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

Tennessee (Disability Rights Tennessee) - H240A150043 - FY2015

General Information

Designated Agency Identification

NameDisability Rights 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 reportAngela Webster
Contact Person phone615-298-1080
Ext.112

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 areas103
2. Individuals receiving I&R outside PAIR priority areas510
3. Total individuals receiving I&R (lines A1 + A2)613

B. Training Activities

1. Number of trainings presented by PAIR staff18
2. Number of individuals who attended training (approximate)998

Under DRT’s training objective, the agency trained individuals with disabilities, family members, advocacy organizations, service providers, public school personnel, private attorneys, and other community members and stakeholders 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 DRT offers. The majority of these trainings were traditional lecture trainings with questions and answers. In addition, some trainings were webinars which allowed for participants to send in questions via email. Training topics included disability discrimination, effective communication, disability sensitivity, disability discrimination in employment settings, transition from school to postsecondary/work, accessibility of Tennessee’s court program, juvenile justice, special education, and current policy. DRT collaborated with many other organizations to provide these trainings, including the Tennessee Department of Education, Lyft, Vanderbilt Psychiatric Hospital, Vanderbilt Program in Interprofessional Learning, Vanderbilt Kennedy Center on Excellence in Developmental Disabilities’ Advocacy Training program, the Disability Rights Bar Association, the Tennessee Employment Lawyers Association, the Tennessee Bar Association, the Tennessee Alliance for Legal Services, Arc Tennessee, the Tennessee Council on Developmental Disabilities’ Partners in Policymaking Leadership Institute, Vanderbilt University’s Peabody College, Vanderbilt University School of Law, Fort Campbell, the University of Memphis, Middle Tennessee State University, Bridges, municipal governments, and the Tennessee Division of Rehabilitation Services. Additionally, DRT staff presented breakout sessions at local conferences such as Fair Housing Matters and the Tennessee Disability MegaConference.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles10
3. PSAs/videos aired4
4. Hits on the PAIR/P&A website240,477
5. Publications/booklets/brochures disseminated40,995
6. Other (specify separately)473,462

Narrative

Monthly editions of DRT’s e-news were distributed during FY2015 covering a wide range of topics including self-advocacy skills, employment services, access to assistive technology and special education rights among others. Additionally, email bulletins were sent throughout the year with special updates relating to public policy and education/training opportunities. Social media communications continued to grow this year. In total 473,462 people were reached via Facebook (398,754) and Twitter (41,487).

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)11
2. Additional individuals served during the year98
3. Total individuals served (lines A1 + A2)109
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)13

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 10

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility1
2. Employment8
3. Program access46
4. Housing1
5. Government benefits/services4
6. Transportation0
7. Education27
8. Assistive technology0
9. Voting0
10. Health care3
11. Insurance0
12. Non-government services1
13. Privacy rights0
14. Access to records0
15. Abuse1
16. Neglect20
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor86
2. Other representation found0
3. Individual withdrew complaint12
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case1
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit7
9. Other3

Please explain

Three individuals who appeared to qualify for PR funding at initial intake provided additional documentation which confirmed they qualified under other funding sources instead. Thus, the PR cases were closed and new cases were opened under other funding sources.

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-advocacy42
2. Short-term assistance18
3. Investigation/monitoring14
4. Negotiation23
5. Mediation/alternative dispute resolution8
6. Administrative hearings0
7. Litigation (including class actions)0
8. Systemic/policy activities2

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 - 2232
3. 23 - 5952
4. 60 - 6410
5. 65 and over15

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females49
2. Males60

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian2
4. Black or African American27
5. Native Hawaiian or Other Pacific Islander0
6. White72
7. Two or more races1
8. Race/ethnicity unknown6

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent52
2. Parental or other family home33
3. Community residential home0
4. Foster care0
5. Nursing home10
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center8
9. Homeless4
10. Other living arrangements1
11. Living arrangements not known1

