On TargetDisability Rights North CarolinaChampions for Equality and Justice

Volume 20 • Summer 2015

2015 Summer Law Interns Bring Commitment, Build Real Life Experience

We are fortunate this summer to have four dynamic law school interns volunteering to help advance critical work in our target areas. While their backgrounds vary, our interns share a common interest in their commitment to disability rights and their eagerness to make an impact outside of the law school classroom.

“I’d like my experience here to arm me as an advocate,” said Katherine Reason, “to teach me how to effect systemic change.” Katherine earned a B.A. in Communications with a concentration in Social Relations & Policy at Michigan State University. As a rising third-year student at Campbell Law School, she is focusing on nonprofit organizations, special education, mental health law and civil rights. Next year she will serve as editor-in-chief of the Law Review.

So far this summer, Katherine has worked on issues related to mental health needs in prison and monitoring in psychiatric hospitals.

Also from Campbell, Meredith Ballard learned quickly the value of her personal experience when speaking with a parent who called our office. Visually impaired herself, Meredith explained one way to teach Braille to the caller’s child, who has a dual deaf/blind diagnosis. At Campbell, Meredith is exploring health law, public school law and appellate work. “Disability law sounds specific, but there are so many avenues it covers.” Meredith plans to build a private law practice that will afford her the opportunity to represent clients on a full range of disability rights issues.

In the meantime, Meredith is a vocal supporter of the MIRA Foundation, which trains and provides service dogs to the blind. She feels strongly that blind teenagers should get guide dogs in early adolescence, when their peers are gaining independence. MIRA Foundation USA is the only organization in the US that provides guide dogs to children under 17. Meredith’s own service dog, Recchi, is guiding her throughout our offices this summer. Disability Rights NC is the kind of environment Lauren Knox was looking for as a rising third year student at Duke Law. Lauren wants to learn not only about disability law in general, but what it means to have a disability and how important it is to have advocates. “The law is important,” said Lauren, “but individual stories show how the medical and clinical landscapes interact, and we don’t always get that in law school.”

Lauren earned a B.A. in Linguistics from the College of William and Mary, and is focusing her Duke studies on employment law and individual rights. She heard about the protection and advocacy system while working with AARP last summer, and was drawn to Disability Rights NC as a way to explore systemic issues on the state level. She is excited about helping with our work on expunging criminal records for individuals

with disabilities seeking services, such as housing or employment. Next year, Lauren will serve as an editor of the Duke Journal of Constitutional Law and Public Policy.

Our fourth intern, Nini Phuah, graduated from San Jose State University with a B.A. in graphic design studies and a minor in criminal justice and worked for ten years in social and human service organizations. Having now finished her first year at Charlotte School of Law, Nini is ready to apply her experience to the real-life legal challenges of our clients, and she hopes to see quick improvements in their personal care services.

Nini has big hopes for the future. She is working on goals to ensure equal access to deaf education, communication, and employment. “I believe that everyone in the deaf community can lead, and one voice is not enough without others,” Nini said. As a person who is profoundly deaf and understands their needs, she wants to include deaf and hard-of-hearing people among those she represents.

Nini has an interest in international human rights and is drawn to the idea of working in Israel, where deaf and hard-of-hearing persons rarely have access to an interpreter and are rarely able to attend college.

As for this summer, Nini is excited to be leading a project of a different sort. She is teaching Lauren, Katherine and Meredith sign language – just one more way our interns are enriching each other and all of the staff at Disability Rights NC.

From the Director

Traveling around the state for our 2015 Listening Sessions, I was reminded that North Carolina is a big state! We visited 17 locations from Murphy (Andrews, actually) to Manteo and from Rockingham to Rocky Mount. I also was reminded of how unpredictable winter in North Carolina can be and how quickly ice and snow can foul up meeting plans. Now that the Listening Sessions have concluded, our staff is reviewing all the information we received to determine where we will focus our work in 2016 and beyond. Recommendations will go to the Board of Directors and PAIMI Advisory Council for consideration this month. With their input, we will publicize the draft Targets for 2016 during July so you will have another opportunity to comment on them. Thank you to everyone who attended the Listening Sessions. We value your time and the information you shared with us. It was especially interesting to hear what you thought would happen to people with disabilities if Disability Rights NC wasn’t around. We heard responses like “have no voice,” “be invisible,” and “be stuck in institutions.” We promise to work hard to prevent those things from happening to people with disabilities living in our state and to ensure they ALL have a voice and receive the respect they deserve.

