The Americans with Disabilities Act as engine of social change: Models of disability and the potential of a civil rights approach

The Americans With Disabilities Act, based on the civil rights/minority group and independent living models of disability, may enhance access to health care, personal assistance, employment, the electoral process, and smoke-free environments for people with disabilities. However, this essential law

The Status of People With Disabilities

The 1998 National Organization on Disability (NOD)/Harris Survey of People With Disabilities drew the following disturbing conclusions concerning people with disabilities in our society:

This survey has found that Americans with disabilities continue to lag well behind other Americans in many of the most basic aspects of life, as previous Harris studies found in 1986 and 1994. Large gaps still exist between adults with disabilities and other adults with regard to employment, education, income, frequency of socializing and other basic measures in ten major 'indicator' areas of life. Furthermore, most of these gaps show little evidence of narrowing. In some cases, the gaps have even widened (Louis Harris and Associates, 1998, p. 5).

Specifically, only about 30% of working-age adults with disabilities are employed full or part time, compared with 80% of adults without disabilities. Although 75% of unemployed individuals with disabilities consistently indicate that they would like to have a job, their employment situation has not improved significantly in the past decade (Louis Harris & Associates, 1986). About 33% of adults with disabilities live in households with incomes of less than $15,000, compared with only 12% of adults without disabilities. Although there have been some significant improvements in the lives of people with disabilities since the enactment of the Americans With Disabilities Act of 1990 (ADA),1 particularly in access to higher education and to places of public accommodation, these individuals continue to be among the most deprived members of our society (Louis Harris & Associates, 1998).

A primary objective of disability policy in our country is to improve the circumstances of people with disabilities by empowering them to participate in the mainstream of society. The ADA embodies the most prominent disability policy of our nation. It was designed as a civil rights law with the purpose of providing a "clear and comprehensive national mandate for the elimination of discrimination against people with disabilities."2 Some policymakers perceive the ADA narrowly as a shield against specific discriminatory acts and have expressed concern that it has been used in ways that were not intended by the drafters. These individuals have an unjustifiably narrow interpretation of the scope of this law, which carries the imprimatur of the disability population's "emancipation proclamation."3 There are others who wish to use the ADA proactively as a sword against virtually all of the problems experienced by people with disabilities. Their vision does not recognize the real limits to the ADA's capacity to address social ills.

In fact, the ADA may to some extent serve as both a shield against discrimination and a sword for broad social change. As a civil rights law focused on discrimination, it is based fundamentally on traditional concepts of discrimination as adapted and applied to the unique circumstances of people with disabilities initially in The Rehabilitation Act of 1973 (e.g., the requirement that employers provide reasonable accommodations to allow people with disabilities to function optimally). Through thoughtful and innovative application, the ADA has helped people with disabilities win many important battles in the war for their independence. However, the ADA alone cannot win the war. Its use to achieve particular social goals is limited by the specific language and legislative intent of the law.

This article examines the theoretical bases underlying the ADA and the extent to which the ADA has been and may potentially be used successfully to achieve the objectives of people with different disabilities. Specifically, it considers whether the ADA can resolve several key issues of interest to many people with disabilities, such as access to health insurance, smoke-free environments, personal assistance services, the electoral process, and employment. Finally, it draws conclusions on whether a civil rights approach can be successful in addressing disability issues and on which other models of disability are necessary to ensure that people with disabilities may achieve the laudable goals of the ADA.

Theoretical Considerations-Models of Disability

For the past 30 years, people with disabilities have been involved in a struggle to participate fully in our society (Shapiro, 1993). The social movement associated with this struggle is often referred to as "the disability rights movement" or "the independent living movement" (DeJong, 1979). Although these terms are often used interchangeably, it is not clear whether they characterize the same movement or two separate movements. The terms have somewhat different connotations and appear to be based on different, though overlapping, models of disability.4

When discussing the disability rights movement, the emphasis tends to be on the recognition of rights of people with disabilities that are fundamental in nature, and if deprived, would violate fundamental notions of fairness (e.g., the right to marry and have children). When discussing the independent living movement, the focus is on removing environmental barriers that prevent people with disabilities from living independently in their communities (e.g., building wheelchair ramps). There is clearly a significant overlap between these concepts, particularly in that the removal of certain environmental barriers is considered by many disability rights advocates to be a fundamental right. However, while their practical goals may be similar, their theoretical underpinnings appear to be somewhat different.

