The five titles of the ADA extended and expanded the protections of the Rehabilitation Act in important ways. They banned discrimination against qualified individuals with disabilities in any aspect of public- or private-sector employment; prohibited discrimination by public institutions, including stateand local governments (whether federal funding is involved or not); and prohibited discrimination in the provision of goods or services by commercial facilities and places of public accommodation, including private health care facilities. The legislation also directed improvements in the availability of certain interstate and intrastate telecommunications services for people with hearing and speech impairments (see Appendix F).

One critical feature of the ADA is that enforcement is, for the most part, reactive. It depends substantially on federal agency responses to complaints by or on behalf of individuals who have encountered violations of the law. The U.S. Congress has been criticized for providing insufficient funding for enforcement, and agencies have been cited for not developing coherent strategies and priorities for enforcement of antidiscrimination laws (see, e.g., NCD [2000c]). The discussion of health care facilities in Chapter 6 illustrates some of the strengths and limitations of the ADA and other laws and regulations in achieving accessible physical environments.

As is true for many other public policies, the effectiveness of the ADA and other policies very much depends on voluntary action by regulated entities, informal pressure by advocates, and the creation of a supportive cultural environment. A supportive and aware public will be vitally important in the years to come as critical choices continue to be made about policies that affect people with disabilities.

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