[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2 Introduced in Senate (IS)]
<DOC>
117th CONGRESS
2d Session
S. 2
To support national training, technical assistance, and resource
centers, to ensure that all individuals with significant expressive
communication disabilities have access to the augmentative and
alternative communication the individuals need to interact with others,
in order to learn, work, socialize, and take advantage of all aspects
of life in the United States.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 17, 2022
Mr. Casey (for himself, Mr. Markey, Mr. Leahy, Ms. Duckworth, Mrs.
Gillibrand, Mr. Sanders, and Mr. Wyden) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To support national training, technical assistance, and resource
centers, to ensure that all individuals with significant expressive
communication disabilities have access to the augmentative and
alternative communication the individuals need to interact with others,
in order to learn, work, socialize, and take advantage of all aspects
of life in the United States.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Augmentative and Alternative
Communication Centers to Establish National Training Act'' or the
``AACCENT Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Communication is a basic human need and fundamental
right, and is essential to self-determination, social
inclusion, and emotional and physical well-being. In enacting a
provision of the Americans with Disabilities Act of 1990
(referred to in this section as the ``ADA''), Congress
recognized that ``physical or mental disabilities in no way
diminish a person's right to fully participate in all aspects
of society,'' and that ``the discriminatory effects of
communication barriers'' are a form of discrimination.
(2) Three decades after the passage of the ADA, Americans
with significant expressive communication disabilities still
experience discrimination in the form of communication
barriers, institutionalization, segregation, and relegation to
lesser services, programs, activities, benefits, jobs, or other
opportunities compared to Americans without significant
expressive communication disabilities.
(3) Data about augmentative and alternative communication
is lacking, but it is estimated there are at least 4,000,000
people in the United States who cannot reliably meet their
daily communication needs using natural speech.
(4) The population of individuals with significant
expressive communication difficulties is at substantial risk
for limited education, unemployment, poor health outcomes,
poverty, and low quality of life.
(5) People can acquire a significant expressive
communication disability and need augmentative and alternative
communication as a result of many health and developmental
conditions at all stages of life.
(6) Research indicates that individuals who belong to
racial or ethnic minority communities face a greater likelihood
of being born with or acquiring expressive communication
disabilities, as well as added difficulties in obtaining
intervention services, including augmentative and alternative
communication.
(7) Individuals with significant expressive communication
disabilities, schools, families, employers, direct support
providers, health care providers, the justice system, and the
general public need more information about how to effectively
deploy, implement, and ensure continued access to robust
communication tools, services, and other supports for
individuals with significant expressive communication
disabilities.
(8) The lived experiences and writings of individuals with
significant expressive communication disabilities demonstrate
the positive impact augmentative and alternative communication
has on their lives. These lived experiences and writings also
illustrate the harm that results from denying augmentative and
alternative communication to those who need it.
(9) The leadership of individuals with significant
expressive communication disabilities is critical in crafting
and implementing effective policies and programs affecting
their lives, including policies and programs regarding
augmentative and alternative communication.
(10) The freedoms of expression, and to be understood, are
essential to both democracy and to individual well-being.
Individuals with significant expressive communication
disabilities must be afforded equal rights, opportunities,
strategies, technologies, services, and other supports to
effectively express themselves and participate in their
communities and in democracy.
SEC. 3. PURPOSE.
The purpose of this Act is to work toward eliminating the continued
discrimination, isolation, marginalization, and denial of equal
opportunity of individuals with significant expressive communication
disabilities by providing for comprehensive national training,
technical assistance, and resource centers to improve access to--
(1) a full range of augmentative and alternative
communication;
(2) equal opportunity;
(3) awareness and implementation of relevant laws,
policies, and practices;
(4) leadership and self-advocacy skills;
(5) capacity, in the case of individuals with significant
expressive communication disabilities, educators,
professionals, and families;
(6) national statistical data; and
(7) societal awareness.
SEC. 4. DEFINITIONS.
In this Act:
(1) Advisory council.--The term ``advisory council'' means
an 11-person advisory council that--
(A) provides guidance, recommendations, and
oversight to an eligible entity;
(B) is comprised exclusively of individuals with
significant expressive communication disabilities who
collectively have diverse--
(i) educational and professional
backgrounds;
(ii) racial, ethnic, gender, and linguistic
identities;
(iii) disabilities, including intellectual
disabilities, ages, and geographic locations;
(iv) levels of income; and
(v) forms of augmentative and alternative
communication relied upon; and
(C) is subject to each of the following conditions:
(i) The initial council members shall be
identified in the grant application by the
partners of the eligible entity.