The underlying concept of the disability rights movement is what has been referred to as the "civil rights model" or the "minority group model." Under this model, people with disabilities are characterized as a discrete oppressed minority group whose "disadvantaged position in American society is based primarily on unfair discrimination" (Scotch & Schriner, 1997). Consequently, the appropriate policy approach is to establish civil rights protections prohibiting discrimination on the basis of disability. This model has been useful in empowering people with disabilities to address many instances of overt and covert discrimination. However, it does not provide adequate policy guidance on how to meet the employment and other needs of people with disabilities when the problems are not the direct result of discrimination.

The independent living movement is based on what has been referred to as the "independent living model" (Batavia, DeJong, & McKnew, 1991). It recognizes disability as a complex phenomenon involving the interaction between impairments, "functional limitations" associated with the impairments, and "disabilities" (i.e., social disadvantages, "handicaps") associated with the limitations (Batavia, 1993b; Nagi, 1969; World Health Organization, 1980). Under this model, disabilities are not inherent in individuals, but rather result from the interaction between individuals and their environments. Therefore, the appropriate intervention is to modify the environment to accommodate the needs of people with disabilities.5 This model has been valuable in altering the widespread perception under the earlier "medical model" that people are disabled primarily by their physical or mental impairments (DeJong, 1979).

However, both the civil rights and independent living models are also unduly oversimplified and do not adequately consider other substantial factors such as individual, family, and cultural variables, which are important in predicting the ability to live independently and productively (Batavia & Beaulaurier, 2001).6 The rhetoric of disability rights advocates often suggests that, if we eliminate discrimination and remove barriers, people with disabilities will be able to function as well as people without disabilities. Common sense suggests this is not necessarily the case. Each individual is unique and will to some extent determine his or her own destiny irrespective of environmental factors.

The ADA, as an antidiscrimination statute, is based fundamentally on the civil rights/minority group model.7 However, by defining discrimination as affirmatively requiring reasonable accommodations to assist people with disabilities to function optimally,8 the ADA is also very consistent with the independent living model. It may be seen as intersecting these two models, or having some basis in both.9 The important question is whether the ADA adequately promotes the breadth of social change necessary to improve the life circumstances of people with disabilities significantly, and if not, what additional policies will be necessary to achieve such a goal.

Attempts to Achieve Broad Social Change

In the first 10 years of the ADA, there already have been several attempts to use the ADA to challenge the legitimacy of certain traditional social arrangements that inherently disadvantage people with disabilities, such as insurance underwriting practices. Thus far, these efforts have had mixed results, and they are unlikely to create fundamental change. Whether the ADA was intended to resolve such issues directly is debatable. This is not to suggest that the ADA has no role in this arena, only that it probably cannot resolve these issues alone.

Although the ADA was intended to achieve social reform primarily on a case-by-case basis, it does provide some insight into how broader issues should be addressed. It indicates, through the general intent of Congress, that a major goal of disability policy in this country is to ensure the inclusion of people with disabilities in the mainstream of our society, and that people with disabilities are to be treated as first-class citizens. Using the ADA as a philosophical statement reflecting our national disability policy provides guidance and is valuable to keep us focused on ultimate policy goals. However, legally it is no substitute for the laws needed to achieve such goals as access to health insurance, personal assistance services, employment, smoke-free environments, and the electoral process.

Health Care Coverage

Some of the most challenging questions under the ADA concern whether and how it may be used to ensure access to health insurance and health care. Clearly, the ADA may have a substantial impact in this area, as illustrated by the Bush Administration's rejection of the Oregon Medicaid Plan proposal that attempted to prioritize coverage of specific services under Medicaid in the state (Department of Health and Human Services, 1994; Astrue, 1994). The problem with the Oregon proposal, which required federal approval, was that the methodology employed to determine the list of priorities used "quality of life" criteria that implicitly assumed people with certain conditions necessarily have a diminished quality of life. The Bush Administration denied the waiver request because it was deemed discriminatory against people with disabilities under the ADA (Astrue, 1994).10 The Clinton Administration later approved the plan after Oregon eliminated all provisions based on quality of life assumptions.

