Disability News Service, Resources, Diversity, Americans with Disabilities Act; Local and National.

Wednesday, February 29, 2012

EEOC Issues Revised Publications on Employment of Veterans with Disabilities | Feb 28, 2012

As posted at EEOC:
###
PRESS RELEASE 2-28-12

EEOC Issues Revised Publications on Employment of
Veterans with Disabilities


User-Friendly Documents Clarify Impact of ADAAA; Commission Will Participate in Employment Conference Sponsored by U.S. Army Wounded Warrior Program
WASHINGTON – The U.S. Equal Employment Opportunity Commission (EEOC) today issued two revised publications addressing veterans with disabilities and the Americans with Disabilities Act (ADA). Both documents are available on the agency’s website at www.eeoc.gov.

The revised guides reflect changes to the law stemming from the ADA Amendments Act of 2008, which make it easier for veterans with a wide range of impairments – including those that are often not well understood -- such as traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD), to get needed reasonable accommodations that will enable them to work successfully. [Prior to the ADA Amendments Act, the ADA’s definition of the term “disability” had been construed narrowly, significantly limiting the law’s protections.]

The revised documents are also an outgrowth of a public meeting the EEOC held on Nov. 16, 2011 entitled “Overcoming Barriers to the Employment of Veterans with Disabilities.” In that meeting, the Commission heard testimony from a panel of experts on the unique needs of veterans with disabilities transitioning to civilian employment. The particular challenges faced by veterans with disabilities in obtaining employment has been the subject of increased attention in recent months, as large numbers of veterans return from service in Iraq and Afghanistan.

The Guide for Employers explains how protections for veterans with service-connected disabilities differ under the Americans with Disabilities Act (ADA) and the Uniformed Services Employment and Reemployment Rights Act (USERRA), and how employers can prevent disability-based discrimination and provide reasonable accommodations.

The Guide for Wounded Veterans answers questions that veterans with service-related disabilities may have about the protections they are entitled to when they seek to return to their former jobs or look for civilian jobs. The publication also explains the kinds of accommodations that may be necessary to help veterans with disabilities obtain and successfully maintain employment.

“We want veterans with disabilities to know that the EEOC has resources to assist them as they transition to, or move within the civilian workforce,” said EEOC Chair Jacqueline A. Berrien. “The release of these publications demonstrates our commitment to ensuring that veterans with disabilities receive the full protection of the laws we enforce, and that employers understand how to comply with those laws.”

On February 27-28 the EEOC will give presentations at an employment conference for severely injured U.S. Army personnel at Fort Belvoir, Virginia, sponsored by the Department of the Army’s Army Wounded Warrior (AW2) Program. The presentations will provide information to employers about the employment of veterans with disabilities and the ADA, and training for severely injured soldiers to help them learn their rights under the ADA as they seek civilian employment.

Over the past decade three million veterans have returned from military service and another one million are expected to return to civilian life over the course of the next five years with the anticipated drawdown of operations in the Middle East. According to an October report from the Bureau of Labor Statistics, unemployment for post-9/11 era veterans hovers around 12 percent, which is more than three percentage points higher than the overall unemployment rate.

# http://www.eeoc.gov/eeoc/newsroom/release/2-28-12.cfm

The EEOC enforces federal laws prohibiting employment discrimination. Further information about the EEOC is available on its web site at www.eeoc.gov.

Dallas Doctor Arrested for Alleged Role in Nearly $375 Million Health Care Fraud Scheme | Feb 28, 2012

As posted at U.S. Department of Health & Human Services:
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News Release

February 28, 2012

Dallas Doctor Arrested for Alleged Role in Nearly $375 Million Health Care Fraud Scheme

Office Manager for Doctor and Five Owners of Dallas-Area Home Health Agencies Also Arrested


WASHINGTON - A physician and the office manager of his medical practice, along with five owners of home health agencies, were arrested today on charges related to their alleged participation in a nearly $375 million health care fraud scheme involving fraudulent claims for home health services.

The arrests and charges were announced today by Deputy Attorney General James Cole and Health and Human Services (HHS) Deputy Secretary Bill Corr, along with Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Sarah R. Saldaña of the Northern District of Texas; HHS Inspector General Daniel R. Levinson; Special Agent in Charge Robert E. Casey Jr. of the FBI’s Dallas Field Office; Dr. Peter Budetti, Deputy Administrator for Program Integrity for the Centers for Medicare and Medicaid Services (CMS); and the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).

The indictment, filed in the Northern District of Texas and unsealed today, charges Jacques Roy, M.D., 54, of Rockwall, Texas; Cynthia Stiger, 49, of Dallas; Wilbert James Veasey Jr., 60, of Dallas; Cyprian Akamnonu, 63, of Cedar Hill, Texas; Patricia Akamnonu, RN, 48, of Cedar Hill; Teri Sivils, 44, of Midlothian, Texas; and Charity Eleda, RN, 51, of Rowlett, Texas, each with one count of conspiracy to commit health care fraud. Roy also is charged with nine counts of substantive health care fraud, and Veasey, Patricia Akamnonu and Eleda are each charged with three counts of health care fraud. Eleda also is charged with three counts of making false statements related to a Medicare claim. All the defendants are expected to make their initial appearances at 2:00 p.m. CST today in federal court in Dallas.

In addition to the indictment, CMS announced the suspension of an additional 78 home health agencies (HHA) associated with Roy based on credible allegations of fraud against them.

Today’s enforcement actions are the result of the Medicare Fraud Strike Force operations, which are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT). HEAT is a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce anti-fraud laws around the country.

“The conduct charged in this indictment represents the single largest fraud amount orchestrated by one doctor in the history of HEAT and our Medicare Fraud Strike Force operations,” said Deputy Attorney General Cole. “Thanks to the historic partnerships we’ve built to combat health care fraud, we are sending a clear message: If you victimize American taxpayers, we will track you down and prosecute you.”

“Thanks to our new fraud detection tools, we have greater abilities to identify the kind of sophisticated fraud scheme that previously could have escaped scrutiny,” said HHS Deputy Secretary Corr. “Our aggressive Medicare Fraud Strike Force operations have enabled us to break up a significant alleged fraud operation and the fraud-fighting authorities in the Affordable Care Act have allowed us to stop further payments to providers connected to this scheme. This case and our new detection tools are examples of our growing ability to stop Medicare fraud.”

According to the indictment, Dr. Roy owned and operated Medistat Group Associates P.A. in the Dallas area. Medistat was an association of health care providers that primarily provided home health certifications and performed patient home visits. Dr. Roy allegedly certified or directed the certification of more than 11,000 individual patients from more than 500 HHAs for home health services during the past five years. Between January 2006 and November 2011, Medistat certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States. These certifications allegedly resulted in more than $350 million being fraudulently billed to Medicare and more than $24 million being fraudulently billed to Medicaid by Medistat and HHAs.

“Today, the Medicare Fraud Strike Force is taking aim at the largest alleged home health fraud scheme ever committed,” said Assistant Attorney General Breuer. “According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services, and billing Medicare for those services. In Dallas, and the eight other Medicare Fraud Strike Force cities, the Criminal Division and our partners in the U.S. Attorneys’ Offices will continue to crack down on Medicare fraud, and hold accountable those stealing from the public fisc.”

“Fraud schemes, like the one we allege Dr. Roy executed, represent the next wave of Medicare and Medicaid crime that we face,” said U.S. Attorney Saldaña. “As enforcement actions have ramped up, not only in the Dallas Metroplex, but in several other areas throughout the country, fraudsters are devising new ways to beat the system. Rest assured, however, that with the tools and resources our district’s Medicare Care Fraud Strike Force provides, we will meet this challenge head-on and bring indictments against those who seek to defraud these critical programs, and you, the taxpayer.”

“Using sophisticated data analysis we can now target suspicious billing spikes,” said HHS Inspector General Levinson. “In this case, our analysts discovered that in 2010, while 99 percent of physicians who certified patients for home health signed off on 104 or fewer people – Dr. Roy certified more than 5,000.”

“The FBI views health care fraud as a severe crime problem,” said FBI Special Agent in Charge Casey. “It causes increased costs for consumers, tax payers and health insurance plans, and degrades the integrity of our health care system and legitimate patient care. Today’s arrests by the Dallas Medicare Fraud Strike Force send a clear message to those persons who are not only defrauding our federal Medicare and Medicaid and private health insurance programs, but victimizing the elderly, the disadvantaged, and those who are at a vulnerable time in their lives due to legitimate health issues. The FBI will continue to dedicate a substantial amount of expert resources to investigate these crimes.”

The indictment alleges that Dr. Roy used HHAs as recruiters so that Medistat could bill unnecessary home visits and medical services. Dr. Roy and other Medistat physicians certified and recertified plans of care so that HHAs also were able to bill Medicare for home health services that were not medically necessary and not provided. In addition, Dr. Roy allegedly performed unnecessary home visits and ordered unnecessary medical services.

According to the indictment, Medistat maintained a “485 Department,” named for the number of the Medicare form on which the plan of care was documented. Dr. Roy allegedly instructed Medistat employees to complete the 485s by either signing his name by hand or by using his electronic signature on the document.

Three of the HHAs Dr. Roy used as part of the scheme were Apple of Your Eye Healthcare Services Inc., owned and operated by Stiger and Veasey; Ultimate Care Home Health Services Inc., owned and operated by Cyprian and Patricia Akamnonu; and Charry Home Care Services Inc., owned and operated by Eleda. According to the indictment, Veasey, Akamnonu, Eleda and others recruited beneficiaries to be placed at their HHAs so that they could bill Medicare for the unnecessary and not provided services. As part of her role in the scheme, Eleda allegedly visited The Bridge Homeless Shelter in Dallas to recruit homeless beneficiaries staying at the facility, paying recruiters $50 per beneficiary they found at The Bridge and directed to Eleda’s vehicle parked outside the shelter’s gates.

Apple allegedly submitted claims to Medicare from Jan. 1, 2006, through July 31, 2011, totaling $9,157,646 for home health services to Medicare beneficiaries that were medically unnecessary and not provided. Dr. Roy or another Medistat physician certified the services. From Jan. 1, 2006, to Aug. 31, 2011, Ultimate submitted claims for medically unnecessary home health services totaling $43,184,628. Charry allegedly submitted fraudulent claims from Aug. 1, 2008, to June 30, 2011, totaling $468,858 in medically unnecessary and not provided home health services.

The indictment alleges that Sivils, as Medistat’s office manager, helped facilitate the fraud scheme by, among other actions, supervising the processing of thousands of plans of care that contained Dr. Roy’s electronic signature and other Medistat physicians’ signatures, permitting HHAs to bill Medicare for unnecessary home health services and accepting cash payments from Cyprian Akamnonu in exchange for ensuring plans of care contained Dr. Roy or another Medistat physician’s signature.

