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					Disability Rights North Carolina
Champions for Equality and Justice

2009 Annual Report

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.

Our Mission

Protect the legal rights of people with disabilities through individual and systems
advocacy.


What We Do

 Investigate complaints about neglect and abuse and suspicious or unexpected deaths in
institutions;
Represent individuals based on Disability Rights North Carolina’s (DRNC) targets and
case selection criteria;
Educate people with disabilities about their many legal, civil, and service rights;
Provide technical assistance, training, publications, and advocacy support for North
Carolinians with disabilities, their families, and representatives;
Conduct outreach to traditionally underserved ethnic and disability communities; and
Bring impact litigation and act as amicus curiae in disability-related cases.


Whom We Help

DRNC provides advocacy help for North Carolinians with disabilities. You could be
eligible for DRNC services if:

You have a developmental or intellectual disability;
You have a psychiatric disability or emotional impairment;
You are a patient in a state psychiatric hospital;
You have a physical, learning, or sensory disability; or
You have a traumatic brain injury.


2009 Board of Directors

Marian Hartman, Chair
Beth Garriss Hardy, Chair Elect
Ann Elmore, Treasurer
Jeff McLoud, Secretary
Greg Best, – New Bern
Kathy Boyd – Wake Forest
Rusty Bradstock – Greensboro
Adonis T. Brown – Durham
Lois Cavanagh-Daley – Raleigh
George “Pete” Clary – Winston-Salem
Ann Elmore – Raleigh
Bart Floyd – Asheville
Beth Garriss Hardy – Summerfield
Marian Hartman – Cary
Lucy Inman – Raleigh
Daniel C. Johnson – Wilson
Brett Loftis – Charlotte
Jeff McLoud – Kinston
Kimberly Taylor – Statesville
Cheryl Mulloy-Villemagne – Waynesville
Willis Williams - Jamesville

Protection & Advocacy for Individuals with Mental Illness Advisory Council

Lois Cavanagh-Daley, Chair – Raleigh
Katrina Boyd – Raleigh
Stephanie Broyhill – Wilkesboro
Laurie Coker – Winston-Salem
David Cornwell – Fletcher
Lucy Inman - Raleigh
Obie Johnson - Winston-Salem
Loretta King - Gastonia
Jeff McLoud, Vice Chair – Kinston
Cheryl O’Kelley – Asheville
Michael Owen - Chapel Hill


DRNC Staff

Adrienne Allison
Charlie Barnes
Jennifer Bills
Diana Burch
Lisa Carroll
Ronald Charlot
Sonya Clark
Rodney Crooms
Angie Downs
Annaliese Dolph
Karen Dozier
Elizabeth Edwards
Kimberly Fakhoury
Dan Fox
Anthony Garcia-Copian
Iris Green
Allyson Hilliard
Nancy Hitchcock
Mavis Jones
Dawn LaSure
Haydee Martinez
Amy Mackin
Carrie Mason
Morris McAdoo
Kady McDonald
Linda McMillan
Michael Murray
Karen Murphy
Susan Pollitt
Lisa Rabon
John Rittelmeyer
Cas Shearin
Holly Stiles
Andrew Strickland
Kathy Smith
Vicki Smith
Kristine Sullivan
Debbie Thome
Christine Trottier
Janice Willmott


Disability Rights NC has 40 employees with legal, advocacy and management expertise.
Not all of our employees work fulltime; we have the equivalent of 12 attorneys, 8
advocates, 2.5 intake specialists, 6.5 support positions, and 5 managers, including the
Executive Director.

Last year we expanded our statewide presence, representing clients in 99 of North
Carolina’s 100 counties. Almost a third of our employees have a disability and almost
two-thirds have a family member with a disability. Three of our employees speak Spanish
and two are conversant in American Sign Language.

During 2009 our staff was divided into teams: Administration; Abuse & Neglect;
Community Inclusion; Education; Information & Referral; and Management.
Dear Friends and Supporters,

Disability Rights North Carolina (DRNC) belongs to the citizens of this state who were
born with or acquire a disability. Our obligations are to all such people throughout their
lives – from birth until, tragically in some cases, after death when they die while under
the care and treatment of their caregivers. Our advocacy work covers every aspect of life,
ensuring people with disabilities have the ability to live free from harm in the
communities of their choice. It is our duty to ensure that people with disabilities have the
same opportunities as any other citizen of this state to participate fully and equally in
society.