However, the ADA is more limited in its ability to invalidate provisions of private sector health care plans that adversely impact people with disabilities, such as preexisting conditions clauses, annual and lifetime benefits caps, and other limitations on benefits (Batavia, 1993a; Feldblum, 1996). Title I of the ADA specifically prohibits discrimination in employee compensation and in other terms, conditions, and privileges of employment, including health insurance. Title III prohibits discrimination by places of public accommodation, including insurance offices and health maintenance organizations. Therefore, insurance arrangements that discriminate against people with disabilities may be in violation of the ADA.

However, Section 501 (c) (1) and (2) state that the ADA "shall not be construed to prohibit or restrict [insurers, HMOs, and other entities that administer benefit plans] from underwriting risks, classifying risks, or administering such risks that are based on or not inconsistent with State law." On the other hand, section 501 (c) also states that these sections "shall not be used as a subterfuge to evade the purposes of Title I and III." The Department of Justice regulations attempted to clarify the apparent inconsistencies among these provisions by stating that insurers may no longer treat people differently on the basis of disability unless their differential treatment is justified by sound actuarial principles or reasonably anticipated experience. The Equal Employment Opportunity Commission (EEOC) has also attempted to interpret these provisions as they apply in the employment context (Feldblum, 1996).11

The courts are still grappling with these issues. Until resolved definitively, this will continue to be a fertile area for litigation, and the ADA will continue to be used to nullify health care coverage and payment policies by insurers, managed care organizations, unions, and employers that are adverse to people with disabilities. Whether such suits are successful will depend largely on whether the treatment of people with disabilities can be "justified" through sound actuarial data or reasonably anticipated experience. If such justification is provided to the satisfaction of the court, the discriminatory treatment will not result in liability. The problem is that people with disabilities, on average, have higher levels of health care utilization and costs than people without disabilities based on actuarial data (DeJong, Batavia, & Griss, 1989). Consequently, the ADA is not likely to resolve this key issue for people with disabilities. Smoke-Free and Other Chemical Irritant-Free Environments

One of the demands raised most rigorously during the hearings for the regulations for Title III of the ADA was for access to environments that are free from smoke, certain chemicals, and other environmental irritants. People with a wide range of conditions including emphysema, lung cancer, and multiple chemical sensitivity (MCS)12 testified that contact with such irritants can be devastating to them physically, and constitutes discrimination against them by places of public accommodation that have such irritants. The regulations neither explicitly recognize this problem as discrimination, nor do they deny it. For this reason, it is not surprising that there have already been several legal challenges based on this theory.

The U.S. Court of Appeals for the Second Circuit ruled in Staron v. MacDonald's Corp., 51 F.3d 353 (April 4, 1995), that the ADA can be used to protect people who are particularly vulnerable to cigarette smoke (Parmet, Daynard, & Gottlieb, 1996). Children with asthma and an adult with systemic lupus brought an action against the restaurant chain under Title III of the ADA for its policy permitting smoking. The court found that, under those particular circumstances in which the plaintiffs clearly met the definition of disability under the ADA, refusing to prohibit smoking constituted a failure to "make reasonable modifications in policies, practices, or procedures..." to provide access. The employment provisions of Title I of the ADA may also potentially protect people vulnerable to smoke.

Most people claiming that they have MCS have not been successful in having their conditions recognized as disabilities by the courts. However, those who have survived that threshold determination still have been unsuccessful in obtaining the relief they have requested-modifications of their workplace environments by removing environmental irritants, thereby allowing them to function optimally. Most courts have found such accommodations to be unreasonable and not required under Title I of the ADA. Moreover, courts have ruled that such accommodations may constitute undue hardships on the employer (Kelley, 1998).