Vicki Smith, Executive Director

Transitioning Individuals with I/DD Out of Adult Care Homes

According to a North Carolina Institute of Medicine report in 2011, more than 18,000 individuals with disabilities lived in Adult Care Homes (ACHs). Many of the facilities categorized as ACHs were not created, designed, or licensed to provide services for individuals with disabilities – especially those with needs that require intensive supports. Believing that as many as 1500 individuals living in ACHs have an intellectual and/or developmental disability (I/DD), the NC Council on Developmental Disabilities awarded a three-year grant to Disability Rights NC to locate these individuals, examine the reasons why they are there, and work with the individuals and their guardians to transition them to a residence in the community of their choice.

The Investigations and Monitoring Unit at Disability Rights NC began its work on this project in September 2013. Much of the effort in the first year focused on identifying individuals with I/DD under the age of 50 who lived in ACHs and determining if they were interested in transitioning to the community. Many ACHs we monitored are remote and geographically isolated from the community. Some ACHs are extremely chaotic, with shouting, yelling and loud music during the day and at night. Residents at some ACHs report witnessing or being victims of fights, theft, and assault. The quality of life can be poor, with little to no opportunity for engagement outside the facility. Boredom is a complaint of many residents in ACHs.

The second year of project work is focused on transitioning individuals to community living. To date, our staff have monitored in 25 ACHs across the state, in some cases multiple times. We identified 17 individuals who expressed an interest in transitioning out of the ACH. Of the 17, three were unable to participate, the guardians of two individuals refused to participate, and one individual died unexpectedly. Three individuals with I/DD have successfully transitioned to community settings and we are continuing efforts for 11 individuals.

“I want to live here a long, long time,” said J. as he sat in his new home. J. is a 40-year-old man with a traumatic brain injury. J. did not want to live in an ACH because he wanted to be some place “quiet” and without a lot of people around him. As a result of this project, J. now lives in a three-bed group home in a part of the State that he loves. He reported recently that he went fishing for the first time in his life and caught a two-pound fish. Project staff connected J. to other informal community supports to help him become more connected to his new community.

N., a 28-year-old man, also transitioned successfully to a community setting. When we met N., he had lived in ACHs for over ten years and had been discharged from several facilities for significant behavioral issues such as fighting and property destruction. N. is an energetic young man who needed much more physical and mental activity in his daily life than was offered in the ACH. He transitioned to a group home with four other individuals in January, where he has his own room for the first time in many years. The home is close to a public bus stop, and he has learned how to ride the bus independently around his new community. He also is employed for the first time at a local grocery store. The manager of the store is so pleased with his work that he increased his hours. N. would like to live independently, so his person-centered plan includes helping him learn the skills needed for independent living such as cooking,

cleaning and laundry. There have been no behavior incidents since N. transitioned to his new home.

In 2015, there were a total of 606 Adult Care Homes serving 36,413 residents. Of those, 1,477 were individuals with I/DD (5.3% of overall ACH population)

Mark Your Calendar!Third Annual Disability Advocacy ConferenceApril 20, 20168:30 am - 5:00 pmThe Friday CenterChapel Hill, NC

The reception honoring the 2016 Champions for Equality and Justice will be held immediately following the conference on April 20, 2016.

Don’t miss celebrating the first recipient of the Adele Foschia Award for Lifetime Cross-Disability Advocacy.

Awards reception ticket sales and the 2016 conference registration will open in early January 2016. Tickets for the awards reception will be sold separately from conference registration. Or get a discount if you attend both!

Adele Foschia helped Disability Rights NC become the results-driven organization it is today. Even after she turned the leadership reins over to Vicki Smith, she never wavered as an enthusiastic supporter of the organization.

For that reason and in recognition of the fact that Adele spent her entire professional life serving people with all types of disabilities, Disability Rights NC created a new award in her name to recognize individuals who have dedicated their life to advocating for people with all types of disabilities. This award will be given from time-to-time to deserving individuals.

Second Annual Conference

Disability Rights NC held its second annual conference at The Friday Center in Chapel Hill on April 14, 2015. Almost 200 people attended the day long education and disability advocacy event.

