RSA-509 - Protection & Advocacy of Individual Rights (PAIR) Program Performance Report

Tennessee (Disability Rights Tennessee) - H240A140043 - FY2014

General Information

Designated Agency Identification

NameDisability Law & Advocacy Center of Tennessee
Address2 International Plaza
Address Line 2Suite 825
CityNashville
StateTennessee
Zip Code37217
E-mail Addresslisap@disabilityrightstn.org
Website Addresshttp://www.disabilityrightstn.org
Phone615-298-1080
TTY
Toll-free Phone800-287-9636
Toll-free TTY
Fax615-298-2046
Name of P&A Executive DirectorLisa Primm
Name of PAIR Director/CoordinatorLisa Primm
Person to contact regarding reportMartha M. Lafferty
Contact Person phone615-298-1080
Ext.128

Part I. Non-Case Services

A. Individual Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas196
2. Individuals receiving I&R outside PAIR priority areas569
3. Total individuals receiving I&R (lines A1 + A2)765

B. Training Activities

1. Number of trainings presented by PAIR staff30
2. Number of individuals who attended training (approximate)1,527

Under our training objective, Disability Law & Advocacy Center of Tennessee (DLAC) presented thirty (30) trainings to approximately 1,527 individuals with disabilities, family members, advocacy organizations, service providers, public school personnel, private attorneys, and others on a variety of topics. The purpose of these trainings was to ensure that participants are aware of the legal rights of individuals with disabilities and the services DLAC offers. Most of these trainings were traditional lecture trainings with questions and answers. In addition, some of these trainings were webinars which allowed for participants to send in questions via email and/or web platform. Training topics included intake; employment discrimination; disability discrimination/disability rights; self-advocacy information and resources; special education with an emphasis on IEP implementation, FBA, BIP, and restraint/isolation issues; disability sensitivity; and the legal rights of people with disabilities who use service animals. When conducting these trainings, DLAC collaborated with many other organizations including the Tennessee Alliance for Legal Services, Legal Aid of East Tennessee, the Tennessee Division of Rehabilitation Services, King & Ballow, Vanderbilt Kennedy Center University Center for Excellence in Developmental Disabilities, Tennessee Works, Tennessee Parent Training and Information Center, Tennessee Voices for Children, Nashville Convention and Visitors Corp, the Center for Independent Living of Middle Tennessee, the Tennessee Disability Coalition, the Tennessee Bar Association, the Arc Tennessee, the Tennessee Council on Developmental Disabilities, Tennessee Community Organizations, University of Tennessee Boling Center University Center for Excellence in Developmental Disabilities, the Tennessee Department of Children’s Services, Behavioral Outreach Services, the National Business Institute, the National Disability Rights Network, the Tennessee Chapter of the American Academy of Pediatrics, and the Sumner County Sherriff’s Association and Tennessee Corrections Institute. Example of our training activities: DLAC partnered with the Tennessee Disability Coalition (TDC) to create and conduct a training about the legal rights of people with disabilities who use service animals. Creation of this training during FY 2014 was a follow up to our successful joint efforts during FY 2013 to educate Tennessee legislators about conflicts between then existing Tennessee law and the Americans with Disabilities Act (ADA) regarding the legal rights of people with disabilities who use service animals. As a result of those efforts, Tennessee law was changed on July 1, 2013 to be consistent with the ADA regarding the rights of service animal users. The Tennessee State Senator who sponsored the legislation changing Tennessee law regarding service animals shared the flyer announcing these trainings on her Facebook page. In addition, on August 8, 2014, Tony Gonzalez, a reporter at the Tennessean newspaper, wrote an article entitled “Sessions to clarify rights of service animal users,” available online at http://www.tennessean.com/story/news/local/2014/08/08/service-dog-trainings-called-business-owners/13803333. This training was geared toward people with disabilities, disability rights advocates, and businesses to share information about service animals, the changes to Tennessee law, and the rights of service animal users under both the new Tennessee law and the ADA. Our specific training goals were as follows: 1. To share information about service animals and applicable TN and federal laws, 2. To equip advocates and businesses with the knowledge and tools to educate others about service animals and applicable laws, and 3. To identify federal and state resources about service animals and applicable laws. We developed a PowerPoint to use during these training sessions along with a quick reference publication with information for service animal users on one side and businesses on the other. During FY 2014, we held three training sessions attended by a total of 35 people. These training sessions were available to people in Knoxville, Nashville, and Memphis, Tennessee. Attendees included people with disabilities who already use service animals, people with disabilities who are exploring the possibility of using a service animal, disability rights advocates from multiple agencies across the state, a restaurant employee, the Nashville International Airport’s ADA Coordinator and Safety Manager, and a staff member from Nashville’s Metropolitan Development and Housing Agency. After each training session, we sent out a follow up survey and received multiple responses indicating the attendees learned information that will be helpful to them going forward. As an example, the staff member from the airport responded as follows: "I learned about the 2 questions that can be asked there is a question about whether an animal is a service animal or not. These would only be appropriate to ask if a person doesn’t have an obvious disability. This training will help us with customer service as our employees interface with customers (with and without disabilities) that are traveling with animals." In addition, that individual shared the training materials with staff in other departments at the Metropolitan Nashville Airport Authority to help educate them about this issue. As a result of these training sessions, individuals with disabilities, advocates, and businesses have accurate information about the rights of people with disabilities who use service animals. In addition, TDC and DLAC now have quick reference flyers that we can disseminate to continue educating others about this issue for years to come.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles15
3. PSAs/videos aired5
4. Hits on the PAIR/P&A website645,931
5. Publications/booklets/brochures disseminated6,995
6. Other (specify separately)186,316

Narrative

During FY 2014, DLAC sent out 186,316 electronic communications to increase awareness about advocacy related issues. These communications included 16 e-newsletters to 20,441 recipients, 308 Facebook Posts viewed by 176,470 people, and Twitter posts that reached 4,800 people. In FY 2014, DLAC added Twitter to its existing social media in order to disseminate time sensitive information in forum that was easily accessible and with a focus on reaching younger demographics.

