,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #aag  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,janu>y #ae1 #bjai,mr4 
,s*um] 7= himself1 ,mr4 ,g>dn]1 ,ms4    
,baldw91 ,mr4 ,b5net1 ,mr4 ,blum5?al1   
,ms4 ,cantwell1 ,mr4 ,casey1 ,mr4       
,coons1 ,ms4 ,duckwor?1 ,mrs4 ,gillibr&1
 ,ms4 ,h>ris1 ,ms4 ,hassan1 ,mr4 ,jones1
 ,mr4 ,leahy1 ,mr4 ,m>key1 ,mrs4        
,murray1 ,mr4 ,van ,holl51 ,ms4 ,w>r51  
,mr4 ,te/]1 ,mr4 ,s&]s1 ,mr4 ,durb91    
,mr4 ,book]1 ,mr4 ,m]kley1 & ,ms4 ,smi?7
 introduc$ ! foll[+ bill2 :i* 0 read    
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to prohibit discrim9ation   
aga9/ individuals ) disabilities :o ne$ 
long-t]m s]vices & supports1 & = o!r    
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,disability ,integration   
,act ( #bjai4  #b4 ,f9d+s & purposes    
7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7
 ,9 enact+ ! ,am]icans ) ,disabilities  
,act ( #aiij 7ref]r$ to 9 ?is ,act z !  
,,ada71 ,congress--  7,a7 recogniz$ t   

hi/orically1 society has t5d$ to isolate
 & segregate individuals ) disabilities1
 &1 despite "s improvem5ts1 su* =ms (   
discrim9ation aga9/ individuals )       
disabilities cont9ue to be a s]i\s &    
p]vasive social problem2 &  7,b7 int5d$ 
t ! ,,ada assure full p>ticipation &    
indep5d5t liv+ = individuals )          
disabilities by address+ discrim9ation  
aga9/ individuals ) disabilities t      
p]si/s 9 critical areas1 includ+        
in/itutionalization4  7#b7 ,:ile        
,congress expect$ t ! ,,ada's           
integration m&ate w\ld be int]pret$ 9 a 
mann] t ensures t individuals :o are    
eligible = in/itutional placem5t are    
able to ex]cise a "r to community-bas$  
long-t]m s]vices & supports1 t          
expectation has n be5 fulfill$4  7#c7 ,!
 hold+s ( ! ,supreme ,c\rt 9 ,olm/ead v4
 ,l4,c41 #ebg ,u4,s4 #eha 7#aiii71 &    
companion cases1 h cle>ly articulat$ t  
individuals ) disabilities h a civil "r 
"u ! ,,ada to p>ticipate 9 society z    
equal citiz5s4 ,h[ev]1 _m ,/ates /ill d 

n provide suffici5t community-bas$      
long-t]m s]vices & supports to          
individuals ) disabilities to end       
segregation 9 in/itutions4  7#d7 ,! "r  
to live 9 ! community is necess>y = !   
ex]cise ( ! civil rights t ! ,,ada 0    
int5d$ to secure = all individuals )    
disabilities4 ,! lack ( adequate        
community-bas$ s]vices & supports has   
imp]il$ ! civil rights ( all individuals
 ) disabilities1 & has und]m9$ ! v      
promise ( ! ,,ada4 ,x is1 !re=e1        
necess>y to recognize 9 /atute a robu/ &
 fully articulat$ "r to community liv+4 
7#e7 ,/ates1 ) a few exceptions1 cont9ue
 to approa* decisions reg>d+ long-t]m   
s]vices & supports f social welf>e &    
budget>y p]spectives1 b = ! promise ( ! 
,,ada to be fully realiz$1 ,/ates mu/   
approa* ^! decisions f a civil rights   
p]spective4  7#f7 ,/ates h n consi/5tly 
plann$ to ensure suffici5t s]vices &    
supports = individuals ) disabilities1  
includ+ ^? ) ! mo/ significant          
disabilities1 to enable individuals )   

disabilities to live 9 ! mo/ integrat$  
sett+4 ,z a result1 _m individuals )    
disabilities :o reside 9 in/itutions are
 prev5t$ f resid+ 9 ! community &       
individuals ) disabilities :o are n 9   
in/itutions f9d !mselves at risk (      
in/itutional placem5t4  7#g7 ,! cont9u+ 
exi/5ce ( unfair & unnecess>y           
in/itutionalization d5ies individuals ) 
disabilities ! opportunity to live &    
p>ticipate on an equal basis 9 !        
community & co/s ! ,unit$ ,/ates        
billions ( doll>s 9 unnecess>y sp5d+    
relat$ to p]petuat+ dep5d5cy &          
unnecess>y conf9em5t4  7b7 ,purposes ,! 
purposes ( ?is ,act are-- 7#a7 to cl>ify
 & /r5g!n ! ,,ada's integration m&ate 9 
a mann] t accel]ates ,/ate compliance2  
7#b7 to cl>ify t e individual :o is     
eligible = long-t]m s]vices & supports  
has a f$]ally protect$ "r to be         
mean+fully integrat$ into t individual's
 community & receive community-bas$     
long-t]m s]vices & supports2  7#c7 to   
ensure t ,/ates provide long-t]m s]vices

 & supports to individuals )            
disabilities 9 a mann] t all[s          
individuals ) disabilities to live 9 !  
mo/ integrat$ sett+1 includ+ !          
individual's own home1 h maximum control
 ov] _! s]vices & supports1 & ensure t  
long-t]m s]vices & supports are provid$ 
9 a mann] t all[s individuals )         
disabilities to lead an indep5d5t life2 
7#d7 to e/abli% a compreh5sive ,/ate    
plann+ requirem5t t includes en=ceable1 
measurable objectives t are design$ to  
transition individuals ) all types (    
disabilities at all ages out (          
in/itutions & into ! mo/ integrat$      
sett+2 &  7#e7 to e/abli% a requirem5t =
 cle> & uni=m annual public report+ by  
,/ates t includes report+ ab\t--  7,a7 !
 numb] ( individuals ) disabilities :o  
are s]v$ 9 ! community & ! numb] :o are 
s]v$ 9 in/itutions2 &  7,b7 ! numb] (   
individuals ) disabilities :o h         
transition$ f an in/itution to a        
community-bas$ liv+ situation1 & ! type 
( community-bas$ liv+ situation into :i*