(ii) Each member of the advisory council
shall be appointed for a period of 5 years.
(iii) The Chair and Vice Chair of the
council shall be selected by the council
members at the first meeting and thereafter as
the council determines to be appropriate.
(iv) The council shall fill any vacancy in
accordance with section 7(b)(8)(C).
(2) Augmentative and alternative communication.--The term
``augmentative and alternative communication'' means any tool,
method, technology, strategy, service, training, coaching, and
other support used to supplement or replace speech.
(3) Competitive integrated employment.--The term
``competitive integrated employment'' has the meaning given the
term in section 7 of the Rehabilitation Act of 1973 (29 U.S.C.
705).
(4) Disability.--The term ``disability'' has the meaning
given the term in section 3 of the Americans with Disabilities
Act of 1990 (42 U.S.C. 12102).
(5) Eligible entity.--The term ``eligible entity'' means a
partnership of at least 2 organizations--
(A) for which the controlling partner of the
partnership is a nonprofit organization headquartered
in the United States that vests power and authority in
individuals with significant expressive communication
disabilities in terms of management, staffing,
decisionmaking, operation, and provision of services;
(B) that includes at least one other organization
headquartered in the United States that is either an
institution of higher education or an association of
professional service providers or educators in the
field of significant expressive communication
disabilities;
(C) that has a cross-disability and cross-
generational focus;
(D) that is advised by an advisory council;
(E) that has adopted a mission that values equal
opportunity and the fundamental right of communication
access, and operating principles that respect the
rights of individuals with significant expressive
communication disabilities to express themselves in the
manner of their choosing; and
(F) of which the organizational members,
collectively--
(i) have knowledge, experience, and
capacity in conducting training, technical
assistance, or knowledge dissemination related
to the priority activities described in section
6;
(ii) have experience working directly with
individuals with significant expressive
communication disabilities in association
with--
(I) early intervention programs,
early childhood programs, elementary or
secondary schools, or postsecondary
education programs; or
(II) 2 or more types of entities
from among--
(aa) centers for
independent living authorized
under part C of title VII of
the Rehabilitation Act of 1973
(29 U.S.C. 796f et seq.);
(bb) home and community-
based service providers;
(cc) employers;
(dd) health care providers;
(ee) protection and
advocacy organizations;
(ff) aging networks;
(gg) caregiver
organizations; or
(hh) State, Tribal, or
local government agencies; and
(iii) have experience developing and
maintaining collaborative working relationships
among disability-led advocacy organizations,
institutions of higher education, professional
associations, or caregiver organizations.
(6) Evidence-based.--The term ``evidence-based'', used with
respect to assistance that is knowledge, a resource, training,
or technical assistance, means assistance--
(A) that demonstrates a rationale based on a high-
quality research finding or positive evaluation that
such assistance is likely to improve a communication
outcome or other relevant outcome; and
(B) for which ongoing efforts are made to examine
the effects of the assistance.
(7) Individual with significant expressive communication
disabilities.--The term ``individual with significant
expressive communication disabilities'' means an individual of
any age--
(A) who has 1 or more real or perceived significant
expressive communication disabilities and may have
other disabilities; and
(B) whose disabilities result in the need for, or
benefit from, augmentative and alternative
communication and other supports to enable the
individual to communicate and to aid the individual in
participating in 1 or more aspects of life.
(8) Institution of higher education.--The term
``institution of higher education'' has the meaning given the
term in section 101(a) of the Higher Education Act of 1965 (20
U.S.C. 1001(a)).
(9) National resource center.--The term ``national resource
center'' means a National Resource Center on Augmentative and
Alternative Communication referred to in section 5(a).
(10) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(11) Significant expressive communication disability.--
(A) In general.--The term ``significant expressive
communication disability'' means any disability,
whether congenital, developmental, or acquired at any
point in life, that prevents or significantly limits an
individual from understanding or being understood using
spoken words, resulting in the individual's need for or
benefit from augmentative and alternative
communication.
(B) Application.--The term does not apply to an
individual whose primary communication disability is
visual or auditory in nature, but does apply to an
individual with a disability described in subparagraph
(A) who also has a visual or auditory communication
disability and who may communicate using sign language.
(12) State.--The term ``State'' means the 50 States, the
District of Columbia, the Commonwealth of Puerto Rico, the
United States Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands.
