Project EMERGE Collaboration Between VERA HOUSE, INC. ARISE Syracuse / Main Office 6181 Thompson Road. Suite 100 635 James Street Syracuse, NY 13206 Syracuse, New York 13203 Phone: (315) 472-3171 Phone: (315) 315-425-0818 TTY: (315) 479-6363 TTY: (315)-425-7263 (business hours) Fax: (315) 472-9252 Fax: (315) 315-425-8942 Web site: http://www.ariseinc.org Web site: http://www.verahouse.org This project was supported by Grant No. 2006-FW-AX-K014 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the Department of Justice, Office on Violence against Women. Acknowledgements Project EMERGE would like to acknowledge the effort of the women who served as the Project EMERGE Advisory Group. Their contribution to the development of Accessibility & Trauma-Informed Review Tool (ATIRT) is invaluable. Thank you also to Project EMERGE Core Group members who served as reviewers and work group members. The feedback we received at the different stages of developing ATIRT was encouraging. In addition, we would like to acknowledge and thank Valerie Fletcher from Universal Design in New York City and Sally Mason of Sojourner House in Phoenix, Arizona for sharing their expertise in the areas of accessibility and providing trauma informed services. Finally, the support, insight, and technical assistance provided by the U.S. Department of Justice, Office on Violence Against Women (OVW) and the Vera Institute of JusticeŐs Accessing Safety Initiative contributed immensely to the development of this tool. The artwork on the front of the tool is a collage of individual pieces created by members of the Project EMERGE Advisory Group. Accessibility & Trauma-Informed Review Tool Authors Jennifer Shaw Project EMERGE Director Funmi Akinpelu Project EMERGE Advocate & BBI Research Fellow Lindsay Ryan Project EMERGE Deaf Community Advocate Trish Schwartz Project EMERGE Staff Interpreter & Team Member Reviewers Randi Bregman Vera House Executive Director Loren Cunningham Vera House Education Director Tom McKeown ARISE Executive Director Nina Lutz ARISE Director of Independent Living Services William N. Myhill Director of Legal Research and Writing, Burton Blatt Institute, Syracuse University Stephan Haimowitz Research Associate, Burton Blatt Institute, Syracuse University** Katherine McDonald Research Associate, Burton Blatt Institute, Syracuse University** Project EMERGE Advisory Group: Ann Smith Georgia Neinmeyer Cindy Paprocki Jaylenne Moore Jenny Terrero Joan Conley Mary Coogan **The opinions, findings, conclusions, and recommendations do not represent official positions of Syracuse University, New York. Accessibility & Trauma-Informed Review Tool Table of Contents Preface....................................................................................................................................................................................................... Development of the ATIRT..................................................................................................................................................................... Prevalence of Domestic and Sexual Violence among People with Disabilties and in the Deaf Community .................................... Overview of Domestic and Sexual Violence .......................................................................................................................................... Accessible Services................................................................................................................................................................................. 10 Trauma Informed Services ................................................................................................................................................................... 11 Description of ATIRT............................................................................................................................................................................ 13 Administering ATIRT............................................................................................................................................................................................. 14 Directions................................................................................................................................................................................................................ 14 Accessibility & Trauma-Informed Review Tool................................................................................................................................. 16 Agency Visibility & Collaboration.........................................................................................................................................................................16 Policy, Protocol, & Practice....................................................................................................................................................................................17 Training & Provider Comfort Level ....................................................................................................................................................................... 