 ^? individuals h transition$4  #c4     
,def9itions & rule  7a7 ,def9itions ,9  
?is ,act3 7#a7 ,activities ( daily liv+ 
,! t]m activities ( daily liv+ has !    
mean+ giv5 ! t]m 9 section #dda4eje (   
title #db1 ,code ( ,f$]al ,regulations  
7or a successor regulation74  7#b7      
,adm9i/rator ,! t]m ,adm9i/rator means--
 7,a7 ! ,adm9i/rator ( ! ,adm9i/ration =
 ,community ,liv+2 or  7,b7 ano!r       
designee ( ! ,secret>y ( ,heal? & ,human
 ,s]vices4  7#c7 ,community-bas$ ,! t]m 
community-bas$1 :5 us$ 9 ref]5ce to     
s]vices or supports1 means s]vices or   
supports t are provid$ to an individual 
) an ,,ltss disability to enable t      
individual to live 9 ! community & lead 
an indep5d5t life1 & t are deliv]$ 9    
:i*ev] sett+ ! individual ) an ,,ltss   
disability has *os5 out ( ! foll[+      
sett+s ) ! foll[+ qualities3  7,a7 ,9 ! 
case ( a dwell+ or a nonresid5tial sett+
 7su* z a sett+ 9 :i* an individual ) an
 ,,ltss disability receives day s]vices 
& support$ employm5t71 a dwell+ or      

sett+--  7i7 t1 z a matt] (             
infra/ructure1 environm5t1 am5ities1    
location1 s]vices1 & features1 is       
integrat$ into ! great] community &     
supports1 = ea* individual ) an ,,ltss  
disability :o receives s]vices or       
supports at ! sett+--  7,i7 full access 
to ! great] community 7includ+ access to
 opportunities to seek employm5t & "w 9 
competitive integrat$ sett+s1 engage 9  
community life1 control p]sonal         
res\rces1 & receive s]vices 9 !         
community72 &  7,,ii7 access to ! great]
 community to ! same ext5t z access to !
 community is enjoy$ by an individual :o
 is n receiv+ long-t]m s]vices or       
supports2  7ii7 t ! individual has      
select$ z a mean+ful *oice f among      
nonresid5tial sett+ options1 includ+    
nondisability-specific sett+s2  7iii7 9 
:i* an individual has rights to privacy1
 dignity1 & respect1 & fre$om f co]cion 
& re/ra9t2  7iv7 t1 z a matt] (         
infra/ructure1 environm5t1 am5ities1    
location1 s]vices1 & features1          

optimizes1 b does n regim5t1 individual 
initiative1 autonomy1 & indep5d5ce 9    
mak+ life *oices1 includ+ *oices ab\t   
daily activities1 physical environm5t1 &
 p]sons ) :om ! individual int]acts2 &  
7v7 t1 z a matt] ( infra/ructure1       
environm5t1 am5ities1 location1 s]vices1
 & features1 facilitates individual     
*oice reg>d+ ! provision ( s]vices &    
supports1 & :o provides ^? s]vices &    
supports4  7,b7 ,9 ! case ( a dwell+1 a 
dwell+-- 7i7 t is own$ by an individual 
) an ,,ltss disability or ! individual's
 family memb]2  7ii7 t is leas$ to !    
individual ) an ,,ltss disability "u an 
individual lease1 t has lockable access 
& egress1 & t includes liv+1 sleep+1    
ba?+1 & cook+ areas ov] :i* an          
individual ) an ,,ltss disability or !  
individual's family memb] has doma9 &   
control2 or  7iii7 t is a gr\p or %>$   
resid5ce-- 7,i7 9 :i* no m ?an #d       
unrelat$ individuals ) an ,,ltss        
disability reside2  7,,ii7 = :i* ea*    
individual ) an ,,ltss disability liv+  

at ! resid5ce owns1 r5ts1 or occupies ! 
resid5ce "u a legally en=ceable agreem5t
 "u :i* ! individual has1 at a m9imum1 !
 same responsibilities & protections z  
t5ants h "u applicable l&lord-t5ant law2
  7,,iii7 9 :i* ea* individual ) an     
,,ltss disability liv+ at ! resid5ce--  
7aa7 has privacy 9 ! individual's sleep+
 unit1 includ+ a lockable entrance door 
controll$ by ! individual2  7bb7 %>es a 
sleep+ unit only if su* individual & !  
individual %>+ ! unit *oose to d s1 & if
 individuals 9 ! resid5ce s *oose1 !y   
also h a *oice ( roommates )9 !         
resid5ce2  7cc7 has ! fre$om to furni% &
 decorate ! individual's sleep+ or liv+ 
unit z p]mitt$ "u ! lease or o!r        
agreem5t2  7dd7 has ! fre$om & support  
to control ! individual's own s*$ules & 
activities2 &  7ee7 is able to h        
visitors ( ! individual's *oos+ at any  
"t2 &  7,,iv7 t is physically accessible
 to ! individual ) an ,,ltss disability 
liv+ at ! resid5ce4  7#d7 ,dwell+ ,! t]m
 dwell+ has ! mean+ giv5 ! t]m 9 section

 #hjb ( ! ,fair ,h\s+ ,act 7#db         
,u4,s4,c4 #cfjb74  7#e7 ,heal?-relat$   
tasks ,! t]m heal?-relat$ tasks means   
specific nonacute tasks1 typically      
regulat$ by ,/ates z m$ical or nurs+    
tasks t an individual ) a disability may
 require to live 9 ! community1         
includ+--  7,a7 adm9i/ration (          
m$ication2  7,b7 assi/ance ) use1       
op]ation1 & ma9t5ance ( a v5tilator2 &  
7,c7 ma9t5ance & use ( a ga/ro/omy tube1
 a ca!t]1 or a /able o/omy4  7#f7       
,individual ) a disability ,! t]m       
individual ) a disability means an      
individual :o is a p]son ) a disability1
 z def9$ 9 section #c ( ! ,am]icans )   
,disabilities ,act ( #aiij 7#db         
,u4,s4,c4 #abajb74  7#g7 ,individual )  
an ltss disability ,! t]m individual )  
an ,,ltss disability means an individual
 ) a disability :o-- 7,a7 9 ord] to live
 9 ! community & lead an indep5d5t life 
requires assi/ance 9 accompli%+--  7i7  
activities ( daily liv+2  7ii7          
in/rum5tal activities ( daily liv+2     

7iii7 heal?-relat$ tasks2 or  7iv7 o!r  
functions1 tasks1 or activities relat$  
to an activity or task describ$ 9 clause
 7i71 7ii71 or 7iii72 &  7,b7 7i7 is    
curr5tly 9 an in/itutional placem5t2 or 
7ii7 is at risk ( in/itutionalization if
 ! individual does n receive            
community-bas$ long-t]m s]vices &       
supports4  7#h7 ,in/rum5tal activities (
 daily liv+  7,a7 ,9 g5]al ,! t]m       
in/rum5tal activities ( daily liv+ means
 "o or m activities relat$ to liv+      
indep5d5tly 9 ! community1 includ+      
activities relat$ to--  7i7 nutrition1  
su* z prep>+ meals or special diets1    
monitor+ to prev5t *ok+ or aspiration1  
or assi/+ ) special ut5sils2  7ii7      
h\sehold *ores & environm5tal ma9t5ance 
tasks2  7iii7 communication &           
int]p]sonal skills1 su* z--  7,i7 us+ ! 
telephone or o!r communications devices2
  7,,ii7 =m+ & ma9ta9+ int]p]sonal      
relation%ips2 or  7,,iii7 secur+        
opportunities to p>ticipate 9 gr\p      
support or pe]-to-pe] support           