This year’s conference featured two keynote speakers from Washington, DC and 16 breakout sessions led by the staff of Disability Rights NC. Andrew Imparato, Executive Director of the Association of University Centers on Disability, and Sharon Lewis, the Senior Advisor to the US DHHS Secretary on Disability Policy and Principal Deputy Administrator of the Administration for Community Living, addressed how new Medicaid services regulations and stronger federal enforcement of the Olmstead

decision will impact disability rights advocacy in our state. Breakout sessions covered a variety of topics including:

• a litigation update from Disability Rights NC’s Director of Litigation, • a review of how Disability Rights NC balances its use of litigation and public policy advocacy to achieve change for people with disabilities,• the status of mental health services after the US DOJ settlement,• an overview of Disability Rights NC’s monitoring work in prisons,• a personal perspective on the use of restraints in institutions,• alternatives to guardianship,• housing rights,• transition from school to work and employment discrimination, and• various Medicaid law topics.

New to this year’s conference was the networking lunch. Attendees had the opportunity to select a lunch table where a particular issue would be discussed. The response to the networking lunch was positive so it will be back in 2016.

We hope to see everyone again in 2016 as well as lots of new faces. The Disability Advocacy Conference not only is an opportunity to learn from the Disability Rights NC staff but allows disability rights advocates and self-advocates to recharge with inspiration and new connections.

2015 Conference Sponsors

Presenting SponsorThe Ireland Family Foundation on behalf of Extraordinary Ventures

Post-Conference Reception SponsorHenson & Fuerst

Exhibit Hall SponsorRHA Howell, Inc.

Breakout Session SponsorsAvison YoungEducationNCBeth Garriss Hardy, Ph.D.MonarchW.G. Alexander & Associates, Attorneys

ChampionsBayada Home Health CareEaster Seals UCP North Carolina & Virginia

Mike Mayer and the Consultants of CRANational Academy of Elder Law Attorneys (NAELA) – NC ChapterNC Council on Developmental DisabilitiesNC Council of Community ProgramsJanna Shisler

SupportersAlberta Professional Services, Inc.AnonymousBenchmarksKathy BoydBrody School of Medicine, East Carolina UniversityAndrew ErteschikMarian HartmanPam JarrettMarketing Association for Rehabilitation Centers, Inc.Nancy MayerSelf- Help Credit UnionSenn DunnGerda Stein

Lots of New Faces at Disability Rights NC

Virginia Fogg - AttorneyGinny joined Disability Rights NC in late 2014. For the past six years, she has represented children in special education and discipline matters in her solo law practice. Ginny grew up in Wilson and attended UNC-Chapel Hill as an undergraduate. She received her law degree from Columbia Law School in 1994. While in law school she served as the Executive Editor of the Journal of Law and Social Problems and represented parents with children in the New York City foster care system through the law school’s Family Advocacy Clinic. After law school, she first clerked for the North Carolina Supreme Court, and then practiced class action litigation and transactional law in northern California. Ginny is married, has two children, and spends her free time attending sporting events and exploring the Triangle food scene.

Carol Hammerstein – Communications and Events CoordinatorCarol joined Disability Rights NC in May 2015. She received a BA in political science from NC State University and is working toward a Master of Fine Arts in film and video from UNC-Greensboro. Carol has been a writer and editor at the News & Observer and a communications manager at the Center for Responsible Lending, a national nonprofit dedicated to fighting predatory lending practices. Alongside her nature-loving son, she enjoys woods, waterways, and exploring the wonders of the American West.

Marian Hartman - InvestigatorMarian is a disability consultant who worked in North Carolina state government for over 30 years. She began her career as an advocate at the Governor’s Advocacy Council on Children and Youth, and then served as the Director of Child and Family Services at New River Mental Health. She spent the last part of her governmental career at the NC Council on Developmental Disabilities and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. While at the Division of MH/DD/SAS, she served as Regional Coordinator of Child and Family Services and as Branch Head for Community Capacity Building. She was responsible for increasing opportunities for community inclusion throughout the state for people with disabilities. Marian served on the Board of Directors for Disability Rights NC from 2006 through 2010, including a two-year term as Board Chair. She joined the staff of Disability Rights NC in May 2015 continuing her work on a project designed to help people with intellectual and developmental disabilities transition out of adult care homes.

Carolina Herrera - ReceptionistCarolina joined Disability Rights NC in October 2014. She enjoys helping people with disabilities and gets to do that daily as she answers the phones and speaks to people who need help protecting their rights. Carolina grew up in New York City and moved to Raleigh two years ago with her three-year-old son, Lyiam. She looks forward to learning more about North Carolina and already is fond of the NC Museum of Natural Sciences and the NC Zoo. Carolina loves a good bargain so you might see her at one of the area’s flea markets on the weekend.

