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

Tennessee (Disability Rights Tennessee) - H240A160043 - FY2016

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 reportElizabeth Setty Reeve
Contact Person phone615-298-1080
Ext.142

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 areas51
2. Individuals receiving I&R outside PAIR priority areas586
3. Total individuals receiving I&R (lines A1 + A2)637

B. Training Activities

1. Number of trainings presented by PAIR staff19
2. Number of individuals who attended training (approximate)1,111

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 stakeholders about 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 abuse and neglect, disability discrimination, effective communication, disability sensitivity, special education, and voting access. DRT collaborated with many other organizations to provide these trainings, including Vanderbilt Kennedy Center on Excellence in Developmental Disabilities’ Advocacy Training program, Tennessee Bar Association, Tennessee Alliance for Legal Services, The Arc of Tennessee, the Tennessee Council on Developmental Disabilities’ Partners in Policymaking Leadership Institute, and Bridges. Additionally, DRT staff presented breakout sessions at local conferences such as the Tennessee Disability MegaConference.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff4
2. Newspaper/magazine/journal articles160
3. PSAs/videos aired9
4. Hits on the PAIR/P&A website244,915
5. Publications/booklets/brochures disseminated10,372
6. Other (specify separately)372,361

Narrative

Monthly editions of DRT’s e-news were distributed to 2,645 subscribers during FY2016 covering a wide range of topics including self-advocacy skills, employment services, access to assistive technology, voting access, disability discrimination, and special education 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 be a means to distribute information. In total 340,621 people were reached via Facebook (261,847) and Twitter (78,774).

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)10
2. Additional individuals served during the year99
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.)11

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 28

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility1
2. Employment7
3. Program access40
4. Housing1
5. Government benefits/services1
6. Transportation2
7. Education28
8. Assistive technology0
9. Voting0
10. Health care3
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse2
16. Neglect35
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor67
2. Other representation found2
3. Individual withdrew complaint14
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.4
6. PAIR withdrew from case1
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit3
9. Other0

Please explain

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-advocacy14
2. Short-term assistance14
3. Investigation/monitoring30
4. Negotiation24
5. Mediation/alternative dispute resolution7
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 - 41
2. 5 - 2231
3. 23 - 5955
4. 60 - 646
5. 65 and over16

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females39
2. Males70

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race6
2. American Indian or Alaskan Native0
3. Asian2
4. Black or African American26
5. Native Hawaiian or Other Pacific Islander0
6. White73
7. Two or more races2
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent39
2. Parental or other family home32
3. Community residential home5
4. Foster care0
5. Nursing home11
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center19
9. Homeless3
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 impairment6
2. Deaf/hard of hearing33
3. Deaf-blind0
4. Orthopedic impairment13
5. Mental illness0
6. Substance abuse0
7. Mental retardation0
8. Learning disability10
9. Neurological impairment13
10. Respiratory impairment0
11. Heart/other circulatory impairment1
12. Muscular/skeletal impairment1
13. Speech impairment0
14. AIDS/HIV1
15. Traumatic brain injury0
16. Other disability31

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities32

2. Number of individuals potentially impacted by policy changes943,000

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.