19 Physical Accessibility ............................................................................................................................................................................................. 21 Communication....................................................................................................................................................................................................... 23 Intake Procedures.................................................................................................................................................................................................... 25 Assessing Trauma History & Safety.......................................................................................................................................................................28 Safety and Comfort................................................................................................................................................................................................. 30 References............................................................................................................................................................................................... 33 Accessibility & Trauma-Informed Review Tool Preface About Project EMERGE In October 2006, Project EMERGE was funded by the Department of Justice, Office on Violence Against Women. Project EMERGE aims to identify specific gaps in service, barriers to safety and accessible support, and system inadequacies for people with disabilities and Deaf people who are survivors of domestic and/or sexual violence. Project EMERGE, a partnership between Vera House and ARISE, strives to build a community movement through increased collaboration, program policy review and education to improve access by building a comprehensive and inclusive coordinated community response for people with disabilities and Deaf people who have experienced domestic and/or sexual violence. Vera House and ARISE have joined the expertise of the personnel at each agency to create Project EMERGE. This partnership is structured around INTERDEPENDENCE, rather than our two agencies merely Ôworking together.Ő Together we are working to create a system of resourcing each other to better deliver services. Project EMERGE is a three-year, grant-funded project with technical assistance provided by the VERA Institute of Justice. The VISION of this project is to: ---create a comprehensive and inclusive community prevention and response system, guided by, and in service to, people with disabilities and Deaf people who are survivors of domestic and sexual violence. Through this system, Vera House, ARISE, and our community partners ensure access, equality, empowerment, and safety for all through accountable and knowledgeable providers. Accessibility & Trauma-Informed Review Tool Development of the ATIRT In December 2008, Project EMERGE recruited participants to join what became the Project EMERGE Advisory Group. This group of women guided Project EMERGE through their expertise as survivors with disabilities and Deaf survivors. The experiences of these women were vital in the development of this tool. The main goal of Project EMERGE while developing this tool was to assist Vera House and ARISE in assessing their ability to provide services that are both accessible and trauma-informed. Also providing guidance in the development of the tool were members of the Work Group. The Work Group is comprised of the executive directors and two program managers of both agencies as well as the project director, advocates and interpreter. Members of the Work Group explored a number of issues in creating the ATIRT, including: Ą how to ensure the tool is user-friendly Ą how to understand the major variables of the tool Ą how different learning styles could inform the provision of accessible and trauma-informed services Ą review of accessibility guidelines, principles and practices of trauma-informed services, principles and practices of universal design Ą research and review of other available accessibility review tools Ą consideration of accessibility from a human rights perspective making reference to the Americans with Disabilities Act (ADA) and the 2006 United Nations Convention on the Rights of Persons with Disabilities Ą exploration and identification of what we believe to be best practice in delivering accessible and trauma-informed services. All the above and other considerations (such as feedback from reviewers and technical assistance from the Office on Violence Against Women) gave the Work Group insight and impetus to develop the Accessibility & Trauma Informed Review Tool Accessibility & Trauma-Informed Review Tool The Prevalence of Domestic and Sexual Violence among Persons with Disabilities and in the Deaf Community Statistics on people with disabilities and the connection to domestic and sexual violence Ą Intimate Partner Violence, sexual assault, and abuse by personal