Tadra Martin - AttorneyTadra joined Disability Rights NC in January 2015. Although she is originally from South Carolina, Tadra is a proud Tarheel. She received her bachelor’s degree from UNC-Chapel Hill and her law degree from Vanderbilt Law School. For over five years, she represented low-income individuals in various areas of civil law as a staff attorney at Legal Aid of North Carolina. Prior to joining Disability Rights NC, Tadra conducted unemployment appeals hearings as a legal specialist at the NC Division of Employment Security. Tadra’s work at Disability Rights NC will focus on protecting the rights of individuals with disabilities to live in the most integrated community setting.

Katherine Slager – AttorneyKat joined Disability Rights NC in January 2015. She received her bachelor’s degree in Psychology from Warren Wilson College in Asheville, and her law degree from UNC-Chapel Hill. Kat served in the Peace Corps before attending law school, teaching English as a second language in Mauritania (West Africa) for two years and in western China for one year. After graduating from law school in 2013, she clerked for Justice Cheri Beasley at the NC Supreme Court. Kat will focus her work on employment discrimination and ensuring public accommodations. She is fluent in French and is working on improving her sign language.

New Office

Disability Rights NC moved to its new location one year ago. Thank you to everyone who joined us on August 21 and 22 for the Open Houses in our new office. We are still conveniently located just off the I-440 Beltline and Glenwood Avenue in Raleigh, NC. Come visit anytime! Our office is open weekdays from 8:00 am to 5:00 pm.

Disability Rights NC Staff

ExecutiveVicki Smith, Executive Director Finance & OperationsCharlie Barnes, Chief Financial OfficerJanice Willmott, Chief Administrative OfficerKarla Blackwell, Administrative AssistantCarolina Herrera, ReceptionistAllyson Hilliard, Accounting AssistantMavis Jones, Office ManagerDennis Knight, IT ManagerHaydee Martinez, Administrative AssistantWill McDowell, Office Aide Legal & AdvocacyApril Giancola, Chief Legal Program OfficerJohn Rittelmeyer, Director of LitigationCas Shearin, Director of Investigations and MonitoringLisa Grafstein, Managing AttorneyJennifer Bills, Senior AttorneyTabitha Bryant, AttorneyRaven DeMonia, ParalegalYasmin Farahi, AttorneyVirginia Fogg, Senior AttorneyAnthony Garcia-Copian, Intake SpecialistIris Green, Senior AttorneyMarian Hartman, AdvocateTadra Martin, AttorneyGabrielle Martino, Investigator Kady McDonald, Intake SpecialistKishona Mimms, InvestigatorLisa Nesbitt, AttorneySteve Noblitt, Advocate

Susan Pollitt, Senior AttorneyLisa Rabon, AttorneyKatherine Slager, AttorneyHolly Stiles, AttorneyKathy Smith, AdvocateKristine Sullivan, AttorneyDebbie Thome, AdvocateChris Trottier, Senior Attorney Policy & OutreachCorye Dunn, Director of Public PolicyElaine Whitford, Director of DevelopmentAnnaliese Dolph, LobbyistCarol Hammerstein, Communications and Events CoordinatorMercedes Restucha-Klem, Public Policy Analyst

Disability Rights NC Board of Directors

Janna Shisler, Chair (Chapel Hill)Deborah Whitfield, Chair-Elect (Charlotte)Charles Walker, Treasurer (Raleigh)D. Jones, Secretary (Greenville)Pat McGinnis, PAIMI Advisory Council Chair (Marion)Ernie Baldwin (Charlotte)Adebola Desalu (Fuquay Varina)Bill Donohue (Winston-Salem)Lourdes Arenas Fernandez (Raleigh)Rachel Fuerst (Raleigh)Katrina Hayes (Raleigh)Michael McGilton (Jacksonville)Natalie Miller (Mooresville)Shelly Stephens (Murphy)Thank You to Board Members Whose Terms Ended

Thank you to the Board members who rotated off the board in December – Kathy Boyd (Board Chair 2013-14), Rusty Bradstock, Cheryl Mulloy-Villemagne (Board Treasurer 2012-14), and Kim Taylor. All four of these board members served for six years and helped shape Disability Rights NC into the accomplished organization it is today.

2014 Champions for Equality and Justice

On November 7, 2014, two advocates for people with disabilities received the Champions for Equality and Justice Award presented annually by Disability Rights NC.

