The Arc logo

The Arc’s Statement on the Military’s Pilot Program for Extending Behavioral Health Therapy for Autism Spectrum Disorders

Washington, DC – The Arc released the following statement after the passage of the 2013 National Defense Reauthorization Act in the House and Senate. The reauthorization will create a one year pilot program to expand the treatment of autism spectrum disorders (ASD) by TRICARE, the health care program for our nation’s military.

“We appreciate this step forward for military families that have children with ASD. We are hopeful that the pilot program will lay the foundation for making critical behavioral health therapies available to military dependents with a range of developmental disabilities that can greatly benefit from the services.

“We regret that language developed by Senators Kirsten Gillibrand and Patty Murray extending coverage to dependents with other developmental disabilities was not included in the final bill. There is considerable research proving applied behavioral analysis (ABA) to be an effective intervention for a number of developmental disabilities, including ASD. ABA is particularly effective in reducing self-injurious behaviors in people with the most significant disabilities.

“The inclusion of other developmental disabilities would also have greatly benefited military families who have children with ASD since many of these children only receive their diagnosis after many years. Limiting the covered services to those with an ASD diagnosis will result in children not being treated at the earliest age possible, which is shown to have lifelong, cost effective benefits.

“We look forward to the Secretary of Defense’s report on the feasibility and advisability of establishing a beneficiary cost share for the treatment of ASD under TRICARE and its Extended Care Health Option (ECHO) Program for dependents with disabilities,” stated Peter V. Berns, the Chief Executive Officer of The Arc.

The Arc logo

New Proposals in Budget Negotiations Could Result in Cuts to Social Security

Washington, DC – The Arc released the following statement in light of reports of new threats to Social Security in negotiations on a budget deal to avert the fiscal cliff. On the negotiating table is a change to the way benefits are calculated known as the “chained Consumer Price Index (CPI).”

“We are very disappointed by the newest proposals in Washington, DC that would result in a chained CPI. The chained CPI would cut all Social Security benefits, including for individuals receiving Social Security disability benefits and Supplemental Security Income. Social Security is an essential lifeline for individuals with disabilities, and the chained CPI would cut their benefits and unnecessarily damage their quality of life. Our nation cannot continue balancing the budget on the backs of individuals with disabilities and must preserve vital supports including Social Security, SSI, Medicaid, and Medicare,” said Marty Ford, Director, Public Policy Office, The Arc.

The chained CPI reduces the cost-of-living adjustment (COLA) that Social Security and Supplemental Security Income (SSI) beneficiaries receive in most years, resulting in people getting smaller benefit increases than they otherwise would under the current calculation.

Cuts from the chained CPI compound and get bigger every year. For the average Social Security Disability Insurance (SSDI) beneficiary, the chained CPI would mean a benefit cut of about $347 per year after 10 years, $720 per year after 20 years, and $1,084 per year after 30 years. After 30 years, the cut is roughly 1 months’ worth of benefits for the average SSDI beneficiary. For SSI, the chained CPI not only lowers the annual COLA but also reduces the initial SSI benefit, which is calculated using a federal benefit rate that adjusts annually for inflation.

The Arc logo

The Arc Responds to New York Times Column on Children’s SSI Program

Washington, DC – In response to The New York Times’ Nicholas Kristof’s December 7 op-ed, “Profiting from a Child’s Illiteracy”, The Arc released the following statement:

“Mr. Kristof’s take on how to break the cycle of poverty completely misses the mark. Our nation doesn’t have to choose between providing two essential supports for low-income children with significant disabilities: early childhood programs and Supplemental Security Income, a lifeline. We must do both. Children with severe disabilities must have access to robust, timely supports to help make the most of their early development, while at the same time, many who are low-income also need Supplemental Security Income to ensure a quality of life that isn’t crushed by economic circumstances. If the Supplemental Security Income lifeline is slashed thanks to articles like this one, it’s those most in need – the children with significant disabilities and their families, who face unimaginable day in and day out financial and personal struggles – who will suffer,” said Peter V. Berns, CEO of The Arc.

The Arc logo

The Arc Announces New Members on National Board of Directors

Washington, DC — The Arc elected a slate of new and returning members of the board of directors to lead its work for the next two years at its recent annual business meeting. This distinguished group includes professionals in the intellectual and developmental disability (I/DD) field and affiliated services, parents, and self-advocates representing a cross section of leaders in this movement dedicated to promoting and protecting the human rights of people with I/DD and supporting their full inclusion and participation in the community throughout their lifetimes.

