,,ii #aagth ,,congress #b;d ,session ,s4 #b ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #ag1 #bjbb,mr4 ,casey 7for himself1 ,mr4 ,markey1 ,mr4 ,leahy1 ,ms4 ,duckworth1 ,mrs4 ,gillibrand1 ,mr4 ,sanders1 and ,mr4 ,wyden7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to support national training1 technical assistance1 and resource centers1 to ensure that all individuals with significant expressive communication disabilities have access to the augmentative and alternative communication the individuals need to interact with others1 in order to learn1 work1 socialize1 and take advantage of all aspects of life in the ,united ,states4 #a4 ,short title ,this ,act may be cited as the ,augmentative and ,alternative ,communication ,centers to ,establish ,national ,training ,act or the ,,aaccent ,act4 #b4 ,findings ,congress makes the following findings3 7#a7 ,communication is a basic human need and fundamental right1 and is essential to self-determination1 social inclusion1 and emotional and physical well-being4 ,in enacting a provision of the ,americans with ,disabilities ,act of #aiij 7referred to in this section as the ,,ada71 ,congress recognized that physical or mental disabilities in no way diminish a person's right to fully participate in all aspects of society1 and that the discriminatory effects of communication barriers are a form of discrimination4 7#b7 ,three decades after the passage of the ,,ada1 ,americans with significant expressive communication disabilities still experience discrimination in the form of communication barriers1 institutionalization1 segregation1 and relegation to lesser services1 programs1 activities1 benefits1 jobs1 or other opportunities compared to ,americans without significant expressive communication disabilities4 7#c7 ,data about augmentative and alternative communication is lacking1 but it is estimated there are at least #d1jjj1jjj people in the ,united ,states who cannot reliably meet their daily communication needs using natural speech4 7#d7 ,the population of individuals with significant expressive communication difficulties is at substantial risk for limited education1 unemployment1 poor health outcomes1 poverty1 and low quality of life4 7#e7 ,people can acquire a significant expressive communication disability and need augmentative and alternative communication as a result of many health and developmental conditions at all stages of life4 7#f7 ,research indicates that individuals who belong to racial or ethnic minority communities face a greater likelihood of being born with or acquiring expressive communication disabilities1 as well as added difficulties in obtaining intervention services1 including augmentative and alternative communication4 7#g7 ,individuals with significant expressive communication disabilities1 schools1 families1 employers1 direct support providers1 health care providers1 the justice system1 and the general public need more information about how to effectively deploy1 implement1 and ensure continued access to robust communication tools1 services1 and other supports for individuals with significant expressive communication disabilities4 7#h7 ,the lived experiences and writings of individuals with significant expressive communication disabilities demonstrate the positive impact augmentative and alternative communication has on their lives4 ,these lived experiences and writings also illustrate the harm that results from denying augmentative and alternative communication to those who need it4 7#i7 ,the leadership of individuals with significant expressive communication disabilities is critical in crafting and implementing effective policies and programs affecting their lives1 including policies and programs regarding augmentative and alternative communication4 7#aj7 ,the freedoms of expression1 and to be understood1 are essential to both democracy and to individual well-being4 ,individuals with significant expressive communication disabilities must be afforded equal rights1 opportunities1 strategies1 technologies1 services1 and other supports to effectively express themselves and participate in their communities and in democracy4 #c4 ,purpose ,the purpose of this ,act is to work toward eliminating the continued discrimination1 isolation1 marginalization1 and denial of equal opportunity of individuals with significant expressive communication disabilities by providing for comprehensive national training1 technical assistance1 and resource centers to improve access to-- 7#a7 a full range of augmentative and alternative communication2 7#b7 equal opportunity2 7#c7 awareness and implementation of relevant laws1 policies1 and practices2 7#d7 leadership and self-advocacy skills2 7#e7 capacity1 in the case of individuals with significant expressive communication disabilities1 educators1 professionals1 and families2 7#f7 national statistical data2 and 7#g7 societal awareness4 #d4 ,definitions ,in this ,act3 7#a7 ,advisory council ,the term advisory council means an #aa-person advisory council that-- 7,a7 provides guidance1 recommendations1 and oversight to an eligible entity2 7,b7 is comprised exclusively of individuals with significant expressive communication disabilities who collectively have diverse-- 7i7 educational and professional backgrounds2 7ii7 racial1 ethnic1 gender1 and linguistic identities2 7iii7 disabilities1 including intellectual disabilities1 ages1 and geographic locations2 7iv7 levels of income2 and 7v7 forms of augmentative and alternative communication relied upon2 and 7,c7 is subject to each of the following conditions3 7i7 ,the initial council members shall be identified in the grant application by the partners of the eligible entity4 7ii7 ,each member of the advisory council