If the diagnosis of MCS becomes more widely recognized, it is likely that the courts will attempt to find ways in which to accommodate such individuals. With the growing trend of telecommuting, some courts will find that working from home is a reasonable accommodation for people with MCS, at least for certain jobs (e.g., attorneys, accountants). This alternative is not available in Title III cases, in which individuals with MCS claim that places of public accommodation (e.g., perfume counters at department stores) are not accessible. Courts are not likely to mandate comprehensive environmental modifications throughout the country, particularly where the alleged irritant is in the building's infrastructure. In the long run, however, this issue may ultimately affect architectural decisions concerning uses of chemicals in buildings. Attendant Care and Other Personal Assistant Services

Another issue that has been raised is whether employers, state and local governments, and places of public accommodation are required to provide personal assistance services, such as attendant care and interpreter services, to people with disabilities. Access to home and community-based attendant care (as opposed to having to rely on institutional care or unpaid assistance from family members and friends) is one of the most pressing issues on the policy agenda of many disability rights advocates (Batavia, DeJong, & McKnew, 1991). There is no general obligation under the ADA to provide attendant care services. However, under certain specific circumstances, such an obligation may arise. For example, if an employee with a disability is required by an employer to travel overnight, and that employee needs the services of a personal assistant (e.g., to transfer from a wheelchair into bed and to take care of personal care), the ADA would require the employer to pay for the personal assistant during the trip.

Another context in which this issue can arise concerns the obligations of a state in planning and implementing its long-term care policy. Recently, six people with disabilities in Tennessee filed suit against their state Department of Health alleging that "Tennessee illegally forces disabled people into nursing homes by systematically denying them in-home long-term care options through TennCare [the state's Medicaid managed care program]." The suit alleges violations of both the federal Medicaid requirements and the ADA. The ADA cause of action claims that the Tennessee program fails to meet the Title II requirement that services for people with disabilities be provided "in the most integrated setting appropriate."

Similar suits are being filed against states throughout the country by people with disabilities who claim that they should be provided the personal assistance resources necessary for them to live independently in their communities. One seminal case recently decided by the U.S. Supreme Court, Olmstead, Commissioner, Georgia Department of Human Services v. L.C.,13 will have a significant impact on such litigation. This case involved two women with mental retardation and mental illnesses that were institutionalized in a state hospital, and who sought to live and receive treatment in their communities. The Supreme Court ruled that under Title II of the ADA, such individuals must be placed in community settings rather than institutions when the State's treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities.

It is certain that Medicaid recipients with disabilities in every state will also use the language of Olmstead to attempt to receive home-based attendant care in their communities. The extent to which they will be successful will depend largely on how the language concerning "resources available to the state" is interpreted and applied. States that wish to avoid paying for personal assistance services will claim that their budget for long-term care services is not adequate to provide community-based services. Whether this argument will prevail in court remains to be determined. In addition, the Olmstead decision is not applicable to demands on private employers and places of public accommodation for the provision of personal assistance services. It is unlikely that the ADA can be used successfully to achieve that level of social change.

Social Security Reform

Policy analysts have argued that the Social Security Disability Income (SSDI) and the Supplemental Security Income (SSI) programs are out of synchrony with the premises of the ADA and the disability rights/independent living movement (DeJong & Batavia, 1990; Rupp & Stapleton, 1998). These programs were established in an earlier age in which it was not reasonable to expect that the majority of people with disabilities were capable of gainful employment and independence (Berkowitz, 1996; Mashaw, Reno, Burkhauser, & Berkowitz, 1996). They are based largely on a medical model equating impairments with the inability to work (Batavia & Parker, 1995).

Although efforts have been made to modify the programs, and to reduce the work disincentives associated with them, very few beneficiaries ever leave the disability rolls (Rupp & Stapleton, 1998). Until the basic assumptions of these programs are changed, it is unlikely that large numbers of people with disabilities will be able to achieve their independent living objectives (Batavia & Parker, 1995). The ADA may play some role at the state level in modifying disability policies, but it cannot change the major Social Security disability programs on which millions of people with disabilities rely.

Discussion-Strengths and Limitations of a Civil Rights Approach

From a disability perspective, there are several advantages associated with the civil rights approach of the ADA to addressing the problems of people with disabilities. First, many of the primary problems faced by such individuals do relate to discrimination, as broadly defined under the ADA, in the form of manmade and often government-sponsored barriers to access. Thus, by mandating the elimination of such barriers, requiring reasonable accommodations and penalizing such discrimination, we may significantly improve the accessibility of our society and the quality of life of its citizens with disabilities. Even in the key area of employment, in which discrimination is only one of several factors and probably not even the most important one, the elimination of discrimination is likely to have a long-run positive impact through influencing the attitudes of employers. As more and more people with disabilities become part of the mainstream, misconceptions are likely to be dispelled and prejudices are likely to be reduced.