After determining that a school system had discriminated against a large group of students with disabilities who received special transportation services, DRT successfully ensured that those students in a rural Tennessee county are provided a free and appropriate public education. It was determined that the students were being dismissed from school approximately 30 minutes early every day depriving them of significant instructional time which is discriminatory under Section 504 of the American with Disabilities Act. DRT demanded that this practice be stopped immediately and asked for compensatory tutoring for all students involved. As a result, transportation services policy for students with disabilities was revised to ensure a consistent dismissal time with the dismissal of general education students. Further, compensatory services were offered to the twenty students impacted by the early dismissal time. Lastly, staff would receive training regarding procedures for reporting such potentially discriminatory practices in the future. DRT continues to be an active part of a collaboration of emergency managers and planners focused on preparedness, response, and recovery in relation to individuals with disabilities. This committee informs policies and practices of emergency planners as to the needs of individuals with disabilities. It further partners with community emergency and disaster planners to identify educational opportunities for individuals with disabilities. In FY2016, the group drafted training materials for first responders, increased functional needs sheltering planning, and engaged in cross training of American Red Cross and DRT staff. A local location of a national chain restaurant is now accessible to individuals utilizing mobility devices. The advocacy efforts started when DRT was contacted by a group of people with permanent mobility disabilities due to strokes. The group informed DRT that a restaurant in the area was not accessible. DRT investigated the issue and determined that the parking and entrance of the restaurant were not accessible as required by the American with Disabilities Act (ADA). DRT advocated for the corporate owner of the restaurant to make changes to the layout of the parking and accessible entrance in order to meet ADA accessibility. The restaurant subsequently made modifications to address the issue and individuals with disabilities reported the ability to access the location. A county municipal building and school board meetings are now accessible to people with disabilities. In a prior fiscal year, due to DRT intervention the school board relocated meetings to an alternate location within the municipal building to make meetings accessible. However, issues regarding parking and public restroom access remained outstanding. Parking issues included obstructions in the accessible path of travel, lack of marked accessible spaces, and lack of sidewalks. The building also lacked accessible restroom facilities as outlined by the ADA. DRT advocated for access to this public municipal building for county residents with disabilities. The county renovated a unisex bathroom to meet ADA design guideline. The county also created two accessible parking spaces, including one van accessible. A van access aisle and a crosswalk from the accessible spaces to the accessible entrance to the building were also installed. 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; and Tennessee Department of Children’s Services. In addition to educating the public and policymakers, DRT collaborated with a number of disability stakeholder groups. 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 2016, DRT worked with partners to educate the public and members of the legislature about legislation with potential to impact Tennesseans with disabilities, including efforts such as "Helping Families in Mental Health Crisis", the Convention on the Rights of Persons with Disabilities and restraint and isolation in educational settings. DRT continues to represent the disability community on the N-Motion Strategic Planning Advisory Committee for Nashville’s Metropolitan Transit Authority (MTA). This committee is made up of community leaders and stakeholders for the purpose of providing public feedback about citizen public transit needs. Due to exponential population growth and resulting traffic congestion the need for a reliable and accessible public transit system is anticipated to increase 15% to 18% over the next three years. Strategic improvements to the current system are needed to handle the expected demand for transportation. MTA has sought input from stakeholders including people with disabilities as it develops a transit system that encompasses the values of the citizens of the city. Stakeholder input identified more frequent service, expanded operation hours, weekend service, safety and dependability as primary goals for the developing system. Based on this feedback and further evaluation, MTA developed three strategic plans for public input. The public selected the strategic plan that includes not only more frequent bus service on all routes but more coverage of the city by public transit through buses, bus rapid transit, street car, light rail, regional service with surrounding counties including regional service for paratransit services for people with disabilities. In addition, the system will be totally accessible to people with disabilities and provide safe environments for all to move about the city on their way to work, recreation, and medical appointments. Once the system is implemented, which will be in the next 25 years, local residents and visitors with and without disabilities will have many options for transportation. DRT will continue to be involved as this plan is further developed and implemented. Through collaboration with the Disability Coalition on Education (DCE), DRT addressed many systemic issues for students with disabilities. First, DCE engaged in providing input and editing public comments on revised eligibility standards for special education. Of particular concern was the proposed changes to the category of Emotional Disturbance. The Tennessee Department of Education (TNDOE) revisions enact a response to intervention approach that has the potential to delay special education rights and services to students receiving services in that category. DCE made numerous suggestions to remedy this issue. The TNDOE is currently considering comments. Second, DRT provided legal input and training to DCE members on a variety of special education issues. DRT attorney and advocate trained members on information from a recent conference on current court decisions in special education and providing written documentation to create a paper trail on a case. These trainings will enable the advocates from the many agencies to have necessary tools to assist their clients with disabilities secure their rights under IDEA and Section 504. Third, DRT actively participates in DCE’s engagement in meetings with and providing input to TDOE and to other Tennessee policymakers as it continues to work on systemic issues impacting students with disabilities across Tennessee. DRT and the DCE chair met with the Assistant Commissioner and the Commissioner of Education to inform them about concerns on a variety of topics including prone restraint, the Special Education Advisory Council including more persons with disabilities, and trends throughout the state our agencies see. The TNDOE has made some revisions to the draft eligibility criteria based upon DCE recommendations such as clearly defining that educational impact includes nonacademic areas thus potentially opening services to more students. TNDOE continues to consider DCE recommendations and frequently requests its input early in the process of making changes.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts4,750
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.

