The Administration for Community Living (ACL) administers programs authorized through a variety of statutes.
Note: Links to legislation may connect to external webpages.
Developmental Disabilities Act
The purpose of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act), as described in the current law, is to “assure that individuals with developmental disabilities and their families participate in the design of and have access to needed community services, individualized supports, and other forms of assistance that promote self-determination, independence, productivity, and integration and inclusion in all facets of community life …" This legislation created the Administration on Intellectual and Developmental Disabilities (AIDD) at ACL.
Older Americans Act
Congress passed the Older Americans Act (OAA) in 1965 (updated most recently in 2016) in response to concern by policymakers about a lack of community social services for older persons. The original legislation established authority for grants to states for community planning and social services, research and development projects, and personnel training in the field of aging. The legislation created the Administration on Aging (AoA) at ACL to manage grant programs and to serve as the federal focal point on matters concerning older adults.
Workforce Innovation and Opportunity Act
The Workforce Innovation and Opportunity Act (WIOA) of 2014 provides comprehensive change to a number of employment and education-related programs, including services for people with physical, intellectual, and developmental disabilities. This legislation transferred the National Institute on Disability, Independent Living and Rehabilitation Research and the assistive technology and independent living programs to ACL from the U.S. Department of Education. In addition, it created the Independent Living Administration, which is part of ACL's Administration on Disabilities.
Assistive Technology Act
The Assistive Technology Act of 1998 (as amended in 2004) supports programs providing grants to states for addressing assistive technology needs of individuals with disabilities. The goal is to increase awareness of and access to assistive technology devices and services that may help with education, employment, daily activities, and inclusion of people with disabilities in their communities.
ACL manages the State Grant for Assistive Technology Program and the Assistive Technology National Activities programs. The Workforce Innovation and Opportunity Act of 2014 transferred these programs from the U.S. Department of Education to ACL.
History of Assistive Technology Legislation
- The Technology-Related Assistance Act of 1988 (Tech Act) P.L. 100—407 was passed in 1988. States competed and awards were made in 1989 by the National Institute on Disability and Rehabilitation Research (NIDRR) in the Department of Education. The Tech Act authorized funding to conduct needs assessments and develop and implement a consumer-responsive system of technology-related assistance based on state needs with a three-year developmental grant and a two-year extension grant that included 25% and 50% reduction in funding level. All states and territories received a grant by 1995.
- The Technology-Related Assistance for Individuals with Disabilities Act Amendments of 1994, P.L.103-218 shifted the focus to systems change activities to increase access to assistive technology through policy advocacy, technical assistance and similar activities designed to change laws, regulations, policies and practices. The 1994 law contained a sunset provision such that funding for state grants would cease after State Assistive Technology (AT) Programs received 10 years of funding. Funding for programs would be reduced by 25% in the 9th year and by 50% in the 10th year. All states matriculated through the 10 year cycle except for one state that only reached year 9. The law also added a requirement for state grantees to contract with the Protection and Advocacy agency along with authorizations for Title II Programs of National Significance and Title III Alternative Financing Programs.
- In 1998, now reauthorized as the Assistive Technology Act of 1998, P.L. 105-394 (known as the “AT Act”) again shifted focus, with less emphasis on systems change and more on support services “to address the assistive technology needs of individuals with disabilities”. It established a 3 year continuation grant for State AT Programs at a level equal to the amount received in the last year under the previous law. All but one State AT Program was at its 50% funding level (one was at a 75% level) during this authorization period. The AT Act added a separate authorization for grants directly to the Protection and Advocacy agencies, maintained Titles II and III from the 1994 law and added Title IV to repeal the Tech Act.
