National Council on Disability
Notice of Funding Opportunity for a Cooperative Agreement
NCD-19-01: Accessible Medical Equipment and Furniture: Providing Access to Healthcare for People with Mobility Disabilities
Type of Award: Cooperative Agreement
Estimated Number of Awards: 1
Maximum amount available for this project: $30,000
The funding amount is contingent on fiscal year 2020 funding availability.
All potential applicants are eligible to apply
Cost sharing is not required
The estimated period of performance is 7–9 months
Authority: Section 401, Title IV of the Rehabilitation Act of 1973, as amended
Full Proposal Deadline: 5:00 p.m. (submitter’s local time), May 31, 2019. Late applications will not be considered.
Deliver 1 hard-copy of business and technical proposals to: National Council on Disability, 1331 F Street, NW, Suite 850, Washington, DC 20004, ATTN: Ana Torres-Davis
Deliver electronic Word and PDF versions of proposals to: firstname.lastname@example.org
The National Council on Disability (NCD) seeks proposals for research and data support for a limited study on the use of accessible medical equipment and furniture in healthcare systems. The findings in this report will primarily serve to assist policymakers and federal agencies, such as the Department of Health and Human Services and the Department of Justice with information needed to make policy decisions designed to improve health outcomes for people with mobility disabilities. The report will also inform healthcare providers on responsibilities under federal laws, and inform people with mobility disabilities of federal laws, policies and healthcare initiatives that impact their ability to access healthcare.
The report will identify and examine healthcare settings or systems (i.e., hospitals, preferred provider organizations or networks owned by hospitals, and physician groups) that widely utilize accessible medical equipment and seek information on both its qualitative and quantitative impacts on the healthcare settings and the patients. It will also examine two new initiatives by healthcare systems/hospitals aimed at increasing accessible medical equipment in their provider’s offices. The report will also seek information on any savings that have been achieved by states that have enacted safe patient handling laws.
Background and Issues
A substantial body of research concludes people with disabilities experience much higher rates of a variety of illnesses compared to their non-disabled peers. Both anecdotal evidence and research studies also raise concerns about the difficulty that people with mobility disabilities experience in accessing healthcare because of inaccessible equipment and furniture, such as radiological diagnostic equipment, such as MRI, PET, X-ray, CAT scan and mammography machines; weight scales; medical examination tables and chairs; hospital beds and lifts. The inability to physically access such equipment reduces the opportunity for people with mobility disabilities to receive preventative care and contributes to the significant health disparities that exist between people with disabilities and those without. When people with disabilities cannot access medical equipment, they have a greater likelihood of not getting proper exams and tests, getting delayed and incorrect diagnoses, and having treatable conditions become worse. Inability to access preventive care is also related to greater reliance on emergency rooms which all result in higher health care costs.
Health care providers must ensure that they have accessible medical equipment under federal law. Under the Americans with Disabilities Act, Section 504 of the Rehabilitation Act and Section 1557 of the Patient Protection and Affordable Care Act, health care providers may not give a person with a disability a service that is not equal to or that is not as effective as what is afforded people without disabilities, and they must ensure that their services and facilities are accessible. The Department of Justice has a long-standing practice of requiring accessible equipment and furniture under the regulatory provisions governing reasonable modifications of policies, practices, or procedures, program accessibility, effective communication, and barrier removal. It has entered into settlement agreements with several medical care providers that have required the provider to purchase accessible equipment and furniture for its facilities, including at least one accessible examination table in each medical department and additional accessible examination tables, radiologic equipment, scales, beds, and lifting devices, as needed. The Department has also issued technical assistance on this issue. However, there is still much work to be done on this critical area of civil rights because most health care providers do not have accessible medical equipment and furniture and there are no federal regulations governing medical equipment and furniture requirements. As such, complaints from people with disabilities who face physical barriers to healthcare are handled on a case-by-case basis, which results in a “wait and see” approach by many healthcare providers – obtaining accessible equipment only after a complaint is lodged with the federal government. This approach is too little and too scattered to meet the letter and the spirit of the law.