In 2014, DRT filed a lawsuit in federal court for injunctive relief and damages on behalf of a deaf man (primary client) and his deaf companion (companion) who were denied effective communication in a hospital setting. The hospital did not consistently provide qualified sign language interpreters onsite or through Video Remote Interpreting (VRI) when necessary for effective communication. The VRI exhibited multiple problems with connectivity, freezing, and blurry video. Our clients went to the Emergency Room (ER) and to the hospital on numerous occasions for a variety of illnesses. In February of 2016, the parties resolved this mater through entry of a Settlement Agreement. That agreement included the hospital system’s payment of monetary damages to the clients and fees/costs to DRT. The hospital also agreed to take multiple actions to ensure effective communication with deaf patients and deaf companions in the future. Those actions include the following: The hospital has improved its effective communications policy and practices through working with DRT on policy changes. Some of these changes include removing language in their policy that encouraged family members to interpret for deaf patients and clarifying the process for getting qualified sign language interpreters from reputable providers. In addition, the hospital designated specific staff to serve as contacts for sign language interpreter requests. The hospital has improved its assessment process for determining need for sign language interpreters. This includes software programs that identify barriers to communication and whether the patient is deaf or hard of hearing. In addition, the ER will maintain VRI machines and cards in their department to assist with the assessment of communication needs of patients. The hospital has improved its VRI services by increasing its bandwidth capacity, supplementing its existing two dedicated VRI laptops with two additional VRI dedicated laptops, routinely testing VRI equipment, and retaining the VRI in the room of deaf or hard of hearing persons. Also, during the initial use of VRI with a deaf or hard of hearing person, hospital staff will ask if that patient or companion is familiar with the use of VRI; and, if not, a staff member will offer to demonstrate the use of VRI. The hospital will provide numerous and ongoing trainings on procuring sign language interpreters and available tools for effective communication to Nurse Educators, House Supervisors, Nurse Managers, newly hired nurses, Department Heads, and existing clinical staff. In addition, the hospital will add to the nursing department’s annual competency exams a training module on the available tools of effective communication, the procedure for securing the services of a sign language interpreter, and the location and use of VRI. The hospital will flag the call button light for patient rooms where a deaf person is admitted and can know to go to the patient’s room when the call light is activated. As a result of all these improvements, deaf patients and deaf companions will now consistently receive effective communication at this hospital. 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 and assist in making health care decisions rather than serve as family support. The hospital did not consistently provide qualified sign language interpreters onsite or through VRI when necessary for effective communication. In addition, there were multiple problems with the hospital’s VRI services including connectivity problems and blurry video. The 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 wife did not fully understand her husband’s medical situation 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. In January 2015, the parties resolved this matter through entry of a Settlement Agreement. That agreement included the hospital system’s payment of monetary damages to the wife and fees/costs to DRT. The hospital also agreed to take multiple actions to ensure effective communication with deaf patients and deaf companions in the future. Those actions include the following: The hospital has improved its video remote interpreting (VRI) services. They were previously using a wireless network that did not have sufficient bandwidth for VRI. They have now switched their VRI to a different network which has more bandwidth and fewer users. One of our clients in this case tested the system during an actual medical situation and she has let us know it is working well. In addition, DRT attorneys also visited the hospital with a sign language interpreter to test the VRI. We tested in multiple locations including inside the emergency room and it worked well. The hospital now maintains video-remote interpreting equipment ("VRI") in all of its emergency rooms to facilitate effective communication with deaf or hard of hearing individuals. Once a deaf patient is admitted, a VRI will stay in their room until discharge. The hospital has revised its admission assessment. Once a patient or companion identifies that the she is deaf or hard of hearing, then the staff member performing the assessment will proceed with questions to elicit information about the person’s communication needs. The hospital’s computer system will force staff to answer these questions. The questions cannot be skipped. Also, once staff note that a person communicates in ASL, the staff then must choose an accommodation (i.e. sign language interpreter) and cannot indicate that no accommodations are needed. Our client has confirmed this process is working well. In addition to providing qualified sign language interpreters through VRI, the hospital now contracts with 2 interpreting agencies that provide onsite interpreters. The hospital will provide an onsite interpreter whenever that is needed by a deaf patient or companion. Examples include someone with low vision, instances when VRI is not working well for the person, MRI or other imaging tests, etc. The hospital has committed to training staff about how to access VRI and onsite interpreters. Training will help ensure that all staff understand how to ensure that deaf patients and companions have access to qualified sign language interpreters through VRI and/or onsite interpreters. Here are details about the training: By December 31, 2015, the hospital had completed training the House Supervisors and staff handling interpreter requests regarding (1) the available tools of effective communication for deaf and hard of hearing individuals at the hospital, (2) contact numbers, available times, and procedure for obtaining the services of the hospital part-time sign language interpreter, (3) contact numbers, available times, and procedure for obtaining the services an on- site sign language interpreter from one of the contracting agencies, and (4) the location and use of VRI. The hospital has also begun training about these topics during orientation for newly hired nurses and case managers. In addition, the hospital provided training about these topics to its Quality Council and will repeat that training annually. Each of the members of the Quality Council will in turn, provide training to the staff members who report directly to them, so they can serve as resources for clinical staff on questions of effective communication. The Diversity Office will also continue its own ongoing efforts to provide training to the existing clinical staff by making 48 presentations over the next 24 months. As a result of all these improvements, deaf patients and deaf companions will now consistently receive effective communication at this hospital. DRT, along with the American Civil Liberties Union (ACLU) and a local law firm, filed a lawsuit against Tennessee Department of Corrections on behalf of inmates with Hepatitis C. The suit alleges that inmates are not receiving appropriate medical care. Currently, the team is trying to obtain class certification.