- The 2004 amended AT Act, also known as the Assistive Technology Act of 2004, P.L.108-364, made significant changes by shifting from a discretionary grant program administered by NIDRR to a formula state grant program administered by the Rehabilitation Services Administration (RSA) in the US Department of Education. The new law required a common set of activities be provided by all State AT Programs (with some limited exceptions) creating more consistency among grantees. It also required explicit, detailed data reporting on the activities conducted. The funding formula established a minimum funding level of $410,000 for states and $125,000 for territories. Any additional appropriations in a fiscal year in which all states have not reached the minimum are allocated half equally among the State grantees and half in a proration based on population. (As of FY15 there are 10 states who have not reached the minimum funding level.)
- In 2014, the Workforce Innovation and Opportunity Act (P.L.113—128) moved administration of the AT Act programs from RSA in the Department of Education to ACL in the Department of Health and Human Services.
- Throughout all authorizations, State AT Programs have been required to serve all people with all types of disabilities, of all ages, in all environments (early intervention, K-12, post-secondary, vocational rehabilitation, community living, aging services, etc.) and address and include all types of assistive technology along with mainstream accessible information and communication technologies.
Technology-Related Assistance Act of 1988 (P.L. 100—407)
Purpose: To provide financial assistance to the States to help each State to develop and implement a consumer-responsive statewide program of technology related assistance for individuals with disabilities.
Title I: Grants to States, competitive 3 year development grants and 2 year extension grants with authorized activities of –
Model Delivery Systems
Statewide Needs Assessments
Public awareness Programs
Training & technical Assistance
Access to technology-related Information
Title II: Programs of National Significance
Part A: Study by National Council on the Handicapped on Financing of AT
Part B: National Information & Referral Network
Part C: Training & Public Awareness Projects
Part D: Demonstration & innovation Projects
Technology Related Assistance Act of 1988, Amendments of 1994 (P.L. 103—218)
Purpose: The purposes of this program are to provide financial assistance to States to support systems change and advocacy activities designed to assist each State in developing and implementing a consumer-responsive comprehensive statewide program of technology-related assistance, for individuals with disabilities of all ages.
Title I: Grants to States, continuation of development or extension grant to accomplish any of the following systems change and advocacy activities:
Model Systems & Alternative State-Financed Systems: Support activities to increase access to, and funding for, assistive technology
The demonstration or short-term loan of assistive technology devices
The establishment of information systems about, and recycling centers for, the redistribution of assistive technology devices and equipment that may include device and equipment loans, rentals, or gifts.
Interagency Coordination and outreach
Identify and coordinate Federal and State policies, resources, and services
Convene interagency work groups to enhance public funding options and coordinate
States were required to enter into a contract with the Protection and Advocacy agency with a prescribed minimum funding amount or allow the federal administering agency to do a direct award of that amount to the state P&A. There was an exception for states that already had an existing grant to a comparable legal advocacy provider.
Title II: Programs of National Significance
Title III: Alternative Finance Programs, competitive grants to states and outlying areas to pay for the federal share of the cost of the establishment and administration of, or the expansion and administration of, specified types of alternative financing systems for assistive technology for people with disabilities. Authorized funding limited to one grant per state for $500,000 total with a required dollar for dollar match by the state.
Assistive Technology Act of 1998 (P.L. 105—394)
Purpose: The purposes of this Act are to provide financial assistance to States to undertake activities that assist each State in maintaining and strengthening a permanent comprehensive statewide program of technology-related assistance, for individuals with disabilities of all ages,
Title I : State Grant Programs, grants awarded to eligible States to support capacity building and advocacy activities, designed to assist the States in maintaining permanent comprehensive statewide programs of technology-related assistance. Authorized activities include:
- Public awareness program (required)
- Interagency coordination (required)
- Technical assistance and training (required)
- Outreach (required)
- Alternative State-Financed Systems (discretionary)
- Demonstrations (discretionary)
- Support for securing devices and services (discretionary)
- Technology-related information
- Partnerships and cooperative initiatives
- Advocacy services
Title I: Protection and Advocacy Programs (P&A), separate grants to be awarded directly to P&A agencies. Appropriation authorization was combined for Title I and allocated 87.5% to State AT Programs, 7.9% to P&A and 4.6% to technical assistance.
