2020 Presidential Primary Candidate Survey on Disability
Joe Biden’s Responses
I believe that every policy should be developed with consideration for impacts on people with disabilities. In the months ahead, I will propose additional steps I will take as president to ensure that people with disabilities are treated with dignity and have a chance to be fully
included in all aspects of American life. See highlights on how my plans will help people with disabilities at: https://joebiden.com/disabilities/
Employment: What are your views on paying a subminimum wage based on disability?
Under the Obama-Biden Administration, we issued an executive order “raising the minimum wage for workers on federal contracts”, including workers with disabilities. As president, I will work to further wage protections for workers with disabilities by enacting legislation
eliminating the subminimum wage based on disability. This is the right thing to do for workers and our economy. Since the historic passage of the Americans with Disabilities Act in 1990, we’ve witnessed that people with disabilities have the ability to work with reasonable accommodations and their full participation in the workforce is not just morally and ethically right, it is good business. People with disabilities should be paid a fair wage consistent with national and state minimum wage laws—not less.
A Biden Administration will also ensure that workers with disabilities who need it have access to supported employment and customized employment services. The Obama-Biden Administration’s Department of Health and Human Services provided funding to increase state
and local capacity to provide supported employment programs to adults with mental illness. As president, I will build on this work to ensure that supported employment services for people with intellectual and developmental disabilities and people with mental illness are expanded. And, I will direct the Department of Education’s Rehabilitation Services Administration to enforce the integrated employment provisions of the Workforce Innovation and Opportunity Act consistent with the regulations issued in 2016. I will also restore the Department of Justice’s guidance on the application of the Supreme Court’s Olmstead decision to employment services. The fact that the Trump Administration revoked such a crucial civil rights protection is disgraceful.
As president, I will work with the disability community to issue a disability employment-focused executive order and to build on the Obama-Biden Administration’s progress to increase federal employment for individuals with disabilities. Under our administration, we increased the percentage and actual number of workers with disabilities in the federal government to a higher level than at any time over the last three decades. I will build on that progress, by leveraging the Schedule A Special Hiring Authority and aggressively enforcing Section 501 of the Rehabilitation Act. I will ensure that my administration is working toward developing specific hiring and advancement goals for individuals with disabilities, including those with significant disabilities.
Assistive Technology: What do you plan to do to increase access to assistive technology for people with disabilities who need it to effectively and independently engage in their communities?
Some of the most tremendous innovations are at their core assistive technologies. The importance of the “curb cut effect”—measures designed for the benefit of people with disabilities that also helps all people — has created a more accessible world that empowers
We need to do more to help employers acquire the assistive technologies needed for people with disabilities to fully participate in the workplace. The Obama-Biden Administration was committed to ensuring that accessible technology was available to Americans with disabilities. For example,the White House worked with the Cabinet to “improve the acquisition and implementation of accessible technology”. As president, I will build on this initiative and work with Congress and the disability community to incentivize employers to develop and obtain more assistive technology to help create a more inclusive workplace.
Many people with disabilities cannot fully realize their right to vote without assistive technology. As president, I will fully implement the Help America Vote Act. One of the key sections of that legislation, which I advocated for, is to ensure that voting systems are accessible for people with disabilities. I will instruct my Department of Justice’s Civil Rights Division to act aggressively to ensure that all polling places are accessible, including the built environment, the availability of ballot-marking devices, and training for poll workers to availability of ballot-marking devices, and training for poll workers.
Special Education: How would you propose to strengthen the IDEA when it is reauthorized so that it truly fulfills its stated purpose of preparing children with disabilities for post-secondary education, employment, and independent living, including children with the most significant disabilities?
The Individuals with Disabilities Education Act (IDEA), signed into law in 1990, promised to provide 40% of the extra cost of special education required by the bill. Currently, the federal government only covers roughly 14% of this cost, failing to live up to our commitment. As president, I will fully fund this obligation within ten years. We must ensure that children with disabilities get the education and training they need to succeed.
But it’s not just about money. As president, I will appoint a Secretary of Education with a true commitment to the full inclusion of students with disabilities. I will make the enforcement of IDEA’s promise of a free appropriate public education, a major priority through the Department of Education Office of Civil Rights. And, as my administration works with Congress on reauthorizing the IDEA, we will advance the fundamental promise of educating all our children in the least restrictive environment. Inclusion isn’t just the law – it’s who we are as a nation. As president, I will make it happen.
What’s more, I will fully implement the special education disproportionality regulation that we put in place during the Obama-Biden Administration. Students with disabilities deserve equal access to the general education classroom, and should have meaningful recourse when subject to disproportionate disciplinary practices or segregation from the general education classroom.
The Obama-Biden Administration’s Department of Education worked to keep students with disabilities safe in their classrooms by providing resources on the use of seclusion and physical restraint and by issuing guidance to public schools regarding the limits required under Federal law on the use of seclusion and physical restraints on students with disabilities. I will build on this work by continuing to protect our students from dangerous physical restraint and seclusion.
Mental Health Services: What is your vision for a system of services to support people with mental illness?