care attendants, are identified as Ňsignificant threats to the safety and well-being of women with disabilities, who are at comparable or greater risk for abuse than women without disabilitiesÓ (Oschwald, M., et.al., 2009, p.796) Ą Numerous nationwide studies consistently show prevalence rates of sexual abuse histories at 50-70% among women in inpatient psychiatric facilities (Facts about mental health & physical and sexual abuse, 1994) Ą Women with disabilities were four times more likely to experience sexual assault than women without disabilities (Cloutier, S., Martin, S., & Poole, C., 2006) Ą Little is known about the prevalence of sexual violence in the Deaf community (Obinna, J., 2005). Ą According to the 2000 U.S. Census, women with disabilities comprise 9.2% of the population. While a small percentage of the population, they have a high probability of being abused (2006). Ą The Colorado Department of Public Health estimates that at least 85% of women with disabilities are victims of domestic violence compared to 25 to 50% of non-disabled women (Chang, et.al., 2004). Ą Women with disabilities have identified issues of violence and abuse as the highest health priority (Berkeley Planning Associates, 1997) Ą For individuals with psychiatric disabilities, the rate of violent criminal victimization including sexual assault was 2 times greater than in the general population (8.2% vs. 3.1%). (Hiday, Swartz, Swanson, Borum, and Wagner,1999) Accessibility & Trauma-Informed Review Tool Overview of Domestic and Sexual Violence What is domestic and sexual violence? Domestic violence is any repeated pattern of behavior used to control or have power over an individual in the context of a relationship. This behavior can occur in all types of relationships including current or former dating relationships, marriage, or cohabitation. Domestic violence can happen in heterosexual, gay or lesbian relationships. Physical, mental, emotional, sexual, verbal, and financial abuse are all examples of ways a person may experience domestic violence. The following are types of abuse and a sampling of behaviors associated with the type of abuse: Ą physical abuse Đ kicking, slapping, punching, strangling, using weapons Ą mental abuse Đ using intimidation to make a person feel afraid, smashing things, using isolation to control who a person sees and talks to, denying or minimizing the abuse, threatening to leave, threats of harm Ą emotional-making a person feel crazy, playing mind games, humiliating a person or making a person feel guilty Ą verbal-name calling, put downs Ą sexual abuse Đ denying sex, hurtful or painful sex, forced sex, rape, cheating Ą financial abuse -denial of access to and control over oneŐs own finances, misuse of financial resources, preventing one from getting or keeping a job Sexual violence is a crime of power and control and can happen to anyone. Sexual violence encompasses rape, sexual assault, sexual abuse and incest. A friend, family member, or acquaintance often perpetrates an act of sexual violence. When a person experiences sexual violence, they have a myriad of emotions and thoughts. There is no right or wrong way to respond to having been sexually assaulted. Experiences Unique to Survivors with Disabilities or Deaf Survivors Ą Survivors with disabilities and Deaf survivors are not exempt from the aforementioned types of abuse and they may also experience abuse that is unique to their disability or being Deaf. People with disabilities or who are Deaf may be more at risk to Accessibility & Trauma-Informed Review Tool experience abuse because they may be unable to defend themselves, unable to report or communicate their experience, less able to escape, are dependent on others and/or fear that they may not be believed, and/or fear what could happen to them if they report the abuse. Abuse can also be more severe and last for longer periods of time. Below are examples of abuse that a person with a disability or who is Deaf may experience: Ą Destruction of, denial of access to, or refusal to fix communication devices or adaptive equipment Ą Withholding or changing oneŐs medications Ą Controlling access to phones, videophones, TTY, transportation service providers, counselors, and healthcare Ą Intentionally miscommunicating to police, family, friends or service providers a Deaf survivorŐs experience Historically, domestic and sexual violence service providers have not been adequately equipped with training or an understanding about the unique dynamics a survivor with disabilities or a Deaf survivor experiences, posing a great barrier to finding safety and support. Below are some experiences of survivors with disabilities and Deaf survivors in their own words: ŇAbused women with disabilities have a double whammy. I didnŐt know whether to deal with my abuse first or my disability. I didnŐt know where to turn, and I lost all hope.