Disability Integration Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 555 To prohibit discrimination against individuals with disabilities who need long- term services and supports, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JANUARY 15, 2019 Mr. SENSENBRENNER (for himself, Mr. DOGGETT, Ms. NORTON, Mr. WELCH, Mr. FITZPATRICK, Mr. CONNOLLY, Ms. TITUS, Mr. SERRANO, Mr. MORELLE, Mr. ESPAILLAT, Ms. DEAN, Mr. SUOZZI, Mr. CARBAJAL, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. MCGOVERN, Mr. KATKO, Mr. PERLMUTTER, Mr. DELGADO, Mr. HIGGINS of New York, Ms. MATSUI, Ms. WASSERMAN SCHULTZ, Ms. OCASIO-CORTEZ, Ms. DELAURO, Ms. DEGETTE, Mr. RASKIN, Ms. BARRAGA´N, Mr. CUMMINGS, Mr. LANGEVIN, Ms. SCHAKOWSKY, Miss RICE of New York, Mr. RUPPERSBERGER, Ms. STEFANIK, Ms. BONAMICI, Mr. CROW, Mr. ENGEL, Mr. TIPTON, Mr. PETERSON, Mr. CASTRO of Texas, Mrs. LAWRENCE, Mr. NEGUSE, and Mr. BRINDISI) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To prohibit discrimination against individuals with disabil- ities who need long-term services and supports, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 555 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Disability Integration 2 Act of 2019’’. 3 SEC. 2. FINDINGS AND PURPOSES. 4 (a) FINDINGS.—Congress finds the following: 5 (1) In enacting the Americans with Disabilities 6 Act of 1990 (referred to in this Act as the ‘‘ADA’’), 7 Congress— 8 (A) recognized that ‘‘historically, society 9 has tended to isolate and segregate individuals 10 with disabilities, and, despite some improve- 11 ments, such forms of discrimination against in- 12 dividuals with disabilities continue to be a seri- 13 ous and pervasive social problem’’; and 14 (B) intended that the ADA assure ‘‘full 15 participation’’ and ‘‘independent living’’ for in- 16 dividuals with disabilities by addressing ‘‘dis- 17 crimination against individuals with disabilities 18 [that] persists in critical areas’’, including insti- 19 tutionalization. 20 (2) While Congress expected that the ADA’s in- 21 tegration mandate would be interpreted in a manner 22 that ensures that individuals who are eligible for in- 23 stitutional placement are able to exercise a right to 24 community-based long-term services and supports, 25 that expectation has not been fulfilled. 26 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 555 IH (3) The holdings of the Supreme Court in 1 Olmstead v. L.C., 527 U.S. 581 (1999), and com- 2 panion cases, have clearly articulated that individ- 3 uals with disabilities have a civil right under the 4 ADA to participate in society as equal citizens. How- 5 ever, many States still do not provide sufficient com- 6 munity-based long-term services and supports to in- 7 dividuals with disabilities to end segregation in insti- 8 tutions. 9 (4) The right to live in the community is nec- 10 essary for the exercise of the civil rights that the 11 ADA was intended to secure for all individuals with 12 disabilities. The lack of adequate community-based 13 services and supports has imperiled the civil rights 14 of all individuals with disabilities, and has under- 15 mined the very promise of the ADA. It is, therefore, 16 necessary to recognize in statute a robust and fully 17 articulated right to community living. 18 (5) States, with a few exceptions, continue to 19 approach decisions regarding long-term services and 20 supports from social welfare and budgetary perspec- 21 tives, but for the promise of the ADA to be fully re- 22 alized, States must approach these decisions from a 23 civil rights perspective. 24 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 555 IH (6) States have not consistently planned to en- 1 sure sufficient services and supports for individuals 2 with disabilities, including those with the most sig- 3 nificant disabilities, to enable individuals with dis- 4 abilities to live in the most integrated setting. As a 5 result, many individuals with disabilities who reside 6 in institutions are prevented from residing in the 7 community and individuals with disabilities who are 8 not in institutions find themselves at risk of institu- 9 tional placement. 10 (7) The continuing existence of unfair and un- 11 necessary institutionalization denies individuals with 12 disabilities the opportunity to live and participate on 13 an equal basis in the community and costs the 14 United States billions of dollars in unnecessary 15 spending related to perpetuating dependency and 16 unnecessary confinement. 