By: Brian Elliott

          There may be something lurking below the surface we need to have on our radars.  As many continue to work from home and our daily temperatures continue their downward trends, people are spending more time inside.  As we become less active, something to be mindful of is the potential of developing a pressure sore.   Especially those that spend a majority of their day sitting or in bed with limited or no ability to change positions or provide forms of pressure relief. 

          A pressure sore actually begins below the skin surface.  Commonly appearing on areas of the skin with bony parts of a body like the tailbone, heel, or hips as examples.  It will occur when the blood is restricted and there is pressure being applied from an outside source like a chair, bed, or shoe.  Sores are assessed by stages 1-4.  Stage 1 being on the relatively minor side and with proper recognition and treatment can be gone in as little as a few days to a week or two.  Although, it can easily become more serious. Each stage ratcheting up the danger level and extending the recovery process.  Stage 4 sores often require hospitalization and potential surgery followed by a recovery time table between a few months to two years. Serious complications like infection to the bone, extended bed rest (weeks to months), potential amputations or other life threatening situations may occur if a sore gets to this stage.

           Most vulnerable to developing a pressure sore are people with reduced mobility.  Other contributing factors putting people at higher risk of sores are:

• ·        Medical conditions impacting blood flow (such as diabetes)
• ·        Lack of nutrition and hydration
• ·        Incontinence (prolonged exposure to urine and feces breaks down skin)

          Common causes are from extended time in one position without pressure relief, clothing bunched under a person and sitting on it, or heels of shoes or socks that are pressing on the heel or Achilles are some examples.  Symptoms to be aware of include redness around the skin that doesn’t go away, sensitivity to touch, skin breakage, or a puss-like substance draining.

          The keys to pressure sore prevention/treatment are the ability to provide pressure relief and change positions along with early recognition and proper care and follow through of wound treatment.  If you become concerned, include medical professionals.  Another important fact if you acquire a pressure sore and it heals, that spot will continue to be vulnerable area and an easier location for any potential return of a pressure sore as that area has already been damaged.  Stay vigilant with your prevention precautions and wound care if any pressure sore ever develops.  #Awareness

           

Additional Info on Stages and Treatment of Pressure Sores

•  Read a personal experience with pressure sores
•    https://msktc.org/sci/factsheets/skincare/Recognizing-and-Treating-Pressure-Sores
•      https://www.sci-info-pages.com/skin-and-pressure-sores/
•         https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

Pressure Sores.  A Personal Experience

By Brian Elliott

          I remember my first introduction to a pressure sore following my spinal cord injury and stay in the hospital.  The nurses came in and said it was time to change the dressing.  Within seconds of removing the bandage, a funky smell began overtaking and filling the air in the room.  I couldn’t wait for them to do their job of cleansing and replacing the dressing.  They couldn’t do it fast enough as I tried to ignore them and what they were doing.  I just closed my eyes and tried to breathe through my mouth.  Then they were gone and I was left with a pungent aroma that seemed to linger in the room.  “How often do they do that?” I asked my roommate.  The nurses had just changed the dressing on a pressure sore he had developed on his backside.

          That was a learning moment.  Pressure sores = bad.  As a newly injured person with a spinal cord injury, my nurses and doctors were adamant with these new terms of ‘pressure sores’ and ‘pressure relief’ and my need to change positions.  They implemented a process of turning me throughout the day and night every two hours while I laid in bed.  I was allowed three positions.  Through the use of rolled sheets and pillows propping me up, they would align me on my left side, flat on my back, and right side.  Placing a pillow between my knees and putting these “moon boots” on that would protect my heels/ankles from lying on the bed.  Remember, bony areas of the body without much fat or muscle are most vulnerable to developing a pressure sore. 

          Once I was out of the bed for a while and in a power chair they would still request I did a pressure relief, which I did through a function of the wheelchair that allowed it to “tilt” back as seen in the photo.   Effectively moving the areas that were taking direct pressure, hence “pressure relief”.  That was my only method when I lacked the physical strength to readjust my position.  But, I also soon found comfort being in the chair and tilting back just a little to relax and hangout or watch TV.  I’d sit for hours with a slight tilt and eventually developed my own pressure sore on my tailbone.  I had been worried about my butt, thought by leaning back slightly I was doing the right thing and saving my tush.  In reality, all I was doing was moving off my butt and now sitting more directly on my bony tailbone.  I wasn’t very big to begin with and had lost 20-30 lbs while in the hospital.  There was very minimal natural protection anywhere on my backside, I eventually developed a stage 1 sore that was noticed by an aide one morning while getting dressed.  Thankfully that was caught early and acted as a reminder I needed to be more vigilant in changing positions and checking for potential sores.