Ó -comment by a survivor with a disability in a Listening Circle as part of the Project EMERGE Needs Assessment ŇSome agencies are not accessible to people with disabilities. It is very difficult to get into their buildings. Some do not have ramps or elevators. Wider doorways and wider doors to bathrooms are neededÓ-comment by a survivor with a disability in a Listening Circle as part of the Project EMERGE Needs Assessment Accessibility & Trauma-Informed Review Tool Accessible Services The spirit of the ADA, established in 1990, set forth a minimum standard of physical access for people with disabilities or who are Deaf. It is the goal of Project EMERGE, as well as the other OVW projects funded under this grant, to go beyond ensuring physical accessibility. True accessibility incorporates not only physical access, but also creating environments, programs, and services that provide a sense of comfort, confidence, and control to the consumer. Ultimately, when an agency can provide services that are holistically accessible or when accessibility is integrated into every aspect of an agency, every person who seeks services from an agency will benefit. What are accessible services? In order to meet the needs of our clients/consumers; we must take necessary steps in developing accessible and welcoming services by designing environments for all that include: Ą Eliminating physical barriers to access the building, both inside and outside Ą Communication by program staff with people who have disabilities or who are Deaf that is at least as effective as communication with those who do not have disabilities or who are Deaf Ą Policies and practices should be reviewed to eliminate unnecessary barriers to accessing services Andrews and Veronen (1993) list four requirements for effective victim services for people with disabilities: 1. service providers need to provide adequate assessment of survivors, including questions about disability-related issues 2. victim service providers should be trained to recognize and effectively respond to needs related to the disability, and disability service providers should be trained in recognizing and responding to physical and sexual trauma 3. barriers to services should be eliminated by providing: Ą barrier-free information and referral services Ą physical accessibility to facilities Ą 24-hour access to transportation, interpreters, and communication assistance, and Ą trained personnel to monitor risks and respond to victims receiving services through disability programs 4. people with disabilities who use personal care assistants (related or not related), either at home or in institutions may need special legal protection against abuse Accessibility & Trauma-Informed Review Tool 10 Trauma-Informed Services What is Trauma? Trauma occurs when one loses the sense of having a safe place to retreat within or outside of oneself to deal with frightening emotions and experiences (Kolk, 1987). It is important to note that if trauma is severe enough, it can impair a personŐs cognitive, emotional, and physical well-being. What is Trauma-Informed Service? Ą A trauma-informed service system is one in which policies and practices reflect an awareness of the impact of trauma on survivorŐs functioning Ą Knowledge about trauma is incorporated into all aspects of service delivery Ą It is a system where consumers, trauma survivors, and people in recovery have effective roles in program development and service delivery Ą Trauma-informed services involve understanding, anticipating, and responding to the issues, expectations, and special needs that a person who has been victimized may present with Ą Trauma-informed services seek to do no harm; for example avoid retraumatizing survivors or blaming them for their efforts to manage traumatic reactions (Moses, Reed, Mazelis, & DŐAmbrosio, 2003) What are the objectives of trauma-informed service? Ą To fully appreciate the trauma and stress in a personŐs life and directly address trauma in the agencyŐs policies and protocols Ą To ensure that service providers are well informed about the dynamics and the aftermath of trauma Ą To create an environment based on safety, respect, and dignity What are the basic principles of trauma-informed service? Ą Understand trauma as a defining force in an individualŐs life Ą Understand how actions labeled Ôproblem behaviorsŐ may actually be coping strategies for dealing with trauma Ą Create an open, cooperative relationship between providers and consumers with an emphasis on safety, choice, and control Ą Create a safe and welcoming environment Ą Avoid confrontations and practices that may be unnecessarily punitive or invasive Ą Ask people ŇWhat has happened to you?Ó rather than ŇWhat is wrong with you?