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LEGAL OBLIGATIONS AND BEST PRACTICS FOR WORKING
WITH PEOPLE WITH DISABILITIES: A Training For Health Plans
Center for Independence of the Disabled, NY © 2015
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Why is disability awareness important
to health plans?
 People with disabilities face physical and other barriers at plans and at provider
sites, such as architectural barriers, inaccessible exam tables and weight scales,
lack of interpreters, inflexible office procedures.
 People with disabilities report being treated unfairly at practitioner offices because
of their disabilities. They report negative attitudes and lack of knowledge about
treating people with their disabilities.
 A survey of primary care physicians found that almost 20 percent were unaware of
the Americans with Disabilities Act (ADA) and 45 percent were not aware of ADA
architectural requirements.
 Physicians receiving training on disability issues were in the minority. Lack of
knowledge or disability-related education is consistent with other reports finding
inadequate preparedness to provide health services to people with disabilities.
Center for Independence of the Disabled, NY © 2015
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Why is disability awareness important
to health plans?
Health plans that serve the Medicare and Medicaid populations are more likely have a
higher percentage of members who have disabilities.
People who have both Medicare and Medicaid have significant health needs, are more
likely than Medicare beneficiaries generally to be in fair or poor health and have
significant functional limitations.
 Within dual eligibles, four identifiable high needs groups:
(i) adults under age 65 with physical or sensory disabilities;
(ii) those 65 or older with multiple chronic conditions and functional limitations;
(iii) individuals with serious psychiatric disabilities and/or drug or alcohol
disorders; and
(iv) individuals with cognitive limitations including intellectual/developmental
disabilities or dementia.
Center for Independence of the Disabled, NY © 2015
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WHAT DOES THE LAW SAY?
Center for Independence of the Disabled, NY © 2015
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The Americans with Disabilities Act (ADA)
• The Americans with Disabilities Act (ADA), the landmark
disability rights law passed in 1990, prohibits discrimination
against people with disabilities in five major areas:
employment, state and local government, public
accommodations, transportation and communication. Health
care plans are covered under the state and federal
government provisions.
• The intent and spirit of the law is that people with disabilities
have the right to participate with their nondisabled peers in
all aspects of society, including access to health care.
Center for Independence of the Disabled,
NY © 2015
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Defining Disability
There are many definitions of disabilities under various federal,
state and local laws. Disability is defined differently by the
Americans with Disabilities Act, New York State Human Rights
Law, and New York City Human Rights Law.
The ADA is a landmark disability rights law passed in 1990.
Because of its importance, courts often look to the ADA for
guidance about disability rights.
Center for Independence of the Disabled, NY © 2015
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The ADA Definition of Disability
Under the ADA, a person with a disability is:
 A person with a physical or mental impairment that
substantially limits one of more major life activities;
 A person with a record of such physical or mental impairment;
 A person who is regarded as having such impairment.
Center for Independence of the Disabled, NY © 2015
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Health Plans Have Obligations Under ADA
Plans are covered under Title II of the ADA and/or Section 504
of the Rehabilitation Act when they contract with the
government to provide health care coverage.
 Under Title II of the ADA, “no qualified individual with a disability shall, by reason
of such disability, be excluded from participation in or be denied the benefits of
the services, programs, or activities of a public entity, or be subjected to
discrimination by any such entity.”
 Title II also states “All governmental activities of public entities are covered, even if
they are carried out by contractors. For example, a State is obligated by Title II to
ensure that services, programs, and activities of a State park inn operated under
contract by a private entity are in compliance with Title II’s requirements.”
Center for Independence of the Disabled, NY © 2015
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Health Plans and Title III
• Health plans as providers of health services and/or as
insurance offices are public accommodations subject to Title
III of the ADA.
Center for Independence of the Disabled,
NY © 2015
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Equal Treatment vs. Equal Opportunity
Equal Treatment v. Equal Opportunity
Basic distinction between the ADA and other civil rights laws based on race,
gender, other factors.
 Under most civil rights laws, nondiscrimination means “equal
treatment.”
