Disability Health Resources About Disability The National Centers for Disease Control and Prevention estimates 29.5%, or almost one in three Tennesseans, are living with some form of disability. According to the CDC, that’s higher than the national average of 25.6%, or about one in four Americans. A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions). There are many types of disabilities, such as those that affect a person’s: . Vision . Communicating . Movement . Hearing . Thinking . Mental health . Remembering . Social relationships CDC.gov . Learning Although “people with disabilities” sometimes refers to a single population, this is a very diverse group of people with a wide range of needs. Many types of disabilities fall under mental health, hearing impairment, etc. Two people with the same type of disability can be affected in very different ways. For example, one person with brain injury may have changes in vision and difficulty with memory and another person with a similar injury may experience challenges in communicating and social relationships. Some disabilities may be hidden or not easy to see. According to the World Health Organization, disability has three dimensions: 1. Impairment in a person’s body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision or memory loss. 2. Activity limitation, such as difficulty seeing, hearing, walking, or problem solving. 3. Participation restrictions in normal daily activities, such as working, engaging in social and recreational activities, and obtaining health care and preventive services. People with disabilities, like all people, are complex. They may have more than one type of disability. Additionally, their network of supports; lifestyle and health related choices; access to resources; geographical location; employment and benefits; and self-advocacy skills are some of the many factors that contribute to an individual’s experience of living with disabilities. Intersectionality with Brain Injury Traumatic Brain Injuries (TBIs) are a leading cause of death and disability in the United States. Over 5 million people have a permanent disability related to Brain Injury – or 1 in 60 people. (BIAA.org) One study found that just over 47% of people 40 or older with a history of Brain Injury live with a disability in at least one area of functioning. (Schneider, Wang, et al., 2021). TBI has long been called a “silent epidemic” because disabilities following Brain Injury often cannot be readily seen. The large number of anoxic brain injuries (caused by lack of oxygen) from drug overdose has more recently been referred to as the “second silent epidemic.” “Even within the disability community, the issues affecting persons with severe Brain Injury are largely invisible and marginalized. (Fin, 2015) Page 1 Intersectionality with Brain Injury continued: Some disabilities put people at a higher risk of sustaining a TBI. This list includes autism, hearing or visual impairment, balance changes, muscle weakness and cognitive impairment. These conditions may make it more likely that someone might trip and fall or exercise poor judgement which leads to an accident. They may be in greater danger of being a victim of physical and/or domestic violence. In addition, a prior Brain Injury makes it more likely someone will sustain another Brain Injury. Common changes following brain injury include reduced memory and attention, decreased problem- solving and organization, changes in judgment and impulse control. It is important to watch for any changes in abilities that might indicate a new brain injury has occurred. . Screening for a prior history of Brain Injury is recommended at every medical visit. . Cognitive screening for those identified with an injury is recommended. . Relevant strategies and accommodations should be taught to the individual to compensate for the changes and to those working with him or her. . Those accommodations should be built directly into programs whenever possible. For example, breaking down instructions into smaller parts and using visual aids. The resources listed below are for disability in general. For information on a specific disability, please search online to find national or state advocacy groups and more information. Screening Tools Substance Abuse Screenings in Tennessee (SBIRT-TN) Screening, Brief Intervention, and Referral to Treatment: SBIRT is a substance abuse screening and referral to treatment initiative. It is patient-centered and offers education and early intervention to identify and address substance misuse in primary care settings. Patients are asked about their substance use confidentially. Institute for Research, Education & Training in Addictions (IRETA) SBIRT Toolkit University of Washington Substance Use Screening & Assessments Instrument Database NASHIA’s OBISSS (Online Brain Injury Screening and Support System) Ohio State University TBI Identification Method - a screening tool for Brain Injury Crisis Intervention Tools 988 Suicide & Crisis Lifeline or you can text to 988; 988lifeline.org to chat with someone. Continuum of Crisis Services and 988 2-minute informational video Veterans Crisis Line: Dial 988, then Press 1; or text 838255. NAMI Blog: How to Help Someone in Crisis Warning Signs and Symptoms Page 2 211 Helpline | Get Connected. Get Help. (unitedwaygreaternashville.org): The 211 Helpline is a 24/7 365-day information and referral help line that provides individuals in need with help in times of crisis and beyond. SAMHSA National Helpline: Confidential free help, from public health agencies, to find substance use treatment and information. 