As outlined in the government’s request to the court to detain Dr. Roy, in June 2011, CMS suspended provider numbers for Dr. Roy and Medistat based on credible allegations of fraud, thus ensuring Dr. Roy did not receive payment from Medicare. Immediately after the suspension, nearly all of Medistat’s employees started billing Medicare under the provider number for Medcare HouseCalls. The court document alleges that Dr. Roy was in fact in charge of day-to-day operations at Medcare, and that Dr. Roy continued to certify patients for home health despite the suspension.

Each charged count of conspiracy to commit health care fraud and substantive health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine. Each false statement charge carries a maximum penalty of five years in prison and a $250,000 fine. The indictment also seeks forfeiture of numerous items including funds in bank accounts, a sailboat, vehicles and multiple pieces of property.

An indictment is merely an allegation and defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

The case is being prosecuted by Assistant U.S. Attorneys Michael C. Elliott, Mindy Sauter and John DeLaGarza of the Northern District of Texas and Trial Attorney Ben O’Neil and Deputy Chief Sam S. Sheldon of the Criminal Division’s Fraud Section. The case was investigated by the FBI, HHS-OIG and MFCU and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Northern District of Texas.

Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,190 defendants who collectively have falsely billed the Medicare program for more than $3.6 billion.

To learn more about the HEAT Strike Force, please visit: www.stopmedicarefraud.gov.


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Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last revised: February 28, 2012

Justice Department Settles Disability Discrimination Case Involving Disabled Veteran in Utah | Feb 27, 2012

As posted at DOJ:
###

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE Monday, February 27, 2012

Justice Department Settles Disability Discrimination Case Involving Disabled Veteran in Utah

WASHINGTON - The Justice Department today announced a $20,000 consent decree that resolves a lawsuit alleging that a Park City, Utah, condominium association and its management company violated the Fair Housing Act by refusing to grant a resident’s request for a reasonable accommodation.

The lawsuit, filed on Nov. 21, 2011, in U.S. District Court for the District of Utah, alleges that the Fox Point at Redstone Association, Property Management Systems and on-site property manager Derek Peterson refused to grant a reasonable accommodation so that Thomas Burton, a disabled combat veteran of the first Gulf War, could keep a small dog in the condominium he rented to help him cope with the effects of depression and anxiety disorder. The lawsuit further alleges that the defendants refused to waive their pet fees and insurance requirements and issued multiple fines that eventually led to the non-renewal of Burton’s lease.

Under the consent decree, which was entered by the U.S. District Court in Utah, the defendants will pay $20,000 in monetary relief to Burton. Additionally, the defendants will attend fair housing training; implement a new reasonable accommodation policy that does not charge pet fees to owners of service or assistance animals and does not require them to purchase liability insurance; and comply with notice, monitoring and reporting requirements.

“In this case, a combat veteran was denied an assistance animal for his disability,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division. “We are pleased that this settlement will compensate Mr. Burton and protect the housing rights of others who need this accommodation.”

“Enforcing the fair housing rights of persons with disabilities in Utah, including disabled veterans, is a priority of this office. We will continue to work to ensure that disabled veterans are not denied accommodations they need to live independently,” said David B. Barlow, U.S. Attorney for the District of Utah.

“No veteran should be denied the right to have a support animal when they return home with mobility impairments or other conditions,” said John Trasviña, Department of Housing and Urban Development (HUD) Assistant Secretary for Fair Housing and Equal Opportunity. “HUD and the Department of Justice are committed to enforcing the Fair Housing Act and ensuring that housing providers grant people with disabilities reasonable accommodations.”

The lawsuit arose as a result of a complaint filed by Burton with HUD. After an investigation of the complaint, HUD issued a charge of discrimination, and the Fox Point at Redstone Association elected to have the case heard in federal court.

The federal Fair Housing Act prohibits discrimination in housing based on race, color, religion, national origin, sex, disability and familial status. More information about the Civil Rights Division and the laws it enforces is available at www.justice.gov/crt . Individuals who believe that they may have been victims of housing discrimination can call the Housing Discrimination Tip Line at 1-800-896-7743, email the Justice Department at fairhousing@usdoj.gov or contact HUD at 1-800-669-9777.

12-258Civil Rights Division

# http://www.justice.gov/opa/pr/2012/February/12-crt-258.html

Tuesday, February 28, 2012

HUD CHARGES BANK OF AMERICA WITH DISCRIMINATING AGAINST HOMEBUYERS WITH DISABILITIES | Feb 27, 2012

As posted at HUD.GOV
###

FOR RELEASE
Monday
February 27, 2012

HUD No. 12-036

Bank of America allegedly applied discriminatory lending requirements for borrowers with disabilities

WASHINGTON--The U.S. Department of Housing and Urban Development (HUD) today announced that it is charging Bank of America with discriminating against homebuyers with disabilities. HUD alleges that Bank of America imposed unnecessary and burdensome requirements on borrowers who relied on disability income to qualify for their home loans and required some disabled borrowers to provide physician statements to qualify for home mortgage loans.

The Fair Housing Act makes it illegal to discriminate in the terms and conditions of a loan to an individual based on a disability, including imposing different application or qualification criteria, and makes it illegal to inquire about the nature or severity of a disability except in limited circumstances not applicable here.

"Holding homebuyers with disabilities to a higher standard just because they rely on disability payments as a source of income is against the law," said John Trasviña, HUD Assistant Secretary for Fair Housing and Equal Opportunity. "Mortgage companies may verify income and have eligibility standards but they may not single out homebuyers with disabilities to delay or deny financing when they are otherwise eligible."

HUD's charge is based on a "Secretary-initiated investigation," and the investigation of complaints filed by two individual borrowers in Michigan and one borrower in Wisconsin who claimed that Bank of America required them to provide personal medical information and documentation regarding their disability and proof of continuance of their Social Security payment in order to qualify for a home mortgage loan. The charge is also being issued as part of the work being conducted by the Federal Financial Fraud Enforcement Task Force's non-discrimination working group.

According to HUD's charge, Bank of America allegedly asked some borrowers for proof of their disabilities and sought evidence of the continuation of their Social Security income before approving loans, after first denying them. The matter will now be handled by the Department of Justice.

FHEO and its partners in the Fair Housing Assistance Program investigate approximately 10,000 housing discrimination complaints annually. People who believe they are the victims of housing discrimination should contact HUD at 1-800-669-9777 (voice), (800) 927-9275 (TTY).

# http://portal.hud.gov/hudportal/HUD?src=/press/press_releases_media_advisories/2012/HUDNo.12-036
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HUD's mission is to create strong, sustainable, inclusive communities and quality affordable homes for all.
HUD is working to strengthen the housing market to bolster the economy and protect consumers; meet the
need for quality affordable rental homes: utilize housing as a platform for improving quality of life; build
inclusive and sustainable communities free from discrimination; and transform the way HUD does business.
More information about HUD and its programs is available on the Internet at www.hud.gov and
http://espanol.hud.gov. You can also follow HUD on twitter @HUDnews, on facebook at
www.facebook.com/HUD, or sign up for news alerts on HUD's News Listserv.

DOJ - Letter to the American Hotel and Lodging Association regarding accessible entry and exit for swimming pools and spas Feb, 21, 2012

As posted at http://www.ada.gov/new.htm
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U.S. Department of Justice
Civil Rights Division
Disability Rights Section - NYA
950 Pennsylvania Avenue, NW
Washington, DC 20530

VIA FIRST CLASS MAIL, FACSIMILE, AND E-MAIL

February 21, 2012

Mr. Kevin L. Maher
Senior Vice President for Governmental Affairs
American Hotel and Lodging Association
1201 New York Avenue, NW
Suite 600
Washington, DC 20005

Dear Mr. Maher:

It was a pleasure to meet with you and representatives of the American Hotel & Lodging Association (AH&LA) recently to hear AH&LA thoughts and concerns with respect to the application of the ADA requirements for accessible entry and exit for swimming pools and spas, given the approach of the March 15, 2012 compliance date for the 2010 ADA Standards. We appreciate your statement that AH&LA members are committed to compliance with the Americans with Disabilities Act and to ensuring that their facilities are accessible to individuals with disabilities.

As we understood from your remarks at the outset of the February 8, 2012 meeting, AH&LA members continue to have questions regarding their obligations to remove architectural barriers in existing facilities, particularly as those obligations pertain to swimming pools and spas. In particular, you requested guidance for AH&LA members about the effect of the March 15, 2012 effective date for the 2010 ADA Standards for Accessible Design (2010 Standards) with respect to readily achievable barrier removal obligations in swimming pools and spas; whether installation of a portable lift at poolside would ever satisfy an entity's readily achievable barrier removal obligations; and whether safety considerations can be taken into account in determining whether barrier removal in existing pools and spas is readily achievable. We hope that our discussion last week was helpful to AH&LA, and, toward that end, we write to memorialize that discussion with respect to the major issues raised in the meeting.

As you know, the Department of Justice published its revised final regulations implementing the ADA for title II (State and local government services) and title III (public accommodations and commercial facilities) on September 15, 2010. See 75 FR 56163. The revised ADA rules are the result of a six-year process to update the Department's regulations. As part of this process, the Department sought extensive public comment, issuing an Advance Notice of Proposed Rulemaking (ANPRM) on September 30, 2004, 69 FR 58768 and two Notices of Proposed Rulemaking (NPRM) on June 17, 2008, 73 FR 34466 (title II) and 73 FR 34508, (title III). The Department also held a public hearing on the NPRMs and during the comment period received over 4,435 written public comments.

The revised regulations update the general nondiscrimination provisions implementing the ADA; with some exceptions, revisions to these general nondiscrimination provisions have been in effect since March 2011. The revised regulations also adopt revised design requirements for new construction and alterations, known as the 2010 ADA Standards for Accessible Design. The 2010 Standards update requirements for accessible fixed or built-in elements that were originally covered in the 1991 ADA Accessibility Guidelines (1991 Standards) and also establish new ("supplemental") requirements for a variety of recreational facilities, including requirements for accessible means of entry and exit for swimming pools and spas. New construction and alterations started on or after March 15, 2012 are generally required to comply with the 2010 Standards. In addition, effective March 15, 2012 the 2010 Standards must be used while meeting ongoing barrier removal obligations, which are discussed in more detail below.

Public accommodations must undertake readily achievable barrier removal.