In 2010, the U.S. Department of Justice issued (DOJ) an Advanced Notice of Proposed Rulemaking (ANPRM) seeking information to assist it in determining if it should propose specific accessibility requirements for non-fixed medical equipment and furniture by entities subject to title II or title III of the ADA. The ANPRM invited comments on types and features of equipment and furniture that would effectively provide equal opportunity to access all services and programs covered by titles II and III of the ADA. It sought comments on scoping (the amount of equipment or furniture that should be provided in different types of facilities to meet the needs of individuals with disabilities), and on events or time frames that should trigger the replacement or modification of inaccessible equipment or furniture with accessible equipment or furniture. It also sought specific cost information, including information on the costs and benefits, as well as anecdotal evidence of the costs and benefits of accessible equipment and furniture in order to inform the regulatory analyses and cost assessments that would be required for a proposed rule. DOJ withdrew the ANPRM on December 26, 2017 without explanation. In a meeting between NCD and DOJ, where NCD encouraged the issuance of the regulation, DOJ officials relayed to NCD that it would be helpful to obtain further information on cost-effectiveness of accessible medical equipment and furniture.
Without a regulation governing medical equipment and furniture, physical barriers to medical care for millions of people with mobility disabilities will remain widespread and their health outcomes will continue to be poorer than their non-disabled peers. NCD maintains that access to healthcare is a civil right guaranteed by the ADA and as such, the issuance of a regulation ensuring its provision should not be dependent, in any way, on a cost analysis. Cost analysis will, however, be helpful in informing the Department of Justice of the cost to our federal healthcare system of not having accessible medical equipment and furniture. The issuance of a regulation is critical to the health of people with disabilities.
Statement of Work
The purpose of the report is to highlight the significant body of research that identifies the connection between healthcare disparities and inaccessible medical equipment and to provide information and data to the Department of Justice to support the issuance of a federal regulation on accessible medical equipment and furniture. It will provide anecdotal evidence based of the experiences of people with mobility disabilities who have experienced inaccessible equipment in healthcare settings as a barrier to receiving healthcare and detail the responsibilities of healthcare providers under federal disability rights laws and how the government has thus far enforced these laws in the healthcare context. The report will identify and examine healthcare settings or systems (i.e., hospitals, preferred provider organizations or networks owned by hospitals, and physician groups) that widely utilize accessible medical equipment and seek information both its qualitative and quantitative impacts on the healthcare settings and the patients. It will also examine two healthcare systems/hospitals that have recently created initiatives aimed at increasing accessible medical equipment in their provider’s offices to determine why they created the initiatives and any results that are available on impacts on healthcare and cost-effectiveness. The report will also seek information on impacts on healthcare employees and cost-savings in states that have enacted safe patient handling laws.
Research questions will include:
- Are there local, state, or regional healthcare systems that purchase accessible medical equipment as a practice? Have they tracked whether the purchases result in cost-savings? If so, what have they found? What impact on patients and providers?
- What is the financial impact of delayed preventive care on healthcare systems?
- What is the financial impact on the healthcare system of over-utilization/mis-utilization of emergency room services?
- What are the costs and benefits, both quantitatively and qualitatively, of providing individuals with disabilities an equal opportunity to access health care?
- Do states that have safe patient handling laws seen improved services to people with mobility disabilities? Have they seen healthcare cost-savings?
- What is the cost difference, if any, between accessible medical equipment and non-accessible equipment, such as exam tables, weight scales, mammography machines and other commonly used diagnostic equipment? How frequently do physicians, clinics, and hospitals purchase or replace medical equipment?
- Is there a method to determine whether medical facilities (e.g. physician’s offices, clinics, hospitals) would save money by purchasing accessible medical equipment? If so, has it been done? What results? If no examples exist, what model could be used to make this determination?
- What data is available on reduced injuries to healthcare workers in settings that utilize accessible medical equipment? Data on cost-savings from reduced injuries?