arrangem5ts2  7iv7 travel & community   
p>ticipation1 su* z %opp+1 arrang+      
appo9tm5ts1 or mov+ ar\nd ! community2  
7v7 c>e ( o!rs1 su* z rais+ *ildr51 tak+
 c>e ( pets1 or select+ c>egiv]s2 or    
7vi7 managem5t ( p]sonal prop]ty &      
p]sonal safety1 su* z--  7,i7 tak+      
m$ication2  7,,ii7 h&l+ or manag+ money2
 or  7,,iii7 respond+ to em]g5t         
situations or uns*$ul$ ne$s requir+ an  
imm$iate response4  7,b7 ,assi/ance ,!  
t]m assi/ance us$ ) respect to          
in/rum5tal activities ( daily liv+1     
includes support provid$ to an          
individual by ano!r p]son due to        
confusion1 dem5tia1 behavioral symptoms1
 or cognitive1 intellectual1 m5tal1 or  
emotional disabilities1 includ+ support 
to--  7i7 help ! individual id5tify &   
set goals1 ov]come fe>s1 & manage       
transitions2  7ii7 help ! individual )  
executive function+1 decisionmak+1 &    
problem solv+2  7iii7 provide           
reassurance to ! individual2 &  7iv7    
help ! individual ) ori5tation1 memory1 

& o!r activities relat$ to indep5d5t    
liv+4  7#i7 ,long-t]m s]vice or support 
,! t]ms long-t]m s]vice or support &    
,,ltss mean ! assi/ance provid$ to an   
individual ) a disability 9 accompli%+1 
acquir+ ! means or ability to accompli%1
 ma9ta9+1 or enhanc+--  7,a7 activities 
( daily liv+2  7,b7 in/rum5tal          
activities ( daily liv+2  7,c7          
heal?-relat$ tasks2 or  7,d7 o!r        
functions1 tasks1 or activities relat$  
to an activity or task describ$ 9       
subp>agraph 7,a71 7,b71 or 7,c74  7#aj7 
,,ltss insurance provid] ,! t]m ,,ltss  
insurance provid] means a public or     
private entity t-- 7,a7 provides funds =
 long-t]m s]vices & supports2 &  7,b7 is
 engag$ 9 comm]ce or 9 an indu/ry or    
activity affect+ comm]ce4  7#aa7 ,public
 entity  7,a7 ,9 g5]al ,! t]m public    
entity means an entity t--  7i7 provides
 or funds in/itutional placem5ts =      
individuals ) ,,ltss disabilities2 &    
7ii7 is--  7,i7 a ,/ate or local        
gov]nm5t2 or  7,,ii7 any dep>tm5t1      

ag5cy1 entity adm9i/]+ a special purpose
 di/rict1 or o!r in/rum5tality1 ( a     
,/ate or local gov]nm5t4  7,b7 ,int]/ate
 comm]ce ,= purposes ( subp>agraph 7,a71
 a public entity %all be consid]$ to be 
a p]son engag$ 9 comm]ce or 9 an indu/ry
 or activity affect+ comm]ce4  7b7 ,rule
 ( con/ruction ,no?+ 9 subsection       
7a77#b7 or any o!r provision ( ?is      
section %all be con/ru$ to preclude an  
individual ) a disability f receiv+     
community-bas$ s]vices & supports 9 an  
integrat$ community sett+ su* z a groc]y
 /ore1 retail e/abli%m5t1 re/aurant1    
bank1 p>k1 conc]t v5ue1 !at]1 or        
workplace4  #d4 ,discrim9ation  7a7 ,9  
g5]al ,no public entity or ,,ltss       
insurance provid] %all d5y an individual
 ) an ,,ltss disability :o is eligible =
 in/itutional placem5t1 or o!rwise      
discrim9ate aga9/ t individual 9 !      
provision (1 community-bas$ long-t]m    
s]vices & supports t enable ! individual
 to live 9 ! community & lead an        
indep5d5t life4  7b7 ,specific          

prohibitions ,= purposes ( ?is ,act1    
discrim9ation by a public entity or     
,,ltss insurance provid] includes-- 7#a7
 ! imposition or application (          
eligibility crit]ia or ano!r policy t   
prev5ts or t5ds to prev5t an individual 
) an ,,ltss disability1 or any class (  
individuals ) ,,ltss disabilities1 f    
receiv+ a community-bas$ long-t]m s]vice
 or support2  7#b7 ! imposition or      
application ( a policy or o!r me*anism1 
su* z a s]vice or co/ cap1 t prev5t or  
t5ds to prev5t an individual ) an ,,ltss
 disability1 or any class ( individuals 
) ,,ltss disabilities1 f receiv+ a      
community-bas$ long-t]m s]vice or       
support2  7#c7 a failure to provide a   
specific community-bas$ long-t]m s]vice 
or support or a type ( community-bas$   
long-t]m s]vice or support ne$$ = an    
individual ) an ,,ltss disability1 or   
any class ( individuals ) ,,ltss        
disabilities2  7#d7 ! imposition or     
application ( a policy1 rule1           
regulation1 or re/riction t int]f]es ) !

 opportunity = an individual ) an ,,ltss
 disability1 or any class ( individuals 
) ,,ltss disabilities1 to live 9 !      
community & lead an indep5d5t life1 :i* 
may include a requirem5t t an individual
 ) an ,,ltss disability receive a s]vice
 or support 7su* z day s]vices or       
employm5t s]vices7 9 a congregate or    
disability-specific sett+2  7#e7 !      
imposition or application ( a wait+ li/ 
or o!r me*anism t delays or re/ricts    
access ( an individual ) an ,,ltss      
disability to a community-bas$ long-t]m 
s]vice or support2  7#f7 a failure to   
e/abli% an adequate rate or o!r paym5t  
/ructure t is necess>y to ensure !      
availability ( a work=ce suffici5t to   
support an individual ) an ,,ltss       
disability 9 liv+ 9 ! community & lead+ 
an indep5d5t life2  7#g7 a failure to   
provide community-bas$ s]vices &        
supports1 on an int]mitt5t1 %ort-t]m1 or
 em]g5t basis1 t assi/ an individual )  
an ,,ltss disability to live 9 !        
community & lead an indep5d5t life2     