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment6
2. Deaf/hard of hearing38
3. Deaf-blind1
4. Orthopedic impairment15
5. Mental illness1
6. Substance abuse0
7. Mental retardation0
8. Learning disability9
9. Neurological impairment8
10. Respiratory impairment0
11. Heart/other circulatory impairment3
12. Muscular/skeletal impairment4
13. Speech impairment1
14. AIDS/HIV0
15. Traumatic brain injury1
16. Other disability22

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities47

2. Number of individuals potentially impacted by policy changes835,400

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) A person who is deaf contacted Disability Rights Tennessee (DRT) regarding a city-operated large format movie theater that did not provide captioning for its films. Most of the films shown are large format documentaries that are educational in nature. DRT contacted the city regarding this issue. The city explained that they have nine "Captiview" devices for viewing captions but that none of their current films were encoded with captioning that would display on the devices. DRT staff educated the city on their responsibility to provide equal program access to individuals with disabilities under Title II of the Americans with Disabilities Act (ADA). The city agreed to provide written transcripts for all current programming along with a red flashlight for low light level reading. The city further agreed to take accessibility under consideration when procuring future films. They also updated their website to include an accessibility statement explaining the availability (or potential lack thereof) of both captioning and audio description for the films shown, as well as contact information that guests who need accommodations can use to make arrangements. Due to DRT intervention, this movie theater is more accessible to individuals with disabilities, specifically persons who are deaf or hard of hearing. 2) Disability Rights TN (DRT) received a complaint regarding denial of a sign language interpreter at a community emergency room. DRT contacted this facility regarding this incident and educated them about their requirements to provide effective communication to persons with disabilities. The facility had a policy in place that required hospital staff to provide effective communication through a certified American Sign Language interpreter (ASL). DRT reviewed this policy and offered recommendation on how it can be revised. As a result of DRT intervention this facility did update their policy to include DRT recommendations, re-trained all hospital staff of the policy and provided access to at least one video phone per facility emergency rooms, posted 5 permanent signs in their facility advertising this service with the universal sign for video conferencing (along with the verbiage as well), and added a facility wide education program to educate everyone that this service is available and who to contact if it is needed. As a result, this facilities emergency department will be accessible for all persons who have sign language interpreting needs. 3) People with disabilities and the groups that serve them are better informed about implementation of the Affordable Care Act (ACA). DRT participates in multiple collaborations regarding ACA issues. DRT will refer callers to navigators for assistance in enrolling in appropriate coverage. Collaborators include the Tennessee Health Care Campaign, Nashville Cares, the Legal Aid Society of Middle Tennessee and the Cumberlands, Baptist Healing Trust, and Seedco. 4) DRT Intake staff along with staff from other legally-based agencies across the state of Tennessee met quarterly to discuss issues related to intake, information & referrals, and client services. DRT was successful in building a collaborative relationship with the Administrative Office of Courts, Tennessee Alliance for Legal Services, Southeast Tennessee Legal Services, Justice for our Neighbors, Legal Aid of East Tennessee, Legal Aid Society of Middle Tennessee and the Cumberlands, and Nashville Metro Government's Financial Empowerment Center. New agencies are expected to join the collaboration in FY 2016. Together DRT and these other agencies have developed and shared a comprehensive list of legal resources and referrals in Tennessee as well as identified gaps in services both by service type and geographic area. Meetings are scheduled to continue into FY 2016. 5) As a result of DRT's collaboration with the Tennessee Department of Education (TNDOE), the Parent Training Organization (STEP), parents of students with disabilities, and school system representatives, the TNDOE Restraint Task Force is able to review data and make recommendations to decrease the use of restraint on students with disabilities. DRT serves on this task force in order to provide legal input and to inform the committee of concerns related to restraint as seen through the cases that come into the P&A agency. This committee has reviewed the first two years of restraint data and is looking for trends and areas of concern that need to be addressed at the state and local levels. In addition, a Q&A fact sheet has been developed that is in the process of being finalized so that families and school systems can better understand the requirements and prohibitions related to restraint in schools and reporting requirements. 