Title III of the ADA requires that public accommodations (e.g., owners, operators, lessors and lessees of hotels, resorts, swim clubs, and sites of events open to the public) remove physical barriers in each existing building or facility to the extent that it is readily achievable to do so (i.e., easily accomplishable and able to be carried out without much difficulty or expense). Known as readily achievable barrier removal, this requirement has been in effect since January 26, 1992, and public accommodations since that date have been required to engage in barrier removal in existing buildings and facilities on an ongoing basis. The regulation implementing the ADA barrier removal obligation recognizes that it is not always readily achievable to remove all architectural barriers in an existing building at the outset, and, as discussed further below, sets forth priorities for removal of barriers over time.

As discussed above, the 2010 Standards add supplemental requirements to the ongoing barrier removal obligation, including requirements for accessible means of entry and exit for pools, spas, and wading pools. These requirements are found at sections 242 and 1009 of the 2010 Standards. If a hotel or motel has more than one pool, it must remove barriers, to the extent that it is readily achievable, at each pool. If is not readily achievable to immediately provide an accessible means of entry and exit at every pool, then the covered entity must remove barriers to the extent that it is readily achievable to do so. It is important to note that the barrier removal obligation is a continuing one, and it is expected that a business will take steps to improve accessibility over time.

To determine whether it is readily achievable to provide an accessible means of entry to an existing pool, public accommodations should consider the following factors:

•The nature and cost of the action;
•Overall resources of the site or sites involved, the number of persons employed at the site, the effect on expenses and resources, legitimate safety requirements that are necessary for safe operation, including crime prevention measures, or the impact otherwise of the action upon the operation of the site;
•The geographic separateness and relationship of the site(s) to any parent corporation or entity;
•The overall resources of any parent corporation or entity, if applicable; and
•The type of operation or operations of any parent corporation or entity, if applicable.

The 2010 Standards apply to "fixed" or built-in elements. A "fixed" element is one that is attached to a covered building or facility. Therefore, for an existing pool with less than 300 linear feet of pool wall, for example, removing barriers will involve providing one accessible means of entry, meaning a built-in or "fixed" pool lift or a sloped entry that complies with the 2010 Standards to the extent that it is readily achievable to do so (larger pools with 300 or more linear feet of pool wall are required to have two accessible means of entry, with at least one being a pool lift or sloped entry). If, in our example, an entity chooses to use a lift complying with the 2010 Standards that is removable or otherwise designated as "portable," it may do so, so long as while the lift is provided at the pool, it is affixed in some manner to the pool deck or apron.

If installation of a fixed lift or sloped entry is not readily achievable, then a public accommodation may consider alternatives such as use of a portable pool lift that is not affixed to the pool facility but incorporates features that in all other respects comply with the 2010 Standards, or the public accommodation may consider other readily achievable accessible means of entry, such as a transfer wall or pool stairs. However, the 2010 Standards' emphasis on the provision of a lift or a sloped entry recognizes the fact that many people with mobility disabilities rely more heavily on these means to independently enter and exit a pool.

When selecting equipment, the public accommodation should factor in the staff and financial resources needed to keep the pool equipment available and in working condition at poolside. Once provided, a pool lift or other accessible means of entry must remain in place and be operational during all times that the pool is open to guests. Accessible features are only required to be available for use when the facility is available to the public. Thus, pool lifts or other accessible means of entry may be stored away from the pool while the pool is closed. For example, if a pool is closed during the winter months, the public accommodation is free to remove the lift from the pool deck and store it.

Determining what is readily achievable requires a fact-specific analysis.

During our meeting, you asked us to provide definitive answers to several broad questions pertaining to readily achievable barrier removal. As we explained, while we understand your desire for definitive answers, such questions cannot be answered in the abstract. The ADA clearly requires places of public accommodation to remove existing barriers that are structural in nature to the extent that it is readily achievable to do so. However, the Department's regulation does not establish a "quantifiable connection" or other mathematical formula to determine if barrier removal is "readily achievable."

When the original title III regulation was being drafted, the Department considered – but ultimately rejected – the idea of trying to establish a mathematical formula because it is virtually impossible to devise a specific ceiling on compliance costs that would adequately take into account the vast diversity of enterprises covered by the ADA's public accommodations requirement, and the economic situation that any particular entity would find itself in at any moment. Therefore, the regulation requires that the determination as to whether the removal of a specific barrier is readily achievable must be made on a case-by-case basis after a thorough consideration of the factors established in the statute. The decision should be made by each public accommodation in consultation with its own legal advisors and others.

If the place of public accommodation is a facility that is owned or operated by a parent entity that conducts operations at many different sites, the public accommodation must consider the resources of both the local facility and the parent entity to determine if required barrier removal is "readily achievable." The administrative and fiscal relationship between the local facility and the parent entity must also be considered in evaluating what resources are available for any particular act of barrier removal.

In striking a balance between guaranteeing access to individuals with disabilities and recognizing the legitimate concerns of businesses and other private entities, the ADA has always allowed for "legitimate safety requirements" to be taken into account in determining whether an action is readily achievable. See 28 C.F.R. § 36.104 (definition of "readily achievable"). As explained in the preamble to the 1991 regulation, a public accommodation may consider legitimate safety requirements in its assessment of whether barrier removal is readily achievable, "so long as the requirements are based on actual risks and are necessary for safe operation of the public accommodation." See id. pt. 36, App. C, p. 885 (2011). Speculation or unsubstantiated generalizations about safety concerns or risks cannot form the basis of a legitimate safety requirement.

With respect to safety concerns expressed during the meeting about pool lifts in unattended pools, we note that the Access Board addressed this very issue in September 2002 in conjunction with its promulgation of its final rule adopting its ADA/ABA Accessibility Guidelines for Recreation Facilities. See 67 FR 56352 (September 3, 2002). These guidelines were incorporated into the Access Board's 2004 ADA/ABA Accessibility Guidelines which were subsequently adopted by the Department as part of the 2010 Standards:

Comment. A few commenters expressed safety concerns where pool lifts are provided in pools that are unattended.
Response. Pool lifts have been commercially available for over 20 years. While the Board recognizes that inappropriate use of pool lifts may result in accident or injury, the Board is not aware of any incidents of injury or accidents involving pool lifts. The Board is also not aware of any evidence that shows that pool lifts are any less safe than other components of a pool facility, such as other means of pool entry, when they are used inappropriately. Manufacturers are also incorporating features which are intended to discourage inappropriate use, such as fold-up seats and covers.
See 67 FR at 56379. The Board's discussion is wholly consistent with the Department's regulatory approach which permits consideration of legitimate safety requirements to inform the readily achievable analysis but insists that such requirements be based on actual risks and be necessary for safe operation of the public accommodation.

In closing, we believe that it is important to reemphasize that determining whether removal of a particular barrier is readily achievable requires a case-by-case assessment that may vary from business to business and sometimes from one year to the next for the same business. If a public accommodation determines that its facilities have barriers that should be removed pursuant to the ADA, but it is not readily achievable to undertake all of the modifications immediately, the Department recommends, as it has for many years, that the public accommodation develop an implementation plan designed to achieve compliance with the ADA's barrier removal requirements over time. Indeed, the March 15, 2012 effective date for the 2010 Standards reflects an 18-month delay in implementation of the revised requirements, which delay was provided, in part, to allow businesses sufficient time to consider the new requirements while developing plans to meet their on-going barrier removal obligations. Such a plan, if appropriately designed and diligently executed, may well serve as evidence of a good faith effort to comply with the ADA's barrier removal requirements.

We hope that this information is helpful. Please do not hesitate to contact the Department if we may be of assistance with this or any other matter.

Sincerely,
Allison Nichol
Chief
Disability Rights Section

cc: Minh N. Vu, Esq., Seyfarth Shaw LLP

# http://www.ada.gov/ahla_letter_2_21.htm

The Association of Community Mental Health Authorities of Illinois : LEGISLATIVE CONFERENCE : April 18 and April 19, 2012

SAVE THE DATE
ACMHAI SPRING LEGISLATIVE CONFERENCE

Wednesday, April 18 and Thursday, April 19, 2012

Hilton Hotel, Springfield, Illinois

Keynote Speakers:

Opening Session, 11:15 Wednesday, April 18, 2012

Dan Rutherford, Illinois State Treasurer

Closing Session, 12:00 Thursday, April 19
Julie Hamos, Director, Illinois Department of Healthcare and Family Services

This year ACMHAI's Spring Legislative Conference will have great content and networking opportunities for leadership, staff and partners of mental health boards and boards for the care and treatment of persons with a developmental disability. Whether a large or small behavioral health authority, ACMHAI member or non-member, there are common issues and big changes underway that will affect our communitites, our children and families in need, our agencies, and our service systems.

ACMHAI once again will be co-hosting a Legislative Reception on Wednesday, April 18 following our Legislative Briefing and visit to the Capitol.

This year, too, we want to extend a special invitation to those across Illinois who are working on a newly-formed Community Mental Health Committee to assess your community's behavioral health system. We welcome the opportunity to meet you and share these two days.

Conference Registration and Hotel Reservations will begin March 5, 2012.

Conference registration including the Opening Luncheon, Legislative Reception, Member Roundtable Breakfast and Closing Luncheon is $100.

For more information about the Spring Legislative Conference contact:

Phyllis Russell, Executive Director, ACMHAI

phyllis@acmhai.org/217-369-5168

For the The Association of Community Mental Health Authorities of Illinois:
http://www.acmhai.org/

...........................................................................
ACMHAI is gathering information and making connections. Last year Illinois Public Act 97-0439, an amendment to the Community Mental Health Act, was signed into law. The legislation requires counties and Cook County townships with no local mental health authorities to form mental health advisory committees comprised of seven community stakeholders by the end of December 2011. The mental health advisory committees are charged with identifying and assessing current mental health services, monitoring the expansion or contraction of those services and, if necessary, recommending additional needed services. These committees are NOT mental health authorities, having neither tax levy nor funding capacity. ACMHAI is now conducting a survey of counties and townships to determine which have appointed committees, are in the process of appointing committees, believe they are exempt from the requirement or were unaware of the requirement. Through these contacts, we have had requests for assistance and information, which we were pleased to provide.

ACHMAI welcomes Phyllis Russell as the Association's new Executive Director. Phyllis brings to the Association extensive experience in human services, community systems of service, public policy, legislative advocacy and association management. Most of her career has been in Illinois, where she has worked in communities from Rockford to Chicago to Springfield and Metro East (the Illinois portion of the St. Louis metro region). Phyllis joined ACMHAI December 1. She looks forward to traveling across the state in 2012 visiting ACMHAI members to introduce herself and learn about the issues, initiatives, challenges and opportunities in their communities.