7#h7 ! imposition or application ( a    
policy1 su* z a requirem5t t an         
individual utilize in=mal support1 t    
re/ricts1 limits1 or delays ! ability ( 
an individual ) an ,,ltss disability to 
secure a community-bas$ long-t]m s]vice 
or support to live 9 ! community or lead
 an indep5d5t life2  7#i7 a failure to  
implem5t a =mal proc$ure & a me*anism to
 ensure t-- 7,a7 individuals ) ,,ltss   
disabilities are (f]$ ! alt]native (    
community-bas$ long-t]m s]vices &       
supports prior to in/itutionalization2 &
  7,b7 if select$ by an individual ) an 
,,ltss disability1 ! community-bas$     
long-t]m s]vices & supports describ$ 9  
subp>agraph 7,a7 are provid$2  7#aj7 a  
failure to ensure t ea* in/itutionaliz$ 
individual ) an ,,ltss disability is    
regul>ly notifi$ ( ! alt]native (       
community-bas$ long-t]m s]vices &       
supports & t ^? community-bas$ long-t]m 
s]vices & supports are provid$ if !     
individual ) an ,,ltss disability       
selects su* s]vices & supports2 &  7#aa7

 a failure to make a reasonable         
modification 9 a policy1 practice1 or   
proc$ure1 :5 su* modification is        
necess>y to all[ an individual ) an     
,,ltss disability to receive a          
community-bas$ long-t]m s]vice or       
support4  7c7 ,additional prohibition ,=
 purposes ( ?is ,act1 discrim9ation by a
 public entity also includes a failure  
to ensure t !re is suffici5t            
availability ( af=dable1 accessible1 &  
integrat$ h\s+ to all[ an individual )  
an ,,ltss disability to *oose to live 9 
! community & lead an indep5d5t life1   
includ+ ! availability ( an option to   
live 9 h\s+ :]e ! receipt ( ,,ltss is n 
ti$ to t5ancy4  7d7 ,con/ruction ,no?+ 9
 ?is section-- 7#a7 %all be con/ru$--   
7,a7 to prev5t a public entity or ,,ltss
 insurance provid] f provid+            
community-bas$ long-t]m s]vices &       
supports at a level t is great] ?an !   
level t is requir$ by ?is section2 or   
7,b7 to limit ! rights ( an individual )
 a disability "u any provision ( law o!r

 ?an ?is section2  7#b7 %all be con/ru$ 
to affect ! scope ( obligations impos$  
by any o!r provision ( law2 or  7#c7    
%all be con/ru$ to prohibit a public    
entity or ,,ltss insurance provid] f us+
 manag$ c>e te*niques1 z long z ! use ( 
su* te*niques does n h ! effect (       
discrim9at+ aga9/ an individual 9 !     
provision ( community-bas$ long-t]m     
s]vices & supports1 z prohibit$ by ?is  
,act4  #e4 ,adm9i/ration  7a7 ,au?ority 
& responsibility  7#a7 ,dep>tm5t (      
ju/ice ,! ,attorney ,g5]al %all-- 7,a7  
inve/igate & take en=cem5t action =     
violations ( ?is ,act2 &  7,b7 en=ce    
section #f7;c74  7#b7 ,dep>tm5t ( heal? 
& human s]vices ,! ,secret>y ( ,heal? & 
,human ,s]vices1 ?r\gh ! ,adm9i/rator1  
%all--  7,a7 conduct /udies reg>d+ !    
nature & ext5t ( in/itutionalization (  
individuals ) ,,ltss disabilities 9     
repres5tative communities1 includ+      
urban1 suburban1 & rural communities1   
?r\gh\t ! ,unit$ ,/ates2  7,b7 publi% & 
dissem9ate reports1 recomm5dations1 &   

in=mation d]iv$ f su* /udies1 includ+ an
 annual report to ,congress1 specify+-- 
7i7 ! nature & ext5t ( progress 9 !     
,unit$ ,/ates 9 elim9at+                
in/itutionalization = individuals )     
,,ltss disabilities 9 violation ( ?is   
,act & fur!r+ ! purposes ( ?is ,act2    
7ii7 ob/acles t rema9 9 ! ef=t to a*ieve
 ! provision ( community-bas$ long-t]m  
s]vices & supports = all individuals )  
,,ltss disabilities2 &  7iii7           
recomm5dations = fur!r legislative or   
executive action2  7,c7 coop]ate )1 &   
provide grants = te*nical assi/ance to1 
,f$]al1 ,/ate1 & local public or private
 ag5cies & organizations t are =mulat+  
or c>ry+ out programs to prev5t or      
elim9ate in/itutionalization (          
individuals ) ,,ltss disabilities or to 
promote ! provision ( community-bas$    
long-t]m s]vices & supports2  7,d7      
implem5t educational & conciliatory     
activities to fur!r ! purposes ( ?is    
,act2 &  7,e7 ref] in=mation on         
violations ( ?is ,act to ! ,attorney    

,g5]al = inve/igation & en=cem5t action 
"u ?is ,act4  7b7 ,coop]ation (         
executive dep>tm5ts & ag5cies ,ea*      
,f$]al ag5cy &1 9 p>ticul>1 ea* ,f$]al  
ag5cy cov]$ by ,executive ,ord] #acbag  
7#ff ,f$4 ,reg4 #ccaee2 relat+ to       
community-bas$ alt]natives = individuals
 ) disabilities71 %all c>ry out programs
 & activities relat+ to !               
in/itutionalization ( individuals )     
,,ltss disabilities & ! provision (     
community-bas$ long-t]m s]vices &       
supports = individuals ) ,,ltss         
disabilities 9 accordance ) ?is ,act &  
%all coop]ate ) ! ,attorney ,g5]al & !  
,adm9i/rator to fur!r ! purposes ( ?is  
,act4  #f4 ,regulations  7a7 ,issuance (
 regulations ,n lat] ?an #bd mon?s aft] 
! date ( enactm5t ( ?is ,act1 !         
,attorney ,g5]al & ! ,secret>y ( ,heal? 
& ,human ,s]vices %all issue1 9         
accordance ) section #eec ( title #e1   
,unit$ ,/ates ,code1 f9al regulations to
 c>ry out ?is ,act1 :i* %all include !  
regulations describ$ 9 subsection 7b74  

7b7 ,requir$ cont5ts ( regulations  7#a7
 ,eligible recipi5ts ( s]vice ,!        
regulations %all require ea* public     
entity & ,,ltss insurance provid] to    
(f]1 &1 if accept$1 provide             
community-bas$ long-t]m s]vices &       
supports z requir$ "u ?is ,act to any   
individual ) an ,,ltss disability :o    
w\ld o!rwise qualify = in/itutional     
placem5t provid$ or fund$ by ! public   
entity or ,,ltss insurance provid]4     
7#b7 ,s]vices to be provid$ ,!          
regulations issu$ "u ?is section %all   
require ea* public entity & ,,ltss      
insurance provid] to provide ! ,attorney
 ,g5]al & ! ,adm9i/rator ) an assurance 
t ! public entity or ,,ltss insurance   
provid]--  7,a7 ensures t individuals ) 
,,ltss disabilities receive assi/ance   
?r\gh h&s-on assi/ance1 tra9+1 cue+1 &  
safety monitor+1 includ+ access to      
backup sy/ems1 )--  7i7 activities (    
daily liv+2  7ii7 in/rum5tal activities 
( daily liv+2  7iii7 heal?-relat$ tasks2
 or  7iv7 o!r functions1 tasks1 or      

