Index
A
AAA Foundation for Traffic Safety, 542
AAMC. See Association of American Medical Colleges
AAP. See American Academy of Pediatrics
AAPCC. See Average adjusted per capita cost
ABA. See Architectural Barriers Act
ABA Guidelines. See Architectural and Transportation Barriers Compliance Board
ABLEDATA, 212
Access Board. See Architectural and Transportation Barriers Compliance Board
Access issues, FCC regulations concerning, 505–506
Access to assistive technologies
recommendations concerning mainstream technologies, 218–219
through noninsurance programs, 273–275
Access to health care and support services, 6–8, 165–177, 433–439
administrative and judicial responses to continuing problems with ADA compliance, 175–177
data on difficulties with physical and communications access in health care facilities, 168–170
improving the accessibility of health care facilities and strengthening implementation of the provisions of the ADA related to health care facilities, 6–7
making needed assistive services and technologies more available to people with disabilities, 7–8
promoting models of coordinated chronic care and other strategies for improving the transition of young people from pediatric to adult health care, 8
public policies to improve health care facility and equipment accessibility, 170–175
reducing barriers to health insurance for people with disabilities, 7
Access to health insurance
disability and risk adjustment of payments to health plans, 239–248
health insurance coverage for people with disabilities, 224–235
health insurance markets and their limits for people with disabilities, 235–239
and the role of risk-adjusted payments to health plans, 222–252
Access to legal services, 470–471
Access to personal assistive services, financial, 265–273
Access to telecommunications technology
Hearing Aid Compatibility Act, 486–491
key laws and policies, 478–518
policy implications of technological change, 516–517
Telecommunications for the Disabled Act, 482–486
Accessibility
enhancing through universal design of mainstream technologies, 200–203
of health care facilities, improving, 6–7, 179–182
Accessible design, defining, 189
Accreditation Council on Graduate Medical Education (ACGME), 132
ACP. See American College of Physicians
Action, defining, 44
Activities, defining, 38
Activities of daily living (ADL), 50, 54, 82–83, 89–92, 97, 227, 261, 267, 413–415
defining, 38
ADA. See Americans with Disabilities Act
ADA Accessibility Guidelines, 173, 493, 507
Adaptive assistive devices, defining, 187
ADL. See Activities of daily living
Administrative responses, to continuing problems with ADA compliance, 175–177
Adolescent medicine, 105
Adolescent transitions
complexity of, 104
income support and work, 112–114
Medicaid and other public health programs, 108–110
other environmental factors, 114–115
populations “at risk” for, 102–103
public policy and other environmental factors, 107–115
transition support and public schools, 110–112
Adoption of available technologies, 211–216
adding quality of life to the framework, 44–45
categorizing personal factors, 45
clarifying activity limitations and participation restrictions, 42–44
as the conceptual framework for disability monitoring and research, 3, 5
depicting functioning and disability as dynamic processes, 46–47
developing environmental factors, 46
recognizing secondary conditions, 46
recommendations concerning, 59–62
Adult care models.
See also Younger adults with disabilities
for organizing pediatric and adult care for individuals with chronic health conditions or disabilities, 118–119
Adult health care providers, as a barrier to successful transition planning and outcomes, 126
Age, demographic trends and increasing disability, 17–19
Agency for Healthcare Quality and Research (AHRQ), 4, 11, 62, 158–159, 228, 293, 307
Agency on Disability and Rehabilitation Research, 317
Aging
atypical, 154
into disability, 143
with disability, 143
life span perspective on, 100–101, 143–144
AHRQ. See Agency for Healthcare Quality and Research
AIA. See American Institute of Architects
Aid to Families with Dependent Children, 268n
Albertson’s, Inc. v. Kirkingburg, 465–466
Alexander v. Choate, 448
Alternative risk adjustment models, predictive ratios for, 412
American Academy of Family Physicians, 121
American Academy of Pediatrics (AAP), 102, 121, 152
American Academy of Physical Medicine and Rehabilitation, 187, 262
American Association for Disability and Health, 302
American College of Physicians (ACP), 118, 121
American Community Survey, 56, 62, 64, 68, 70, 84
Content Test disability items, 52
Disability Work Group, 52
American Foundation for the Blind, 213
American Institute of Architects (AIA), 171n
American Medical Association, 434
American National Standards Institute (ANSI), 172, 489, 491
American Printing House for the Blind, 516
American Psychatric Association, 39
American Sign Language (ASL), 430
Americans with Disabilities Act (ADA), 3–4, 12, 24, 55, 110n, 163, 170–177, 180, 230, 404, 426–452, 491–516, 520, 530–540, 552
access to health care, 433–440
challenges to coverage design, 448–451
closed-captioning mandates, 511–515
complainants with psychiatric disabilities, 471
discriminatory administration challenges, 447–448
discriminatory allocation of resources within an established plan design, 442–447
effect on employment rates and wages, 458
as extending and expanding the Rehabilitation Act, 34
health care coverage and financing, 440–451
historical background and legislation, 491–493
interaction between ADA violations and medical malpractice, 439–440
physical access to health care services, 433–439
recommendations, concerning, 180
Section 255 of the Telecommunications Act, 503–507
Section 508 of the Rehabilitation Act, 507–508
Section 713 of the Communications Act, 511–515
settlement involving the Washington Hospital Center, highlights of, 177
and subtle forms of discrimination, 439
Telecommunications Accessibility Enhancement Act, 502–503
Television Decoder Circuitry Act, 508–511
Title IV telecommunications relay services, 481, 494–502
Amputee Coalition of America, 302
ANSI. See American National Standards Institute
Architectural and Transportation Barriers Compliance Board (Access Board), 4, 7, 12–13, 171–174, 180–182, 192, 202, 209–210, 218–219, 435, 438, 452, 481
Architectural Barriers Act (ABA), 170, 172, 180, 478, 502
ASL. See American Sign Language
Assistive technologies and services for people with disabilities, 2, 183–221.
