[Senate Hearing 117-320]
[From the U.S. Government Publishing Office]


                                                       S. Hrg. 117-320

                     CLICK HERE: ACCESSIBLE FEDERAL
                         TECHNOLOGY FOR PEOPLE
                        WITH DISABILITIES, OLDER
                        AMERICANS, AND VETERANS

=======================================================================

                                HEARING

                               BEFORE THE

                       SPECIAL COMMITTEE ON AGING

                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS


                             SECOND SESSION

                               __________

                             WASHINGTON, DC

                               __________

                             JULY 28, 2022

                               __________

                           Serial No. 117-20

         Printed for the use of the Special Committee on Aging
         
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        Available via the World Wide Web: http://www.govinfo.gov
        
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                    U.S. GOVERNMENT PUBLISHING OFFICE                    
48-178 PDF*(Star Print)      WASHINGTON : 2022                     
          
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                       SPECIAL COMMITTEE ON AGING

              ROBERT P. CASEY, JR., Pennsylvania, Chairman

KIRSTEN E. GILLIBRAND, New York      TIM SCOTT, South Carolina
RICHARD BLUMENTHAL, Connecticut      SUSAN M. COLLINS, Maine
ELIZABETH WARREN, Massachusetts      RICHARD BURR, North Carolina
JACKY ROSEN, Nevada                  MARCO RUBIO, Florida
MARK KELLY, Arizona                  MIKE BRAUN, Indiana
RAPHAEL WARNOCK, Georgia             RICK SCOTT, Florida
                                     MIKE LEE, Utah
                              ----------                              
                 Stacy Sanders, Majority Staff Director
                 Neri Martinez, Minority Staff Director
                         
                         
                         C  O  N  T  E  N  T  S

                              ----------                              

                                                                   Page

Opening Statement of Senator Robert P. Casey, Jr., Chairman......     1
Opening Statement of Senator Tim Scott, Ranking Member...........     3

                           PANEL OF WITNESSES

Eve Hill, Attorney and Partner, Brown, Goldstein & Levy, LLP, 
  Washington, D.C................................................     5
Anil Lewis, Executive Director for Blindness Initiatives, 
  National Federation of the Blind, Atlanta, Georgia.............     7
Jule Ann Lieberman, (accompanied by her husband John Lieberman) 
  Assistive Technology Program Coordinator, TechOWL, Devon, 
  Pennsylvania...................................................     9
Ronald Holmquest, Retired and U.S. Navy Veteran, Mount Pleasant, 
  South Carolina.................................................    11

                           CLOSING STATEMENT

Closing Statement of Senator Tim Scott, Ranking Member...........    27

                                APPENDIX
                      Prepared Witness Statements

Eve Hill, Attorney and Partner, Brown, Goldstein & Levy, LLP, 
  Washington, D.C................................................    33
Anil Lewis, Executive Director for Blindness Initiatives, 
  National Federation of the Blind, Atlanta, Georgia.............    44
Jule Ann Lieberman, Assistive Technology Program Coordinator, 
  TechOWL, Devon, Pennsylvania...................................    49
Ronald Holmquest, Retired and U.S. Navy Veteran, Mount Pleasant, 
  South Carolina.................................................    51

                        Questions for the Record

Eve Hill, Attorney and Partner, Brown, Goldstein & Levy, LLP, 
  Washington, D.C................................................    55
Anil Lewis, Executive Director for Blindness Initiatives, 
  National Federation of the Blind, Atlanta, Georgia.............    59
Jule Ann Lieberman, Assistive Technology Program Coordinator, 
  TechOWL, Devon, Pennsylvania...................................    63
Ronald Holmquest, Retired and U.S. Navy Veteran, Mount Pleasant, 
  South Carolina.................................................    66

                       Statements for the Record

American Council of the Blind, written statement.................    71
American Foundation for the Blind, written statement.............    74
Blinded Veteran's Association, presented by James R. Vale, Esq., 
  written statement..............................................    82
Consortium for Constituents with Disabilities, written statement.    87
Deepa Goraya, Attorney, written statement........................    93
Jonathan Lazar, Ph.D., LL.M., Professor, written statement.......    95
Ken Lebron, Director, Berks County Veterans' Affairs, written 
  statement......................................................   102
National Association of the Deaf, written statement..............   106
National Disability Rights Network, written statement............   108
Ronald Biglin, written statement.................................   112

 
                     CLICK HERE: ACCESSIBLE FEDERAL
                         TECHNOLOGY FOR PEOPLE
                        WITH DISABILITIES, OLDER
                        AMERICANS, AND VETERANS

                              ----------                              


                        THURSDAY, JULY 28, 2022

                                       U.S. Senate,
                                Special Committee on Aging,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 10 a.m., 
virtually via Webex, Room 562, Dirksen Senate Office Building, 
Hon. Robert P. Casey, Jr., Chairman of the Committee, 
presiding.
    Present: Senators Casey, Blumenthal, Rosen, Tim Scott, 
Braun, and Rick Scott.

                  OPENING STATEMENT OF SENATOR
                 ROBERT P. CASEY, JR., CHAIRMAN

    The Chairman. The hearing will come to order. Thank you 
everyone for being here this morning. I will start with my 
opening, then I will turn to Ranking Member Scott.
    This week marks the 32nd anniversary of the signing of the 
Americans with Disabilities Act. As we commemorate that 
anniversary, our Committee will examine an important disability 
issue, how to improve the accessibility of Federal information 
technology for people with disabilities.
    The COVID-19 pandemic accelerated a long-term shift in 
delivering government services using virtual front doors 
instead of physical front doors. Unfortunately, over the years, 
the U.S. Government has not prioritized making these virtual 
front doors accessible to people with disabilities, especially 
most recently. Digital access significantly affects older 
Americans and veterans, who experience disabilities at higher 
rates than the general population and more frequently use these 
government services.
    Federal law requires that the Executive branch agencies 
make their technology accessible to people with disabilities. 
However, bipartisan oversight that I have led shows the U.S. 
Government is falling short on digital accessibility. I want to 
thank Ranking Member Scott and our Aging Committee colleague 
Senator Burr for joining me in these oversight efforts.
    In 2018, my office heard from veterans who have a 
disability or more than one disability, who reported problems 
accessing the Department of Veterans Affairs' websites and 
kiosks. In response, I worked alongside Senator Jerry Moran to 
pass the bipartisan VA Website Accountability Act in 2020. That 
law requires the VA to report on the accessibility of its 
websites and intake kiosks.
    The resulting report had stark findings. Fewer than 10 
percent--let me say that again--fewer than 10 percent of its 
websites were fully accessible as of last Fall and the 
Department's plans to fix them were, in a word, inadequate. My 
understanding is that the VA will soon be responding to the 
letter I sent with Senator Scott and other colleagues regarding 
these longstanding accessibility shortfalls. I will be 
reviewing those plans and look forward to working with the 
Department to address these longstanding issues.
    While serious, the VA's accessibility shortfalls are not 
unique, unfortunately. A long list of Federal agencies, and 
even the White House, have settled lawsuits in recent years 
alleging their websites and technology are not accessible. That 
is why I am concerned that the Department of Justice has not 
evaluated Federal technology access for a decade. Federal law 
requires, as I said, these evaluations every two years.
    The Biden Administration has rightfully prioritized 
improving digital access, but years of inattention to 
accessibility means there still is a lot of work to do.
    Someone who just happens to live in the same county I live 
in--his name is Ron Biglin and I am holding up a letter, some 
of which I have highlighted--Ron Biglin, he lives in Clarks 
Summit, Pennsylvania, not too far from Scranton. He is one of 
the people who has suffered from this inattention. He submitted 
a statement for the record, and I will make that statement part 
of the record.
    Ron Biglin is an Air Force veteran, who is blind. He can 
fish, kayak, and even do online banking, but the VA's My 
HealtheVet site does not work with his screen reader, making 
him unable to use it. Ron wrote a pertinent part in his 
statement: ``When you are visually impaired you want to be as 
independent as possible and having problems getting on VA 
websites takes away this independency. If the VA could lead the 
way to make access easier, this would be a great plus and then 
also other government agencies could do the same.'' I could not 
have said it any better than Ron Biglin said it.
    We would not ask someone using a wheelchair to walk up the 
courthouse steps, but in a real sense we are doing something 
similar when we ask people with disabilities to use Federal 
websites. We are saying that all the time in government 
services, and thankfully it has worked for a lot of Americans, 
but when we are telling people to use these Federal websites, 
mobile apps, and other technologies that are inaccessible, that 
makes no sense. We have got to do better than that as a Federal 
Government and as a society.
    I thank our witnesses for being here today and I look 
forward to hearing how to address these issues for people with 
disabilities, for seniors, and for veterans across the country 
like Ron Biglin and so many others.
    I will now turn to Ranking Member Scott.