activities relat$ to an activity or task
 describ$ 9 clause 7i71 7ii71 or 7iii72 
7,b7 coord9ates1 conducts1 p]=ms1       
provides1 or funds dis*>ge plann+ f     
acute1 rehabilitation1 & long-t]m       
facilities to promote individuals )     
,,ltss disabilities liv+ 9 ! mo/        
integrat$ sett+ *os5 by ! individuals2  
7,c7 issues1 conducts1 p]=ms1 provides1 
or funds policies & programs to promote 
self-direction & ! provision (          
consum]-direct$ s]vices & supports = all
 populations ( individuals ) ,,ltss     
disabilities s]v$2  7,d7 issues1        
conducts1 p]=ms1 provides1 or funds     
policies & programs to support in=mal   
c>egiv]s :o provide s]vices =           
individuals ) ,,ltss disabilities2 &    
7,e7 ensures t individuals ) all types (
 ,,ltss disabilities are able to live 9 
! community & lead an indep5d5t life1   
includ+ ensur+ t ! individuals h maximum
 control ov] ! s]vices & supports t !   
individuals receive1 *oose ! sett+ 9 :i*
 ! individuals receive ^? s]vices &     

supports1 & ex]cise control & direction 
ov] _! own lives4  7#c7 ,public         
p>ticipation  7,a7 ,public entity ,!    
regulations issu$ "u ?is section %all   
require ea* public entity to c>ry out an
 ext5sive public p>ticipation process 9 
prep>+ ! public entity's self-evaluation
 "u p>agraph 7#e7 & transition plan "u  
p>agraph 7#aj74  7,b7 ,,ltss insurance  
provid] ,! regulations issu$ "u ?is     
section %all require ea* ,,ltss         
insurance provid] to c>ry out a public  
p>ticipation process t involves hold+ a 
public he>+1 provid+ an opportunity =   
public comm5t1 & consult+ ) individuals 
) ,,ltss disabilities1 9 prep>+ ! ,,ltss
 insurance provid]'s self-evaluation "u 
p>agraph 7#e74  7,c7 ,process ,9 c>ry+  
out a public p>ticipation process "u    
subp>agraph 7,a7 or 7,b71 a public      
entity or ,,ltss insurance provid] %all 
ensure t ! process meets ! requirem5ts (
 subp>agraphs 7,a7 & 7,c7 ( section     
#aaae7;d77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acae7;d77#b771 except  

t--  7i7 ! ref]5ce to at ! ,/ate level  
%all be disreg>d$2 &  7ii7 ! ref]5ce to 
an application %all be consid]$ to be a 
ref]5ce to ! self-evaluation or plan    
involv$4  7#d7 ,additional s]vices &    
supports ,! regulations issu$ "u ?is    
section %all e/abli% circum/ances "u :i*
 a public entity %all provide           
community-bas$ long-t]m s]vices &       
supports "u ?is section beyond ! level (
 community-bas$ long-t]m s]vices &      
supports :i* w\ld o!rwise be requir$ "u 
?is subsection4  7#e7 ,self-evaluation  
7,a7 ,9 g5]al ,! regulations issu$ "u   
?is section %all require ea* public     
entity & ea* ,,ltss insurance provid]1 n
 lat] ?an #cj mon?s aft] ! date (       
enactm5t ( ?is ,act1 to evaluate curr5t 
s]vices1 policies1 & practices1 & !     
effects !re(1 t d n or may n meet !     
requirem5ts ( ?is ,act &1 to ! ext5t    
modification ( any su* s]vices1         
policies1 & practices is requir$ to meet
 ! requirem5ts ( ?is ,act1 make !       
necess>y modifications4 ,!              

self-evaluation %all include--  7i7     
collection ( basel9e in=mation1 includ+ 
! numb]s ( individuals ) ,,ltss         
disabilities 9 v>i\s in/itutional &     
community-bas$ sett+s s]v$ by ! public  
entity or ,,ltss insurance provid]2     
7ii7 a review ( community capacity1 9   
communities s]v$ by ! entity or provid]1
 9 provid+ community-bas$ long-t]m      
s]vices & supports2  7iii7 id5tification
 ( improvem5ts ne$$ to ensure t all     
community-bas$ long-t]m s]vices &       
supports provid$ by ! public entity or  
,,ltss insurance provid] to individuals 
) ,,ltss disabilities are compreh5sive1 
are accessible1 are n duplicative (     
exi/+ 7z ( ! date ( ! id5tification7    
s]vices & supports1 meet ! ne$s ( p]sons
 :o are likely to require assi/ance 9   
ord] to live1 or lead a life1 z describ$
 9 section #d7;a71 & are high-quality   
s]vices & supports1 :i* may include     
id5tify+ sy/em improvem5ts t create an  
option to self-direct receipt ( su*     
s]vices & supports = all populations (  

su* individuals s]v$2 &  7iv7 a review (
 fund+ s\rces = community-bas$ long-t]m 
s]vices & supports & an analysis ( h[ ^?
 fund+ s\rces c\ld be organiz$ into a   
fair1 coh]5t sy/em t af=ds individuals  
reasonable & timely access to           
community-bas$ long-t]m s]vices &       
supports4  7,b7 ,public entity ,a public
 entity1 includ+ an ,,ltss insurance    
provid] t is a public entity1 %all-- 7i7
 include 9 ! self-evaluation describ$ 9 
subp>agraph 7,a7--  7,i7 an assessm5t ( 
! availability ( accessible1 af=dable   
transportation across ! ,/ate involv$ & 
:e!r transportation b>ri]s prev5t       
individuals f receiv+ long-t]m s]vices &
 supports 9 ! mo/ integrat$ sett+2 &    
7,,ii7 an assessm5t ( ! availability (  
integrat$ employm5t opportunities 9 !   
jurisdiction s]v$ by ! public entity =  
individuals ) ,,ltss disabilities2 &    
7ii7 provide ! self-evaluation describ$ 
9 subp>agraph 7,a7 to ! ,attorney ,g5]al
 & ! ,adm9i/rator4  7,c7 ,,ltss         
insurance provid] ,an ,,ltss insurance  

provid] %all keep ! self-evaluation     
describ$ 9 subp>agraph 7,a7 on file1 &  
may be requir$ to produce su*           
self-evaluation 9 ! ev5t ( a review1    
inve/igation1 or action describ$ 9      
section #h4  7#f7 ,additional requirem5t
 = public entities ,! regulations issu$ 
"u ?is section %all require a public    
entity1 9 conjunction ) ! h\s+ ag5cies  
s]v+ ! jurisdiction s]v$ by ! public    
entity1 to review & improve community   
capacity1 9 all communities ?r\gh\t !   
entirety ( t jurisdiction1 9 provid+    
af=dable1 accessible1 & integrat$ h\s+1 
includ+ an evaluation ( available units1
 unmet ne$1 & o!r id5tifiable b>ri]s to 
! provision ( t h\s+4 ,9 c>ry+ out t    
improvem5t1 ! public entity1 9          
conjunction ) su* h\s+ ag5cies1 %all--  
7,a7 ensure1 & assure ! ,adm9i/rator & !
 ,attorney ,g5]al t !re is1 suffici5t   
availability ( af=dable1 accessible1 &  
integrat$ h\s+ 9 a sett+ t is n a       
disability-specific resid5tial sett+ or 
a sett+ :]e s]vices are ti$ to t5ancy1 9

