Tennessee Brighter Futures: 
Disability 

Welcome and Introductions 

Carrie Carlson 
Advocate 

Donna DeStefano 

Assistant Executive Director 



DISABILITY DISABILITY 
A physical, mental, cognitive, or developmental condition that 
impairs , interferes with, or limits a persons ability to engage in 
or certain tasks or activities. 



Who are People with Disabilities 

A person with a disability can be a person with: 

• 
a mobility or physical disability, 
• 
sensory (vision or hearing) disability 
• 
intellectual disability 
• 
psychiatric or other mental disability 
People with medical conditions --e.g., HIV/AIDS, epilepsy, 
rheumatoid arthritis, and cancer --also covered under the ADA. 


Disability Alphabet -JAN 


Alcoholism Migraines 
Blindness Neurodiversity 
Chronic Pain Obesity 
Drug Addiction Post-traumatic stress disorder (PTSD) 
Epilepsy Sleep Disorders 
Fatigue Vertigo 
Hearing Impairments 
Intellectual disability 
Lyme Disease 

4 



Disability by the Numbers 

Understanding Disability Statistics 

• 
Depends on definition *** 
• 
Range is 37.3-61 million 
Disability Impacts All of Us --Centers for Disease Control and 
Prevention 

• 
61 million adults in the U.S. live with a disability 
• 
Up to 1 in 4 (26 percent) adults in the U. S. have some type of 
disability 

The CDC estimates 29.5%, one in three Tennesseans, are 

Disability 
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. 


Disability History 

Colonial America: Almshouses 

Institutionalization: Experimental 
”treatments”, bloodletting, 
lobotomies, horrific treatment 

Eugenics movement (18001900’
s): Mass sterilization 


Bethlem Royal Hospital, London 


Disability “Movements” 


1964: Civil Rights Act of 1964 
1973: The Rehabilitation Act of 
1975: Individuals with Disabilities Education 

Act (IDEA) 

1990: Signing of the Americans with Disabilities 
Act (ADA) 

1996: Olmstead 

1996 -2017: TN became the 14th 
state to close 
large state institutions for people with 

https://adata.org/ada-timeline 

disabilities. 

8 



Americans with Disabilities Act of 1990 

Civil Rights Law 


•Origins in the Civil Rights Law of 1964 
and the Disability Rights Movement. 
•More about the ADA at 
https://www.ada.gov/ 
https://adata.org/ 


ADA General Requirements 

•Physical access 
•Effective communication*** 
•Reasonable modification of policies, practices, and 
procedures. 
The Americans with Disabilities Act applies to anyone within the 
jurisdiction of the United States, regardless of their immigration 
status; meaning anyone present in the U.S. can seek protection under the 
ADA. 


ADA Definition of Disability 

The ADA defines a person with a disability in three 
ways 

1. A person who has a physical or mental impairment that substantially 
limits one or more major life activities. 
2. A person with a record of an impairment, even if he or she does not 
currently have a disability. 
3. A person who does not have a disability but is regarded by others as 
having a disability is also protected under the ADA. 
https://www.ada.gov/ 


Southeast ADA Center logo; graphic of 8 states in Region 4 

Region IV 

• 
A project of Burton Blatt Institute at Syracuse University (bbi.syr.edu) 
• 
Serve the eight states in the Southeast region 
Alabama, Florida, Georgia, Kentucky, 
Mississippi, North Carolina, South Carolina, Tennessee 

• 
One partner organization in each state 
In Tennessee, it is the Tennessee Disability Coalition. 
Donna DeStefano is the ADA Network Contact – donna_d@tndisability.org 


Health Equity 

Health equity is achieved when everyone 
has the opportunity to be as healthy as 
possible. 


Health 
Disparities 
Preventable differences in health 
outcomes that are linked to 
social, economic, and 
environmental factors. 
Health 
Disparities 
Preventable differences in health 
outcomes that are linked to 
social, economic, and 
environmental factors. 
14 



Disability and Health Care Access 

• 
1 in 4 adults with disabilities 18 to 44, do not have a usual health care 
provider. 
• 
1 in 5 adults with disabilities 18 to 44, have an unmet health care 
need because of cost in the past year. 
• 
1 in 4 adults with disabilities 45 to 64, did not have a routine checkup 
in the past year. 