 Because of the extent and nature of barriers for people with
disabilities, the ADA requires that affirmative steps (reasonable
accommodations, modifications or provision of auxiliary aids) be taken
to ensure that people with disabilities are given equal opportunity to
participate.
Center for Independence of the Disabled, NY © 2015
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What are examples of affirmative steps
to ensure equal opportunity?
 Architectural modifications
 Reasonable accommodations
 Auxiliary aids
Center for Independence of the Disabled, NY © 2015
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Civil Rights Law Compliance
for Health Plans
 Plans should provide program accessibility for everyone and in all aspects
of the program, not just physical accessibility at provider’s offices.
 Plans must be able to communicate effectively in all aspects of the plan
with all people with disabilities— including but not limited to those who
are blind/have visual impairments, deaf/have hearing impairments, have
speech impairments, have cognitive or intellectual disabilities, or have
psychiatric disabilities.
 People with disabilities also may include people with limited English
proficiency and limited literacy.
 Plans must have an adequate network of ADA-compliant providers to
ensure people with disabilities have full and equal access to choice in
health services without discrimination.
Center for Independence of the Disabled, NY © 2015
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ADA standards are augmented by FIDA
requirements in the MOU, the 3-Way
Contract, and NYS DOH Guidances
For example, in New York, Fully-Integrated Dual Advantage (FIDA)
plans are also subject to disability rights requirements through
other agreements, contracts, etc.
– The Center for Medicare & and Medicaid Services (CMS) and
New York State Department of Health (NYSDOH) negotiated an
Memorandum of Understanding (MOU) that has detailed
requirements as to how the program must operate with regard
to people with disabilities.
–CMS, NYSDOH and FIDA plans have a 3-way contract that
defines in detail about ensuring rights of people with
disabilities.
–NYSDOH has issued a Letter to Providers about accessibility
of their clinics and practices.
Center for Independence of the Disabled, NY © 2015
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HOW DOES THE LAW AFFECT YOUR PLAN’S ACTIVITY?
Center for Independence of the Disabled, NY © 2015
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Common Global Issues for FIDA Plans
• Too narrow in defining disability: Plans often think too
narrowly about the types of disabilities that members might
have. In plan materials and trainings, sensory (blind/vision
impaired, deaf/hard of hearing) and mobility impairments are
mentioned, but other less obvious disabilities, e.g. speech
impairments, cognitive impairments, mental illness, are not
discussed.
Center for Independence of the Disabled,
NY © 2015
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Common Global Issues for
FIDA Plans (cont.)
• Too narrow in thinking about reasonable accommodation
– Types of reasonable accommodations: The reasonable accommodations
mentioned in materials and trainings are often limited to accessibility and
accommodations for sensory impairments (e.g., alternate formats, TTY).
Examples of reasonable accommodations for other disabilities, e.g., assistance
filling out forms or scheduling flexibility due to effects of medications, are
often omitted.
– When reasonable accommodations are available: Often the materials and
training limit reasonable accommodation discussions to limited circumstances,
e.g., communicating with the call centers or availability of alternate formats,
rather than clearly making known to staff and members that reasonable
accommodations are available at any stage of interaction with the plan—e.g.,
call center, grievances, and advisory boards.
Center for Independence of the Disabled,
NY © 2015
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Best Practice for Global Issues
• Identifying people with disabilities
– Train staff to think broadly about the full range of
disabilities. Using the ADA definition of disability and
focusing on functional limitations rather than only
presenting a list of disabilities is useful.
– Train staff to make an individual assessment as to
disability. Train staff that people with the “same” disability
may be different in the degree and method of impairment.
For example, a person with cerebral palsy may or may not
have cognitive impairments and may or may not need to
use a wheelchair.
Center for Independence of the Disabled,
NY © 2015
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Best Practice for Global Issues (cont.)
•
Identifying the need for reasonable accommodations
– Train staff to think broadly and creatively about reasonable accommodations
(i.e., not limited to alternate formats or TTY) and focus on what
modifications/supports are necessary to make the service/interaction
effective. For example, train staff about simplifying or repeating information
for a person with cognitive disability or filling out forms for someone who has
a limitation (whether cognitive or physical) that makes it difficult to fill them
out.