Monday, February 27, 2012

Illinois Legislation aims to end free disability-parking abuses | Feb 27, 2012

BY CHRIS FUSCO | Chicago Sun Times

Legislation crafted to stop able-bodied drivers from illegally using disabled-parking placards or license plates to park for free in metered parking spots has been introduced in Springfield.

The proposal by state Rep. Karen May (D-Highland Park), which comes in response to a Chicago Sun-Times “Watchdogs” investigation, would end free parking for all but a handful of the 700,000 people statewide who have disabled-parking placards and license plates that entitle them to the free-parking benefit.

The Sun-Times found that in Chicago — where meter rates have risen dramatically under former Mayor Richard M. Daley’s meter-privatization deal — the system is widely abused, with able-bodied people using relatives’ placards, fake placards and stolen placards to park for free.

City taxpayers pay for that: The private company that now runs Chicago’s parking-meter system has billed the city $13.5 million to reimburse it for the free disabled-parking spots the company provided in 2010.

May’s proposal would limit free disability parking to people with severe disabilities who are unable to do one or more of the following:

“Manage, manipulate or insert coins or obtain tickets or tokens in parking meters . . . due to the lack of fine motor control of both hands.

“Reach above his or her head to a height of 42 inches from the ground, due to a lack of finger, hand, or upper extremity strength or mobility;

“Approach a parking meter due to his or her use of a wheelchair or other device; and walk more than 20 feet due to an orthopedic, neurological, cardiovascular, or lung condition in which the degree of debilitation is so severe that it almost completely impedes the ability to walk.”

The Illinois Secretary of State’s Office would issue these people a “free parking sticker” after receiving a doctor’s confirmation of one or more of these disabilities.

Disabled-parking placard and plate holders would continue to be allowed to park in handicapped-only spots in parking lots but would not have the free-parking benefit in metered zones.

# http://www.suntimes.com/news/watchdogs/10826074-452/bill-aims-to-end-free-disability-parking-abuses.html

Sunday, February 26, 2012

Family Seeks Federal Probe Of Autistic boy Fatal Shooting By Calumet City, IL. Cops | Feb 26, 2012

WBBM Newsradio’s Bob Roberts reports

CALUMET CITY, Ill. (CBS)– About 10 people marched with the family of 15-year-old Stephon Watts Saturday, demanding sanctions against the Calumet City police officers who shot the autistic teen to death.

{photo: Stephon Watts, 15, was shot and killed by Calumet City police officers on Feb. 1, 2012. Police said he had cut an officer with a kitchen knife, but his family said it was only a butter knife. -Watts Family Photo}



One of the teen’s uncles, Minister Aaron Watts, said he intended to begin sit-ins each Wednesday at the Calumet City police station, 1200 Pulaski Rd., at the approximate hour that Stephon was shot.

“Three of the officers knew him,” he told the crowd, which included a number of anti-brutality activists.

NAACP South Suburban chapter President David L. Lowery Jr. said he and the family are scheduled to meet March 9 with an investigator from the U.S. Department of Justice to discuss the case.

Lowery places little trust in the Illinois State Police Public Integrity Unit investigation, which began immediately after the shooting.

“It’s the code of blue,” Lowery said. “It’s difficult for the police to police the police.”

The family’s minister, Bishop Lance Davis, said he is “angry” that state police have told the family virtually nothing about the investigation.

Another of Stephon’s uncles, Wayne Watts, said that the teen’s father, Steven Watts, is losing sleep over the shooting, which he witnessed in the basement of the Watts family home.

“It’s a nightmare he cannot get rid of, no matter how I try to talk with him,” Wayne Watts said. “He keeps saying, ‘Brother. I keep seeing the smoke. I keep seeing the smoke (from the officers’ guns).’”

Minister Watts said he is still seeking a legislator to sponsor a measure that would require all first responders in Illinois to receive training on ways to deal, without having to resort to deadly force, with persons with autism who are acting out.

The measure he seeks also would impose automatic suspension without pay if a first responder injures or kills someone known to have autism.

Calumet City Police contend that Stephon slashed at the officers with a kitchen knife. Steven Watts claims that nothing of the sort happened, and that Stephon had a butter knife that he was using to try to pry open the cabinet in which his computer had been locked for disciplinary reasons.

Police had been called to the Watts home because of Stephon’s acting out 10 times in two years. Steven Watts has said that he had been advised to do so by local hospitals in order to obtain a police report, before seeking hospital treatment. He said he asked for one officer to come to the home to take the report, but said that Stephon had calmed down by the time police arrived and that he told them he did not need their assistance.

# http://chicago.cbslocal.com/2012/02/26/family-seeks-federal-probe-of-fatal-shooting-by-calumet-city-cops/

California's Lax investigations leave Abuse of Disabled unpunished | Feb. 25, 2012

Police force for state institutions didn't process crime scenes or follow leads – even after deaths.

By RYAN GABRIELSON | Orange County Register Communications

COSTA MESA, CA. – In 50 years of life, Van Ingraham never uttered a word.
After his neck was broken in his room at Fairview Developmental Center in 2007, the severely autistic man clung to life for six days, unable to tell anyone what had happened. After his death, doctors said the injury was so violent, it looked like he'd been put in a headlock.

{photo: Retired police officer Larry M. Ingraham's brother, Van Ingraham, had his neck broken June 6, 2007, at Fairview Developmental Center in Costa Mesa where he was a resident. He died five days later at age 50}

I knew this was no minor fall like they'd said," Ingraham's brother Larry, a former San Diego police officer, said in an interview. "Because being a cop all those years, being in the line of work I've been in, I knew there's a person out there ... that had done this to him."

If he had been living in a typical home, Ingraham's case would have been investigated by local law enforcement. But Ingraham's injuries occurred inside Fairview, a state-run institution with an internal police force and its own way of doing things. Records and interviews show that the department's police investigators failed to process the crime scene, collect forensic evidence or follow important leads. No one was ever prosecuted for his death.

California has assembled a unique police force, called the Office of Protective Services, to protect about 1,800 of its most vulnerable patients – men and women with cerebral palsy, severe autism and other mental disabilities who live in state institutions and require round-the-clock monitoring and protection from abuse.

But an investigation by California Watch has found that detectives and patrol officers at the state's five board-and-care institutions routinely fail to conduct basic police work even when patients die under mysterious circumstances.

The Office of Protective Services often learns about potential criminal abuse hours or days after the fact – if it finds out at all. Of the hundreds of abuse cases reported at the centers since 2006, California Watch could find just two cases in which the department made an arrest.

Most abuse cases are logged but never prosecuted. In the death of Ingraham, for instance, three medical experts said the 50-year-old likely had been killed. The center's detective, a former nurse who'd never investigated a suspicious death, failed to identify what – or who – had caused the fatal injury.

The people they are sworn to protect have profound developmental disabilities and live in a different world from most Californians. Some patients have spent decades in the centers, from childhood to death. Some cannot form words and have IQ scores in the single digits.

Federal audits and investigations by disability rights groups, as well as hundreds of pages of case files and other data reviewed by California Watch, show that staff members have been accused of choking, shoving, hitting and sexually assaulting patients at the facilities. None of these cases was prosecuted.

California is budgeted to spend $577 million this fiscal year to operate the centers, or roughly $320,000 per patient. More than 5,200 people work in the institutions – roughly 2 1/2 staff members for each patient. The five centers are in Los Angeles, Orange, Riverside, Sonoma and Tulare counties.

In most other states, local law enforcement or state police take the lead in conducting criminal investigations at developmental centers.

Critics of the state Department of Developmental Services, which oversees the institutions and Office of Protective Services, have said the tight-knit relationship between police and staff makes it difficult to create a separation between the investigators and the investigated.

In a few cases, caregivers and others with minimal police training have been hired for law enforcement positions in the same facility. The commander at the Lanterman Developmental Center in Pomona worked there as a primary caregiver. The force's police chief is a former firefighter at the Sonoma Developmental Center.

The police force also suffers from a convoluted chain of command, interviews and records show. Detectives cannot make arrests without checking with department lawyers in Sacramento. Local police must be informed when serious injuries or deaths occur, leaving law enforcement agencies pointing the finger of responsibility at each other.

"It seems like something is not working in California. And that's probably a major understatement," said Tamie Hopp, an official with the national organization Voice of the Retarded, who noted that the volume of abuse cases in California, and the lack of prosecutions, is cause for alarm.

Over the past eight months, California Watch has provided state officials with the findings of its investigation, including inspection records, activity logs, interviews with family members, case files and data on suspected abuse cases.

Terri Delgadillo, director of the Department of Developmental Services, said her department has a zero-tolerance policy that includes reporting any injuries, even those remotely suspicious, to the state Department of Public Health. She said the department is committed to conducting thorough investigations.

Delgadillo, nevertheless, has asked an outside consulting group – the Consortium on Innovative Practices, based in Alabama – to review the methods and training of her police force. The nonprofit group was recommended by the U.S. Department of Justice, which issued a scathing critique of the department in 2006.

"For the department, the priority is to make sure that we're doing the best job providing consumer safety and services," Delgadillo said in an interview. "And if there are issues that need to be addressed – and there's always room for improvement – we're looking to do that."

The department said that from January 2008 to last month, 67 developmental center employees were fired for "client-related" offenses. But officials declined to say how many of those employees, if any, were dismissed for abusing patients, where they worked or if any of them had been arrested.

Delgadillo also declined to comment on specific allegations of abuse or mistreatment at the developmental centers, citing patient privacy laws. Corey Smith, the former firefighter who is now police chief, said he was not permitted to speak with reporters.

CASES INCREASE

The developmental centers have been the scene of 327 patient abuse cases since 2006, according to inspection data from the California Department of Public Health. Patients have suffered an additional 762 injuries of "unknown origin" – often a signal of abuse that under state policy should be investigated as a potential crime.

At the state's five centers, the list of unexplained injuries to patients includes deep cuts on the head; a fractured pelvis; a broken jaw; busted ribs, shins and wrists; bruises and tears to male genitalia; and burns on the skin the size and shape of a cigarette butt.

Delays by the Office of Protective Services often make cases harder, if not impossible, to solve. California Watch was able to identify at least a dozen incidents in which delays from 24 hours to several days occurred.

In one case from 2005, Timothy Lazzini, a 25-year-old quadriplegic patient with cerebral palsy, coughed up a bloody glycerin swab at the Sonoma Developmental Center. He died from internal bleeding that night, Oct. 22.

Three swabs – each 4 inches long and twice as thick as a Q-tip – had torn Lazzini's esophagus. He coughed out one, but two others remained lodged in his stomach, autopsy records show.

At that point in his life, Lazzini's disabilities had left him mostly paralyzed, and he received food through a tube in his abdomen.