Part II. Individuals Served

A. Individuals Served

Count individual once per FY. Multiple counts not permitted for lines A1 through A3.

1. Individuals still served as of October 1 (carryover from prior FY)20
2. Additional individuals served during the year73
3. Total individuals served (lines A1 + A2)93
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)6

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 13

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility0
2. Employment12
3. Program access38
4. Housing0
5. Government benefits/services0
6. Transportation0
7. Education27
8. Assistive technology0
9. Voting0
10. Health care0
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse3
16. Neglect19
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor47
2. Other representation found2
3. Individual withdrew complaint20
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.2
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit13
9. Other2

Please explain

One was closed administratively due to the following: Information this client provided during intake indicated the client’s issue should be opened under PAIR. However, the documentation of disability which this client provided after case opening indicated that client’s issue should be funded under another grant.

One was closed administratively because it was initially opened under an incorrect PAIR objective due to a clerical error.

E. Intervention Strategies Used in Serving Individuals

List the highest level of intervention used by PAIR prior to closing each case file.

1. Technical assistance in self-advocacy10
2. Short-term assistance23
3. Investigation/monitoring29
4. Negotiation24
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)0
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 40
2. 5 - 2230
3. 23 - 5936
4. 60 - 649
5. 65 and over18

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females41
2. Males52

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaskan Native0
3. Asian2
4. Black or African American22
5. Native Hawaiian or Other Pacific Islander0
6. White63
7. Two or more races0
8. Race/ethnicity unknown4

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent45
2. Parental or other family home32
3. Community residential home0
4. Foster care0
5. Nursing home7
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center9
9. Homeless0
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

Identify the individual's primary disability, namely the one directly related to the issues/complaints

1. Blind/visual impairment7
2. Deaf/hard of hearing29
3. Deaf-blind0
4. Orthopedic impairment12
5. Mental illness0
6. Substance abuse0
7. Mental retardation0
8. Learning disability19
9. Neurological impairment14
10. Respiratory impairment1
11. Heart/other circulatory impairment1
12. Muscular/skeletal impairment1
13. Speech impairment1
14. AIDS/HIV0
15. Traumatic brain injury1
16. Other disability7

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities24

2. Number of individuals potentially impacted by policy changes940,525

Describe your systemic activities. Be sure to include information about the policies that were changed and how these changes benefit individuals with disabilities. Include case examples of how your systemic activities impacted individuals served.