The Arc’s new board president, Nancy Webster of Indian Head Park, Illinois, said upon her appointment: “I’m honored to be a part of this organization’s leadership at this critical juncture in our movement. We have come so far – closing institutions and moving people into communities across the country, expanding services so that people with disabilities are included in society, and educating the public about what people with I/DD can achieve – but we have a lot of work ahead of us. New challenges emerge every day that threaten the progress we have made, and The Arc is uniquely poised to lead the charge to ensure the rights of people with disabilities are protected across the nation.”

Peter V. Berns, CEO of The Arc, said: “Under Nancy’s leadership and with the strong backing of the incredibly diverse and talented individuals appointed to our board, The Arc has powerful momentum going into 2013. I thank all of our new board members and outgoing appointees for their commitment to people with I/DD and their dedication to the long term success of The Arc.”

The Arc’s Board Development Committee completed the process of preparing the slate of officers and directors for election in July. The Committee identified and selected a group of candidates that, collectively, has the knowledge, skills and expertise to meet The Arc’s leadership needs. The process by which the Committee worked to select the candidates unfolded over the course of a year, and included reviewing the board roles and responsibilities, developing a nominating process work plan, reviewing and updating the criteria relevant to board composition, conducting a board composition analysis, and completing candidate interviews. The slate was then presented at the 2012 annual business meeting.

National Board Members of The Arc

Officers

President: Nancy Webster, Indian Head Park, IL – Nancy has served as a member of the board of directors since 2002. Previously, she served as the Chair of the Committee on the Future of The Arc. Prior to joining the board of directors for The Arc, Nancy was active in The Arc of Illinois. Her first and most important advocacy role has been as a sibling to her sister, Martha, who has an intellectual disability.

Vice President: Ron Brown, Dallas, TX – Ron has served as a member of the board of directors since 2006. He has over 36 years of experience in the volunteer arena as an advocate for the disability community. He has served on the local, state, and national board of directors of The Arc.

Treasurer: M.J. Bartelmay, Hermitage, PA – M.J. has served The Arc at every level – national, state, and local since 1992. He is a Past-President of both The Arc of Pennsylvania and a local chapter. In addition to his work with The Arc, he has also held numerous positions as an advocate and leader for people with I/DD. M.J. has a son with an intellectual disability.

Secretary: Elise McMillan, Nashville, TN – Elise has served as a member of the board of directors since 2005. She also serves as a Co-Chair of the Policy and Positions Committee, which is responsible for updating The Arc’s position statements. She is a Past-President of The Arc of Davidson County and The Arc of Tennessee and she remains actively involved with both chapters. In addition to her work for The Arc, Elise is Co-Director of the Vanderbilt Kennedy Center for Excellence in Developmental Disabilities; Director of Community Outreach; and Senior Associate in the Department of Psychiatry. Elise and her husband have three adult children, including a son with Down syndrome.

Immediate Past President: Mohan Mehra, Cortlandt Manor, NY – Mohan has served in leadership positions with The Arc at the national, state and local levels. He has 25 years of experience in business strategy, marketing, sales, and business development at General Foods Corporation and Kraft Foods and as a consultant for major consumer packaged goods companies. Mohan and his wife are parents of Brian, a young man with Down syndrome.

Returning Board Members

Tony Anderson, Sacramento, CA – Tony is the Chair of the National Conference of Executives (NCE), and Executive Director of The Arc of California.

Barbara Coppens, Cherry Hill, NJ – Barbara is a self-advocate and currently works as an Advocate Assistant with Disability Rights New Jersey. She also serves on the board of directors for The Arc of New Jersey and is a member of the governmental affairs committee. Over the years she has also been involved with Partners in Policy Making.

Hugh M. Evans, Baltimore, MD – Hugh is a Vice President of T. Rowe Price Group, Inc. He is the parent of a young daughter with Trisomy 21.

Gary Horner, Pittsburgh, PA –Gary is the Executive Vice President and Chief Financial Officer of ACHIEVA/The Arc of Greater Pittsburgh.