Many people with significant disabilities are able to live in the community when they
receive appropriate support and services. The elimination of those supports and services
for economic reasons does not eliminate people’s needs or their right to due process. The
budget cuts adopted by the N.C. General Assembly fractured an already fragile system of
care for people with disabilities. The system is now more fragile than the vulnerable
people it is intended to serve. The need for legally based advocacy is enormous. The fear
that diminished services will force people who have been successfully living in the
community to move into more restrictive settings is very real.

The Board of Directors of DRNC approved the transfer of all available resources to
legally challenge specific cuts to services for people with disabilities. But there will never
be enough resources to provide legal representation to every person with a disability who
is in need. Recent 2008 estimates from the U.S. Census Bureau for North Carolina
calculate that there are at least 1,822,500 people with disabilities living in our state.
DRNC has one attorney for every 165,682 North Carolinians eligible for our services.

We have a huge responsibility and limited resources. So the Board was forced to make
difficult decisions regarding where to spend DRNC’s limited resources on specific
targets. Federal laws including landmark legislation such as the Individuals with
Disabilities Education Act (IDEA), the Fair Housing Act, and the Americans with
Disabilities Act (ADA) provide specific protections and entitlements. It is our job to
make them real. The underlying principle of these entitlements is due process, which
means proper notification; consistent eligibility criteria; clear and publicly known
standards used for decision making; the right to appeal decisions; and the maintenance of
effort during any appeal. Our role is to enforce those entitlements.

We use a variety of strategies to enforce the rights of people with disabilities, including
mediation, administrative negotiation and litigation. We are strategic in using our tools,
knowing that it is the outcome that is most important, not the tool we use to achieve it.
We are pleased that we’ve achieved many positive outcomes without having to use the
most expensive and time consuming tool – litigation. Yet we are ready to wield that tool
if it will get the job done.

Within these pages you will see examples of our efforts during fiscal year 2009 (October
1, 2008 to September 30, 2009) on behalf of people with disabilities. The examples tell
the stories, the real lives behind the statistics. They are the stories of our children, our
sisters and brothers, our parents, our friends and our neighbors.

Vicki Smith, Executive Director
Marian Hartman, Chair of the Board of Directors


Disability Rights North Carolina (DRNC) is the state’s federally mandated protection and
advocacy system (P&A). A P&A is charged with providing information and referral and
pursuing legal, administrative, and other appropriate remedies to resolve issues of abuse
or neglect or violation of rights based on disability for individuals with disabilities or
groups of such individuals.


Meaningful Information and Referral

A core function of a P&A is Information and Referral (I&R). When someone calls us for
assistance, we listen and respond. It is vital that DRNC responds quickly, because people
don’t call to tell us everything is all right. They call us looking for help because
something in their life or the life of a family member is not working. Sadly, we do not
have enough resources to assign an attorney or an advocate to every caller. But we can
listen. We can help identify legal rights. We can develop effective referrals and good
information. We have developed easy-to-use guides and self advocacy tools – fact sheets,
explanations of rights, and advice about what to do next. We have dedicated 2.5 Intake
Specialists to our I&R function.


Cases opened before October 1, 2008: 181
Cases opened on or after October 1, 2008: 469
Total cases worked on from October 1, 2008 to September 30, 2009: 650
Cases still open on October 1, 2009: 107
Information & referral provided to 1815 callers

“I cannot praise or thank DRNC enough. Staff are both kind, sensitive, knowledgeable
and highly professional.”