17 (b) PURPOSES.—The purposes of this Act are— 18 (1) to clarify and strengthen the ADA’s inte- 19 gration mandate in a manner that accelerates State 20 compliance; 21 (2) to clarify that every individual who is eligi- 22 ble for long-term services and supports has a feder- 23 ally protected right to be meaningfully integrated 24 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 555 IH into that individual’s community and receive commu- 1 nity-based long-term services and supports; 2 (3) to ensure that States provide long-term 3 services and supports to individuals with disabilities 4 in a manner that allows individuals with disabilities 5 to live in the most integrated setting, including the 6 individual’s own home, have maximum control over 7 their services and supports, and ensure that long- 8 term services and supports are provided in a manner 9 that allows individuals with disabilities to lead an 10 independent life; 11 (4) to establish a comprehensive State planning 12 requirement that includes enforceable, measurable 13 objectives that are designed to transition individuals 14 with all types of disabilities at all ages out of institu- 15 tions and into the most integrated setting; and 16 (5) to establish a requirement for clear and uni- 17 form annual public reporting by States that includes 18 reporting about— 19 (A) the number of individuals with disabil- 20 ities who are served in the community and the 21 number who are served in institutions; and 22 (B) the number of individuals with disabil- 23 ities who have transitioned from an institution 24 to a community-based living situation, and the 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 555 IH type of community-based living situation into 1 which those individuals have transitioned. 2 SEC. 3. DEFINITIONS AND RULE. 3 (a) DEFINITIONS.—In this Act: 4 (1) ACTIVITIES OF DAILY LIVING.—The term 5 ‘‘activities of daily living’’ has the meaning given the 6 term in section 441.505 of title 42, Code of Federal 7 Regulations (or a successor regulation). 8 (2) ADMINISTRATOR.—The term ‘‘Adminis- 9 trator’’ means— 10 (A) the Administrator of the Administra- 11 tion for Community Living; or 12 (B) another designee of the Secretary of 13 Health and Human Services. 14 (3) COMMUNITY-BASED.—The term ‘‘commu- 15 nity-based’’, when used in reference to services or 16 supports, means services or supports that are pro- 17 vided to an individual with an LTSS disability to en- 18 able that individual to live in the community and 19 lead an independent life, and that are delivered in 20 whichever setting the individual with an LTSS dis- 21 ability has chosen out of the following settings with 22 the following qualities: 23 (A) In the case of a dwelling or a nonresi- 24 dential setting (such as a setting in which an 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 555 IH individual with an LTSS disability receives day 1 services and supported employment), a dwelling 2 or setting— 3 (i) that, as a matter of infrastructure, 4 environment, amenities, location, services, 5 and features, is integrated into the greater 6 community and supports, for each indi- 7 vidual with an LTSS disability who re- 8 ceives services or supports at the setting— 9 (I) full access to the greater com- 10 munity (including access to opportuni- 11 ties to seek employment and work in 12 competitive integrated settings, en- 13 gage in community life, control per- 14 sonal resources, and receive services 15 in the community); and 16 (II) access to the greater commu- 17 nity to the same extent as access to 18 the community is enjoyed by an indi- 19 vidual who is not receiving long-term 20 services or supports; 21 (ii) that the individual has selected as 22 a meaningful choice from among nonresi- 23 dential setting options, including nondis- 24 ability-specific settings; 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 555 IH (iii) in which an individual has rights 1 to privacy, dignity, and respect, and free- 2 dom from coercion and restraint; 3 (iv) that, as a matter of infrastruc- 4 ture, environment, amenities, location, 5 services, and features, optimizes, but does 6 not regiment, individual initiative, auton- 7 omy, and independence in making life 8 choices, including choices about daily ac- 9 tivities, physical environment, and persons 10 with whom the individual interacts; and 11 (v) that, as a matter of infrastructure, 12 environment, amenities, location, services, 13 and features, facilitates individual choice 14 regarding the provision of services and 15 supports, and who provides those services 16 and supports. 