability and funding issues in a more comprehensive manner.
The 1970s began with the introduction of the Developmental Disabilities Services and Facilities Construction Amendments of 1970 (P. L. 91-517). These amendments gave states broad planning and implementation responsibilities to develop a program of services and offer local communities a voice in determining needs, priorities, and a delivery system. The Act authorized the creation of a Developmental Disabilities Council in each state to serve in a planning and advisory capacity, and create a forum for discussions among parents, people with disabilities, state agencies, and private service providers.
The term "developmental disability" was created to refer to "a disability attributable to mental retardation, cerebral palsy, epilepsy, or another neurological condition," and used for planning purposes and funding allocations.
In 1975, the Developmental Disabilities Assistance and Bill of Rights Act made significant changes to the 1970 legislation and the term developmental disability was broadened to include autism and dyslexia. The Act was revised again in 1978 and the term developmental disability was again redefined. The severity of an individual's functional impairments was emphasized and references to specific disability categories were eliminated.
In 1991, Amendments to the Act included children and developmental disability was defined as: "a severe, chronic disability of a person 5 years of age or older which:
- is attributable to a mental or physical impairment or combination of mental and physical impairments,
- is manifested before the person attains age twenty-two;
- is likely to continue indefinitely;
- results in substantial functional limitations in three or more of the following areas of major life activities:
- self-care,
- receptive and expressive language,
- learning,
- mobility,
- self-direction,
- capacity for independent living, and
- economic sufficiency; and
- reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services which are of lifelong or extended duration and are individually planned and coordinated; except that such term when applied to infants and young children means individuals from birth to age 5, inclusive, who have substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disabilities if services are not provided."
The passage of the Social Security Act in 1935 during Franklin D. Roosevelt's administration was very important because of its long range implications for people with disabilities and families. The Act created a national insurance system for people who are elderly; established a federal-state unemployment insurance program; granted aid to states on a matching basis for dependent mothers and children, people with disabilities, and people who are blind; and supported public health services.
Prior to 1970, Congress passed other legislation that reflected a growing recognition of disability issues, and efforts were begun to address and respond to some of these issues:
Year | Description |
---|---|
1950 | A public assistance program for people who are "totally and permanently disabled" was added to the Social Security Act. Each state determined eligibility standards and assistance levels according to standards set out in the Act. The program was state administered with financial assistance from the federal government. |
1954 | The National Vocational Rehabilitation Act of 1920, which established a system of state vocational rehabilitation agencies, underwent major revisions and became the Vocational Rehabilitation Act. |
1958 | Financial support was provided to colleges and universities under P. L. 85-926 for training personnel in leadership positions about teaching children with mental retardation. In 1963, this legislation was expanded to include grants for training higher education teachers and researchers in a broader array of disabilities. |
1963 | Title V of the Social Security Act was amended to establish a grant program to improve prenatal care for women from low income families because this group carries an extremely high risk of children with mental retardation and other birth defects. The Mental Retardation Facilities Construction Act authorized federal support for the construction of mental retardation research centers, university affiliated training facilities, and community facilities for children and adults with mental retardation. |
1965 | The Social Security Act of 1965 established the Medicare program under Title XVIII. Statutory authority for the Medicaid program is contained in Title XIX. The initial goal of the Medicaid program was to improve access to and the quality of medical care for all low income people; there were no provisions that related solely to individuals with disabilities. States were required to provide certain services to individuals who were categorically needy, and could offer optional services and choose to cover individuals who were medically needy. |
1965 | The Elementary and Secondary Education Act of 1965 authorized a multi-billion dollar financial aid program to help states and local school districts educate children who were considered "educationally deprived." Local districts were required to provide supplementary services to meet the needs of these children. The legislative history of the Act refers to children with disabilities as "educationally disadvantaged children." |
1967 | The Mental Retardation Amendments of 1967 expanded the 1963 Act by authorizing funds to help with the costs of starting services in community mental retardation facilities. The Bureau of Education for the Handicapped was established within the United States Department of Health, Education, and Welfare. Parents continued to advocate for legislative changes, particularly during the 1970s. Following are some legislative milestones in the history of the disabilities movement: |
1970 | The Developmental Disabilities Services and Facilities Construction Amendments of 1970 were passed. This legislation gave states broad responsibility for planning and implementing comprehensive services for people with severe disabilities, and authorized the creation of a Developmental Disabilities Council in each state to plan and coordinate activities. |
1971 | Amendments to Title XIX of the Social Security Act authorized Medicaid reimbursements for intermediate care facility (ICF) services. Services were defined as those services designed to meet the needs of individuals "…who do not require the degree of care and treatment which a hospital or skilled nursing facility is designed to provide, but who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities…." These amendments also authorized public institutions to be certified as intermediate care facilities under certain conditions, thus making services provided in a public institution mediate care facilities under certain conditions, thus making services provided in a public institution eligible for Medicaid reimbursement. |