Title II—National Activities
Title III—Alternative Financing Mechanisms, consistent with the 1994 law; a state may receive only one grant with a maximum of $500,000 and a required dollar for dollar state cash match. Total funding, including federal dollars and state match, was required to be placed in permanent separate account under control of a community based organization who would administer the program and increase consumer control and choice. Sustainability of program was to be assured.
Title IV—Repeal and Conforming Amendments: repealed the Tech Act.
2004 Amendments to the AT Act of 1998 (P.L.108-364)
- The AT Act of 1998 was reauthorized in 2004 and made significant changes to the funding of State AT Program and added many new program requirements. It also formalized the separate formula grant program for P&A in a separate section. The new law also provided a one year authorization for the previous Title III program that was eliminated in this authorization. Specific changes include --
- Changed from a discretionary grant administered by the National Institute on Disability and Rehabilitation Research to a state formula grant program, administered by the US Department of Education, Rehabilitation Services Administration (RSA).
- All 56 states and US territories were established as formula grants under Section 4 of the Act, State Grants for Assistive Technology.
- The focus of the AT Act of 2004 is to improve access and acquisition of assistive technology by providing direct services that will support individuals with disabilities.
- The Act establishes a new set of required core program services, grouped into State Level (device demonstration, device lending, state financing and device reuse) and State Leadership (public awareness including information and assistance, training, technical assistance, and collaboration) areas, to increase program consistency across the nation. The Act specifies the percentage of the grant award to support such activities with an emphasis on State Level.
- The requirement to serve people with all types of disabilities, all ages, in all environments (school, work, home, leisure) remained.
- Extensive, specific annual data reporting is required for all state level and state leadership activities along with systems change outcomes and performance measures.
- AT Act authorizes a minimum award of $410,000 for state grants programs (52 grantees) and a minimum of $125,000 for territories (4). Until the minimums are reached, funding increases above the 2004 base year are allocated half equally to all grantees and half are allocated on a proportion based on population. After the minimums are reached all increases are allocated based on population.
- A special rule for fiscal year 2005 authorized funding in excess of the 2004 base amount to be used for one year competitive grants in accordance with Title III of the AT Act of 1998 (Alternate Financing).
SECTION 4. STATE GRANTS FOR ASSISTIVE TECHNOLOGY
State Level Activities
- State Financing Activities (includes, but not limited to, financial loan programs, administration of direct provision programs, and activities that enable acquisition through cost savings like cooperative buying programs)
- Device Reutilization Programs (includes exchange, recycle/refurbish/repair, and long-term loan)
- Short-term Device Loan Programs
- Device Demonstration Programs
State Leadership Activities:
- Training and Technical Assistance
- Public Awareness (includes information and assistance)
- Coordination and Collaboration
Required Activities and Use of Funding:
- All State Level and State Leadership activities are required unless the State AT Program utilized comparability or flexibility provisions.
- States must submit a State Plan that describes activities to be conducted with input from required consumer majority Advisory Council (required members specified by law).
- States must spend at least 60% of the federal funding on State Level activities and no more than 40% on State Leadership activities (unless flexibility is utilized, see below) and must allocate 5% of State Leadership funding to transition activities.
- Comparability can be claimed when financial support is provided for that activity from another source and is comparable to the amount that would have been available through the Section 4 AT Act dollars.
- Flexibility is an option which allows any State AT Program to choose to implement only two or three of the four required State Level activities.
- If flexibility is utilized, at least 70% of the AT Act funds must support State Level activities and no more than 30% can be used for State Leadership activities.
- SECTION 5. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES RELATED TO ASSISTIVE TECHNOLOGY
Formula grant awards to state protection and advocacy organizations to enable such systems to assist in the acquisition, utilization or maintenance of assistive technology devices or services for individual with disabilities.