The report will be no more than 75 pages long (not including endnotes) and must include:
- A review of the literature and evidence supporting the need for accessible medical equipment;
- A description of applicable federal laws and policies, and applicable state laws if any exist;
- Recommendations to Congress, federal policy-makers, relevant federal agencies, and healthcare systems.
With substantial involvement by NCD, the deliverables for this project will include:
Development of an invitee list and agenda for a virtual convening of stakeholders to be held early in the development of the project to ensure key stakeholders are invested in the project and able to provide meaningful and timely input. Stakeholders may include, but are not limited to, a representative from: The Carle Foundation; Centene Healthcare; disability organizations that have conducted work on the report topic; the American Medical Association; the US Department of Health and Human Services and a person with a disability who has experienced accessibility barriers to healthcare.
A virtual convening of stakeholders early in the project term.
Twenty interviews with key stakeholders.
A detailed preliminary framing paper.
A revised framing paper.
An initial report draft incorporating findings, conclusions, and recommendations that can be drawn from the examination.
A second report draft.
A final report. that documents methodology, findings, and recommendations and must include a separate section containing recommendations, organized according to the entity to which they are directed.
A brief “Report Highlights” document that succinctly and in plain language encapsulates the report’s scope and purpose, major findings, and recommendations, and contains a link to the full report at the bottom, akin to GAO’s Report Highlights, see: https://www.gao.gov/products/GAO-19-126
All reports must fully adhere to NCD’s editorial requirements (see section on editorial requirements below).
Any methodology used to obtain stakeholder input must allow for open-ended discussions between stakeholders, as opposed to soliciting answers to specific, predetermined questions. While the use of data from existing surveys is permitted, conducting surveys for purposes of this study is strongly discouraged. The inclusion of people with disabilities must be integral to the planning, development, and execution of this project.
The awardee is responsible for reasonable accommodations at any meetings, events, forums, focus groups, etc. (i.e. sign language interpreters, CART reporters, and other such providers, as well as documents or other materials that are made available in public forums), associated with this agreement, except when making a presentation at an NCD meeting.
The awardee will co-present in person before NCD at a quarterly Council meeting and must factor travel expenses into the proposed budget.
Proposals that merely offer to conduct a project in accordance with the requirements of the government’s scope of work will not be eligible for award. Submissions must explain. the proposed technical approach in conjunction with the tasks to be performed in achieving the project objectives.
This solicitation does not commit the government to contract for any work or services whatsoever. Respondents are advised that the Federal Government will not pay for any information or administrative costs incurred in response to this solicitation notice. All costs associated with responding to this solicitation notice will be solely at the responding party’s expense. It is the responsibility of the interested parties to monitor grants.gov and ncd.gov sites for additional information.
Proposal Information and Instructions
Proposals must be submitted in two parts: A 'Technical Proposal' and a 'Business Proposal. Each part shall be separate and complete so that evaluation of one may be accomplished independently of the other. The technical proposal must not contain reference to cost; however, resource information, such as data on labor hours and categories, materials, subcontracts, etc., must be contained in the technical proposal so that the offeror’s understanding of the scope of the work may be evaluated. It must describe the offeror’s technical approach in sufficient detail to provide a clear and concise presentation that includes, but is not limited to, the requirements of the technical proposal instructions.
Proposals must be signed by an official authorized to bind the submitting organization/s.
Alternate proposals or proposals which deviate from the requirements may be submitted; if they address the requirements in the statement of work, and if overall performance would be improved or not compromised and are in the best interest of the Government. Alternate proposals, or deviations from any requirements of this funding opportunity, must be clearly identified.
NCD will evaluate proposals in accordance with the evaluation criteria set forth in this solicitation.
The winning proposal submitted in response to this solicitation will become part of the cooperative agreement.
A detailed work plan must be submitted indicating how each aspect of the statement of work is to be accomplished. The technical approach should contain as much detail as necessary to fully explain the proposed technical approach or method.