1-6. DLAC engaged in six (6) systemic projects to ensure that medical providers, including physicians and dentists, provide effective communication. These activities resulted from DLAC being alerted to problems that people who are deaf or hard of hearing have experienced in these settings. As a result of these activities, multiple medical providers will now provide sign language interpreters and/or other appropriate auxiliary aids and services to individuals who are deaf or hard of hearing, including patients and their companions. In addition, these medical providers are no longer charging individuals who are deaf or hard of hearing for the cost of providing sign language interpreter services. Similarly, these providers no longer require patients who are deaf or hard of hearing to try to communicate by exchanging written notes for complex or lengthy topics. Following is an example of these activities: DLAC was contacted by a 68-year-old, African American female who is deaf. She told us that her physician would not provide her with a sign language interpreter for her medical appointments. Our client reported that for two appointments she requested an interpreter but one was not provided. Our client reported that she paid for interpreter services herself so that she could communicate during these medical appointments. DLAC contacted the doctor’s office and explained the Americans Disabilities Act (ADA) requirements regarding effective communication. The doctor’s office agreed to provide interpreter services for all of our client’s subsequent office visits and to reimburse her for the costs she incurred when providing interpreters for her first two appointments. The doctor’s office also agreed to provide auxiliary aids and services, including sign language interpreters, when necessary for effective communication with any patient in the future. We followed up with our client and confirmed that her doctor provided a qualified sign language interpreter at the subsequent appointment. As a result of DLAC’s intervention, our client and other individuals with disabilities will receive effective communication at this physician’s office. As a result of DLAC’s activities to educate physician’s offices and hospitals such as the one in this example about the ADA’s effective communication requirements, approximately 125,000 people with hearing disabilities will have effective communication during interactions with medical providers. 7-12. DLAC addressed inappropriate service animal policies at six (6) businesses, including two (2) doctors’ offices, a funeral home, a grocery store, and a restaurant. One example of these activities follows: A 49-year-old Caucasian woman who is blind and uses a service animal DLAC for assistance because the manager of a West Tennessee location of a national chain restaurant refused to serve her while she was accompanied by her service animal. Our client also told us that the restaurant manager said he would serve her if she left her service dog outside. DLAC contacted the restaurant manager and company president regarding this incident and explained the ADA’s provisions regarding service animal users. The company’s president conducted an internal investigation and confirmed the refusal of service by the manager. The president reported to us that the company conducts periodic trainings for all managers and employees about ADA issues including service animal issues. In addition, he reported that due to this incident, the company provided training to the manager who refused service to our client and all employees at the company’s multiple restaurants regarding the rights of people with disabilities who use service animals. The company used training materials provided by DLAC in these training activities. This company also apologized to our client and gave her three coupons for free meals at any of its restaurants. Our client and all people with disabilities who use service animals will be able to eat at all west Tennessee locations of a national chain restaurant without worrying about discrimination. DLAC’s systemic advocacy will impact the lives of approximately 25,000 people with disabilities who use service animals. 13. A building in Nashville has become more accessible due to DLAC systemic advocacy. DLAC was contacted by a 54-year-old African American woman with a mobility disability. She told us that the building in which her doctor’s office and other medical offices are located does not have an accessible entrance. We educated the building’s owner about ADA accessibility requirements and requested changes to address our client’s specific issues. The owner agreed to address those issues and made the following changes: 1. installation of an automatic door, 2. creation of additional accessible parking spaces, and 3. creation of accessible path of travel. As a result of these changes, our client and other people with mobility disabilities will be able to readily access this building and the services of businesses therein. We estimate these changes will impact 100 people with mobility disabilities. 14. The Partnership for Families, Children and Adults (PFCA) in Chattanooga, Tennessee alerted DLAC about a communication discrimination issue. PFCA informed us that a State of Tennessee department had refused to provide a sign language interpreter for a deaf person’s upcoming administrative hearing. We initially provided PFCA with a copy of the Tennessee law that specifically requires Tennessee departments to provide sign language interpreters for administrative hearings in which there is a deaf party or witness. PFCA attempted to educate the Tennessee department about its responsibility to provide a sign language interpreter for the upcoming hearing. However, the department claimed that the law did not apply and also indicated that providing a sign language interpreter would be too expensive. At that point, DLAC provided legal representation to this client. We contacted the general counsel for the department in question, educated that attorney and other department attorneys about the applicable law, and obtained their agreement to provide a sign language interpreter for our client’s upcoming administrative hearing. As a result of our assistance, our client was able to effectively communicate during his administrative hearing about property that had been seized by the State of Tennessee. In addition, this Tennessee department now understands its responsibility to provide sign language interpreters for deaf parties and witnesses in the future. This outcome will impact approximately fifty (50) deaf individuals. 15. A juvenile court in a rural East Tennessee county refused to provide a sign language interpreter to our deaf client for her minor child’s court proceeding. Our client, a 42-year-old African American, contacted DLAC for help with this issue. She told us that she needed to be able to understand the court proceeding in order to provide support for her son. DLAC provided attorney representation for this issue. We informed the court clerk about the effective communication requirement of the Americans with Disabilities Act (ADA) and he agreed to provide our client with a sign language interpreter for the upcoming court proceeding and all future court proceedings she plans to attend in her minor son’s case. We also explained to this client the process for requesting an interpreter for future proceedings. As a result of DLAC assistance, our client was able to meaningfully participate in her son’s court proceeding and understands how to request interpreters for future proceedings. In addition, this court clerk now understands how to comply with the ADA’s effective communication requirement in order to meet the needs of court participants who are deaf. We anticipate this outcome will impact approximately 25 people who are deaf. 16. DLAC assisted a metropolitan housing authority with reviewing and revising its effective communication policy as a result of a conciliation agreement set forth by the U.S. Department of Housing and Urban Development (HUD). The HUD conciliation agreement addressed a complaint filed by a DLAC client against this housing authority which managed her apartment building. The incident which precipitated the filing of the complaint with HUD occurred when the housing authority police failed to provide effective communication to our client, who is deaf, when presenting a search warrant, searching her apartment and issuing a citation. The conciliation agreement, which was reached during FY2013, set forth specific terms to be addressed, one of which required the housing authority to prepare and readily provide an effective communication policy for individuals with disabilities. DLAC and the housing authority worked together during FY2014 to complete the revisions to the effective communication policy and the housing authority subsequently disseminated the policy throughout its offices and residential facilities. This policy change has the potential impact 200 people with disabilities which impact communication. 17. DLAC visited a counseling center in a rural area and noted accessibility issues related to the path of travel to the center’s entrance and parking. DLAC brought these issues to the center’s attention, provided resource information about potential solutions, and advocated for this business to remedy the identified issues. The counseling center ultimately agreed to resolve the concerns. Because of DLAC’s advocacy efforts, approximately 150 individuals with mobility disabilities will now be able to fully access services provided by this agency. 18. DLAC continued to participate in the Functional Needs Sheltering group, which coordinates the planning for integrated sheltering for persons with disabilities in the event of an emergency. This collaborative effort consists of county emergency managers, American Red Cross personnel, Tennessee Emergency Management representatives, county public health officials, and representatives from the Tennessee Department of Health and Human Services. DLAC is the only disability representative on the group. This group actively addresses the emergency sheltering needs of individuals with disabilities and other functional needs in approximately forty (40) counties in the Appalachian region. Approximately 75 % of these counties are rural and significantly underserved. In the event of emergency, the individuals most likely to use shelters are individuals in lower socio-economic demographics and those who lack natural support systems. These activities will continue in FY 2015 and have the potential to impact 200,000 people with disabilities. 