6) Disability Rights Tennessee (DRT) participated in the Citizens Advisory Committee for the Metropolitan Transit Authority’s (MTA) Amp project to provide regular feedback and recommendations concerning accessibility of this high performance transportation option for people with disabilities as well as receiving information about the Amp design to the MTA’s engineers and assist in the final design of the Amp project. DRT provided input about accessibility issues throughout the entire publicly televised process. However, MTA’s Amp project eroded into an additional bus route and would not be the high performance option it was meant to be following heavy community opposition to facets of the project. MTA’s Chief Executive Officer (CEO) recommended that the Amp not move to construction as ultimately configured, and that the focus be shifted to an overall strategic plan for transit services and facilities in the Region. This plan will incorporate design considerations for high capacity/high performance transit facilities such as that contemplated in the original Amp proposals. 7) DRT participated as the advocacy representative on Tennessee's Interstate Compact for Juveniles State Council. Each state is required by statute to establish a state council for overseeing its interstate affairs dealing with the Compact. The state council serves as an advocate when seeking resources, improving operations, resolving disputes and conducting training. The council is also charged with reviewing and analyzing existing rules governing the Compact and making recommendations for change when appropriate. Because of DRT's participation, members of the council are better informed on issues affecting children with disabilities in the juvenile justice system. DRT will continue to be involved with this council in FY 2016. 8) DRT continued to increase its visibility and reliability as a leading resource on disability issues during the past year through submission of public comments on a number of issues with potential impact for Tennesseans with disabilities. Comments were provided to state and federal departments, including: • Tennessee Department of Human Services • Tennessee Department of Education • Tennessee Department of Intellectual and Developmental Disabilities • US Department of Transportation • Tennessee Bureau of TennCare 9) The 2015 MegaConference was another successful collaborative event of the DD Network Partners (the TN Council on Developmental Disabilities, Vanderbilt Kennedy Center UCEDD, UT Boling Center UCEDD, and DRT) along with The Arc Tennessee. Attendance at this year’s event totaled 672, of which 112 individuals received stipends to cover the cost of attending. DRT once again served as a contributing sponsor of the conference by donating $5,000 toward stipends for the conference and serving as a key member of the steering committee as well as acting as chair of the program committee. Staff distributed information about DRT's programs and services and disability related information across service areas. The theme for this year's conference was "It all starts with one", with topics including community and social inclusion, person-centered planning, public policy, education advocacy, post-secondary education options, as well as a specific track on employment options for individuals with disabilities. 10) Through collaboration with the Disability Coalition on Education (DCE), DRT assisted in addressing many systemic issues for students with disabilities. First, DCE engaged in numerous training collaborations, including working with the Department of Education (TDOE) to conduct trainings or information sessions on Response to Intervention and Instructionally Appropriate IEP's. Second, DRT provided legal input to DCE in the efforts to provide input to TNDOE on a variety of issues. These included ongoing work regarding the implementation of a new Occupational Diploma, policies related to "read aloud" for content based end of course tests, input of the draft of manuals for Instructionally Appropriate IEP's and Response to Intervention (RTI), and newly passed legislation, the Individualized Education Account, a voucher for students with special education needs. Third, DRT provided information to DCE on a variety of topics. These included DRT's education of legislators regarding various pieces of legislation with potential to impact students with disabilities. DCE continues to engage in meetings with and provide input to TDOE and to other Tennessee policymakers as it continues to work on systemic issues impacting students with disabilities across Tennessee. 11) DRT regularly provides input on public policy issues which impact people with disabilities. In addition to educating the public and policymakers on our own as an agency, DRT generally works with collaborators on these issues. Specifically, DRT works as a member of the Disability Policy Alliance and with the Tennessee Disability Coalition to impact disability policy issues in Tennessee. During fiscal year 2015, DRT worked with partners to educate the public and members of the legislature about legislation with potential to impact Tennesseans with disabilities, including: A bill creating a voucher option for students with disabilities; a law to establish "The Achieving a Better Life Experience (ABLE) Act" of 2015 to allow Tennesseans to be able to take advantage of the ABLE Act, passed late last year at the federal level; the “Aging Caregiver” bill, a bill to provide access to the Self-Determination Waiver for eligible individuals with intellectual disabilities (ID) waiting for Medicaid Waiver services on the Department of Intellectual and Developmental Disabilities (DIDD) waiting list; and the Protection of Volunteer-Insured Drivers of the Elderly (PROVIDE) Act grants immunity from civil liability to individuals providing volunteer transportation services to senior citizens through a charitable organization or human service agency, so long as the individual is acting in good faith within the scope of his or her official duties.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts32,000
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.

