Disability Integration Act Summary

The bill has 9 sections.

Section 1. “Short Title” – “Disability Integration Act of 2015”.

Section 2. “Findings & Purposes”. The “Findings” provide the need and rationale for the bill. They generally cover the poorly addressed, or unaddressed, ADA/”Olmstead” issues that exist currently. There are still various forms of discrimination such as, lack of sufficient, appropriate services, forced institutionalization and failure to support people with disabilities in the most integrated setting.

The “Purposes” cover just that; what the bill sets out to do and accomplish such as strengthening the ADA’s “integration mandate”, supporting services in the most integrated setting & requiring comprehensive planning and reporting of activities and efforts carried out because of this bill.

Section 3. “Definitions and Rule”. The “Definitions” provides for understanding key terms such as “community-based”, “health-related tasks”, “dwelling”, “ADLs & IADLs”, “individual with an LTS&S disability” and so on.

“Rule” refers to a rule of construction of the bill that clarifies that nothing in the bill precludes services being provided in an integrated, community setting such as a grocery store, restaurant, park, etc.

Section 4. “Discrimination”. This sectiondeclares as illegal discrimination, and prohibits,various practices that are common in almost every state’s home and community LTS&S programs. Some examples include: 1). Eligibility criteria that screen out individuals or classes of individuals. 2). Service caps & cost caps. 3). Waiting lists. 4). Inadequate reimbursement rates/pay rates. 5). Failure to provide emergency or backup assistance. 6). Failure to ensure that individuals are able too make fully informed choices between the institutionand home and community. 7). Failure to ensure sufficient affordable, accessible housing

Section 5. “Administration”. This section describes the administrative and oversight responsibilities shared between HHS and DOJ/the Attorney General (AG). The AG will be responsible for investigation of potential violations of this law and enforcement of compliance with it.

HHS will conduct and disseminate research and publish reports of progress or barriers to progress, provide technical assistance and educational activities. HHS will also make recommendations to Congress and the Administration and make referrals to DOJ for investigation and enforcement. Finally, various federal agencies must cooperate and comply with compliance activities.

Section 6. “Regulations”. The AG and the Secretary of HHS will issue regulations 24 months after enactment of the bill. These regulations will require all public and private funders/providers to plan to be able to offer all individuals eligible for an institution, a home and community service and support alternative.

The regulations specify certain services be provided. Hands-on assistance, cueing, training, safety monitoring and backup services are required. These different kinds of supports must be offered for ADLs, IADLs, health related tasks and other functions, tasks and activities as needed as an alternative to the institution.

Other benefits of the bill include discharging planning and support for individuals to reside in the most integrated setting, support for self-direction, and support for informal caregivers. Programs and providers must ensure that all services and supports are cross-age and cross-disability and maximize control and direction by the individual.

The regulations call for a robust public participation process in each State’s self-evaluation and transition planning. Private long term care insurance companies must also conduct public participation activities including a public hearing, opportunity for public input and comment and consulting with consumers of LTS&S.

Self-evaluation planning must occur during the first 42 months after enactment. Self- evaluation planning must be comprehensive and look at financing, workforce, services, etc.

Transition plans must address the issues discussed in the self-evaluation and must result in full compliance. Transition plans are due not later than 42 months after enactment and must achieve full compliance as quickly as possible, but not later than 12 years after enactment.

If the transition plans are being faithfully implemented, the state will receive an extra 5% in the FMAP for that State.

Section 7. Provides exemptions for religious organizations.

Section 8. “Enforcement”. Civil relief through injunctions, preventative orders, restraining orders, etc. is available. The remedies and procedures of this act are available for aggrieved individuals who feel their rights under the act have been violated. Courts may appoint an attorney for aggrieved individuals without regard to fees or payment.

Actual and punitive damages are available as is immediate injunctive relief. The AG will investigate and enforce alleged violations of the act. The court may assess a civil penalty not to exceed $100,000 for the first violation and $200,000 for the second and subsequent violations.

Section 9. Construction. This section is technical and contains references to existing statutes and regulations. This section clarifies and directs how this act is to be construed by taking into account similarities with existing laws and regulations including the Civil Rights Act of 1968 and the ADA.

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