1-800-662-4357 Tennessee REDLINE: 24/7/365 resource for substance abuse treatment referrals. Anyone can call or text 800-889-9789 for confidential referrals. TN Statewide Crisis Phone Line: 24 hours/365 days; a free resource for anyone experiencing a mental health crisis; provides support, guidance and appropriate community supports. (855-274-7471) National Maternal Mental Health Hotline: Call or text 1-833-TLC-MAMA (1-833-852-6262). TTY users can use a preferred relay service or dial 711 and then 1-833-852-6262. Tips EMA Guide: https://www.tn.gov/content/dam/tn/health/documents/cedep/ep/afn_tips_sept2023.pdf Some important milestones in the disability rights movement Rehabilitation Act of 1973: The Rehabilitation Act prohibits discrimination on the basis of disability in programs conducted by Federal agencies, in programs receiving Federal financial assistance, in Federal employment, and in the employment practices of Federal contractors. This was the first major legislative effort to secure equal access for people with disabilities. Individuals with Disabilities Education Act (IDEA) of 1975: A law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children. Americans with Disabilities Act (ADA) of 1990: The ADA is a landmark civil rights law that prohibits discrimination against disabled people in all areas of public life. Disability rights are civil rights. From voting to parking, the ADA is a law that protects people with disabilities. TBI Act (1996) At the time, the TBI Act was the only federal legislation that specifically addressed TBI prevention, research, and service delivery through grants to states that were originally administered by the Health Resources and Services Administration (HRSA). The key federal agencies involved are: the Centers for Disease Control (CDC), National Institutes of Health (NIH), and the Administration of Community Living (ACL). People First of Tennessee, U.S. Department of Justice vs. Tennessee, Greene Valley, Clover Bottom and Nat. T Winston Developmental Centers. (1996) In 1995, Greene Valley, Clover Bottom and Nat. T Winston Developmental Centers were the subject of an investigation by the U.S. Department of Justice and a lawsuit was brought by advocates for people with disabilities over conditions at the three institutions. After two decades of work to improve the state’s service delivery system, all parties agreed to an Exit Plan in January 2015, which included the closure of GVDC. Testimonials: https://www.mouthmag.com/peoplefirst.htm Page 3 Olmstead v. L.C. (1999): This Supreme Court ruling affirmed the rights of individuals with disabilities to live in their communities rather than be institutionalized. National Websites Wrightslaw.com Parents, advocates, teachers, and attorneys come to Wrightslaw for reliable, up-to-date information about special education law and advocacy for children with disabilities. Association on Higher Education and Disability AHEAD is the leading professional membership association for individuals committed to equity for persons with disabilities in higher education. College Living Experience (CLE) helps people with autism spectrum disorder (ASD), NVLD, dyslexia and other disabilities gain the skills they need to become independent. Brain Injury Association of America: As the voice of brain injury, we improve the quality of life of people affected by brain injury across their lifespan through advancing prevention, awareness, research, treatment, education, and advocacy. ADA Live! is a free monthly show broadcast nationally on the Internet. Learn about your rights and responsibilities under the Americans with Disabilities Act (ADA). Southeast ADA Center: Information, Guidance and Training on the Americans with Disabilities Act Job Accommodation Network (JAN): JAN provides the following A to Z listings by disability, topic, and limitation. This information is designed to help employers and individuals determine effective accommodations and comply with Title I of the Americans with Disabilities Act (ADA). State Resources The Tennessee Disability Coalition Tennessee Disability Coalition is an alliance of organizations and individuals joined to promote the full and equal participation of people with disabilities in all aspects of life. To support this mission, the Coalition offers the following programs: . Public Policy Program . Americans with Disabilities Act (ADA) Program . Family Voices of Tennessee . WorkAbleTN . Brain Links . Discretionary Small Grants Program 2024 Tennessee Disability Score Card: Tennessee Disability Coalition's ratings of Tennessee's policies, practices, opportunities, and outcomes for residents with disabilities. Disability Etiquette Guide: Etiquette suggestions for interacting with people with disabilities. Page 4 Statewide Independent Living Council of Tennessee (SILC) The Statewide Independent Living Council (SILC) is an independent nonprofit governed by people with disabilities. Our goal is to advance advocacy and independence for Tennesseans with disabilities by collaborating with all interested parties. We believe that people with disabilities are the best