Ó Accessibility & Trauma-Informed Review Tool 11 In conclusion, Fallot and Harris (2009) state that trauma-informed service should emphasize safety, choice, trust, collaboration, and empowerment as defined below: Safety: Ensuring physical and emotional safety Trust: Maximizing trust through task clarity, consistency, and interpersonal boundaries Choice: Maximizing consumer choice and control Collaboration: Maximizing collaboration and sharing power Empowerment: Prioritizing empowerment and skill-building Accessibility & Trauma-Informed Review Tool 12 DESCRIPTION OF ATIRT The Accessibility & Trauma-Informed Review Tool is designed to assess and guide improvement of an agency/programŐs ability to provide services that are both accessible and trauma-informed. This tool addresses areas that are core to service delivery of agency/programŐs in eight content areas. Agency Visibility & Collaboration: This section assesses the collaborative partnership among agencies/programs and the visibility of the agency/program in the community. Policy, Protocol, & Practice: Policies and protocols are the foundation for ensuring practices that are accessible and responsive to trauma. The purpose of this section is to assess that an agency/programŐs policies and protocols address accessibility and trauma. Training & Provider Comfort Level: This section assesses an agency/programŐs understanding of disability and domestic/sexual violence and their comfort level in providing services to survivors with disabilities and Deaf survivors. Physical Accessibility: The purpose of this section is to assess how easily a person can get to, enter, and freely move around an agency. This section does not address ADA compliance. It is recommended that agencies/programs use an ADA recommended checklist to provide a comprehensive review of the agency/programŐs physical accessibility (see http://adaptiveenvironments.org/neada/pubdocs/pub_307_checklist.pdf ). Communication: This section assesses an agency/programŐs ability to provide information in a variety of formats and reviews how people of different abilities interact with an agency. Intake Procedures: This section assesses how accessibility and trauma responsiveness have been incorporated into an agency/programŐs intake procedures. Assessing Trauma History & Safety: This section assesses the ability of an agency/program to incorporate questions about domestic and/or sexual violence. Safety and Comfort: This section assesses the ability of an agency/program to provide an environment that is safe as well to explore safety planning when a person discloses they may be experiencing domestic and/or sexual violence. Accessibility & Trauma-Informed Review Tool 13 Administering ATIRT ATIRT was designed with domestic and/or sexual violence based agencies in mind. Questions are geared toward those agencies but in no way exclude other agencies from using this tool. This tool has been designed to assist agencies in assessing their accessibility and responsiveness to survivors with disabilities and Deaf survivors. Organizations that have identified a need and desire to become more accessible and responsive to survivors with disabilities or Deaf survivors should use this tool to guide their assessment. The ATIRT is meant to provide a broad sampling of guiding questions, practical ideas, and suggestions. Depending on the size of the agency, Project EMERGE recommends that ATIRT be used programmatically such as with a team of rehabilitation specialists or advocates. If an agency is smaller (e.g. a rural domestic violence agency with less than ten staff), it may be more helpful to complete the tool as an entire agency. Responding to the questions with consideration for the unique work each program does will be critical for an accurate review of the program. Project EMERGE believes that by conducting the review within each program, the dialogue among staff will create opportunities for identifying the areas where they already provide accessible and trauma-informed services, as well as the areas where improvements to service provision, policies and protocols are needed. Staff who participate in the assessment should include leadership and direct services team members. Other administrative and support staff, such as people who have direct contact with consumers, should also be included (i.e. administrative assistants, receptionists, volunteers). It is not necessary to be working in partnership with a domestic and/or sexual violence agency or with a disability-based agency. However, the expertise of those agencies should not be overlooked. It may be important to formulate or build on an existing partnership after the assessment is complete to fully implement policy or protocol changes. Some of the concepts mentioned in the tool may already be in place in an agency program whereas others may refer to ideas or service provisions that a program has not previously considered before. Directions In order to complete the assessment of an agency/program, Project EMERGE strongly recommends using a facilitator who has extensive knowledge in the fields of domestic and sexual violence and disability related issues to adequately administer ATIRT and offer recommendations for improvement. Keeping the size of the agency in mind, the facilitator will meet with the staff of an agency/organization or program. This should be done during a regularly scheduled staff meeting to ensure that as many program staff as possible are present. The facilitator will introduce the tool, explain its purpose, administer the tool, and then will guide the Accessibility & Trauma-Informed Review Tool 14 program staff to consider what steps need