          Then a while after that all healed, I found another spot one night when I was getting undressed.  Apparently while getting dressed that morning the back of my shoe had rolled over and was pushing on my heel/Achilles area through the whole day.  Without sensation that something may be hurting, I never knew.  This was a little more serious.  Borderline stage 2 pressure sore.  Thankfully it was in a location that was easy to remove all the pressure. I went without a sock or shoe and just a simple house slipper on that foot for almost a month while taking care of that new sore.  One of the few times that not being able to walk has proven helpful.  It prevented me from re-opening the wound.  I have since become devoted to checking my heels for rolled socks or shoes everyday as I get in my chair in the mornings.

          I have chalked those two sores up as adjusting to life with a spinal cord injury and learning to understand my body.  Grateful that the sores weren’t more serious.  Important lessons learned none the less.  Since then, I have been pressure sore free.  Once you become a member of the wheelchair user club, pressure sores are likely to pop up and pretty much everyone in the club has had one or at least knows some people that have.   Use the lessons learned through others experiences as helpful tips and reminders to be careful about yourself.  As always, it is extremely helpful to educate yourself on ways that may help, like different cushions or seating posture to help distribute weight better and away from sensitive areas.  It is important to always be conscious about your body and how you are treating it.  You only get one, treat it well by staying vigilant and it will reward you with longevity.  #Awareness

         Have an experience you want to share or tips for people to avoid getting a sore?  Share the info in the comments below to help other people know more about pressure sores.

Autonomic Dysreflexia and Living with a Spinal Cord Injury

By:  Brian Elliott

          How well do you know yourself?  Inside and out.  As a person with a disability, there are many things that are important to know.  An article from New Mobility Magazine about a condition called Autonomic Dysreflexia (AD), a potentially life threatening situation that had me thinking about how truly important it is to know your body along with a level of comfort around your disability.  Each disability comes with its unique characteristics, and just like snowflakes, no two people with disabilities are exactly the same.  At the risk of over generalizing across disabilities, I am going to stay with spinal cord injury (SCI) for this posting. 

           Obtaining a SCI is like getting a new body.  You need to learn how it operates and what function it has.  For starters, people with SCI no longer have full control over bowel and bladder function.  Meaning they can no longer hold a full bladder as before the SCI. When it’s time to go; it’s time to find somewhere to go.  Knowing yourself and establishing those baselines are a way to gauge severity.  Is something not quite right?  Or, is something wrong?  Similar to the old adage “are you hurt or injured”, there is a difference. 

          Knowing your body and what “normal” feels like is an important part to living with a SCI.  Which is weird to say in regards to someone with a SCI that may have decreased or no sensation in parts of their body.  Yet, it truly is important to identify that “normal” feeling; how you generally feel throughout a majority of days.  It’s when that “normal” feeling is gone that it is time to start going through a mental checklist of common issues for feeling “off”.  Even though the spinal cord is no longer fully functioning to send signals down to the nerves below the level of injury, the body finds a way to bypass those normal routes for warnings and sends other signals like increased blood pressure, blotchy skin, headaches, sweating (people with SCI do not sweat below their level of injury normally) as some examples that a person with a SCI may experience when something is not right.  These are also the early warnings signs of AD.  For myself as an example, the most common culprit is a full bladder. If after using the facilities to empty out the bladder but still not feeling “right”, it is time to go through other potential common causes. How does a person without sensation go through the options and determine what’s wrong? It starts with the normal culprit checklist that was mentioned earlier.