experts on their needs. Centers for Independent Living Across Tennessee TRI-STATE RESOURCE AND ADVOCACY CORPORATION Chattanooga DisAbility Resource Center Knoxville Empower Tennessee Nashville T.A.R.P. Center for Independent Living Paris Jackson Center for Independent Living Jackson Disability Connection Midsouth Memphis TennCare Learn about and apply for Medicaid services in Tennessee. Tennessee Department of Human Services, Disability Services Vocational Rehabilitation: (VR) Services which help individuals with disabilities get, keep, or advance in a job. Office locator across Tennessee: Vocational Rehabilitation Regional Offices, Community Tennessee Rehabilitation Centers, and Tennessee Technology Access Centers TN Disability Pathfinder -statewide database of services including everything from social service agencies to low-income medical clinics to recreational programs. Tennessee Department of Health, Adult Protective Services (APS) staff investigate reports of abuse, neglect, or financial exploitation of adults who are unable to protect themselves due to a physical or mental limitation. APS staff assess the need for protective services and provide services to reduce the identified risk to the adult. For additional information, download our brochure. Disability Rights Tennessee: DRT is Tennessee’s Protection & Advocacy Network and has served—at no cost—more than 50,000 clients with disabilities. Our mission is to protect the rights of Tennesseans with disabilities. Factsheet: Effective communication in medical settings TNSTEP – Special Education support for Tennessee Families. As Tennessee's Parent Training and Information Center, we are dedicated to supporting families of children and youth with disabilities who are navigating special education services and youth who are transitioning from high school into adulthood. We provide accurate, timely, and relevant information and training related to special education rights, equal access to quality education, and connections to community resources. A Guide to Long-Term Services and Supports in Tennessee Infographics & Factsheets Tennessee Disability Coalition Disability Etiquette Guide Page 5 Your Rights Under Section 504 of the Rehabilitation Act Centers for Disease Control (CDC) Disability Impacts All of Us Increasing Physical Activity Among Adults with Disabilities Adults with Disabilities: Ethnicity and Race Disability & Health U.S. State Profile Data for Tennessee Trainings TN Businesses for the Better 101 Presentation Southeast ADA Center 4-part webinar series The History of Disabilities Articles The Neglect of Persons with Severe Brain Injury in the United States: An International Human Rights Analysis by Ezer, Wright and Fins, Health and Human Rights Journal. June 2020. Adaptive Fitness: Wellness for People with Disabilities Through Exercise SAMHSA Advisory on Preventing Substance Use Among Young Adults with Disabilities Disability Wellness Brain Health: How to Have a Healthy Brain Throughout Life: research-based tips for creating a healthy brain, regardless of age. Videos Crip Camp: A Disability Revolution: A 2020 documentary about disability rights. Support Groups and Related Groups Tennessee Brain Injury Virtual Support Group Zoom meetings – held on the 1st and 3rd Tuesday each month. For more information regarding meetings, call the TBI Program Hotline at 1-800-882-0611. Access the statewide Zoom link and to learn more about support group meetings in your region. Empower Tennessee Peer Groups Empower Tennessee’s peer groups are here to empower these people to live the lives they imagine. Peer group members rave about how much they enjoy the wisdom and humor shared with them about all subjects related to living and thriving with a disability. Page 6 Caregiver Resources Tennessee Caregiver Coalition https://tncaregiver.org/ National Family Caregiver Support Program - https://acl.gov/programs/support-caregivers/nationalfamily- caregiver-support-program Hidden Disabilities Sunflower: a simple tool for you to voluntarily share that you have a disability or condition that may not be immediately apparent – and that you may need a helping hand, understanding, or more time in shops, at work, on transport, or in public spaces. National Respite Locator Service: https://archrespite.org/caregiver-resources/respitelocator/ CDC: Healthy Habits: Caring for Yourself When Caring for Another Family Caregiver Alliance Support Group This online group is in e-mail format. Participants send and receive e-mail to take part in discussions. You can receive your posts all together, in one delivery each day, or you can receive them one-by-one, as they are sent. The choice is yours. It’s fun, easy, and available 24 hours a day, 7 days a week. Family Caregiver Alliance Resources for Caregivers Practical Caregiving Tips . Self-Care for Family Caregivers . Hiring In-Home Help . Writing a Personal Care Agreement . Researching Care . Types of Residential Care . Hospital Discharge Planning Working Successfully with Dementia . Helping You Understand Dementia Behaviors . Communicating with Someone with Dementia . Facts About Dementia . Real-Life Strategies for Dementia Caregiving TN Brighter Futures groups that are a part of this System of Care Tennessee Disability Coalition Empower Tennessee Disability Rights Tennessee Tennessee Commission on Aging and Disability Page 7