Thomas A. Judd, Esq. Minneapolis, MN – Thomas is an active member of The Arc of Greater Twin Cities in St. Paul, MN, where he served as president of the board of directors. He is personally connected to The Arc’s mission as a family member of several people with disabilities.

Michael Mack, Silver Spring, MD – Michael has been on the board of directors since 2004. He serves as Co-Chair of the Policy and Positions Committee that is responsible for updating The Arc’s position statements. Michael is the parent of a young man with an intellectual disability.

Joseph Meadours, Sacramento, CA – Joe is a self-advocate and author of three books, one of which focuses on policymaking from the viewpoint of a self-advocate.

Pat Napoliello, San Francisco, CA – Pat is a parent of Joseph, who has Angelman Syndrome, and has been the inspiration for her years of advocacy.

Randy Patrick, Aurora, CO – Randy is also on the board of The Arc of Colorado, and is an Account Manager with Rexell USA.

Kurt Rutzen, Minneapolis, MN –Kurt is a self-advocate and program specialist for the University of Minnesota Institute on Community Integration’s Research and Training Center on Community Living.

New Board Members

Fred Misilo, Northborough, MA – Fred is the Immediate Past-President of The Arc of Massachusetts and a longstanding board member of that chapter. He has devoted 35 years of service to The Arc both locally and nationally. Fred is an Officer and Chair of the Trust and Estate Department and Chair of the Elder Law and Special Needs Practice Group at the law firm of Fletcher Tilton PC.

Michele Poole, Lake Worth, FL – Michele has served for many years on the state and local level as the President of The Arc of Palm Beach and as board member. She is the current President of The Arc of Florida. On the national level, Michele was co-founder and Past President of the Shaken Baby Coalition. She has a daughter with a developmental disability. She is also CFO-Secretary-Treasurer at North Ridge Electric, Inc. in Pompano Beach, FL.

Philip Richards, Birmingham, AL – Phillip is the Past-President of The Arc of Walker County, Past-President of The Arc of Jefferson County, and currently sits on the board of The Arc of Alabama. On the national level, he has served on the Marketing and Resource Development Committee when The Arc began its work to develop a new visual identity and brand. Philip is a Manager of External Affairs at Energen, a diversified energy company.

Margaret-Lee Thompson, Redmond, WA – Margaret-Lee has worked in public policy for 40 years. She became a member of The Arc of Washington when her son was born in 1968, and has remained an active advocate with The Arc ever since. She is the founder of the King County Parent Coalition for Developmental Disabilities, a grassroots organization involved in advocacy and parent education.

Carol Wheeler, Washington, DC – Carol is a member of the President’s Committee for People with Intellectual Disabilities. Her professional experience includes leadership roles in a wide range of non-profit organizations and positions in the White House, on Capitol Hill and as Vice President of Government Affairs for the National Association of Broadcasters. She is the mother of a transition age son with Williams Syndrome.

On December 20, 2012 Gary Bass, Doug Church, and Kelly Piacenti are expected to be elected as Board Elected Directors:

Gary Bass, Washington, DC – Gary is the Executive Director of the Bauman Foundation, a Washington, DC based grant making foundation. In 1983, he founded OMB Watch, a national research, educational, and advocacy organization that he directed or 28 years. He has deep expertise in public policy and fundraising.

Doug Church, Oak Hill, VA – Doug is the Founding Chairman and Director of Virginia Heritage Bank, and the father of an adult son with intellectual and developmental disabilities. He also serves as the Chairman of the Arc of Northern Virginia’s Foundation

Kelly Piacenti, Chester, NJ – Kelly is the Special Needs National Director, The MetLife Center for Special Needs, and the mother of a young son with developmental disabilities.

The Arc also thanks our outgoing Board members: Joyce Lipman (Maryland), Susan Bassett (Indiana), Sam Givhan (Mississippi), and Mary Jordan (Tennessee).

The Arc logo

Parent, Advocate for The Arc Lunches With Vice President Biden to Discuss Fiscal Cliff’s Impact on His Family

Washington, DC – Today, Bob Hage of Pennington, New Jersey, a parent of twin daughters with significant disabilities and tireless advocate for The Arc, met with Vice President Joe Biden for lunch along with six other individuals at the Metro 29 Diner in Arlington, Virginia to share his story about how a $2,000 or more middle class tax increase as a result of going over the “fiscal cliff” will impact his family’s ability to pay for disability-related expenses in 2013.