1) Disability Rights Tennessee provided legal representation to successfully address a school system’s refusal to allow a student to be accompanied by his service animal. Our client is an 8- year-old boy with Type I diabetes which causes him to experience radical and sudden changes in his blood sugar levels throughout the day. These shifts have the potential to cause significant harm including hypoglycemia, unconsciousness, coma, and even death. During August 2014, our client’s mother approached his school about the possibility of obtaining a service dog to help control her son’s blood sugar levels, alert him to emergency issues including hypoglycemia, and alert others in the event her son is already too ill to respond. At that time, school officials indicated they would allow our client to bring a service dog to school. Therefore, his family began fundraising efforts to meet the $15,000 cost for the service dog. Once the fundraising efforts were complete and the dog had been trained, the service dog was scheduled to arrive from Diabetic Alert Dogs of America in February 2015. Around that same time, the county School Board informed this family that their son would not be allowed to bring his service dog to school. In a letter to the family, the School Board indicated it would not provide the reasonable accommodation of allowing Brayden’s service dog to accompany him because it was not “medically necessary” and other reasonable accommodations had been provided to him. Due to this school system’s refusal to allow this student to bring his service dog to school, after his dog arrived, he attended school for several months without the dog. This was frustrating for both our client and his service animal. In addition, this delay interfered with the dog’s training for use in the school setting and caused our client’s mother to feel that her son did not have all tools needed to keep him safe at school. This client’s service dog, Luke, has demonstrated an ability to not only accurately determine his blood sugar levels but also predict the dramatic swings in blood sugar that he experiences up to ten minutes before they happen. Due to this school system’s denial of the reasonable accommodation of use of his service dog in the school setting, our client had no choice but to finish the 2014-2015 school year without his service dog accompanying him to school which put his health at an increased risk. Disability Rights Tennessee (DRT) attorneys assisted this student and his family by simultaneously sending a demand letter to this school system and filing a complaint with the Office for Civil Rights of the U.S. Department of Education (OCR). DRT asserted that this school system was violating both Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973 by refusing to allow our client to be accompanied to school by his service animal. During negotiations DRT also learned that this school system did not have in place an appropriate policy regarding the rights of students who use service animals. As a result of negotiations, this school system agreed to allow our client to be accompanied to school by his service animal going forward. As a result, our client has been accompanied to school by his service animal since the very first day of the current school year which began in August 2015. In addition, this school system paid $1,512.00 to Diabetic Alert Dogs of America for their trainer’s travel costs so that our client and his dog were able to obtain additional training in the school setting. This training was necessary due to the gap between the dog’s initial training and the school system’s agreement to allow him to take his dog to school. DRT also worked with the school system’s attorney to draft a service animal policy which fully complies with the requirements of the ADA and Section 504. Because the school system has implemented that policy, this case has resulted in a systemic impact. Our client and other students with disabilities will now be able to take their service animals to school without fear of discrimination. 2) In July 2014 DRT filed a lawsuit in federal court for injunctive relief and damages on behalf of a deaf couple who were denied effective communication in a hospital setting and their family members/companions who were forced to interpret for the couple rather than serve as family support and assist in making health care decisions. The deaf husband was hospitalized for serious illnesses and eventually died. During his hospitalization, the husband experienced hallucinations and was unable to effectively communicate with staff. The hospital failed to provide him with access to an interpreter over a period of several days. The deaf wife did not understand the serious nature of her husband’s cancer due to the hospital’s failure to provide a sign language interpreter at key junctures of communication. In addition, the wife did not receive effective communication during her own hospitalization for injuries from a car wreck. This lawsuit is set for trial in early 2016. 3) On November 21, 2014, DRT filed a lawsuit in federal court on behalf of 2 deaf men who had repeatedly been denied effective communication by a hospital. One plaintiff has multiple serious medical conditions. The other is the first plaintiff’s companion and also visits this hospital for his own health care needs. The hospital had insisted and continues to insist these plaintiffs use video remote interpreting (VRI) services for communication with hospital staff. However, the hospital’s VRI has multiple problems including blurriness, difficulty connecting, and ghost images. So, the VRI does not result in effective communication for the gentlemen. Plaintiffs are seeking injunctive relief and damages. The case is set for trial in June 2016.

