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PROTECTION & ADVOCACY |
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Oklahoma Disability Law Center, Inc. |
March, 1999 |
In this issue:
(1) Medicaid Managed Care Coalition Minutes
(2) Guide to Multiculturism
(3) US Department of Justice Sues AMC Theaters
(4) Access Board & Technical Assistance: Guidelines for Accessible Vehicles
(5) Fair Housing Accessibility Guidelines -- Frequently Asked Questions
(6) US Department of Justice Reaches Agreement with Holiday Inns
(7) Statistics about Prevalence of Abuse and Neglect of People with Disabilities Living in Facilities
(8) Education: P&A Accomplishments
Medicaid Managed Care Coalition Minutes January 29, 1999
This meeting was a joint effort of the Medicaid Managed Care Coalition and the Policy Consortium. Much of the discussion dealt with the recent Focus Groups which occurred in Tulsa on January 25th and 26th. The Focus Groups were organized by Laura Dempsey-Polan at Tracey McKowen's request. Tracey works with the Oklahoma Health Care Authority and is responsible for developing the marketing materials which will provide information to the ABD population which is converting to the SoonerCare Plus managed care health plans in July '99. The purpose of the Focus Groups was to allow the OHCA to gather pertinent information toward developing marketing materials for enrollment which would be accessible for individuals with disabilities. Laura reported that the Focus Groups were well attended and that individuals spoke out and provided constructive suggestions to the OHCA. A working group of the Coalition interested in creating a white paper will meet on Wednesday, February 10th. The paper will be sent to Tracey McKowen of the Oklahoma Health Care Authority (OHCA) with a copy to both Garth Splinter and the Commission. The white paper will be a follow-up effort by Coalition members to provide feedback to the OHCA regarding pertinent access issues which we want documented. This will give the Coalition another opportunity to provide the OHCA with a written record addressing access issues relevant to the ABD population. (There was also some discussion of trying to get documented comments from various physicians who are unwilling to contract with the OHCA.) Additionally, Coalition members will begin to develop a legislative fact sheet in support of reinvestment into the health care system. This fact sheet can be utilized to educate legislators and other interested stake holders. The OHCA has requested an extension for enrolling ABD individuals into the SoonerCare Choice plans. This would effect individuals residing in rural Oklahoma. The Policy Consortium dealt with much of the current difficulties we are having in successfully receiving the legislative tracking information. We are having technical difficulties in converting the GIT files which Keith Smith accesses for tracking purposes, into a readable format for the Policy Consortium list serv. If this continues to be unsuccessful we will explore other methods. In the meantime, Laura shared a copy of the 1999 state disability related legislation tracking list bills prepared by Jean Jones with the Office of Handicapped Concerns. Submitted by Linda Jaco
An Advocates Guide to Multiculturalism
Society has the responsibility of providing the most effective treatment, care and protection of rights to individuals diagnosed with a mental illness. However, complaints of abuse, neglect, and rights violations against mental health professionals surface daily from people residing in psychiatric institutions.
Advocates are in place because individuals responsible for ensuring client rights are not violated have abdicated their duty. For most of these vulnerable individuals, we are their
last resort. For this reason, we must not abdicate our responsibility to comprehensively serve our clients to the best of our ability.
As far as multicultural barriers, an advocate must go the extra mile to understand the intricacies of their client's cultural framework and develop intervention strategies that reinforce or create supportive services of inclusion.
The minority culture should not be compared to the majority culture. Comparison implies insufficiencies and inadequacies. Cultural awareness suggests consciousness of a particular issue. To recognize the value in a person's culture, is to affirm the relevance of that individual. Read everything you can find, talk to people who know the culture, become involved, and ask questions. Your search will provide understanding beyond that available in any case note.
There are four major nonwhite ethnic groups represented in our society: Latin-Americans, African-Americans, Asian-Americans and Native- Americans. Of these four, African- Americans and Latin-Americans, in most instances, are believed to be the minority groups most likely to be represented in the mental health system today.
In casework, an advocate must consider how his or her client's culture was instrumental in shaping and developing his/her frame of reference.
Elaine Sutton Mbionwu
Mental Health Advocate
Georgia Advocacy Office
How do you determine if your organization is culturally competent? Cultural competence is a set of congruent practice skills, attitudes, policies and structures, which come together in a system agency, or among professionals and enable that system, agency or those professionals to work effectively in the context of cultural differences. "Cultural Competence means knowing the people you serve, how they differ from you and from each other and how that affects what they accept from you," National Resource Center for Youth Services.