shall be appointed for a period of #e years4 7iii7 ,the ,chair and ,vice ,chair of the council shall be selected by the council members at the first meeting and thereafter as the council determines to be appropriate4 7iv7 ,the council shall fill any vacancy in accordance with section #g7;b77#h77;,c74 7#b7 ,augmentative and alternative communication ,the term augmentative and alternative communication means any tool1 method1 technology1 strategy1 service1 training1 coaching1 and other support used to supplement or replace speech4 7#c7 ,competitive integrated employment ,the term competitive integrated employment has the meaning given the term in section #g of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gje74 7#d7 ,disability ,the term disability has the meaning given the term in section #c of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abajb74 7#e7 ,eligible entity ,the term eligible entity means a partnership of at least #b organizations-- 7,a7 for which the controlling partner of the partnership is a nonprofit organization headquartered in the ,united ,states that vests power and authority in individuals with significant expressive communication disabilities in terms of management1 staffing1 decisionmaking1 operation1 and provision of services2 7,b7 that includes at least one other organization headquartered in the ,united ,states that is either an institution of higher education or an association of professional service providers or educators in the field of significant expressive communication disabilities2 7,c7 that has a cross-disability and cross-generational focus2 7,d7 that is advised by an advisory council2 7,e7 that has adopted a mission that values equal opportunity and the fundamental right of communication access1 and operating principles that respect the rights of individuals with significant expressive communication disabilities to express themselves in the manner of their choosing2 and 7,f7 of which the organizational members1 collectively-- 7i7 have knowledge1 experience1 and capacity in conducting training1 technical assistance1 or knowledge dissemination related to the priority activities described in section #f2 7ii7 have experience working directly with individuals with significant expressive communication disabilities in association with-- 7,i7 early intervention programs1 early childhood programs1 elementary or secondary schools1 or postsecondary education programs2 or 7,,ii7 #b or more types of entities from among-- 7aa7 centers for independent living authorized under part ,c of title ,,vii of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gif;f et seq472 7bb7 home and community-based service providers2 7cc7 employers2 7dd7 health care providers2 7ee7 protection and advocacy organizations2 7ff7 aging networks2 7gg7 caregiver organizations2 or 7hh7 ,state1 ,tribal1 or local government agencies2 and 7iii7 have experience developing and maintaining collaborative working relationships among disability-led advocacy organizations1 institutions of higher education1 professional associations1 or caregiver organizations4 7#f7 ,evidence-based ,the term evidence-based1 used with respect to assistance that is knowledge1 a resource1 training1 or technical assistance1 means assistance-- 7,a7 that demonstrates a rationale based on a high-quality research finding or positive evaluation that such assistance is likely to improve a communication outcome or other relevant outcome2 and 7,b7 for which ongoing efforts are made to examine the effects of the assistance4 7#g7 ,individual with significant expressive communication disabilities ,the term individual with significant expressive communication disabilities means an individual of any age-- 7,a7 who has #a or more real or perceived significant expressive communication disabilities and may have other disabilities2 and 7,b7 whose disabilities result in the need for1 or benefit from1 augmentative and alternative communication and other supports to enable the individual to communicate and to aid the individual in participating in #a or more aspects of life4 7#h7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja7;a7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja7;a774 7#i7 ,national resource center ,the term national resource center means a ,national ,resource ,center on ,augmentative and ,alternative ,communication referred to in section #e7;a74 7#aj7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#aa7 ,significant expressive communication disability 7,a7 ,in general ,the term significant expressive communication disability means any disability1 whether congenital1 developmental1 or acquired at any point in life1 that prevents or significantly limits an individual from understanding or being understood using spoken words1 resulting in the individual's need for or benefit from augmentative and alternative communication4 7,b7 ,application ,the term does not apply to an individual whose primary communication disability is visual or auditory in nature1 but does apply to an individual with a disability described in subparagraph 7,a7 who also has a visual or auditory communication disability and who may communicate using sign language4 7#ab7 ,state ,the term ,state means the #ej ,states1 the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 the ,united ,states ,virgin ,islands1 ,guam1 ,american ,samoa1 and the ,commonwealth of the ,northern ,mariana ,islands4 #e4 ,grants 7a7 ,in general ,the ,secretary shall award #c grants through an open competition to eligible entities1 with applications approved under section #g1 to create1 maintain1 and administer a network of ,national ,resource ,centers on ,augmentative and ,alternative ,communication4 ,each national resource