19. DLAC participated as a member of the AccessRide Policy Advisory Committee (APAC) of the Metropolitan Transit Authority (MTA). DLAC questioned and verified policies, provided suggestions to improve the AccessRide Riders’ Handbook and placed useful ideas on the table in an effort to assist in improving the door to door service for people with disabilities. This year several issues have been identified that need to be addressed such as double booking passengers, developing a no-show policy that is open to interpretation and not user friendly, internal procedure breakdowns that negatively affect the ridership and accountability issues. DLAC will work on an ongoing basis to provide solutions and impact change for approximately 20,000 people with disabilities so they can live their lives without barriers. 20. DLAC participated in the Citizens Advisory Committee for the Amp in Nashville. The Amp is a proposed full-service 7.1 mile bus rapid transit system that is being planned for one of Nashville’s major corridors. The mayor requested DLAC’s participation due to our agency’s systemic work regarding transportation issues impacting the disability community. This non-partisan, advisory body has provided regular feedback and recommendations to the Metropolitan Transit Authority’s (MTA) Amp engineers to assist in the final design of the project. In addition, this committee has served as a vehicle for the MTA to share information on a regular basis about the Amp design with the community that each member represents. The committee has tentatively approved two thirds of the route design but is reserving final judgment until travel data is presented in order to confirm the route will allow large numbers of people to travel more quickly than by automobile. This ongoing project has the potential to impact 20,000 people with disabilities and will be completed in FY 2015. 21. DLAC signed onto the Council for Parent Attorneys and Advocates’ (COPAA) amicus brief supporting the appellant student’s position in the Sixth Circuit case F.H. v. Memphis City Schools, Case No. 13-6323. In addition, DLAC organized several other statewide advocacy agencies to sign onto COPAA’s brief. In his Complaint, this student and his mother alleged that the Memphis City Schools allowed for the abuse and neglect of this student and breached a settlement agreement. There were several issues on appeal. The primary issue was that the lower court dismissed these claims because plaintiffs filed them directly in federal court instead of first exhausting administrative remedies. The Sixth Circuit reversed the lower court and made clear in its holding that abuse and neglect are not issues which arise under the Individuals with Disabilities Education Improvement Act (IDEIA) and, therefore, do not require exhaustion. The Court also explained that “…requiring exhaustion of Appellants’ 42 U.S.C. § 1983 claims would create an additional administrative barrier not present for non-disabled children.” It is estimated this result has the potential to impact 100,000 students with disabilities. 22. People with all types of disabilities continue to have increased access to Tennessee’s court program as a result of DLAC’s systemic efforts toward that end. During fiscal year 2014, DLAC engaged in ongoing collaborations to ensure that people with disabilities have effective access to TN’s court program by conducting activities including but not limited to the following: We continued informally monitoring compliance of the State of Tennessee and all Tennessee counties with the ADA and ADA Judicial Branch Policy that result from Lane v. Tennessee. We reviewed intake calls and individual cases regarding court program accessibility issues to identify any patterns that may indicate systemic compliance issues. We also remained available as a resource for the Tennessee Administrative Office of the Courts’ (AOC) ADA Coordinator for the State Court Program and participated in the education subcommittee of the Tennessee Supreme Court’s Access to Justice (ATJ) Commission. In addition, we provided input to private attorneys with questions about the process for requesting from Tennessee courts disability related reasonable modifications for themselves and/or their clients. In March 2014 DLAC’s Legal Director spoke on a panel with members of the Tennessee Supreme Court and others at the National Judicial College conference in Nashville. She discussed our Lane v. Tennessee case and the resulting Tennessee Judicial Branch ADA Policy. She also discussed the improvements in access to justice for Tennesseans with disabilities a result of the Lane case and Judicial Branch ADA Policy. In addition, she discussed remaining barriers preventing people with disabilities from full access to justice in Tennessee, focusing on barriers experienced by people who are deaf. These activities have the potential to impact approximately 50,000 Tennesseans with disabilities who interact with Tennessee’s court program. 23. DLAC participates in the Employment First Taskforce which was established by Executive Order No. 28, “An Order Establishing the Tennessee Employment First Initiative to Expand Community Employment Opportunities for Tennesseans with Disabilities.” The purpose of this taskforce is to identify state barriers to employment for people with disabilities and to develop recommendations (i) to eliminate those barriers, (ii) identify best practices to increase competitive and integrated employment for Tennesseans with Disabilities and (iii) provide training/information to stakeholders to increase their awareness of effective strategies to improve competitive and integrated employment outcomes for Tennesseans with disabilities. This taskforce, which includes state agencies, nonprofit organizations, universities, service providers and Tennesseans with disabilities and their families, met quarterly throughout the year and in September issued a report to the Governor of Tennessee entitled "Expect Employment." Accomplishments achieved during the first year following the signing of the Executive Order include, but are not limited to, the following: (i) Identification of employment barriers to employment of individuals with disabilities through processes such as community conversations and surveys of families of individuals with disabilities. (ii)Development of recommendations to reduce or eliminate those barriers through updating of policies of several state agencies, commencement of revision of Medicaid waivers to support employment as a first option, preparation of a draft memorandum of understanding between 5 state agencies to align goals, priorities and resources for transitioning youth and expansion of a data system to include relevant data from multiple state agencies and their clients. (iii)Identification of best practices and resources to increase integrated and competitive employment opportunities, which included the launch of an Individual Placement and Supports program in four community health centers, revised service agreements between VR and its vendors to create stronger incentives for vendors to achieve employment outcomes and implementation of Project SEARCH at two new sites. The taskforce has developed seven recommendations for the upcoming second year of its operation, including creation and implementation of a three year strategic workforce development plan, engaging and supporting Tennessee businesses in employing Tennesseans with Disabilities and increasing the knowledge of individuals with disabilities and their families about the benefits of employment as a life goal. This activity is ongoing and has the potential to impact 200,000 people with disabilities. 24. During FY2014 DLAC responded to a wide range of policy and legislative initiatives with the potential to impact Tennesseans with disabilities. DLAC staff researched and tracked hundreds of pieces of Tennessee legislation, providing weekly updates to DLAC’s leadership team and attorneys, board of directors, partner agency staff, and over 100 other interested community members in an effort to keep all informed of the day to day movement of legislation of interest to the disability community. Additionally, DLAC collaborated with other disability focused organizations to educate policy makers on the implication of proposed legislation. DLAC also partnered with other disability focused and social service organizations to host legislative advocacy days such as Disability Day on the Hill, Children’s Advocacy Days, and Social Work Day on the Hill. Through DLAC’s policy work, staff also kept abreast and responded to federal legislative efforts such as the Convention on the Rights of Persons with Disabilities and restraint and isolation in educational settings. To increase our agency’s visibility and reliability as a leading resource about disability issues during the past year, DLAC also responded to a number of issues with potential impact for Tennesseans with disabilities through submission of public comments. A sampling of public comments provided by DLAC to state agencies/departments and federal entities includes the following: Tennessee Division of TennCare regarding assistive technology, transition planning, waiver reform, waiver renewal; Tennessee Division of TennCare/Tennessee Department of Intellectual and Developmental Disabilities regarding concept paper which outlined services; Tennessee Department of Intellectual and Developmental Disabilities about the Provider Manual draft document; Tennessee Department of Education regarding proposed rule changes including Occupational Diploma; United States National Park Service regarding proposed service animal regulation; United States Internal Revenue Service about guidance for tax-exempt social welfare organizations on candidate-related political activities; Public Hearings for the Tennessee Human Rights Commission, National Commission on Voting Rights Regional, and the Tennessee Department of Human Services Division of Rehabilitation Services FY2015 State Plan. These public policy activities have the potential to impact 150,000 people with disabilities.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts125,000
2. Number of individuals named in class actions0