Five Elements of a Culturally Competent Agency:
1) Values diversity by accepting that people it serves are from different backgrounds and will make different choices based on cultures;
2) Assesses its sense of culture by recognizing that the agency is shaped by its own culture and how it interfaces with other cultures;
3) Accepts the dynamics of difference and recognizes that culturally prescribed patterns of communications, etiquette and problem solving often result in misjudgements and misinterpretations;
4) Incorporates cultural knowledge into all levels of service delivery and
5) Adapts to diversity by building a context for a cross-culturally and disability
acceptance.
JUSTICE DEPARTMENT SUES THEATER CHAIN FOR FAILING TO COMPLY WITH ADA
American Multi-Cinema, Inc. and AMC Entertainment, operators of one of the nation's largest chains of movie theaters, were sued by the Justice Department for not providing stadium style seating to individuals who use wheelchairs. The lawsuit, filed in U.S. District Court in Los Angeles, alleges that the companies violated the Americans with Disabilities Act (ADA) by denying movie-goers who use wheelchairs or cannot climb stairs equal access to stadium-style seats. Stadium style seats are seats that are placed on risers to provide unobstructed views with improved viewing angles. Except in AMC's largest auditoriums, patrons cannot access stadium-style seats unless they can climb stairs.
The Justice Department began investigating AMC's stadium style theaters in the Los Angeles area after receiving complaints from persons with disabilities there who were denied access to stadium-style seats in those theaters. The Department negotiated with AMC for seven months in an attempt to resolve this matter short of litigation.
"This is a matter of basic fairness," said Bill Lann Lee, Acting Assistant Attorney General for Civil Rights. "People who use wheelchairs go to the movies, and pay the same prices, as everyone else. They should have access to seats of comparable quality to those available to most other patrons."
AMC and AMC Entertainment introduced stadium-style seating to motion picture theaters in the U.S. and the trend has recently taken over the movie theater industry. In AMC's stadium-style theaters, many seats are stadium-style, which are located on stepped 18-inch risers and provide a comfortable, unobstructed view of the screen over the heads of persons seated in all rows ahead. There are a few rows of seats at the very front of the theater that are accessed by a sloped aisle. Wheelchair seating is located in this front section in all but a handful of the largest auditoriums in AMC's theater megaplexes, which can have as many as 30 auditoriums.
The seating in the front section of the theater is much closer to the large screen and on a lower level than the stadium-style seats and does not provide the same comfortable, unobstructed view of the screen. By placing almost all wheelchair seating locations in the front section of the theater, AMC has denied access to the better seats for all persons whose disabilities prevent them from climbing stairs.
The ADA requires places of public accommodation, such as movie theaters, to provide equal access to persons with disabilities and prevents them from providing persons with disabilities a lower quality of goods and services than they provide other members of the general public.
The complaint specifically names two AMC theaters in the Los Angeles area, the Norwalk theater, located at 12300 E. Civic Center in Norwalk, California, and the Promenade 16 theater, located at 21801 Oxnard Street in Woodland Hills, California, but covers all of AMC and AMC Entertainment's theaters with stadium-style seating nationwide. AMC operates theaters with stadium-style seating in Arizona, Colorado, Florida, Georgia, Illinois, Kansas, Missouri, North Carolina, Ohio, Texas, Virginia, and California.
"AMC says it is 'changing the way the world sees movies.' We're just making sure that change complies with the law." added Mr. Lee.
Under the ADA, newly constructed facilities, including motion picture theaters, must be readily accessible to and usable by individuals with disabilities. In addition to requiring that some seating be made available to individuals who use wheelchairs, the ADA also requires that those wheelchair seating locations provide lines of sight that are "comparable" to the lines of sight provided to other moviegoers. In the new stadium-style theaters operated by AMC and AMC Entertainment, however, the wheelchair seating locations do not provide comparable lines of sight, because they are much closer to the screen with inferior viewing angles than the stadium-style seats.
The lawsuit seeks an order requiring AMC to design, construct, and operate its theaters with stadium-style seating so that they comply with all ADA requirements, including the requirement to provide wheelchair seating areas with comparable sightlines. For those facilities that AMC has already built or has under construction, the lawsuit seeks an order requiring AMC to make whatever modifications are necessary to comply with the ADA. The lawsuit also seeks an order requiring AMC to pay damages for patrons with disabilities who have attended movies at AMC theaters and been denied access to stadium-style seats, and to pay civil penalties.