Bob Hage and his wife Odette Adrian are a middle class family struggling to make ends meet. They have a 13-year old son Vann, and twin 9-year old daughters Annika and Maya, who have severe developmental disabilities and are non-verbal and medically fragile. As a family with children with special needs, they experience the same expenses and stresses other families encounter. However, they also face the additional financial, emotional, and physical challenges of providing very expensive care for two of their children.

“This was a critical opportunity to impress upon the Vice President the importance of protecting Annika, Maya, and millions of families like ours from a tax increase that will have devastating consequences. My daughters can’t afford to lose the ground they have gained through therapies that will allow them to reach their full potential. Not only did Vice President Biden listen, he clearly understands the challenges families like mine face, and I walked away trusting that the Vice President will do everything he can to protect my daughters’ future,” said Bob Hage.

Bob Hage and his wife Odette Adrian want Annika and Maya to have happy and fulfilling lives just as other parents want for their children. In order for them to help Annika and Maya achieve these goals, they need to pay for critical services. If the country goes over the “fiscal cliff” and their taxes go up $2000 or more, they will be forced to eliminate some of their daughters’ therapies and activities, which have proven to be crucial to their development.

Annika and Maya go to speech therapy, which has been instrumental in moving them from being totally dependent on liquid tube feedings to eating all their nutrition from pureed foods. Currently, speech therapy’s primary goal is to help Annika and Maya learn to chew so they can eat solid food.

Annika and Maya have significant dental issues and anything other than regular checkups, such as fillings and beyond, requires hospitalization and anesthesia. These other routine procedures are not covered by their medical insurance and will be cost prohibitive.

Both girls participate in weekly music and gymnastics classes for children with special needs. While music and gymnastics is recreational for most children, it is vitally important to Annika and Maya’s development. The music class focuses on building finger strength and coordination through piano and helps the girls to vocalize through singing. The gymnastics class concentrates on building muscular strength and endurance which is especially important for children with low muscular tone.

An increase of $2,000 or more in taxes would have a major impact on the Adrian-Hages’ ability to provide the services and supports their children with severe disabilities need.

“Annika and Maya shouldn’t face the consequences of gridlock in Washington over taxes. My girls need these services to learn and keep basic life skills, like chewing food, and to gain some strength so that they can be as independent as possible. But my wife and I may be forced to make some unimaginable choices if our taxes go up by $2,000 at the beginning of the year,” said Bob Hage.

The Arc logo

The Arc’s Public Policy Director to Be Honored by Social Security Administration

Washington, DC – Today, The Arc’s Marty Ford, will be honored by the Social Security Administration (SSA) for her years of leadership and commitment to SSA’s disability programs. Ford serves as the Director of The Arc’s Public Policy office, driving the organization’s public policy agenda.

In her current role, she leads the five person team representing The Arc on Capitol Hill and before federal agencies. With nearly 30 years of experience, Ford is a recognized leader in federal public policy affecting people with disabilities, particularly the Social Security disability system, long term services and supports, and Medicaid, and has testified numerous times before Congress. She served three years as Chairperson of the Consortium for Citizens with Disabilities (CCD), a coalition of over 110 national organizations, and continues as its Immediate Past Chairperson. She also serves on the Boards of Directors of the National Academy of Social Insurance and Advance CLASS.

The award will be presented by Michael J. Astrue, Commissioner of Social Security, on Capitol Hill on Thursday, December 6. During the event, Commissioner Astrue will also announce the expansion of the list of conditions that qualify under SSA’s Compassionate Allowances program. The Compassionate Allowances program is designed to quickly identify diseases and other medical conditions that, by definition, meet Social Security’s strict standards for disability benefits. Since its inception, the initiative has helped ensure that Americans with the most severe disabilities receive their benefit decision within days instead of months or years.

“I’m honored to be receiving this award, and I want to thank Commissioner Astrue for his years of service at the Social Security Administration and his efforts to improve the agency’s services to people with disabilities, including people with intellectual and developmental disabilities. As he wraps up his term, the expansion of the Compassionate Allowances program will be an important part of his legacy,” said Ford.

The Arc logo

The Arc Reacts to the U.S. Senate’s Defeat of the Convention on the Rights of Persons With Disabilities

Washington, DC – The Arc released the following statement in response to the U.S. Senate’s defeat of the United Nations Convention on the Rights of Persons with Disabilities (CRPD).