• Look over yourself for anything out of place.  Maybe a foot is turned or you acquired an injury you weren’t aware of at the time like a cut.
• Use the restroom to empty your bladder.
• Remove shoes to check for a toe facing the wrong direction or sock bunched and pinching skin.  Maybe the heel of the shoe rolled down when putting it on and is pushing into an Achilles tendon. Those are common sources that can lead to a pressure sore.  You do not want any pressure sores!    
• Make sure other clothing is not bunched on your back, sides, under your butt and thighs.  Also leading causes to get a pressure sore.
• Find a way to lean back and elevate your legs above your heart.  Many power chairs come with a tilt feature or have someone tilt a regular wheelchair back and rest that way for a few minutes.
• If you are still having issues, it’s time to start taking the clothes off.  Ideally at home in your bed if possible.  Give your entire body a check looking for redness or other abnormalities.
• Try for a bowel movement. 

Best case scenario, one of those quick and easy checks or the little self-exploration combined with laying down or bowel movement found the cause and you begin feeling better.  If not, time to get on the phone with a medical professional. No matter how long a person has had a SCI, these are concerns and checks to use and always have in the back of your mind.  #Awareness

 There is neither enough time in the day nor ways to express the awareness and gratitude you deserve.  The assistance that you have provided and continue to do for your loved ones deserves to be shouted from atop buildings and written on those banners you see dragged behind airplanes.  Regardless of how disability has been introduced to your life, whether a person was born with their disability or developed one later in life, you stepped right in.  Especially in the early phases, while everyone is still trying to figure out how to adjust and survive.  Developing a routine and pooling together information come in a crash-course that at times can feel like trying to drink from a fire hose.  Of course the severity and type of disability play a role, as each type of disability comes with its own unique traits. Those traits dictate the needs in regards to the frequency and extent of assistance that a person needs.  These relationships are certainly unique. 

          Consider some of the dynamic(s) that are involved.  Sometimes, the person with a disability has a need that their life literally depends on others for assistance.  That small factor aside, a dynamic that truly makes these relationships unique, is its close quarter nature.  When family are also functioning as a caregiver, the person with a disability often lives in the same home as the family member providing the care.  Think about that and when you have a stressful day at work.   At the end of the day, most jobs typically get to leave and go back to your own life, a chance to separate, unwind, and perhaps vent about the day. Those aren’t really as easy to do when you live under the same roof.  The only person around to hear you vent, may just be the same one that is the source of those feelings in the first place.  Those with disabilities have responsibilities too in these relationships.  Often, people with disabilities are harder and more vocal with their own opinions and frustrations to family members in the caregiving role than they are with a non-family under the same circumstances.  As someone that has been in this scenario, I make it a point to say please and thank you with any request.  May not seem like much, but I feel it is important to recognize tat you did something for me and I appreciate it.  Plus, nobody wants to be around someone where they are constantly told what to do and never treated wit respect or common courtesy. 

          Additionally, much of the assistance and care is provided without financial gains being the incentive.  When a caregiver isn’t available for whatever reason, family and friends are the ones looked to for providing support.  Caregivers, sorry if I break this news to you, but you most likely are not going to get rich from the service(s) you provide.  Although, you are definitely an important figure in the live(s) of those you help.  If the person with a disability is Medicaid eligible, check into Home Help Services and getting paid for the service(s) you provide.  Caregivers deserve to be paid, and in many cases should be being paid more.

          As I mentioned earlier, your willingness to set aside those minor incidents and help a loved one cannot be thanked enough or reciprocated in kind.  I know I speak for many other people when I give my deepest and most sincere THANK YOU for all that you have done.  I know it has not always been easy, but your support and assistance over time has been unmeasurable.  THANK YOU to all of you out there with the ability and willingness to help a loved one.

#awareness

For those who do not have their own transportation or need accessible transportation, Reserve-A-Ride is one of the best transportation options around town and throughout Jackson County.

A Jackson Area Transportation Authority (JATA) program, Reserve-A-Ride is a curb-to-curb service for the general public, including wheelchair users in Jackson County. JATA will pick up passengers and transport them to their desired destination.

The service is available on a first-come, first-serve basis. Call (517) 788-8410 to schedule a pickup.

“Reserve a Ride, with an on-time performance of 95%, is likely the most reasonably priced public transportation in the county of Jackson,” said Chad Cumberworth, JATA’s Government and Community Relations Manager. “This service offered by the Jackson Area Transportation Authority provides approximately 30,000 trips to individuals each year.”