See also Access to assistive technologies
challenges to development and effective provision and use, 203–216
defining, 187n
enhancing accessibility through universal design of mainstream technologies, 200–203
key policies that promote, 192–194
private health insurance coverage, 265
public health plan coverage of, 260
types of technologies used, 186–191
Assistive Technology Act, 186–188, 192–193, 212, 273
Assistive Technology Development Fund, 207
Assistive technology devices, defining, 186–187
Assistive Technology Programs, 115
Associated conditions, defining, 142
Association for the Advancement of Medical Instrumentation, 173
Association of American Medical Colleges (AAMC), 132
Asthma Follow-up Survey, 53n
Attitudes, as an environmental factor, 114
Atypical aging, 154
Automated teller machines (ATM), 202
Available technologies
awareness, adoption, and maintenance of, 211–216
guidance for health professionals, 213–214
through the consumer’s eyes, 215–216
Average adjusted per capita cost (AAPCC), 244–246, 410, 413
Awareness, of available technologies, 211–216
B
Balanced Budget Act, 245, 254n
Barden et al. v. Sacramento, 547
Barriers
created by mainstream technologies, examples of, 201
to health insurance for people with disabilities, reducing, 7
Barriers to successful transition planning and outcomes, 123–129
adult health care providers, 126
family, 126
pediatrician, 126
for young people with disabilities, examples of, 125
Behavioral and Social Science Research Program, 305
Behavioral Risk Factor Surveillance System (BRFSS), 53, 55, 63, 70, 170
Asthma Follow-up Survey, 53n
Biomimetic MicroElectronic Systems ERC, 304n
BLS. See Bureau of Labor Statistics
BMI. See Body mass index criteria
Body functions and structures, defining, 38
Body mass index (BMI) criteria, 79
Bragdon v. Abbott, 434
BRFSS. See Behavioral Risk Factor Surveillance System
BTS. See Bureau of Transportation Statistics
Built environments, 114
Bureau of Labor Statistics (BLS), 4, 10, 55, 58–63, 127
Bureau of Transportation Statistics (BTS), 521, 523–524
C
California Health Interview Survey, 170
Call to Action to Improve the Health and Wellness of Persons with Disabilities, 28
Capacity building, for disability research, continued need for, 313–314
Capacity qualifier, defining, 40n
Capitation payments to health plans
achieving payment accuracy for populations with disabilities, 408–409
commonly used risk factors producing different levels of payment accuracy, 410–413
predictive accuracy of risk adjusters, 409–410
Captioned telephone relay services, 496–497
Care coordination, 8.
See also Chronic care systems
and transition planning, 124
for young people with disabilities, examples of barriers to, 125
Caregivers, spouses and families as, 19.
See also Families, Personal assistance services
CARF. See Commission on Accreditation of Rehabilitation Facilities
CARF Guide to Accessibility, 181
CDC. See Centers for Disease Control and Prevention
Center for Assistive Technology, 215
Center for Birth Defects and Developmental Disabilities, 6
Center for Health Program Development and Management, 407
Center for Injury Prevention and Control, 302
Center for Personal Assistance Services, 274
Center for Universal Design, 189n
Centers for Disease Control and Prevention (CDC), 2, 4, 6, 9, 11–15, 19, 50, 63–64, 77, 79, 134–135, 151, 178–179, 220–221, 293, 301–303, 315–317, 436
as the lead agency for a federal disability prevention initiative, 28, 30
questionnaire on health-related quality-of-life, 45
Centers for Independent Living program, 115, 274
Centers for Medicare and Medicaid Services (CMS), 62, 64, 198n, 206, 225–226, 242–243, 254n, 262, 266n, 268n, 278, 307, 396–397, 400–401, 414–415, 421
Centers on the Demography of Aging, 305
Cerebral palsy, 155
literature on secondary conditions in, 148–149
Chartbooks on disability, recent, 67
Chemical, Bioengineering, Environmental, and Transport Systems Division, 303
Child Health Assessment and Monitoring Program, 53
Children.
See also Children with special health care needs
with activity limitation, 75–76
characteristics of, that may affect the complexity of health care transitions, 104
trends in overweight (obesity) for, 79
Children with special health care needs
Christopher and Dana Reeve Paralysis Resource Center, 275
Christopher Reeve Foundation, 275
Chronic care systems, 8
features of disability-competent, 120
Chronic health conditions, 398
causing limitations of activities, 71
Chronic Illness and Disability Payment System, 243–244
Chronic pain, 149
Civil Rights Act, 433, 491, 530
Cleveland v. Policy Management Systems Corp., 472
Clinical Science Research and Development Service, 299
Closed-captioning mandates
in the Communications Act, 511–515
emergency alert system, 514–515
historical background and legislation, 511–512
CMS. See Centers for Medicare and Medicaid Services
CMS Hierarchical Conditions Categories model (CMS-HCC), 245, 414
Coalition of Organizations for Accessible Technology (COAT), 517
COBRA. See Consolidated Omnibus Budget Reconciliation Act
Coding
environmental factors, 46
Coin-operated telephones, 485
Commission on Accreditation of Rehabilitation Facilities (CARF), 181
Commission on Education of the Deaf, 509
Committee on Transition Care, 121
Commonly used risk factors producing different levels of payment accuracy, 410–413
diagnosis codes and functional status, 410–413
health status measures as risk factors, 410–413
prior utilization as a risk factor, 410
closed-captioning mandates, 511–515
emergency alert system, 514–515
historical background and legislation, 511–512
Community-dwelling Medicare beneficiaries, having difficulty performing personal care activities without help or special equipment, 91
Community Transportation Association of America, 542, 544
Community transportation resources, 530–549
complementary paratransit services, 535–542
heavy, commuter, and light rail systems, 531–532
other community providers and obligations, 542–548
private transportation sector, 548–549
public transportation agencies, 530–531
Comorbidities, 142
Compatibility issues
FCC regulations concerning, 506–507
rules for hearing aids with wireless telephones, 490
Competition and consumer choice, in health insurance markets for people with disabilities, 239
Complementary paratransit services, 535–542, 553
cost and ridership patterns for people with disabilities, 537
Complexity, defining, 44
Computer and electronic technologies, 23, 184, 187–188.
See also Section 508 of the Rehabilitation Act
Conditions potentially contributing to disability, potentially explaining trends, 77–80
Confidentiality considerations, 497
Congressional Budget Office, 96
Connecticut, 257
Consolidated Omnibus Budget Reconciliation Act (COBRA), 229, 232
Consortium on Spinal Cord Medicine (CSCM), 148, 199
Consumer-driven plans, and risk segmentation in insurance markets, 403–404
Consumers
available technologies through the eyes of, 215–216
awareness of available technologies, 211–212
involvement at the research and development stage, 208–210
Coordinated programs, 4, 14, 314–315.
See also Care coordination
for human service, 545
Coordination of disability research. See Disability research;
Federal disability research programs
Cordless telephones, in the Hearing Aid Compatibility Act, 491
Costs.
See also Medical costs, and populations;
Rising costs;
Societal costs
of health care for working-age adults, 237
recovery considerations, 497–498
Council on Access and Mobility, 545
Court decisions, plaintiff victories from, 468
Courthouse Access Advisory Committee, 174
Coverage of assistive technologies, 253–286
access to assistive technologies and services through noninsurance programs, 273–275
assessing expansions in the context of rising costs, 282–283
medical necessity and, 256–257
rising costs and the challenge of expanding coverage of assistive services and technologies, 276–283
types of limitations on coverage, 255–258
Coverage of personal assistance services, 265–273
Coverage of specific services or products, criteria used to determine, 283
CPS. See Current Population Survey
Craig Handicap Assessment and Reporting Technique, 200n
Cross-condition studies, literature on, 152–153
CSCM. See Consortium on Spinal Cord Medicine
Current Population Survey (CPS), 55–56, 63, 84, 202, 456
Current Procedural Terminology, coding scheme for physician services, 122
D
Data on disability.