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 DRT provides services. While individual cases are funded under one grant, other activities such as trainings, collaborations, outreaches, monitoring activities and similar projects may be conducted under more than one grant, or across all grants. 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 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: 17 Number of monitoring projects: 15 Case summary: Disability Rights TN (DRT) received a complaint that a 55 - year - old, Caucasian male diagnosed with neurological disorders and an amputee has not received appropriate medical treatment at a Tennessee Department of Correction (TDOC) prison. The allegations more specially stated our client was not receiving any physical therapy at the facility and being denied a prosthetic leg. DRT conducted an investigation into the allegations that included several face to face interviews with client at the facility, review of client medical records provided by TDOC, interviews and phone calls with facility medical staff and other collaterals. Based on investigative findings DRT was able to substantiate the allegations. DRT found that our client had not received any physical therapy while at the facility. During the course of this investigation DRT advocated for our client to be transferred to TDOC’s Deberry Special Needs Facility (DSNF), where our client could receive the medical treatment needed. As a result of DRT intervention, our client was approved for transfer to DSNF where our client could receive therapy and facilities are accessible. 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 medical providers will not grant reasonable modifications necessary to allow individuals with disabilities to access critical healthcare services. Objective 1: Assist persons experiencing communication discrimination in business and government settings. Objective 2: Advocate to change selected discriminatory policy and/or practice. Collaboration with other entities: collaboration with other organizations addressing communication discrimination and employment discrimination including the Tennessee Association for the Deaf, the various Communication Centers for the Deaf and Hard of Hearing across Tennessee, the Tennessee Council for the Deaf and Hard of Hearing, Tennessee’s Administrative Office of the Courts, Tennessee’s Access to Justice Commission’s Committee on Disability and Language Barriers, Tennessee Employment Consortium, the 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. Number of persons assisted with communication discrimination: 27 Number of discriminatory policies and/or practices DRT advocated to change: 17 Case Summary 1: A local Metro government denied our client the right to use reading software in the application process for a position working in the local jail. Our client, a white 35-year-old male with a significant reading disability but who was succeeding in a college program, came to DRT because he wasn't able to use the reading program he used in college. DRT filed a complaint with the EEOC. Even though the EEOC was unable to find enough proof of an outright denial of reasonable accommodations to our client, DRT was still able to negotiate with the Metro Attorney and Human Resources Director. DRT educated them about the the use of assistive technologies in the application process, and they agreed to utilize training materials on the subject developed by DRT when training personnel. Client indicated he was very pleased that his situation brought the problems in the process to the attention of the Metro government and that they would be training staff on the requirements and use of software. Case Summary 2: The wife of an 82 -year -old Caucasian male who is deaf contacted Disability Rights Tennessee (DRT) and reported that a skilled nursing facility (SNF) refused to provide a qualified sign language interpreter when her husband was a resident there. Our client and his wife reported that the staff required him to write notes with them for communication. They also asked his wife to serve as his sign language interpreter. DRT sent a letter and made phone calls to the SNF. DRT provided information about effective communication and the Americans with Disabilities Act (ADA). The SNF subsequently agreed to provide qualified sign language interpreters in the future when requested. DRT requested a copy of the SNF policy for providing effective communication. The SNF and their parent company prepared such a policy, and DRT assisted by reviewing and suggesting edits to the policy. The current effective communication policy applies to over 250 company facilities across the country. As a result of DRT intervention, all 250 facilities operated by the parent company of this SNF have a written policy regarding the provision of effective communication. Current and future deaf residents of these facilities will be assured of the provision of effective communication. Case summary 3: Disability Rights Tennessee assisted a 17- year -old Caucasian male student with obtaining appropriate accommodations from a high school athletic association (Association). Our client is deaf and has been on his school's wrestling team since seventh grade. His county school system provides sign language interpreting services for all of his practices