•
Understanding that each interaction or service for members may be a point when
a reasonable accommodation may be needed.
– Train staff that reasonable accommodations are not limited to certain times,
e.g., call center or member materials.
Center for Independence of the Disabled,
NY © 2015
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Disability and Managed Care:
Areas where accommodations are critical
Providing Information/Communications:
– Call Centers
– Informational/Marketing Sessions
– Marketing Materials
Enrollment:
– Printed materials
– Online applications
– Telephone assistance with applications
Member Services
– Access to services
– Ensuring adequate network of ADA compliant providers
– Information Access
Center for Independence of the Disabled, NY © 2015
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Disability and Managed Care:
Areas where accommodations are critical
Grievances
– When to submit
– How to submit
– How to get help
Disenrollment
– How to disenroll
– How to get help
Member Feedback/Advisory Boards
– How to provide feedback
– Materials for Advisory Board members
Center for Independence of the Disabled, NY © 2015
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Making sure call centers provide equal access
for people with disabilities
Call Centers must:
• Provide information on accessing oral interpretation
services and written materials in alternative,
cognitively accessible formats.
• Inform callers that interpreters are free.
• Fill out forms over the telephone upon request.
Center for Independence of the Disabled, NY © 2015
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Common Call Center Issues
• TRAINING
– Call Center representatives, who are often the first and/or
the main contact for members, are often not trained how
to identify whether a person has a disability that should be
accommodated
– Call Center representatives are often not trained as to how
to provide a reasonable accommodation for the
interaction they themselves are having with the member
or how to arrange for a reasonable accommodation for
plan services
Center for Independence of the Disabled,
NY © 2015
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Common Call Center Issues (cont.)
– Call Center representatives and member information often
lack information as to a member’s right to reasonable
accommodation and to grieve internally or externally a
decision made about reasonable accommodations
•Communication With People Who Are Deaf Or Hard Of Hearing
– TTY lines are in place, but there often are no provisions for
other technological equivalents, such as texting or video
conferencing, that are being more frequently used by
people who are deaf/hard of hearing
Center for Independence of the Disabled,
NY © 2015
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Best Practices (BP) for Call Center service
representatives to provide equal access
for people with disabilities
ASSESSMENT/RECORD OF DISABILITIES AND NEEDS
•Provide Participants with a means to identify their disability for any presently
needed accommodations and have those recorded for the future
–BP: Train Call Center representatives about the full array of disabilitiesphysical, sensory, cognitive, developmental- and how they affect how
people function.
–BP: It is essential that the intake process includes a disability
accommodation needs assessment, including the opportunity to identify
and request reasonable accommodations.
–BP: Train Call Center representatives to inquire further if callers present
clues that a person may need a reasonable accommodation.
–BP: Assessment should include information on functional needs and a
record of reasonable accommodations that are updated as needed.
Center for Independence of the Disabled, NY © 2015
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Best Practices (BP) for Call Center service
representatives to provide equal access
for people with disabilities (cont.)
PROVIDING REASONABLE ACCCOMMODATIONS
•Communications
–Be trained in TTY (Tele Typewriter), Video Relay services,
remote interpreting services, providing accessible PDF
materials, and other Alternative Formats.
–Be capable of speaking directly with, or arranging for an
interpreter, to speak with participants in their primary
language, including American Sign Language, or through an
alternative language device or telephone translation service.
Make oral language interpretation services available free-ofcharge, including ASL.
Center for Independence of the Disabled,
NY © 2015
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Best Practices for Call Center service
representatives to provide equal access
for people with disabilities (cont.)
–Maintain the availability of services, such as TTY services,
computer-aided transcription services, telephone handset
amplifiers, assistive listening systems, closed caption
decoders, and other services for Deaf and hard of hearing
Participants.
•Demonstrate sensitivity to culture, including disability culture
and independent living philosophy.
Center for Independence of the Disabled,
NY © 2015
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Best Practices for Information/Marketing Sessions
• All events should be held in ADA-compliant locations,
including facilities with accessible restrooms.