Second, civil rights laws have not been subject to the strict budgetary and regulatory restraints of other types of legislation for people with disabilities. There is a recognition that, because civil rights are fundamental to justice, once they are recognized they must be provided largely irrespective of cost. Congress and the implementing agencies may determine and impose the most cost-effective means of ensuring the right, but cannot deny the right due exclusively to the costs.14 This is an enormous advantage for disability rights advocates.

There are also several significant disadvantages to a civil rights approach. Even if all discrimination against people with disabilities were eliminated, many such individuals will continue to experience problems. In the employment area in particular, most analysts believe it is unlikely that the civil rights approach of the ADA will be successful for people who do not already have jobs (Burkhauser & Daly, 1996; Burkhauser, 1997). They argue that other factors in addition to discrimination are responsible for the high level of unemployment among people with disabilities. These include inadequate education, informational problems, and productivity differentials for such individuals (Baldwin, 1997; Daly, 1997). Others stress that most employment discrimination claims are made by individuals who have jobs and who have lost jobs, not those who are seeking new jobs, and less than half are successful in achieving desired relief (Mudrick, 1997). Still others emphasize that people with disabilities compete in a market in which there are too few jobs (Yelin, 1997).

One of the drawbacks of a civil rights approach is that it generally achieves social change very slowly. The case-by-case approach will have limited utility in altering the fundamental assumptions about the qualities of a worker and the work process. Of course, individual cases can have some deterrent effect on behavior generally. However, ADA cases involving employment discrimination under Title I and failure to make readily achievable modifications under Title III are extremely fact-sensitive and not generalizable to other situations. Many of the accommodations that will be required for individual employees will not have lasting or systemic effects in the workplace. Providing a blind person with appropriate computer technology does not guarantee that all employees with disabilities will be assessed for their optimal needs.

Finally, relying primarily on a civil rights approach alone could prove to be counterproductive in the long run. Because the civil rights model is based fundamentally on fairness, a backlash is likely to occur if the law is perceived to be unfair or subject to abuse in its implementation. On its face, the ADA is a carefully balanced and reasonable statute. It does not require any employer to hire any person with or without a disability who is not the most qualified for the job. It does not require employers to provide any accommodations that are not reasonable. It does not require any modifications to existing buildings that are not readily achievable (unless the building is already undergoing substantial renovation), and it does not impose any costs on any entity for which such costs would be an undue burden or hardship.

However, to the extent that overzealous plaintiffs force employers and covered entities to defend long expensive suits, this can create a negative perception in the eyes of the public. There is no evidence of widespread abuse of the ADA. Yet a few isolated but well-publicized instances of frivolous claims can potentially compromise the credibility of a sound civil rights law. The disability community must continue to be vigilant in policing itself in enforcing the ADA and other disability laws.

Conclusion--Implications for Future Disability Policy

Achieving the objectives of disability policy in the 21st century will be in some ways more difficult and in some ways easier than achieving the progress made in the previous century. It will be easier because the vision of the disability rights/independent living movement, as operationalized legislatively in the ADA, has been firmly rooted and is rapidly being assimilated into our national culture. This paradigm shift is a necessary condition to the achievement of future goals.

It will be more difficult because the "easy" work has already been done. Those employers who are amenable to ADA compliance have complied. Those who are opposed have learned creative ways in which to avoid compliance. Those people with disabilities who have the "tools" to gain access to the opportunities of our society have gained such access. Those who do not have not. The harder job will be to induce those who resist compliance to comply voluntarily in their own self-interest, and to provide the tools to those who do not have them.

A civil rights approach is not likely to achieve the next set of goals. The ADA may, in the long run, indirectly help to change attitudes by exposing more employers to people with disabilities. However, its direct effect on those who resolutely refuse to comply is likely to be small. Moreover, any attempt to increase the direct incentive to comply, by increasing the financial cost of noncompliance, may backfire. These employers may conclude that the best way to avoid liability damages is to avoid hiring people with disabilities in the first place, because liability damages are most likely to be imposed in cases concerning promotions or firings.