                 OPENING STATEMENT OF SENATOR 
                   TIM SCOTT, RANKING MEMBER

    Senator Tim Scott. Thank you, Mr. Chairman, and thank you 
to the witnesses for being here today. Without any question we 
look forward to hearing your testimony.
    For many of our Nation's seniors and people with 
disabilities, accessing Federal resources and services has been 
too big of a problem that must be solved. This is especially 
true for our veterans, and that is why Senator Casey and I are 
working to solve problems with a variety of solutions. I thank 
you, Mr. Chairman, for your participation in so many of the 
efforts to include working with the VA and to improve the 
website accessibility for disabled veterans and disabled VA 
employees. We also requested the DOJ comply with reporting 
requirements regarding improved website accessibility for 
Americans with disabilities.
    In May, I hosted an event to honor our active duty, 
reserve, and national guard and military personnel, defense 
contractors, and those who fought in Afghanistan and Iraq. We 
had nearly 700 attendees at home in Charleston, South Carolina. 
It was a wonderful event. It was a wonderful way for us to 
acknowledge the incredible sacrifice, and those who serve our 
country should be honored on a consistent basis.
    I would like to acknowledge our South Carolina 
servicemembers, veterans, and those currently stationed at 
military bases throughout this Nation.
    One out of four of our veterans have a disability that is 
consistent with their military service, and the median age of 
our veterans is around the age of 65.
    Tony Green is a veteran from Charleston, South Carolina, 
who served in the Navy for eight years. Following his military 
career, he had problems assimilating into civilian life and 
started suffering severe bouts of depression. He went from 
living in the comfort of his own home to living in a homeless 
shelter. Determined to change his life, he reached out to the 
VA and received treatment for his bipolar disorder.
    The VA and its telehealth services, which he accesses from 
his phone and laptop to receive care and manage his medication, 
have made all the difference in the world for Tony. He took 
advantage of the VA's comprehensive work-therapy program that 
led him to a job with the Palmetto Goodwill's Ability One 
program. He went from a food service worker, to cook, to 
supervisor. Tony is now an assistant project manager in 
downtown Charleston. He is also the first homeowner in his 
family.
    Telehealth became a godsend for millions of Americans like 
Tony, especially our seniors during COVID-19. Patients 
connected with their doctors even when they were isolated. From 
March 2020 through February 2021, more than 28 million Medicare 
beneficiaries used telehealth services.
    Donna Avant, named the 2021 Pharmacist of the Year, has 
been providing telehealth education free of charge, to the 
residents of Bamberg County, South Carolina, since 2020, in 
this rural community, where the nearest doctor is 12 miles 
away, the nearest emergency room is half an hour away, and, 
more that 100 seniors received free tablets for health 
screenings in chronic disease education, such as diabetes and 
hypertension.
    Seniors use Zoom and the phone. It improved access to 
health care, to doctors, and specialists that they otherwise 
might not be able to see. South Carolina is a leader in 
telehealth innovation. The Medical University of South Carolina 
has one of just two federally recognized telehealth centers of 
excellence in the Nation.
    In 2021, I introduced the Telehealth Modernization Act with 
Senator Schatz and a bipartisan group including Senators 
Collins and Warnock, which makes telehealth flexibilities 
permanent even after this pandemic is completely done. Without 
congressional action, however, these emergency provisions will 
end, and they will end soon, like in mid-October of this year. 
For the tens of millions of Medicare beneficiaries and others 
who rely on telehealth services, that would be tragic.
    Federal regulations have not kept up with the technological 
advancements that we have seen in this country. We must keep 
telehealth available and accessible for all Americans, 
including our seniors, our military heroes, and disabled 
individuals, so that they can take care of themselves and meet 
the needs they have.
    I look forward to learning from today's witnesses. Thank 
you, Mr. Chairman, and I yield back.
    The Chairman. Ranking Member Scott, thank you for your 
statement. I will now move to witness introductions.
    Our first witness is Ms. Eve Hill, a disability rights 
lawyer at Brown, Goldstein & Levy. Ms. Hill previously as 
Deputy Assistant Attorney General at the U.S. Justice 
Department in the Civil Rights Division, where she was 
responsible for oversight of the division's disability rights, 
education, and Title VI enforcement and the American Indian 
Working Group.
    She founded Inclusivity Strategic Consulting, a unit of the 
law firm designed to help businesses, organizations, government 
agencies, and industry groups to achieve real inclusion of 
people with disabilities in their workforces and their 
communities.
    Our second witness is Mr. Anil Lewis, Executive Director 
for Blindness Initiatives at the National Federation of the 
Blind. Mr. Lewis oversees the development and implementation of 
projects that improve the education, employment, and quality of 
life of all blind people.
    Our third witness is Ms. Jule Ann Lieberman, the Assistive 
Technology Specialist at TechOWL's Institute on Disabilities at 
Temple University in Philadelphia. Ms. Lieberman conducts 
assistive technology demonstration training for TechOWL and is 
responsible for public awareness activities at that 
organization. She is also blind herself and she will tell us 
how she has been personally affected by accessibility problems 
with Federal websites.
    Ms. Lieberman is accompanied by her husband, John 
Lieberman. She is also accompanied by her guide dog, Bob. That 
is a good name, and for our fourth and final witness I will 
turn to Ranking Member Scott.
    Senator Tim Scott. Thank you, Mr. Chairman.
    Ronald G. Holmquest retired to South Carolina after a 
successful career in the Navy and later as a computer 
programmer and small business owner. Raised in New Jersey, he 
joined the U.S. Navy after graduating from high school. He 
served overseas in Japan and was honorably discharged in 1966, 
having been promoted to petty officer second class.
    He then pursued a career as a computer programmer and IT 
specialist in the New York City area. More importantly, he 
married Bonnie and they started a family. Ronald and Bonnie 
just celebrated their 56th wedding anniversary. What a 
blessing.
    Seeking a different pace, they moved to Vermont, where 
Ronald continued his work as an IT specialist and a small 
business owner. In 2015, he moved to Charleston--good 
decision--area to be closer to his family and granddaughter, 
who is now 10 years old. He is proud to have moved to South 
Carolina.
    Currently Mr. Holmquest receives care for chronic medical 
conditions at the Ralph H. Johnson VA Health System. He relies 
on telehealth and remote home monitoring devices to stay 
connected to his care team.
    Mr. Holmquest, we look forward to your hearing testimony 
today, and once again, happy 56th wedding anniversary.
    The Chairman. I join in those sentiments. Thank you, 
Ranking Member Scott.
    Before we move to witness statements I just want to make it 
clear for our audience that various Senator will be in and out 
of the hearing today. Thursday mornings are busy here. Lots of 
hearings and commitments that people have, so we will be 
acknowledging Senators as they arrive and as they have been 
present. I know we are joined already by Senator Rick Scott, 
and so we will now move to our first witness statement.
    Ms. Hill, you may begin.

STATEMENT OF EVE HILL, ATTORNEY AND PARTNER, BROWN, GOLDSTEIN & 
                  LEVY, LLP, WASHINGTON, D.C.