Someone at the developmental center likely put the swabs inside his mouth before he died. Dr. Ken Christensen, Lazzini's physician, told Office of Protective Services investigators that it was possible for Lazzini to swallow the swabs, but "it is unlikely for him to be able to pick it up and put it into his mouth." The pathologist who performed Lazzini's autopsy noted the same thing.

The Office of Protective Services assigned the case to a detective more than 24 hours after a caregiver discovered Lazzini bleeding from the mouth, the police file shows. By then, if any evidence was available at the scene, it was gone.

"I noted the area was cleaned up," Rod Beck, the detective, wrote in his report. "I did not note G-swabs in the bedroom area and none were seen in the drawers of his dresser."

Lazzini's death, and the slow response by the Office of Protective Services, has left his family heartbroken and without a conclusive answer as to how he was killed.

"He is gone, and they really haven't given us as a family the information that we need to be at peace," said Stephanie Contreras, Lazzini's sister. "There is no peace at all."

In the case of Van Ingraham, his family received $800,000 in a settlement with the state, but no arrests were ever made.

Records show Fairview officers didn't collect physical evidence from his room. Detectives overlooked evidence that a caregiver last seen with Ingraham had altered the log of his activities. And they omitted from the case file an expert's opinion – from one of two medical experts who said Ingraham probably had been put in a headlock – that the death "was likely a homicide."

"This incompetent, horrendous organization called Office of Protective Services takes it and just makes a mess, just a complete mangled mess of the investigation," said Larry Ingraham, the patient's older brother by six years.

Chicago police homicide Detective Mark Czworniak, who reviewed the Ingraham case for California Watch, said the Office of Protective Services waited too long to collect evidence and interview witnesses, and he questioned why it omitted the biomechanical expert's opinion that Ingraham was killed.

"Personally, I think it's better to include as much information as possible when constructing a final report than to pick and choose what goes in," he said. "This is because of exactly what happened down the road with this investigation. Someone started reviewing it and now, because information was excluded, it has an appearance that things were being covered up."

The Ingraham case remains unsolved.

SEXUAL ASSAULTS UNPROSECUTED

Sexual abuse cases, too, have been shelved without prosecution.

In April 2010, at the Canyon Springs Developmental Center in Riverside County, a janitor twice sexually abused a mentally disabled female patient when caregivers were out of sight. Under California law, sex with any developmentally disabled person who is incapable of giving consent is considered rape.

The patient, who is not identified in state records, had been sexually assaulted before. She was institutionalized at age 12 after her father impregnated her, a state health department citation shows.

The female patient, then 39 years old, told center employees she "did it" with the janitor in the women's bathroom and in a hallway during a fire drill. An unidentified Canyon Springs employee notified the state Department of Public Health.

The Office of Protective Services investigated the case but made no arrests. State regulators also investigated and ruled the incidents sexual abuse, according to a citation issued to Canyon Springs.

In December 2010, Canyon Springs was fined $800 by public health officials in the incidents. No criminal charges followed – the Riverside County District Attorney's Office said it has no record of receiving any case referrals from Canyon Springs, which houses about 50 patients.

Rather than placing the janitor under arrest, developmental center officials ordered him to undergo training on his "legal duty" regarding patient abuse, according to state records.

In another case with even fewer details available, a female patient at the Sonoma Developmental Center accused a male caregiver of sexually assaulting her during a bath in early 2000, police records show. The institution responded by assigning two men to bathe the patient.

On July 6, 2000, both caregivers allegedly raped her, again during bathing.

The institution did not inform its own police officers about the details of either incident. Records show Ed Contreras, then Sonoma's police commander, received an anonymous tip four days after the second rape allegedly took place.

"They weren't following the law," Contreras said in an interview. "They weren't reporting it to the Police Department. They weren't reporting it to me."

Contreras said no arrests were made in the case.

In other states, local or state police most often are responsible for investigating criminal cases at institutions. But city and county law enforcement agencies in California have not shown an interest in developmental center cases and don't have funding to expand their scope, according to Delgadillo.

"Oftentimes, local law enforcement does not want to get involved," said Delgadillo, who in the past has worked for the California Department of Corrections and Rehabilitation as a manager in the juvenile justice division.

Local police or sheriff's deputies can act more independently than an internal police force responsible for investigating their colleagues and bosses, said Jane Hudson, senior staff attorney for the National Disability Rights Network, a patient advocacy organization.

"If there's a crime committed," Hudson said, "you let the criminal investigators go in first rather than the institution bagging the bloody shirt."
###

California Watch, the state's largest investigative reporting team, is part of the independent, nonprofit Center for Investigative Reporting. For more, visit californiawatch.org. Gabrielson can be reached at rgabrielson@cironline.org.

http://www.ocregister.com/news/police-341698-state-department.html

Saturday, February 25, 2012

College Success for Students With Physical Disabilities - NEW BOOK FOR SPRING 2012

"College Success for Students With Physical Disabilities" (Prufrock Press),
is a college planning guide for students with physical disabilities and chronic medical conditions. Students will learn about their rights under the laws governing education and disability, self-advocacy, choosing a college, how having a physical disability affects admissions testing, the increased responsibilities in college, and how to make sure they get everything they need. The book contains forms, checklists, interviews with other students, advice from college disability services personnel, and profiles of disability-friendly colleges across the United States.
###

College application tips for disabled students
By Menachem Wecker, U.S. News & World Report
February 7, 2012

There are about 1.1 million physically disabled undergraduates in the U.S., according to Steve Kaye, research director of the Disability Statistics Center at the University of California at San Francisco, citing data from the 2010 U.S. Census Bureau.

While this figure represents about 5.9 percent of all students, most colleges and universities aren't meeting their needs. This is particularly true if the students' physical disabilities are so serious that they drastically affect daily living, according to Chris Wise Tiedemann, who co-authors the website Disability Friendly Colleges (disabilityfriendlycolleges.com) with her son Tom, who has cerebral palsy.

According to Tiedemann, author of "College Success for Students With Physical Disabilities" (Prufrock Press), only five schools

Edinboro University of Pennsylvania
University of California at Berkeley
University of Houston
Wright State University
Illinois at Urbana-Champaign

Tiedemann says seriously disabled applicants should consider one of those five schools. Tom, for example, studies at Edinboro. But students with less serious disabilities have more options if they do their research properly. Here are some tips for disabled applicants.

Prepare early: Start contacting college disability services offices as freshmen and sophomores in high school.

Gabe Trujillo, a quadriplegic and graduate student at Arizona State University, also advises researching whether target schools have support groups, clubs and adaptive sports for disabled students. "It's important to get out and mingle with your classmates," he says.

Visit prospective campuses if possible: Disabled applicants and parents should check campuses for handicapped parking availability, accessible buildings with elevators, and curb cuts (ramps leading up to sidewalks). "If these things are not easily available, attitudes about handicapped students may not be what they should be," Tiedemann says.

Don't confuse high school and college: Just because high schools accommodated a disability doesn't mean colleges will, even if you specify it in your application, says Matthew Kandel, manager of the online company, Newcastle Tutors, who has worked with many disabled students.

"Students need to proactively contact the office of disabled services at their school and provide ample documentation of the disability in order to receive services," Kandel says.

"Parents and students are almost invariably unaware of how much more responsibility is placed upon a college student," Tiedemann says. "Most students do not leave for college with experience in hiring aides to help them get showered (and) dressed. If they haven't prepared in high school for this, they are sunk."

White House Call on 'Disability Issues' Is on February 29, 2012



The White House hosts monthly calls to update you on disability issues, and to introduce you to the people who work on those issues in the Federal Government. These calls are open to everyone. The calls are off the record and not for press purposes.

If you would like to be added to the White House Disability Group email distribution list, please visit http://www.whitehouse.gov/disability-issues-contact and fill out the "contact us" form in the disabilities section, or you can email disability@who.eop.gov with your full name, city, state, and organization.

The information for the next call is as follows:

* Date of Call: 2/29/2012
* Start Time: 3:00 p.m. EST (dial in 5 minutes early)
* Dial in: (800) 230-1766
* Code: “White House Monthly Disability Call”

For live captioning at the start time of the event, please login by visiting:
http://www.fedrcc.us//Enter.aspx?EventID=1907398&CustomerID=321.
This login is only for people who are deaf or hard of hearing.

Friday, February 24, 2012

Tyson Foods Settles EEOC Disability Discrimination Lawsuit | Feb 23, 2012

EEOC PRESS RELEASE 2-23-12

Company Agrees to Pay $35,000 to Applicant Denied Employment Because of Epilepsy

ST. LOUIS – Tyson Foods, Inc., one of the world’s largest processors of chicken, beef and pork, will pay $35,000 and furnish other relief to settle a disability discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC), the agency announced today. The EEOC had charged that Tyson Foods refused to hire a former employee because he had epilepsy.

The EEOC lawsuit filed in May 2010 (EEOC v. Tyson Foods, Inc., Case No. 2:10-cv-04072-NKL) alleged that Tyson failed to hire Mark White for an open maintenance job in its Sedalia, Mo., plant because he had epilepsy and that Tyson’s refusal to hire White violated the Americans with Disabilities Act (ADA). White’s epilepsy had been controlled by medication for twelve years and he had been previously employed by Tyson on two occasions during this time period. However, Tyson instituted a new medical assessment procedure since last hiring White, and refused to hire him because he did not pass a medical evaluation required for applicants with epilepsy to determine whether he could safely perform the job. The doctor who performed the evaluation for Tyson did not examine White, but relied on outdated medical research in determining that he could not safely perform the job. At the same time, Tyson employed several other persons with epilepsy who had been grandfathered in.

Besides agreeing to pay White $35,000 as back pay and compensatory damages, Tyson agreed to institute a new assessment procedure for similar cases. Henceforth, an applicant who is disqualified from employment because of Tyson’s required medical assessment has the right to a second medical assessment at the applicant’s expense. Further, an independent and determinative third medical assessment will be made for any applicant not hired after the second assessment. The consent decree settling the suit, which must be approved by U.S. District Judge Nanette Laughrey, also provides for injunctive relief, including training to individuals involved in the assessment procedure, posting notification to employees, and compliance reporting to the EEOC.

“The potentially three-step medical assessment process agreed to by the parties is an extraordinary step in the right direction in terms of making sure disabled employees are given a full and fair opportunity to compete in the workplace,” said EEOC attorney Melvin Kennedy.

EEOC Regional Attorney Barbara Seely said, “While the terms of the consent decree only affect Tyson’s Sedalia facility, Tyson employs more than 117,000 people at more than 400 facilities and offices, and we are hopeful that the process we have agreed to works well enough that Tyson adopts it in other facilities.”

