The ADA at 30: the Importance of Law and Health Policy in Expanding Equity

On July 26th the Americans with Disabilities Act (ADA) celebrates 30 years of ensuring the rights of over 61 million persons with disabilities to pursue and enjoy the same opportunities available to all Americans. Similar to the Civil Rights Act of 1964, the ADA codifies protections that seek to improve access and participation and eliminate barriers imposed by discrimination, but with a focus on those with disabilities. Over the past three decades, the law has been strengthened through amendments, additional landmark legislation such as the Patient Protection and Affordable Care Act (ACA), and new rule making, each time expanding equity to citizens with disabilities in areas such as employment, community accessibility, the provision of healthcare, and an improved overall quality of life.

However, as new issues arise in an ever-increasingly complex health system, so too does the need to address these issues with improved legal remedies and policy prescriptions. ODPHP recently released a report from the Healthy People Law and Health Policy Project. The project is a partnership between the HHS Office of Disease Prevention and Health Promotion (ODPHP), the Centers for Disease Control and Prevention (CDC), the CDC Foundation, and the Robert Wood Johnson Foundation (RWJF). The report, The Role of Law and Health Policy in Achieving Healthy People’s Disability and Health Goals Around Access to Care, Activities Promoting Health and Wellness, Independent Living and Participation, and Collecting Data in the United States, is the second in a series of reports that highlights the practical application of law and policy to improve health across the nation and further push toward achieving the ambitious goals set by Healthy People 2020.

The research contained within the Healthy People Law and Health Policy report supports new and existing legal initiatives and evidence-based policy solutions that community and tribal leaders, government officials, public health professionals, health care providers, lawyers, and social service providers can use in their communities to increase access to care and improve the health of people with disabilities. Specifically the report identifies 5 Key Findings:

  • Federal legislation has evolved to address the needs of people with disabilities
  • Limited accessibility to community resources creates barriers to health and well-being
  • Engaging state and local initiatives can improve outcomes for people with disabilities
  • Improving disability data collection can inform policy and program development
  • More research is needed to address the needs of people with disabilities

For an illustration of this health law and policy approach in action, the Law and Health Policy Project’s Bright Spots offer case studies and testimonials from across the nation that showcase community successes in using law and policy to meet their own health improvement goals, as well as the achievement of objectives for people with disabilities as set forth in Healthy People 2020.

Among these Bright Spots is a recent one demonstrating how an enforcement action by Boston Center for Independent Living, Greater Boston Legal Services, and the Disability Law Center led to a negotiated settlement helping to address the disparity in health care access for people with disabilities in the Boston area. The settlement included the incorporation of important accessibility standards—starting with accessible equipment—into existing provider contracts. The negotiation also led to some promising new programs, like MassHealth’s Hospital Incentive Program that provides financial rewards when hospitals demonstrate progress toward getting accessible medical diagnostic equipment.

Another Bright Spot focused on the role of policy in helping to provide care to American Indian and Alaska Native (AI/AN) individuals with disabilities, as well as the need for better data to address critical lapses in identifying people with disabilities in AI/AN communities, demonstrated an important link between this population’s health and how strong connections to culture, family, and community can actually reduce the risk of chronic  diseases in AI/AN communities. Collection of better data helped to guide better care, more focused advocacy for these communities, and a model for culturally relevant rehabilitative care.

By incorporating law and health policy approaches into the care model, all facets of life for those with disabilities can be improved. The ADA has proven this approach, as has the legislation, programs, and policy initiatives that have risen in its wake. At 30 the ADA has helped to achieve many of the goals of fully integrating people with disabilities into society, and with continuing research and the establishment of new avenues mitigating barriers, will continue progress towards a system that fully services the needs of all.

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