17 (B) In the case of a dwelling, a dwelling— 18 (i) that is owned by an individual with 19 an LTSS disability or the individual’s fam- 20 ily member; 21 (ii) that is leased to the individual 22 with an LTSS disability under an indi- 23 vidual lease, that has lockable access and 24 egress, and that includes living, sleeping, 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 555 IH bathing, and cooking areas over which an 1 individual with an LTSS disability or the 2 individual’s family member has domain 3 and control; or 4 (iii) that is a group or shared resi- 5 dence— 6 (I) in which no more than 4 un- 7 related individuals with an LTSS dis- 8 ability reside; 9 (II) for which each individual 10 with an LTSS disability living at the 11 residence owns, rents, or occupies the 12 residence under a legally enforceable 13 agreement under which the individual 14 has, at a minimum, the same respon- 15 sibilities and protections as tenants 16 have under applicable landlord-tenant 17 law; 18 (III) in which each individual 19 with an LTSS disability living at the 20 residence— 21 (aa) has privacy in the indi- 22 vidual’s sleeping unit, including a 23 lockable entrance door controlled 24 by the individual; 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 555 IH (bb) shares a sleeping unit 1 only if such individual and the 2 individual sharing the unit choose 3 to do so, and if individuals in the 4 residence so choose, they also 5 have a choice of roommates with- 6 in the residence; 7 (cc) has the freedom to fur- 8 nish and decorate the individual’s 9 sleeping or living unit as per- 10 mitted under the lease or other 11 agreement; 12 (dd) has the freedom and 13 support to control the individ- 14 ual’s own schedules and activi- 15 ties; and 16 (ee) is able to have visitors 17 of the individual’s choosing at 18 any time; and 19 (IV) that is physically accessible 20 to the individual with an LTSS dis- 21 ability living at the residence. 22 (4) DWELLING.—The term ‘‘dwelling’’ has the 23 meaning given the term in section 802 of the Fair 24 Housing Act (42 U.S.C. 3602). 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 555 IH (5) HEALTH-RELATED TASKS.—The term 1 ‘‘health-related tasks’’ means specific nonacute 2 tasks, typically regulated by States as medical or 3 nursing tasks that an individual with a disability 4 may require to live in the community, including— 5 (A) administration of medication; 6 (B) assistance with use, operation, and 7 maintenance of a ventilator; and 8 (C) maintenance and use of a gastrostomy 9 tube, a catheter, or a stable ostomy. 10 (6) INDIVIDUAL WITH A DISABILITY.—The term 11 ‘‘individual with a disability’’ means an individual 12 who is a person with a disability, as defined in sec- 13 tion 3 of the Americans with Disabilities Act of 14 1990 (42 U.S.C. 12102). 15 (7) INDIVIDUAL WITH AN LTSS DISABILITY.— 16 The term ‘‘individual with an LTSS disability’’ 17 means an individual with a disability who— 18 (A) in order to live in the community and 19 lead an independent life requires assistance in 20 accomplishing— 21 (i) activities of daily living; 22 (ii) instrumental activities of daily liv- 23 ing; 24 (iii) health-related tasks; or 25 VerDate Sep 11 2014 21:01 Feb 04, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H555.IH H555 pamtmann on DSKBFK8HB2PROD with BILLS 12 •HR 555 IH (iv) other functions, tasks, or activi- 1 ties related to an activity or task described 2 in clause (i), (ii), or (iii); and 3 (B)(i) is currently in an institutional place- 4 ment; or 5 (ii) is at risk of institutionalization if the 6 individual does not receive community-based 7 long-term services and supports. 8 (8) INSTRUMENTAL ACTIVITIES OF DAILY LIV- 9 ING.— 10 (A) IN GENERAL.—The term ‘‘instru- 11 mental activities of daily living’’ means one or 12 more activities related to living independently in 13 the community, including activities related to— 14 (i) nutrition, such as preparing meals 15 or special diets, monitoring to prevent 16 choking or aspiration, or assisting with 17 special utensils; 18 (ii) household chores and environ- 19 mental maintenance tasks; 20 (iii) communication and interpersonal 21 skills, such as— 22 ( [Text truncated for display. 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