to be taken to move the program toward providing more accessible and trauma-informed services. For questions with a yes/no answer, yes answers (except Q32) will indicate an agency is more accessible and more responsive to survivors of trauma. A no response for question 32 is preferred, which would indicate that there are no barriers to accessing the agency and its services. The facilitator will be responsible for documenting responses of the staff, noting responses on which the staff reached consensus and surprises, as well as themes of the responses. For answers that require a more detailed response (e.g. questions 3, 5, 7, etc.), the facilitator will again list staff responses. At the end of the assessment, the facilitator will highlight some general themes or areas that need immediate attention by the agency/organization. The facilitator will schedule a follow up meeting with agency leaders to provide recommendations for both the individual programs of an agency and the agency as a whole. The report should be both oral and in written format and occur within two months of the assessment. Accessibility & Trauma-Informed Review Tool 15 ACCESSIBILITY & TRAUMA-INFORMED REVIEW TOOL INSTRUCTIONS: There are eight sections in this tool. Responses to the items of the tool are either YES or NO or a brief narrative. At the end of each section, you may include comments and practical suggestions, if applicable. AGENCY/PROGRAM VISIBILITY & COLLABORATION 1) Does your agency/program regularly collaborate with agencies/programs that serve people with disabilities? Ą Yes Ą No 2) Does your agency/program regularly collaborate with agencies/programs that serve Deaf people? Ą Yes Ą No 3) Please list the agencies/programs and how you collaborate: _______________________________________________________________________________________________________________ 4) Does your agency/program regularly collaborate with domestic and/or sexual violence agencies/programs? Ą Yes Ą No 5) Please list the agencies/programs and how you collaborate: Accessibility & Trauma-Informed Review Tool 16 6) Do your agency/program brochures, outreach materials, website, etc. indicate accommodations will be provided for people with disabilities or people who are Deaf? Ą Yes Ą No 7) How does your agency/program indicate accommodations will be provided? _______________________________________________________________________________________________________________ 8) Is your agency/program contact information listed with access signs (TTY, Wheelchair accessibility, etc)? Ą Yes Ą No 9) If your agency/program has TTY #, is it listed on the agency/program website, brochures, letterhead, etc.? Ą Yes Ą No Comments Practical Suggestions POLICY, PROTOCOL & PRACTICE 10) Does your agency/program cultivate a model of doing ŇwithÓ rather than ŇtoÓ or ŇforÓ people? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 17 11) How does your agency/program cultivate a model of doing ŇwithÓ rather than ŇtoÓ or ŇforÓ people? 12) Does your agency/program work to ensure that the most supportive options for services are made available to people? Ą Yes Ą No 13) How does your agency/program work to ensure that the most supportive options for services are made available to people? 14) Does your agency/program have emergency procedures as they relate to people with disabilities? Ą Yes Ą No 15) Are staff at your agency/program trained to implement the emergency procedures as they relate to people with disabilities? Ą Yes Ą No 16) Does your agency/program have a policy pertaining to environmental/multiple chemical sensitivities? Ą Yes Ą No 17) Are the staff at your agency/program trained to implement the agency/programŐs policies pertaining to environmental/multiple chemical sensitivities? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 18 Comments Practical Suggestions TRAINING & PROVIDER COMFORT LEVEL 18) Does your agency/program provide staff with training on working with people with disabilities or with Deaf people? Ą Yes Ą No 19) How much experience do staff at your agency/program have working or interacting with people with disabilities or Deaf people? 20) Does your agency/program provide staff training for working with survivors of domestic and/or sexual violence? Ą Yes Ą No 21) How much experience does your staff have working or interacting with people who are victims of domestic and/or sexual violence? 22) Does your agency/program offer disability etiquette training? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 19 23) How often does your agency/program provide disability etiquette training? 24) Who provides disability etiquette training? 25) Does your agency/program provide training on the dynamics of domestic and sexual violence? Ą Yes Ą No 26) How often does your agency/program provide training on the dynamics of domestic and sexual violence? 27) Who provides training on the dynamics of domestic and sexual violence? 28) Is your agency/program familiar with person-first language? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 20 29) Does your agency/program use person-first language to emphasize the person and not the disability (e.g., person using a wheelchair vs. wheel chair bound, person with a disability vs. disabled person)? Ą Yes Ą No 30) Does your agency/program provide information/training to staff about verbal and/or nonverbal cues that indicate a person may be feeling uncomfortable during meetings or on the phone? Ą Yes Ą No Comments Practical Suggestions PHYSICAL ACCESSIBILITY 31) Is staff at your agency/program encouraged to inform people of any barriers to accessing your agency/programŐs location? Ą Yes Ą No 32) Is your agency/program accessible to people with limited mobility? Ą Yes Ą No 33) How is your agency/program accessible or not accessible? Accessibility & Trauma-Informed Review Tool 21 34) Are there any barriers that prevent people from easily accessing your agency/program and its services? Ą Yes Ą No 35) What are the barriers? 36) Are people with mobility issues and visual disabilities easily able to enter your building? Ą Yes Ą No 37) Are people with mobility or visual disabilities easily able to maneuver through the building? Ą Yes Ą No 38) Are doorways, signs, emergency exits in Braille? Ą Yes Ą No 39) Does your agency/program have at least one accessible bathroom? Ą Yes Ą No 40) Are phones accessible for people in wheelchairs to use comfortably? Ą Yes Ą No 41) Does your alarm system (i.e. smoke alarms, fire alarms, etc.) have auditory and visual alarms in each room? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 22 Comments Practical Suggestions COMMUNICATION 42) Does staff have the ability to receive calls from a variety of communication devices (i.e. TTY, Videophone, etc.) ? Ą Yes Ą No 43) What communication devices does your agency/program have? 44) Does your agency/program ensure the functionality of your communication devices? Ą Yes Ą No 45) How does your agency/program ensure the functionality of these devices? 46) Does your agency/program have a budget for American Sign Language (ASL) interpreters? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 23 47) Is staff trained on how to arrange for an ASL interpreter? Ą Yes Ą No 48) Does your agency/program have access to an ASL interpreter 24-hours per day? Ą Yes Ą No 49) If your agency/program has a TTY, are directions for the TTY posted near the TTY? Ą Yes Ą No 50) Are staff members trained to handle a TTY call? Ą Yes Ą No 51) Are staff members trained to handle a Video Relay Call? Ą Yes Ą No 52) Does your agency/program have a TTY or videophone for consumers to use? Ą Yes Ą No 53) Does your agency/program provide materials in alternative formats i.e. Braille, Large Print, JAWS (reads materials on computer)? Ą Yes Ą No 54) Please list the materials and their alternative formats: Accessibility & Trauma-Informed Review Tool 24 Comments Practical Suggestions INTAKE PROCEDURES 55) Does your agency/program offer a variety of location choices for meeting with people (e.g. coffee shop, library, community center)? Ą Yes Ą No 56) Do staff members provide information about accessing the location where the meeting will take place (parking, privacy, getting into the building, etc.)? Ą Yes Ą No 57) Do staff members inform people about the amount of paperwork that may need to be completed at initial appointments? Ą Yes Ą No 58) Does your agency/program provide people with the option of arriving early to the appointment to complete paperwork? Ą Yes Ą No 59) Do staff members ask if people need assistance to complete paperwork? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 25 60) Does your agency/program provide people with options or support for completing paperwork? Ą Yes Ą No 61) What options and/or support does your agency/program provide for completing paperwork? 62) Does your agency/program offer to mail paperwork to people so they may complete paperwork prior to the appointment? Ą Yes Ą No 63) How does your agency/program determine if it safe to mail paperwork to people? 64) Do staff members inform people how long they may have to wait for their appointment? Ą Yes Ą No 65) Do staff members ask people about any accommodations that might be helpful to them? Ą Yes Ą No 66) How is this included in your agency/programŐs intake process? Accessibility & Trauma-Informed Review Tool 26 67) Do staff revisit accommodation needs with people periodically? Ą Yes Ą No 68) Does your agency/program keep track of peopleŐs accommodation needs? Ą Yes Ą No 69) How does your agency/program keep track of peopleŐs accommodation needs? 70) Do staff clearly explain the meaning of confidentiality to people? Ą Yes Ą No 71) Does your agency/program provide detailed information about peopleŐs rights and responsibilities regarding confidentiality? Ą Yes Ą No 72) Does your agency/program provide detailed information to people when confidentiality ends? Ą Yes Ą No 73) Do staff members inform people about who will have access to their information? Ą Yes Ą No 74) Are people provided with information about their rights and responsibilities from the agency/program? