When more than one in six people around the world have some sort of disability, disability rights are inseparable from human rights. As the United Nations prepares to commemorate International Day of Persons with Disabilities, it is important to recognize the role people with disabilities play in society, helping to create a more inclusive and sustainable world for all.
Earlier this year, I joined the United States’ delegation of the American Association of Intellectual and Developmental Disabilities (AAIDD) to visit Czechia, also known as the Czech Republic, to learn about disability policy, services, and experiences. Our experience focused on policy structures, service delivery systems, and community priorities that meet the needs of people with disabilities. Czechia is one of 191 nations that have ratified the United Nations Convention on the Rights of Persons with Disabilities, which outlines the rights of people with disabilities worldwide and what countries can do to protect those rights. While Czechia and the United States differ in how they approach disability policy and services, people with disabilities face many of the same barriers. Discrimination, including social and educational exclusion, and low expectations of people with intellectual and developmental disabilities are realities in both countries. In addition, a lack of physically accessible environments, as well as workforce shortages and limited self-advocacy opportunities, create a strain on limited resources. Reflecting on our shared challenges offers insights into how adjustments to approaches could serve as a catalyst for change in both nations.
“No wrong door” policies benefit people with disabilities.
Czech citizens have access to a robust national fee-for-service health plan that covers the costs of their medical and health care expenses, funded through a mix of funds from the central government, regional taxes, and private insurance. This means Czech citizens with disabilities have access to health care regardless of the ability to pay. Regionally based networks provide social care, including housing, employment, specialty care, and educational support. Some funding for social care comes from the central government, which is supplemented by local funds and private individual payments. The Czech system is by no means straightforward or easy to navigate, but there is “one door in” for health care and “one door in” for social care for all people. Reducing the burden for individuals (in terms of access, time, eligibility) and government (in terms of redundancy, cost, oversight) with a No Wrong Door system for all ensures their needs are met efficiently.
While the U.S. does not provide universal health care, there are increasing efforts to create “one door” to access social care. Federal, state, and local agencies in the United States have made significant investments to establish No Wrong Door systems to provide easier access to long-term services and supports, and each state offers No Wrong Door access points to get started. But the Czech system shows that we have a way to go in achieving that goal. The simplicity of the Czech system compares favorably when reflecting on the complexities of eligibility for various disability-related programs in the United States. Demystifying and streamlining access to long-term services and supports can help older adults and people with disabilities coordinate the support they need to live and work in the community.
A robust anti-discrimination plan can help advance policy change.
In Czechia, the Government Board for Persons with Disabilities advises the government on disability policy. The board includes cabinet members from across the government and representatives of the disability community and developed the National Plan for the Promotion of Equal Opportunities for Persons with Disabilities 2021–2025. Like the U.S. American with Disabilities Act, the Czech plan determines strategic direction and recommends policies to ensure equal opportunity for persons with disabilities. It details what data will be collected, how the data will be collected, and who will collect data and monitor plan progress. The plan is updated every five years. Czechia and the United States share a commitment to including disability perspectives in government policy and protecting the rights of people with disabilities across government agencies.
In the United States, we’ve taken a more piecemeal approach to disability policy. Litigation (for example, Olmstead v L.C.) or a federal administration’s priorities (as expressed through the Equal Employment Opportunity Commission or Department of Justice enforcement, for example) has often dictated how and the extent to which we have we strengthened and codified anti-discrimination measures to protect people with disabilities. Policy refinement and reauthorization are critical for protecting the rights of people with disabilities. The United States can take a lesson from Czechia’s approach, which updates their national plan every five years to incorporate new policy approaches, service standards, and expected outcomes. More consistent updates to U.S. and state policy could better address the changing needs of the disability community. The Public Comment Project outlines how citizens can provide input to the federal government on critical issues.
Local engagement matters.
While a national plan for addressing the needs of Czech people with disabilities guides decision making and priorities, grassroots advocacy still matters. At the local and regional levels, advocates and family members play a key role in holding the government and national planners accountable for their commitments. Inclusion Czech Republic, a chapter of Inclusion International, is an advocacy organization that mobilizes and represents the needs and interests of Czech people with disabilities and their families. Inclusion Czech Republic’s approach includes encouraging parents and advocates to connect with officials at the local and regional levels by attending local government meetings to ensure policy makers are aware of people with disabilities and their needs. This approach has resulted in more local government attention and engagement on disability issues.
Inclusion Czech Republic’s approach is similar to that of the parental organization that became The Arc in the 1950s, which helps provide educational and employment opportunities for children with disabilities. Its work is a valuable reminder that state and local engagement on issues is an important complement to federal public policy and a vital part of ensuring accountability that can significantly affect the day-to-day life of people with disabilities and their families. As a younger nation, Czechia (founded in 1993) can benefit from many of the lessons we’ve learned in the United States about the effectiveness of consistent advocacy. First developed in Minnesota, Partners in Policymaking programming teaches people how to engage with disability policy at all levels of government. Citizen engagement in the policy process strengthens democracy and helps educate policy makers on the issues most critical to people with disabilities and their families.
This month, Secretary of State Antony Blinken reflected that ensuring disability rights are part of a robust foreign policy, saying, “…we have a responsibility—all of us—to deliver for all of our people. Not some of them, not certain groups—all of our people. And that’s in part because everyone’s safety, everyone’s security, everyone’s prosperity is deeply connected...” As a new team member at Mathematica who is motivated by my lifelong dedication to the inclusion of people with disabilities, I am committed to using my experience in Czechia to inform research that enhances the well-being and quality of life of people with disabilities worldwide. On International Day of Persons with Disabilities, we celebrate the year-round pursuit of equal rights and inclusion for people with disabilities.