Earlier this year, a federal court in Waco, Texas, ruled that two stadium-style movie theaters in the Cinemark movie theater chain violated the ADA by forcing patrons who use wheelchairs to sit in the front two rows of the theaters in sloped floor seating. That case is currently on appeal. The Department is also investigating other movie theaters and theater chains that do not offer wheelchair locations that provide comparable lines of sight in stadium-style theaters.
Individuals interested in finding out more about the ADA or the lawsuit can call the Department's toll-free ADA Information Line at (800) 514-0301 or (800) 514-0383/TDD or access the ADA Home Page at http://www.usdoj.gov/crt/ada/adahom1.htm.
ACCESS BOARD & TECHNICAL ASSISTANCE -- Guidelines for Accessible Vehicles
The Board developed the guidelines for accessible vehicles which are incorporated in the Department of Transportation ADA regulations, 49 CFR Part 38. The Board provides technical assistance on the design features which must be incorporated in vehicles required to be accessible by the DOT regulation. Policy and operational issues, including the requirements for complementary paratransit, are covered by the DOT regulation.
Technical assistance is available on the vehicle guidelines by writing to Access Board, 1331 F St., NW, Suite 1000, Washington, D.C. 20004-111. You can also call 1-800-USA-ABLE (1-800-872-2253) or 202-272-5434 for 10am-5:30pm, Eastern time, Monday-Friday (except 2pm-4pm Wednesday). TTY users should call
1-800-993-2822 or 202-272-5449. Questions can also be sent by fax to 202-272-5447 or by E-mail to ta@access-board.gov. Questions send by fax or E-mail must include a telephone number, and a good time to call. At present, we are unable to provide direct responses by E-mail. The Board also maintains a computer bulletin board which can be accessed at 202-272-5448.
The Board has developed a series of technical manuals, one for each of the transportation modes (e.g., buses, vans, light rail, and rapid rail) covered by the ADA. Each manual states the requirement, followed by explanatory text.
FAIR HOUSING ACCESSIBILITY GUIDELINES -- FREQUENTLY ASKED QUESTIONS
The Fair Housing Amendments Act of 1988 (Pub.L. 100-430, approved September 13, 1988) (the Fair Housing Amendments Act) amended title VIII of the Civil Rights Act of 1968 (Fair Housing Act or Act) to add prohibitions against discrimination in housing on the basis of disability and familial status. The Fair Housing Amendments Act also made it unlawful to design and construct certain multifamily dwellings for first occupancy after March 13, 1991, in a manner that makes them inaccessible to persons with disabilities, and established design and construction requirements to make these dwellings readily accessible to and usable by persons with disabilities. Section 100.205 of the Department's regulations at 24 CFR part 100
implements the Fair Housing Act's design and construction requirements (also referred to as accessibility requirements).
On March 6, 1991 (56 FR 9472), the Department published final Fair Housing Accessibility Guidelines (Guidelines) to provide builders and developers with technical guidance on how to comply with the accessibility requirements of the Fair Housing Act. (The Guidelines are codified at 24 CFR Ch.I, Subch.A., App. II. The preamble to the Guidelines is codified at 24 CFR Ch.I, Subch.A., App.III.) The Guidelines are organized to follow the sequence of requirements as they are presented in the Fair Housing Act and in 24 CFR 100.205. The Guidelines provide technical guidance on the following seven requirements: Accessible building entrance on an accessible route; Accessible common and public use areas; Usable doors (usable by a person in a wheelchair); Accessible route into and through the dwelling unit; Light switches, electrical outlets, thermostats and other environmental controls in accessible locations; Reinforced walls for grab bars; and Usable kitchens and bathrooms.
The design specifications presented in the Guidelines are recommended guidelines only. Builders and developers may choose to depart from these guidelines and seek alternate ways to demonstrate that they have met the requirements of the Fair Housing Act. The Fair Housing Act and the Department's implementing regulation provides, for example, for use of the appropriate requirements of the ANSI A117.1 standard. However, adherence to the Guidelines does constitute a safe harbor in the Department's administrative enforcement process for compliance with the Fair Housing Act's design and construction requirements.