SEC. 5. GRANTS.
(a) In General.--The Secretary shall award 3 grants through an open
competition to eligible entities, with applications approved under
section 7, to create, maintain, and administer a network of National
Resource Centers on Augmentative and Alternative Communication. Each
national resource center shall be a comprehensive training, technical
assistance, and resource center created to work toward eliminating the
continued discrimination against, isolation of, marginalization of, and
denial of effective communication for and equal opportunity of,
individuals with significant expressive communication disabilities,
through activities including the priority activities described in
section 6.
(b) Awards for Multiple Centers.--The Secretary shall award the
grants for national resource centers in 3 geographically diverse
locations, and shall designate one of the centers as the lead
administrative center.
(c) Lead Administrative Center.--The lead administrative center
shall coordinate--
(1) all activities of the centers;
(2) specialization of priorities among the centers;
(3) dissemination of information among the centers;
(4) responses of the centers to the Secretary; and
(5) ensuring that the full range of individuals with
significant expressive communication disabilities is served by
the centers.
(d) Amount.--The Secretary shall, to the extent practicable, award
the 3 grants in amounts that total not more than $9,000,000 per year of
a period described in subsection (e).
(e) Periods.--The Secretary shall award each grant for a period of
5 years, through an open competition held initially and at the end of
each 5-year period. An eligible entity that receives a grant under this
section may reapply for such a grant at the end of the grant period.
SEC. 6. NATIONAL RESOURCE CENTER PRIORITY ACTIVITIES.
The priority activities of a national resource center shall be to--
(1) increase access to and effective implementation of the
full range of augmentative and alternative communication for
all individuals with significant expressive communication
disabilities in the United States, regardless of age, race,
ethnicity, gender, gender identity, LGBTQ+ status, immigration
status, educational achievement, socioeconomic condition,
primary language, nature or severity of disability, location of
residence, and age of onset of the significant expressive
communication disability;
(2) increase the capacity of individuals with significant
expressive communication disabilities, educators, professional
service providers, families, and direct support professionals
to support individuals with significant expressive
communication disabilities by creating and disseminating
evidence-based knowledge, resources, training and technical
assistance, and recommended practices in ensuring individuals
with significant expressive communication disabilities have the
tools and other supports necessary to exercise self-
determination and effectively access and participate in all
aspects of life, including education, employment, health care,
and community living;
(3) promote awareness and implementation of the laws,
regulations, policies, practices, procedures, and systems that
facilitate access to the full range of augmentative and
alternative communication and promote equal access and
opportunity for individuals with significant expressive
communication disabilities;
(4) support and enhance the skills and leadership of
individuals with significant expressive communication
disabilities and their families to advocate for the rights of
the individuals to effective communication, education, self-
determination, access to justice, and equal opportunity and
participation in all aspects of life;
(5) support the improved collection, availability, and
dissemination of demographic and characteristic data, with a
cross-disability and cross-generational focus, regarding
individuals with significant expressive communication
disabilities in the United States, the barriers the individuals
experience to meaningful access to augmentative and alternative
communication, and the unmet communication support and other
needs of this population; and
(6) increase societal awareness and knowledge about
individuals with significant expressive communication
disabilities and the importance of, need for, benefits of, and
rights to meaningful access to effective communication tools
and other supports in all aspects of community and life.
SEC. 7. APPLICATIONS.
(a) In General.--To be qualified to receive a grant under section
5, an eligible entity shall submit an application to the Secretary at
such time and in such manner as the Secretary may require.
(b) Contents.--Each such application from an eligible entity shall
include, at a minimum, each of the following:
(1) A description of the experience of each partner
organization in the entity in providing training, information,
advocacy, and support related to augmentative and alternative
communication and individuals with significant expressive
communication disabilities.
(2) A description of each partner organization's experience
in providing training, information, advocacy, and support
related to augmentative and alternative communication and to
individuals with significant expressive communication
disabilities, to--
(A) early intervention specialists;
(B) elementary education, secondary education,
postsecondary education, and specialized instructional
support personnel as defined in section 8101 of the
Elementary and Secondary Education Act of 1965 (20
U.S.C. 7801);
(C) caregiver groups;
(D) providers of home and community-based services
for adults;
(E) health care providers and educators;
(F) employers;
(G) providers of services to older adults;
(H) law enforcement agencies, courts, offices of
district attorneys, and other public and private
security agencies and businesses;
(I) institutional long-term care services and
support providers;
(J) nursing home providers; and
(K) other stakeholders.