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: 35 Number of monitoring projects: 11 Case summary 1: Disability Rights TN (DRT) was contacted by the post-conviction attorney for a 65-year-old Caucasian male with a Hepatitis C (HCV) diagnosis to report that he was being denied appropriate healthcare treatment for this diagnosis. Our client reported that he is in constant pain and is in fear of developing cancer and/or irreparable damage to his liver due to this treatment denial. Upon request to the Tennessee Department of Corrections (TDOC) administration, our client’s case was reviewed by the HCV treatment committee (set up by the TDOC) and it was determined that “he does not at this time have a rapidly progressive disease and is not accelerating to progressive degeneration of his clinical status.” Therefore, the committee recommended that our client not be offered medication treatment of his disease and he will be monitored for any changes in his health status and his case will be reviewed again in six months. Despite this recommendation, DRT requested that our client receive medication treatment for his HCV diagnosis. DRT continues to monitor this client, as well as other inmates with HCV, as part of an ongoing lawsuit against TDOC for inappropriate medical treatment. Case Summary 2: Disability Rights TN (DRT) conducted several monitoring visits to this treatment facility that provides trauma focused care for male and female youth from ages 10-18. During these visits DRT observed educational programs, interviewed youth and staff. This facility has been undergoing staff turnover in the upper administration and has been making significant changes to its in house school. Education has been a major concern at this facility and reports from youth indicated a need for changes. The facility is still working on these changes but DRT has observed significant improvements. While most youth reported no concerns with the facility and their case, the few that reported complaints about staff and rules, that information was shared with the risk manager for him follow up on these reports 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: 36 Number of discriminatory policies and/or practices DRT advocated to change: 21 Case Summary 1: A 33-year-old Caucasian male who is deaf contacted Disability Rights Tennessee (DRT) and reported that a dental office refused to provide a sign language interpreter for his appointments. Our client reported that he did not require an interpreter for general cleaning appointments but did need an interpreter in order to receive effective communication when other dental procedures were being completed. He stated he had tried unsuccessfully to explain this to the dental office staff but they continued to state they could not provide an interpreter. DRT contacted the office and provided the office manager with information regarding the Americans with Disabilities Act (ADA) and the requirements for the provision of effective communication. DRT further explained our client’s need for sign language interpreting services when the communication would be more complex than a general cleaning appointment. The office agreed to provide a qualified sign language interpreter for our client’s next appointment. As a result of DRT intervention, our client is assured he will receive sign language interpreting services upon his request and a dental office has been educated in regards to its legal requirements for provision of effective communication. Case Summary 2: A 60-year-old African American man who is deaf and new to Tennessee reached out to Disability Rights Tennessee for help after he was told at a job fair that he could not work in a company’s warehouse because his deafness made it unsafe for him despite his years of experience in the same position. DRT represented him in negotiating with the company to allow him an equal opportunity to apply for the job with a provided sign language interpreter and he received an apology. He passed the required testing and soon began training for this full time position with a provided interpreter and is now happily employed again. 