center shall be a comprehensive training1 technical assistance1 and resource center created to work toward eliminating the continued discrimination against1 isolation of1 marginalization of1 and denial of effective communication for and equal opportunity of1 individuals with significant expressive communication disabilities1 through activities including the priority activities described in section #f4 7b7 ,awards for multiple centers ,the ,secretary shall award the grants for national resource centers in #c geographically diverse locations1 and shall designate one of the centers as the lead administrative center4 7c7 ,lead ,administrative ,center ,the lead administrative center shall coordinate-- 7#a7 all activities of the centers2 7#b7 specialization of priorities among the centers2 7#c7 dissemination of information among the centers2 7#d7 responses of the centers to the ,secretary2 and 7#e7 ensuring that the full range of individuals with significant expressive communication disabilities is served by the centers4 7d7 ,amount ,the ,secretary shall1 to the extent practicable1 award the #c grants in amounts that total not more than #i1jjj1jjj per year of a period described in subsection 7e74 7e7 ,periods ,the ,secretary shall award each grant for a period of #e years1 through an open competition held initially and at the end of each #e-year period4 ,an eligible entity that receives a grant under this section may reapply for such a grant at the end of the grant period4 #f4 ,national resource center priority activities ,the priority activities of a national resource center shall be to-- 7#a7 increase access to and effective implementation of the full range of augmentative and alternative communication for all individuals with significant expressive communication disabilities in the ,united ,states1 regardless of age1 race1 ethnicity1 gender1 gender identity1 ,,lgbtq status1 immigration status1 educational achievement1 socioeconomic condition1 primary language1 nature or severity of disability1 location of residence1 and age of onset of the significant expressive communication disability2 7#b7 increase the capacity of individuals with significant expressive communication disabilities1 educators1 professional service providers1 families1 and direct support professionals to support individuals with significant expressive communication disabilities by creating and disseminating evidence-based knowledge1 resources1 training and technical assistance1 and recommended practices in ensuring individuals with significant expressive communication disabilities have the tools and other supports necessary to exercise self-determination and effectively access and participate in all aspects of life1 including education1 employment1 health care1 and community living2 7#c7 promote awareness and implementation of the laws1 regulations1 policies1 practices1 procedures1 and systems that facilitate access to the full range of augmentative and alternative communication and promote equal access and opportunity for individuals with significant expressive communication disabilities2 7#d7 support and enhance the skills and leadership of individuals with significant expressive communication disabilities and their families to advocate for the rights of the individuals to effective communication1 education1 self-determination1 access to justice1 and equal opportunity and participation in all aspects of life2 7#e7 support the improved collection1 availability1 and dissemination of demographic and characteristic data1 with a cross-disability and cross-generational focus1 regarding individuals with significant expressive communication disabilities in the ,united ,states1 the barriers the individuals experience to meaningful access to augmentative and alternative communication1 and the unmet communication support and other needs of this population2 and 7#f7 increase societal awareness and knowledge about individuals with significant expressive communication disabilities and the importance of1 need for1 benefits of1 and rights to meaningful access to effective communication tools and other supports in all aspects of community and life4 #g4 ,applications 7a7 ,in general ,to be qualified to receive a grant under section #e1 an eligible entity shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 7b7 ,contents ,each such application from an eligible entity shall include1 at a minimum1 each of the following3 7#a7 ,a description of the experience of each partner organization in the entity in providing training1 information1 advocacy1 and support related to augmentative and alternative communication and individuals with significant expressive communication disabilities4 7#b7 ,a description of each partner organization's experience in providing training1 information1 advocacy1 and support related to augmentative and alternative communication and to individuals with significant expressive communication disabilities1 to-- 7,a7 early intervention specialists2 7,b7 elementary education1 secondary education1 postsecondary education1 and specialized instructional support personnel as defined in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja72 7,c7 caregiver groups2 7,d7 providers of home and community-based services for adults2 7,e7 health care providers and educators2 7,f7 employers2 7,g7 providers of services to older adults2 7,h7 law enforcement agencies1 courts1 offices of district attorneys1 and other public and private security agencies and businesses2 7,i7 institutional long-term care services and support providers2 7,j7 nursing home providers2 and 7,k7 other stakeholders4 7#c7 ,a description of each partner organization's experience working with ,state1 local1 or ,tribal government agencies