1972 | The Social Security Act of 1972 authorized a consolidated, federally administered cash benefits program for needy individuals and couples who are aged, blind, or have a disability. This program, Supplemental Security Income (SSI), established a basic federal income support level for eligible individuals. Children with disabilities under the age of 18, including children who are blind, were eligible for benefits provided their disabilities were comparable in severity to adult recipients. |
1973 | The Rehabilitation Act was completely rewritten with stronger emphasis on providing rehabilitation services to people with severe disabilities. 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 established the Community Development Block Grant (CDBG) program. Block grants were a major source of federal aid to urban areas. Funds could be used for architectural barrier removal and the construction of accessible public facilities. Each urban area was required to prepare a Housing Assistance Plan that reflected the needs of people with disabilities within that area. |
1975 | The Education for All Handicapped Children Act mandated that educational systems provide "a free appropriate public education" in the "least restrictive setting" for all eligible children with disabilities. The Act required that an individualized education program (IEP) be developed, annual goals and short-term objectives identified, and specific special education and related services described. Part B of the Act was expanded to provide federal financial assistance to states and local education agencies so they could meet their obligations. Since 1986, the Act has included a formula grant program (Part H) to assist states to develop a statewide network of early intervention services for infants and toddlers with disabilities. Part C awards grants or cooperative agreements to strengthen and coordinate education, training, and related services for youth with disabilities to assist in the transition process to post-secondary education, vocational training, competitive employment, continuing education, independent and community living or adult services. In 1990, this legislation was retitled the Individuals with Disabilities Education Act (IDEA). |
1975 | The Education for All Handicapped Children Act mandated that educational systems provide "a free appropriate public education" in the "least restrictive setting" for all eligible children with disabilities. The Act required that an individualized education program (IEP) be developed, annual goals and short-term objectives identified, and specific special education and related services described. Part B of the Act was expanded to provide federal financial assistance to states and local education agencies so they could meet their obligations. Since 1986, the Act has included a formula grant program (Part H) to assist states to develop a statewide network of early intervention services for infants and toddlers with disabilities. Part C awards grants or cooperative agreements to strengthen and coordinate education, training, and related services for youth with disabilities to assist in the transition process to post-secondary education, vocational training, competitive employment, continuing education, independent and community living or adult services. In 1990, this legislation was retitled the Individuals with Disabilities Education Act (IDEA). |
1975 | The Developmental Disabilities Assistance and Bill of Rights Act reauthorized all formula grants to state Developmental Disabilities Councils to address federal priority areas (employment, community living, child development, system coordination and community education) and an optional state selected priority area; University Affiliated Facilities (later University Affiliated Programs); and authorized the establishment of state protection and advocacy systems to protect the rights of people with developmental disabilities. The 1993 Amendments recognize that "disability is a natural part of the human experience that does not diminish the right of individuals with developmental disabilities to enjoy the opportunity to live independently, enjoy self-determination, make choices, contribute to society, and experience full integration and inclusion in the economic, political, social, cultural, and educational mainstream of American society" (Section 101). State Developmental Disabilities Councils are required to conduct "systemic change, capacity building, and advocacy activities" (Section 124). |
1981 | The Omnibus Budget Reconciliation Act authorized the home and community-based waiver program. This waiver program "waived" federal requirements so that states could provide personal care and other services to individuals who would require institutional care in a Title XIX facility if these services were not available. |
1982 | The Tax Equity and Fiscal Responsibility Act (TEFRA) allowed states to cover home care services under Medicaid for children with disabilities, even when family income and resources exceeded the under Medicaid for children with disabilities, even when family income and resources exceeded the state's financial eligibility standards. |
1986 | Amendments to the Rehabilitation Act required states to show that policies exist regarding the order in which individuals are selected to receive services ("order of selection" process) and to justify those policies; include in the state plan a plan for youth transition to employment; and reflect how the supported employment program would be implemented in the state. The definition of "severe handicap" was amended to include both functional and categorical criteria, and a definition of "employability" was added. |
1986 | The Employment Opportunities for Disabled Americans Act made permanent the work incentives pro- visions, Sections 1619(a) and 1619(b), of the Social Security Act. These provisions authorize 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 that is equivalent to coverage under Medicaid. |
1988 | The Technology Related Assistance for Individuals with Disabilities Act established grant programs to encourage the development and distribution of assistive technology for people with disabilities. The primary purpose of the Technology Act was to close the gap between the development of innovative technologies and the actual use of those technologies by people with disabilities. |
1990 | The Americans with Disabilities Act (ADA) was passed. This landmark legislation affirms the rights of citizens with disabilities and prohibits discrimination in employment (Title I), public services (Title II), public accommodations and services that are operated by private entities (Title III), and telecommunications (Title IV). |
1990 | The Individuals with Disabilities Education Act (IDEA) authorized funding for competitive grants to states in which the state vocational rehabilitation agency and state educational agency jointly applied to develop, implement, and improve a system of transition services for students aged 14 and older. |
1991 | Federal "Home of Your Own" initiative begins with a five year grant by the Administration on Developmental Disabilities. |