See also Disability trends
on difficulties with physical and communications access in health care facilities, 168–170
issues influencing the accuracy of risk scores, 415–417
recent statistical, 67
Declines, in health conditions that contribute to disability in childhood, 81–82
Defense Advanced Research Projects Agency, 308
Deficit Reduction Act, 109, 135, 263, 271–272, 277
Developmental disorders, contributing to disability, 2
DHHS. See U.S. Department of Health and Human Services
Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR), 39
Disability
common conceptual framework for, 36
definition and monitoring of, 35–64
depicting as a dynamic process, 46–47
in middle life, conditions contributing to, 86–88
overview of national surveys that include measures of, 48
projecting the future of, 95–97
rates by sex and age, 69
recent chartbooks and other profiles of statistical data on, 67
and related societal trends, 17–19
and risk adjustment of payments to health plans, 239–248
umbrella term for physical or mental impairments, activity limitations, and participation restrictions, 5, 38
Disability and Business Technical Assistance Centers, 181
Disability and Health Program, 301
Disability and Health Team, 6, 301, 303, 316
Disability-competent chronic care systems, features of, 120
Disability in America: Toward a National Agenda for Prevention, xiii, 2, 17, 19, 30, 59, 66, 99, 137–138, 162, 184, 222, 224, 254, 385
developments since publication of, 22–25
Disability monitoring, 2–5, 54–59
adopting and refining the ICF as the conceptual framework for disability monitoring and research, 3, 5
creating a comprehensive system for, 5
developing and implementing panel surveys, 56–59
expanding measures of the environment, 56
recommendations concerning, 4, 10, 59–64
Disability Payment System, 243
Disability research, 5–6, 287–320.
See also Federal disability research programs
challenges of organizing and coordinating, 308–314
defining, 288n
federal sponsors of, 290
recommendations concerning, 14–15, 314–319
Disability Statistics Subcommittee, 63
current estimates of disability and related conditions, 66–72
monitoring trends in disability, 72–73
projecting the future of disability in America, 95–97
Discrimination
administrative challenges, 447–448
and health insurance and employment, 230–231
more subtle forms of, 439
nondiscrimination provisions of ADA, 174
Disease management, 280n
Distribution of difference, between HMO and fee-for-service mean risk factors for Medicare beneficiaries, 400
Doe v. Mutual of Omaha, 450
Down syndrome, literature on secondary conditions in, 150–152, 156
Down Syndrome Medical Interest Group, 152
Driving
and the aging of society, 526–529
self-regulation by people with disabilities, 528
DSM IV TR. See Diagnostic and Statistical Manual of Mental Disorders
Dumont-Driscoll, Marilyn, 133
Durable medical equipment, defining, 188
Dynamics of Economic Well-Being System, 57, 63–64
E
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, for Medicaid-eligible children, 80, 109, 129, 232, 257, 263–264, 268
Early Childhood Longitudinal Study, 58
EAS. See Emergency alert system
Education of health care professionals
health care professionals, directions for research, 156–158
pediatricians and adult care physicians, 130–133
recommendations concerning improvements to, 159–161
Education for All Handicapped Children Act, 80, 453.
See also Individuals with Disabilities Education Act (IDEA)
EEOC. See Equal Opportunity Employment Commission
Effectiveness of Title I, 464–472
countervailing policies, 471–472
“Electronic newsroom technique” (ENT), 513
Electronic technologies, advances in, 2.
See also Computer and electronic technologies
Emergency access issues, 499–502
Emergency alert system (EAS), in Section 713 of the Communications Act, 514–515
Emergency captioning, in Section 713 of the Communications Act, 513–514
Emergency Treatment and Labor Act, 433
Employers
large and small, and risk segmentation in insurance markets, 401–403
practices and attitudes, 460–463
Employment
rates and wage disparities, 456–460
trends among adults with disabilities, 85–86
Employment-based insurance, for younger adults with disabilities, 228–231
Employment discrimination provisions of ADA
books, articles, and reports, 473–477
cases, 473
implementation and impact, 453–477
measuring the effects of Title I, 456–464
rethinking the “cause” of the effectiveness of Title I, 464–472
statutes, regulations, and legislative materials, 473
Enabling America: Assessing the Role of Rehabilitation Science and Engineering, xiii, 2, 20, 30, 36, 99, 138, 207–208, 210, 288, 385
developments since publication of, 22–25
Engineering Research Centers (ERCs), 304n
Enhancing Education for Chronic Illness Care initiative, 132
ENT. See “Electronic newsroom technique”
Environmental factors
accessible health care facilities, 165–177
coding in ICF, 46
context of disability in health care facilities, 162–182
defining, 39
expanding measures of, to improve disability monitoring, 56
further development of, 46
recommendations concerning, 4, 12–13, 178–182
research on the role of the environment in disability, 164–165
Environmental modifications, defining, 187
EPSDT. See Early and Periodic Screening, Diagnostic, and Treatment benefit
Equal Opportunity Employment Commission (EEOC), 429, 468–471
ERCs. See Engineering Research Centers
“Ever disabled” population, 397
Extension of health insurance coverage, key principles for, 284
F
Fair employment practice agencies (FEPAs), 469–471
Families
affecting health care transitions, 106–107
and assistive technologies, 199–200
as caregivers, 19
increased stress on, 1
size of, 19
Family Opportunity Act, 109
FCC. See Federal Communications Commission
FDA. See U.S. Food and Drug Administration
Federal Communications Commission (FCC), 429, 480–482, 495
Federal Communications Commission (FCC) regulations, 505–507
in the Hearing Aid Compatibility Act, 487
Section 255 of the Telecommunications Act, 505–507
in Section 713 of the Communications Act, 512–513
in the Television Decoder Circuitry Act, 510–511
usability, 506
Federal Communications Commission (FCC) regulations in the Telecommunications for the Disabled Act, 485–486
coin-operated telephones, 485
telephones frequently needed by people with hearing loss, 485
telephones provided for emergency use, 485
Federal Communications Commission (FCC) regulations in Title IV telecommunications relay services, 495–497
captioned telephone relay services, 496–497
Internet protocol relay services, 496
other mandated services, 497
Spanish relay services, 497
speech-to-speech relay services, 496
text-to-speech relay services, 495
video relay services, 496
voice and hearing carryover, 497
Federal disability research programs, 6, 289–308
increasing the visibility and coordination of, 6, 315–317
National Center for Medical
Rehabilitation Research, 295–299
National Institute on Disability and Rehabilitation Research, 289–295
other sponsors of disability research, 300–308
Federal Interagency Forum on Child and Family Statistics, 18
Federal Transit Administration (FTA), 531–532
FEPAs. See Fair employment practice agencies
Financial assistance for assistive technology in selected federal programs, summary, 274
Foster care, 107
Foundation for Physical Medicine and Rehabilitation, 187
FTA. See Federal Transit Administration
Functional Independence Measure, 200n
Functioning
common conceptual framework for limitations of, 36
defining, 38
Funding considerations, 497–498.