Linda McDonoughLinda McDonough has not only led advocacy efforts for people with disabilities but has inspired others to become advocates as well. She is the mother of two daughters, neither of whom fit well into public schools. So she founded a school called Just Right Academy for her children and other students who don’t fit the mold. Opened five years ago, Just Right Academy is a nonprofit, private elementary and secondary learning center focused on instruction for children who need structure and positive reinforcement, movement, and reduced stress. It has been a success and continues to grow, especially supporting children on the autism spectrum.

After graduating from Western Carolina University in 1977 with a bachelor’s degree in English and minors in Reading and Education, Linda taught in both public and private schools. For many years, she worked as a private tutor to help children with dyslexia learn to read and write. From 1992 to 2008, she served as the Director of Christian Education at the Church of the Holy Family, where she founded the Augustine Project, a program that provides trained tutors to low-income children with reading difficulties. She continues to serve as a tutor, trainer, and board member. Linda was recognized for her work on the Augustine Project by the NC Chapter of the International Dyslexia Association with the June Lyday Orton Award for service to people with dyslexia.

Linda was nominated for the Champions for Equality and Justice Award by Laura Branan who said she is inspired by Linda’s advocacy for North Carolinians with special needs and mental illness. When the General Assembly threatened to close The Wright School, a private school for children aged 6-12 with behavioral and emotional disorders, Linda used social media to organize citizens of NC to write and call their state legislators to ask them to continue to fund The Wright School. Linda’s advocacy leadership inspired many people to support and advocate for The Wright School community.

Linda improved awareness by speaking at the annual mental health state legislative breakfast in Chapel Hill and testifying before the Medicaid Reform Advisory Committee. She participated in the non-violent Moral Monday protests in Raleigh and rallied others to join her. Betty PaeslerKnown as “Nurse Betty” to the staff of Disability Rights NC, Betty Paesler is tiny in stature, but big on passion. Her selfless contributions to Disability Rights NC help ensure safer, more humane and effective treatment for the people we serve. She retired from Central Regional Hospital as Director of Nursing in 2009, after serving patients there and at Dorothea Dix Hospital for nearly 30 years. Betty was a pioneer in advocating for mentally ill patients and their families by empowering and educating both consumers and mental health providers regarding hope and confidence within the recovery model. She initiated and directed the first treatment mall in the nation that successfully integrated forensic patients with the civil population. She

shared her experience as a co-author for “Integrating Forensically and Civilly Committed Adult Inpatients in a Treatment Mall at a State Hospital,” an article published in the journal Psychiatric Services in 2009. In addition, she created and implemented a protocol for mental health directives to afford patients the opportunity to choose treatments in advance of a major psychiatric regression.

Patient care and administration was not Betty’s only responsibility. She also educated staff members on advances in clinical practice and led QI initiatives. Betty directly supervised the nursing care in the Forensic Division at Dix (consisting of 90 beds; pretrial, minimum, medium and maximum security) from 2002-2009.

Her graduate degree is in Psychiatric/Mental Health Nursing with a focus on underserved and difficult to serve populations, such as patients living in geographic areas that are difficult to reach, underserved patients not responsive to therapy, and people with chronic mental health issues. She was involved in a research project that studied the barriers to the implementation of a childhood immunization program aimed at low income families. Betty has completed 18 semester hours of doctoral work focusing on education and health care.

Betty began volunteering with Disability Rights NC after her retirement and has given hundreds of hours of her time to help us serve our clients better. Her expertise treating people with severe mental illness makes her an invaluable resource for our investigations and monitoring work. Along with staff, she monitors conditions at the mental health hospital at Central Prison as well as Unit One, the disciplinary unit where prisoners are locked down 23/7. Betty helps Disability Rights NC staff members understand the nuances of issues such as chemical restraint and how to respond to a person who is experiencing delusions or hallucinations. Her expertise as a nurse in general is invaluable because she can explain complex medical issues.

2014 Awards Reception Sponsors

Platinum ChampionsCadgewith Farms Ltd.Vicki Smith

Gold ChampionsKathy BoydDevelopmental Associates (Heather Lee and Steve Straus)Easter Seals UCP NC & VirginiaGarriss Hardy & Associates

Silver ChampionsCampbell University Law SchoolChris GriffinHenson & FuerstMichael Murray

Janna Shisler

Bronze ChampionsKen ButlerSally CameronWilliam DonohueApril GiancolaGreater Triangle Rep Payee Services, Inc.Ginny HiltonAshley LindsayRoger ManusGreg McGrew

Legal Updates

Fourth Circuit Recognizes Interacting with Others as a Major Life Activity

The Fourth Circuit Court of Appeals recently decided an appeal filed by Disability Rights NC in an employment discrimination case. Jacobs v. N.C. Administrative Office of the Courts, et al., 780 F.3d 562 (4th Cir. 2015). The court’s opinion discussed and adopted the EEOC regulation that “interacting with others” is a major life activity. This case is the first one we are aware of where a federal court of appeals recognized interacting with others as a major life activity.