Cumberworth said JATA recently received a $1.1 million grant from the Federal Transit Administration for a ‘Rides to Wellness’ program that is expected to start by the end of this year. The new program will provide non-emergency same day, door-to-door transportation to individuals.

Under Rides to Wellness, the drivers will pick up passengers at their residence and take them, for example, to their doctor’s appointment. The drivers will then wait for them to finish their appointment, and return them home or to another wellness destination such as a pharmacy or grocery store.

For now, here’s what you need to know about Reserve-A-Ride:

**You have to wear a facemask while you’re in a JATA bus or mini-van and in the transfer center.**

Call JATA in advance if you need a ride. You might get lucky and get a ride the same day if there’s a bus available. If you need a ride on a Saturday or Sunday, you’ll have to call JATA before 4 p.m. the Friday before.

If you live inside Jackson’s city limits, Reserve-A-Ride is available from 6 a.m. to 10 p.m. Monday through Friday; 10 a.m. to 10 p.m. on Saturdays and 7 a.m. to 4 p.m. on Sundays. If you live outside of Jackson, the county Reserve-A-Ride is available from 6 a.m. to 6 p.m. Monday, Wednesday and Friday.

JATA vehicles are equipped with lifts or ramps to assist the physically disabled. Up to 24 passengers can fit in a small bus. A pickup can be made curbside or in a designated parking area if one is available.

As the service provider, JATA reserves the right to deny service for non-compliance with passenger rules.

Here are the four big rules for riders:

•      Once JATA arrives, you have 30 minutes to get on the bus or mini-van.
•       All passengers who require assistance beyond JATA service limitations must provide their own personal care attendant, commonly known as a PCA. The PCA is allowed to ride on the vehicle at no charge, but only with ADA-certified passengers.
•       If someone you know is coming with you, he or she will have to pay the same fare you paid. All passengers are required to pay a fee or show a ticket or pass, unless prior arrangements have been made with the JATA scheduling office.
•       Give the JATA scheduling office at least a 2-hour heads-up if you need to cancel a ride. If you don’t cancel a ride and a JATA shows up, you could lose your privileges for a while. You also may be charged for the non-canceled ride the next time you ride a JATA vehicle. If not canceling becomes a habit, you could lose the service.

There are 12 other rules to follow:

•         No eating, drinking or smoking
•         No talking on cell phones
•         No profanity or shouting
•         No soliciting
•         No littering or defacing JATA property
•         Playing radios is prohibited, unless you have earplugs
•         Drivers do not make change (so bring the exact fare)
•         Passengers without correct fare will not be allowed to board (told you)
•         Shoes and shirts must be worn
•         No unnecessary conversation with the driver
•         Parents must keep their children seated for the duration of the trip
•         Children under the age of 5 must be accompanied by an adult

Also, if you call for a ride, make sure the building you’re calling from is safely accessible. Parking areas, including driveways, must be free of snow, ice or other obstructions.

If you’re certified for the “Americans with Disabilities Para-transit Priority Certification” (ADA), you can make reservations up to two weeks in advance during normal business hours.

For more information, visit www.jacksontransit.com.

2020 Youth Leadership Advocacy Academy

By: Brian Elliott

The 2020 Youth Leadership Advocacy Academy (YLAA) led by disAbility Connections employee Daniel Klink concluded recently.  The class consisted of Jackson area high school students who met online (due to Covid) twice a week, for six weeks and covered the systems that are in place to support people with disabilities, disability history in the U.S., learned about local/state/governance, and engaged with local governmental leadership to get a greater understanding of how and what is done behind the scenes of government on a daily basis. 

Students interacted through a curriculum that provided a broader understanding of what it means to be a person with a disability in 2020, while also acknowledging where we came from and the struggles/advancements that have been involved over time.  Throughout the six week course, the class was able to review a timeline of disability in America, viewed and discussed the impactful film Lives Worth Living (highly recommended for any that haven’t seen it), as well as interviews with Mayor Dobies of Jackson, U.S. Congressman Tim Walberg, disAbility Connections Deputy Director Travis Barnett, and Jackson County Treasurer Karen Coffman.  In fact, the program was so impactful and such a success, that it will function as a pilot program.  Next year, Centers for Independent Living across the state will be picking it up and using it to teach their local youth.