Describe your litigation/class action activities. Explain how individuals with disabilities benefited from your litigation activities. Be sure to include case examples that demonstrate the impact of your litigation.

DLAC currently represents clients in two (2) federal lawsuits alleging failure of hospitals to provide effective communication to deaf patients and/or deaf companions. Both lawsuits allege the hospitals failed to consistently provide qualified sign language interpreters. One of the hospitals repeatedly asked a deaf patient’s hearing family members to help with communication. The other hospital repeatedly relies upon a Video Remote Interpreting (VRI) service which does not meet the Americans with Disabilities Act (ADA) requirements for VRI and does not result in effective communication for our clients. Both lawsuits are in their initial stages. It is likely that resolution of these claims will impact approximately 125,000 persons who are deaf or hard of hearing.

Part V. PAIR'S Priorities and Objectives

A. Priorities and Objectives for the Fiscal Year Covered by this Report

For each of your PAIR program priorities for the fiscal year covered by this report, please:

  1. Identify and describe priority.
  2. Identify the need, issue or barrier addressed by this priority.
  3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
  4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
  5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions.
  6. Provide at least one case summary that demonstrates the impact of the priority.

Many PAIR activities conducted throughout the fiscal year are completed in collaboration with other grants under which DLAC provides services. While individual cases are funded under one grant, other activities such as systemic projects, trainings, collaborations, outreaches, monitoring activities and similar projects may be conducted under more than one grant. Priority 1: Persons with disabilities will experience reduced abuse and neglect. Need addressed: Individuals with disabilities continue to experience abuse and neglect in public and private facilities in Tennessee due to limited resources, lack of knowledge of service providers, lack of supervision by service providers, lack of effective oversight by administrators, and the failure to follow identified best practices. Objective 1: Investigate 6 significant injuries or incidents that appear to result from abuse/neglect in institutional or community facilities. Objective 2: Monitor institutional and community facilities as to protect the residents’ safety and civil rights. Collaboration with other entities: collaboration with other organizations addressing abuse/neglect issues including Tennessee’s Regional Abuse Neglect Prevention Committees, the Tennessee Department of Children’s Services, the Tennessee Department of Human Services, the Tennessee Department of Mental Health and Substance Abuse Services, and the Tennessee Department of Intellectual and Developmental Disabilities. Number of investigations of significant injuries/incidents: 15 Number of monitoring projects: 18 Case Summary: A family member of a 61-year-old Caucasian man with a mobility disability contacted DLAC to report concerns about his lack of medical care at the prison where he is incarcerated. When we met with our client, we observed that his legs were swollen, red, and had fluid draining from them. He told us that he was being treated for cellulitis by oral antibiotics and was in extreme pain. Upon observing this client’s egregious condition, DLAC demanded in writing that this prison provide our client with more aggressive medical treatment. During the course of this investigation our client was transferred to a second prison which sent him to the hospital where he was diagnosed with Methicillin-resistant Staphylococcus aureus (MRSA) infection, treated, and sent to a special needs prison for ongoing care. Upon the review of his medical records, DLAC learned that the facility under investigation had performed lab tests on our client which were positive for MRSA. However, that facility failed to quarantine our client or send him to another facility for more aggressive care. DLAC concluded that the facility under investigation failed to provide our client with timely and effective medical care. DLAC also concluded that this failure resulted in our client’s development of MRSA and put him at risk of significant health consequences including death. As a result of this investigation DLAC issued recommendations to the facility and will be further addressing these concerns systemically during Fiscal Year 2015. DLAC recommended that this prison take the following actions: 1. Maintain sick call forms as a part of each inmate’s medical file, 2. Provide timely and effective medical care to all inmates, 3. Seek outside medical treatment when more aggressive care is needed, 4. Review the care that inmates are receiving from the existing medical provider to determine if there is a need to secure a new provider who can provide effective care to inmates housed at this facility. Priority 2: Persons with disabilities will be protected from disability related discrimination. Need addressed: Individuals with disabilities continue to experience communication discrimination in business and government settings. For example, many businesses and government programs are reluctant to provide auxiliary aids and services such as sign language interpreters and information in alternate formats. Individuals with disabilities also continue to experience discrimination in employment. Such discrimination includes refusal to hire, termination, and failure to grant necessary reasonable accommodations. In addition to communication discrimination and employment discrimination, there continue to exist other discriminatory policies and practices which negatively impact people with disabilities. For example, some businesses are refusing to allow people with disabilities to be accompanied by their service animals. Objective 1: Assist 40 persons experiencing communication discrimination in business and government settings. Objective 2: Assist 7 persons experiencing discrimination in employment. Objective 3: Advocate to change 3 selected discriminatory policy and/or practice. Collaboration with other entities: collaboration with other organizations addressing communication discrimination, employment discrimination, and discriminatory policies and practices including Tennessee Association for the Deaf, the various Communication Centers for the Deaf and Hard of Hearing across Tennessee, Tennessee Council for the Deaf, Deaf-Blind, and Hard of Hearing, Tennessee’s Administrative Office of the Courts, Tennessee Employment Consortium, Tennessee Alliance of Legal Services’ Employment Law Task Force, Tennessee Bar Association, Tennessee Disability Coalition, Tennessee Employment Lawyers Association, Tennessee Rehabilitation Centers, Tennessee Career Centers, and Vocational Rehabilitation Job Placement Vendors. Number of persons assisted with communication discrimination: 59 Number of persons assisted with employment discrimination: 9 Number of discriminatory policies and/or practices DLAC advocated to change: 18 Case Summaries: A 49-year-old African-American male who is deaf contacted DLAC to report concerns regarding an area Tennessee Career Center (CC). Our client visited the CC to seek assistance in filing for unemployment insurance benefits and requested that the center provide a sign language interpreter to ensure effective communication. The CC did not provide an interpreter and provided multiple pages of information to explain the filing process and the next steps our client should complete. Because American Sign Language, rather than English, is our client’s primary language, he was unable to understand the written information and did not complete the steps as outlined. After not receiving any benefit payments, he contacted DLAC for assistance. DLAC contacted the CC to discuss our client’s issue. The CC then contacted the state unemployment benefits office to request further information. Our client subsequently received a payment for the entire amount of the unemployment benefits due to him. DLAC obtained detailed information from the state office regarding the calculation of our client’s benefits and in turn provided that information to our client during a meeting. DLAC and our client met with the staff at the CC to review his case issues. The CC manager reported that all staff in that facility and in a nearby CC received training in the provision of effective communication for individuals with disabilities and learned the process for providing a sign language interpreter when requested by clients of the CC. Our client also demonstrated to the CC staff how individuals who are deaf can use the video relay system at the CC to place phone calls when seeking unemployment benefits or when setting up job interviews. As a result of DLAC intervention, our client received his unemployment insurance benefits and the staff of two area career centers received training in regards to the provision of effective communication for individuals with disabilities. In the future, individuals with disabilities will receive auxiliary aids and services upon request in order to fully participate in the programs and services of these area career centers. DLAC received three complaints from people with mobility disabilities about physical barriers preventing access to School Board meetings in an East Tennessee county. DLAC investigated the complaints and confirmed that these meetings were being held on the second floor of a building which lacked an accessible entrance to that floor. In addition, we confirmed that the school board has a practice of requiring that people with disabilities give 48 hours prior notice of planned attendance in order for the meeting to be moved to an accessible location. DLAC educated the school system about the Americans with Disabilities Act’s (ADA) program accessibility requirements and advocated for a change in the location of the meeting as a temporary solution to the issue. In addition, DLAC advocated for renovations to the building in order to create a permanent solution. As a result of DLAC’s advocacy efforts, the school board agreed to rotate meetings among accessible schools in the county and to renovate the entire building where school board meetings ad been held. This renovation includes not only moving the meeting room to the accessible first floor but also making all first floor bathrooms accessible. During FY 2015, DLAC will monitor these planned renovations. Priority 3: People with disabilities will be integrated in the community. Need addressed: There is an ongoing failure of Tennessee school systems to appropriately implement IEPs and 504 plans. These school systems also fail to develop appropriate Functional Behavior Assessments and Behavior Intervention Plans. There is an ongoing need for increased community services for people with disabilities. DLAC continues to work to ensure that non-English speaking persons have access to disability related information. Objective 1: Advocate for community services for people with disabilities Objective 2: Advocate for appropriate implementation of 4 IEPs and 504 plans. Objective 3: Advocate for 2 appropriate Functional Behavior Assessments (FBAs) and Behavior Intervention Plans (BIPs). Objective 4: Provide disability related information to non-English speaking persons. Collaboration with other entities: collaboration with other entities addressing community integration including Disability Coalition on Education, Tennessee Voices for Children, Tennessee Division of Rehabilitation Services, Encuentro Latino, and Multicultural Alliance on Disability. Number of projects to advocate for community services: 1 Number of students assisted with IEPs and 504 Plans: 17 Number of students assisted with FBAs and BIPs: 5 Number of projects to provide disability related information to non-English speaking persons: 2