It also is the first Fourth Circuit case applying the amended ADA, which restored the broad definition of disability which had been eroded by the courts. The opinion states that an individual with a mental illness must be reasonably accommodated if the accommodation will enable the person to remain employed, even if that means shifting job duties among employees.

In 2011, Disability Rights NC, with co-counsel Vanessa Lucas of Edelstein & Payne, filed a lawsuit against the Clerk of Court for New Hanover County alleging employment discrimination. Plaintiff Christina Jacobs was employed in January 2009. Soon after she was employed, her job duties were changed and she was required to staff the front desk, interacting with the public for most of the day. This was a problem because Ms. Jacobs has Social Anxiety Disorder. She disclosed her condition and requested a reasonable accommodation – that her duties not require constant public interaction. She was terminated shortly thereafter.

Class Action Settlement in Innovations Waiver Case Applies to All Nine MCOs in North Carolina

The class action filed against the State and Cardinal Innovations challenged substantial changes to the Innovations Waiver program, all implemented without benefit of any

appeal rights for the hundreds of recipients whose services would be reduced as a result. L.S. et al. v. Wos et al., 11-cv-0354-FL (EDNC).

On April 6, 2015, U.S. District Court Judge Louise Flanagan gave her final approval to the settlement in L.S. v. Wos. The terms of the settlement require the NC Medicaid agency and all of its contractors to extend substantial due process protections to the waiver participants.

Judge Flanagan’s approval makes the terms of the settlement agreement applicable to all nine Managed Care Organizations (MCOs) in the state and begins a nine-month compliance monitoring period during which the MCOs will implement the terms of the settlement, including the modification of any of their policies which conflict with the settlement.

The Settlement applies to all participants in the NC Innovations Waiver and requires that steps be taken to:• Ensure that Innovations Waiver participants are empowered to request the services they want to request, in the amount and for the length of time they want to request them;• Clarify that the Support Needs Matrix will be used as a guideline and not as a binding limit for certain NC Innovations services;• Clarify and explain the due process rights of NC Innovations Waiver participants; and• Inform NC Innovations Waiver participants of their rights and responsibilities under the Waiver.

Dentist Sued for Failure to Provide ASL Interpreter and NC DHHS Sued as Co-Defendant for Failure to Ensure No Discrimination in the Medicaid Program

In February 2015, Natishia Sanderson sued the dental office of Bruce Tripp, DDS, PA and the NC Department of Health and Human Services. Ms. Sanderson is deaf and requested that Dr. Tripp provide a sign language interpreter during her dental appointment. Federal law requires Dr. Tripp to provide an effective means of communication with his patients. Dr. Tripp told Ms. Sanderson to hire her own interpreter, otherwise he and his staff would communicate with her in writing. Ms. Sanderson had seen a previous dentist without an interpreter, but it was an ineffective method of communication resulting in her suffering through unnecessary pain. Ms. Sanderson is covered by the Medicaid program.

Under federal regulations governing Medicaid, the state Medicaid agency (NC DHHS) is required to ensure that members of its network of providers do not discriminate based on disability. The State is required to adopt grievance procedures and to promptly and equitably resolve complaints of disability-based discrimination in the Medicaid program.

In October 2013, Ms. Sanderson first attempted to file a grievance with the Medicaid agency but nothing happened. Multiple attempts to elicit an adequate response from state officials were unsuccessful. Consequently, DHHS was included as a defendant in the suit filed against Dr. Tripp because it is the state agency responsible for

the administration of the Medicaid program in North Carolina. Sanderson v. Tripp, et al., No. 4:15-cv-23 (EDNC).

Podiatrist Sued for Failing to Allow Guide Dog in Examination Room

Roger Wiker is visually impaired and uses a guide dog, Fred, to navigate his environment. When he went to an appointment at his local podiatrist he was informed that Fred could not accompany him to the examination room. The reason given by the podiatry practice was that the treatment room was a sterile environment and therefore animals were not allowed. Disability Rights NC filed suit against the podiatry practice group and the physician-owned Professional Association under which the practice operates. Wiker v. Advanced Foot and Ankle Center, No. 5:15-cv-4 (WDNC).