The technical proposal must reflect a clear understanding of the nature of the work being undertaken. The technical proposal must include information on how the project is to be organized, staffed, and managed. Information must demonstrate an understanding and describe the management of important events or tasks. The technical proposal must explain how the management and coordination of consultant and/or subcontractor efforts will be accomplished.
The technical proposal must include a list of names and proposed duties of the professional personnel, consultants, and key subcontractor employees assigned to the project. Their resumes must be included and should contain information on education, background, recent experience, and specific requirement related or technical accomplishments. The approximate percentage of time each individual will work on the project must be included. The proposed staff hours for each of the above individuals must be allocated against each task or subtask for the project.
The technical proposal must provide the general background, experience, and qualifications of the organization. Similar or related contracts, subcontracts, or grants should be included and contain the name of the customer, contract or grant number, dollar amount, time of performance, and the names and telephone numbers of the contracting officer’s representative or project officer and contracting/grants officer.
The technical proposal must contain a discussion of present or proposed facilities which will be used in the performance of the contract.
The technical proposal must contain a proposed timeline and “deliverables and payment schedule” chart which will be used to guide the conduct of the research. Payments will be based on 3 deliverables - with the last payment occurring after NCD approval of the final draft of reports.
Format of Technical Proposals
1. Abstract (no more than 2 pages)
A two-page summary shall be provided abstracting the proposal contents (e.g., objectives, activities, expected outcomes) in language understandable to an informed layperson. The narrative should be limited to no more than 250 words.
2. Table of Contents
3. Introduction (no more than 10 pages)
Offerors shall summarize, in their own words, the purposes and objectives of the project to demonstrate their complete understanding of NCD’s intent and requirements. This section also should contain a specific statement of any interpretations, questions, qualifications, limitations, deviations, or exceptions to the scope of work and the extent to which the offeror’s proposal can be expected to meet the requirements set forth in the scope of work.
4. Procedural Plan (no more than 20 pages)
This section shall fully describe the theoretical and technical approaches the offeror will employ in complying with each task in the scope of work. While a general statement of strategy is appropriate, the offeror shall be specific in describing the way the overall review will be conducted, and the intended approach to the design.
Contain a proposed timeline and deliverables schedule that will be used to guide the conduct of the study and monitor the work.
5. Management Plan and Schedule (no more than 10 pages)
The management plan shall show the feasibility of implementing the offeror’s resources. The offeror shall present a time chart that specifies the amount of time (in person days) each staff member will commit to implementing each task. The plan shall present a clear description of the working relationships among personnel. Finally, the plan shall contain a method for insuring the timely and successful completion of each work task.
Personnel with major responsibilities shall be listed by name, title, position, academic background, relevant experience, responsibilities with the project, and the extent to which this commitment is assured. This section should include specific time commitments of staff to other projects, both Federal and non-Federal. Consultants who have agreed to serve on the project should be similarly identified and assurances of their commitment included. The Project Director shall be committed for no less than approximately 60 percent of the cooperative agreement. Vitae for all principal personnel, including consultants, should be appended to the proposal. Each curriculum vitae should be limited to not more than two (2) pages and should emphasize areas of experience directly relevant to this work statement.
7. Organization Experience
This section shall describe the offeror’s pertinent experience and qualification in conducting work of a similar nature. Offerors shall offer evidence of not more than five previous related assignments, including the names and telephone numbers of client project offices who would be able to comment on the offeror’s performance of those assignments. Summaries (not to exceed one page) of related work shall be included. References to products resulting from these related activities shall also be included.
This section shall identify those resources (other than personnel), facilities, and equipment (e.g., library holdings, computer hardware, and software) available for use in conducting this project.
9. Current Contractual Obligations
Each offeror will be required to outline both federal and non-federal contractual obligations existing during the time period of this award for all projects involving personnel who will be assigned to this project. Such organizations/agencies must be identified by name and the percentage of work time allotted to these projects by personnel committed to the proposed project must be provided.