• Sign language interpreters should be provided if needed to
ensure effective communication.
• Alternate formats of materials should be available.
• Service/sales representatives should be trained on reasonable
accommodations-both how to provide one at the event, e.g.,
assistance in filling out forms, and how reasonable
accommodations are obtained for member services.
Center for Independence of the Disabled,
NY © 2015
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COMMON WRITTEN INFORMATION
& COMMUNICATIONS ISSUES
• Failure to have full information about rights to reasonable
accommodations
– The right to a reasonable accommodation is often not
mentioned.
– The right to appeal a decision about reasonable
accommodations, which can be grieved, is often not stated
• Information about communication accommodations for nonsensory disabilities, e.g., cognitive disabilities or speech
impediments, is often not available.
Center for Independence of the Disabled,
NY © 2015
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Common Written Information
& Communications Issues (Cont.)
• The full array of marketing materials and written materials are
not available in alternate formats. Under the MOU and 3-way
Contract, the following materials (but not limited to these
materials) must be available in alternate formats:
•
•
•
•
Education and Outreach materials
Enrollment and disenrollment materials
Benefit coverage information
Operational letters for:
– Enrollment;
– Disenrollment;
– Claims or service denials
– Complaints
– Internal appeals
– External appeals
– Provider terminations
– Service Authorizations
Center for Independence of the Disabled,
NY © 2015
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Common Written Information
& Communications Issues (cont.)
• The list of communication accommodations are often limited
with no indication that other appropriate accommodations
may be available.
– For example, the list of alternate formats are often limited
Braille or large print.
– Some plans do not state other accommodations, such as
reading materials to members or electronic versions of
materials, may be available.
Center for Independence of the Disabled,
NY © 2015
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Best Practices:
Written Information/Communications
• Provide assistance to Participants with cognitive impairments; for
example, provide Marketing, Outreach and Participant Communications in
simple, clear language at a 4th to 6th Grade reading and below, and, if
necessary, individualized assistances to ensure materials are understood.
• Provide reasonable accommodations needed to ensure effective
communication, including, but not limited to:
– Alternate formats, including, but not limited to:
• Large print in at least 16-point font;
• Braille;
• Materials available in formats compatible with optical recognition software:
– Reading materials to members;
– Filling out forms upon request;
– Using different technology, such e-mail, telephone, text, video relay, etc.
Center for Independence of the Disabled, NY © 2015
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Best Practices:
Written Information/Communications
• Make available information on how to access oral
interpretation services and written materials in alternative,
cognitively accessible formats.
• Make available information on the availability of reasonable
accommodations and how they can be arranged and
delivered.
Center for Independence of the Disabled, NY © 2015
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Common Problems with Members Services
• How to obtain reasonable accommodation for member
services is not clearly stated in member materials.
• Often the only reasonable accommodations mentioned are
alternate formats or TTY.
• ASSESSMENT:
– Assessment of the disabilities often made using the NYS Department of Health Uniform
Assessment System (UAS) forms. The UAS, which has the stated goal of assessing the
need for community-based long-term care services and programs, are does not fully
meet the FIDA plan’s need to determine a disability and need for reasonable
accommodation for plan services.
– The UAS focuses on independent living skills and does not adequately capture
someone’s need for accommodations to access services outside the home.
Center for Independence of the Disabled,
NY © 2015
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BEST PRACTICS: MEMBER SERVICES
Interdisciplinary Team (IDT) and Case Managers
In New York, the FIDA plans call for Person-Centered care, which includes Care
managers and nurses who must have knowledge of ADA and the obligation to provider
reasonable accommodations and modification of policies conducting Participant
assessments and coordinating care.
In addition, under the FIDA plan, the Inter-disciplinary Team (IDT) coordinates care,
including facilitating reasonable accommodations.
 IDA team must be trained on person-centered planning process, cultural
competence, disability, accessibility and accommodations, independent living
and recovery, and wellness principals, and ADA/Olmstead principals. It must
include, among other things:
– Participant’s preferred language
– Barriers or obstacles that need to be addressed
– Reasonable accommodations
 Case managers are assigned based on individual needs, (e.g., communication, cognitive,
or other barriers.) Participant has a right to choose and change care manager.