Our culture and health care systems too often treat mental illness as different from physical health conditions. It’s wrong. As Vice President, I was a champion for efforts to implement the federal mental health parity law, improve access to mental health care, and eliminate the stigma around mental health. As president, I will redouble these efforts to reduce stigma, ensure enforcement of mental health parity laws, and expand funding for mental health services.
I am proud that the Affordable Care Act (ACA) provided individuals with pre-existing conditions, including a mental health challenge, access to health insurance. People with disabilities were a arge beneficiary of this new policy, including those with mental health conditions. The ACA also requires insurance companies to cover mental and behavioral health treatment as an essential benefit, and cover that care at parity with physical health benefits. And, the ACA gave 60 million Americans access to mental health and substance use disorder benefits.
Yet, despite this progress, I know that our parity laws are under-enforced and too many people are still denied the mental health care they need. As president, I will make sure enforcing our mental health parity laws is a priority. Currently states vary in how they define essential health benefits when it comes to mental health. In my Administration, we will set clear standards raising the bar for mental health coverage, including habilitative services and other forms of behavioral health care.
I will also build on the Affordable Care Act to make sure low-income individuals with mental health disabilities have access to insurance. Access to affordable health insurance that includes coverage for mental health shouldn’t depend on your zip code or income. Governors and state legislatures in 14 states have refused to take up the Affordable Care Act’s expansion of Medicaid eligibility, denying access to Medicaid for an estimated 4.5 million adults. My plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.5 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additionally, I will ensure people making below 138% of the federal poverty level get covered. I’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for
low-income populations (such as SNAP).
I will also ensure my Department of Health and Human Services stops states from privatizing Medicaid and allowing private companies to profit off Medicaid while cutting services for those who need them the most. I will also expand primary care and innovative health care delivery models in rural communities. One way I will do this is by building new health clinics and deploying telehealth in rural America.
The Obama-Biden Administration successfully used the USDA Community Facility Direct Loan & Grant Program to build rural hospitals and mental health clinics across rural America and equip them with the best technology. As president, I will expand this grant funding, with a focus on accelerating the deployment of telehealth for mental health and specialty care. Telehealth – the use of videoconferencing and other technology to provide remote care – can be a vital resource for rural communities with limited access to providers.
Too many people with mental health or substance use disorders end up incarcerated. I will expand federal funding for mental health and substance use disorder services and research. People with mental health disabilities or substance use disorders should have access to
affordable, quality care long before their situations escalate and they interact with the criminal justice system. As noted above, the Biden Plan will expand health insurance coverage so more Americans have access to treatment, ensure enforcement of mental health parity laws, and expand funding for mental health services.
I will also get people who should be supported with social services – instead of in our prisons – connected to the help they need. Too often, those in need of mental health care or rehabilitation for a substance use disorder do not get the necessary care. Instead, they end up
having interactions with law enforcement that lead to incarceration. The same is true for homeless individuals. That’s not fair to those individuals, and it’s not fair to police officers. To change the nature of these interactions, the Biden Administration will fund initiatives to partner mental health and substance use disorder experts, social workers, and disability advocates with police departments. These service providers will train police officers to better de-escalate interactions with people in severe emotional distress. They’ll also help police officers learn how to better approach individuals with certain disabilities, like those with autism or who are deaf, so misunderstanding does not lead to incarceration or worse. And, these service providers will respond to calls with police officers so individuals who should not be in the criminal justice system are diverted to treatment for addiction or a mental health disability, or are provided with the housing or other social services they may need.
I will also expand access to mental health and substance use disorder treatment, as well as educational opportunities and job training for individuals during and after incarceration. Jails are not the preferred approach for rehabilitation. That’s why the Biden Administration will
expand the use of drug courts and other diversion programs. But, when individuals end up incarcerated and are experiencing a mental health condition or a substance use disorder, they should have access to adequate treatment. And, all incarcerated individuals should have the opportunity to pursue education and skills training so they can more easily find employment after their release. Incarcerated individuals should have the opportunity to learn to read, earn a GED, or learn a new trade while imprisoned. The Biden Administration will expand funding for all of these programs and services, during and after incarceration.
Because I also want to make sure that our kids get the mental health care they need, I will double the number of psychologists, guidance counselors, nurses, social workers, and other health professionals in our schools. One in five children in the U.S. experience a mental health condition. Yet, too many of our children are not getting the mental health care they need from a trained professional. We need mental health professionals in our schools to help provide quality mental health care, but we don’t have nearly enough. The current school psychologist to student ratio in this country is roughly 1,400 to 1, while experts say it should be at most 700 to 1. That’s a gap of about 35,000 to 60,000 school psychologists. Teachers too often end up having to fill the gap, taking away from their time focusing on teaching. I will make an unprecedented investment in school mental health professionals in order to double the number of psychologists, guidance counselors, nurses, social workers, and other health professionals employed in our schools, and partner with colleges to expand the pipeline of these professionals.
This way we can focus on investing in prevention in our schools and ensure that behavioral and emotional challenges can be addressed by health care professionals, and not our criminal justice system. And, I will restore the Obama-Biden Administration guidance to help schools address the high number of suspensions and expulsions that disproportionately impact students of color and students with disabilities.