Settlement Requires State to Prohibit 24-Hour Use of Restraint Device in All State-Operated Developmental Disability Centers

Nicholas is a young man with autism residing at J. Iverson Riddle Developmental Center (JIRDC) who was routinely held in a device referred to as an “ambulatory restraint.” The device consisted of a leather belt with two leather wrist cuffs attached by straps and operated to restrict the range of motion of Nicholas’ arms. He was kept in this device 24-hours-a-day for 13 consecutive days, including while he showered and slept. He was forced to wear at least the belt portion of the device for 157 days in a row. After multiple failed attempts to address the matter with staff from both JIRDC and the NC Department of Health and Human Services (DHHS), Disability Rights NC filed a legal complaint against both JIRDC and DHHS for violating the young man’s rights under the US Constitution. Nicholas C. v. Wos, No. 1:14-cv-72 (WDNC).

The parties reached a settlement agreement which requires DHHS to develop and implement policies at all three state-operated developmental disability centers:• prohibiting the use of a restraint device on an individual who is sleeping;• requiring staff to release an individual from a restraint device to eat, shower and use the toilet; and• requiring staff to release an individual from a restraint device as soon as the likelihood of immediate harm has ended.The settlement also requires DHHS to provide training to its staff on federal and state legal requirements for the use of restraint.

On the Cutting-Edge at SXSW

In March 2015, Disability Rights NC attorney Holly Stiles was part of a panel discussion on “Enhancing Human Functionality with Technology” at the South by Southwest (SXSW) Interactive festival in Austin, Texas. SXSW Interactive describes itself as an “incubator of cutting-edge technologies and digital creativity… [featuring] compelling presentations and panels from the brightest minds in emerging technology.” During the

panel, Holly discussed access to technology as a civil rights issue for people with disabilities and focused on technology as a tool that fosters full integration in the community. Other members of the panel included Virginia Ingram, an advocate for accessibility by design who looks to technology for solutions in business and in life, and Mick Ebeling, co-founder of Not Impossible, a foundation that strives to make inexpensive, do-it-yourself (DIY), accessible technology for people with disabilities. Learn more about Virginia Ingram or Not Impossible at www.virginiaingram.com and www.notimpossible.com.

While at SXSW, Holly attended a variety of presentations on topics including:• using remote presence devices that enable people with disabilities who cannot travel to “be there”;• designing products and systems that promote aging in place;• DIY brain hacking (!); and• 3D bio-printers.

Holly shared that “it was exhilarating to be surrounded by people who are pushing the boundaries of their respective fields. It feels like you are in the eye of a storm of creativity. You can feel the energy surrounding you on all sides.” We asked Holly if there was any one experience that was particularly memorable and she said that “during the panel on the use of remote presence devices, Ms. Krishnaswarmy showed us her ‘selfies’ using one of the devices. It sounds trivial, but it really hit home for me. Just imagine if you were unable to move your arms independently and were being left out of the cultural phenomenon that is the selfie!”

Holly also visited Disability Rights Texas, the protection and advocacy system for Texas located in Austin, and met with Brian East and Lia Davis, attorneys who are working on the same types of cases handled by the Community Access Team at Disability Rights NC.

Volunteer Spotlight: Angela Lassiter

Angela Lassiter, an attorney in Raleigh, attended the pro bono training in October 2014. She was interested in Disability Rights NC’s program because she “thoroughly enjoys advocating for those who have difficulty voicing their opinions and positions.” She has experience working with individuals with lived experience of mental and physical disabilities. She said, “It is truly an amazing day when you can assist someone, who has been judicially declared to be incompetent, in a complete restoration of their rights.”

Shortly after taking the pro bono training class, Ms. Lassiter took a case where the client wanted to have his competency restored. Several months later, Ms. Lassiter shared the good news that the client’s competency had been fully restored. “I was able to joyously celebrate with my client on his restoration and had confirmation of my purpose in the legal field when he hugged me and said thank you because he didn’t believe this day would ever come.”

Angela practices law in Raleigh with a focus on estate planning, elder law, special proceedings, and estate administration. She received undergraduate degrees in Criminal

Justice and Corrections and Forensic Biology before attending law school at NC Central University. She can be reached at 919-244-2475.

Pro Bono Legal Services Program at Disability Rights NC

In 2011, Disability Rights NC launched its pro bono legal services program to better meet the ever-growing need for attorneys to handle Medicaid Appeals and restoration of competency cases. All attorneys interested in accepting a pro bono case will receive training (with CLE credit) and mentoring, as needed, from an attorney at Disability Rights NC. We welcome experienced practitioners as well as new lawyers to volunteer for the program.