We are in the post-American with Disabilities Act (ADA) times.  People born in the late 1980s 1990 and beyond have grown up with the idea that things should be accessible through ramps, inclusive classrooms, braille on signs, power doors, or closed captioning, and more.  If you were born after this time, you could honestly assume these measures have always just been around.  The history of disability in America paints a different picture.  When asked if there were any segments that stood out or surprised the students, Klink stated, “They were really surprised about the history of disability and how people were treated, many had never seen or known what it was like pre-ADA. (Discussions) Provided a different aspect that many hadn’t considered”.   

Before the class wrapped up for the 2020 session, the students were asked what type of project they thought would be beneficial, given all that they had encountered over the previous six weeks.  They were able to come to a group consensus with two ideas that they thought would be worthwhile:

• ·        Develop an anti-bullying project around disability to implement with the incoming freshman class each year at local schools.
• ·        Have an annual ADA assembly each year within the area schools to help inform schools and more importantly students, about the rights for people with disabilities.

These are great ideas and help to show both the importance of the information to the students and the ability to advocate for their own needs, but also that disability history and experiences need to be shared.  A greater understanding of disability history and struggle for inclusion can help create a community of greater overall awareness and inclusion we can all enjoy.

ADA is Turning 30 – Disability Rights

By: Brian Elliott

          On July 26^th, the Americans with Disabilities Act (ADA) will have officially been a law of the land across the U.S. following its signing and passing in 1990 by President George H.W. Bush.  The ADA is a civil rights law that has five Titles/Sections under its canopy which guarantee equal opportunity for individuals with disabilities in public accommodations, employment, transportation, state and local government services, and telecommunications.  The ADA ensures that people with disabilities (PWD) are able to have the same opportunities and rights as everybody else.  Though these nearly 30 years have brought some immense changes for the better, room for improvement remains.

          The ADA helps to even the playing field and provide an opportunity.  PWD want to and are able to go places and do stuff!   Yes, depending on the severity and disability of a person, minor or major accommodations have to be made at minor or sometimes major costs.  However, do not let potential additional equipment/costs deter you.  With those accommodations, PWD are just as capable, likely, and able to do as meagerly or remarkably as well as any other person out there.  The ADA gives us a chance to put our work next to everybody else.

          A majority of the changes following the passage of the ADA have not only been beneficial for PWD but people in general as well.  Have you ever used a curb cut on the sidewalks, a ramp rather than stairs, entered through an automatic door, noticed braille on a sign, or benefited by closed captioning watching a show (maybe at home or a restaurant)?  Aside from making life easier for everybody, notice what else those changes have done?  They made it possible for more people to participate, be included, and get involved. 

          Simple changes like working from home, virtual meetings, flexible work schedules, or stores and restaurants offering curbside service are just a few examples of accommodations that are commonly implemented now and have been monumental in a businesses’ ability to function.  Pre-Covid-19, there were many documented instances where PWD were denied these exact same reasonable accommodations forcing them to move on and go without or try to file lawsuits citing ADA violations.  

          A common expression in the disability rights movement still applies here: “Nothing about us without us”.  PWD asked to be included or when that didn’t work, publicly forced their way into various decision making groups and, as a result, have become common fixtures at local, regional, and national meetings.  As alluded to earlier, some vast improvements within sections of the ADA have been made thanks to PWD getting involved in the decision making process.  These efforts have resulted in: transportation services with accessible vehicles, employers interviewing/hiring PWD and providing accommodations as needed, and alternate forms of communication and services for students with disabilities.  These may not seem all that impactful now, yet they were/are clear signs to all community members they are valued and welcomed.  To continue movement on these issues the whole community should always continue to be considered.  When decisions are being made we should always ask ourselves who is at the table?  Nothing about us, without us.

          Accessibility will always be a hot topic among the disability community and it should be a priority for any entity.  Accessibility goes beyond only physical access to buildings or services, it includes an ability to provide alternate materials like braille, image boards, or audio versions, alternate communication methods (languages, American Sign Language, tablets), and websites adapted to screen readers and images with alt text to describe photos are all forms of accessibility.  The good news is these changes are not impossible to do or difficult to learn. They can be adjusted for after the fact.  Meaning it is possible for a business by updating their old materials into accessible forms.  While retrofitting physical spaces for accessibility may be more difficult and costly (especially with our older buildings throughout the Midwest), accessibility can easily and affordably be built into any new construction project.  The only reason something isn’t built accessibly now is because the builder/designer chooses not to (cough cough: home builders!  Even though ADA doesn’t apply to private residencies). 