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 27 75) Do people receive documents outlining their rights and responsibilities regarding agency/program services? Ą Yes Ą No Comments Practical Suggestions ASSESSING TRAUMA HISTORY & SAFETY 76) When people call your agency/program, do staff members ask if they currently are in a safe environment (i.e. no one is listening in on their conversation, the perpetrator/abuser is not present)? Ą Yes Ą No 77) Are staff trained to respond to disclosures of domestic and/or sexual violence? Ą Yes Ą No 78) How is staff prepared to respond to disclosures of domestic and/or sexual violence? 79) How people with disabilities who have experienced domestic and/or sexual violence know they can safely disclose their experience to staff in your agency/program? Accessibility & Trauma-Informed Review Tool 28 80) Do staff members ask questions about sexual safety to help people identify if they have experienced abuse and/or trauma? Ą Yes Ą No 81) Do staff members ask questions about physical safety to help people identify if they have experienced abuse/trauma? Ą Yes Ą No 82) Do staff members ask questions about emotional safety to help people identify if they have experienced abuse/trauma? Ą Yes Ą No 83) Do staff members ask questions about financial safety to help people identify if they have experienced abuse/trauma? Ą Yes Ą No 84) Do staff members ask people if they feel safe with their Personal Care Attendants (PCA), family members, and/or partners? Ą Yes Ą No 85) Generally, how are staff instructed to ask people about the above safety related questions (e.g. ask direct questions, talk to the person alone)? 86) Do staff members ask about safety concerns in follow-up contacts with people who disclose abuse? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 29 87) How are staff trained to minimize the possibility of re-traumatizing people when asking questions about their trauma history? 88) Do staff members respond in a compassionate, non-blaming manner when a person discloses domestic and/or sexual violence? Ą Yes Ą No 89) How are staff trained to respond in a compassionate, non-blaming manner? SAFETY AND COMFORT 90) Does the agency/program environment indicate that the agency/program is a safe place for people with disabilities to talk about domestic and/or sexual violence? Ą Yes Ą No 91) How does the agency/program environment indicate that the agency/program is a safe place for people with disabilities to talk about domestic and/or sexual violence? 92) Do your agency/program materials indicate the agency/program is a safe place for people to talk about domestic and/or sexual violence? Ą Yes Ą No Accessibility & Trauma-Informed Review Tool 30 93) How do your agency/program materials indicate the agency/program is a safe place for people to talk about domestic and/or sexual violence? 94) Are staff encouraged to provide the option of keeping a door opened or closed when meeting individually with a person in an office or meeting room? Ą Yes Ą No 95) Does your agency/program offer to meet people at the front door to help them feel more comfortable and safe? Ą Yes Ą No 96) Does your agency/program offer to escort people to their car/call a bus/etc. to help them feel more comfortable and safe? Ą Yes Ą No 97) Do staff members in your agency/program work in partnership with people to create immediate/short term safety plans when needed? Ą Yes Ą No 98) Does your agency/programŐs safety planning process explore each personŐs unique barriers to safety (i.e. a person with a disability, a person who is Deaf, a person whose first language is not English)? Ą Yes Ą No 99) How does your agency/program increase the physical safety of people during program activities? Accessibility & Trauma-Informed Review Tool 31 100) How does your agency/program increase the emotional safety of people during program activities? Comments Practical Suggestions Accessibility & Trauma-Informed Review Tool 32 References Andrews, A. B., & Veronen, L. J. (1993). Sexual assault and people with disabilities. Special issue: sexuality and disabilities: a guide for human service practitioners. Journal of Social Work and Human Sexuality, 8(2), 137-159. Berkeley Planning Associates. (1997). Disabled women rate caregiver abuse and domestic violence number one issue. Berkeley, CA: Department of Education. Change, J.C., Martin, S.L., Moracco, K.E., Dulli, L., Scandlin, D., Loucks-Sorrel, M.B., Turner, T., Starsoneck, L., Dorian, P.N., & Bou-Saada, I. (2004). Helping women with disabilities and domestic violence: strategies, limitations and challenges of domestic violence programs and services. Journal of WomenŐs Health, 12(7), 699-708. Cloutier, S., Martin, S., & Poole, C. (2002). Sexual assault among North Carolina women: prevalence and health risk factors. Journal of Epidemiologic Community Health, 56, 265Đ271. DisAbled WomenŐs Network Ontario. (2007). Family violence against women with disabilities. Retrieved October 14, 2009, from http://dawn.thot.net/violence_wwd.html Fallot, R. D. & Harris, M. (2009). Creating cultures of trauma-informed care (CCTIC): A self-assessment and planning protocol. 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