See also Costs
for clinical, health services, social, behavioral, and other disability research that is commensurate with the need, 5–6
in Title IV telecommunications relay services, 497–498
trends for NIDRR, NCMRR, and VA RR&D, 291
Future issues in Title IV telecommunications relay services, 498–502
interoperability of VRS protocols, 499
Future of disability in America in a public health context, 27–30
Future of Public Health, The, 27
G
GAO. See Government Accountability Office
General Accounting Office. See Government Accountability Office
General Services Administration, 172, 192
Germany, implementing the ICF in, 43
Goals
of health care transition planning for young people, 103
of monitoring, expanding to improve disability monitoring, 54–56
Government Accountability Office (GAO), 254n, 258, 293, 542
Government role, in research and development, 207–208
GTE, 483
Guardians, affecting health care transitions, 106–107
Guidance on available technologies, for health professionals, 213–214
Guidelines for Design and Construction of Health Care Facilities, 171n
H
HAC. See Hearing aid compatible phones
HBRA. See Health-based risk adjustment
HCBS. See Home- and Community-Based Service waiver program
HCO. See Voice and hearing carryover (VCO and HCO)
Health and Retirement Study, 53, 57, 305
Health-based risk adjustment (HBRA), 415–416, 420.
See also Risk adjustment
lessons from purchasers who have implemented, 406–408
risk segmentation in insurance markets and the need for, 398–406
Health care facilities
selected universal design and other features for, 167
strengthening implementation of ADA provisions related to, 6–7, 34
Health Care Financing Administration, 245, 309n.
See also Centers for Medicare and Medicaid Services (CMS)
Health care services and systems, 115–130
approaches to health care transitions for young people, 120–123
barriers to successful transition planning and outcomes, 123–129
organization of pediatric and adult care for individuals with chronic health conditions or disabilities, 117–120
research on health care transition planning, 129–130
Health care transitions for young people with disabilities, 98–135
adolescent transitions, public policy, and other environmental factors, 107–115
characteristics of child and adolescent health that may affect the complexity of, 104
critical transition from child to adult, 101–103
directions for research on, 131
education of pediatricians and adult care physicians, 130–133
examples of barriers to, 125
family and guardian factors, 106–107
health care services and systems, 115–130
individual and family factors affecting, 104–107
support and public schools, 110–112
transitions to adult care in a life span perspective, 100–101
with and without activity limitations, usual sources of, 116
Health conditions
associated with disability in late life, 94
contributing to disability, 2
defining, 38
Health insurance coverage for people with disabilities, 224–235.
See also Medicaid programs;
Medicare
for older adults with disabilities, 225–226
for younger adults with disabilities, 227–232
Health insurance markets and their limits for people with disabilities, 235–239
competition and consumer choice, 239
market failure and publicly financed health insurance for certain groups, 237–238
standard models of insurance, 235
violations of standard insurance models in health care, 235–237
Health maintenance organization (HMO), 116, 223, 400, 416
Health-related quality-of-life, 44
Health Resources and Services Administration, 101–102
Health Services Research and Development Service, 299–300
Health status measures as risk factors, diagnosis codes and functional status, 410–413
Healthy & Ready to Work Center, 102
Healthy People 2000, 28
Healthy People 2010, 27–28, 55, 138, 184, 302
public health objectives in, 29
Hearing aid compatibility, 483–484
Hearing Aid Compatibility Act, 481, 486–491
cordless telephones, 491
FCC regulations, 487
historical background and legislation, 486–487
Hearing aid compatible (HAC) phones, 479
Hill Burton Act. See Hospital Survey and Construction Act
Historical background
of disability policy development, 30–33
of the Hearing Aid Compatibility Act, 486–487
of Section 255 of the Telecommunications Act, 503–505
of Section 713 of the Communications Act, 511–512
of the Telecommunications for the Disabled Act, 482–485
of the Television Decoder Circuitry Act, 508–509
HMO. See Health maintenance organization
Home- and Community-Based Service (HCBS) waiver program, 269–272
Home health benefits
coverage of personal care services as, 267
personal assistance services under Medicaid, 269
Hospital Survey and Construction Act, 433
Human functioning, components and domains of in the ICF, 41
I
IADL. See Instrumental activities of daily living
ICC. See Interagency Coordinating Council
ICD-10. See International Classifications of Diseases
ICDR. See Interagency Committee on Disability Research
ICF. SeeInternational Classification of Functioning, Disability and Health
ICIDH. SeeInternational Classification of Impairments, Disability and Handicaps
IDEA. See Individuals with Disabilities Education Act
Impairments
common conceptual framework for, 36
defining, 38
Implementation factors in risk-adjusted payment to health plans, 415–421
implementation environment, 420–421
influencing the accuracy of risk scores, 420–421
model calibration issues, 419–420
risk adjustment model design fitting the application, 417–418
adding quality of life to the framework, 44–45
categorizing personal factors, 45
clarifying activity limitations and participation restrictions, 42–44
depicting functioning and disability as dynamic processes, 46–47
further developing environmental factors, 46
recognizing secondary conditions, 46
recommendations concerning, 59–62
Improving the Quality of Long-Term Care, 20
“In-home-use” criterion, 4, 262, 285–286
Income support, and work, 112–114
Indian Health Service, 310n
Individuals with Disabilities Education Act (IDEA), 4, 11, 58, 80, 110, 114, 134–135, 188, 214, 273, 453, 515
Information technologies, advances in, 2.
See also Computer and electronic technologies
Innovation and technology transfer, recommendations concerning, 217–218
Institute for Improving Medical Education, 132
Institute of Medicine (IOM), xiii, 2–3, 6, 17, 20–25, 36–37, 49, 56, 59, 66, 70, 73, 99, 137, 147, 158–163, 178–179, 184, 207–208, 210, 219, 222–224, 254, 283, 287–289, 300, 308, 310, 385
Instrumental activities of daily living (IADL), 50, 54, 82–83, 89–92, 97, 227
Insurable event, defining, 235
Insurance. See Health insurance coveage for people with disabilities
Insurance programs for people with disabilities, 277, 395–396
for children with and without special health care needs, 233
Interactions, between ADA violations and medical malpractice, 439–440
Interagency Committee on Disability Research (ICDR), 4, 15, 60–61, 292n, 294, 310–312, 317–319
Interagency Committee on Disability Statistics, 4, 10, 59–62
Interagency Coordinating Council (ICC), 502
Interagency Subcommittee on Disability Statistics, 60
International Classification of Functioning, Disability and Health (ICF), 4–5, 10, 12, 15, 25, 37–47, 59–62, 105, 163–165, 178–179, 317–319.