“This is a sad day for individuals with disabilities across the globe. The simple truth is that the Convention on the Rights of Persons with Disabilities would help individuals with disabilities around the world obtain the rights and protections we have here in the United States. The ratification of this treaty would have unified us with millions of disability advocates, family members, and self-advocates of all nations. This isn’t the end of this fight – advocates across our country will continue to work to make sure that our friends and colleagues abroad know that we stand with them and share their goals,” said Peter Berns, CEO of The Arc.

The Arc has been working with numerous other disability advocacy groups and U.S. Senators to garner support for the ratification of this treaty, which will promote, protect, and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities. For months, The Arc’s Public Policy team and grassroots advocates across the country have been working to promote the CRPD and ensure ratification. And in October 2012, The Arc hosted its annual convention in Washington, DC with Inclusion International, a global federation of family-based organizations advocating for the human rights of people with intellectual disabilities worldwide. A major focus of the conference was the vital importance of the CRPD and the release of Inclusion International’s Global Report on the Right to Live and Be Included in the Community.

The United States signed the CRPD on July 30, 2009, joining the 141 other signing nations. As of June 2012, the Convention had 113 ratifications and 153 signatures. On May 17, 2012, following almost three years of thorough review, the Obama Administration submitted its treaty package to the U.S. Senate for its advice and consent for ratification. Over 165 disability rights organizations and 21 veterans’ service organizations support ratification of the treaty. Senator Bob Dole, who was a champion of the Americans with Disabilities Act, was present for the vote and urged his fellow Republicans to vote in favor of the treaty. Unfortunately, his plea along with strong Congressional and disability community support was not enough to overcome the unfounded fears raised by the opposition.

The Arc logo

The Arc Responds to ABC News Report on Restraint and Seclusion

Washington, DC – After reviewing the ABC News piece on restraint and seclusion in America’s schools, The Arc issued the following statement.

“No child should ever be exposed to these kinds of harmful practices. Children with disabilities are especially at risk and these practices are used on them at disproportionate rates. The Arc applauds ABC News’ work to shed light on restraint and seclusion in America’s schools, and we hope it sparks action in Congress to pass legislation to put in place national standards that keep our classrooms safe and require all school personnel to receive training in effective positive behavioral interventions,” said Peter Berns, CEO of The Arc.

Background

Reports from the Government Accountability Office and the National Disability Rights Network have documented that children are injured, traumatized and even killed as a result of restraint and seclusion in schools and that the use of these dangerous techniques is widespread. The Arc believes that the harm suffered by students through the use of dangerous restraint and seclusion practices in our nation’s schools is unacceptable. Numerous alternatives to restraint and seclusion exist, including positive behavioral interventions and supports and other methods for preventing and stopping problem behaviors.

In March of 2012, The Office for Civil Rights in the U.S. Department of Education released data from the 2009-10 school year that shows that tens of thousands of school-aged children were secluded or restrained. The Department’s data are from 72,000 schools that educate 85 percent of the nation’s students. It shows that 70 percent of students subjected to the techniques have disabilities. There are no current federal standards on the use of the techniques in schools.

The Arc supports the Keeping All Students Safe Act, introduced by U.S. Senator Tom Harkin of Iowa and U.S. Representative George Miller of California, to allow the use of physical restraint only when someone is in danger of being harmed, while ensuring that personnel receive proper training, that parents are aware of any restraint or seclusion used with their children and that the most dangerous types of restraint and seclusion are eliminated.

The Arc logo

The Arc at the Table With President Obama to Discuss Tax Cuts for the Middle Class, Budget, and Medicaid

Washington, DC– Today, The Arc’s CEO Peter Berns participated in a small meeting with President Barack Obama, Vice President Joe Biden, and senior economic advisors about the President’s goal to stop middle class tax increases and to raise revenues to help invest in the nation and reduce the deficit. The discussion centered on the urgency of passing a plan to avert raising taxes on the middle class and to raise revenues to finance the federal government without allowing drastic cuts to programs that people with intellectual and developmental disabilities (I/DD) and other vulnerable groups rely on, like education, housing and employment. These cuts are scheduled to take place on January 1, 2013, along with the expiration of a variety of tax provisions. Without a deal this year, The Arc is very concerned about the future of Medicaid and Supplemental Security Income, along with Social Security and Medicare.