           Over the last nearly 30 years with the ADA, PWD are doing better now than before and there has been a shift towards acknowledging the needs of PWD and their inclusion in society.  The ADA should be celebrated for permanently establishing the civil rights of PWD and what it has been able to accomplish so far with its limited scope.  Going forward, I ask that you make a conscious effort to seek out the “other” people and offer them a seat.  Those that you don’t see at work, in your meetings, on TV, or out in the streets.  There’s a reason you aren’t seeing them.  There is still a stigma attached to disability.  People with disabilities are different, and being different makes others uncomfortable. When Covid-19 is all said and done, please remember what it felt like to be isolated at home, unemployed, unable to physically visit friends and family, or to get services out in the community.  Even with the ADA, PWD didn’t need a pandemic to encounter those scenarios because they are frequently a part of life.

         Despite the ADA’s impressive impact on society, the five titles within the Americans with Disabilities Act aren’t all encompassing.  The ADA has limitations and strict guidelines.  Since its inception and to this day, efforts have been aimed at undoing the strength of the ADA in courts, effectively trying to void the hard fought civil rights of PWD.  Here’s to 30 years of battling for inclusion with the help of the ADA and beyond!  #awareness

As we close in on the ADA become 30 years old on July 26th, staff here at dC were presented with the prompt:  What does the ADA mean to you? 

The ADA impacts lives in multiple ways and can have varying degrees of importance to individuals.  Below are some responses as we share how the ADA has interacted with our lives and how we feel about the ADA.

What does the ADA mean to me?

That is a wide range kind of question.  It’s everything from being able to have accessibility into any building; to laws allowing me to be treated like everyone else.

In a nut shell,  “the ADA allows me to actually live the life that I always wanted without any barriers.”

Mindy Albert - Information & Referral Specialist

Accessibility and Accommodations.  That’s what I think of when asked what the Americans with Disabilities Act (ADA) means to me.  I was 5 years old when the 1990 enactment of the ADA became law with its seismic shift towards public opportunities and services for people with disabilities.  I am now grateful for their hard work and awed at what they accomplished nearly 30 years ago.  There is still work that can be done, but I know I wouldn’t be able to have done what I have without them laying the groundwork and starting to break down barriers.  Although there are areas that can be improved upon, I have had a far easier path to take in getting an education, going out with friends, traveling around the country, and getting services to live as independently as possible thanks to the people that took on the government for the civil rights of people with disabilities.

Brian Elliott - Advocacy & Accessibility Manager

Growing up in a country (Germany) that did not have the ADA and then coming to the U.S. I appreciate the opportunities the ADA brings to all of us. The Americans with Disabilities Act helps to level the playing field so that people can live a life that is not dictated by disability, but ability, a life of meaning and value.

According to the CDC one in four U.S. adults have a disability, and most people, in the course of their lives, will either experience a disability or know someone who has one. This shows that disability is not an exception or abnormality, but a normal part of life. Sooner or later we are all likely to experience limitations in some areas of life.

Ina Correll - Quality Assurance & Administrative Assistant

What does the ADA mean to me?  I have lived the entirety of my life—starting as far back as age 6—under the cloud of depression and anxiety. 

It wasn’t until I was 25 years old that I sought any treatment.  I thought that I was experiencing the effects of being naturally incapable of dealing with life, but I didn’t have any option but to try to work my way out of my problems. 

 I began taking medication and attending therapy.  I began to see how many of the challenges I had experienced in school, in social situations, and in employment—had all stemmed from an un-diagnosed mental health disability. 

The ADA established rights for individuals with disabilities and lays out the responsibilities for those in positions of power.  It levels out the playing field for people whose disadvantages lie not in having a lack of capacity, but in living in a society that doesn’t ensure equal access and opportunity for all.  The ADA created an opportunity that I didn’t know I had. 