See also Improving the ICF
adopting and refining as the conceptual framework for disability monitoring and research, 3, 5
components and domains of human functioning in, 41
directions for further work on, 61
major concepts in, 38
International Classification of Impairments, Disability and Handicaps (ICIDH), 37
International Classifications, 37
International Classifications of Diseases (ICD-10), 37, 39
Internet applications, 192
Internet protocol (IP) relay services, 496
Interoperability of VRS protocols, 499
IOM. See Institute of Medicine
IP. See Internet protocol relay services
Iraq War, 299
ITEM Coalition, 206
J
Job Access and Reverse Commute Program, 542
Joint Commission, 4, 6, 12, 180–181
Journal of Rehabilitation Research and Development, 299
Judicial responses, to continuing problems with ADA compliance, 175–177
K
Kaiser Family Foundation, 195
Kaiser Permanente, 176
L
Laboratory of Epidemiology, Demography and Biometry, 305
Lead exposure, 82
Legislative background
of the Hearing Aid Compatibility Act, 486–487
of Section 255 of the Telecommunications Act, 503–505
of Section 713 of the Communications Act, 511–512
of the Telecommunications for the Disabled Act, 482–485
of the Television Decoder Circuitry Act, 508–509
of Title IV telecommunications relay services, 494–495
Life situation, defining, 39
Life span perspective, 100–101, 139–144
Lifeline program, 518
Limitations on insurance coverage, 255–258
insurance status of adults with disabilities, 227
medical necessity and coverage, 256–257
in work, 84
Local governments, and the pedestrian environment, 546–548
Long-term care workers, 19
Longitudinal Study of Aging, 53, 57
Lower court decisions, few plaintiff victories from, 468
M
Mainstream technologies, 183–221
challenges to development and effective provision and use of assistive technologies, 203–216
enhancing accessibility through universal design of mainstream technologies, 200–203
examples of barriers created by, 201
key policies that promote assistive technology and universal design of mainstream technologies, 192–194
types of technologies used or encountered by people with disabilities, 186–191
Maintenance, of available technologies, 211–216
Majocha v. Turner, 436
Mandated services, 497
Mandatory minimum standards, 498
TRS, 500
Mannick v. Kaiser Foundation Health Plan, 437
Market failure
in health insurance markets for people with disabilities, 237–238
and publicly financed health insurance for certain groups, 237–238
Maryland, 246
Massachusetts, 237
MCHB. See U.S. Maternal and Child Health Bureau
Measures of the environment, expanding to improve disability monitoring, 56
Medicaid programs, 2–4, 7–8, 13–14, 23, 25–26, 108–109, 114, 119, 127–129, 134, 222–226, 237–244, 248–250, 285–286.
See also Deficit Reduction Act
coverage of personal assistance services, 268–273
early periodic screening, detection, and treatment benefits, 264
and other public health programs, 108–110
personal assistance services and home health benefits, 269
recommendations concerning, 250–252
for younger adults with disabilities, 231–232
Medical and Prosthetic Research program, 299
Medical costs, and populations, 397–398
Medical Expenditure Panel Survey, 228, 233, 236, 259n
Medical home model of pediatric care, 8
for organizing pediatric and adult care for individuals with chronic health conditions or disabilities, 117–118
Medical necessity, and coverage, 256–257
Medical Rehabilitation Coordinating Committee, 311–312, 319
Medicare, 4, 7, 13–14, 23–26, 30, 33, 114, 119, 128, 212, 222–226, 238–243, 248–250, 285–286
beneficiaries over age 65 living in nursing homes and other facilities, 93
coverage of assistive technologies, 258–263
coverage of personal assistance services, 266–268
coverage of personal care services as a home health service, 267
initial legislation for, 33
recommendations concerning, 250–252
and risk segmentation in insurance markets, 399–401
for younger adults with disabilities, 231–232
Medicare Advantage plans, 226, 395, 397, 399, 409
Medicare Current Beneficiary Survey, 54, 57, 68, 87, 90–92, 170
Medicare Modernization Act, 310n
Medicare Payment Advisory Commission (MedPAC), 246, 255n, 267
Medicare+Choice plans, 226
Medicine-Pediatrics Program Director’s Association, 121
MedPAC. See Medicare Payment Advisory Commission
Meltzer v. Kaiser Permanente, 176
Mental Health Parity Act, 231
Milestones in U.S. disability policy, timeline of, 31–32
Minimum standards. See Mandatory minimum standards
Minnesota, 413
Models
calibration issues influencing the accuracy of risk scores, 419–420
of coordinated chronic care, 8
Monitoring trends in disability, 72–73
Murphy v. United Parcel Service, 33, 466–467
N
National Academy of Sciences, 20, 22n
National Aeronautics and Space Administration, 310n
National Captioning Institute, 508
National Center for Health Statistics, 4, 10, 49n, 59–64, 72
National Center for Medical Rehabilitation Research (NCMRR), 4–6, 14–15, 20, 146, 198, 289–290, 295–299, 315–317, 386
funding trends for, 291
National Center for Transit Research, 539
National Center of Medical Home Initiatives for Children with Special Health Care Needs, 117n
National Center on Birth Defects and Developmental Disabilities (NCBDDD), 301–302
National Center on Secondary Education and Transitions, 111
National Children’s Study, 59, 101
National Council on Disability, 111, 193, 214, 467, 531
National disability monitoring system, 47–59
improving disability monitoring, 54–59
progress in disability monitoring, 49–54
recommendations concerning, 62–64
National Early Intervention Longitudinal Study, 58
National Emphysema Treatment Trial, 309
National Health and Nutrition Examination Surveys, 82, 88
National Health Interview Survey (NHIS), 49–51, 55–56, 63, 67n, 68, 70–75, 77, 83–84, 87–92, 102, 117, 168, 184, 199, 233–234, 456, 521
Disability Supplement, 137
redesigned, disability-related content in, 51
National Health Service (UK), 102, 122
National Heart, Lung, and Blood Institute, 306
National Institute for Occupational Health and Safety, 301n
National Institute of Biomedical Imaging and Bioengineering, 305
National Institute of Child Health and Human Development (NICHD), 295
National Institute of Mental Health, 310n
National Institute of Neurological Disorders and Stroke, 305
National Institute of Nursing Research, 305
National Institute on Aging (NIA), 53, 62, 305
National Institute on Deafness and Other Communication Disorders, 305
National Institute on Disability and Rehabilitation Research (NIDRR), 4, 12–15, 20, 50, 64, 102, 138, 146, 178–179, 181, 192, 198, 220–221, 274, 289–295, 315–317, 386
funding trends for, 291
National Institutes of Health (NIH), 2, 4, 6, 12, 14–15, 178–179, 217, 289–295, 304–307, 315–317
Patient-Reported Outcomes Measurement Information System, 304–305
National Instructional Materials Accessibility Standard, 516
National Long-Term Care Survey, 53, 57, 90, 92, 184, 245, 305
National Longitudinal Survey of Labor Market Experience, Youth Cohort, 58, 75n
National Longitudinal Transition Study-2, 58
National Nursing Home Surveys, 92–93
National Organization on Disability (NOD), 519
National Science Foundation (NSF), 217, 289, 303–304
National Society for Crippled Children, 172n
National Spinal Cord Injury Statistical Center, 146
National Study of Women with Physical Disabilities, 170
National Survey on Assistive Technology and Information Technology, 49n
National Transit Database, 537
NCBDDD. See National Center on Birth Defects and Developmental Disabilities
NCMRR. See National Center for Medical Rehabilitation Research
New Freedom Initiative, 194n, 262, 545
NHIS. See National Health Interview Survey
NIA. See National Institute on Aging
NICHD. See National Institute of Child Health and Human Development
NIDRR. See National Institute on Disability and Rehabilitation Research
NIDRR-supported Rehabilitation Engineering Research Centers, focus of, 209
NIH. See National Institutes of Health
NOD. See National Organization on Disability
NOD-Harris Interactive poll, 521
Non-group insurance, and risk segmentation in insurance markets, 404
NSF. See National Science Foundation
O
See also Overweight (obesity) in children
Office for Civil Rights, 438–439
Office of Disability, Aging, and Long-Term Care Policy, 307–308
Office of Disability and Health, 4, 6, 14–15, 315–317
Office of Special Education and Rehabilitative Services, 292n
Ohio, 156
Older adults with disabilities, health insurance for, 225–226
Older Americans Research and Services Center Instrument, 200n
Olmstead v. L.C., 33, 268, 270, 441, 450
and discriminatory allocation of resources within an established plan design, 442–447
One-Stop employment centers, 192
Organization of disability research, 287–320
continued need for capacity building, 313–314
federal disability research programs, 289–308
recommendations concerning, 4, 14–15, 314–319
weak coordinating mechanisms, 310–313
Outcomes of assistive technology use, 196–200
Overweight (obesity) in children, trends in, 79
P
PacAdvantage, 403
PACE. See Program of All-Inclusive Care for the Elderly
Pain
in cerebral palsy, 149
chronic, 149
identified in crop-condition studies, 153
in spinal cord injury, 147–148
Panel surveys, developing and implementing to improve disability monitoring, 56–59
Paralyzed Veterans of America (PVA), 146, 148, 158
Paratransit service coverage, and potential expansion costs, 541
Participation
clarifying restrictions on, 42–44
Pathology, common conceptual framework for, 36
Patient-Reported Outcomes Measurement Information System (PROMIS), 49n, 197, 304–305
Payment accuracy, for populations with disabilities, achieving, 408–409
Payment for adults with functional limitations, sources of, 229
Pedestrian environment, local governments and, 546–548
Performance qualifier, defining, 40n
Personal assistance services.
