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On Target  eNews                                              August 2016

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On Target eNews comes to you the first Tuesday of each month with updates on our clients, our organization, and our work. We also publish a full newsletter three times a year.

Volunteer for our Board of Directors

We have a vacancy on the Board of Directors of Disability Rights NC. If you are interested, please review this page of our website to see the requirements. You will need to submit an application.

Pro Bono Profile: Attorney gets child needed services in her first case

Cindy Sanders larger 2Cynthia Sanders is well prepared for a second career in environmental law. The former fisheries biologist from Charlotte, NC earned a dual degree – her law degree from the University of South Carolina and a Masters in Environmental Law and Policy from the Vermont Law School. But an energetic 6-year-old with cerebral palsy (CP) and a need for in-home skill-building services may have turned her attention to another kind of public interest law, that of disability rights.

Cynthia’s first case as a practicing attorney was a pro bono case referred to her by Disability Rights North Carolina. It involved a child with CP whose family had requested and been denied a certain number of hours of services to help him progress in his development. Like so many of the cases we hear about, the denial by his Managed Care Organization (MCO) seemed arbitrary to the family, and unrelated to the specific circumstances of their child.

Cynthia’s task was to assist the client in appealing the denial and to represent him in a hearing before an Administrative Law Judge at the Office of Administrative Hearings. She gathered evidence to support the child’s need for services, primarily from his clinicians. In this case, both sides, her client and the MCO, agreed to participate in mediation.

This was her first case, and it was a complicated Medicaid appeal, an area in which Cynthia had received training by Disability Rights attorneys, but one with which she had no direct experience.

“I was apprehensive, but I was able to work closely with Disability Rights NC staff,” said Cynthia. And it was successful. After many hours of preparing witnesses and analyzing records, the two sides reached an agreement in mediation. A hearing was no longer needed, and the child was authorized to receive the services he needed.

Cynthia is eager to do pro bono work for Disability Rights NC again. Although environmental law is still on her mind, her interests have definitely broadened after this experience.

“As long as it is public interest work, I’m interested,” said Cynthia.

If you are an attorney interested in volunteering for the pro bono legal services program at Disability Rights North Carolina, contact Elaine Whitford at 919-856-2195, ext. 236 or Our next pro bono training will be held in Raleigh on September 15. Registration is open now.

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Two days left to make your voice heard

Each year, Disability Rights NC seeks public input on what areas of disability advocacy it should focus. With limited resources, it's impossible to address every violation of rights experienced by a person with a disability. But we try to make as big an impact as possible and improve systemic problems.

The Proposed 2017 Targets were approved by the board of directors on June 17, 2016. Our online survey is open to receive input on our proposed targets. In addition, the survey offers an opportunity for the public to tell us about other issues that are important to people with disabilities in North Carolina. The survey will be open until 6:00 pm on August 4, 2016. Contact our office at 877-235-4210 if you need assistance completing the survey.

Options Counseling puts older adults and people with disabilities in the driver's seat

P1010928 5Right, Jan Moxley, Options Counseling Program Specialist

A scenario is set in a Disability Rights NC training session: Roberta, a 32-year-old woman with a spinal cord injury who lives in a nursing home is a candidate for “Options Counseling,” a program to help older adults and people with disabilities make decisions about current and long-term support needs. Twelve counselors-in-training in the room must role play, conducting an initial interview between Roberta and her counselor, using Options Counseling principles.

If you think terms like “person-centered” and “self-directed” are simply buzzwords, you should check this program out.

In 2012, the NC Department of Health and Human Services Division of Aging and Adult Services introduced an Options Counseling pilot program. Counselors with significant experience and education in the human services field focus on empowering clients to make their own decisions.

Said Jan Moxley, options counseling program specialist, “This service helps people think through the pros and cons of the various options while taking into consideration their situation, values, resources and preferences.”

And how is the program different from similar counseling services for long-term care? Well, you may have heard stories of counseling sessions that were rushed, not followed up on, or ended up with a plan that was based more on the counselor’s preferences than that of the client. Big no-no’s in this program.

“It’s all about the individual. What they think, want, need. The counselor’s role is to listen, reflect back to the person what he or she has heard, identify options and assist in weighing the pros and cons of each,” said Moxley. “The individual sets the pace in conversation, whether or not to develop an action plan, where to meet, when follow-up will occur.”

It works like this: the process is directed by the individual or their legal representative, but may include others that they wish to have present. The counselor conducts a personal interview to discover strengths, values and preferences of the individual. The counselor helps explore resources and service options and helps the individual weigh the pros and cons of the different options. The counselor helps develop an action plan and assists in applying for services when requested, and finally, follows up to be sure that the decisions and supports are working well. The necessary time is taken for all these steps to be fully played out.

North Carolina was one of twenty states to receive a federal grant to develop the program. With approximately 600 people receiving counseling in state fiscal year 2015-16, “this relatively young program has room to grow in terms of the number of people served,” said Moxley.  Across the state, 97 Options Counselors have been certified, and another 12 are in training.

That training adds up to 42 to 50 hours. In addition to the one-day disability rights and systems advocacy training provided by Disability Rights NC, it includes two days of training in “person-centered thinking,” four on-line training modules in Options Counseling concepts and standards, interviewing, resources basics, and health literacy and cultural competency, and an online SHIIP (Senior Health Insurance Information Program) training.

In the disability rights training, the trainees discuss as a group the different issues that came up when they went through the Roberta role play. Elaine Whitford of Disability Rights NC, who conducts the training, is pleased that none of the trainees have hesitated to believe that Roberta can move out of the nursing home if she wishes.

In fact, Roberta’s case is based on a real client, she said. A young man who was in an accident and thought he’d never be able to live outside a nursing home. “It took 18 months piecing together services, finding an accessible location in the same town where his family lives, allowing him the dignity of risk and to make his own mistakes,” she said. Now he lives in his own apartment, hires and fires his caretakers, and with assistive technology is feeding himself.

Individuals who are affiliated with an Aging and Disability Resource Center (ADRC) or an Area Agency on Aging and meet the educational and work experience criteria can apply to become certified as a counselor.

For more details on becoming a counselor, or for information on how you or a loved one can receive Options Counseling, which is a free service, contact Jan Moxley through the Division of Aging and Adult Services website.

Tel: (919) 856-2195        Toll Free: (877) 235-4210        Email:

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