and matches. Throughout most of his wrestling career, referees have allowed this student's sign language interpreter to move around the mat during matches in order to enable his coach to effectively communicate with him. However, that changed during our client's junior year. At that time, a high school athletic association put restrictions in place preventing his interpreter from leaving her seat during matches. As a result, our client was unable to see the interpreter while wrestling. We provided legal representation to this client and asked the athletic association to grant reasonable accommodations to allow our client to appropriately interact with his interpreter during matches. As a result of negotiations, the Association agreed to allow our client's interpreter to move around the perimeter of the mat outside the outer white circle. In addition, the Association sent a letter to this student's coach confirming the accommodation. As a result, our client was able to fully participate in the Regional State Tournament last season and will be able to fully participate in all matches and tournaments this year Priority 3: People with disabilities will be integrated in the community. Need addressed: There is an ongoing systemic failure to provide adequate services to Tennesseans with disabilities, particularly individuals with developmental disabilities without intellectual disability such as autism spina bifida or cerebral palsy. Although some improvements have occurred, much remains to be done to ensure that Tennesseans with disabilities have access to appropriate services within their communities. Additionally, there is a persistent 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. DRT continues to work to ensure that non-English speaking persons have access to disability related information. 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. Collaboration with other entities: collaboration with other organizations addressing these issues including the Developmental Disabilities Network Partners, the Disability Coalition on Education, The Arc Tennessee, Tennessee Voices for Children, Support and Training for Exceptional Parents, the Tennessee Division of Vocational Rehabilitation Services, the Tennessee Bar Association, the Tennessee Employment Consortium, the Tennessee Collaborative on Meaningful Work, Encuentro Latino, and the Multicultural Alliance on Disability. Number of projects to advocate for increased community services: 3 Number of students provided advocacy for appropriate IEP and 504 Plan implementation: 11 Number of students provided advocacy for appropriate FBAs and BIPs: 9 Number of projects to provide disability related information to non-English speaking persons: 2 Case summary 1: A student whose orthopedic impairments resulted in pain while riding the school bus over rough roads or speed bumps is now provided transportation to and from school in the fastest, most direct route. Disability Rights TN (DRT) was contacted by the parent of a sixteen-year-old, Caucasian female diagnosed with orthopedic impairments who resides in a rural area requesting assistance obtaining appropriate implementation of the student's IEP. Specifically, the student's doctors had written orders related to specific positioning of the client's wheelchair on the bus and the conditions under which the client could be transported. Despite these doctor’s orders, the client was transported in the wrong position on the bus on a route that included an area with multiple speed bumps. The ride to and from school was very painful for the client and exacerbated her medical condition. DRT worked with the parent and school to implement a new bus route for the client. The client's wheelchair was moved to the proper location on the bus, and the student was transported directly from home to school, then from school to home. The amount of time on the bus was the shortest possible time span and the route included no speed bumps. Case summary 2: The concerned grandmother of a 17 year-old African American female student with a diagnosis of ADHD and Bipolar disorder from an urban county contacted Disability Rights Tennessee (DRT) to investigate the school’s failure to provide appropriate behavior supports through her granddaughter’s Behavior Intervention Plan and the issues related to a restraint and isolation incident that resulted in an injury by staff and discipline referrals due to disability related behaviors. Our client’s grandmother reported her granddaughter asked a teacher if she could be taken out of class for downtime. The teacher that would usually assist her granddaughter was dealing with a school matter and was not available and the other teacher denied her granddaughter’s request. Our client’s grandmother reported that having a calm down place is a part of her Behavior Plan and further stated a demand was made for our client to sit down and copy the work from the board but her granddaughter was overwhelmed and refused. Our client then put her head down on the table, the issue escalated and our client had a "meltdown". According to our client’s grandmother, the male teacher put our client’s hands behind her back and lifted her up off her feet. She states her granddaughter yelled that he was hurting her. The teacher removed our client from the room and took her to an isolated