 ord] to provide individuals ) ,,ltss   
disabilities a mean+ful *oice 9 _! h\s+2
  7,b7 9 ord] to address ! ne$ =        
af=dable1 accessible1 & integrat$ h\s+--
  7i7 9 ! case ( su* a h\s+ ag5cy1      
e/abli% relation%ips ) ,/ate & local    
h\s+ au?orities2 &  7ii7 9 ! case ( !   
public entity1 e/abli% relation%ips )   
,/ate & local h\s+ ag5cies1 includ+ h\s+
 au?orities2  7,c7 e/abli%1 :]e ne$$1   
necess>y pref]5ces & set-asides 9 h\s+  
programs = individuals ) ,,ltss         
disabilities :o are transition+ f or    
avoid+ in/itutional placem5t2  7,d7     
e/abli% a process to fund necess>y home 
modifications s t individuals ) ,,ltss  
disabilities c live indep5d5tly2 &  7,e7
 ensure1 & assure ! ,adm9i/rator & !    
,attorney ,g5]al1 t funds & programs    
implem5t$ or ov]se5 by ! public entity  
or 9 ! public entity's jurisdiction are 
t>get$ t[>d af=dable1 accessible1       
integrat$ h\s+ = individuals ) an ,,ltss
 disability :o h ! l[e/ income levels 9 
! jurisdiction z a priority ov] any o!r 

developm5t until capacity b>ri]s = su*  
h\s+ are remov$ or unmet ne$s = su* h\s+
 h be5 met4  7#g7 ,designation (        
responsible employee ,! regulations     
issu$ "u ?is section %all require ea*   
public entity & ,,ltss insurance provid]
 to designate at lea/ "o employee to    
coord9ate ! entity's or provid]'s ef=ts 
to comply ) & c>ry out ! entity or      
provid]'s responsibilities "u ?is ,act1 
includ+ ! inve/igation ( any compla9t   
communicat$ to ! entity or provid] t    
alleges a violation ( ?is ,act4 ,ea*    
public entity & ,,ltss insurance provid]
 %all make available to all int]e/$     
individuals ! "n1 (fice address1 &      
telephone numb] ( ! employee designat$  
pursuant to ?is p>agraph4  7#h7         
,grievance proc$ures ,! regulations     
issu$ "u ?is section %all require public
 entities & ,,ltss insurance provid]s to
 adopt & publi% grievance proc$ures     
provid+ = prompt & equitable resolution 
( compla9ts alleg+ a violation ( ?is    
,act4  7#i7 ,provision ( s]vice by o!rs 

,! regulations issu$ "u ?is section %all
 require ea* public entity submitt+ a   
self-evaluation "u p>agraph 7#e7 to     
id5tify1 z "p ( ! transition plan       
describ$ 9 p>agraph 7#aj71 any o!r      
entity t is1 or acts z1 an ag5t1        
subcontractor1 or o!r in/rum5tality ( ! 
public entity ) reg>ds to a s]vice1     
support1 policy1 or practice describ$ 9 
su* plan or self-evaluation4  7#aj7     
,transition plans ,! regulations issu$  
"u ?is section %all require ea* public  
entity1 n lat] ?an #db mon?s aft] ! date
 ( enactm5t ( ?is ,act1 to submit to !  
,adm9i/rator1 & beg9 implem5t+1 a       
transition plan = c>ry+ out ?is ,act t  
e/abli%es ! a*ievem5t ( ! requirem5ts ( 
?is ,act1 z soon z practicable1 b 9 no  
ev5t lat] ?an #ab ye>s aft] ! date (    
enactm5t ( ?is ,act4 ,! transition plan 
%all--  7,a7 e/abli% measurable         
objectives to address ! b>ri]s to       
community liv+ id5tifi$ 9 !             
self-evaluation "u p>agraph 7#e72  7,b7 
e/abli% specific annual t>gets = !      

transition ( individuals ) ,,ltss       
disabilities1 & %ifts 9 fund+1 f        
in/itutional sett+s to integrat$        
community-bas$ s]vices & supports1 &    
relat$ programs2  7,c7 describe specific
 ef=ts to support individuals ) ,,ltss  
disabilities to avoid unwant$           
in/itutionalization ?r\gh ! provision ( 
,,ltss2 &  7,d7 describe ! mann] 9 :i* !
 public entity has obta9$ or plans to   
obta9 necess>y fund+ & res\rces ne$$ =  
implem5tation ( ! plan 7reg>dless ( :e!r
 ! entity began c>ry+ out ! objectives (
 ?is ,act prior to ! date ( enactm5t (  
?is ,act74  7#aa7 ,annual report+  7,a7 
,9 g5]al ,! regulations issu$ "u ?is    
section %all e/abli% annual report+     
requirem5ts = ea* public entity cov]$ by
 ?is section4  7,b7 ,progress on        
objectives1 t>gets1 & ef=ts ,!          
regulations issu$ "u ?is section %all   
require ea* public entity t has submitt$
 a transition plan to submit to !       
,adm9i/rator an annual report on !      
progress ! public entity has made dur+ !

 previ\s ye> 9 meet+ ! measurable       
objectives1 specific annual t>gets1 &   
specific ef=ts describ$ 9 p>agraph      
7#aj74  7#ab7 ,o!r provisions ,!        
regulations issu$ "u ?is section %all   
include su* o!r provisions & requirem5ts
 z ! ,attorney ,g5]al & ! ,secret>y (   
,heal? & ,human ,s]vices det]m9e are    
necess>y to c>ry out ! objectives ( ?is 
,act4  7c7 ,review ( transition plans   
7#a7 ,g5]al rule ,! ,adm9i/rator %all   
review a transition plan submitt$ 9     
accordance ) subsection 7b77#aj7 = !    
purpose ( det]m9+ :e!r su* plan meets ! 
requirem5ts ( ?is ,act1 includ+ !       
regulations issu$ "u ?is section4  7#b7 
,disapproval ,if ! ,adm9i/rator det]m9es
 t a transition plan review$ "u ?is     
subsection fails to meet ! requirem5ts (
 ?is ,act1 ! ,adm9i/rator %all          
disapprove ! transition plan & notify ! 
public entity t submitt$ ! transition   
plan (1 & ! reasons =1 su* disapproval4 
7#c7 ,modification ( disapprov$ plan ,n 
lat] ?an #ij days aft] ! date (         

disapproval ( a transition plan "u ?is  
subsection1 ! public entity t submitt$ !
 transition plan %all modify !          
transition plan to meet ! requirem5ts ( 
?is section & %all submit to !          
,adm9i/rator1 & comm5ce implem5tation (1
 su* modifi$ transition plan4  7#d7     
,inc5tives  7,a7 ,det]m9ation ,= #aj    
ye>s aft] ! issuance ( ! regulations    
describ$ 9 subsection 7a71 ! ,secret>y (
 ,heal? & ,human ,s]vices %all annually 
det]m9e :e!r ea* ,/ate1 or ea* o!r      
public entity 9 ! ,/ate1 is comply+ ) ! 
transition plan or modifi$ transition   
plan ! ,/ate or o!r public entity       
submitt$1 & obta9$ approval =1 "u ?is   
section4 ,not)/&+ any o!r provision (   
law1 if ! ,secret>y ( ,heal? & ,human   
,s]vices det]m9es "u ?is subp>agraph t !
 ,/ate or o!r public entity is comply+ )
 ! correspond+ transition plan1 !       
,secret>y %all make ! increase describ$ 
9 subp>agraph 7,b74  7,b7 ,increase 9   
,,fmap ,on mak+ ! det]m9ation describ$ 9
 subp>agraph 7,a7 = a public entity     