    Ms. Hill. Good morning, Mr. Chairman. Good morning, Mr. 
Ranking Member and members of the Committee. As has already 
been said, my name is Eve Hill. I am a partner at Brown, 
Goldstein & Levy, and I have dedicated most of my career to 
implementing the rights of people with disabilities.
    Imagine trying to do your job without access to the 
internet, when everyone else--your boss, your coworkers, your 
competitors--has access. Picture yourself having to call a 
customer service line every time you need information from an 
office while your competitors and colleagues get the 
information they need with a click, or waiting for a coworker 
to find time to read a data base to you or to interpret a video 
for you, while your colleagues click, scroll, and go.
    Imagine traveling an hour or more to get to a medical 
office and waiting for in-person assistance while everyone sees 
a doctor through telehealth from their home. Or imagine a 
telehealth appointment in which your child has to interpret 
your intimate details for your doctor. We all laughed at the 
scene in the movie Coda, when the daughter had to interpret the 
sex lives of her parents for their doctor, but it is not funny, 
and it is not fiction.
    In 2022, 97 percent of the top million home pages in the 
world had accessibility barriers, an average of 51 barriers per 
page, and there is no reason for this. Digital accessibility is 
not technologically complex. It has been solved since Mark 
Zuckerberg was in high school.
    Section 508 of the Rehabilitation Act has required Federal 
agencies to make their technology accessible for 24 years, but 
30 percent of the most popular Federal Government webpages are 
inaccessible, and these are ones we use all the time, like 
weather.gov, energystar.gov, and census.gov, and websites are 
the simplest form of technology to make accessible. The 
accessibility of other forms of Federal technology is dismal. 
Clients of my firm right now are dealing with trainings 
required by the Centers for Medicare and Medicaid Services that 
do not work with blind people's screen readers, and within 
intake kiosks at the Social Security Administration that are 
not accessible to blind people, and Federal employees with 
disabilities are dealing with inaccessible software programs 
that make it nearly impossible to do their jobs as well as 
timekeeping software, office machines, and online trainings 
that make their jobs more difficult.
    One might think this inaccessible technology is a relic of 
the past, but it is not. One blind employee of a large Federal 
agency for years worked on an inaccessible program that was 
central to her job, and recently the agency replaced the 
program, with a new one that is also inaccessible, and that 
agency failed to act on the employee's formal Section 508 
complaint for eight years, so far.
    In another recent case, an agency sat on a Section 508 
complaint for nearly five years, and had to be sued under the 
Administrative Procedure Act in order to act.
    The Social Security Administration, as a policy matter, is 
refusing to adopt accessible technology, insisting on wet ink 
signatures for documents to apply for SSDI benefits in spite of 
the wide availability, security, and accessibility of 
electronic signatures.
    So what to do? Section 508, in my opinion, needs six 
improvements. First, transparency. As you mentioned, the 
Justice Department is required to report on compliance every 
couple of years but has not done so since 2012. At the same 
time, GSA is collecting information on compliance but does not 
share that information with the Justice Department, with 
Congress, or with the public.
    Second, up-to-date standards. Technology develops quickly 
and accessibility guidelines keep pace, but Federal regulation 
does not. The Web Content Accessibility Guidelines 2.1 were 
released in 2018, and have not been incorporated into the 
Section 508 standards. Congress needs to ensure that the Access 
Board has the resources it needs to keep its standards up-to-
date.
    Third, testing. Agencies clearly cannot rely on the 
aspirational, misleading, or incorrect statements of their 
technology vendors. They must have the ability to test 
technology accessibility themselves before they roll it out.
    There needs to be a significant remediation effort of 
barriers that already exist in technology, and fifth, 
oversight. Self-oversight has not worked. A Federal agency 
should be tasked with enforcing compliance with Section 508.
    Finally, accountability. The Federal agencies that are 
violating Section 508 are violating civil rights. They are 
harming taxpayers by buying technology that is not worth what 
we paid for it and by making it harder for public servants with 
disabilities to do their jobs, and vendors of inaccessible 
technology need to be held accountable to their Federal 
customers.
    Thank you very much for inviting me today and I appreciate 
your interest in this topic.
    The Chairman. Thank you, Ms. Hill, for your testimony.
    Mr. Lewis, you may begin your statement.

          STATEMENT OF ANIL LEWIS, EXECUTIVE DIRECTOR

         FOR BLINDNESS INITIATIVES, NATIONAL FEDERATION

                 OF THE BLIND, ATLANTA, GEORGIA

    Mr. Lewis. Thank you. I want to thank the honorable members 
of the Special Committee on Aging for this opportunity to 
present on this extremely important topic. I see ICT, 
information communications technology as very important because 
it creates opportunities for us to access the fundamental civil 
rights that should be extended to every American citizen.
    As stated, my name is Anil Lewis. I am the Executive 
Director of Blindness Initiative for the National Federation of 
the Blind, the most transformative organization of blind people 
in this country, and we believe that access to public services 
and public information is a fundamental civil right. We 
recognize that ICT holds the hope for us to access these 
Federal programs in a more dynamic fashion.
    In my written testimony I go through the process of 
explaining how when I went blind in 1989, the old service 
systems that were in place made it frustrating, if not 
impossible, for me to access these services. I loved the term 
that you used and I am going to use it. Now that we have moved 
to the place of the virtual front door, those old services are 
even worse, because we put more resources into creating the 
virtual front door and taken them away from the old services, 
which were mediocre at best.
    Again, the accessible ICT--and I mean accessible, not just 
information communications technology itself; if it is not 
accessible it does not work--it holds hope for us to finally 
really be able to access the information and the services like 
every other American citizen. Through screen readers that 
convert speech, the digital information on computers into 
speech for the blind person to hear, refreshable Braille 
displays like the one I am using today, which converts that 
digital information into a tactile form that I can read with my 
fingers, we can provide access and information to blind 
individuals and those with low vision, individuals that are 
deafblind, and because it is speaking the technology, those 
individuals who are illiterate and could not read, because it 
is in a digital and accessible format, it can convert to 
foreign languages, again, creating opportunities for every 
American citizen to access the programs and services that we 
should be allowed to.
    Rather than going through a litany of personal examples, in 
my testimony you will see references of how inaccessibility has 
adversely impacted a representative sample of over thousands of 
people with disabilities, and it is preventing them from 
accessing services from the IRS, the Social Security 
Administration, Centers for Medicare and Medicaid, Department 
of Education, Small Business Administration, the Veterans 
Administration, and also even Homeland Security, and the reason 
that it is impacting is not just because we cannot access the 
information and services but also we cannot become viable 
Federal employees if the systems that are used to support the 
employment are not accessible or non-vision accessible to blind 
individuals.
    I want to spend most of my time in these remaining few 
minutes not to talk about the problems that are created but 
just get people to paradigm shift and recognize that 
accessibility is not difficult. That is the big thing. 
Accessible coding is just good coding, so we are not adding an 
additional burden on the existing systems to make them 
accessible if we focus on accessibility during the design and 
development process.
    The only big problem is there is a flawed accessibility 
implementation strategy within the Federal Government. In my 
written testimony I do an analogy around typing, where 
individuals within the Federal Government are using Smith 
Corona typewriters to create documents, taking that document 
and giving it to someone who can use a word processor to create 
a digital accessible document, so of course, that person who 
runs that Smith Corona typewriter is going to think that it is 
difficult, and of course it is going to be more expensive 
because you have to add another layer. The strategy should be 
to teach that one who is working on that Smith Corona 
typewriter how to use the word processor to create that 
accessible document from the start, and then it is seamless. No 
additional cost, no additional difficulty. It just works.
    I just want to stress, well, really appreciate the fact 
that this is a very good, collaborative effort, a bipartisan 
effort to really meet this need. We know that is law. Let's 
just implement it, and the Federal Government can be an 
exemplar. One, the Federal Government can continue to strive to 
be a model employer, making sure that blind people and other 
people with disabilities have the opportunity to obtain 
employment, lateral movement, and upward mobility within the 
Federal Government.
    Two, the Federal Government can implement a procurement 
process that demands that vendors to the Federal Government 
make sure that they provide accessible technology and other 
services so that they can encourage those vendors to make sure 
that they are developing accessible information from the 
beginning. This will also affect not only the vendors' 
production of accessible materials but also the training of 
individuals in the IT profession, because a person who learned 
to program and develop, as long as they learn about 
accessibility it is just part of their everyday.
    I would just really give one quick example of what has been 
really refreshing for me lately. We know that they have been 
offering free COVID tests to every American citizen. The 
National Federation of the Blind reached out to the 
Administration and recognized that these tests were not 
accessible to blind individuals. We, long story short, have 
been working with the National Institutes of Health, the 
Administration of Community Living, and we are working to make 
sure that the whole process, from soup to nuts, is accessible, 
the website is accessible, the instructions for the kits, we 
are working with those manufacturers to make sure they are 
accessible, the kits themselves, we are working them to be 
accessible, and the beautiful part about this is twofold. One, 
people are recognizing that accessibility is not expensive and 
it is not difficult, and two, we are enculturating the thought 
of accessibility into this whole infrastructure so that every 
other product or service that NIH works with, especially when 
we are talking about telemedicine and all these other home 
health care pieces of devices that they are working with, are 
accessible, born accessible from the start, so the same insulin 
pump that a sighted person uses, a blind person can use because 
it is accessible. The same home chemotherapy that a person 
without a disability uses is the same one that a blind person 
can use who has to have chemo. It is just a win-win.
    I am just optimistic that not only will this help us access 
the fundamental rights that we deserve, but the multimodal 
resulting impact of all this technology also helps every 
American citizen, not only just in literacy and language 
translation, but someone who can see also gets comfort in the 
validation of an audible confirmation when something happens.
    Again, thank you for this time to present. I am looking 
forward to working collaborative with you moving forward to 
make the Federal Government the exemplar and introduction of 
accessibility that creates a better quality of life for every 
American citizen. Thank you.
    The Chairman. Mr. Lewis, thank you for your statement.
    As I mentioned we will be acknowledging Senators. Senator 
Blumenthal has joined us, and now I will introduce our third 
witness, Ms. Lieberman.