room that was dark and the windows were boarded. According to our client, she was slammed up against the wall. At that point our client began to have an asthma attack, one teacher had her bent over with her hands behind her back, and another teacher was spraying her mouth with the inhaler. Our client’s grandmother reported that our client’s caseworker from Mental Health Cooperative had just arrived at the school for a visit right after the incident occurred. DCS was contacted by the case manager and our client went to the hospital to be assessed. The hospital physician concluded that our client suffered trauma and her teeth were fractured and she had a possible concussion. Upon opening the case, DRT requested and reviewed the education records and determined that the client’s individualized Behavior Intervention Plan was not appropriate and no progress data was provided to address supports. DRT requested the incident report for review and met with the school district’s Exceptional Education Department staff to discuss the investigation results and educated staff on the Stated Isolation and Restraint laws. DRT referred our client’s parent to contact Child Protective Services to file a report. During the case, the school system elected to transfer the student to another special day school to receive support. DRT assisted in ensuring an appropriate Behavior Intervention Plan was developed in our client’s new school setting due to the inappropriate restraint incident. DRT ensured that the school revised our client’s Individualized Education Program Plan. DRT made follow-up contact with the Director of Exceptional Education for the school system to discuss restraint and isolation concerns with the prior school and provided information that resulted in an action plan that the offending school is required to develop regarding environmental school changes. In addition, we requested that the school system’s Schools Transition Coordinator be available to provide resources at the IEP meeting which the coordinator did attend. DRT also recommended an appointment with Vocational Rehabilitation, which was scheduled, to assist with information on additional resources. Due to the restraint and isolation event, our client elected to graduate with a special education diploma but will return in the fall to work toward a general education diploma. Our client and her grandmother were able to gain self-advocacy skills that will enable them to successfully navigate and utilize these skills through future incidents/situations. Our client now has plans in place that provide her with the supports and skills needed to be successful in the school environment. Priority 4: Persons with disabilities will become empowered to exercise their rights, access services, and live independently. Need addressed: Priority 5 addressed information, leadership and empowerment (ILE) activities. In addition, our agency conducted additional ILE activities directly related to Priorities 1-4. 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, Center for Independent Living of Middle Tennessee, Vanderbilt Law School’s Disability Law Society, Vanderbilt Law School’s Animal Law Society, Sumner County Sheriff's Department, Tennessee Department of Education, Tennessee Department of Children’s Services, Disability Coalition on Education, Nashville Predators Foundation, Mental Health Association of Middle Tennessee, Living with Autism, Vanderbilt Psychiatric Hospital, Vanderbilt Kennedy Center, Arc Tennessee, Youth Villages, Tennessee Department of Mental Health and Substance Abuse Services, Civil Rights Education and Enforcement Center, Tennessee’s Attorney General’s office, Court Appointed Special Advocates, Legal Aid Society of Middle Tennessee and the Cumberlands, Tennessee Commission on Children and Youth, Tennessee Child Advocacy Centers, Tennessee District Public Defenders Conference, Tennessee Council on Developmental Disabilities, Tennessee Alliance for Legal Services, Tennessee Bar Association, American Red Cross, Metro Nashville Public Schools, Disability Rights Bar Association, City of Knoxville, Community Action Commission, Goodwill Industries, Multiple Sclerosis Society, Disability Resource Center, Amputee Coalition, University of Tennessee, Community Advocates, University of Tennessee Boling Center, Tennessee Department of Labor and Workforce Development, Tennessee Division of Rehabilitation Services, Encuentro Latino, Multicultural Alliance on Disability, Tennessee Department of Intellectual and Developmental Disabilities, Tennessee Voices for Children, Tennessee Association of the Deaf-Blind, Hearing Loss Association of Nashville, Tennessee Supreme Court’s Access to Justice Commission’s Education Committee, The Arc of Tennessee, the Tennessee Council on Developmental Disabilities, and the Statewide Independent Living Council of Tennessee. Number of outreaches: 168 Number of trainings: 18 Number of collaboration projects: 47 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, juvenile justice, employment issues, and access to community services. Although it is difficult to precisely determine the number of persons this priority may impact, DRT estimates that our collaborative efforts impact approximately two (2) million individuals with disabilities across Tennessee and throughout the United States.