10. Issues and Associated Data Items
When responding to the tasks and when identifying what should receive emphasis, careful consideration should be given to the issues identified, their associated data items, and the statement of products desired in the final reports.
All information provided by NCD must be returned to NCD upon completion of the analysis and no later than 10 working days after the completion of the cooperative agreement. The information may not be reproduced or released without the prior written permission of NCD.
11. Rights in Data, Copyright, and Disclosure
a. Data – The term data as used here includes written reports (progress, draft, and final), electronic format and work of any similar nature that is required under any resulting Cooperative Agreement to perform this project. It does not include the awardee’s financial reports, or other information incidental to awardee administration. Data submitted to and accepted by the NCD under the cooperative agreement shall be the property of the NCD, and NCD shall have full and unlimited rights to use such data for any purpose in whatever manner deemed desirable and appropriate, including making it available to the public. Such use shall be without any additional payment to the awardee. Data may be published as the property of NCD without giving authorship to the awardee.
b. Copyright – The awardee relinquishes all copyrights and/or privileges developed under the Cooperative Agreement. The awardee shall not include in the data any copyrightable matter without the written approval of NCD, unless the awardee provides NCD with the written permission of the copyright owner for the NCD to use the matter.
c. Disclosure – The awardee agrees not to divulge or release any information, reports or recommendations developed or obtained with the performance of any cooperative agreement with NCD, and not otherwise available to the public, without the prior approval of the NCD.
d. Final approval of deliverables
All final deliverables are the product of NCD and require acceptance and approval by NCD prior to payment. NCD reserves the right to make substantive edits to all deliverables.
12. Award Information
NCD will make an award to the responsible offeror(s) whose proposal conforms to the solicitation and is most advantageous to the Federal Government.
Upon notification of intent to award, the offeror will be expected to consult with NCD to:
Finalize a mutually agreeable timeline and deliverables schedule that will be used to guide the conduct of the study and monitor the work;
Develop a payment schedule chart to be used for installment payments of the award based on 3 deliverables;
Meet with select NCD staff and board members at a pre-award meeting.
Throughout the project, the awardee and the NCD Agreement Coordinator will conduct mutually agreed upon monthly conference calls to include other project staff members, NCD staff and, as appropriate, selected project advisors and NCD council members.
The awardee will provide monthly electronic progress reports to the NCD Contracting Officer’s Representative three days prior to the monthly conference calls.
The business proposal shall contain a detailed budget for the project and the certifications and representations required by OMB Circular A-110.
Note: For each type of entity, there is a set of Federal principles for determining allowable costs. Allowable costs shall be determined in accordance with the cost principles applicable to the entity incurring the costs. Thus, allowable costs incurred by State, local or federally-recognized Indian tribal governments is determined in accordance with the provisions of OMB Circular A–87, “Cost Principles for State and Local Governments.” The allowable of costs incurred by non-profit organizations is determined in accordance with the provisions of OMB Circular A–122, “Cost Principles for Non-Profit Organizations.”
The allowable costs incurred by institutions of higher education is determined in accordance with the provisions of OMB Circular A–21, “Cost Principles for Educational Institutions.” The allowable costs incurred by hospitals is determined in accordance with the provisions of appendix E of 45 CFR part 74, “Principles for Determining Costs Applicable to Research and Development under Grants and Contracts with Hospitals.” The allowable costs incurred by commercial organizations and those non-profit organizations listed in Attachment C to Circular A–122 is determined in accordance with the provisions of the Federal Acquisition Regulation (FAR) at 48 CFR part 31.
Technical Evaluation Criteria
Evaluation criteria will score proposals with a maximum of 100 points, divided as follows:
1. A clear understanding of the nature of the work (20 points)
The proposal presents a clear understanding of the tasks required and the importance, quality and reliability of those tasks. The proposal will present the rationale and/or interpretation of the project approach.