Monitoring and Investigation/Ensuring Safe and Humane Treatment in Facilities

Other core P&A functions include monitoring facilities and investigating incidents of
serious abuse/deaths. DRNC monitors facilities to make sure vulnerable people who rely
on the care and treatment of others are safe, receive appropriate services and are
discharged appropriately when it’s time to leave. Often our mere presence in a facility
protects the residents from intentional and accidental harm. We keep people safer
because we show up. We listen to the people who live in these facilities and we follow up
when they are in jeopardy.
The follow-up often takes the form of a secondary investigation in which we make sure
that any internal investigation required by the facility, school or other provider was done
appropriately. A central part of our investigation is to determine if the internal
investigation considered the testimony and allegations of the victim and treated them as
credible. Our investigation attempts to identify the event(s) that led up to or caused a
person with disabilities to be harmed. Our goal is to change the policies, staff training,
patterns and other issues to reduce the likelihood that another person will be harmed.

To adequately cover the monitoring and investigatory functions for psychiatric hospitals,
group homes, ICF/MR facilities, Private Residential Treatment Facilities, etc., DRNC has
assigned approximately 4.5 full time equivalent positions to this function.


The Right to Be Safe from Harm

Female adolescents living in a state operated psychiatric hospital complained of sexual
abuse by a health care technician assigned to their unit. DRNC’s investigation determined
that this individual had inappropriately approached three adolescent females offering
them privileges (including french fries) in return for sex. The hospital’s team that
investigated the allegation did not treat the young women as credible and therefore took
no action. Following DRNC’s report, the facility undertook a re-investigation and
substantiated the allegation. As a result the health care technician is no longer employed,
and the facility formed a workgroup to re-evaluate the investigation process. Of particular
importance was a re-evaluation regarding the burden of proof required to substantiate an
allegation.

DRNC also investigated the death of RM, a recent resident of an adult care facility in
eastern North Carolina. RM, who had a complex medical history including end-stage
renal disease requiring dialysis and an amputation requiring wound care, died just fifteen
days after leaving the facility.

When he left the adult care facility, RM was able to find an apartment, and a preacher
helped him move his belongings. RM was discharged from the facility without his
medications, though, and so had to go back to the facility the next day to collect his
numerous medications, including nine different oral medicines, an Accu-Chek® monitor
with strips, insulin syringes, vials of insulin and wound care supplies. RM was discharged
without any services in place.

Someone alerted DSS Adult Protective Services. The APS social worker scrambled to
arrange services, first having to find a doctor to sign an order. The social worker told
DRNC that the services were scheduled to start on the very day that RM was found
unresponsive in his apartment. His blood glucose level was 23 and his foot was infected.

After an investigation, it was found that the facility failed to do the following: (1) notify
the county DSS responsible for placement services; (2) provide RM with the name,
address and telephone number of the regional long term care ombudsman; (3) discharge
RM with his medications. The facility produced a corrective action plan which included a
thorough discharge checklist, training for all staff and quality assurance measures.

AB, a resident of a state operated facility, was found dead entangled in her protective
restraints. DRNC monitored the facility soon after the death and attended a meeting of
the facility’s Human Rights Committee about the death. The SBI and the Medicaid Fraud
Office of the Attorney General’s office, as well as the Health Care Registry Office, are
investigating. DRNC is monitoring the investigations of these other oversight agencies.


Annual Targets

Each year the Board of Directors and its Protection & Advocacy for Individuals with
Mental Illness (PAIMI) Advisory Council struggle with the decision of how DRNC will
focus its resources for the coming year. We call this focus our “targets.” We aim to meet
our targets by achieving a certain outcome by the end of the year. (While some P&As use
the term “priorities,” DRNC resists the idea that one issue is a greater priority than
another. We prefer “targets.”) Our targets allow us to direct how staff will spend their
time and energies during the year. By paying attention to a desired outcome, DRNC is
challenged to constantly adapt our strategies using all of the tools we have: education,
negotiation, mediation, and litigation. We use the tool most appropriate to achieving the
targeted outcome.


“I believe that with the help of Disability Rights North Carolina, we have improved and
built a stronger patient-centered system of care at both Dorothea Dix Hospital and
Central Regional Hospital. It is a partnership that works and one that we value.”