Nick Swallow - Independent Living Specialist

Now it is your turn and there are no right or wrong answers. 

Simply leave your response below in the comments to share how you feel about the ADA and how it interacts within your daily life. 

What does the ADA mean to you?

 

Service Animals are Trained to Work

By Brian Elliott

          People are using service animals across many disabilities, and they are not always easily identifiable to an outside observer.  A person with diabetes, epileptic seizures, or anxiety does not broadcast disability the same way as a wheelchair or white stick.  Similar to someone parking in a handicapped spot and stepping out to walk to the door, disabilities are not always evident from the outside.  It is important to know that within the ADA:

• ·        There are no restrictions on a dog’s breed or size.
• ·        No requirements that service animals need to be wearing something that designates them as a service animal. 

Only two questions may be asked when inquiring about a person’s service animal:

• 1)   Is this a service animal required because of a disability?
• 2)   What task has the dog been trained to perform?

          That’s it.  Worker’s can’t ask to see the task performed or for documentation of any kind.  No other questions may be asked of the person and their service animal.  Even though there is not a requirement to be wearing a vest or a leash and workers cannot ask any other questions, a service animal must still be under the control of the handler at all times.  A handler that is unable to control their dog because of bad behavior, incontinence, etc., may be asked to remove the dog from the premises.  The person may still return without the dog to get services if they desire.

          A service animal is defined under the Americans with Disabilities Act (ADA) as a dog that has been trained to do work or perform a specific task for a person with a disability.  Notice that distinction, the dog performs a specific task for the person and their disability.  There is not an official training course or governing body that accredits and provides documentation to people and their service animals.  Although, it is VERY important to note that animals who solely provide comfort/emotional support are NOT service animals under the ADA.  Miniature Horses are now also covered under the definition of a service animal as the only exception provided.  Public spaces that must accommodate for dogs as service animals must also consider allowing a mini horse with these four extra considerations:

• 1.   Is the miniature horse is housebroken;
• 2.   The miniature horse is under the owner’s control;
• 3.   The facility can accommodate the miniature horse’s type, size, and weight; and
• 4.   The miniature horse’s presence will not compromise legitimate safety requirements necessary for safe operation of the facility.

          Other aspects of a service animal to keep in mind are that they are exempt from the typical pet fees and the service animal takes priority over other people.  In other words, when a person with a disability goes somewhere with their service animal that typically would charge for having a pet, such as a hotel or rent in an apartment and a pet fee typically is added to the bill, these charges are NOT allowed under the ADA.  Remember that these are working animals and not strictly pets.  Charges can be applied for pets, but not a service animal.  Only when damages have occurred from a service animal can charges be applied.  As far as other people and a person’s service animal, the service animal has every right to be with their person.  If there is a person with fears, allergies, or issues related to a service animal, it is on that person to make arrangements as needed.  Whether that means going to the other side of the room or through other methods, the person with a service animal cannot be asked to leave because someone else is uncomfortable.

          There are a wide range of jobs for the dogs in these careers.  Yes, these are careers for the service animals.  When you see someone out with their service animal, remember that it is working and not just out for leisure and fun.  Even though having a job to do is fun for many of these animals and they thrive through the ability to work, please keep your hands to yourself.  Ask first and only if the handler says it is alright, then you may pet.  I know it’s hard to resist, but the service animal has an important job and should be allowed to do so without interference.   

          Recapping what was covered and we all now know about service animals:

• ·        Service animal is defined as a dog (or mini horse) that has been trained to do a specific task for a person with a disability.
• ·        There are no size, breed, weight, or official uniform for a service animal.
• ·        Emotional support animals are NOT service animals.
• ·        No official accreditation's.
• ·        There are a variety of reasons a person may have a service animal.
• ·        Workers are only allowed to ask two questions.
• ·        Pet fees do not apply to service animals.
• ·        Service animals get priority over other people.
• ·        Ask first, then pet.