Since publication of the Guidelines, the Department has received many questions regarding applicability of the design specifications set forth in the Guidelines to certain types of new multifamily dwellings and to certain types of interior housing designs. The Department also has received several questions concerning the types of new multifamily dwellings that are subject to compliance with the design and construction requirements of the Fair Housing Act. Given the wide variety in the types of multifamily dwellings and the types of dwelling units, and the continual introduction into the housing market of new building and
interior designs, it was not possible for the Department to prepare accessibility guidelines that would address every housing type or housing design. Although the Guidelines cannot address every housing design, it is the Department's intention to assist the public in complying with the design and construction requirements of the Fair Housing Act through workshops and seminars, telephone assistance, written replies to written inquiries, and through the publication of documents such as this one. The Department has contracted for the preparation of a design manual that will further explain and illustrate the Fair Housing Act Accessibility Guidelines.
The complete version of "Questions and Answers about the Fair Housing Accessibility Guidelines" can be found on the internet at:
http://www.hud.gov/fhe/fhefhasp.html. FOR FURTHER INFORMATION CONTACT: For technical questions contact Office of Fair Housing and Equal Opportunity, Room 5112, Department of Housing and Urban Development, 451 Seventh Street, Washington DC 20410, telephone 202-708-2618 (voice), 202-708-1734 TTY; for copies contact the Fair Housing Information Clearinghouse at 1-800-343-3442 (this is a toll free number), or 1-800-290-1617 (this is a toll-free TTY number).
HOLIDAY INN HOTELS TO ESTABLISH NATIONWIDE MEDIATION PROGRAM UNDER AGREEMENT REACHED WITH JUSTICE DEPARTMENT
The owner of the Holiday Inn and Crowne Plaza chain of hotels will make it easier for guests with disabilities to get a room and will set up a system to mediate access-related complaints, under two agreements reached today with the Justice Department.
The first agreement, with Bass Hotels & Resorts (BHR), is the Justice Department's first settlement under the Americans with Disabilities Act (ADA) that establishes a nationwide mediation program to address future complaints. BHR will pay for the mediation program, but it may be used by all the nearly 2000 domestic BHR owned or licensed hotels, including franchised hotels. BHR owns, operates or franchises all hotels that use the Holiday Inn, Staybridge Suites, or Crowne Plaza brand names. The second agreement with BHR resolves complaints alleging the chain's central reservations system refused to guarantee reservations for accessible rooms, or, sometimes provided designated accessible rooms that were not accessible.
"No American should be denied an opportunity to stay where they choose, just because they happen to have a disability," said Acting Assistant Attorney General Bill Lann Lee. "After today's agreement, travelers with disabilities will be able to make reservations for rooms, instead of having reservations about whether the room will be there."
Under the agreements, BHR will: bring 3 Crowne Plaza hotels that it owns and manages into compliance; provide ADA training materials and architectural assistance to franchisees, as well as revise their Rules of Operation and Standards Manuals; pay $75,000 to the Key Bridge Foundation, to provide ADA-experienced mediators to help resolve future ADA complaints from persons with disabilities and submit reports on mediations conducted under the program to the Justice Department, for evaluation; change its central reservations system to allow people to guarantee accessible rooms and require hotels to hold accessible rooms for people with disabilities; and, pay approximately $75,000 to resolve all outstanding issues.
The out-of-court agreement stems from an investigation of complaints filed with the Justice Department about various Holiday Inn and Crowne Plaza brand hotels. The complaints alleged a wide range of ADA violations, including: insufficient numbers of accessible rooms, inaccessible entrances, designated accessible guest rooms that lacked grab bars or had insufficient maneuvering space in bathrooms; hotel restaurants without accessible restrooms, and hotels without any closed captioned televisions or telecommunications devices for the deaf (TDDs).
In addition to the agreements with the chain, 19 individual franchisees also signed agreements with the Justice Department, requiring them to modify their hotels. The agreements address 19 complaints received by the Department against the Holiday Inn and Crowne Plaza chain. The Department is currently negotiating agreements with additional franchisees.
Title III of the ADA requires that places of public accommodation, such as hotels and motels, be accessible to persons with disabilities. Newly constructed hotels and hotels altered after the law went into effect, must be built or altered according to specific guidelines, called ADA Standards for Accessible Design. Pre-existing hotels, on the other hand, must meet those standards only if it is readily achievable to do so.