Lanier M. Cansler, Secretary, N.C. Department of Health and Human Services, The Sun
News, October 8, 2009


DRNC Staff:

Top row, left to right: Charlie Barnes, Dan Fox, Christine Trottier, John Rittelmeyer,
Michael Murray, Ronald Charlot, Andrew Strickland and Holly Stiles.
Second row, left to right: Mavis Jones, Elizabeth Edwards, Angie Downs, Karen Dozier,
Anthony Garcia-Copian, Carolyn Mason, Sonya Clark, Allyson Hilliard and Rodney
Crooms.
Third row, left to right: Lisa Rabon, Linda McMillan, Debbie Thome, Jennifer Bills,
Kathy Smith, Annaliese Dolph, Kimberly Fakhoury, Iris Green and Susan Pollitt.
Bottom row, left to right: Janice Willmott, Cas Shearin, Kady McDonald, Nancy
Hitchcock, Amy Mackin, Karen Murphy, Vicki Smith, Haydee Martinez and Lisa
Carroll.
Not pictured: Adrienne Allison, Diana Burch, Dawn LaSure, Morris McAdoo, Kristine
Sullivan.


The Right to Live in the Community

Eugene is 29 years old and was born with an intellectual disability. When he was 15,
Eugene received a spinal cord injury after an altercation with staff in a group home where
he lived. He is now paralyzed from the chest down and uses a power chair to get around.
He was in a state-operated nursing home for persons with mental illness for more than 10
years without access to the community or peers. DRNC discovered Eugene during one of
our monitoring visits to this facility. After months of work, Eugene left the nursing home
to live in the community. Eugene now lives in an alternative family licensed home.
Eugene made a list of the first things he wanted to do when he got back to the
community: go to the zoo, go to a basketball game and get his GED. Eugene is very
happy to be living in the community once more.


Ronnie is a 30-year-old male with a developmental disability. Ronnie has no use of his
right side and uses either a walker or a wheelchair to get around. He also has low vision.
Ronnie spent his childhood in a series of foster homes. His last foster home was not
wheelchair accessible, leaving him a virtual prisoner. He left that home and moved to a
group home that also was not wheelchair accessible. Eventually Ronnie was placed in an
assisted living facility where he had little to do and no friends his own age. With help
from his church and DRNC, Ronnie moved to a private home. He has the freedom to do
as he wishes. He is more confident and is becoming an expert in self advocacy. Currently
Ronnie provides advice on issues such as accessibility and independent living to a variety
of disability agencies.


The Right to Work

        AM is a person with a visual impairment who receives SSI. She is employed with
Marriott Hotels as a reservation agent/operator. She had difficulty seeing the hotel’s guest
registry databases on her computer monitor and the telephonic guest identification
screens. Not only did she have difficulty adequately performing the functions of her job,
she had constant headaches. She requested an accommodation, but never received a
response. Once DRNC became involved, Marriott Hotel addressed the computer screen
issue by providing a new monitor with features that enhanced the computer images and
fonts.


The Right to Equal Access to Public Services

AB is 13 years old and has diabetes. AB’s parents purchased a diabetic alert dog to
monitor her sugar levels constantly instead of AB’s having to go to the school nurse’s
office for hourly finger pricks. But the principal and superintendent denied access to
AB’s service animal. DRNC argued before the school board that permitting the service
animal at school was a reasonable accommodation under Section 504. The school board
granted the reasonable accommodation. AB and her service animal are successfully going
to school and other places of public accommodation.

JA is 17 years old and has autism. He loves to skate but needs a personal assistant to help
him with his balance. A local skating rink refused to allow an assistant to walk or skate
with JA while he was skating. The rink considered it an unreasonable request. DRNC
negotiated an agreement with the skating rink that allowed JA to skate at the rink at any
time during business hours with a personal assistant. The rink agreed the assistant could
skate or walk.

AB is 54 years old. She is deaf and presented as having low-vision. She alleged that she
was denied sign language interpretation on several occasions while attempting to access
health care services from a large regional health care facility. DRNC represented AB in a
Mediation of her ADA Title III Complaint filed with the U.S. Department of Justice. A
confidential settlement was reached, which included systematic changes to increase
accessibility for AB and other people with disabilities, especially deaf and hard-of-
hearing individuals, who seek health care services at the facility.


“Thanks to your organization Jon now goes skating weekly and enjoys being part of the
experience like everyone else!”


The Right to Vote

DRNC completed almost 200 polling site surveys on Election Day and over 100 for the
One-Stop Voting period leading up to the 2008 election. Polling sites were tested for
compliance with the Americans with Disabilities Act.