Presently, we host a three and a half hour CLE twice a year to train attorneys on how to represent clients in Medicaid appeal hearings and restoration to competency matters. This program includes an hour on how to work with clients with diminished capacity which the NC State Bar recognizes for ethics CLE credit.

“Disability Rights NC is committed to ensuring people live in the least restrictive environments possible while maintaining their independence and dignity. Our pro bono program echoes this philosophy by training attorneys in the community to help our clients when we are not able to do so,” stated April Giancola, Chief Legal Programs Officer and administrator of the pro bono program.

All attorneys licensed to practice in North Carolina who are interested in volunteering for the pro bono program should contact April Giancola at april.giancola@disabilityrightsnc.org or 919-856-2195.

Disability Rights NC Continues to Advocate for Required Prison Reform

Although Governor McCrory has asked North Carolina lawmakers to provide $24 million to address mental health care needs in Central Prison, the NC House has set aside only half that in their budget and the NC Senate is predicted to authorize even fewer funds. Once the House and Senate settle the difference, only a fraction of what the governor has requested is likely to be approved.

Frank Perry, secretary of the Department of Public Safety, and David Guice, commissioner of Adult Correction and Juvenile Justice, have both recognized the need for systemic reform. But they will not be successful without the funds “necessary to provide a humane and constitutionally adequate system of care for prisoners with mental illness,” said Vicki Smith, Executive Director of Disability Rights NC.

In December 2014, Commissioner Guice told lawmakers that there are 4,645 inmates receiving mental health services in North Carolina prisons and many of them are in long-term isolation. Changes are underway, he said, but the needed fixes – more therapy, more medical oversight, specialized units – will not be cheap.

Specialized units would allow isolated inmates with mental illness to come out of their cells and receive treatment. Adequate funds would allow staff to improve

screening, open all the beds at the Central Prison mental health hospital in Raleigh, and increase the number of mental health providers across the state’s prison system.

Reform of mental health issues in our State’s prison system has been newly catalyzed by the unfortunate death of Michael Kerr in March of 2014. During an acute mental breakdown, Mr. Kerr was placed in a segregation cell in Alexander Correctional Institution. He died of dehydration after correctional officers, medical and mental health staff left him handcuffed for days and failed to get him treatment.

Disability Rights NC investigated the case and demanded action—the prison system should consult with a national expert on mental health needs in the prison setting, improve screening for mental health upon admission, discontinue the use of segregation for inmates with serious mental illness, provide meaningful treatment, and cease the practice of punishing inmates for behaviors related to their illness. We called on officials to declare the vacancy rate for mental health staff an emergency.

Disability Rights NC has been demanding reform since 2009, when we investigated injuries suffered by an inmate left in a prison segregation cell for more than 500 consecutive days. The inmate, who had mental disabilities, was injured after he set a fire in his cell. Disability Rights NC advised the prison system that the policies and procedures they followed to protect individuals against the harm resulting from long-term segregation were grossly inadequate.

In 2011, an internal audit of mental health services at Central Prison revealed horrendous conditions. Disability Rights NC joined with advocates to demand an outside investigation, staff training, updated procedures, and reform tracked by an outside agency to determine compliance and degree of success.

These efforts help put into place consultation from an expert on mental health issues in prisons, an advisory group (which includes Disability Rights NC) that meets bi-monthly with prison administrators, and a new Department of Public Safety CIT training initiative. Part of the new mental health hospital has opened at Central Prison, and Disability Rights NC now has a regular P&A system monitoring presence at the Central Prison Hospital and its segregation unit.

Disability Rights NC will continue to press to ensure that prisoners with disabilities in North Carolina have the care they are constitutionally entitled to receive while in prison, as well as transition support for successful release and reintegration into their communities.

Disability Rights North Carolina is a federally mandated protection and advocacy system with funding from the U.S. Department of Health and Human Services, the U.S. Department of Education, and the Social Security Administration. It is a 501(c)(3) nonprofit organization.

Disability Rights North CarolinaChampions for Equality and Justice3724 National Drive, Suite 100

Raleigh, North Carolina 27612919-856-2195877-235-4210888-268-5535 TTY919-856-2244 fax

Upon request, information is available in alternate formats.

North Carolina’s Protection and Advocacy System

www.disabilityrightsnc.org