7includ+ a ,/ate71 ! ,secret>y ( ,heal? 
& ,human ,s]vices %all1 z describ$ 9    
subp>agraph 7,c71 increase by #e        
p]c5tage po9ts ! ,,fmap 7b %all 9 no    
ev5t increase ! ,,fmap above #ajj p]c5t7
 = ! ,/ate 9 :i* ! public entity is     
locat$ = am\nts exp5d$ by ! ,/ate =     
m$ical assi/ance consi/+ ( home &       
community-bas$ s]vices furni%$ "u !     
,/ate ,m$icaid plan "u title ,,xix ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 or a waiv] ( su* plan--  
7i7 t-- 7,i7 are id5tifi$ by a public   
entity or ,,ltss insurance provid] "u   
subsection 7b77#e77;,a77iii72  7,,ii7   
result$ f %ifts 9 fund+ id5tifi$ by a   
public entity "u subsection             
7b77#aj77;,b72 or  7,,iii7 are          
environm5tal modifications to a*ieve !  
af=dable1 accessible1 integrat$ h\s+    
id5tifi$ by a public entity "u          
subsection 7b77#f77;,e72 &  7ii7 are    
describ$ by ! ,/ate 9 a reque/ to !     
,secret>y ( ,heal? & ,human ,s]vices = !
 increase4  7,c7 ,p]iod ( increase ,!   

,secret>y ( ,heal? & ,human ,s]vices    
%all increase ! ,,fmap describ$ 9       
subp>agraph 7,b7--  7i7 beg9n+ ) ! fir/ 
qu>t] t beg9s aft] ! date ( !           
det]m9ation2 &  7ii7 end+ ) ! qu>t] 9   
:i* ! next annual det]m9ation "u        
subp>agraph 7,a7 occurs4  7,d7          
,additional condition = paym5t  7i7     
,/ate report ,z a condition = ! receipt 
( a paym5t bas$ on an increase describ$ 
9 subp>agraph 7,b7 ) respect to am\nts  
to be exp5d$ by ! ,/ate = m$ical        
assi/ance consi/+ ( home &              
community-bas$ s]vices describ$ 9       
subp>agraph 7,b71 ! ,/ate %all report to
 ! ,secret>y1 = ! report+ ye>1 ! am\nt (
 funds exp5d$ by ! ,/ate = home &       
community-bas$ s]vices 7z def9$ 9       
subp>agraph 7,e77ii77 9 t ye>4 ,! ,/ate 
%all make ! report 9 a =mat develop$ or 
approv$ by ! ,secret>y4  7ii7 ,r$uction 
9 paym5t if failure to ma9ta9 ef=t ,if !
 am\nt report$ "u clause 7i7 by a ,/ate 
) respect to a report+ ye> is less ?an !
 am\nt report$ "u clause 7i7 ) respect  

to ! previ\s fiscal ye> or fiscal ye>   
#bjai1 :i*ev] 0 ! great] report$ am\nt1 
! ,secret>y %all provide = a r$uction 9 
! paym5t to ! ,/ate bas$ on ! increase4 
7,e7 ,def9itions ,9 ?is p>agraph3 7i7   
,,fmap ,! t]m ,,fmap means ! ,f$]al     
m$ical assi/ance p]c5tage = a ,/ate     
det]m9$ "u section #aije7;b7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acif;d7b77 )\t reg>d to any increases 9
 t p]c5tage applicable "u o!r           
subsections ( t section or any o!r      
provision ( law1 includ+ ?is section4   
7ii7 ,home & community-bas$ s]vices     
def9$ ,! t]m home & community-bas$      
s]vices means any ( ! foll[+ s]vices    
provid$ "u a ,/ate ,m$icaid plan "u     
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 or a waiv]
 ( su* plan3  7,i7 ,home &              
community-bas$ s]vices provid$ "u       
subsection 7c71 7d71 or 7i7 ( section   
#aiae ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acifn74  7,,ii7 ,home heal?  
c>e s]vices4  7,,iii7 ,p]sonal c>e      

s]vices4  7,,iv7 ,s]vices describ$ 9    
section #aije7;a77#bf7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acif;d7a77#bf77 7relat+ to ,,pace      
program s]vices74  7,v7 ,self-direct$   
p]sonal assi/ance s]vices provid$ 9     
accordance ) section #aiae7;j7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acifn7j774  7,,vi7 ,community-bas$     
att5dant s]vices & supports provid$ 9   
accordance ) section #aiae7k7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acifn7k774  7,,vii7 ,rehabilitative    
s]vices1 )9 ! mean+ ( section           
#aije7;a77#ac7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;d7a77#ac774   
7iii7 ,report+ ye> ,! t]m report+ ye>   
means ! mo/ rec5t fiscal ye> prec$+ !   
date ( a report "u subp>agraph 7,d77i74 
7d7 ,rule ( con/ruction ,no?+ 9         
subsection 7b77#aj7 or 7c7 or any o!r   
provision ( ?is ,act %all be con/ru$ to 
limit ! rights1 protections1 or         
requirem5ts ( any o!r ,f$]al law1 relat+
 to integration ( individuals )         

disabilities into ! community & enabl+  
^? individuals to live 9 ! mo/ integrat$
 sett+4  #g4 ,exemptions = religi\s     
organizations ,?is ,act %all n prohibit 
a religi\s organization1 association1 or
 society f giv+ pref]5ce 9 provid+      
community-bas$ long-t]m s]vices &       
supports to individuals ( a p>ticul>    
religion connect$ ) ! beliefs ( su*     
organization1 association1 or society4  
#h4 ,en=cem5t  7a7 ,civil action  7#a7  
,9 g5]al ,a civil action = prev5tive    
relief1 includ+ an application = a      
p]man5t or tempor>y injunction1 re/ra9+ 
ord]1 or o!r ord]1 may be in/itut$ by an
 individual describ$ 9 p>agraph 7#b7 9  
an appropriate ,f$]al di/rict c\rt4     
7#b7 ,aggriev$ individual  7,a7 ,9 g5]al
 ,! rem$ies & proc$ures set =? 9 ?is    
section are ! rem$ies & proc$ures ?is   
,act provides to any individual :o is   
be+ subject$ to a violation ( ?is ,act1 
or :o has reasonable gr\nds = believ+ t 
su* individual is ab\t to be subject$ to
 su* a violation4  7,b7 ,/&+ ,an        