The Right to Reasonable Accommodations in Publicly Funded Housing

SK is 14 years old and diagnosed with severe autism. SK was to receive educational and
other services during the summer away from home. Before the summer term started, the
group home where he planned to stay was closed, so his mother rented a private house for
SK and his staff. She paid the rent in full. But when the landlord discovered SK had
autism, the landlord demanded that SK and his staff vacate the rental immediately or else
they would be evicted. DRNC intervened and SK and his staff were not evicted.

HG is four years old and diagnosed with autism. His parents asked their homeowners
association for permission to construct a five-foot fence in their backyard so HG could go
outside and play. The association denied that request. Representing HG’s parents, DRNC
reached a settlement agreement so HG can now safely play in his own backyard.
The Right to Live and Receive Services in Community Settings

JE has cerebral palsy. At 15, he needs a specialized car seat to be safe during transport.
JE’s mother requested payment for the car seat under the CAP-MR/DD waiver and
provided two letters documenting the medical necessity of the seat. In spite of this
evidence, a contractor for the Department of Medical Assistance (DMA) continued to
demand additional information and closed the case due to insufficient information. After
DRNC became involved, the request for the car seat was granted.

SLW was born with spina bifida. At 46, she lives in her own home and uses a wheelchair
for mobility. Six years ago, SLW experienced acute respiratory failure. Now she is
dependent on a ventilator, a tracheotomy, and oxygen 24 hours a day. Her elderly parents
live nearby and provide eight hours of daily care for her – all they physically can do. For
the remaining 16 hours of the day, SLW received private duty nursing (PDN) services,
since she cannot safely be alone. Last summer, SLW received notice from the Division of
Medical Assistance (DMA) that her PDN hours were being reduced to twelve hours a day
due to her “stability and caregiver’s availability.” There was no change in her medical
condition or circumstance to justify the reduction in services. This would have forced
SLW into an institution. DRNC represented SLW in mediation and discovered that DMA
had not reviewed SLW’s complete record of nursing interventions. After providing
additional information to the mediator, DMA re-authorized 16 hours of PDN for an
additional 60-day period. DRNC will continue to monitor DMA’s authorization process
for PDN.


Keeping Kids in School

JH has problems with his anger and has been unsuccessful in school, earning only a half
credit in the last three years. Part of the reason JH has been so unsuccessful is because he
has been suspended repeatedly. In fact, prior to this school year, JH ended every year on
homebound placement. JH had numerous meetings related to discipline over the years,
but the team always determined that his behavior was not a result of his disability, and so
the team was able to change JH’s placement without due process. This year, DRNC
attended several team meetings with JH and his mother. This time, the team determined
his behavior was caused by the interplay of his two disabilities. JH stayed in school and
finished the year. JH is attending a new high school this year and is doing well.

DRNC filed a complaint with the North Carolina Department of Public Instruction (DPI)
on behalf of GS, a seven-year-old diagnosed with ADHD, mood disorder, and a learning
disorder. DPI confirmed GS’s school system failed to provide a free, appropriate public
education (FAPE) services to GS and nine other students. In a corrective action plan, DPI
requested the school system offer compensatory services to each child. DPI also
requested the school system provide training for the middle school administrators and
special education teacher regarding proper implementation of Individual Education Plans
as written. In addition, DPI’s corrective action plan provides guidelines to elementary and
middle school administrators and special education teachers regarding collaboration at
the end of each school year in order to effectively transition students from one school to
the other. GS also will receive 12 sessions of compensatory education.


Reducing Inappropriate Restraint in Schools

RJ is a 14-year-old student who has autism and attends a public separate school serving
students whose primary disability is developmental delay or intellectual disabilities. RJ’s
parents complained that their son had been subjected to inappropriate restraint resulting
in physical injury. DRNC investigated and found that school personnel at this school
lacked knowledge about what constitutes a physical restraint or when it is appropriate. As
a result, the use of restraint and seclusion was not consistent, appropriately documented
or reported. A corrective action agreement was reached that school staff would receive
proper training. The training received by the school benefits and protects not only our
client, but also approximately 100 other students who attend this school.