- SECTION 6. NATIONAL ACTIVITIES
Competitive grants for authorized activities that include:
National Public Awareness Toolkit – not funded
Research and Development – not funded
State Training and Technical Assistance – funded
National Information Internet System – funded
Data Collection and Reporting Assistance – funded
Christopher and Dana Reeve Paralysis Act
The Christopher and Dana Reeve Paralysis Act authorized the creation of the Paralysis Resource Center to promote paralysis research, rehabilitation research and care, and improve quality of life for people with paralysis and other physical disabilities.
Elder Justice Act
Passed in 2010, the Elder Justice Act is the first comprehensive legislation to address the abuse, neglect, and exploitation of older adults at the federal level. The law authorized a variety of programs and initiatives to better coordinate federal responses to elder abuse, promote elder justice research and innovation, support Adult Protective Services systems, and provide additional protections for residents of long-term care facilities.
The Elder Justice Act established the Elder Justice Coordinating Committee to coordinate activities related to elder abuse, neglect, and exploitation across the federal government.
It is also a source of authority for ACL programs and activities that include:
Health Insurance Portability and Accountability Act (HIPAA)
ACL receives Health Care Fraud and Abuse Control (HCFAC) funding as authorized by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The HCFAC funds, which are received from the Medicare Trust Fund, are used to support Senior Medicare Patrol infrastructure, technical assistance, and other program support and capacity-building activities designed to enhance program effectiveness.
Help America Vote Act (HAVA)
Help America Vote Act (HAVA) (PDF): Signed into law on October 29, 2002, assigns responsibility for the administration of the law’s disability provisions (sections 261 and 291) to the Secretary of the U.S. Department of Health and Human Services, who delegated the HAVA Programs to the Administration on Intellectual and Developmental Disabilities at ACL.
Medicare Improvements for Patients and Providers Act (MIPPA)
The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 allocated federal funding (through Section 119) for State Health Insurance Assistance Programs (SHIPs), Area Agencies on Aging (AAAs), and Aging and Disability Resource Centers (ADRCs) to provide outreach to low-income Medicare beneficiaries to increase enrollment in Medicare low-income assistance programs.
Omnibus Budget Reconciliation Act (OBRA)
The State Health Insurance Assistance Program (SHIP) was created under Section 4360 of the Omnibus Budget Reconciliation Act (OBRA) of 1990 (Public Law 101-508). This section of the law authorized the Centers for Medicare & Medicaid Services (CMS) to make grants to states to establish and maintain health insurance advisory service programs for Medicare beneficiaries. Grant funds were made available to support information, counseling, and assistance activities relating to Medicare, Medicaid, and other related health insurance options such as: Medicare supplement insurance, long-term care insurance, managed care options, and other health insurance benefit information.
In January 2014, authorized in the Consolidated Appropriations Act of 2014, the SHIP program was transferred from CMS to the Administration for Community Living (ACL). This transfer reflects the existing formal and informal collaborations between the SHIP programs and the networks that ACL serves. At the community level, many SHIPs are either housed in, or create local partnerships with Area Agencies on Aging. Similarly, almost 50 percent of the SHIPs are co-located with the Senior Medicare Patrol (SMP) program, which is also administered by ACL.
Public Health Service Act
Section 398 of the Public Health Service Act: ACL administers the Alzheimer’s Disease Disease Supportive Services Program (ADSSP) program created by Congress in 1991 under Section 398 of the Public Health Service Act (P.L. 78-410; 42 U.S.C. 280c-3). It was amended by the Home Health Care and Alzheimer’s Disease Amendments of 1990 (PL 101-557) and by the Health Professions Education Partnerships Act of 1998 (PL 105-392).
Title XXIX of the Public Health Service Act (42 U.S.C 201): ACL administers the Lifespan Respite Care Program created by Congress in 2006 under Title XXIX of the Public Health Service Act.