(3) A description of each partner organization's experience
working with State, local, or Tribal government agencies in
providing training, information, and support related to
augmentative and alternative communication for full expression
and individuals with significant expressive communication
disabilities.
(4) A description of each partner organization's prior
partnerships with disability-led organizations focused on
augmentative and alternative communication and individuals with
significant expressive communication disabilities.
(5) Evidence of how the applicant satisfies the
requirements of section 4(5).
(6) A description of the applicant's plan to ensure that
the applicant will provide training, technical assistance, and
information to target audiences, especially those audiences in
need of knowledge and access to augmentative and alternative
communication.
(7) A description of the applicant's plan to implement the
priority activities in section 6, including how the
organizational members of the eligible entity will partner,
collaborate, and operationalize the activities.
(8) Advisory council information, including--
(A) a description of the advisory council,
including a list of the inaugural members of the
advisory council;
(B) an assurance that the Chair and Vice Chair of
the advisory council will be selected by the advisory
council members at the first meeting of the advisory
council and thereafter as the council determines to be
appropriate; and
(C) an assurance that, in filling a vacancy on the
advisory council, the advisory council will--
(i) solicit nominations from the population
of augmentative and alternative communication
users;
(ii) if there is not more than 1 nominee
for the vacancy, confirm the nominee as a new
member; and
(iii) if there is more than 1 nominee for
the vacancy, vote to determine the nominee to
fill the vacancy and subsequently confirm the
nominee.
(9) A description of how other individuals with significant
expressive communication disabilities will be involved in the
governance and operations of the national resource center
involved, especially through employment of individuals with
significant expressive communication disabilities.
(10) A description of how the applicant will design and
make training, technical assistance, and information available
in accessible formats, including plain language.
(11) Assurances that the applicant, acting through the
national resource center, will work with the stakeholders
identified in section 9(d).
(12) Assurances that the applicant, acting through the
national resource center, will provide the Secretary with
requested data and information for purposes of evaluating the
grant activities.
SEC. 8. AWARD PRIORITY.
In awarding grants for activities described in this Act, the
Secretary shall give priority to an eligible entity with at least 1
partner organization that--
(1) demonstrates a minimum of 3 years of experience
providing training and technical assistance and disseminating
information related to augmentative and alternative
communication and individuals with significant expressive
communication disabilities, and being otherwise engaged in the
priority activities described in section 6;
(2) demonstrates that individuals with significant
expressive communication disabilities and those who use
augmentative and alternative communication are purposefully
involved in the governance and operation of the organization,
especially through their employment in service, delivery, and
leadership positions;
(3) demonstrates the ability to collaborate with disability
self-advocacy, education, direct service, health care,
employment, aging, caregiver, and housing organizations,
whether the organizations are public agencies or private
entities; and
(4) demonstrates expertise in promoting accessibility and
the use of universal design (the latter as defined in section
103 of the Higher Education Act of 1965 (20 U.S.C. 1003)) in
providing training and technical assistance, and information
dissemination.
SEC. 9. USE OF FUNDS.
(a) In General.--An eligible entity that receives a grant under
section 5 shall use the grant funds to manage and carry out the
priority activities described in section 6, activities described in
this section, and any additional activities approved by the Secretary.
(b) Coordination With Federal Programs.--The work of a national
resource center shall link to current and future policy and activities
undertaken throughout the Federal Government in relation to self-
advocacy, supported decisionmaking, person-centered planning, community
living, and competitive integrated employment for individuals with
disabilities and particularly for individuals with the most significant
expressive communication disabilities, for the purpose of increasing--
(1) success and self-determination in life;
(2) the provision of inclusive early intervention services,
elementary education, secondary education, and postsecondary
education programs;
(3) competitive integrated employment;
(4) health, wellness, and personal safety;
(5) economic security;
(6) civic engagement;
(7) community integration; and
(8) improvement in other aspects of life.