Center for Independence of the Disabled, NY © 2015
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Best Practices: Member Services
Interdisciplinary Team (IDT) and Case Managers
• Assessments of disabilities and need for reasonable
accommodation should address the limitations of the UAS.
– Plans should assess a person’s ability to understand
information about health care or health plans.
– Plans should assess a person’s ability to communicatespeech or sensory impairments.
– The assessment should note any functional limitations
outside the home and any necessary reasonable
accommodations.
– The assessment should note if the effect of medications or
treatments require reasonable accommodations.
Center for Independence of the Disabled,
NY © 2015
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BEST PRACTICS: MEMBER SERVICES
Interdisciplinary Team (IDT) and Case Managers
• The process of obtaining reasonable accommodations must
be made clear to members by member materials and the IDT.
• Records of functional limitations and reasonable
accommodation needs should be kept so that requests for
reasonable accommodations, e.g., materials in alternate
formats, do not have be made repeatedly.
Center for Independence of the Disabled,
NY © 2015
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Common Problems with Members Services:
Network Adequacy
• Network Adequacy: It is often unclear whether the provider
network is ADA-compliant.
– The provider directories only give information about
physical accessibility.
– There is no clear way members can obtain information
about ADA-compliance of members beyond basic physical
accessibility.
– Websites often lack a search feature for accessibility of
providers.
Center for Independence of the Disabled,
NY © 2015
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Common Problems with Members Services:
Network Adequacy (cont.)
– The Provider ADA Attestation Form does not capture all
the necessary information to ensure that a provider is
ADA-compliant.
• The form lacks specific questions about the accessibility of exam tables and medical
equipment.
• There are no questions about whether the elevator has beeps or audio cues.
• The form lacks specific questions about communication capacity of providers-TTY, texting,
video relay, alternate formats.
• The form lacks questions about communication capacity of medical staff or availability of
qualified interpreters.
• The form does not ask whether provider staff is trained to accommodate a full range of
disabilities, including cognitive or psychological disabilities.
Center for Independence of the Disabled,
NY © 2015
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BEST PRACTICES: NETWORK ADEQUACY
Ensuring Network Adequacy of ADA-Compliant
providers
In New York, a FIDA plan must ensure ADA-compliance of its network of
providers by, at minimum:
• Conducting on-site visits to participating Providers to assess for meaningful
compliance with ADA requirements;
• Naming an individual within the plan who is responsible for ADA
compliance;
•Ensuring that all Providers’ physical sites are accessible to all Participants.
Center for Independence of the Disabled, NY © 2015
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Best Practices: Network Adequacy
Ensuring Network Adequacy of ADA-Compliant
providers
•
In NY, FIDA Plans must collect completed ADA Accessibility Attestation forms from new
Network Providers that join their networks during the demonstration.
– Attestation should include NON-PHYSICAL access issues, e.g., flexible scheduling,
communication capacity , etc.;
– FIDA Plans must collect sufficient information from Participating Providers to assess
compliance with the ADA;
– All participation providers must notify FIDA plan within 10 business days of any change
in ability to meet ADA Accessibility standards; and
– FIDA Plans must conduct site visits to confirm provider accessibility
Center for Independence of the Disabled, NY © 2015
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Best Practices: Network Adequacy
Ensuring Network Adequacy of ADA-Compliant
providers (cont.)
•
FIDA plans should supplement the ADA Attestation form to capture all the necessary
information about ADA-compliance.
– The plans need to ensure that physical accessibility extends to all aspects of the office
visit: elevators, waiting rooms, restrooms, exam tables, and medical/diagnostic
equipment.
– The plan needs to inquire about the accessibility features of the building, e.g., elevator,
as well as the office for any route a patient may need to use to get to the office.
– The plan should inquire about non-physical access ADA issues, such as communication
capacity and availability of reasonable accommodations for all types of disabilities.