The EEOC enforces the ADA and other federal laws prohibiting employment discrimination. Further information about the EEOC is available on its web site at www.eeoc.gov.

# http://www1.eeoc.gov/eeoc/newsroom/release/2-23-12.cfm

U.S. Access Board to Hold Public Hearing on Draft ICT Rule at CSUN Conference On March 1, 2012

On March 1, the U.S. Access Board will hold a public hearing on a draft update of requirements for information and communication technology (ICT) in San Diego at the International Conference on Assistive Technology and Persons with Disabilities organized by California State University, Northridge (CSUN). The event will allow members of the public to comment on the released draft which updates requirements for ICT covered by Section 508 of the Rehabilitation Act and Section 255 of the Telecommunications Act. The hearing will be open to the general public, including those who are not registered to attend the conference. Those who wish to provide comments are encouraged to contact Kathy Johnson at johnson@access-board.gov, (202) 272-0041 (voice), or (202) 272-0065 (TTY).

Additional information is available on the Board’s website at:
http://www.access-board.gov/508.htm

Public Hearing on the Draft Update of ICT Requirements
March 1, 1:00 – 3:00
27th Annual CSUN Conference
Manchester Grand Hyatt, Ballrooms Elizabeth D & E
One Market Place
San Diego, CA

Doctors: Illinois Medicaid crisis to get worse | Feb 24, 2012

By CHRIS CASHMAN - Northwest Herald

Doctors are howling over Gov. Pat Quinn’s plan to cut Medicaid spending by $2.7 billion next year. There are fears that cuts could lead to more McHenry County doctors refusing to treat Medicaid patients and an exodus of doctors to other states.

In his annual budget address this week, Quinn said reductions could be accomplished by cutting payments to doctors and hospitals, halting some services and restricting eligibility for the program.

He said Medicaid, which provides care for 2.7 million people in Illinois, “is on the brink of collapse.”

Dr. Paul DeHaan of Crystal Lake, an orthopedic surgeon with Mercy Health System in McHenry, said Medicaid already is in crisis, and that Quinn’s plan will make things worse.

“Access for Medicaid patients to get in to see a doctor is limited,” DeHaan said. “There are only a small number of practices that will accept new Medicaid patients. Too many doctors won’t or can’t see new Medicaid patients.”

“Private practices are small businesses, just like any small business,” DeHaan added. “They’re strangling under the financial burden of the Medicaid system as it already exists.”

DeHaan, who was in private practice in McHenry for 20 years before joining Mercy Health System six years ago, said Medicaid payments are less than the cost of providing services.

And health-care providers are paid “very, very late. It creates a cash-flow problem for doctors. They cannot make a profit.”

“This makes it necessary to increase the cost to other patients with medical insurance to defray the cost of Medicaid shortfalls,” DeHaan said. “Doctors are losing money seeing Medicaid patients.”

The result is that Medicaid-eligible patients call doctor after doctor, unable to find care.

“And this is the current situation,” DeHaan said. “When Gov. Quinn cuts funding, it’s going to get even worse.”

According to the Illinois State Medical Society, half of physicians who train in Illinois leave the state after residency.

“If we are in a situation where health-care economics get even worse, we’re going to lose even more talent from our remarkable medical schools,” DeHaan said. “Should reimbursements fall even further, they would be foolish to stay in Illinois. They could go to other states and be much better off economically.”

The number of Medicaid enrollees in McHenry County has risen 103 percent since 2005, while increasing 30 percent statewide, said Robert Rosenberger, executive vice president and chief financial officer for Centegra Health System. The system operates two hospitals and multiple other facilities in McHenry County.

“That shows that there are a whole lot more people to go on the Medicaid rolls,” Rosenberger said.

“Gov. Quinn offered no specifics on how to save $2.7 billion,” Rosenberger said. “So it’s hard to say how it will impact the hospital.”

He said 15 percent to 16 percent of the patients Centegra doctors see are on Medicaid.

“Independent physicians may cap it at 1 [percent] or 2 percent, he said.

The state owes Centegra $6 million this fiscal year – and $10 million total – in Medicaid payments.

“We’re very strong from a financial standpoint,” Rosenberger said. “That helps us absorb some of the blows from Medicaid.

“Health-care providers need to find a way to decrease costs while increasing quality,” Rosenberger said. “That’s health-care reform.”

For Dr. Steve Campau, who practices general medicine in Mercy’s Algonquin office, the Medicaid crisis is a “community problem.”

“Medicaid is the last resort of people who have been thrown away from every segment of society: employers, insurers, their family,” Campau said. “Nobody wants to be responsible.”

“It’s the end result of misplanning and abdication of responsibilities,” he said. “Promises that have been made have far exceeded the resources that have been allocated for them.”

What is Medicaid?

Medicaid provides health coverage to more than 50 million children, families, pregnant women, the elderly, and people with disabilities.

All states provide Medicaid to infants and children under age 6 with family incomes up to 133 percent of the federal poverty level, or FPL, ($29,725 for a family of four in 2011). Medicaid is available in every state for children under age 19 with family incomes up to $22,350 (100 percent FPL). Medicaid covers U.S. citizens and eligible immigrants.

Source: InsureKidsNow.gov

# http://www.nwherald.com/2012/02/23/doctors-medicaid-crisis-to-get-worse/aqeihrx/

David Cicarelli who won Disability civil rights lawsuit moves into new group home | Feb 24, 2012

By Lisa Black, Chicago Tribune

When the moving truck finally arrived, David Cicarelli popped out of his parent's house with a 10-pack of juice boxes, excited that his long wait was over at last.

The movers were behind schedule, but the real delay to leave a Lincolnshire facility began years ago for Cicarelli, 38, who has developmental disabilities and had long been denied his request to live closer to his family in a community-based group home.


On Thursday, though, Cicarelli prepared to end his temporary stay at his parents' home and spend his first night at his new home in Wheeling — the result of a federal lawsuit settled with a landmark consent decree in June. Cicarelli was one of five plaintiffs in the civil rights case, filed against the state of Illinois in 2005 in an effort to bring the state into compliance with the federal Americans with Disabilities Act.

The 1990 law requires that people with disabilities be allowed to live in the "most integrated setting" within their communities. But state funding limited choices and led to a high rate of institutionalization, said Laura Miller, an attorney for Equip for Equality, one of several advocacy groups that filed the lawsuit.

"We still have a long way to go because we are just beginning implementation of the consent degree," Miller said.

Under the settlement, the state must allow thousands of people with developmental and intellectual disabilities to move into community-based housing of their choice and must provide expanded service to others. The agreement allowed the state a six-year timetable to achieve the goal, but required that the five plaintiffs be allowed to move more quickly.

"I feel pretty good," said Cicarelli, who watched workers load his dresser, a croquet set and a wooden party tray onto the moving truck.

He has his own bedroom at the new home provided by Clearbrook, an Arlington Heights-based agency that provides housing and services to people with developmental disabilities.

The two-story, five-bedroom house is furnished with leather couches, a big-screen television and an airy kitchen with granite countertops. A Clearbrook staff member will work 18-hour shifts so that residents are constantly supervised when they are not at a daily workshop in Palatine.

At his request, one wall in Cicarelli's bedroom was painted royal blue, which represents nearby Wheeling High School's colors.

His mother expects life will change dramatically for Cicarelli and that he will need to become more self-disciplined than he was at his prior home at Riverside Foundation in Lincolnshire. Cicarelli had lived at Riverside since 1997, where he adhered to daily routines followed by its approximately 100 residents.

"It's better for him to be more independent, to live away from your parents, because that's how we grow," said his mother, Juli, who with her husband lives two miles away from the Wheeling home.

Cicarelli enjoyed his friends and staff at Riverside but wanted more privacy, he said. Over the years, he frequently changed rooms, often because of conflicts with roommates, his mother said.

Staff members kept his room clean, woke him up in the morning and fed him meals.

At his new home, "there are staff here to remind him, but their job isn't, 'David do this, David do that,'" said Rachael Pelc, a Clearbrook employee. "The goal is not to do everything for him. … If David decides to stay up late at night, he'll still have to get up early for workshop."

At Riverside, he was a popular deejay on dance nights, playing Destiny's Child and other favorites on a CD player that he carried in his backpack.

He had recently moved to his parents' house, a temporary transition while the Wheeling house was being renovated.

During one of his last days at Riverside, Cicarelli walked purposefully down the halls, wearing a tie and sweater and nodding at a bevy of friends who yelled, "Good luck, David!"

"I'm excited for it," he said at the time. "I could come back here and visit."

Besides Cicarelli, all but one of the plaintiffs have settled in new housing or received additional services at home, said Barry Taylor, vice president of Equip for Equality.

"The state will start doing outreach to people about their rights under the decree, and people will start moving by the end of the year," Taylor said.

# http://www.chicagotribune.com/news/local/ct-met-disabled-man-moves-20120224,0,5948858.story

Thursday, February 23, 2012

California : Police force's sloppy investigations leave abuse of disabled unsolved | Feb 23, 2012

By Ryan Gabrielson | California Watch

California has assembled a unique police force to protect about 1,800 of its most vulnerable patients - men and women with cerebral palsy, severe autism and other mental disabilities who live in state institutions and require round-the-clock monitoring and protection from abuse.

But an investigation by California Watch has found that detectives and patrol officers at the state's five board-and-care institutions routinely fail to conduct basic police work even when patients die under mysterious circumstances.

Most abuse cases simply are logged but never prosecuted, including the suspicious death of a severely autistic man whose neck was broken. Three medical experts said the 50-year-old patient, Van Ingraham, likely had been killed. But the center's detective, a former nurse who'd never investigated a suspicious death, failed to identify what - or who - had caused the fatal injury.

The police force, called the Office of Protective Services, often learns about potential criminal abuse hours or days after the fact - if they find out at all. Of the hundreds of abuse cases reported at the centers since 2006, California Watch could find just two cases where the department made an arrest.

The people they are sworn to protect have profound developmental disabilities and live in a different world from most Californians. Some patients have spent decades in the centers, from childhood to death. Some cannot form words and have IQ scores in the single digits.

Records indicate that caregivers have inflicted abuse on patients without facing prosecution. The precise number of times nurses, janitors or staff supervisors have been implicated is unknown - the state has censored thousands of pages of documents detailing the cases.

But federal audits and investigations by disability-rights groups, as well as hundreds of pages of case files and other data, show staff members allegedly involved in choking, shoving, hitting and sexually assaulting patients at the facilities. None of these cases were prosecuted.