Ableism 


Ableism is the discrimination and prejudice 
against people with disabilities, based on 
the assumption that they are inferior to non-
disabled people. It can lead to bias, 
prejudice, and discrimination, which can 
prevent people with disabilities from 
reaching their full potential. 

It can include harmful stereotypes, 
misconceptions, and generalizations about 
people with disabilities. 



What does ableism 
look like? 

• 
Beliefs: The assumption that people with disabilities need to be "fixed" or 
defined by their disability. 
• 
Language: Using euphemisms to avoid saying the word "disabled”. 
• 
Behavior: Avoiding a disabled person because you're uncomfortable 
interacting with them. 
• 
Comments: Making derogatory comments, jokes, or gestures about a 
person's disability. 
• 
Employment: Withdrawing a job offer from a disabled person. 
• 
Healthcare: Ableism can affect interactions with doctors, healthcare 
policies, and health outcome. 

Disability Etiquette 


How to connect with 
people with disabilities 

Remember: a person with a 
disability is a person with feelings. 

Treat him or her as you would want 
to be treated, and then let 
common sense and friendship 
break down any barrier.s you may 
encounter. 



Disability Etiquette 101 

We are people who may or may not identify as having a disability! 

• 
It’s okay to ask us if we need anything 
• 
It is not okay to just do things for us (more to come) 
• 
It is okay to interact with us like you would anyone else 
• 
It is okay to ask us to repeat something or let us know that you don’t 
understand 
It is okay to be patient with me and I’ll be patient with you! 


Meeting a person with a 
disability 


• Not everyone is okay with hugs or handshakes 
• Speak directly to a person with a disability 
• We are not here to be your inspiration 
• Don’t act like you understand, when you don’t 
• It’s okay to use common expression – “see you later” or ”I better run” 
• Don’t change the way you speak to people 
• Treat adults like adults 

Interacting with a person with a disability 

• 
Speech is not indicative of the person’s intelligence 
• 
Pay attention to the person 
• 
Assistive devices are part of that person – don’t touch them 
• 
Don’t talk to the interpreter, speak to the person 
• 
Use plain language – 
• 
Slay, Cap, Snatched, Skibidi, IFYKYK 
Silence in the form of patience is golden!! 


Insert your own disability, 
or chronic health condition. 

If you’ve met one person with _____, 
you’ve met one person with ____. 



Culture 

Having a disability is one 
piece of a persons’ identity, it 
doesn’t define them. 

24

InclusionInclusion
25 



Person-centered 

Are you giving the person a seat at 
your table, or are you a guest at their 
table? 


This Photo by Unknown Author is licensed under CC BY NC 

Including 
people with 
disabilities 

Policies & procedures development 
Website access 
Intake process design 
Inclusive meeting practices 
Event planning 
Social media 

Steps you take. 

Think about the steps you take to find a service provider… 

• 
How do you know that you need a service?
• 
Physician referral, symptom, family member, FB add… 
• 
How do you find what you need?
• 
Friend, internet, Google, Case Manager, Church 
• 
How to you contact them for an apt?
• 
Email, call, text, go to the office… 
• 
How do you get to and from that appointment?
• 
Walk, car, bus… 
• 
How do you fill out the paperwork?
• 
Do you need assistance? 
• 
How do you pay? 

--
Accessibility 
In the digital 
& physical 
world. 


Website 
Accessibility 


• 
Is your website accessible? 
• 
Have you had someone with a 
disability check it? 
• 
Do you have good color contrast? 

Marketing and Digital Content 
Accessibility. 

• 
Add Alt Text to images 
• 
Add captions to videos 
• 
Providing all text documents – 
infographics, flyers, handouts. 

A rainbow-colored swirly lines 
moving from top to bottom 
This Photo by Unknown Author is licensed under CC BY NC 

Effective 
Communication 

Ask! 

• 
ASL (American Sign Language) 
• 
Large print documents 
• 
Braille 
• 
Interpreting 
• 
Plain language 
• 
Patience/time 

How and Where? 

• 
Do you offer in-person or hybrid 
services/appointments? 
• 
Will you go to the person? 
• 
Is your office in an accessible 
location? 
• 
Do you have an accessible 
building? 
• 
Are you on a bus route? 
33

Intake Process 

• 
How long does it take? 
• 
Is it electronic or paper? Are there options? 
• 
Has the language been checked? 
• 
Plain language, appropriate reading level, etc… 
• 
Do you rely on family members to assist in this process? 
• 
This could be harmful! 