– The plan should inquire about provider staff training on ADA issues.
Center for Independence of the Disabled,
NY © 2015
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Best Practices: Network Adequacy
Ensuring Network Adequacy of ADA-Compliant
providers: Physical Accessibility
Physical Barrier Removal
•
•
•
Providers are responsible for altering or modifying waiting, exam and changing
rooms to ensure access to persons with a range of physical, sensory and cognitive
impairments.
Providers are responsible for providing medical equipment that ensures an
individual with a disability can receive the same health care services. Examples
include but are not limited to: Adjustable exam tables, accessible weight scales
(platform/roll-on scales)
Providers responsible for safe and comfortable transfers without using patient’s
family member, friend, etc.
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BEST PRACTICES: NETWORK ADEQUACY
Ensuring Network Adequacy of ADA-Compliant
providers: Programmatic Access
Providers should not only provide physical accessibility, but
programmatic accessibility as well. In NY, FIDA are required to have written
policies and procedures to ensure ADA compliance by providers, including
ensuring that physical, communication, and programmatic barriers do not
inhibit Participants with disabilities from obtaining all covered Items and
services from the FIDA Plan.
For example, programmatic access can be providing flexibility in scheduling as
an accommodation.
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Best Practices: Network Adequacy
Provider Site Reviews
FIDA plans must conduct site reviews.
– Site Review should include:
• for both physical and programmatic accessibility,
• documenting any deficiencies in compliance; and
• monitoring correction of deficiencies.
– Plans should confirm compliance through the Provider ADA
Accessibility Attestation form and a random sampling of on-site
compliance review.
Center for Independence of the Disabled, NY © 2015
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Best Practices: Network Adequacy
Accessibility: Training Providers
FIDA plans must train providers on Physical Accessibility and the ADA in the
following areas:
• Reasonable accommodations to those with hearing, vision, cognitive, and
psychiatric disabilities;
• Waiting room and exam room furniture that meets needs all Participants,
including those with physical and non-physical disabilities;
• Accessibility along public transportation routes and/or provide enough
accessible parking;
• Clear signage and way finding , e.g., color and symbol signage, throughout
facilities; and
• Any other requirements in the ADA Accessibility Attestation Form.
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Best Practices: Network Adequacy
Provider Directories: Providing ADA information
FIDA plans must have provider directories that contain:
•information on Providers with areas of special experience, skills and training, including
providers with expertise in treating people with disabilities
•whether the participating Provider is accessible for people with disabilities, including office,
exam room(s) and equipment
•the cultural and linguistic capabilities of the Provider, including languages spoken by
Provider or skilled medical interpreter at site.
•whether participating Provider or Pharmacy meets the ADA Accessibility Attestation Form
requirements
•Languages spoken by Providers or by skilled medical interpreters at the Provider’s site,
including ASL, and whether translation services are available.
Provider information about both physical and programmatic accessibility should be readily
available whether online, in print, and through the call center.
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Best Practices: Network Adequacy
Provider training: Reasonable Accommodations
FIDA Plans must train providers about disabilities and reasonable accommodations,
Including:
– Ascertaining the need for accommodation;
– Methods to ensure privacy during intake procedures;
– Transferring and positioning techniques; and
– Sensitivity and awareness of the needs of individuals with various disabilities, including
cognitive disabilities;
– Identify and locate which examination and procedure rooms are accessible, where
accessible equipment is stored and how to use it;
– How to uses transfer and positioning aids and equipment, such as patient lifts, gait belts
and variety of stabilizing supports.
– Their obligations to:
• Have procedures to evaluating compliance with accessibility standards on an
ongoing basis.
• Inform patients of their rights in understandable formats and provide
straightforward methods for receive and resolving complaints.
• Have flexibility in scheduling needs.