California is budgeted to spend $577 million this fiscal year to operate the centers, or roughly $320,000 per patient. More than 5,200 people work in the institutions - roughly 2.5 staff members for each patient. The five centers are in Los Angeles, Orange, Riverside, Sonoma and Tulare counties.

In most other states, local law enforcement or state police take the lead in conducting criminal investigations at developmental centers.

Critics of the state Department of Developmental Services, which oversees the institutions and the Office of Protective Services, have said the tight-knit atmosphere between the in-house police and staff makes it difficult to create a separation between the investigators and the investigated.

In a few cases, caregivers and others with minimal police training have been hired to work as law enforcement in the same facility. The commander at the Lanterman Developmental Center in Pomona worked there as a primary caregiver. The force's police chief is a former firefighter at the Sonoma Developmental Center.

The police force also suffers from a convoluted chain of command, interviews and records show. Detectives cannot make arrests without checking with department lawyers in Sacramento. Local police must be informed when serious injuries or deaths occur, leaving law enforcement agencies pointing the finger of responsibility at each other.

"It seems like something is not working in California. And that's probably a major understatement," said Tamie Hopp, an official with the national organization Voice of the Retarded, who noted the volume of abuse cases in California, and the lack of prosecutions, is cause for alarm.

Over the past eight months, California Watch has provided state officials with the findings of its investigation, including inspection records, activity logs, interviews with family members, case files and data on suspected abuse cases.

Terri Delgadillo, director of the Department of Developmental Services, said her department has a zero-tolerance policy that includes reporting any injuries, even those remotely suspicious, to the state Department of Public Health. She said the department is committed to conducting thorough investigations.

"For the department, the priority is to make sure that we're doing the best job providing consumer safety and services," Delgadillo said in an interview. "And if there are issues that need to be addressed - and there's always room for improvement - we're looking to do that."

She has hired a consulting group, the Consortium on Innovative Practices based in Alabama, to review the methods and training of her police force. The nonprofit group was recommended by the U.S. Department of Justice, which issued a scathing critique of the department in 2006.

The department said that from January 2008 to last month, 67 developmental center employees were fired for "client-related" offenses. But officials declined to say how many of those, if any, were dismissed for abusing patients, where they worked or if any of them had been prosecuted.

Delgadillo also declined to comment on specific cases of alleged abuse or mistreatment at the developmental centers, citing patient privacy laws. Corey Smith, the former firefighter who is now police chief, said he was not permitted to speak with reporters for this story.

Abuse cases increase

The developmental centers have been the scene of 327 patient abuse cases since 2006, according to inspection data from the California Department of Public Health. Patients have suffered an additional 762 injuries of "unknown origin" - often a signal of abuse that under state policy should be investigated as a potential crime.

At the state's five centers, the list of unexplained injuries includes patients who suffered deep cuts on the head; a fractured pelvis; a broken jaw; busted ribs, shins and wrists; bruises and tears to male genitalia; and burns on the skin the size and shape of a cigarette butt.

Timothy Lazzini, a quadriplegic cerebral palsy patient at the Sonoma Developmental Center, died in 2005 after he swallowed 4-inch swabs that shredded his esophagus. After his death, Lazzini's doctor and a pathologist concluded it was highly unlikely that Lazzini could have placed the swabs in his own mouth.

But records show detectives waited too long to start their investigation.

His death, and the slow response by the Office of Protective Services, has left Lazzini's family heartbroken and without a conclusive answer as to how he was killed.

"He is gone and they really haven't given us as a family the information that we need to be at peace," said Stephanie Contreras, Lazzini's sister. "There is no peace at all."

The rate of suspected abuse cases within the walls of the five institutions has risen - even as hundreds of developmentally disabled patients have been moved to group homes and smaller nursing facilities.

The patient population at developmental centers dropped by 12 percent from 2008 to 2010, state records show, but reports of abuse have increased 43 percent during those three years. Unexplained injuries jumped 8 percent in the same period.

Public health officials acknowledged the state doesn't keep a tally of the number of times caregivers have abused patients. That information is kept hidden from the public in individual case files.

Kathleen Billingsley, director of policy and programs for the Department of Public Health, said she didn't know whether inspectors were notifying law enforcement agencies when they uncover evidence of abuse. She said public health inspectors conduct thorough investigations separately from the police.

"If there is any cross between enforcement individuals at the state facility and the work we do, I am not familiar with that," Billingsley said.

The Los Angeles County district attorney's office, which oversees Lanterman, couldn't identify a single criminal case referred from the center's police force. District attorneys in Tulare, Orange and Riverside counties also reported no prosecutions for patient abuse in the past decade. Sonoma County refused to disclose its records.

On average, police in California solve about two-thirds of all homicides and about half of all aggravated assaults - or at least make an arrest and "clear" the cases. The clearance rate for the Office of Protective Services is unknown because the department keeps the information secret.

Thankless jobs, hidden from the public

The Office of Protective Services has existed in various forms and names since the late 19th century, when California opened its first institution for the developmentally disabled. That facility in San Jose - first known as the Agnews Insane Asylum - opened in 1885 and closed in 2009.

Interviews with current and former Office of Protective Services employees suggest the organization's structure from its beginning has contributed to its dysfunction.

Patrol officers dress much like those at any other police department. They wear tan and green uniforms with gold badges. Handcuffs are hooked to their belts. They drive marked squad cars. But there are key differences.

Officers and caregivers are confined together in a 24-hour facility monitoring an unpredictable, sometimes uncontrollable population. Beyond a paycheck, the job is mostly thankless and hidden from the public. Officers are not allowed to carry guns; many carry pepper spray instead. They often work their shifts alone.

Greg Wardwell, a sergeant who spent more than 20 years patrolling the Sonoma Developmental Center before retiring last year, said the state has undermined its own police force through neglect and incompetence.

"You can look like a cop and we'll call you a cop, but you don't really have any way of being a cop," Wardwell said. "Because we're not going to train you, we won't provide safety equipment. The salary will be so bad that we won't be able to recruit anybody of talent."

Salaries for the roughly 90 sworn officers are half of what police earn in the state's big city departments. Yet, roughly a third of officers within the Office of Protective Services are among the best compensated in California law enforcement, with much of their pay gained through overtime. One officer's income has topped $200,000 a year.

Families must rely on the Office of Protective Services to provide evidence for lawsuits when their relatives are harmed or killed at a developmental center. Records show the state paid out nearly $9 million in legal settlements - out of 68 separate lawsuits - from 2004 to 2010.

In 2005, Disability Rights California issued a report on a pattern of unexplained genital lacerations suffered by male patients at an unnamed developmental center. The cases were potentially sex assaults, but the investigations were woefully incomplete, documents show.

"Photographs were not taken," the report states. "Not all witnesses, nor all key witnesses, were interviewed. Physical evidence was not collected. Victims did not receive thorough medical workups to look for other indications of abuse."

Leslie Morrison, director of investigations at Disability Rights California, said the report showed how the developmentally disabled can be treated as second-class citizens.

"If this had happened to 3-year-old boys in a day care center, people would have been alarmed, police would have been called, there would have been an outrage," Morrison said. "It wouldn't have just been treated as just, 'Oh, look, there's a cut, we better sew that up.'"

In the case of the 50-year-old autistic man, Van Ingraham, his family received $800,000 in a settlement with the state. Ingraham died in 2007 after sustaining a broken neck while in his room at the Fairview Developmental Center in Orange County.

Fairview officers didn't collect physical evidence from Ingraham's room, records show. Detectives overlooked evidence that a caregiver last seen with Ingraham had altered the log of his activities. And they omitted from the case file an expert's opinion that Ingraham's death "was likely a homicide."

"This incompetent, horrendous organization called Office of Protective Services takes it and just makes a mess, just a complete mangled mess of the investigation," said Larry Ingraham, the patient's older brother and a veteran of the San Diego Police Department.

Sexual assaults unprosecuted

Sex abuse cases, too, have been shelved without prosecution.

In April 2010, at the Canyon Springs Developmental Center in Riverside County, a janitor twice sexually abused a mentally disabled female patient when caregivers were out of sight. Under California law, having sex with any developmentally disabled person who is incapable of giving consent is considered rape.

The patient, who is not identified in state records, had a history of being assaulted. She was institutionalized at age 12 after her father impregnated her, a state health department citation shows.

The patient had been diagnosed with moderate mental retardation, schizoaffective disorder and post-traumatic stress disorder. Canyon Springs staff had been working with her to curb any behavior "possibly leading to sexual activity," her file states.

The female patient, then 39 years old, told center employees she "did it" with the janitor in the women's bathroom and in a hallway during a fire drill. An unidentified Canyon Springs employee notified the state Department of Public Health.

The Office of Protective Services investigated the case but made no arrests. State regulators also investigated and ruled the incidents as sexual abuse, according to a citation issued to Canyon Springs.

In December 2010, Canyon Springs was fined $800 by public health officials for the incidents. No criminal charges followed - the Riverside County district attorney's office said it has no record of receiving any case referrals from Canyon Springs, which houses about 50 patients.

Rather than placing the janitor under arrest, developmental center officials ordered him to undergo training on his "legal duty" regarding patient abuse, according to state records.

The Office of Protective Services concluded that the janitor didn't commit a crime, Delgadillo said. She declined to answer other questions about the incident or to say whether the janitor, whose name has been kept secret by the state, continues to work at Canyon Springs.

In another case with even fewer details available, a female patient at the Sonoma Developmental Center accused a male caregiver of sexually assaulting her during a bath in early 2000, police records show. The institution responded by assigning two men to bathe the patient.

On July 6, 2000, both caregivers allegedly raped her, again during bathing.

The institution did not inform its own police officers about the details of either incident. Records show Ed Contreras, then Sonoma's police commander, received an anonymous tip four days after the second alleged rape.

"They weren't following the law," Contreras said in an interview. "They weren't reporting it to the police department. They weren't reporting it to me."

Contreras said no arrests were made in the sex assaults. The Sonoma County district attorney's office declined to release records on the cases or any other criminal allegations from the developmental center.

Inside institutions, a different world

The Sonoma Developmental Center is a quaint neighborhood in the middle of wine country. Fairview in Costa Mesa is near the Orange County fairgrounds and surrounded by strip malls and a golf course. Lanterman is wedged between train tracks and a highway east of Los Angeles.

Next door to a Cathedral City cemetery, tiny Canyon Springs could be mistaken for an office park. The Porterville Developmental Center, southeast of Visalia, does have the look of an institution - among the 500 patients, the facility houses about 200 developmentally disabled patients who have committed crimes or who are under arrest.

Inside, the centers feature wide hallways. Walls are decorated much the same as elementary school classrooms, with colors and construction paper cutouts to signal upcoming holidays.