There is no doubt we need a better system of care for the mental health needs of adults and children. According to the National Alliance on Mental Illness, ”individuals living with mental illness experience recovery through a combination of community services, medication, peer
support, housing, education, employment and other supports.” When people have access to all appropriate treatment options they, along with their doctors or other providers, can decide what works best for them. In Medicaid, integrating mental health and addiction treatment into primary care must be a priority. The stigma and discrimination against people with mental illness prevent millions from seeking and receiving effective treatment. We can and must do better.
Workforce Shortage: Please explain how you would address this immediate and growing workforce shortage?
Health care is personal to me. Weeks before I was sworn in to the United States Senate, I got a phone call saying my wife and daughter had just been killed in a tractor trailer accident. My two boys were hospitalized for a long time. And, when my mother’s health was fading in her 90s and when my son Beau was battling cancer – my family had the support and compassion from amazing direct support professionals. Their kindness is something I will forever be grateful for, and will never forget. I mean this sincerely, using an expression of my mom’s, “you all do God’s work.”
Direct support work is uniquely challenging and as you noted, the turnover rate is high. Our direct support professionals must get the support they need to stay in their field, and thrive. My dad had an expression, he said “Joey, a job is worth a lot more than a paycheck, it’s about your dignity, it’s about your respect, it’s about your role in the community, it’s about being able to look your kid in the eye and say, ‘honey, it’s gonna be okay.’” Too many people can’t do that today.
A Biden Administration will focus on efforts to recruit and retain more Americans to join the direct support sector. One way to encourage more people to become direct support professionals is to ensure that it pays a living wage. Those that work in this field should not
have to get a second job to pay household bills. No one should work a full-time job and live in poverty. It’s wrong. As president, I will ensure that professionals providing supports for individuals with disabilities have good jobs, earn a living wage, and have access to affordable health care.
I will secure a $15 minimum wage for all workers, including our direct support professionals who provide care to people with disabilities living in our communities. And, I will support indexing the minimum wage to the median hourly wage so that low-wage workers’ wages keep up with those of middle income workers. Every worker deserves to earn enough to live a middle-class lifestyle, provide for their family, save for retirement, and send their kids to college.
The Obama-Biden Administration extended long overdue overtime and minimum wage protections to nearly 2 million home care workers. As president, I will codify these protections into law and build on them, including by ensuring these workers have the right to organize and
collectively bargain. I will support the Domestic Workers’ Bill of Rights legislation that expands federal protections to the home care Workforce.
As president, I will defend and build upon the Affordable Care Act to ensure every American, including direct support professionals, has access to quality, affordable health care. My plan takes a number of steps to build on Obamacare, including allowing Americans who are
uninsured or who don’t like their coverage to buy into a public option like Medicare. My plan also increases premium tax credits so more people will have lower premiums and lower deductibles. I also believe that Medicaid plays an absolutely critical role in our health care
system and it must be protected and strongly funded going forward. As president, I will fight all efforts to undermine it, such as work requirements and other tactics to reduce enrollment.
I will also protect Medicaid to ensure that its beneficiaries can access home- and community-based long-term care when they want it, and that home care and direct support professionals get paid a good wage. Medicaid pays for more long-term care than any other insurer in the country. In fact, roughly 6 in 10 individuals residing in nursing homes are enrolled in Medicaid, including many older Americans. Yet, the Trump Administration is reportedly considering a plan to cut Medicaid funding by turning it into a block grant. The Biden Plan will
protect Medicaid funding and make sure the program gives those on Medicaid who need long-term care the flexibility to choose home- and community-based care. In addition, the Biden Administration won’t let states skirt their duties under Medicaid and will take enforcement action against any state that allows profiteering to get in the way of Medicaid beneficiaries’ health.
For many, this is more than a job, it is a vocation and labor of love. Our system should include opportunities to develop in the field with supervisory positions and other mechanisms to advance, so that they can increase their capacity to serve and increase their wages. I will
increase affordable in-person and online training opportunities for direct support professionals. I will also provide two years of community college or other high-quality training program without debt and will invest $50 billion to create and support partnerships between high
schools, community colleges, businesses, unions, and other workers to identify in-demand knowledge and skills in a community, like direct care and support, to develop or modernize training programs. And I will partner with health care workers and accelerate the testing and
deployment of innovative solutions, including new models of upskilling, that improve quality of care and increase wages for low-wage health care workers, like home care workers.
I also recognize that many families have informal caregivers, which allow those needing care to remain in the community. The Biden Plan will help Americans pay for long-term care by providing relief for Americans needing long-term care by creating a $5,000 tax credit for
informal caregivers, modeled off of legislation supported by AARP. These informal caregivers – whether family members or other loved ones – have for too long been doing tireless work without any financial support.
Finally, a Biden Administration will ensure that people with disability have increased access to home and community-based services. The ACA strengthened the Money Follows the Person program by including additional states to apply for funding. I will work with Congress to secure long-term re-authorization of the Money Follows the Person program to ensure that we bring people with disabilities out of institutions and into the community.