See also Personal care services
coverage under Medicaid, 268–273
coverage under Medicare and private insurance, 266–268
examples of federal programs (other than Medicare and Medicaid) that provide some support for, 275
and Medicaid home health benefits, 269
Personal assistive devices, defining, 187
Personal care services.
See also Personal assistance services
civilians needing help with, 90
coverage of as a home health service under Medicare, 267
and routine care limitations, 82–83, 89–92
Personal factors
categorizing, 45
Physical Disabilities Branch, 296n
Policies that promote assistive technology and universal design of mainstream technologies, 2, 192–194.
Assistive Technology Act, 193
environment of disability, 2, 30–34
implications of technological change, 516–517
to improve health care facility and equipment accessibility, 170–175
Section 508 of the Rehabilitation Act, 192–193
Poliomyelitis, literature on secondary conditions in, 149–150
Postpolio syndrome, 150
Postschool experiences of young people with disabilities, selected survey findings about, 113
Pre-Elementary Education Longitudinal Study, 58
Prediction of Medicare beneficiary costliness, by risk adjustment method, 247
Predictive accuracy of risk adjusters, 409–410
President’s Committee on Employment of the Physically Handicapped, 172n
Preventing and managing risk selection, and risk segmentation in insurance markets, 405–406
Prevention and management of secondary conditions, 11, 138, 159–161
Principal Inpatient Diagnosis-Diagnostic Cost Group model, 245
Prior utilization, as a risk factor, 410
Private health insurance
coverage of assistive technologies, 265
coverage of personal assistance services, 266–268
Private sector role, in research and development, 205–207
Private transportation sector, 548–549
Product research and development of assistive technologies, 205–211
challenge of technology transfer and commercial application, 210–211
involvement of consumers at the research and development stage, 208–210
role of government in research and development, 207–208
role of the private sector in research and development, 205–207
Professional awareness, recommendations for increasing, 221
developing educational programs, evidence-based reviews, practice guidelines, and other materials to support health professionals in caring for people with disabilities, 8–9
launching a national public health campaign to increase public and health care professional awareness of assistive and accessible technologies, 9
recommendations concerning, 134, 159–161
Professional transition model, 122
Program of All-Inclusive Care for the Elderly (PACE), 410, 412, 415
Projections, of the future of disability in America, 95–97
PROMIS. See Patient-Reported Outcomes Measurement Information System
Psychiatric disabilities, complainants with, 471
Public awareness, recommendations for increasing, 220–221
launching a national public health campaign to increase public and health care professional awareness of assistive and accessible technologies, 9
Public health and disability, 27–30
objectives, 29
Public transportation agencies, 530–531
PVA. See Paralyzed Veterans of America
Q
Quality-of-life
adding to the ICF framework, 44–45
CDC questionnaire on, 45
defined, 44
health-related, 44
Quality of Life Technology ERC, 304n
R
Rail systems, heavy, commuter, and light, 531–532
RAIS. See Risk Adjustment Impact Study
“Reasonable accommodations,” defining, 455
Recommendations, 10–15, 216–221, 283–286, 314–319
Recommendations concerning access to health insurance and the role of risk-adjusted payments to health plans, 248–252
improving risk adjustment methods, 248–250
other issues in Medicare and Medicaid, 250–252
Recommendations concerning adopting and improving the ICF, 59–62
Recommendations concerning assistive and mainstream technologies for people with disabilities, 4, 13–14, 216–221
accessible mainstream technologies, 218–219
increasing coverage and access, 283–286
increasing professional awareness, 221
increasing public awareness, 220–221
innovation and technology transfer, 217–218
Recommendations concerning definition and monitoring of disability, 4, 10, 59–64
Recommendations concerning health care transitions for young people, 4, 10–11, 133–135
Recommendations concerning organization and support of disability research, 4, 14–15, 314–319
directions for research, 314–315
improving disability research coordination and collaboration, 317–319
increasing funding and visibility of federal disability research, 315–317
Recommendations concerning secondary conditions and aging with disability, 10–12, 158–161
improving the education of health care professionals, 159–161
organizing the knowledge base, 158–159
Recommendations concerning the environmental context of disability, 4, 12–13, 178–182
expanding research on environmental factors, 178–179
improving accessibility of health care facilities, 179–182
Rehabilitation Act, 33–34, 110n, 170, 172, 189, 202, 208n, 292n, 317, 491, 504
Electronic Equipment Accessibility amendment, 192
Section 504 of, 430
Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), 212n, 213–214
Rehabilitation engineering research, defining, 288n
Rehabilitation Engineering Research Centers, 168, 207, 210, 217, 293
focus of NIDRR-supported, 209
Rehabilitation Research and Development Service (RR&D), 5, 289, 299–300
funding trends for, 291
Rehabilitation Research and Training Centers, 293
Rehabilitation science, defining, 288n
Rehabilitation Services Administration, 310
Relative risk differences, between high- and low-risk participating health plans, 402
Research.