Case summaries: The concerned mother of a 12 year-old Caucasian female student diagnosed with ADHD and Specific Learning disability from an urban county contacted DLAC because the school was not properly implementing her daughter’s Individualized Education Program (IEP). This parent explained that the school purchased a reading and math program to assist her daughter but school staff were not utilizing the program. The parent also reported that the staff had not been appropriately trained about how to use the program. The parent reports that based on the IEP the program is to be utilized 4 times a week for 30 minutes. Parent also told us that her daughter’s grades are declining and she had not made any progress since starting the reading program. She also reported that she requested a re-evaluation due to the deficits but the school had not begun the process. DLAC reviewed education records and determined that there were no progress reports relating to the program or any progress monitoring. Our client’s grades did reflect a continued deficit in reading and in math. DLAC attended several IEP meetings and advocated to ensure appropriate academic supports were provided to meet client’s IEP goals. This included a revised schedule to ensure all direct service hours were met in the IEP and an agenda to facilitate communication regarding progress. The school staff agreed to also send progress monitoring reports home every two weeks related to the reading and math programs. DLAC further ensured school staff were appropriately trained in regards to both state approved computerized academic intervention programs by the Assistive Technology Specialist for the school district. Subsequent to the staff completing the training, our client showed marked improvement within three weeks. In addition, DLAC advocacy resulted in the school completing a full comprehensive psycho-educational re-evaluation for this student. That evaluation demonstrated that our client does continue to meet the criteria for a specific learning disability. DLAC assisted in ensuring a revised school schedule so that our client received additional services in special education, academic intervention, and related services. Through this process, this student and her family also gained self-advocacy skills that will enable them to successfully navigate educational issues that may arise in the future and our client now has the supports and skills she needs to be successful in the school environment A young man whose grades were falling and who was getting into trouble on a daily basis at school is now excelling academically and behaviorally in school. DLAC was contacted by the parent of an eleven-year-old African American male with ADHD who lives in an urban area. This parent asked for our agency’s help obtaining appropriate behavior supports for her son. DLAC worked with the parent, the school and the client’s doctor to ensure continuity of services between home and school. A new Functional Behavior Assessment and Behavior Support Plan (BSP) were completed for the client. At the end of the school year, a meeting was held with the current teaching staff as well as the teaching staff for the upcoming school year to review the BSP. The IEP team met again after the beginning of the school year to amend the BSP for the current school year. Thanks to the revisions to the BSP and successful implementation of the BSP, the client has improved his grade point average considerably and has had no significant behavior issues.