People interested in finding out more about the ADA or today's agreement can call the toll-free ADA Information Line at (800) 514-0301 or (800) 514-0383/TDD or access the ADA home page at:
http://www.usdoj.gov/crt/ada/adahom1.htm
STATISTICS ABOUT THE PREVALENCE OF ABUSE AND NEGLECT OF PEOPLE WITH DISABILITIES LIVING IN FACILITIES IN THE UNITED STATES OF AMERICA
The Protection and Advocacy System has unique authority to investigate and prevent abuse and neglect affecting persons with disabilities residing in institutions. Unfortunately, institutional abuse and neglect continues to be a prevalent problem. Here are some statistics demonstrating this:
According to the 1990 Census, roughly 2.1 million Americans with disabilities live in institutions, most of them in nursing homes. (H. Stephen Kaye, Ph.D.,(1997) Disability Watch - The Status of People with Disabilities in the United States.)
In FY 1997, the Protection and Advocacy System responded to more than 33,000 concerns regarding abuse
and neglect. (Annual Report of the P&A System 1997-1998.)
According to 1995 figures from the Health Care Financing Administration, 18% of nursing homes nationally were found to be deficient in providing care that enhanced human dignity.
Some 17% of nursing homes were found deficient due to overuse or misuse of physical restraints; chemical
restraints are even more widely misused. (H. Stephen Kaye, Ph.D.,(1997) Disability Watch - The Status of People with Disabilities in the United States.)
A 50-state survey by the Hartford Courant (October 1998), has confirmed 142 deaths during or shortly after restraint or seclusion in the past decade. The survey focused on mental health and mental retardation facilities and group homes nationwide. Of these deaths, 23 people died after being restrained in face-down floor holds, another 20 died after they were tied up in leather wrist and ankle cuffs and ignored for hours. Causes of death could be confirmed in 125 cases. Of those patients, 33 percent died of asphyxia, another 26 percent died of cardiac-related causes.
Between 50 and 150 such deaths occur every year across the country, according to a statistical study
commissioned by the Courant and conducted by a research specialist at the Harvard Center for Risk Analysis.
Women with disabilities living in institutions appear twice as likely to be victimized, as those living in the
community (Sobsey, 1994).
EDUCATION
The P&A network concentrates a significant amount of its advocacy resources on the representation of students with disabilities to ensure that they receive the appropriate educational services guaranteed to them
by federal and state laws. The primary federal law mandating special education services is the Individuals with Disabilities Education Act (IDEA), which requires the provision of a free appropriate public education in the least restrictive environment to students who need special services in order to benefit from education.
On education issues, ODLC works closely with PRO-Oklahoma (Oklahoma's federally funded parent training and information center). In order to read about ODLC & PRO's relationship, check out the newsletters on our website,
http://www.flash.net/~odlcokc/1297nl.html (working relationship) and http://www.flash.net/~odlcokc/398nl.html (ODLC shares office in Tulsa with PRO). PRO has an excellentbasic rights handbook that each parent should have for his or her child. ODLC's & PRO's collaboration achieves the missions of each office to the benefit of the student. Examples of what ODLC has accomplished in the educational area: During this past year ODLC achieved a revision to the State due process hearing rules that requires hearing officers to file their opinions in a more timely manner. (If you know someone who is in the midst of a due process hearing and cannot obtain an order from the hearing officer in a timely manner, please let us know.) ODLC obtained permission for the Oklahoma Supreme Court's mediation service (with IDEA specialty) to conduct it's first federal court mediation of an IDEA issue. ODLC recently obtained a favorable due process ruling for a student with developmental disabilities to participate in vo-tech courses as a part of his transition plan. The vo-tech vigorously opposed the student's inclusion because of disability. ODLC has achieved favorable results both by administrative order and by mediation for students who were scheduled for premature graduation from high school. ODLC recently obtained a favorable ruling for a student and all students similarly situated using transportation as a part of their IEP's in the Tulsa Public Schools. (If you know anyone in the Tulsa Public Schools who is not receiving transportation
services in the manner contemplated in his or her IEP or is being transported in an unsafe manner, please let us know. If these problems exist in any other school district, let us know.)
Oklahoma Disability Law Center, Inc.
Webpage:
http://www.flash.net/~odlcokcJoin the ODLC Disability Law List by checking the box indicated on the webpage.
[Oklahoma City Office]
2915 Classen Blvd., Suite 300
Oklahoma City, OK 73106
(405) 525-7755 (v/tdd)
(800) 880-7755 (v/tdd)
(405) 525-7755 (fax)
[Tulsa Office]
2828 East 51st Street, Suite 302
Tulsa, OK 74105
(918) 743-6220 (v/tdd)
(800) 226-5883 (v/tdd)
(918) 743-7157 (fax)
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