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 DRT 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, 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. 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. 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 discrimination in communication and employment, there continue to exist other discriminatory policies and practices which negatively impact people with disabilities. For example, some medical providers will not grant reasonable modifications necessary to allow individuals with disabilities to access critical healthcare services. 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 the Tennessee Association for the Deaf, the various Communication Centers for the Deaf and Hard of Hearing across Tennessee, the Tennessee Council for the Deaf and Hard of Hearing, the 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, the 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, 504 plans, Functional Behavior Assessments and Behavior Intervention Plans. Objective 3: Provide disability related information to non-English speaking persons. 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. DRT 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, DRT will conduct outreaches, focus groups, and trainings. DRT 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) 4300,892/$254,907 State $0/$0 Program income $0/$0 Private $0/$0 All other funds $40,289/$40,289 Total (from all sources) $341,181/$295,196 B. Budget for the fiscal year covered by this report Category Prior Fiscal Year/ Current Fiscal Year Wages/salaries $158,196/$156,135 Fringe benefits (FICA, unemployment, etc.) $35,628/$41,144 Materials/supplies $7,027/$8,833 Postage $376/$478 Telephone $5,314/$5,740 Rent $23,021/$27,896 Travel $7,217/$7,024 Copying $1,708/$2,651 Bonding/insurance $1,660/$2,074 Equipment (rental/purchase) $4,896/$3,553 Legal services $0/$100 Indirect costs $38,651/$47,850 Miscellaneous $11,503/$22,346 Total Budget $295,197/$325,824 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 0 Vacant 0 Clerical 0 Full-time 4 100% 4 Part-time 0 Vacant 0 D. Involvement with advisory boards (if any) Disability Rights Tennessee does not have an advisory board for PAIR. E. Grievances filed under the grievance procedure There were no PAIR grievances filed during Fiscal Year 2013. 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 Rights Tennessee (DRT) has all P&A grants and the CAP grant within its authority. DRT’s intake process entails identification of problems according to the federal eligibility criteria. There is also identification of cross-grant possibilities with discussions among DRT’s Intake team, Regional 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 DRT. There is a longstanding relationship between DRT and this program with DRT providing training to the Long-term Care Ombudsman and those Ombudsman making referrals to DRT.

Certification

Signed?Yes
Signed ByLisa Primm
TitleExecutive Director
Signed Date12/16/2015