Priority 4: Persons with disabilities will become empowered to exercise their rights, access services, and live independently. Need addressed: Priority 4 addressed information, leadership and empowerment (ILE) activities. In addition, our agency conducted additional ILE activities directly related to Priorities 1-3. All ILE activities addressed the needs of individuals with disabilities, family members or guardians, advocacy organizations, service providers, local and state government officials and staff, the general public and others to increase their level of knowledge about the legal rights of individuals with disabilities. These activities supported the empowerment of individuals with disabilities to become independent and enjoy the same opportunities as persons who do not have disabilities. Objective 1: Provide general agency information through outreach and training and obtain public comment and input on future agency priorities. Objective 2: Collaborate in community, state, or national efforts to expand the rights of persons with disabilities and increase services to meet needs. Collaboration with other entities: Tennessee Administrative Office of the Courts, Knoxville Center of the Deaf, Bridges, Deaf Connect, Partnership for Families Children and Adults, Tennessee Bar Association, King & Ballow, Tennessee Disability Coalition, Tennessee Health Care Campaign, Nashville Cares, Legal Aid Society of Middle Tennessee, Baptist Healing Trust, Seedco, Disability Coalition on Education, Tennessee Department of Education, Sumner County Sheriff’s Office, Support and Training for Exceptional Parents, Tennessee Voices for Children, Tennessee Alliance for Legal Services, Legal Aid of East Tennessee, Memphis Area Legal Services, Tennessee Division of Rehabilitation Services, Vanderbilt Kennedy Center University Center for Excellence in Developmental Disabilities, Tennessee Works, Nashville Convention and Visitors Corp, Center for Independent Living of Middle Tennessee, Arc Tennessee, Tennessee Council on Developmental Disabilities, Tennessee Community Organizations, University of Tennessee Boling Center University Center for Excellence in Developmental Disabilities, Tennessee Department of Children’s Services, Behavioral Outreach Services, the National Business Institute, the National Disability Rights Network, Tennessee Chapter of the American Academy of Pediatrics, World Relief, the Tennessee Early Intervention Service, Metro. Nashville Social Services, National Weather Service, Tennessee Emergency Management Agency, Metro. Nashville Office of Emergency Management, Voluntary Organizations Active in Disaster, Tennessee Higher Education Commission, Vanderbilt’s Equal Opportunity Affirmative Action and Disability Services Department, Memphis Center for Independent Living, City of Knoxville American Red Cross - ET Chapter, Knoxville Emergency Management Agency, Knox County Health Department, National Federal of the Blind—Tennessee Chapter, Middle Tennessee Council of the Blind, Tennessee Association of the Deaf, Tennessee Registry of Interpreters for the Deaf, Tennessee Library Services for the Deaf, Nashville Metropolitan Transit Authority, Rochelle Center, Allied Taxi, Autism Society of East Tennessee; disAbility Resource Center; City of Knoxville; East Tennessee Technology Access Center; Knox County Community Action Committee; Knoxville Area Transit; Tennessee Career Center, City of Knoxville Community Action Commission, Goodwill Industries, Amputee Coalition, University of Tennessee Community Advocates, Council of Parents Attorneys Advocates, Statewide Independent Living Council, Court Appointed special Advocates, Tennessee Commission on Children and Youth, Tennessee Child Advocacy Centers, and Tennessee District Public Defenders Conference, Encuentro Latino, and Multicultural Alliance on Disability. There were no numeric goals set for the objectives under this priority. As described below, DLAC participated in numerous information, empowerment and leadership (ILE) activities. Number of outreach activities, training sessions, and public comments: 404 Number of collaboration projects: 50 Impact of priority: These activities addressed issues including but not limited to abuse/neglect, special education, disability discrimination, effective communication, access to the court system for people with disabilities, employment issues, and community services. Although it is difficult to precisely determine the number of persons this priority may impact, DLAC estimates that our collaborative efforts have the potential to impact approximately 1 million individuals with disabilities in Tennessee.

B. Priorities and Objectives for the Current Fiscal Year

Please include a statement of priorities and objectives for the current fiscal year (the fiscal year succeeding that covered by this report), which should contain the following information:

  1. a statement of each prioirty;
  2. the need addressed by each priority; and;
  3. a description of the activities to be carried out under each priority.