           STATEMENT OF JULE ANN LIEBERMAN, ASSISTIVE

            TECHNOLOGY PROGRAM COORDINATOR, TECHOWL,

                      DEVON, PENNSYLVANIA

    Ms. Lieberman. Thank you very much for this opportunity to 
speak before you today. I come to you not only as a person, as 
evident with the gray hair, of the aging community but also as 
a person who is blind. I was diagnosed in 1970 with a 
progressive vision loss, so I have gone through all the various 
stages of low vision to the point where now I would be 
considered profound vision loss or blind, and again, this does 
impact your daily life, especially when you do not have equal 
access to information.
    I work with TechOWL, which stands for Technology Our Whole 
Lives. It is an Assistive Technology Act program that is 
located within the Institute on Disabilities at Temple 
University. Our office works very hard to promote the 
independence of persons with disabilities and also promotes 
self-esteem and other personal choice opportunities.
    With that said, again, my experience teaching, I have been 
teaching for 24 years persons with vision loss, how to operate 
a computer independently, and that would be the use of 
assistive technology, as described previously, like screen 
readers.
    I have to comment. When Ms. Hill made the comment about the 
scene in Coda, it flashed on a memory of my son accompanying me 
to my mammogram appointment. We were given a form to fill out, 
and he had to ask questions. My son, I am very proud of him, 
and he is probably one of the kindest persons in the world. He 
said at the end, ``Mom, I know more about you than I ever 
wanted to know.''
    Again, equal access and equal opportunities to provide 
information is critical for anybody with any disability, of any 
age, so even though I am within the older population now--I 
guess you could say that--I plan to continue working for some 
time, and having access to this information, not only for 
myself but also for the customers that I serve, I provide 
information assistance at my office and so very often I have to 
direct people to finding locations on the internet, over the 
phone, and it really bothers me when I know, in fact, I cannot 
get that information completely. Sometimes there are 
roadblocks.
    As an example, these past few years we have all been in a 
crisis situation, dealing with health inequities and also the 
health situation as a result of COVID. I am a person that 
thinks information is power, and I rely on reliable 
information. I would hope that the Federal Government and its 
resources, like at the CDC, would be able to provide me with 
accurate information. You do not want us to merely be relying--
as their best efforts are--with news media and/or social media 
to provide us with information that may or may not be accurate, 
so we look for these resources that we would hope that would 
ensure accurate information.
    I tried to find the prevalence of COVID activity, and this 
was in the spring of 2020, again, in my region, my State, and 
my county, and it was presented in a graph with no description, 
so it was very frustrating. I could get to one point, to where 
I could actually identify where I lived, and everything was 
represented in a graph which provided me no information at all, 
and so, you know, for me, I had to rely on other sources.
    Now I am very, very fortunate that I have a very supportive 
family, incredibly supportive family, so as a routine, my son 
would come up--we were both teleworking. Obviously, our offices 
were shut down, and as a routine he would come up at least once 
or twice a week, at lunchtime, sit down with his computer, and 
say, ``Okay, Mom, here are the updates.'' He would read them 
aloud to me, and it provided assurance to both of us and helped 
us make decisions on our activities. Is it safe for me to go to 
the grocery store? Is it safe for me to go to church?
    The things that are important to us, we need to know that 
information so that I know that, okay, I am safe if I wear my 
mask or what other guidelines are there, but having that 
initial information of how often this is happening in my 
neighborhood is incredibly important.
    You know, going down then to the spring of 2021, it was 
wonderful that we had the availability of vaccines. 
Unfortunately, when I tried to research how I could get a 
vaccine and make a vaccine appointment the sites that were 
directed by the CDC, including some providers, in order for you 
to access the information on availability of vaccines you had 
to click on a map.
    Okay, pointing and clicking is not an option for me. If it 
is a graphical representation and the only access you have is 
clicking with a mouse, it is no access, and then if I did get 
any information I would not be able to make an appointment.
    So out of frustration, I posted on our office, the 
Institute on Disabilities, listserv, what am I going to do 
about this? I need to find a vaccine, and fortunately a very 
respected manager--Jamie, thank you--sent me a phone number at 
the Area Office on Aging and Disability and she said, ``I 
believe there are starting to have appointments in your area.'' 
It took me five minutes to schedule an appointment. I did not 
have that information otherwise. There was no information of 
calling, you know, that agency anywhere, so that I could make 
that appointment myself.
    With that said, it was a very positive experience that I 
had good relationships with my coworkers and a very supportive 
family, but that is not the case for everyone. I do work with 
individuals that may be vulnerable, for example, that they are 
blind and they are relying on someone that perhaps is less 
trustworthy or abusive. You do not want them to be providing 
that information to someone when they are seeking support 
services from the government. I really do not think that is 
something that should be expected, but again, it does put 
people in a very risky situation.
    Again, I am fortunate that I do have a great support 
network, but that is not the case of many of my colleagues. I 
am active in the Pennsylvania Council of the Blind. Many of my 
colleagues do not have that option. They live alone, and they 
do not have those resources, so again, I am fortunate that I 
do, to a point, or it stops, and that is where I am hoping that 
these actions that you are taking today in this conversation, 
you can carry it forth, and like my colleagues here on right 
said to me, that it follows through. If you start with one, 
make some corrections at the VA, and then other websites to see 
how it works. Then they can become accessible--likewise in the 
commercial market. It is going to happen.
    Again, it is something that is not hard to do. There are 
guidelines. Most people, when they create a website that is not 
accessible, it is not because they are intentionally trying to 
lock me out of information. They just do not understand that is 
a need, and so, therefore, they do not know.
    In my written testimony I have some reference of where you 
could find about the website accessibility guidelines that are 
available, so that they can review, and also that there is 
information about how to get support services in order to do 
that.
    I do caution our Federal websites----
    The Chairman. Ms. Lieberman, I just want to make sure we 
can move on to our next witness, if you can wrap up.
    Ms. Lieberman. Very quickly, yes. I just wanted to caution 
you not to take advantage of the commercial ones that say, ``We 
can fix your accessibility.'' Those overlays that they provide 
use artificial intelligence that, unfortunately, as much as 
this has evolved, it is not the answer. They cannot guess what 
my needs are. We have to be able to use our software 
independently.
    Thank you for your attention.
    The Chairman. Thanks, Ms. Lieberman.
    We will now conclude our witness statements with Mr. 
Holmquest. You may begin.