in providing training1 information1 and support related to augmentative and alternative communication for full expression and individuals with significant expressive communication disabilities4 7#d7 ,a description of each partner organization's prior partnerships with disability-led organizations focused on augmentative and alternative communication and individuals with significant expressive communication disabilities4 7#e7 ,evidence of how the applicant satisfies the requirements of section #d7e74 7#f7 ,a description of the applicant's plan to ensure that the applicant will provide training1 technical assistance1 and information to target audiences1 especially those audiences in need of knowledge and access to augmentative and alternative communication4 7#g7 ,a description of the applicant's plan to implement the priority activities in section #f1 including how the organizational members of the eligible entity will partner1 collaborate1 and operationalize the activities4 7#h7 ,advisory council information1 including-- 7,a7 a description of the advisory council1 including a list of the inaugural members of the advisory council2 7,b7 an assurance that the ,chair and ,vice ,chair of the advisory council will be selected by the advisory council members at the first meeting of the advisory council and thereafter as the council determines to be appropriate2 and 7,c7 an assurance that1 in filling a vacancy on the advisory council1 the advisory council will-- 7i7 solicit nominations from the population of augmentative and alternative communication users2 7ii7 if there is not more than #a nominee for the vacancy1 confirm the nominee as a new member2 and 7iii7 if there is more than #a nominee for the vacancy1 vote to determine the nominee to fill the vacancy and subsequently confirm the nominee4 7#i7 ,a description of how other individuals with significant expressive communication disabilities will be involved in the governance and operations of the national resource center involved1 especially through employment of individuals with significant expressive communication disabilities4 7#aj7 ,a description of how the applicant will design and make training1 technical assistance1 and information available in accessible formats1 including plain language4 7#aa7 ,assurances that the applicant1 acting through the national resource center1 will work with the stakeholders identified in section #i7;d74 7#ab7 ,assurances that the applicant1 acting through the national resource center1 will provide the ,secretary with requested data and information for purposes of evaluating the grant activities4 #h4 ,award priority ,in awarding grants for activities described in this ,act1 the ,secretary shall give priority to an eligible entity with at least #a partner organization that-- 7#a7 demonstrates a minimum of #c years of experience providing training and technical assistance and disseminating information related to augmentative and alternative communication and individuals with significant expressive communication disabilities1 and being otherwise engaged in the priority activities described in section #f2 7#b7 demonstrates that individuals with significant expressive communication disabilities and those who use augmentative and alternative communication are purposefully involved in the governance and operation of the organization1 especially through their employment in service1 delivery1 and leadership positions2 7#c7 demonstrates the ability to collaborate with disability self-advocacy1 education1 direct service1 health care1 employment1 aging1 caregiver1 and housing organizations1 whether the organizations are public agencies or private entities2 and 7#d7 demonstrates expertise in promoting accessibility and the use of universal design 7the latter as defined in section #ajc of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajjc77 in providing training and technical assistance1 and information dissemination4 #i4 ,use of funds 7a7 ,in general ,an eligible entity that receives a grant under section #e shall use the grant funds to manage and carry out the priority activities described in section #f1 activities described in this section1 and any additional activities approved by the ,secretary4 7b7 ,coordination with ,federal programs ,the work of a national resource center shall link to current and future policy and activities undertaken throughout the ,federal ,government in relation to self-advocacy1 supported decisionmaking1 person-centered planning1 community living1 and competitive integrated employment for individuals with disabilities and particularly for individuals with the most significant expressive communication disabilities1 for the purpose of increasing-- 7#a7 success and self-determination in life2 7#b7 the provision of inclusive early intervention services1 elementary education1 secondary education1 and postsecondary education programs2 7#c7 competitive integrated employment2 7#d7 health1 wellness1 and personal safety2 7#e7 economic security2 7#f7 civic engagement2 7#g7 community integration2 and 7#h7 improvement in other aspects of life4 7c7 ,information dissemination ,notwithstanding the priority activities described in section #f1 a national resource center shall ensure information and other resources about augmentative and alternative communication and individuals with significant expressive communication disabilities are made available as appropriate to-- 7#a7 individuals with significant expressive communication disabilities and their families2 7#b7 institutions of higher education2 7#c7 ,state1 ,tribal1 and local educational agencies2 7#d7 law enforcement agencies1 courts1 offices of district attorneys1 and other public and private security agencies