DW is 12 years old and attends a public separate school. He has an Individual Education
Program with a behavior plan. His parents contacted DRNC because the school has a
seclusion room where they put DW when his behaviors become explosive. His parents
felt this strategy was not working, since his behavior was getting worse. After DRNC’s
intervention, the school agreed to use a time-out space instead. When his behavior begins
to escalate, he will be given an opportunity to go to a time-out space instead of being put
in the seclusion room. With this new plan, his angry behaviors have decreased.


Our 2008-2009 Audit and 990 will be posted on www.disabilitryrightsnc.org.


Thank you to our generous donors
$5000+
Disability Advocacy Training Technical Assistance (Vicki Smith)


$1500+
Lucy C. Daniels
Paul L. Erickson
Jeff McLoud

$500+
Charlie and Sandra Barnes
Kathy B. Boyd
Lloyd and Syma Gerard
Beth G. Hardy
Robert and Sandra Hedrick
Maureen Morrell
$100+
Law Office of Stacey B. Bawtinhimer
Walter and Betsy Bennett
Martha Brock
Sarah R. Cameron
Wayne Cipperly
Connie and Laurie Cochran
Ann T. Elmore
Ruth Eppinette
Sue E. Estroff
Adele Foschia
Myrtle Frith
Iris and Joseph Green
Susan and Thomas Hadley
Alex Hagan
Marian B. Hartman
Lucy Inman
Mellonee Kennedy
Roger Manus
Erin McGovern
Gregory and Cheryl McGrew
Sylvia Novinsky
Travis M. Payne
Suzy Pollitt and Bill Rowe
Melanie Regner
Carol H. Reilly
John and Jennifer Rittelmeyer
Cas Shearin and Devon Tolson
John M. Silverstein
William Simpson
Jane Stein
David Thompson
Christine Trottier
Andrew and Gwen Whiteman
Willis and Delsie Williams
Rebecca Wood

$99 and under
Willa Lee Allen
Scott B. Badesch
Allison Lee Beale
Gregory and Lourie Ann Best
Pamela Weaver Best
Jennifer Bills
Robert (Rusty) Bradstock
Adonis Brown
Diana and Paul Burch
Lisa Carroll
Lois Cavanagh-Daly
Jill Ledford Cheek
Sonya Clark
George “Pete” Clary
G. Rankin Coble, Jr. and Jane Kendall
Rebekah W. Davis
Willie and Shirley Dawson
Annaliese Dolph
Catherine Anne Drinkard
Adrienne Fox
Dan Fox
Terry Grunwald
Allyson Hilliard
Nancy T. Hitchcock
Marcy Hobart
Harriet S. Hopkins
Mavis C. Jones
Rabbi Raachel Jurovics
A. Larkin Kirkman
B. L. Litwack
Brett and Sally Loftis
Martha W. Lowrance
Elizabeth MacMichael
Laurence V. Marks
Charles and Elizabeth Martin
Haydee Martinez
Carrie Mason
Morris McAdoo
Kathy H. McDonald
Linda McMillan
Marjorie Moore
Cheryl Mulloy-Villemagne
Karen Murphy
Joanne Murray
Nancy W. Novell
Terri Nunn
James and Cheryl O’Kelley
Mary Ann Parrott
Daniel R. Pollitt and Linda Weisel
Sam and Lisa Rabon
David J. Richard
Kathy and Rocky Smith
William and Andree L. Stanford
Kristine Sullivan
Leslie and Virginia Tharrington
Deborah and David Thome
Christopher Tobin
Janice and David Willmott
Annelle Woggon and Kenneth Ratcliffe

Through 12/15/2009

DRNC is a 501(c)(3) nonprofit charitable corporation. Your contribution is tax-
deductible as allowed by law. We hope to see your name on this list next year!


Disability Rights
North Carolina
2626 Glenwood Avenue
Suite 550
Raleigh, NC 27608

919-856-2195
877-235-4210
888-268-5535 TTY
919-856-2244 fax

www.disabilityrightsnc.org

North Carolina’s Protection and Advocacy System

				
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Description: North Carolina Spinal Cord Injury Attorney document sample