 STATEMENT OF RONALD HOLMQUEST, RETIRED AND U.S. NAVY VETERAN, 
                 MOUNT PLEASANT, SOUTH CAROLINA

    Mr. Holmquest. Good morning Chairman Casey, Ranking Member 
Scott, and distinguished panel. Thank you for inviting me to 
speak to the Senate Aging Committee about my experience with 
telehealth and the VA.
    You can probably tell I am not a native of South Carolina. 
I spent most of my life up north before moving here seven years 
ago. There are a lot of good reasons to live in South Carolina. 
I moved here to be close to my son, daughter-in-law, and 
granddaughter, who is now 10 years old. I have the pleasure of 
helping to take care of her a few days a week.
    When I moved to South Carolina in 2015, South Carolina 
veterans welcomed me. I was invited to the Port of Charleston 
for the commissioning ceremony for the USS Ralph Johnson, a 
guided missile cruiser named after a Marine from South Carolina 
who posthumously received the Medal of Honor for his heroic 
actions during the Vietnam War. Ralph Johnson used his body to 
shield two fellow Marines from a grenade, absorbing the blast 
and dying instantly. I am wearing this baseball cap today in 
his honor.
    South Carolina veterans recommended that I check into the 
VA. I have been with the Charleston VA since 2016. What I did 
not expect before I moved here was the excellent health care I 
would get at the Ralph H. Johnson VA Health Center, which is 
also named after that same heroic Marine.
    A couple of years ago, the VA invited me to sign up for 
telehealth, and I was skeptical. I have lots of severe medical 
problems, but I never signed up for VA health care before 2016, 
because I thought it was for veterans who were hurt and maimed 
in Vietnam and other wars. I figured they needed it more than I 
did.
    I served in the U.S. Navy during the Vietnam War, but most 
of my active service was in Japan, where I served as a 
communications technician. A highlight was attending a 
performance by Bob Hope. After being honorably discharged from 
the Navy, I eventually ended up in Montpelier, Vermont, where I 
worked in information technology.
    I also served as a volunteer EMT for about a decade in Fire 
and Rescue. In those days, all we had was bottled oxygen to 
keep people going until the ambulance arrived. We did not have 
all the modern technology they have these days. Sometimes the 
ambulance got lost on the back roads of rural Vermont. I guess 
it was tough to navigate when the cows moved.
    With telehealth, the VA can manage my complex chronic 
conditions very well. The VA assigned me a telehealth case 
manager--what a pleasure. Mine is an RN with a Bachelor of 
Science in Nursing who knows her stuff. Her name is Frances 
Santana. I thought that they were all vets, but not all of them 
are, and they always say, ``Thank you for your service.''
    The Ralph Johnson VA Health Center is a teaching hospital, 
so some of the docs are from the Medical University of South 
Carolina, so you get the best, smartest medical staff to be 
found.
    A function of telehealth is that they watch after you. I 
send my vitals to my RN daily and if there is a problem you get 
a call immediately. She has direct contact with docs, fellow 
RNs, and other providers, and will get answers to your problems 
or education for you on medicine and procedures. She gets 
problems resolved for you.
    A big plus at the VA is that one computer system is looked 
at by all, including docs, RNs, and medical staff. When you 
have an appointment, your provider has all the necessary 
information.
    I have many decades of experience as a computer programmer 
from the early days of the industry. It is so important to have 
computers fully and properly used to benefit patients.
    Another point is that telehealth and technology have made 
care more personal, not less. I have five different 
cardiologists who treat me. When I have questions about a 
medication or why I have been taken off of a medication, I 
would pick up the phone and call Frances. She checks with the 
doctor and tells me they prescribed it because other 
medications have adverse reactions to my existing medications.
    I also use MyHealtheVet to make appointments. It is very 
effective.
    Telehealth is critically important to veterans' care. All 
veterans should have this opportunity. Telehealth and the VA 
need to stay for the benefit of all vets. It would be a shame 
to lose these valuable assets.
    Thank you for letting me share my story.
    The Chairman. Mr. Holmquest, thanks so much for your 
testimony and thank you for your service. We are grateful, and 
we are grateful you are with us today.
    I will now turn for our first set of questions to Senator 
Blumenthal, and we are joined by Senator Braun.
    Senator Blumenthal. Thank you very, very much, Senator 
Casey, and thanks to you and Ranking Member Scott for having 
this hearing, which is so important. Thanks to all of the 
experts who have come to talk to us, and a special thanks to 
you, Mr. Holmquest, for your service.
    I gather you are now in South Carolina but you lived for a 
long time in Vermont, and as a fellow New Englander I am 
especially grateful for your personal insight into how 
telehealth and the VA, this technology, is making your life 
better, and I would agree with you that South Carolina is a 
good place to live and it is also a nice place to visit. Thanks 
to Senator Scott for inviting you to be part of this proceeding 
and sharing your story, which is really powerful because I 
think you have shown us how telehealth, and I am quoting you, 
``Telehealth and technology have made care more personal, not 
less.'' I think that is a really important point.
    I am on the Veterans Affairs Committee and the Armed 
Services Committee. Telehealth really has broadened and 
deepened the kind of care that people have available, 
especially for people who have disabilities and may not be able 
to travel to the VA hospital in West Haven or in Newington, but 
can get care at home if they have access to the technology.
    In Connecticut, 21 percent of all adults live with a 
disability, and 27 percent of all veterans--27 percent of all 
veterans in our state--have a disability, so this kind of 
technology is very, very important to them, and I wonder if you 
could tell us a little bit, Mr. Holmquest, talking about maybe 
some of your buddies in South Carolina, how access to this 
technology is very important to them, and maybe some of the 
difficulties they have encountered in accessing telehealth.
    Mr. Holmquest. I think the access to telehealth, for 
myself, if I had a question I would not know who to call as far 
as a doctor was going to be concerned, but I could call Frances 
and get her to be contacting the appropriate doctors, the 
appropriate services that you might need, get those services to 
give me a call to set up an appointment to followup on what is 
needed for my care. That was the biggest assistance for me was 
to have that synergy where she could talk to other people. I 
would not know who to call, to be honest with you, but she 
could, and she handles that for me very well. It is just 
fantastic. If I have a problem of any kind my phone call is to 
her first, and she can solve the problem for me.
    Senator Blumenthal. You mentioned you have access to five 
different cardiologists, some of the best in the State, maybe 
the Nation.
    Mr. Holmquest. Yes, absolutely. I came down with some heart 
problems, and because this is a teaching hospital there are VA 
doctors, MUSC doctors that all get together. They have their 
meeting in the morning, when they talk to you when you are in 
the hospital. There is a whole bunch of them that come in there 
and discuss what is going on, and when they leave there they 
have a plan of attack on what is going on.
    In fact, one day they said, ``Oh, by the way, we have 
discussed this and we think you need a defibrillator implanted 
in you.'' I said, ``Wait a minute. Am I that bad?'' Their 
decision was it is better to have a defibrillator available 
than have to wait for one, so I was very pleased with that. I 
went along with what they said.
    I trust every single doctor and nurse at the VA. They are 
just fantastic. The people that are with the VA are dedicated. 
The people that help them out, the nurses and so on, everybody 
is so dedicated and qualified to do their job here. It is 
unbelievable.
    Senator Blumenthal. Well, we are trying to push the VA to 
do even more of that kind of telehealth, and the present 
Secretary of the VA, Dennis McDonough, is very much on board 
with that approach. I am going to pass along your insights and 
your story to him, and thank you very much for joining us 
today.
    Two of my sons have served, one as a Navy SEAL, the other 
as a Marine Corps combat infantry officer in Afghanistan. They 
have made use of VA services from time to time, and I hope it 
is available to even more people in South Carolina, throughout 
the country. Thanks to Chairman Casey and to our Ranking 
Member, Senator Scott, for this hearing today. Thank you.
    Mr. Holmquest. Thank you, sir. Thank them for their 
service.
    Senator Blumenthal. Thank you.
    The Chairman. Thank you, Senator Blumenthal. I will turn 
next to Ranking Member Scott who will share his time with 
Senator Braun, I am told.
    Senator Tim Scott. Thank you, Chairman Casey, and thank 
you, Senator Blumenthal, for your kind comments about the 
importance of living in South Carolina, and for visiting South 
Carolina, if you have to represent other states, and thank you 
also for your time and your service and your dedication on the 
Veterans Committee as well as the Senate Armed Services 
Committee. Certainly working in a bipartisan coalition or 
fashion is really important for our country to see and have 
here our witnesses watch that. Hopefully we will improve just a 
little bit and people's perception of how Congress or the 
Senate actually works together.
    Mr. Holmquest, thank you for your comments. I am certainly 
proud to have you in South Carolina and thank you for your 
comments about Mr. Johnson as well, Ralph H. Johnson, who gave 
his life for the salvation--saving the lives of two other 
Marines was such a powerful story. I was at his commissioning 
of the USS Ralph Johnson in 2018. A powerful story that we 
should all read about, and I thank you, Senator Blumenthal, for 
focusing many of your questions on the importance of telehealth 
and how telehealth is actually bridging a gap and bringing 