This is not to suggest that the ADA is no longer necessary. It remains essential to prohibit existing and future discrimination, to ensure that people with disabilities don't lose the ground they have gained in recent years, and to continue to provide a strong statement that people with disabilities are entitled to all of the rights and privileges of citizenship and residency in this country. However, the ADA and other civil rights laws are rapidly reaching their limits in achieving the broader social reform that will be necessary for people with disabilities to achieve their potential in our society.

We need a new supplemental approach to achieve the goals of people with disabilities.15 The new approach must meet the needs both of people with disabilities and the social institutions with which they interact. It must entail substantial responsibilities on the part of both parties. Without addressing the needs of the institutions as well, the needs of the individuals with disabilities realistically will never be met. Without addressing the responsibilities of people with disabilities, as well as those of the organizations, people with disabilities will never be treated as equals.

Some will criticize that a model based on voluntary mutual accommodation and mutual responsibility, without a legally enforceable mandate and penalties, is unrealistic. They may be correct, and again we are not suggesting that laws based on the civil rights approach be repealed. However, they must also ask themselves whether it is realistic to expect additional civil rights legislation to resolve these issues. How many employers who do not otherwise wish to hire a person who is blind or deaf or brain-injured will do so solely due to the ADA? It is easy enough for an employer simply to conclude that the individual was not the most qualified person for the job. How many judges will be willing to close down a building because it contains chemicals that cause a severe reaction in a relatively few people? Ultimately, unless we can convince social institutions to accommodate people with disabilities, in their own self-interest notwithstanding legal consequences, they will not do so to the extent that is socially optimal.

Disability policy in this century will require a reconceptualization of disability and its consequences by our society.16 The old industrial mindset perceives disabilities as deviations from the norm resulting in financial burdens; needed accommodations are perceived simply as costs. The new information age perspective must perceive disability as one of many human variations, which, if accommodated appropriately, will benefit everyone into the indefinite future. Part of this perspective is recognizing the value of universal design. As we know from the utilization of curbcuts by bicyclists, pedestrians, and parents with baby carriages, the changes we make to accommodate people with disabilities can benefit everyone. The voluntary acceptance of residential building standards that require at least one living area to be accessible would increase building costs modestly, but would benefit all residents who, at some time, might require the use of a wheelchair or other mobility device (e.g., cane, walker).

To the extent that ADA enforcement embraces the new perspective, it is likely to be more effective in achieving fundamental change. For example, the EEOC's ADA regulations indicate that reasonable accommodations for some people with disabilities may include "job restructuring," which may entail irregular work schedules, rest breaks, and time off for treatment."' These requirements, in contrast to raising a desk to accommodate a wheelchair, have touched a nerve in the business community in large part because they address the fundamental assumptions on which work is organized in our society. They are changing the way in which many people perceive work and the relationships associated with it.

Too many of our businesses, under strong competitive pressures, are trapped in an industrial mindset: do it now, do it quick, do it our way. Under a more flexible approach, workers with and without disabilities will be given greater control and responsibility for the production process. This approach has the potential to achieve greater satisfaction for everyone-employees, employers, and particularly people with disabilities who are most disadvantaged by current obsolete systems. Some of the most successful companies in our post-industrial economy have already incorporated this approach by voluntarily adopting flexible policies for all employees, including flexible hours and the ability to work at home. This is already benefiting those people with disabilities who are highly educated and able to contribute their skills to these corporations.

The ADA was enacted with much fanfare. Many policymakers, scholars, and advocates believe that its intention was to create broad, systemic changes that would integrate people with disabilities into the mainstream of society. As this discussion has shown, however, the potential of the ADA to create such social change is inherently limited. The ADA is a necessary, but insufficient, law based on a necessary, but insufficient, theoretical framework to address the many problems faced by people with disabilities in this country. To resolve these problems, and to reduce the enormous gaps between people with and without disabilities, additional policy tools based on new models will be necessary.

Andrew I. Batavia is associate professor at the School of Policy and Management of Florida International University. He formerly served in several key disability policy positions in the federal government, including senior staff member of the White House Domestic Policy Council, Legislative Assistant to U.S. Senator John McCain of Arizona, Special Assistant to U.S. Attorney General Dick Thornburgh, and Executive Director of the National Council on Disability.

Kay Schriner is research professor at the University of Arkansas. She is the founding editor of the Journal of Disability Policy Studies, and has published extensively on a broad array of disability policy issues including employment, voting rights, and the ADA.