individual ) a disability %all h /&+ to 
in/itute a civil action "u ?is          
subsection if ! individual makes a prima
 facie %[+ t ! individual--  7i7 is an  
individual ) an ,,ltss disability2 &    
7ii7 is be+ subject$ to1 or ab\t to be  
subject$ to1 su* a violation 7includ+ a 
violation ( section #d7;b77#aa774  7#c7 
,appo9tm5t ( attorney2 no fees1 co/s1 or
 security ,^u application by !          
compla9ant describ$ 9 p>agraph 7#b7 & 9 
su* circum/ances z ! c\rt may det]m9e to
 be j1 ! c\rt may appo9t an attorney = !
 compla9ant & may au?orize ! comm5cem5t 
( su* civil action )\t ! paym5t ( fees1 
co/s1 or security4  7#d7 ,futile ge/ure 
n requir$ ,no?+ 9 ?is section %all      
require an individual ) an ,,ltss       
disability to engage 9 a futile ge/ure  
if su* p]son has actual notice t a      
public entity or ,,ltss insurance       
provid] does n int5d to comply ) !      
provisions ( ?is ,act4  7b7 ,damages &  
injunctive relief ,if ! c\rt f9ds t a   
violation ( ?is ,act has occurr$ or is  

ab\t to occur1 ! c\rt may aw>d to !     
compla9ant--  7#a7 actual & punitive    
damages2  7#b7 imm$iate injunctive      
relief to prev5t in/itutionalization2   
7#c7 z ! c\rt det]m9es to be            
appropriate1 any p]man5t or tempor>y    
injunction 7includ+ an ord] to          
imm$iately provide or ma9ta9            
community-bas$ long-t]m s]vices or      
supports = an individual to prev5t      
in/itutionalization or fur!r            
in/itutionalization71 tempor>y re/ra9+  
ord]1 or o!r ord] 7includ+ an ord]      
enjo9+ ! def5dant f engag+ 9 a practice 
t violates ?is ,act or ord]+ su*        
affirmative action z may be             
appropriate72 &  7#d7 9 an appropriate  
case1 injunctive relief to require !    
modification ( a policy1 practice1 or   
proc$ure1 or ! provision ( an alt]native
 me?od ( provid+ ,,ltss1 to ! ext5t     
requir$ by ?is ,act4  7c7 ,attorney's   
fees2 liability ( ,unit$ ,/ates = co/s  
,9 any action comm5c$ pursuant to ?is   
,act1 ! c\rt1 9 its discretion1 may all[

 ! p>ty br++ a claim or c\nt]claim "u   
?is ,act1 o!r ?an ! ,unit$ ,/ates1 a    
reasonable attorney's fee z "p ( ! co/s1
 & ! ,unit$ ,/ates %all be liable = co/s
 to ! same ext5t z a private p]son4  7d7
 ,en=cem5t by attorney g5]al  7#a7      
,d5ial ( rights  7,a7 ,duty to          
inve/igate ,! ,attorney ,g5]al %all     
inve/igate alleg$ violations ( ?is ,act1
 & %all und]take p]iodic reviews ( !    
compliance ( public entities & ,,ltss   
insurance provid]s "u ?is ,act4  7,b7   
,pot5tial violation ,! ,attorney ,g5]al 
may comm5ce a civil action 9 any        
appropriate ,f$]al di/rict c\rt if !    
,attorney ,g5]al has reasonable cause to
 believe t--  7i7 any public entity or  
,,ltss insurance provid]1 includ+ a gr\p
 ( public entities or ,,ltss insurance  
provid]s1 is engag$ 9 a patt]n or       
practice ( violations ( ?is ,act2 or    
7ii7 any individual1 includ+ a gr\p1 has
 be5 subject$ to a violation ( ?is ,act 
& ! violation raises an issue ( g5]al   
public importance4  7#b7 ,au?ority (    

c\rt ,9 a civil action "u p>agraph      
7#a77;,b71 ! c\rt-- 7,a7 may grant any  
equitable relief t su* c\rt consid]s to 
be appropriate1 includ+1 to ! ext5t     
requir$ by ?is ,act--  7i7 grant+       
tempor>y1 prelim9>y1 or p]man5t relief2 
&  7ii7 requir+ ! modification ( a      
policy1 practice1 or proc$ure1 or !     
provision ( an alt]native me?od (       
provid+ ,,ltss2  7,b7 may aw>d su* o!r  
relief z ! c\rt consid]s to be          
appropriate1 includ+ damages to         
individuals describ$ 9 subsection       
7a77#b71 :5 reque/$ by ! ,attorney      
,g5]al2 &  7,c7 may1 to v9dicate !      
public int]e/1 assess a civil p5alty    
aga9/ ! public entity or ,,ltss         
insurance provid] 9 an am\nt--  7i7 n   
exce$+ #ajj1jjj = a fir/ violation2 &   
7ii7 n exce$+ #bjj1jjj = any subsequ5t  
violation4  7#c7 ,s+le violation ,=     
purposes ( p>agraph 7#b77;,c71 9 det]m9+
 :e!r a fir/ or subsequ5t violation has 
occurr$1 a det]m9ation 9 a s+le action1 
by judgm5t or settlem5t1 t ! public     

entity or ,,ltss insurance provid] has  
engag$ 9 m ?an "o violation ( ?is ,act  
%all be c\nt$ z a s+le violation4  #i4  
,con/ruction ,= purposes ( con/ru+ ?is  
,act-- 7#a7 section #d7;b77#aa7 %all be 
con/ru$ 9 a mann] t takes into acc\nt   
its simil>ities ) section               
#cjb7;b77#b77;,a77ii7 ( ! ,am]icans )   
,disabilities ,act ( #aiij 7#db         
,u4,s4,c4 #abahb7;b77#b77;,a77ii772     
7#b7 ! fir/ s5t5ce ( section            
#f7;b77#e77;,a7 %all be con/ru$ 9 a     
mann] t takes into acc\nt its           
simil>ities ) section #ce4aje7;a7 (     
title #bh1 ,code ( ,f$]al ,regulations  
7z 9 effect on ! day be=e ! date (      
enactm5t ( ?is ,act72  7#c7 section #g  
%all be con/ru$ 9 a mann] t takes into  
acc\nt its simil>ities ) section        
#hjg7;a7 ( ! ,civil ,rights ,act ( #aifh
 7#db ,u4,s4,c4 #cfjg7;a772  7#d7       
section #h7;a77#b7 %all be con/ru$ 9 a  
mann] t takes into acc\nt its           
simil>ities ) section #cjh7;a77#a7 ( !  
,am]icans ) ,disabilities ,act ( #aiij  

7#db ,u4,s4,c4 #abahh7;a77#a772 &  7#e7 
section #h7;d77#a77;,b7 %all be con/ru$ 
9 a mann] t takes into acc\nt its       
simil>ities ) section #cjh7;b77#a77;,b7 
( ! ,am]icans ) ,disabilities ,act (    
#aiij 7#db ,u4,s4,c4                    
#abahh7;b77#a77;,b774