Many PAIR activities conducted throughout the fiscal year will be completed in collaboration with other grants under which DLAC provides services. While individual cases will be funded under one grant, other activities such as trainings, collaborations, outreaches, monitoring activities and similar projects may be conducted under more than one grant. Priority 1: Persons with disabilities will experience reduced abuse and neglect. Objective 1: Investigate significant injuries or incidents that appear to result from abuse/neglect in institutional or community facilities. Objective 2: Monitor institutional and community facilities as to protect the residents’ safety and civil rights. Need addressed: Individuals with disabilities continue to experience abuse and neglect in public and private facilities in Tennessee due to limited resources, lack of knowledge of service providers, lack of supervision by service providers, lack of effective oversight by administrators, and the failure to follow identified best practices. Anticipated Activities: Investigations; individual advocacy; systemic advocacy; negotiation; monitoring visits; use of media coverage when appropriate; educating policy makers when appropriate; legal representation if issues cannot be resolved at a lower level; and collaboration with other organizations addressing abuse/neglect issues such as Tennessee’s Regional Abuse Neglect Prevention Committees, Tennessee Department of Children’s Services, Tennessee Department of Human Services, Tennessee Department of Mental Health and Substance Abuse Services, and Tennessee Department of Intellectual and Developmental Disabilities. Priority 2: Persons with disabilities will be protected from disability related discrimination. Objective 1: Assist persons experiencing communication discrimination in business and government settings. Objective 2: Advocate to change selected discriminatory policies and practices. Need addressed: Individuals with disabilities continue to experience communication discrimination in business and government settings. For example, many business and government providers are reluctant to provide auxiliary aids and services such as sign language interpreters and information in alternate formats. In addition to discrimination in communication and employment, there continue to exist other discriminatory policies and practices which negatively impact people with disabilities. For example, businesses are refusing to allow people with disabilities to be accompanied by their service animals. Anticipated Activities: Individual advocacy; systemic advocacy; negotiation; use of media coverage when appropriate; educating policy makers when appropriate; legal representation if issues cannot be resolved at a lower level; and collaboration with other organizations addressing communication discrimination and employment discrimination such as Tennessee Association for the Deaf, the various Communication Centers for the Deaf and Hard of Hearing across Tennessee, Tennessee Council for the Deaf and Hard of Hearing, Tennessee Chapter of the National Federation of the Blind, the Tennessee Chapter of the American Council of the Blind, Tennessee’s Administrative Office of the Courts, Tennessee’s Access to Justice Commission’s Education Committee, Tennessee Employment Consortium, Tennessee Alliance of Legal Services’ Employment Law Task Force, the Tennessee Employment Lawyers Association, Tennessee Rehabilitation Centers, Career Centers, and Vocational Rehabilitation Job Placement Vendors. Priority 3: People with disabilities will be integrated in the community. Objective 1: Advocate for increased community services for people with disabilities. Objective 2: Advocate for appropriate implementation of IEPs and 504 plans. Objective 3: Advocate for appropriate Functional Behavior Assessments and Behavior Intervention Plans. Objective 4: Provide disability related information to non-English speaking persons. Need addressed: People with disabilities have an ongoing need for increased community services. There is an ongoing failure of Tennessee school systems to appropriately implement IEPs and 504 plans. These school systems also fail to develop appropriate Functional Behavior Assessments and Behavior Intervention Plans. DLAC continues to work to ensure that non-English speaking persons have access to disability related information. Anticipated activities: Individual advocacy; systemic advocacy; negotiation; use of media coverage when appropriate; legal representation if issues cannot be resolved at a lower level, media activities when appropriate; education of policy makers; and collaboration with other organizations addressing these issues such as the Developmental Disabilities Network Partners, the Disability Coalition on Education, The Arc Tennessee, Tennessee Voices for Children, the Tennessee Division of Vocational Rehabilitation Services, Encuentro Latino, and the Multicultural Alliance on Disability. Priority 4: Persons with disabilities will become empowered to exercise their rights, access services, and live independently. Objective 1: Provide general agency information through outreach and training and obtain public comment and input on future agency priorities. Objective 2: Collaborate in community, state, or national efforts to expand the rights of persons with disabilities and increase services to meet needs. Need addressed: Priority 4 addresses information, leadership and empowerment (ILE) activities. In addition, our agency plans to conduct additional ILE activities directly related to Priorities 1-3. All ILE activities address the needs of individuals with disabilities, family members, advocacy organizations, service providers, local and state government officials and staff, the general public and others to increase their level of knowledge about the legal rights of individuals with disabilities. These activities support the empowerment of individuals with disabilities to become independent and enjoy the same opportunities as persons who do not have disabilities. Anticipated Activities: Priority 4 specifies the activities to address the identified need. In addition, in direct support of one or more of priorities 1-3, DLAC will conduct outreaches, focus groups, and trainings. DLAC will also create publications in direct support of one or more of Priorities 1-3.

Part VI. Narrative

At a minimum, you must include all of the information requested. You may include any other information, not otherwise collected on this reporting form that would be helpful in describing the extent of PAIR activities during the prior fiscal year. Please limit the narrative portion of this report, including attachments, to 20 pages or less.

The narrative should contain the following information. The instructions for this form outline the information that should be contained in each section.

  1. Sources of funds received and expended
  2. Budget for the fiscal year covered by this report
  3. Description of PAIR staff (duties and person-years)
  4. Involvement with advisory boards (if any)
  5. Grievances filed under the grievance procedure
  6. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency

A. Sources of funds received and expended Source of Funding Amount Received Amount Spent Federal (section 509) 301,199 260,910 State Program income 0 0 Private All other funds 108,434 108,434 Total (from all sources) 409,633 369,344 B. Budget for the fiscal year covered by this report Category Prior Fiscal Year Current Fiscal Year Wages/salaries 187,834 168,564 Fringe benefits (FICA, unemployment, etc.) 41,954 45,085 Materials/supplies 9,075 9,189 Postage 477 450 Telephone 7,145 4,974 Rent 37,380 19,851 Travel 7,284 6,500 Copying 597 1,246 Bonding/insurance 2,761 1,728 Equipment (rental/purchase) 7,564 3,241 Legal services 0 100 Indirect costs 49,268 40,188 Miscellaneous 18,005 16,768 Total Budget 369,344 317,884 C. Description of PAIR staff (duties and person-years)

Type of Position FTE % of year filled Person-years Professional Full-time 23 100% 23 Part-time Vacant Clerical Full-time 4 100% 4 Part-time Vacant D. Involvement with advisory boards (if any) Disability Law & Advocacy Center of Tennessee does not have an advisory board for PAIR. E. Grievances filed under the grievance procedure During FY 2014, DLAC received two (2) case level grievances from PAIR clients. One was filed by a 63-year-old Caucasian female with a mobility disability. The other was filed by the mother of a 13-year-old Caucasian male with a learning disability. Both grievances were filed due to dissatisfaction with DLAC’s decision to close the case. DLAC’s Legal Director reviewed the services provided to both clients and confirmed those services were appropriate. She also confirmed that both cases were ready for closure and provided a written response to both grievances.

F. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency Disability Law & Advocacy Center of Tennessee (DLAC) has all P&A grants and the CAP grant within its authority. DLAC’s intake process entails identification of problems according to the federal eligibility criteria. There is also identification of cross-grant possibilities with discussions among DLAC’s Intake team, Advocacy Directors, Executive Director, and Legal Director about the course of action to be taken by the different grants involved in the specific priorities. Program coordination also occurs during the establishment of priorities and objectives. After each program establishes preliminary drafts of its priorities and objectives, an analysis takes place to determine if there are areas of coordination. The Tennessee Long-term Care Ombudsman Program is not within DLAC. There is a longstanding relationship between DLAC and this program with DLAC providing training to the Long-term Care Ombudsman and those Ombudsman making referrals to DLAC.

Certification

Signed?Yes
Signed ByLisa Primm
TitleAuthorized Certifying Official
Signed Date12/15/2014