On Target
Disability Rights North Carolina
Champions 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 40year-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 twopound 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 Conference
April 20, 2016
8:30 am - 5:00 pm
The Friday Center
Chapel 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 timeto-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 Sponsor
The Ireland Family Foundation on behalf of Extraordinary Ventures
Post-Conference Reception Sponsor
Henson & Fuerst
Exhibit Hall Sponsor
RHA Howell, Inc.
Breakout Session Sponsors
Avison Young
EducationNC
Beth Garriss Hardy, Ph.D.
Monarch
W.G. Alexander & Associates, Attorneys
Champions
Bayada Home Health Care
Easter Seals UCP North Carolina & Virginia
Mike Mayer and the Consultants of CRA
National Academy of Elder Law Attorneys (NAELA) – NC Chapter
NC Council on Developmental Disabilities
NC Council of Community Programs
Janna Shisler
Supporters
Alberta Professional Services, Inc.
Anonymous
Benchmarks
Kathy Boyd
Brody School of Medicine, East Carolina University
Andrew Erteschik
Marian Hartman
Pam Jarrett
Marketing Association for Rehabilitation Centers, Inc.
Nancy Mayer
Self- Help Credit Union
Senn Dunn
Gerda Stein
Lots of New Faces at Disability Rights NC
Virginia Fogg - Attorney
Ginny 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 Coordinator
Carol 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 - Investigator
Marian 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 twoyear 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 - Receptionist
Carolina 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 - Attorney
Tadra 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 – Attorney
Kat 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 UNCChapel 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
Executive
Vicki Smith, Executive Director
Finance & Operations
Charlie Barnes, Chief Financial Officer
Janice Willmott, Chief Administrative Officer
Karla Blackwell, Administrative Assistant
Carolina Herrera, Receptionist
Allyson Hilliard, Accounting Assistant
Mavis Jones, Office Manager
Dennis Knight, IT Manager
Haydee Martinez, Administrative Assistant
Will McDowell, Office Aide
Legal & Advocacy
April Giancola, Chief Legal Program Officer
John Rittelmeyer, Director of Litigation
Cas Shearin, Director of Investigations and Monitoring
Lisa Grafstein, Managing Attorney
Jennifer Bills, Senior Attorney
Tabitha Bryant, Attorney
Raven DeMonia, Paralegal
Yasmin Farahi, Attorney
Virginia Fogg, Senior Attorney
Anthony Garcia-Copian, Intake Specialist
Iris Green, Senior Attorney
Marian Hartman, Advocate
Tadra Martin, Attorney
Gabrielle Martino, Investigator
Kady McDonald, Intake Specialist
Kishona Mimms, Investigator
Lisa Nesbitt, Attorney
Steve Noblitt, Advocate
Susan Pollitt, Senior Attorney
Lisa Rabon, Attorney
Katherine Slager, Attorney
Holly Stiles, Attorney
Kathy Smith, Advocate
Kristine Sullivan, Attorney
Debbie Thome, Advocate
Chris Trottier, Senior Attorney
Policy & Outreach
Corye Dunn, Director of Public Policy
Elaine Whitford, Director of Development
Annaliese Dolph, Lobbyist
Carol Hammerstein, Communications and Events Coordinator
Mercedes 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 McDonough
Linda 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 Paesler
Known 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 Champions
Cadgewith Farms Ltd.
Vicki Smith
Gold Champions
Kathy Boyd
Developmental Associates (Heather Lee and Steve Straus)
Easter Seals UCP NC & Virginia
Garriss Hardy & Associates
Silver Champions
Campbell University Law School
Chris Griffin
Henson & Fuerst
Michael Murray
Janna Shisler
Bronze Champions
Ken Butler
Sally Cameron
William Donohue
April Giancola
Greater Triangle Rep Payee Services, Inc.
Ginny Hilton
Ashley Lindsay
Roger Manus
Greg 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 StateOperated 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 longterm 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 bimonthly 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 Carolina
Champions for Equality and Justice
3724 National Drive, Suite 100
Raleigh, North Carolina 27612
919-856-2195
877-235-4210
888-268-5535 TTY
919-856-2244 fax
Upon request, information
is available in alternate formats.
North Carolina’s Protection and
Advocacy System
www.disabilityrightsnc.org