See also Federal disability research programs;
Organization of disability research
challenges, knowledge gaps, and research directions, 154–156
on environmental factors, recommendations concerning expansion of, 178–179
on health care transition planning, 129–130
on health care transitions for young people, directions for, 131
product research and development, 205–211
Research capacity, defining, 313
Research Data Assistance Center, 64
Research in Disabilities Education program, 303
Research to Aid Persons with Disabilities program, 303
RESNA. See Rehabilitation Engineering and Assistive Technology Society of North America
See also Medical costs, and populations;
Societal costs
assessing expansions of coverage in the context of rising costs, 282–283
and the challenge of expanding coverage of assistive services and technologies, 276–283
and implications for people with disabilities, 277–282
responses to rising costs and implications for people with disabilities, 277–282
Risk Adjustment for Measuring Health Care Outcomes, 395
Risk Adjustment Impact Study (RAIS), 401, 404–405
Risk adjustment methods
criteria for assessing, 244
recommendations for improving, 248–250
Risk adjustment models
design fitting the application, 417–418
influencing the accuracy of risk scores, 417–418
predictive ratios for alternative, 412
Risk adjustment of insurance premiums in the United States and implications for people with disabilities, 394–425
adequacy of capitation payment for people with disabilities, 408–415
conclusion, 423
current issues and trends, 421
implementation factors that can influence the accuracy of risk scores, 415–421
insurance programs for people with disabilities, 395–396
lessons from purchasers who have implemented HBRA for health plan payment, 406–408
medical costs and populations, 397–398
next generation methods, 421–423
risk segmentation in insurance markets and the need for health-based risk adjustment, 398–406
Risk segmentation in insurance markets
defining, 239n
and the need for health-based risk adjustment, 398–406
Risk selection, defining, 239n
Robert Wood Johnson Foundation (RWJF), 118n, 272n, 401
Rodde v. Bonta, 447
RR&D. See Rehabilitation Research and Development Service
S
Safe, Accountable, Flexible, Efficient Transportation Equity Act, 545
Sanchez v. Johnson, 444
SBIR. See Small Business Innovation Research Program
Scandinavia, 535
SCHIP. See State Children’s Health Insurance Program
School Board of Nassau County v. Arline, 466
Science and Technology in the Service of the Physically Handicapped, 22n
SCPE. See Specialized customer premises equipment
Secondary health conditions, 2
and aging with disability, 136–161
cross-condition studies of, 152–153
directions for research and education, 153–158
life span perspective, 139–144
recognizing, 46
and spinal cord injury, 146–148
Secondary prevention, 138
Section 255 of the Telecommunications Act, 503–507
historical background and legislation, 503–505
Section 508 of the Rehabilitation Act, in the ADA, 192–193, 507–508
Section 713 of the Communications Act, 511–515
emergency alert system, 514–515
historical background and legislation, 511–512
Selected Significant Condition risk adjustment model, 407
Senate Committee on Appropriations, 207, 302–303
Senate Select Committee on Aging, 521
Services. See Assistive technologies and services for people with disabilities;
Personal assistive services;
Personal care services
SHCN. See Special health care needs
SIPP. See Survey of Income and Program Participation
Small Business Innovation Research Program (SBIR), 294
Small Business Technology Transfer Program, 306
SNPs. See Special needs plans
SOA. See Society of Actuaries
Social and human service agencies, 542–546
Social Security Act, 33, 58n, 257, 268n, 269, 272n
amendments to, 80
Social Security Administration (SSA), 4, 11, 18, 81, 113–114, 134–135, 251
Social Security Disability Insurance (SSDI), 4, 14, 30, 33, 54n, 76n, 85, 95–96, 113n, 114, 222–223, 231, 246, 250–252, 457
Societal costs.
See also Costs;
Medical costs, and populations;
Rising costs disability and, 17–19
of inaction, 1
Society of Actuaries (SOA), 404, 411
Spanish relay services, 497
Special Education Elementary Longitudinal Study, 5
Special needs plans (SNPs), 395–396, 409
Special Olympics, 302
Specialized customer premises equipment (SCPE), 480
subsidies for, in the Telecommunications for the Disabled Act, 484–485
Speech-to-speech relay services, 496
Speed of answer considerations, 497
Spinal cord injury, literature on secondary conditions, 146–148
Sponsors of disability research, 300–308
Centers for Disease Control and Prevention, 301–303
National Science Foundation, 303–304
other units of the U.S. Department of Health and Human Services, 307–308
units of NIH other than NCMRR, 304–307
U.S. Department of Defense, 308
Spouses as caregivers, 19
SSA. See Social Security Administration
SSDI. See Social Security Disability Insurance
SSI. See Supplemental Security Income program
Standard models of insurance, in health insurance markets for people with disabilities, 235
Standards. See Mandatory minimum standards
Standards Committee 63 on Electromagnetic Compatibility, 489
STAR (transportation) systems, 543
State Children’s Health Insurance Program (SCHIP), 4, 8, 14, 109–110, 126, 129, 134, 234, 250–252, 263, 281, 284
State Medicaid Manual, 268n
State University of New York at Buffalo, 211
STP. See Supplemental Transportation Programs
Stress on individuals and families, increased, 1
IOM Committee on Disability in America: A New Look, 389–391
IOM Workshop on Disability in America: An Update, 387–389
Supplemental Security Income (SSI) program, 30, 54, 80, 85, 95, 96n, 109, 112, 114, 134, 232, 457
Supplemental Transportation Programs (STPs), 542
Support of disability research, 287–320
challenges of organizing and coordinating disability research, 308–314
federal disability research programs, 289–308
Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities, 55
Survey of Income and Program Participation (SIPP), 54, 56–57, 70, 94, 456–457, 459
Sutton v. United Airlines, Inc., 465
T
TAEA. See Telecommunications Accessibility Enhancement Act
TATRC. See Telemedicine and Advanced Technology Research Center
Tax Equity and Financial Responsibility Act, 270
TCRP. See Transit Cooperative Research Program
TDA. See Telecommunications for the Disabled Act
Technological change.
See also Assistive technologies and services for people with disabilities;
Available technologies;
Electronic technologies, advances in;
Information technologies, advances in;
Mainstream technologies
liberating consequences of, 23
policy implications of, 516–517
Technologies used or encountered by people with disabilities, 186–191
assistive technology defined, 186–189
in the environment, 114
mainstream technology and universal design defined, 189–191
Technology, defining, 186
Technology for Long-Term Care, 212
Technology-Related Assistance for Individuals with Disabilities Act, 186
Technology transfer and commercial application, challenge of, 210–211
Telecommunications Accessibility Enhancement Act (TAEA), 481, 502–503
Telecommunications Act
historical background and legislation, 503–505
Telecommunications for the Disabled Act (TDA), 480, 482–486
historical background and legislation, 482–485
Telecommunications relay services (TRS), 494–502
background and statutory provisions, 494–495
mandatory minimum standards, 500
other relay considerations, 497–498
Telemedicine and Advanced Technology Research Center (TATRC), 308
Telephones.