Other Considerations 

• Visual 
• bright lights, low lights, too busy, 
• Auditory 
• Noisy, echo, loud sounds (air, doors slamming) 
• Physical 
• Distance/size of the space, not accessible, small chairs, 
low or high chairs) 
• 
Do you have an accessible restroom? 
• 
Adult-sized height adjustable adult sized changing table? 
• Smell 
• Smells can be toxic to people 

Intersection 

36

TN Disability Scorecard 

The Problem 
Tennessee’s Homework 

Topics: 

• 
Family Caregiver 
• 
Housing 
• 
Mental Health Services 
• 
Access to Justice 
• 
Aging 
• 
Employment 
• 
Transportation 
37

The Disability community has the highest rates of 
sexual assault of any group in America. 

) 

People with disabilities experience higher rates of domestic violence and sexual 
assault than non-disabled people. 70% of people with disabilities experience 
some form of abuse and are three times more likely to be sexually assaulted. 


Because of misogyny and ableism, disabled women are 
especially vulnerable. 

• 
80% of women with disabilities have been sexually assaulted, and 
• 
they experience intimate partner violence at a rate 40% higher than non-
disabled women. 
• 
Not only is the likelihood of violence high, but the acts of violence 
themselves are also more frequent and severe. 

Substance Use Disorder (SUD) 

Disabilities and SUD can be a common pair. 

• 
People with disabilities are more likely to live with substance use 
disorders (SUDs) than the general population, and they are also less 
likely to receive treatment. 
• 
People with an addiction are also more likely to become disabled, 
either through accidental injury or through long-term side effects of 
substance abuse. 
• 
People with physical disabilities experience SUDs at 2 to 4 times the 
rate of the general population. 

Mental Health 

Adults with disabilities report experiencing frequent mental distress 
almost 5 times as often as adults without disabilities. 

• 
In 2018, an estimated 17.4 million (32.9%) adults with disabilities 
experienced frequent mental distress, defined as 14 or more 
reported mentally unhealthy days in the past 30 days. 
• 
Frequent mental distress is associated with poor health behaviors, 
increased use of health services, mental disorders, chronic disease, 
and limitations in daily life. 

Homelessness: 1 of 2 

There is a strong correlation between homelessness and 
disability. People with disabilities are more likely to experience 
homelessness than the general population, and people 
experiencing homelessness are more likely to have a disability. 


Homelessness: 2 of 2 

• Prevalence: Nearly half of people experiencing homelessness have adisability, which is 2.5 times higher than the general population. 
• Chronic homelessness: 31% of people experiencing chronic homelessnesshave a disability, and 65% of those people are unsheltered. 
• Eligibility: 84% of disabled people with low incomes are eligible for housingassistance, but don't receive it. 
• Discrimination: People with disabilities face discrimination in housing, 
healthcare, employment, and wages. 
• Accessibility: Many shelters are inaccessible to people with disabilities. 
• Healthcare expenses: People with disabilities are more likely to live inpoverty than those without disabilities. 
• Job-related injuries: People who work in jobs with high risk of injury, like
carnival workers, may become homeless if they are disabled. 


TBI & Disability: 1 of 2 

• 
Athletes with LD or ADHD are more likely to sustain a concussion 
and have prolonged symptoms. 
• 
47.4% of individuals aged 40 and older in the United States with a 
history of head injury live with disability. 

TBI & Disability: 2 of 2 

Individuals with a pre-existing disability who sustain a concussion 
may struggle with: 

• 
inadequate testing and diagnosis, 
• 
unusual symptoms, 
• 
unique mental health challenges, and 
• 
disability stigma in healthcare. 

Disabilities with an increased likelihood for sustaining 
a concussion: 

Individuals with the following disabilities may have an increased fall risk, or 
reduced ability to be aware of their surroundings. This poses the risk of running 
into other objects or people. 

• 
Individuals who are blind or visually impaired 
• 
Disabilities with increased fall risk such as those with developmental 
disabilities, gait dysfunction, muscle weakness etc. 
• 
Neurological disorders such as epilepsy 
• 
Intellectual disabilities