A Brief Overview of the Five Titles under the Americans with Disabilities Act

By: Brian Elliott

          You most likely have heard the term at some point, Americans with Disability Act or more commonly referred to as the “ADA”, but do you know what, where, or how it actually applies?  If you do, awesome!  This will work as a refresher and if not, no worries, I’ll share some basic details so you will at least have a better understanding of what the ADA is, along with where and how it potentially applies within daily living. (Photo Credit: ADA National Network (adata.org)

          Nearly 30 years ago, the ADA was signed into United States law on July 26^th, 1990.  The ADA prohibits discrimination on the basis of disability in state and local government, employment, public accommodations, commercial facilities, transportation, and telecommunications.  As far as addressing the core issue, what is a disability?  The ADA defines a disability as a mental or physical impairment that substantially limits one or more major life activities, a person that has a history or documented record of such an impairment, or perceived by others as having such an impairment.  Notice that the ADA does not specifically name all the impairments that are covered, as it is dependent on the individual.

Within the ADA, they address five Title fields:

• ·        Title I – Employment
• ·        Title II – Public Services
• ·        Title III – Public Accommodations
• ·        Title IV – Telecommunications
• ·        Title V – Miscellaneous

          Title I focuses on employment.  Under Title I, a business with 15 or more employees must provide an opportunity for people with disabilities (PWD) to benefit from employment related prospects that are open to others.  Also established under Title I are some basic guidelines to use during the interview process of what can and cannot be asked of people prior to a job offer.  Once a PWD is hired, it is then a responsibility of the employer to consider requests for ‘Reasonable Accommodation(s)’.  These are accommodations that a PWD requests as it will allow them to do their job to the greatest extent possible.  Requests for an accommodation can be anything that allows them to perform the job functions such as an adjustable workstation that raises or lowers to allow standing or a wheelchair to fit underneath, modifications to work schedules, ability to work from a virtual setting (sound familiar?), equipment or policy modifications, and provision of services such as American Sign Language interpreters are a few examples that PWD may request.  Once a request is made, the employer has a responsibility to assess the request and provide a solution or options unless the request will cause an undue hardship to the entity. 

          Title II addresses public services that are provided by state or local government.  These services must give PWD equal opportunity to benefit from programs, services, and activities such as voting, town meetings, or recreation and social services as a few examples.  In addition, public transportation busses must be accessible for PWD.  Similarly, public services are responsible for effectively communicating with ALL people.  Including those with hearing, speech, or visual impairments.  Unless the entity can prove that a reasonable accommodation to their practice, policy, or procedure will fundamentally alter the service, program, activity or causes an undue hardship, they are expected to make an accommodation to the greatest extent possible.

          Covered within Title III are the businesses and Non-Profit service providers that are public services such as restaurants, hotels, retail stores, as well as privately owned transportation services.  These services should be prepared to effectively communicate with people that are blind, deaf, or have speech difficulties and must comply with non-discrimination that prohibits segregation, exclusion, or unequal treatment while also following the architectural standards for new and altered buildings by removing barriers in their existing buildings where possible.  An important point to remember is that Title III applies regardless of business size or employee numbers, unlike Title I which applies to businesses of 15 or more employees.

          Telecommunications under Title IV refers to phone and TV services for PWD.  Phone carriers are required to establish Inter and Intra State Telecommunication Relay Services 24 hours a day 7 days a week.  These allow those with hearing or speech disabilities to use TeleTYpe or Telecommunications Device for the Deaf, and callers with voice phones to communicate with each other via a 3^rd party communications assistant. 
Also covered under Title IV are Closed Captioning services for federally funded public service announcements.

          Title V contains provisions related to the ADA as a whole, including its relationship to other laws, state immunity, impact on insurance benefits and providers, prohibition against retaliation and coercion, illegal drug use, and fees to an attorney.

          There you have it.  The five Titles under the ADA along with a brief description in layman’s terms in an effort to help provide you a baseline understanding of what the ADA is along with where, how, and who the ADA applies within our society. 

• ·        Title I – Employment
• ·        Title II – Public Services
• ·        Title III – Public Accommodations
• ·        Title IV – Telecommunications
• ·        Title V – Miscellaneous

There are more details and information available out there and I encourage you to consult with a lawyer if you think there is an issue that needs to be addressed.  For more information and greater details within the ADA, here are a few links for references:

• www.ADA.gov – Information and Technical Assistance on the ADA.
• www.adata.org – Information, guidance, and training on the ADA.
• www.askjan.org - Questions related to accommodation, ADA, and workplace issues.