“I think everyone agrees that raising taxes on the middle class will hurt families, and that it would be particularly troubling to those that have a loved one with I/DD. These families report that they already don’t have the money they need for the care and support their loved ones need to live a decent life in the community. What will they do if they suddenly have a bigger tax bill come January 1st?” Berns said.

“We welcome the President’s framework for generating revenue and protecting low income families,” Berns added. “Medicaid, Medicare, Social Security, and Supplemental Security Income, which are lifeline programs for people with disabilities, should not be at risk in these budget negotiations. This approach from President Obama would help keep our nation’s commitment to people with disabilities.”

The Arc has been on the front lines of the recent budget battles to protect Medicaid, Social Security, Supplemental Security Income, and Medicare from cuts. As the nation faces this January 1 deadline, known as the “fiscal cliff”, The Arc is urging Congress to restore the scheduled cuts in non-defense discretionary programs and find other ways – specifically through increasing revenues as included in President Obama’s plan – to move the nation forward. This effort is critical to protecting the people that rely on Medicaid, Social Security, Supplemental Security Income, and Medicare from losing these critical services and supports.

“We can’t afford to not protect Medicaid. Medicaid is the lifeline keeping people with disabilities from unfathomable alternatives – like being institutionalized and losing their independence – and preserving all that we have worked for as a nation over the last 60 years to bring people with disabilities out of the shadows and into society,” said Berns.

Berns was joined at the White House by Sister Simone Campbell, NETWORK, Chad Griffin, Human Rights Campaign, Wade Henderson, Leadership Conference on Civil Rights, Deepa Iyer, National Council of Asian Pacific Americans, Ben Jealous, NAACP, Marc Morial, National Urban League, Janet Murguia, National Council of La Raza, Barry Rand, AARP, Kristin Rowe-Finkbeiner, MomsRising.org, Rev. Al Sharpton, National Action Network, Aaron Smith, Young Invincibles, and Rev. Jim Wallis, Sojourners.

The Arc logo

The Arc of Virginia to Receive National Award for Victory on Closing Institutions

Washington, DC – On October 26, The Arc of Virginia will be honored with The Arc’s Advocacy Matters! Award for their ongoing advocacy work on behalf of individuals with intellectual and developmental disabilities (I/DD) in Virginia. The Arc of Virginia played an instrumental role in the Commonwealth of Virginia and the U.S. Department of Justice (DOJ) reaching an historic settlement (U.S. v. Virginia Settlement Agreement) requiring the state to close some institutions and provide community-based services for thousands of individuals with I/DD. The award will be presented during The Arc of the United States’ National Convention and International Forum. Jamie Liban, Executive Director of The Arc of Virginia will accept the award on behalf of the organization.

“The Arc of Virginia has tirelessly advocated on behalf of individuals with intellectual and developmental disabilities for decades. Like all civil rights victories, there were many advocates working for a common cause leading up to this historic settlement. We are proud of the amazing work of Jamie Liban, The Arc of Virginia Board of Directors and the thousands of advocates who helped make this a reality for the people of Virginia,” said Peter Berns, CEO of The Arc.

Judge John A. Gibney of the United States District Court for the Eastern District of Virginia issued an order approving the settlement in U.S. v. Virginia Settlement Agreement on August 23. The signing of the court order means that Virginia will move from a system that is reliant on large, segregated institutions to one that is focused on safe, integrated community-based services. Virginia will close four of five institutions and provide new Medicaid waiver services for more than 4,000 individuals. Once the waivers are fully funded, thousands of individuals with I/DD will receive the services they need to remain in their homes in the community and many individuals living in institutions will be able to move into community settings.

Jamie Liban will also participate in a concurrent session with officials from the Department of Justice during convention. During the session, she will share The Arc of Virginia’s experience over the course of the DOJ investigation, negotiations and litigation, as well as The Arc of Virginia’s plans to continue its advocacy work throughout the implementation phase. The session will provide an overview of activities related to the U.S. v. Virginia Settlement Agreement and advise other chapters of The Arc on how they can support DOJ in their enforcement of the Americans with Disabilities Act and the Olmstead decision, a ruling that requires states to eliminate unnecessary segregation of people with disabilities and to ensure that persons with disabilities receive services in the most integrated setting appropriate to their needs.