expert care to where the person who needs it the most.
    With your questions I am going to go ahead and defer to 
Senator Braun, since you and I both were going to focus on the 
telehealth environment. Senator Braun, I will give you the 
balance of my time.
    Senator Braun. Thank you, and thank you, Mr. Chairman, as 
well.
    My question is going to be for Ms. Lieberman. Before I got 
here in Senate I ran a logistics and distribution company for 
37 years, and I remember vividly, early on, how crude our 
systems were when we were starting to automate. I think it 
might have been a Radio Shack system or something when we first 
started.
    I do know that to be competitive in any business now, and 
especially in one like ours, when it is sprawling--it was so 
little for so long--technology, and being on the leading edge 
was the differentiator, in many cases, whether you were going 
to be successful in business or not.
    Two of my four kids, my sons, started about 15 years ago 
right when we were getting some size, and we had to say either 
we are going to embrace technology or we are going to be left 
in the dust. Thank goodness my older son, he got schooled in 
it, is great at it, and we decided to do it, and he and my 
younger son now run the company with one of my two daughters.
    I was listening to the testimony, and it is so reminiscent 
of what, in the early days, where we were not quite doing 
things the way they should be, mostly due to budgetary issues, 
and since I have been here in the Senate our technology is 
pretty good here for Senators, and I am sure over in the other 
side for Representatives, but I get complaints often when we 
are interfacing with the IRS, with the VA, and then hearing 
your testimony, especially in trying to access, being impaired 
in the way that you have to deal with it, you know, it is 
really kind of almost shameful.
    Because when you have got all these agencies spending this 
much money, yet you are having simple issues of connectivity, 
you look at the stats here which the Information Technology 
Innovation Foundation, 30 percent of the most popular Federal 
websites did not pass an automated accessibility test for their 
home page. I mean, that is almost laughable if it would not be 
so sad.
    So please elaborate on, in your particular case, what you 
have experienced, and then maybe give me a few ideas, give us a 
few ideas on what minimally needs to be done to see a 
difference.
    Ms. Lieberman. Sure. I think, first off, understanding how 
someone that is blind is accessing a website is the way things 
are logically arranged. Screen readers technically will read 
from left to right, up and down, and they will read everything, 
so when things are designed, especially those that are low 
vision, that it is cluttered and things are low contrast, for 
example, that can be very difficult for them to navigate and 
also for the screen reader to interpret the information.
    So what most screen readers will do--that is the software 
that I use to access--it will then allow us to be able to 
navigate quickly to various section of information, so if a 
website is designed with good structure, with headings and with 
well-labeled links--when I say well-labeled link, when you talk 
about those automated accessibility checkers, I am kind of 
burning it underneath because sometimes they will say 
everything is fine or your links are labeled, but it is not 
helpful when they are labeled ``click here'' or ``see more,'' 
because it is taken out of context in that list that the screen 
reader will do. It is very, again, disconcerting because I do 
not know what it is referring to, so having things that are 
well-structured, well-labeled, well-described, so graphics that 
are important.
    I will have to commend NASA, the most recent ones with the 
images from space is a delightful visit for somebody who is 
blind, because it does give us a great appreciation of what 
these images, and very well-crafted descriptions, so there are 
some organizations that are getting it, that understand it.
    Again, I mentioned the AI, the artificial intelligence that 
is being applied. That is not a good way of going about it. If 
you want to think about having accessibility you start with the 
basics of accessible design, so there are, as I mentioned, 
there are guidelines that you can refer to, and the best thing 
that I have found at my office they like to do is they pass it 
by, if Jule Ann can read it then it is okay, so a lot of times 
I will be asked by other organizations.
    In fact, I recently provide technical assistance for the 
Southeast Pennsylvania Transportation Authority, or SPTA, on 
the accessibility of their website, and I provided them 
examples with my screen reader aloud, so they can hear it, and 
what the experience was.
    So yes, there is information out there on how you can 
create it. Good structure from the beginning, good design saves 
a lot of time and remediation. You do not want to wait until a 
complaint.
    Senator Braun. That all makes sense, and I think for as 
much money as we spend and for all the good things we try to do 
through our various agencies, and as important as high-speed 
anything is, when you have got that and you are not formulating 
the right home pages, the right techniques, I would welcome any 
of you to make sure to give us--on the side of getting ahold of 
us. My Senate office, if you are having trouble doing it 
through the agencies, call my Senate office. Tell my staff, and 
we will get in touch with those various agencies to see why 
they are not maybe putting the resources, putting the effort to 
it, when that is so highly recommended. It is so great when it 
does work, where you do not have to deal with the frustration 
of the basics, so keep that in mind. Thank you.
    Thank you, Mr. Chairman.
    The Chairman. Thank you, Senator Braun.
    I will also turn back to Ms. Lieberman for a question and I 
will include it in this question. I will direct it also to Mr. 
Lewis. Both of you have had personal experience living with a 
disability, as your testimony indicates so clearly. You have 
also both had decades of experience working with people with 
disabilities. You have seen both ends of it, hearing from those 
who have had their own experiences and having your own.
    The hearing we are having today is, as I said earlier, 
particularly relevant because we celebrate this week the 32-
year anniversary of the Americans With Disabilities Act, and 
the goal of the law is then-President Bush said, to quote, 
``Let the shameful wall of exclusion come tumbling down.'' That 
wall of exclusion is still, unfortunately, so evident in some 
of these issues we are talking about today.
    Thirty-two years later, people with disabilities still face 
these walls of exclusion because of how technology has advanced 
and how we have not kept up with making that technology 
accessible, and of course, we are focused today on Federal 
agencies.
    I would ask both Ms. Lieberman and Mr. Lewis, can each of 
you share an example of people that you have worked with who 
have experienced information technology barriers and the impact 
that it has had on them.
    Ms. Lieberman. Do you want to go first?
    Mr. Lewis. No, I am a Southern gentleman.
    Ms. Lieberman. Oh, a Southern gentleman. Well, thank you, 
Southern gentleman. I am from Pennsylvania so we talk a little 
fast.
    Actually, Senator Casey, I did forget to mention that my 
formative years were spent in St. Clair, which is a small town 
in Schuylkill County.
    The Chairman. Schuylkill County, right.
    Ms. Lieberman. Oh yes. I am a coal-cracker too, my 
background, but I lived 40 years outside of Philadelphia in 
Chester County.
    To answer your question as far as the people that I have 
worked with, access is critical, as I have mentioned several 
times, and some of the barriers that they have, if a website is 
designed, oh, that you just need to tab, if you open up most 
websites, especially Federal websites, I believe when I 
attempted to look at the IRS one I think the opening page had 
over 200 links, so if you use your Tab key it is going to tab 
through each one of those links, so there has to be a way so 
that you can structure it so that you can get to things very 
quickly to get your answer, because quite frankly, time is not 
only money but time is also patience, so how much patience do 
you have?
    I have had several individuals that will tell me, ``Oh, I 
just gave up because it was too tedious. It was too hard to get 
to the information that I needed,'' and that seems to be one 
of, I would say, the carryover in most cases with all 
disabilities, and the older population. Our aging population, 
they want an answer now. They do not want to have to go through 
15 steps in order to get to that answer. They want to have that 
information as easily found as possible, so that is pretty much 
the experience I have had with others, as well, on websites, 
not just Federal websites but in general.
    Mr. Lewis. I would have to offer that with respect to 
websites, we have a host of different examples of individuals 
that have tried to access information from the Federal 
Government website, and it is not even just the factor that you 
go to that site and it is inaccessible. It is to the point 
where there is a little bit of accessibility, so you can go 
through the process of actually providing essential information 
to get to the place where you need to get the information that 
you are requesting, and after you go through the tedious 
process of trying to maneuver through, and you are finally 
getting to that place where you are able to click this link 
that gives you access to this document that you have been 
searching for, for about an hour, you click it and the 
resulting document is inaccessible. I mean, it like the virtual 
front door is open and you walk in, and there are other doors 
that are still closed.
    The one I really like to highlight, because we are talking 
about, again, information communication technology--and let me 
say for the record, I am a believer in the potential. My 
undergraduate is in computer information systems, and I have 
been, for years, talking to individuals that this is not very 
difficult, because in the world of digital information it all 
boils down eventually to 1's and 0's, and if we focus on doing 
internet development and design process, we can make it 
accessible. It is not a problem. We just have to make sure that 