Primary caregivers, called psychiatric technicians, guide patients from place to place, feeding them and distributing medication. Each patient communicates differently, and the units are filled with shouts, groans, shrieks and crying. Patients share bedrooms. Some are crowded with stuffed animals, posters and family pictures. Others are empty, save for the full-sized beds and a cabinet.

Parents and siblings can visit every week for hours at a time. Fairview patients range from 15 to 94 years old, said Bill Wilson, the institution's executive director. Most are between the ages of 40 and 60.

More than two-thirds of patients are diagnosed with profound mental disabilities, according to research from UC San Francisco. The institutions have whole units for patients who are emotionally volatile, prone to striking themselves and others.

The disabled population adds greater complexity to criminal investigations. For a host of reasons, their observations can be tainted by fantasies and falsehoods. Their emotions veer from happy to inconsolable without warning. Patients slap and punch at their faces and legs, and at each other.

"They come to us after they've burned every bridge in the community," said Erinn Kanney, a program manager at Fairview.

Outside of California, local or state police most often are responsible for investigating criminal cases at institutions. But city and county law enforcement agencies inside the state have not shown an interest in developmental center cases and don't have funding to expand their scope, according to Delgadillo.

"Oftentimes, local law enforcement does not want to get involved," said Delgadillo, who in the past has worked for the California Department of Corrections and Rehabilitation as a manager in the juvenile justice division.

Local police or sheriff's deputies can act more independently than an internal police force responsible for probes into their colleagues and bosses, said Jane Hudson, senior staff attorney for the National Disability Rights Network, a patient advocacy organization.

"If there's a crime committed," Hudson said, "you let the criminal investigators go in first rather than the institution bagging the bloody shirt."

Delayed notification hinders investigations

Delays by the Office of Protective Services often make investigations harder, if not impossible, to solve.

Although no public records exist showing how frequently the police force receives late notification of potential abuse cases, California Watch was able to identify at least a dozen incidents in which delays from 24 hours to several days occurred.

Forensic experts say the first two days following a crime are critical. A person walking through a crime scene can ruin fingerprints, DNA samples and other evidence, said Dennis Kilcoyne, a Los Angeles Police Department homicide detective. Witness statements can change with time, especially after they've conferred with others, he said.

"People's emotions are in play, and they may say things that, after they've thought about it or consulted with an attorney, (they) won't say a week from now," said Kilcoyne, a 27-year veteran.

Delays have hurt criminal investigations and given the centers' employees time to alter and destroy evidence, records and interviews show.

That's what happened in the case of Timothy Lazzini, the 25-year-old quadriplegic patient with cerebral palsy, who coughed up a bloody glycerin swab at the Sonoma Developmental Center. He died from internal bleeding that night, Oct. 22, 2005.

Three swabs - each 4 inches long and twice as thick as a Q-tip - had torn Lazzini's esophagus. He coughed out one, but two others remained lodged in his stomach, autopsy records show.

At that point in his life, Lazzini's disabilities had left him mostly paralyzed, and he received food through a tube in his abdomen.

Someone at the developmental center likely put the swabs inside his mouth before he died. Dr. Ken Christensen, Lazzini's doctor, told Office of Protective Services investigators that it was possible for Lazzini to swallow the swabs, but "it is unlikely for him to be able to pick it up and put it into his mouth." The pathologist who performed Lazzini's autopsy noted the same thing.

The Office of Protective Services assigned the case to a detective more than 24 hours after a caregiver discovered Lazzini bleeding from the mouth, the police file shows. By then, if any evidence was available at the scene, it was gone.

"I noted the area was cleaned up," Rod Beck, the detective, wrote in his report. "I did not note G-swabs in the bedroom area and none were seen in the drawers of his dresser."

The glycerin swabs are lemon flavored and intended to moisten a patient's mouth, but caregivers were not supposed to use them on Lazzini, according to the case file. The patient did not have the physical ability to remove the swabs himself, one of Lazzini's doctors told police.

During his interviews with caregivers, Beck learned that some technicians had been using the glycerin swabs as a pacifier for Lazzini, putting them in his mouth when he "got vocal."

Lazzini's caregivers all denied ever putting swabs in his mouth, however. Only one of the seven questioned by police admitted to using them on any patient.

Records that might have proven otherwise were destroyed, according to the police report. Daily caregiver notes from the previous week went missing. Someone blacked out information in two separate logs documenting patient care on the day Sonoma employees discovered Lazzini bleeding.

"The initials were heavily lined out," Beck wrote.

Mark Czworniak, a Chicago Police Department homicide detective, reviewed the Lazzini case file for California Watch. He said that without records, crime scene evidence or corroborating statements from witnesses, there is no way to link anyone to the swabs that killed Lazzini.

It might have been multiple caregivers, Czworniak wrote, "or a completely unobservant health care worker, supplying Timothy L. with the G-swab one after another, not noticing, or caring where each swab disappeared to, and not surmising that Timothy L. was swallowing them."

Lazzini's sister, Stephanie Contreras, who lives in the Sonoma County town of Windsor, and other family members sued the state in 2006 over Lazzini's death and settled two years later for $100,000.

The Department of Public Health also fined the Sonoma Developmental Center $90,000 in August 2007, citing "mistreatment, neglect or misappropriation of resident property" - the failure to prevent Lazzini from swallowing the swabs.

But the Office of Protective Services closed the Lazzini case without determining what had happened.

Oversight reorganized

For much of its history, the Office of Protective Services was fragmented, with officers reporting only to administrators at their own facility.

Then, after a series of critical stories about the Sonoma center in the local Index-Tribune newspaper, Sacramento officials took greater control of the Office of Protective Services. They created a statewide police chief and borrowed veteran officers from the California Highway Patrol to fill the job.

In 2006, the U.S. Justice Department's Civil Rights Division criticized the care at Lanterman, in Pomona, in a letter sent to Gov. Arnold Schwarzenegger. They noted a failure to properly collect evidence, inadequate witness interviews, delays in beginning investigations and the inability to close unsolved cases.

The audit outlined the case of a patient, identified only as A.Z., who died on Aug. 7, 2002. The federal audit did not include details of the case but said the patient "died of multiple blunt force trauma after being stomped repeatedly in his bedroom at Lanterman."

The Office of Protective Services identified two suspects - the patient's caregiver and a roommate. Although there was evidence pointing to both men, the audit said, Lanterman police concluded the roommate had committed the crime but was too mentally impaired to face charges.

"Regardless of who was responsible," the auditors said, "the fact that A.Z. suffered severe pain and ultimately died at Lanterman, in spite of the state's obligation to keep him safe, is deeply disturbing."

Patricia Flannery, the state official responsible for developmental center operations, said Lanterman has remedied the deficiencies documented by the justice department. "We haven't heard from them in two years," she said.

During the Schwarzenegger administration, however, the Department of Developmental Services hired less-experienced candidates to run the police force.

In 2007, the department hired Nancy Irving, a longtime government labor mediator, analyst and program manager, as the force's interim police chief. She had not been certified as a law enforcement officer.

The career path of Victor Davis is not unusual.

Davis started at Lanterman as a part-time psychiatric technician in 1989, working his way up to a supervising caregiver. In 1998, the Department of Developmental Services put him on the police force as an investigator, skipping him over two ranks of police officers despite his lack of law enforcement background.

Today, Davis is Lanterman's commanding officer, in charge of all criminal investigations. Davis declined to comment in detail, and attempts to interview him during a tour of Lanterman were cut off by a top-level official with the department.

The police force in 2008 added its first policies on investigating abuse and neglect, closing investigations, responding to sex assault and responding to a crime scene or emergency. But policies on preserving evidence, managing investigations and collaborating with outside law enforcement remain unwritten to this day.

Detectives have not had the authority to send investigations to prosecutors themselves. In most police departments, officers and detectives begin working with prosecutors in the early stages of an investigation. Some district attorneys send their prosecutors to work hand in hand with police at crime scenes.

But the Office of Protective Services follows a different playbook. The agency's manual states that detectives and commanders must clear cases with administrators and civil attorneys at the Sacramento headquarters before sharing cases with local police or prosecutors.

Delgadillo, director of the Department of Developmental Services for the past five years, said the police agency follows state standards for evidence collection.

Delgadillo said she has reorganized the force so that police commanders answer to Sacramento rather than local administrators at the centers. This move, which was fully enacted in 2007, is intended to protect against interference by employees and officials who might be implicated in wrongdoing, she said.

Delgadillo acknowledged the old policy had been a potential conflict of interest.

"They're reporting directly up to us to make sure that there's no conflict between the developmental center and the investigation that's actually being conducted," Delgadillo said.

The department's legal team exists to protect the state from civil liability claims, a fact that raises concerns among patient advocates and legal experts who say prosecutions and arrests for abuse of patients have taken a back seat.

Delgadillo said the Office of Protective Services submits cases to department lawyers first to ensure "the investigation and the information is as complete as possible."

Since 2006, state regulators have confirmed 21 patient abuse cases and 173 injuries of unknown origin at the Lanterman Developmental Center in Pomona. But the Los Angeles County district attorney's office said it is unable to find a single case referred by Lanterman investigators in the past decade.

And the head of the district attorney's elder abuse and dependent adult section, Robin Allen, said she didn't know the developmental center had its own officers and detectives. With more than 300 patients, Lanterman is one of the largest elder caregivers in Los Angeles County.

Department of Developmental Services officials provided California Watch with the case numbers for six incidents they claim had been forwarded to prosecutors in Los Angeles County. But the district attorney's office said the case numbers didn't match anything in their records.

Even cases of brazenly documented abuse have ended without criminal charges.

In 2005, a caregiver at Lanterman took a cell phone picture of her co-worker with his hands wrapped around the neck of a 48-year-old male patient with mental disabilities.

In the photo, the patient's "facial expression showed that he was not enjoying the action," a state Department of Public Health inspector wrote in a report about the incident.

The photograph, taken May 5, 2005, was e-mailed to the phones of multiple Lanterman employees - itself a violation of patient privacy laws. Another caregiver witnessed the choking and anonymously reported it a week later in a letter to public health officials and Lanterman administrators.

But the Office of Protective Services did not arrest the employees involved or forward the case to prosecutors. Inspection records don't say whether the caregivers were reprimanded or fired, but Lanterman itself was fined $800 by the Department of Public Health.

# CIR staff writers Agustin Armendariz and Emily Hartley contributed to this report. This story was edited by Robert Salladay and Mark Katches. It was copy edited by Nikki Frick.

California Watch, the state's largest investigative reporting team, is part of the independent, nonprofit Center for Investigative Reporting. For more, visit www.californiawatch.org. Gabrielson can be reached at rgabrielson@cironline.org.

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