and businesses2 7#e7 national1 ,state1 regional1 ,tribal1 and local employers1 to enable businesses to hire into competitive integrated employment more individuals who use augmentative and alternative communication2 7#f7 national1 ,state1 ,tribal1 and local government agencies that provide services and other supports to individuals with significant expressive communication disabilities1 including agencies responsible for emergency preparedness1 employment support1 and vocational rehabilitation1 agencies responsible for ,state programs under the ,assistive ,technology ,act of #aihh 7#bi ,u4,s4,c4 #cjja et seq471 agencies responsible for ,state alternative financing programs1 ,state agencies responsible for the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 and the agencies overseeing the provision of home and community-based services2 7#g7 national and local disability and aging advocacy organizations1 including disability self-advocacy organizations2 7#h7 family support organizations1 including the parent training and information centers supported under section #fga of the ,individuals with ,disabilities ,education ,act 7#bj ,u4,s4,c4 #adga72 7#i7 centers for independent living and ,statewide ,independent ,living ,councils authorized by title ,,vii of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gif et seq472 7#aj7 network partners1 including the ,state ,councils on ,developmental ,disabilities described in section #abe of the ,developmental ,disabilities ,assistance and ,bill of ,rights ,act of #bjjj 7#db ,u4,s4,c4 #aejbe71 the protection and advocacy systems described in section #adc of that ,act 7#db ,u4,s4,c4 #aejdc71 and ,university ,centers for ,excellence in ,developmental ,disabilities ,education1 ,research1 and ,services supported under subtitle ,d of title ,i of that ,act 7#db ,u4,s4,c4 #aejfa et seq471 participating in activities under that ,act 7#db ,u4,s4,c4 #aejja et seq472 7#aa7 ,state agencies and area agencies on aging1 entities carrying out long-term care ombudsman programs1 and other entities funded under the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjja et seq472 7#ab7 health care providers and educators1 health care advocacy organizations1 nursing home providers1 and institutional long-term care facilities2 7#ac7 professional organizations and organizations that certify preservice training programs2 and 7#ad7 other groups and entities as identified by the eligible entity and the advisory council of the eligible entity4 7d7 ,stakeholder collaboration ,a national resource center shall collaborate with-- 7#a7 organizations of individuals with significant expressive communication disabilities2 7#b7 disability organizations2 7#c7 entities carrying out ,state assistive technology programs and ,state alternative financing programs2 7#d7 ,state1 ,tribal1 and local educational agencies2 7#e7 the councils1 systems1 and university centers described in subsection 7c77#aj72 7#f7 entities carrying out national1 ,state1 ,tribal and ,native ,hawaiian1 and local programs authorized by the ,older ,americans ,act of #aife2 7#g7 the federally funded ,rehabilitation ,engineering ,research ,center on ,augmentative and ,alternative ,communication2 7#h7 ,state agencies responsible for vocational rehabilitation programs1 as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb72 7#i7 professional associations whose members come in contact with and support individuals who may use augmentative and alternative communication2 7#aj7 local boards1 as defined in section #c of the ,workforce ,innovation and ,opportunity ,act 7#bi ,u4,s4,c4 #cajb72 and 7#aa7 other ,state1 regional1 ,tribal1 and local entities with the ability to provide support for individuals who need and use augmentative and alternative communication4 #aj4 ,annual report ,an eligible entity that receives a grant under section #e to support a national resource center shall annually prepare and submit to the ,secretary1 the ,secretary of ,education1 and the relevant subcommittees of the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 the ,special ,committee on ,aging of the ,senate1 and the ,committee on ,education and ,labor of the ,house of ,representatives1 the ,subcommittee on ,labor1 ,health and ,human ,services1 ,education1 and ,related ,agencies of the ,committee on ,appropriations of the ,senate1 and the ,subcommittee on ,labor1 ,health and ,human ,services1 ,education1 and ,related ,agencies of the ,committee on ,appropriations of the ,house of ,representatives a report containing1 consistent with criteria established by the ,secretary1 information on-- 7#a7 activities conducted by the national resource center to achieve the purpose of this ,act2 7#b7 collaboration by the national resource center with other entities to achieve the purposes of this ,act2 7#c7 barriers to and strategies for equitable access to augmentative and alternative communication and other supports for individuals who belong to racial1 ethnic1 and linguistic minority communities and face a greater likelihood of being born with or acquiring significant expressive communication disabilities as well as added difficulties in obtaining effective augmentative and alternative communication2 7#d7 identified gaps in available demographic and characteristic data on individuals with significant expressive communication disabilities in the ,united ,states2 and 7#e7 the unmet needs of individuals with significant expressive communication disabilities1 from diverse backgrounds1 in the ,united ,states and policy recommendations to address such unmet needs4 #aa4 ,authorization of appropriations ,there is authorized to be appropriated to carry out this ,act #i1jjj1jjj for each of fiscal years #bjbc through #bjbg4