2. Procedural Plan (30 points)
The proposal contains evidence of a fully described technical approach to comply with each of the tasks in the scope of work. The proposal is consistent with the goals, objectives, compliance requirements, and is practical in terms of producing needed information, analysis and recommendations.
3. Management Plan and Schedule (20 points)
The degree to which the project team, including any use of consultants, is organized, managed, and motivated to accomplish effective and efficient implementation of all tasks to be completed. The proposal budget is appropriate to the administration of the project. The time frame is realistic. Plans and schedules to assure smooth cooperation with the NCD staff involved are evident. The proposal clearly identifies who will be key personnel and includes a table showing the number of person-days by tasks for each of the key personnel.
4. Personnel (15 points)
The proposal provides evidence of the specific qualifications and skills of staff and consultants to be assigned to this project, and their experience and familiarity with the topic, including relevant laws, regulations, procedures and practices in the Federal Government. Skills in writing and conducting research should also clearly demonstrated.
5. Organizational Experience (15 points)
The proposal describes to which the overall experience and past performance of the offeror in executing similar projects should be described. Evidence of related assignments should be detailed. Offeror shall present evidence of related assignments, including the names and telephone numbers of previous project officers who would be able to comment on the offeror’s performance of those assignments.
Proposal Review Information
Reviews of proposals submitted to NCD are solicited from peers with expertise in the substantive area of the proposed project. Reviewers are selected by the NCD staff overseeing the review process. A conflict check is conducted to ensure that reviewers have no conflicts that prevent a review of offeror’s proposal. Special efforts are made to recruit reviewers from non-academic institutions, minority-serving institutions, or adjacent disciplines to that principally addressed in the proposal. Reviewers score and comment on each proposal. Reviews are treated as confidential documents. The NCD staff overseeing the review examines the scores and comments and formulates a recommendation.
Notice of Award
NCD will notify the offeror by telephone, e-mail, and/or letter. This will begin negotiations for a cooperative agreement. The notification is not authorization to begin performance. Notification of the award will be made by Ana Torres-Davis, an NCD Attorney Advisor. Organizations whose proposals are declined will be advised as promptly as possible. A summary of the strengths and weaknesses identified by reviewers, of each declined proposal, not included identifying names or information about proposal reviewers, will be made available upon request.
Project Start and End Dates
The projected start of the Cooperative Agreement is October 1, 2019. The projected end date is to be determined but will be between April 1, 2020 and June 1, 2020. The projected due date for final drafts is one month prior to the end of the cooperative agreement.
Final drafts must be professionally edited before they are submitted to NCD.
Citations & Style Guide for NCD Reports
NCD requires awardees to utilize the Chicago Style Manual for reports and papers and employs the documentary note system of citation (otherwise known as notes and bibliography). An explanation of this style of citation can be found at: http://library.williams.edu/citing/styles/chicago1.php and http://www.chicagomanualofstyle.org/tools_citationguide.html.
Accessibility of Reports
NCD reports must be totally accessible to all people with disabilities at all iterative stages of its drafting and editing. All graphs and charts must have full text descriptions embedded as alt-text and ensure that it is Section 508 compliant. All drafts and final versions must be submitted in electronically in Word and PDF format.
About the National Council on Disability
Overview and Purpose
The National Council on Disability (NCD) is an independent federal agency comprised of a team of Presidential and Congressional appointees, an Executive Director appointed by the Chair, and a full-time professional staff. The purpose of NCD is to promote policies, programs, practices, and procedures that guarantee equal opportunity for all people with disabilities regardless of the nature or significance of the disability and to empower people with disabilities to achieve economic self-sufficiency, independent living, and inclusion and integration into all aspects of society.
The current statutory mandate of NCD includes the following:
Reviewing and evaluating, on a continuing basis, policies, programs, practices, and procedures concerning individuals with disabilities conducted or assisted by federal departments and agencies, including programs established or assisted under the Rehabilitation Act of 1973, as amended, or under the Developmental Disabilities Assistance and Bill of Rights Act, as well as all statutes and regulations pertaining to federal programs that assist such individuals with disabilities, to assess the effectiveness of such policies, programs, practices, procedures, statutes, and regulations in meeting the needs of individuals with disabilities.