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, 504 Plans, and Behavior Support Plans. Objective 3: 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 of 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: 6 Number of students provided advocacy for appropriate IEP, 504 Plan, and BSP implementation: 27 Number of projects to provide disability related information to non-English speaking persons: 2 Case summary: The parent of an African American middle school student with ADHD contacted DRT because her daughter had not received appropriate behavior supports in school, resulting in repeated in and out of school suspensions, juvenile charges, and possibility of paying over $800 in restitution for marking on a wall. The parent videotaped her wiping the mark off with a cloth so restitution was excessive and possibly retaliation. DRT represented the client in a due process request that settled in mediation. The settlement agreement included the following: (1) The school system agreed to contract with a third party board certified behavior analyst to observe our client in her normal school environment. The board certified behavior analyst would provide a functional behavior assessment that will be used to create behavior intervention plan and will be involved in the development and implementation of the behavior intervention plan. The observations for the functional behavior assessment was to occur as soon as possible after the start of school August 1, 2016. If there are issues with our client’s behavior prior to the observation occurring, our client’s mother should be contacted by the school immediately. (2) The school system agreed to allow a therapist to enter school grounds and our client’s classroom to work with her and the teachers as long as the therapist does not interfere with classroom instruction. (3) The school system will conduct an educational assessment of our client to determine a baseline of her academic status and provide additional services if deemed necessary by the IEP team. (4) The school system will conduct training with its staff on interacting with children with mental illness. This training should begin immediately and be completed within 6 months of this agreement. (5) The school system will expunge our client’s record regarding the incident with the marker in the hallway and our client’s parent will be permitted to examine our client’s records to ensure that the records are expunged and will inform the school of any discrepancies. (6) The Special Education Director will draft a letter that will be given to the DA’s office to share as appropriate with the Court detailing our client’s diagnoses and services with the school system. This letter will also state that the school system is not seeking restitution and will not pursue payment for removing the marker from the wall of the school. If requested by the parent or our client’s attorney, the Special Education Director will provide this letter in the form of an affidavit. (7) The client’s parent will receive daily communication with her daughter’s school regarding her daughter’s behavior. Our client’s teachers will receive training and guidance on sending this daily communication. (8) The IEP team will consider changing schools for our client if, under the new administration, she continues to have difficulty. As a result of these changes, our client and other students with disabilities affecting behavior will be more likely to receive the services they need to succeed in the school setting. 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, 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, The Arc of 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, and the Statewide Independent Living Council of Tennessee. Number of outreaches: 116 Number of trainings: 19 Number of collaboration projects: 46 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; 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 of 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) 300,658 290,077 State 0 0 Program income 0 0 Private 0 0 All other funds 46,064 46,064 Total (from all sources) 346,722 336,141 B. Budget for the fiscal year covered by this report Category Prior Fiscal Year Current Fiscal Year Wages/salaries 189,781 146,155 Fringe benefits (FICA, unemployment, etc.) 42,078 43,962 Materials/supplies 7,890 10,017 Postage 371 478 Telephone 6,088 5,740 Rent 26,157 28,657 Travel 7,471 5,000 Copying 880 2,509 Bonding/insurance 1,789 2,074 Equipment (rental/purchase) 1,472 1,661 Legal services 0 100 Indirect costs 41,005 44,225 Miscellaneous 11,161 23,546 Total Budget 336,143 314,124 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 Ombudsmen and those Ombudsmen making referrals to DRT.

Certification

Signed?Yes
Signed ByLisa Primm
TitleExecutive Director
Signed Date12/23/2016