(c) Information Dissemination.--Notwithstanding the priority
activities described in section 6, a national resource center shall
ensure information and other resources about augmentative and
alternative communication and individuals with significant expressive
communication disabilities are made available as appropriate to--
(1) individuals with significant expressive communication
disabilities and their families;
(2) institutions of higher education;
(3) State, Tribal, and local educational agencies;
(4) law enforcement agencies, courts, offices of district
attorneys, and other public and private security agencies and
businesses;
(5) national, State, regional, Tribal, and local employers,
to enable businesses to hire into competitive integrated
employment more individuals who use augmentative and
alternative communication;
(6) national, State, Tribal, and local government agencies
that provide services and other supports to individuals with
significant expressive communication disabilities, including
agencies responsible for emergency preparedness, employment
support, and vocational rehabilitation, agencies responsible
for State programs under the Assistive Technology Act of 1988
(29 U.S.C. 3001 et seq.), agencies responsible for State
alternative financing programs, State agencies responsible for
the Medicaid program under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.), and the agencies overseeing the
provision of home and community-based services;
(7) national and local disability and aging advocacy
organizations, including disability self-advocacy
organizations;
(8) family support organizations, including the parent
training and information centers supported under section 671 of
the Individuals with Disabilities Education Act (20 U.S.C.
1471);
(9) centers for independent living and Statewide
Independent Living Councils authorized by title VII of the
Rehabilitation Act of 1973 (29 U.S.C. 796 et seq.);
(10) network partners, including the State Councils on
Developmental Disabilities described in section 125 of the
Developmental Disabilities Assistance and Bill of Rights Act of
2000 (42 U.S.C. 15025), the protection and advocacy systems
described in section 143 of that Act (42 U.S.C. 15043), and
University Centers for Excellence in Developmental Disabilities
Education, Research, and Services supported under subtitle D of
title I of that Act (42 U.S.C. 15061 et seq.), participating in
activities under that Act (42 U.S.C. 15001 et seq.);
(11) State agencies and area agencies on aging, entities
carrying out long-term care ombudsman programs, and other
entities funded under the Older Americans Act of 1965 (42
U.S.C. 3001 et seq.);
(12) health care providers and educators, health care
advocacy organizations, nursing home providers, and
institutional long-term care facilities;
(13) professional organizations and organizations that
certify preservice training programs; and
(14) other groups and entities as identified by the
eligible entity and the advisory council of the eligible
entity.
(d) Stakeholder Collaboration.--A national resource center shall
collaborate with--
(1) organizations of individuals with significant
expressive communication disabilities;
(2) disability organizations;
(3) entities carrying out State assistive technology
programs and State alternative financing programs;
(4) State, Tribal, and local educational agencies;
(5) the councils, systems, and university centers described
in subsection (c)(10);
(6) entities carrying out national, State, Tribal and
Native Hawaiian, and local programs authorized by the Older
Americans Act of 1965;
(7) the federally funded Rehabilitation Engineering
Research Center on Augmentative and Alternative Communication;
(8) State agencies responsible for vocational
rehabilitation programs, as defined in section 3 of the
Workforce Innovation and Opportunity Act (29 U.S.C. 3102);
(9) professional associations whose members come in contact
with and support individuals who may use augmentative and
alternative communication;
(10) local boards, as defined in section 3 of the Workforce
Innovation and Opportunity Act (29 U.S.C. 3102); and
(11) other State, regional, Tribal, and local entities with
the ability to provide support for individuals who need and use
augmentative and alternative communication.
SEC. 10. ANNUAL REPORT.
An eligible entity that receives a grant under section 5 to support
a national resource center shall annually prepare and submit to the
Secretary, the Secretary of Education, and the relevant subcommittees
of the Committee on Health, Education, Labor, and Pensions of the
Senate, the Special Committee on Aging of the Senate, and the Committee
on Education and Labor of the House of Representatives, the
Subcommittee on Labor, Health and Human Services, Education, and
Related Agencies of the Committee on Appropriations of the Senate, and
the Subcommittee on Labor, Health and Human Services, Education, and
Related Agencies of the Committee on Appropriations of the House of
Representatives a report containing, consistent with criteria
established by the Secretary, information on--
(1) activities conducted by the national resource center to
achieve the purpose of this Act;
(2) collaboration by the national resource center with
other entities to achieve the purposes of this Act;
(3) barriers to and strategies for equitable access to
augmentative and alternative communication and other supports
for individuals who belong to racial, ethnic, and linguistic
minority communities and face a greater likelihood of being
born with or acquiring significant expressive communication
disabilities as well as added difficulties in obtaining
effective augmentative and alternative communication;
(4) identified gaps in available demographic and
characteristic data on individuals with significant expressive
communication disabilities in the United States; and
(5) the unmet needs of individuals with significant
expressive communication disabilities, from diverse
backgrounds, in the United States and policy recommendations to
address such unmet needs.
SEC. 11. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this Act
$9,000,000 for each of fiscal years 2023 through 2027.
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