it is intentional and not done after we have done this 
wonderful creation of something, and then we say, oh, now we 
should make it accessible. No. That is why it is difficult. 
That is why it is expensive.
    Social Security Administration, trying to reach 
efficiencies in dealing with the old-school service system, 
where people have to go into the office to get access to 
services, and the kiosk system, which I have credibility. It is 
much better than going and just pulling a number. You can 
provide information that allows them to streamline the type of 
service that you specifically need. You just simply go to the 
kiosk, you enter your information including your Social 
Security number, your reason for the visit, boom, and you get 
associated not only just with a number but with the number that 
goes to that person that is going to help you with that 
specific issue.
    The only problem is as a blind person when I go to that 
kiosk it is inaccessible, so either now I have to coordinate my 
visit to the Social Security office with a friend or family 
member that I trust, or because it is not staffed by the Social 
Security Administration staff, I have to ask a total stranger 
to enter my Social Security number into this kiosk in order for 
me to get the same services.
    So yes, there are a host of examples we can give, but 
again, I would still like to continue to focus on the fact that 
the knowledge for accessibility is there, the tools already 
exist. It is really just about the efficient and ethical 
implementation of these strategies, and then that way all the 
money we are spending on DOJ complaints and the four-year wait 
to get access to services, all that time, energy, and resources 
can be refunneled into training the people who are developing 
the information delivery systems, and then it is a win-win for 
everybody.
    The Chairman. Thanks very much, and I will turn next to Ms. 
Hill. As you know, the Department of Justice is required to 
issue a report on the Executive branch's compliance with 
accessibility requirements in Section 508 of the Rehabilitation 
Act, which you were highlighting and you know so much about.
    This report has not been completed in the past ten years. 
As I mentioned, Ranking Member Scott, Senator Burr, and I 
recently joined together to call on the Justice Department to 
begin issuing these reports again. We were joined by Senator 
Durbin, Senator Grassley, Senator Murray, Chair of the Health 
Education Labor Pensions Committee, and Senator Duckworth.
    In your view, why are these reports important, number one, 
and how will Pennsylvanians who rely on government services 
like Medicare, Social Security, and the VA Health System 
benefit from these reports being made available again?
    Ms. Hill. Thank you. Yes, transparency is really important 
in this field because without it agencies are tempted to not 
comply and wait to see if they get caught by someone who 
encounters the barrier. This transparency encourages agencies 
to take accessibility seriously at the beginning of a 
technology purchase, when it is easy and inexpensive to do, 
rather than wait and have to do fixes that are expensive and 
time-consuming, and Pennsylvanians and others will benefit not 
only from that cost savings but from the improved level of 
customer service that all that technology will provide if it is 
accessible from the beginning, not only for people with 
disabilities who will be able to count on being able to use it 
but as Mr. Lewis has said, accessibility is good design, so 
everyone with and without a disability will benefit from that 
additional good design, and the Federal Government's purchase 
power will improve those vendors' ability to have accessible 
products as a matter of course, and that ripples out into the 
rest of the world.
    The Chairman. Well that all makes sense and it is all the 
more reason why we have got to keep pushing every agency, but 
in this case to push the Department of Justice to begin to 
issue those reports again after such a long period of time of 
not issuing those reports.
    I will turn back to Ms. Lieberman. In your role as 
Coordinator of the Assistive Technology Program in Pennsylvania 
you come in contact with many people with many different types 
of disabilities. We know that there are over 61 million 
Americans in our country with a disability, and almost two-
million of those are in the State of Pennsylvania.
    As I mentioned earlier, the pandemic has accelerated the 
Federal Government's adoption of electronic information and 
technology communications to share information and provide 
services online. That is a good thing that those services are 
available online. Critical benefits from the Federal 
Government, such as Medicare enrollment, now primarily take 
place online.
    Can you tell the Committee why it is essential to ensure 
online services, especially Federal online services, are 
accessible?
    Ms. Lieberman. I think, well, besides the fact that it is 
my right, as a citizen of the United States, to expect that I 
can obtain services when it is need, something like Medicare, 
for example, it is vital that I would have that access to that 
information and be able to complete it independently.
    Things that would be of note would be when we are requested 
to complete a form online that all the form fields are labeled. 
They may show up on the screen but the screen reader does not 
have that information so it is not telling me, so I just get 
blank edit fields.
    So for me, to quickly, efficiently apply without having to 
ask somebody else to help me, that is the type of barriers that 
I see as well, with individuals that contact our office, that 
they seem to have issues. Is it because the technology is too 
complex, so they think, or is it the website is not accessible? 
Sometimes I have to do a little detective work to try it out 
myself, to see if, indeed, if it is, again, operator error or 
is it an error literally in the design of the website.
    I have encountered that a few times over the years--I have 
been there nine years--and I would say I can think of 25 cases 
where people have asked me to get that assistance for them in 
order for them to access information on the internet, whether 
it be Medicare or any other location on the internet.
    I do not know if I answered your question. Hopefully I did.
    The Chairman. You did, and thank you for that testimony. I 
appreciate it.
    We will now turn to Senator Rosen for her questions.
    Senator Rosen. Well, thank you so much, Chair Casey. I 
really appreciate you bringing forward this hearing, and thank 
you to everyone for being here, digitally, and we just 
appreciate what you have been doing and how we can help you.
    I want to talk a little bit about digital equity because 
the Bipartisan Infrastructure Law that Congress passed last 
year, it is the most significant Federal investment we have 
ever made to close the digital divide, something that is really 
important.
    I was proud to be one of the group of Senators that helped 
draft the key portions of the law, which included critically 
important digital equity provisions. The past three years have 
shown us how critical access to affordable, high-speed 
broadband is for everyone. The pandemic has shown us that, but 
speed and low cost are just part of ensuring digital equity for 
all individuals. Digital literacy, access to devices that meet 
users' needs, applications that enable and encourage self-
sufficiency and participation--well, they are all components of 
ensuring digital equity and inclusion.
    So in drafting the equity provisions of the infrastructure 
law Congress did make it a priority to improve the digital 
equity as well, including for individuals with disabilities.
    So I would like to ask Mr. Lewis and then Ms. Lieberman, 
how are your organizations working with NTIA and the State 
broadband offices to ensure that these digital equity programs 
that we created here in Congress are promoting equity among our 
aging, disabled, and our veterans communities, and if you are 
not collaborating, this is something that we should consider 
doing. Do you need help? Can you just speak to that?
    Let's start with Ms. Lieberman.
    Ms. Lieberman. I am very fortunate where I work. TechOWL 
has participated very much so in health equity issues in two 
areas. Initially, we received some money from the Area Office 
on Aging funding, and with that we expanded our lending library 
so that we could introduce iPads to seniors so that they could 
have that same access to telehealth, to Zoom, as we had 
previously heard described, so they could have all that kind of 
access, and we put it into our lending library and made the 
decision for them to borrow it for rather extensive time 
periods so that they can explore whether that works for them 
first, because one of the things that we have noticed over the 
years, assistive technology can be abandoned. If people have 
not had an opportunity to try it first, then they have a 
tendency to purchase something or have something provided and 
it sits in the drawer. The last thing we wanted to do was to 
have this resource not used properly, so that is the intent 
that we had with addressing the need initially.
    We now subsequently have received funding so that we can 
expand the health equity to providing tablets for individuals 
that have no computer access in the home, and that, again, is 
not necessarily disability based but it could be anybody that 
does not have that access in the home, and that program is 
going like gangbusters with applications from across the State. 
I think the latest I heard was that we were up to like 1,200--
but do not quote me on the data--applications that we have 
provided for the Android tablets.
    Senator Rosen. We have just a minute left. Mr. Lewis, could 
you speak a little bit? Are you having cooperation with other 
offices to be sure that we are doing some of the same things 
that Ms. Lieberman spoke about?
    Mr. Lewis. Sure, I will be brief, and just State that I 
will be reaching out to you after the hearing to see how we can 
work with those entities, because as a nationwide organization 
of blind individuals we have been focusing mostly on working 
regarding broadband access with some of the commercial 
providers, Comcast, et cetera, some of the innovative programs, 
they have been doing to get in the rural areas, but I would 
like to explore other ways that we can work with some of the 
entities that you just mentioned.