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Best Practices: Network Adequacy
Provider Access: Provider Training
FIDA plans must train providers about disability culture and sensitivity, including:
– Various types of chronic conditions prevalent among eligible Individuals;
– Awareness of personal prejudices;
– Legal obligations to comply with the ADA requirements;
– Definitions and concepts, such as communication access, medical equipment access,
physical access, and access to programs;
– Types of barriers encountered by eligible Individuals;
– Training on person-centered planning (i.e., PCSI’s) and self-determination, the social
model of disability, the independent living philosophy, and the recovery model;
– Use of evidence-based practices and specific levels of quality outcomes; and
– Working with Participants on mental health diagnosis, including crisis prevention and
treatment.
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Best Practices: Network Adequacy
Provider Access: Reference Materials
In addition, FIDA plans must have a comprehensive online reference tool for the
Participating Providers about:
– Reasonable accommodations
– Cultural and linguistic competency
– Availability and access standards, including but not limited to requirements of
the ADA Accessibility Attestation Form.
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BEST PRACTICES: Equal opportunity to participate in plan
feedback - Advisory Board
 Plans should have feedback from participants reflect the diversity of its members,
including people with disabilities.
 In NY, FIDA plan are required to have the composition of the participant advisory
committee reflect the diversity of the FIDA population and have participation of
individuals with disabilities within the governance structure of the FIDA Plan.
 Reasonable accommodations must be provided to assist participants in the
feedback sessions or advisory committees to assist with the cost, transportation,
reasonable accommodations, and other challenges of attending any in-person
sessions.
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COMMON PROBLEMS WITH GRIEVANCES
• The right to grieve reasonable accommodation decisions is
not among the listed rights for members or made readily
known.
• The right to reasonable accommodations during the grievance
procedure is not in the staff training materials.
Center for Independence of the Disabled,
NY © 2015
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BEST PRACTICES: Accessibility of the complaint/grievance
system
•
•
•
In NY, FIDA Plans must provide reasonable accommodations in the grievance
process including assistance in completing any forms or other procedural steps,
which shall include interpreter services and toll-free numbers with TTY/TTD and
interpreter capacity.
The right to grieve reasonable accommodation decisions should be made clearly
known in the written materials and member materials.
The right to grieve to external agencies for adverse decisions about reasonable
accommodations should be clearly stated.
Center for Independence of the Disabled, NY © 2015
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The Supreme Court Olmstead decision says you
have to be cared for in the most integrated setting –
what does that mean?
All care must be provided in compliance with the
ADA and Olmstead.
Center for Independence of the Disabled, NY © 2015
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Olmstead Decision
• Background: In Olmstead, Lois Curtis and Elaine Wilson, who
had mental illness and developmental disabilities, were
voluntarily admitted to the psychiatric unit in the state-run
Georgia Regional Hospital.
After the women's medical treatment there had ended,
mental health professionals determined that each was ready
to move to a community-based program. However, both
women were confined in the institution for several years after
the initial treatment was concluded. They filed suit under the
Americans with Disabilities Act (ADA) for release from the
hospital.
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NY © 2015
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Olmstead Decision (cont.’d)
• On June 22, 1999, the United States Supreme Court held that
unjustified segregation of persons with disabilities constitutes
discrimination under the ADA, Title II, and public entities must
provide community-based services when:
(1) such services are appropriate;
(2) the person receiving services are not opposed to
community-based treatment; and
(3) community-based services can be reasonably
accommodated when considering the available resources
and the needs of others who are receiving disability services
from the entity.
Center for Independence of the Disabled,
NY © 2015
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Best Practices: Olmstead
• FIDA Plans and Providers should be trained on the Olmstead
decision and how to provide services in the most integrated
setting possible
Center for Independence of the Disabled,
NY © 2015
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Contact information
The Center for Independence of the Disabled, New York’s (CIDNY) goal is to
ensure full integration, independence and equal opportunity for all people with
disabilities by removing barriers to the social, economic, cultural and civic life
of the community.
CIDNY
841 Broadway
Suite 301
New York, NY 10003
212-674-2300 (Voice)
646-350-2681 (Video Phone)
www.cidny.org
Center for Independence of the Disabled,
NY © 2015
CIDNY – Queens
80-02 Kew Gardens Road
Suite 107
Kew Gardens, NY 11415
646-442-1520 (Voice)
347- 905-5088 (Video Phone)
www.cidny.org
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