- Recognize, Assist, Include, Support, and Engage Family Caregivers Act of 2017 (RAISE Act)
The RAISE Act of 2017 was created to develop (with an advisory council) a Family Caregiver Strategy to promote adoption of person- and family-centered care, long-term care service planning, and information and referral services for caregivers.
The Rehabilitation Act of 1973 (as revised multiple times in various years) prohibits discrimination on the basis of disability in programs conducted by federal agencies, in programs receiving federal financial assistance, in federal employment, and in the employment practices of federal contractors. The most recent revision of the legislation occurred in 2014 with the Workforce Innovation and Opportunity Act (see more information above).
The provisions of Title II of the Rehabilitation Act of 1973 created ACL's National Institute on Disability, Independent Living, and Rehabilitation Research with the mission to generate new knowledge and to promote its effective use to improve the abilities of individuals with disabilities to perform activities of their choice in the community; and to expand society's capacity to provide full opportunities and accommodations for its citizens with disabilities. Visit this website for information about the purpose of NIDILRR and research areas it covers. The Workforce Innovation and Opportunity Act of 2014 transferred NIDLRR from the U.S. Department of Education to ACL.
Title VII of the Rehabilitation Act of 1973 created the Independent Living Services and Centers for Independent Living programs. The Workforce Innovation and Opportunity Act of 2014 created the Independent Living Administration and transferred these programs to ACL from the U.S. Department of Education.
- Supporting Grandparents Raising Grandchildren Act of 2018
The Supporting Grandparents Raising Grandchildren Act of 2018 established a federal advisory council to identify, promote, coordinate, and disseminate to the public information, resources, and the best practices available to help grandparents and other older relatives meet the needs of children in their care and maintain their own health.
Traumatic Brain Injury Reauthorization Act of 2018
Recognizing the large number of individuals and families struggling to access appropriate and community-based services, Congress authorized the Federal TBI Program in the TBI Act of 1996 (PL 104-166). The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. The Act gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. The TBI Act also delegated responsibilities in research to the National Institutes of Health, and prevention and surveillance to the Centers for Disease Control and Prevention.
The Traumatic Brain Injury Act of 2008 (P.L. 110-206) reauthorized the programs of the TBI Act of 1996. The 2000 Amendments (PL 106-310—Title XIII of the Children’s Health Act) recognized the importance of protection and advocacy (P&A) services for individuals with TBI and their families by authorizing the Health Resources and Services Administration (HRSA) to make grants to federally mandated State Protection & Advocacy Systems.
The TBI program transitioned from HRSA to the Administration for Community Living (ACL) on October 1, 2015. Due to the passage of the TBI Reauthorization Act of 2014, the Department of Health and Human Services (HHS) Secretary Sylvia Burwell was given the authority to review the program’s aims and goals and determined ACL would be best positioned to support the TBI Program due to its mission to advance policy and implement programs that support the rights of older Americans and people with disabilities to live in their communities.
The current authorizing legislation is the Traumatic Brain Injury Program Reauthorization Act of 2018 (P.L 115-377; (42 U.S.C. 300d–52). It raised the authorization levels for the TBI State Partnership Program and TBI P&A and officially designates ACL as the administering agency for both programs. Also, the new provision for partners at the Centers for Disease Control will allow them to implement and analyze concussion prevalence and incidence data, filling a longstanding data gap that will bolster all TBI programs.
Note: Current Centers for Disease Control and Prevention estimates (Selassie et al., 2009) include only TBI emergency department visits, hospitalizations and deaths in the United States (2002-2006). In the Children's Health Act of 2000, Congress recognized that the estimated figure of Americans living with TBI-related disability is an under-count. Estimates fail to capture individuals who have visited physician's offices, individuals who have not sought treatment for a head injury, State-level TBI data, or TBIs counted from Federal, military or Veterans Affairs hospitals.