Journal of Disability Policy Studies

The physical and mental health status of women providing care to adult relatives with developmental disabilities was compared with that of the general female population in the United States. There were no differences on physical health across four age groups. However, the mental health of midlife caregivers (45—54 years of age) and older caregivers (older than 65 years) was worse than national norms. This may be associated with two key periods: transitions to adulthood of individuals with disabilities and transitions when aging caregivers are no longer able to provide care. Greater unmet needs for services contributed to poorer mental health. Poorer access to health care also contributed to poorer mental and physical health. Unmet needs for services and out-of-pocket disability-related expenses appeared to pose difficulties for working age caregivers in affording the financial costs of health care for themselves.

This study assessed compliance with the public accommodations provisions (Title III) of the Americans with Disabilities Act (ADA). Title III of the ADA requires the removal of physical, procedural, and attitudinal barriers that prohibit people with disabilities from entering public establishments and accessing their goods and services. The physical accessibility of 90 establishments located in three ethnic minority communities was assessed. Following each assessment, ADA information and feedback were presented to business owners and managers in either English or Spanish. Results revealed that 23 (25.6%) were fully accessible, 43 (47.8%) were accessible with minor assistance, and 24 (26.7%) were inaccessible with minor assistance. Establishments identified as for-profit tended to be more accessible than those identified as not-for-profit. Overall, findings indicate that much work remains to improve the ADA compliance of places open to the public.

Criminal sexual assault statutes vary across the 50 U.S. states and the District of Columbia. However, most statutes mandate increased restrictions and penalties for crimes committed against victims with cognitive impairments. Current statutes pertaining to victims with cognitive impairments and the standards and methods typically used by courts to determine victims' capacity to consent are evaluated. The authors analyze these policies and demonstrate that the statutes stem from and perpetuate a legacy of systematic oppression including, but not limited to, the sexual exploitation and deprivation of people with cognitive impairments. They argue that current statutes not only fail to diminish but may also enhance the risk of sexual assault to adults with cognitive disabilities. The authors further argue that these statutes deprive adults with cognitive impairments of their civil liberties. They conclude with recommendations for changes in policy and practice.

The Medicaid Buy-In program, a state Medicaid option since the late 1990s, is designed to encourage adults with disabilities to work by allowing them to buy into Medicaid when their earnings are above the standard Medicaid eligibility limits. This study provides a descriptive profile of enrollment, expenditures, and earnings for Buy-In participants in 27 states between 2000 and 2004. Analyses indicate that younger participants receiving no federal income support when they enroll in the Buy-In program have higher earnings compared with older participants receiving Social Security Disability Insurance payments. The innovative process used in this study to link data from multiple agencies could be adapted for exploring other policy issues related to the employment of individuals with disabilities.

College students with psychiatric disabilities face multiple challenges. Judicial rulings under the Americans With Disabilities Act (ADA) of 1990 have generated outcomes that are sometimes more harmful than helpful. To reduce discrimination against persons with disabilities requires, among other things, a cultural shift in how psychiatric disabilities are viewed. This article examines (a) challenges that students with psychiatric disabilities face on higher education campuses; (b) the definition of disability under the ADA, with a focus on major life activities that may be substantially limited for people with psychiatric disabilities; (c) the implications of judicial rulings under the ADA for students with psychiatric disabilities; and (d) recommendations for accommodating students with psychiatric disabilities in higher education settings.

From 1997 to 2003, Illinois was spending approximately 80% of its long-term care budget on nursing homes and institutional care and was facing significant challenges to its long-term care delivery and the need to rebalance toward community-based supports for people with disabilities. A case-based program evaluation was done to analyze Moving Out of the Nursing Home to the Community, a community-based participatory research (CBPR) project. The Chicago-based project documented the experiences and concerns of 200 disabled people attempting to transition out of nursing homes to least restrictive community living, actively involving participants in an empowerment and systems and policy change program. The authors describe the partnership between the University of Illinois at Chicago and two centers for independent living; the project's research, policy-related goals, and activities; and the outcomes realized. Barriers and facilitating factors to long-term care systems change are described, as are implications for other CBPR partnerships focused on disability public policy.