Balancing Safety and Empowerment:  Residential Domestic Violence/Sexual Assault Programs & Program Participant Access to Medications Examples of Written Comments Regarding Medication Access Excerpted below are written comments the Wisconsin disabilities project has offered to community-based domestic violence/sexual assault programs that have participated in on-site accessibility assessments.1 These comments are reflective of many of the concerns that arise regarding medication access when we conduct on-site accessibility assessments. These excerpts were taken from written follow-up reports we completed after conducting an on-site assessment. As you will see below, the comments are written and structured to address specific concerns the Assessment Team identified during the on-site assessment. Those concerns then are followed by specific recommendations that the community-based agency might consider implementing to address/alleviate the identified access concern.2 Issues Related To Intake Forms/Intake Interviews * Concern: Several questions used during the intake interview are overly broad, intrusive, and could be a violation under the Americans with Disabilities Act: o The question regarding whether someone has been told by a health care worker or agency that s/he is disabled, as well as the actual intake interview form which asks about whether the client (or children) has a disability, the type, and for client, whether they receive disability insurance; o The question medical/health care issues: medical concerns and level of detail could be perceived as intrusive and could illegally force person to disclose a disability. o Do you have health care insurance? When did you become disabled? Have you applied for disability benefits? o What does exclusion because of need for “medical services” really mean? o The term “medical services” is broad. o The questions regarding medications. * Recommendations: Overall, think about why you ask specific questions on your intake forms. What is the purpose for requesting that level of detailed information? The asking of these questions could be experienced as invasive, could endanger the woman if records are subpoenaed, and could be experienced as discriminatory by a potential resident. Regarding the question of whether someone has told the client they are disabled or asked about a disability: This question is another way of asking whether someone has a disability. * Someone disclosing that they have a disability versus being “told” they have a disability relies heavily on being labeled with a particular diagnosis, assumes that a person has sought and received services to get that label, and immediately suggests to clients that the label defines them, their needs, and whether or not they might receive services, including the type of services offered. o Lack of clarification to service recipients why agency asks individuals at intake whether they have a disability. Without an explanation, a person denied services could allege that the denial was based on discrimination due to that person’s disability. o While agency may ask about whether someone has a disability for statistical and grant purposes, this question must be asked of everyone for whom an intake is being conducted. This question also must be followed by a statement that you are asking this question for grant purposes AND that their response is voluntary. Train staff asking the question about the purpose of and need for these additional statements. * NOTE: Many domestic violence programs wonder whether it is okay to ask whether a person has a disability, even when not required by a grant. Generally, this should be avoided. More important than knowing if a person has a disability is whether or not the person needs a reasonable accommodation or a reasonable modification to your policies or practices. As long as you routinely ask everyone, your agency can ask whether a person needs an accommodation. You might give some examples to a program participant (e.g., help with an application, materials in large print, or an American Sign Language interpreter). Asking About Medical Issues * Regarding the question about medical/health care issues: o An individual is not required to disclose this requested information. o Instead of asking this question, let the person know that you are interested in learning about anything they think you need to know to provide effective services and support. Asking About Medications * Regarding the question about medications for client or client’s children: o An individual is not required to disclose this requested information. o What is the purpose of requesting this specific information from a program participant? o Disclosure could be detrimental to a survivor; e.g., disclosing this information could jeopardize a woman and her children if the records were subpoenaed for a child custody determination. * Concern: Agency’s policy on program participants’ access to their medications could be experienced by program participants as invasive, as well as restrictive if the participant must rely on requesting medication from staff. Also, there are liability concerns for agency when a program participant who needs medication fails to receive immediate access to medications. * Recommendation: Clarify the policy and procedure for residents using shelter. Because someone might need their medication immediately and due to the power and control dynamic that some individuals with disabilities have experienced by their abusers around their medication, we recommend that shelter programs institute a procedure whereby each resident would have her own locker in which to keep medications. This practice relieves staff from the responsibility of retrieving a person’s medications, unintentionally monitoring a person’s medication regimen, and returns control over medications fully to the resident. Having a locker in the accessible bedroom, for example, also would alleviate the concern with a resident using that bedroom who needs her medication at night. This handout has been prepared under the Violence Against Women with Disabilities and Deaf Women Project Grant 2006-FW-AX-K003 awarded by the Office on Violence Against Women, Office of Justice Programs, U.S. Department of Justice. Points of view in this document are those of the review team and do not necessarily represent the official position in policies and the U.S. Department of Justice. 1 Although this document includes some legal references, it is written for non-lawyers and is not intended to provide specific legal advice. Individual situations and laws vary, change and develop over time, so we suggest that programs consult with an attorney regarding their policies and procedures in this subject arena. 2 The written report is not intended as legal advice. The community-based agency is not a client of Disability Rights Wisconsin and this report is intended as technical assistance only and not to create an attorney-client relationship. The information in this report is of a general nature and is not meant to apply to any specific situation involving a particular individual. ?? ?? ?? ?? Wisconsin’s Violence Against Women with Disabilities & Deaf Women Project: ASI Grantee Meeting St. Louis, MO 1