See also Wireless telephones coin-operated, 485
frequently needed by people with hearing loss, 485
provided for emergency use, 485
Teletypewriter (TTY) users, 479
Television Decoder Circuitry Act, 508–511
historical background and legislation, 508–509
Tennessee, 448
Text-to-speech relay services, 495
The ARC v. Braddock, 444
Ticket to Work and Work Incentives Improvement Act, 472
Ticket to Work and Work Incentives Panel, 114
Ticket to Work program, 4, 11, 114, 134–135
Title I of the ADA, 85
access to legal services, 470–471
ADA complainants with psychiatric disabilities, 471
the administrative charge process, 469–470
benefits for many plaintiffs through settlements, 468–469
employer practices and attitudes, 460–463
employment rates and wage disparities, 456–460
enforcement problems, 34, 469–471
measuring the effects, 456–464
narrowing the protected class in the courts, 465–469
plaintiff victories through lower court decisions, 468
Supreme Court decisions, 465–467
Title IV telecommunications relay services in the ADA, 494–502
background and statutory provisions, 494–495
Traditional transit services, need to improve, 534
Transit Cooperative Research Program (TCRP), 534
Transitions.
See also Health care transitions for young people with disabilities
care coordination and planning, 124
recommendations concerning secondary conditions, and aging with disability, 4, 10–12
Transitions from child to adult care, 101–103
adolescent population “at risk” for transition, 102–103
goals of health care transition planning for young people, 103
in a life span perspective, 100–101
Transportation patterns and problems of people with disabilities, 519–560
community transportation resources, 530–549
summary and conclusions, 552–554
transportation as part of a package of solutions, 549–551
transportation modes used by drivers with disabilities, 525
travel patterns of people with disabilities, 521–529
Traumatic Brain Injury Model System program, 312
Travel patterns of people with disabilities, 521–529
driving and the aging of society, 526–529
overall travel patterns, 522–526
travel modes used, 524
Trends
in chronic health conditions causing limitations of activity, 87
in chronic health conditions related to activity limitations, 95
in employment rates for people with any type of activity limitation, 86
in overweight (obesity) for children, 79
in the prevalence of obesity, 89
in the proportion of civilians needing help with ADLs or IADLs only, 83
in the proportion of civilians who are unable to work, 85
in self-reported health conditions and mobility limitations, 88
Trends in disability in early life, 73–82
declines in selected health conditions that contribute to, 81–82
potential explanations of trends, 75–81
Trends in disability in late life, 88–95
disabilities within group residential care settings, 92–93
health conditions associated with, 94
personal care and routine care limitations, 89–92
potential explanations for late-life trends, 94–95
Trends in disability in middle life, 82–88
conditions contributing to, 86–88
employment trends among adults with disabilities, 85–86
limitations in work, 84
personal care or routine care limitations, 82–83
TRS. See Telecommunications relay services
TTY. See Teletypewriter users
U
UCSF. See University of California at San Francisco
Uniform Federal Accessibility Standards, 182
United Cerebral Palsy Association, 148
United Kingdom, 58n, 102, 122, 527–528
United Nations, 54n
United States Army Research and Materiel Command, 308
United States Postal Service, 172
Universal design
Assistive Technology Act, 193
for health care facilities, 167
for mainstream technologies, 192–194
other policies, 194
principles of, 191
Section 508 of the Rehabilitation Act, 192–193
University of California at San Francisco (UCSF), 274
University of Maryland, 407
University of Michigan, 195, 211, 214, 259
University of Minnesota, 64
University of Pittsburgh Medical Center (UPMC), 215
U.S. Census Bureau, 4, 10, 17, 51–52, 57, 59–63, 67–68, 70, 91, 521
U.S. Commission on Civil Rights, 111
U.S. Congress, 4, 6–8, 11–15, 81, 113, 128, 158–159, 180–182, 192–193, 207–208, 210, 218–219, 238n, 245, 248–250, 254n, 256, 263, 285–286, 292n, 304, 306, 315–319, 481, 484
U.S. Constitution, 172
U.S. Department of Commerce, 195, 202, 206, 211
U.S. Department of Defense, 172, 207, 289, 299, 302, 308
U.S. Department of Education, 2, 4, 11, 58, 102, 111–112, 115n, 134–135, 207, 268n, 289, 294, 306, 310n, 316, 508
U.S. Department of Health and Human Services (DHHS), 4, 14, 55, 159, 171, 194n, 212, 233n, 278, 285–286, 289, 294, 302, 306–308, 430, 432, 438, 451.
See also individual agencies and offices
U.S. Department of Housing and Urban Development, 172
U.S. Department of Justice, 4, 6, 12, 171, 173–177, 180–181, 192–193, 202, 210, 429–430, 432, 438–439, 451
U.S. Department of Labor, 114, 293
U.S. Department of the Interior for Indian Affairs, 310n
U.S. Department of the Treasury, 502
U.S. Department of Transportation, 173, 289, 310n, 429, 466, 521, 531, 542
U.S. Department of Veterans Affairs (VA), 4, 12–13, 133n, 174–175, 180–182, 198, 207, 209, 259, 289, 310n
U.S. disability policy, timeline of milestones in, 31–32
U.S. Food and Drug Administration (FDA), 81, 197–198, 205, 207n, 258
U.S. Maternal and Child Health Bureau (MCHB), 4, 11, 58n, 74, 101–102, 110, 117, 134–135, 233n, 271, 307
U.S. Supreme Court, decisions of, 33, 80–81, 172, 174, 268, 270, 434, 448–450, 465–467
U.S. Surgeon General, 27–28, 101
Usability, FCC regulations concerning, 506
“Use-in-the-home.” See “In-home-use” criterion
V
VA. See U.S. Department of Veterans Affairs
VCO. See Voice and hearing carryover (VCO and HCO)
Veterans Health Administration (VHA), 4–5, 12, 146, 178–179, 224n
Video relay services (VRS), 496
interoperability of protocols, 499
Violations of standard insurance models in health care, in health insurance markets for people with disabilities, 235–237
Vocational Rehabilitation programs, 273
Voice and hearing carryover (VCO and HCO), 497
VRS. See Video relay services
W
Walter Reed Army Medical Center, 308
Washington Group, 54n
Washington Hospital Center, 174, 438, 447
highlights of ADA settlement involving, 176–177
Weak coordinating mechanisms, for disability research, 310–313
Web Accessibility Initiative, 482
Well-being, defining, 44n
West Virginia, 109n
Wheelchair Recycler, 275
WHO. See World Health Organization
Wireless telephones
in the Hearing Aid Compatibility Act, 488–491
hearing aid compatibility rules for, 490
Women’s Health and Aging Study, 49n, 57, 99
Work.
See also Employment
limitations in, 84
Workforce Investment Act, 192–193, 507
Workshop on Disability in America: A New Look, table of contents for, 392–393
World Health Assembly, 37
World Health Organization (WHO), 3, 5, 25, 36–37, 40, 42, 61, 305
World War II, 238n
World Wide Web Consortium, 482
Y
Young people with disabilities.
See also Health care transitions for young people with disabilities
examples of barriers to care coordination and transition for, 125
selected survey findings about postschool experiences of, 113
usual sources of health care for, 116
Younger adults with disabilities, 227–232.
See also Trends
employment-based insurance for, 228–231
Medicare and Medicaid for, 231–232
Your Rights Under the Americans with Disabilities Act, 430n