    Senator Rosen. Well, thank you. I really appreciate that. 
We will get together.
    I know I only have 42 seconds left. The last thing I wanted 
to just ask, and I will take the response off the record, is 
driver-assisted technology for disabled veterans, because in 
Nevada we have 225,000 veterans, but we are getting all this 
new technology that you do not have to drive the car, and I 
think our veterans really deserve that, and so we are 
developing legislation to provide tax credit to all disabled 
veterans, no matter what level of disability, to cover the cost 
of driver-assisted technologies, whether they are just helping 
them to park or cruise control, the mirrors, any of the 
features that we have. It does not have to be a driverless 
vehicle.
    Mr. Holmquest, we are going to ask you this question. You 
can submit that answer to us off the record. I am not in the 
room so I am sure there is somebody after me. Otherwise, if 
Chair Casey says there is not we can have you answer. 
Otherwise, I will take it off the record.
    The Chairman. It is perfectly appropriate to answer it if 
he would want to.
    Senator Rosen. Oh thank you. Mr. Holmquest, how do driver-
assisted technologies and all the related supports help level 
the playing field for disabled veterans and their quality of 
life after they return home?
    Mr. Holmquest. I am not clear on the driver-assisted cars.
    Senator Rosen. Well, maybe not where they drive you by 
themselves, but I know that there are new technologies that 
will help you park, right, assisted parking, or there are 
special mirrors so you can see the backup cameras, they can 
help you notice if someone is getting close and merging, so 
that is what I would like to ask you about.
    Can you hear me okay?
    [No response.]
    Senator Rosen. That is okay. We can take it off the record. 
Okay.
    The Chairman. Mr. Holmquest, yes, if you want to you can 
provide an answer in writing, or if you want to answer now. 
What is your preference?
    Mr. Holmquest. I would take it off record if we can because 
we just got interrupted by a loud-speaker here.
    The Chairman. Oh, okay.
    Mr. Holmquest. I did not hear what you were saying. I am 
sorry.
    Senator Rosen. Okay. Well, thank you. All right. Well, 
thank you. Thank you, Chair Casey. I appreciate it.
    The Chairman. Senator Rosen, thanks very much, and just for 
everyone to know, and Mr. Holmquest, we often have questions 
that get submitted for the record and they are answered in 
writing, that becomes part of the record after the hearing is 
over, so there is nothing unusual about that, and we appreciate 
his willingness to do that.
    I know we have to conclude a little bit early today, but 
before we do that I just wanted to pose maybe one more question 
to Ms. Hill about the law. Section 508 of the Rehabilitation 
Act, as we cited before, establishes a floor from which experts 
at the Access Board set standards for accessible information 
technology for the Federal Government.
    Despite the good intentions of this law, Section 508, there 
are serious accessibility gaps across the Federal Government. 
Today's hearing has, if anything, reinforced that fact. Are 
there changes to Section 508 that would bring it in line with 
the time, so to speak, after a quarter century of this law 
being on the books?
    Ms. Hill. Thank you for that question. I think we have 
learned a great deal over the last 24 years about how 
implementation of accessibility in technology works, and one of 
the things that we have learned, both in the private sector and 
in the Federal Government, is that self-monitoring does not 
work, and so a Federal agency should be tasked with enforcing 
compliance with Section 508. The Federal Government experienced 
a similar issue with the Architectural Barriers Act back in the 
1960's, and the Access Board was eventually given enforcement 
authority under that act, and the same thing could happen here.
    In addition, right now the vendors of inaccessible 
technology, who may be not giving their clients the full scope 
of the inaccessibility of their technologies, need to have 
methods of accountability, so Federal agencies need to be able 
to take action against those vendors and to rescind contracts 
and take other actions, and that is not available, or not clear 
right now in Section 508.
    The Chairman. Well that is helpful to have that because we, 
obviously, want to make changes to law where we can. Mr. Lewis 
said it pretty well in his opening, and I am quoting from his 
very simple, blunt statement. He said, ``Accessibility is not 
that difficult. It is the law. Let's just implement it.'' 
Sometimes the challenge is implementing the law appropriately, 
and we have got some shortfalls here, but in addition to 
implementation of existing law we want to consider ways that we 
can, in fact, change the law.
    I just have one more question that my staff has given me, 
and I want to make sure that we get this on the record. The 
Blind Veterans of America first brought Federal accessibility 
shortfalls to my attention way back in 2018. I did not realize 
it was that long ago. They remain concerned that the VA is 
still far behind.
    Ms. Hill, I am going to turn to you again because these are 
questions we should have answered on the record if we can. You 
have received the report required by the VA Website 
Accountability Act, the law that I passed with Senator Moran 
that I made reference to earlier. We know the VA is answering 
questions about how they will move the ball forward, but what 
should we be looking for as markers of success? If you could 
give us some free guidance on that.
    Ms. Hill. Certainly. If an entity is planning to achieve 
success in accessibility there are a few things they have to 
do. One is stop digging into inaccessibility. Stop bringing in 
new technologies that are not accessible, and that involves not 
taking your vendor's word for it but testing your own 
technology before you roll it out, and that involves both 
automated and user testing.
    The other things are a substantial remediation effort, and 
that involves planning, identifying what is wrong, which really 
requires an audit of what is wrong, and then prioritizing when 
you are going to fix things in order--what is most important to 
fix--scheduling deadlines, assigning staff with responsibility 
and authority to get the job done, and paying attention to 
whether the deadlines are met, and then consequences for when 
the deadlines are met, and in the things that I saw from the 
VA, none of those elements were present.
    The Chairman. Well that is very helpful for us as we 
discharge one of the obligations of the members of the Senate 
and committees in the Senate, and that is oversight, is one of 
the changes that you have suggested.
    I want to thank our witnesses for their testimony and for 
their willingness to bring their professional and personal 
experience to this hearing so that we can make changes and hold 
Federal agencies and hold our government accountable, and to 
make sure that there is accessibility for people with 
disabilities, in all kinds of settings but especially in 
settings like the Veterans Administration.
    Today's hearing shows that there is a long way to go before 
Federal technology is fully accessible for people with 
disabilities, for older Americans, and for veterans. It also 
shows that Congress needs to take a close look at Section 508 
of the Rehabilitation Act to see if changes are needed. In the 
meantime, there is a path to ensuring websites and other 
technologies are accessible with existing laws, as I mentioned 
earlier.
    I plan to work with the Biden Administration to make sure 
it continues prioritizing improved disability access to Federal 
technology and online services. A good first step would be for 
the Department of Justice to begin issuing, again, the biennial 
accessibility reports required by Section 508 of the 
Rehabilitation Act. This will provide taxpayers with an 
important status update that is at least eight years past due.
    As we move forward, let's keep the disability community's 
long-held motto of ``Nothing about us, without us.'' We should 
keep that front of mind and make sure that they have a seat at 
the table when it comes to accessing important information that 
they need and that their families need.
    Ranking Member Scott has submitted a closing statement for 
the record, and with that I want to mention for the record as 
well that if Senators have additional questions for the 
witnesses or statements to be added, as I mentioned earlier, 
the hearing record will be kept open for seven days, until next 
Thursday, August 4th.
    Again I want to thank our witnesses for their testimony and 
for their work in preparing for this hearing and being with us 
today, and this concludes today's hearing.
    [Whereupon, at 11:25 a.m., the Committee was adjourned.]
    
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                           CLOSING STATEMENTS

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                 CLOSING STATEMENT OF SENATOR 
                   TIM SCOTT, RANKING MEMBER

    Thank you, Mr. Chairman, and the witnesses for your 
testimony. Today's hearing highlighted how we can continue to 
develop policies that enable our seniors, veterans, and those 
with disabilities to remain connected.
    I will continue to prioritize legislation that grants all 
Americans access to telehealth services. The Telehealth 
Modernization Act is an important step to ensure that the tens 
of millions of Medicare beneficiaries and others who have 
relied on telehealth during the COVID emergency can continue to 
receive these services.
    I also join Chairman Casey in looking forward to the 
responses from the VA and DOJ regarding our letters on 
improving website accessibility.
    Thanks to today's witnesses, Congress is better informed to 
take steps to improve access for our seniors, veterans and 
Americans with disabilities. Thank you all for your testimony 
today.  
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                                APPENDIX

     
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                      Prepared Witness Statements

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                        Questions for the Record

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                       Statements for the Record

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