Reviewing and evaluating, on a continuing basis, new and emerging disability policy issues affecting individuals with disabilities in the Federal Government, at the state and local government levels, and in the private sector, including the need for and coordination of adult services, access to personal assistance services, school reform efforts and the impact of such efforts on individuals with disabilities, access to health care, and policies that act as disincentives for individuals to seek and retain employment.
Making recommendations to the President, Congress, the Secretary of Education, the Director of the National Institute on Disability, Independent Living, and Rehabilitation Research and other officials of federal agencies about ways to better promote equal opportunity, economic self-sufficiency, independent living, and inclusion and integration into all aspects of society for Americans with disabilities.
Providing Congress, on a continuing basis, with advice, recommendations, legislative proposals, and any additional information that NCD or Congress deems appropriate.
Gathering information about the implementation, effectiveness, and impact of the Americans with Disabilities Act of 1990 (ADA) (42 U.S.C. § 12101 et seq.).
Advising the President, Congress, the Commissioner of the Rehabilitation Services Administration, the Assistant Secretary for Special Education and Rehabilitative Services within the Department of Education, and Director of the National Institute on Disability, Independent Living, and Rehabilitation Research on the development of the programs to be carried out under the Rehabilitation Act of 1973, as amended.
Providing advice to the Commissioner of the Rehabilitation Services Administration with respect to the policies and conduct of the administration.
Making recommendations to the Director of the National Institute on Disability, Independent Living, and Rehabilitation Research on ways to improve research, service, administration, and the collection, dissemination, and implementation of research findings affecting people with disabilities.
Providing advice regarding priorities for the activities of the Interagency Disability Coordinating Council and reviewing the recommendations of this council for legislative and administrative changes to ensure that such recommendations are consistent with NCD’s purpose of promoting the full integration, independence, and productivity of individuals with disabilities.
Preparing and submitting to the President and Congress an annual report titled National Disability Policy: A Progress Report.
In 1995, NCD was designated by the Department of State to be the U.S. government’s official contact point for disability issues. Specifically, NCD interacts with the special rapporteur of the United Nations Commission for Social Development on disability matters.
Consumers Served and Current Activities
Although many government agencies deal with issues and programs affecting people with disabilities, NCD is the only federal agency charged with addressing, analyzing, and making recommendations on issues of public policy that affect people with disabilities regardless of age, disability type, perceived employment potential, economic need, specific functional ability, veteran status, or other individual circumstance. NCD recognizes its unique opportunity to facilitate independent living, community integration, and employment opportunities for people with disabilities by ensuring an informed and coordinated approach to addressing the concerns of people with disabilities and eliminating barriers to their active participation in community and family life.
NCD plays a major role in developing disability policy in America. In fact, NCD originally proposed what eventually became the ADA. To view our past and current key issues, and for general information about NCD, please visit our website at www.ncd.gov
NCD was established in 1978 as an advisory board within the Department of Education (P.L. 95-602). The Rehabilitation Act Amendments of 1984 (P.L. 98-221) established NCD as an independent agency.
 See Access to Medical Care for Individuals with Mobility Disabilities, https://www.ada.gov/medcare_mobility_ta/medcare_ta.pdf
 See, e.g., Regulatory Flexibility Act of 1980, 5 U.S.C. 603¬04 (2006); E.O. 13272, 67 FR 53461 (Aug. 13, 2002); E.O. 12866, 58 FR 51735 (Sept. 30, 1993), as amended by E.O. 13497, 74 FR 6113 (Jan. 30, 2009); OMB Budget Circular A-4, http://www.whitehouse.gov/OMB/circulars/a004/a-4.pdf (last visited June 25, 2010). For the specific questions posed by DOJ on costs and benefits, See p. 43460 of the ANPRM.