The Bureau of Substance Abuse Services Policy 1994 (Updated 2002)
The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973 challenge the nation to fully integrate individuals with disabilities into jobs and services. The legislation and regulations require that agencies make reasonable accommodations and provide accessible services for individuals with disabilities. The Massachusetts Department of Public Health, Bureau of Substance Abuse Services is committed to facilitating compliance with these important Civil Rights Acts among agencies that provide prevention, intervention and treatment services for alcoholism and other drug abuse.
In accordance with Section 504 of the Rehabilitation Act, the Americans with Disabilities Act Massachusetts Constitutional Amendment Article 114; and Executive Order 246, no qualified person with a disability shall on the basis of their disability, be excluded from participation in, be denied equal benefit of, or otherwise be subjected to discrimination under any program, service, activity or employment opportunity provided by the Massachusetts Department of Public Health or by programs funded or licensed by the Massachusetts Department of Public Health, Bureau of Substance Abuse Services.
The Americans with Disabilities Act prohibits discrimination on the basis of disability in the services, programs or activities of all state and local governments. Disability is defined as a "physical or mental impairment that substantially limits one or more of the major life activities of such individual; a record of such an impairment; or being regarded as having such an impairment" (28 CRFR Section 35). The ADA extends the general prohibition of discrimination established under section 504 of the Rehabilitation Act of 1973 to all public services. Programs and services are required to be accessible to individuals with disabilities; requirements also ensure that communication with persons with disabilities is as effective as it is for the other program participants.
The Bureau recognizes that individuals with disabilities have at least the same degree of susceptibility to problems with alcohol and other drugs as the general population. The Bureau of Substance Abuse Services estimates that seven to ten percent of the general population may need treatment for the abuse of alcohol and other drugs and that similar or greater proportions of men and women with disabilities may have limited access to the continuum of substance abuse services because of structural, programmatic, communication, and attitudinal barriers, which can restrict participation. We are committed to removing the barriers that impede access to individuals with disabilities. The goal of the Bureau of Substance Abuse Services is to achieve access to the statewide continuum of substance abuse services.
In 1986, The Executive Office of Human Services (EOHHS) sought to systematically enhance access to substance abuse services for individuals with disabilities through the formation of an Interagency Task Force. The Task Force has evolved over time and remains the prime vehicle to promote change. Membership includes representatives from the Bureau of Substance Abuse Services, the Massachusetts Commission for the Blind, the Massachusetts Department of Mental Retardation, the Massachusetts Rehabilitation Commission, the Massachusetts Office on Disabilities, Independent Living Centers, consumers and substance abuse treatment, intervention and prevention programs.
Major accomplishments since the formation of the Task Force include the funding of a Statewide Accessibility Coordinator; the naming of a Bureau of Substance Abuse Services ADA/504 Coordinator, an assistive equipment loan program, a complete ADA/504 Self Evaluation Plan from each substance abuse provider, the development of the Bureau of Substance Abuse Services Directory of Accessible Services, and accessibility improvements in more that 100 treatment programs. We continue to work with the Task Force to ensure that all agencies update ADA/504 Self-Evaluation Plans, help identify and coordinate regional and statewide training's on disability, continue to expand the directory of accessible services and assist us in developing policy and identifying goals on access to services.
Bureau of Substance Abuse Services ADA/504 Coordinator
In the past, the Statewide Accessibility Coordinator has worked with the Bureau of Substance Abuse Services ADA/504 Coordinator to promote access to programs and services. Besides coordinating the Statewide Substance Abuse and Disability Task Force and its subcommittees, the Bureau's ADA/504 Coordinator and the Statewide Accessibility Coordinator have also provided technical assistance to providers and Independent Living Centers, coordinated the 44 Access Award recipients, developed referral procedures, informed providers about laws and required regulations on disability access, and, along with Independent Living Centers, made recommendations to the Department of Public Health regarding the providers awarded access funds.
ADA/504 Self-Evaluation Plans
The ADA and 504 regulations required programs to complete self-evaluations to assess current accessibility, identify the barriers to complete access and develop a transition plan for achieving access. The Task Force has facilitated completion of the ADA/504 Self-Evaluations The plans provide opportunities to foster collaboration between addiction treatment and prevention services and Independent Living Centers. The collaboration promoted closer working relationships and increased mutual understanding within the two service systems. The Task Force members also review the plans for completion and provide recommendations for enhancements.
The Department of Public Health continues to promote working relationships and strongly encourages the development of affiliations among substance abuse providers, local Independent Living Centers, Independent Living Programs for the Deaf and Hard of Hearing, Massachusetts Rehabilitation Commission, Massachusetts Commission for the Blind, Statewide Head Injury Program, Massachusetts Commission for the Deaf and Hard of Hearing, Department of Mental Retardation and other relevant state and community disability related organizations. In an on-going effort to provide access to treatment and services for all of the Commonwealth's consumers.
Trainings and Technical Assistance
The Department of Public Health will continue to encourage training and technical assistance for substance abuse services. The Department of Public Health will continue to coordinate statewide trainings on individuals with disabilities and also encourage regional training committees to include accessibility trainings.
In the past, the Independent Living Centers received Department of Public Health funds to provide technical assistance, trainings and consultation to help alcohol and other drug treatment programs fulfill the Americans with Disabilities Act and 504 self-evaluation requirements. These contracts were designed to facilitate access to substance abuse treatment and to encourage collaboration between the two service systems.
Programs should be aware that effective treatment for individuals with disabilities may require increased training for program staff. Clinicians need to be comfortable working with men and women with disabilities as well as understand the issues surrounding this population
While the treatment goals of a program do not change, the interventions may require some modifications in order to be useful with clients who have disabilities.
Trainings which address awareness, knowledge, attitudinal changes and behavior will be made available on both a statewide and regional basis. Compliance with Section 504 of the Rehabilitation Act, the Americans with Disabilities Act and successful completion of the ADA/504 Self-Evaluation Plans are part of the Massachusetts Statewide Core Curriculum. Disability and substance abuse awareness, sensitivity and referral, and network building are also a part of the Bureau's training calendar.
Materials in Alternative Format/Prevention
The Bureau of Substance Abuse Services is committed to providing access for those individuals with disabilities so that they may obtain treatment, maintain recovery and participate in prevention programs. Prevention models may need modification for people with disabilities and take into account the increased risk factor associated with disabilities. In many cases alcohol and other drug abuse prevention materials require modification if they are to be used by persons with disabilities. The required modification may include transcribing material into Braille, large print, video or audio cassette, or some form of sign language. The Bureau is committed to exploring the development of alternative prevention and education curricula, which utilize appropriate communication methods. Resources can be borrowed from the Regional Centers for Healthy Communities located through the state, or from the AdCare Educational Institute, Inc.
The Massachusetts Department of Public Health, Bureau of Substance Abuse Services continues to creatively structure its resources to serve individuals with disabilities. With the support of substance abuse treatment programs we can ensure equal access to individuals to the full range of treatment, intervention and prevention of substance abuse continuum of care.
BSAS Access Policy for Individuals with Disabilities
The Bureau of Substance Abuse Services is committed to achieving access in the full spectrum of addiction treatment services. The goal of access can only be achieved through consistent and persistent work. Renovations may make programs physically accessible for people with physical disabilities and various auxiliary aids and services can enable equally effective communication and program participation for blind and visually impaired, deaf and hard of hearing individuals and individuals with cognitive dysfunction. However, true integration into services requires staff learning and skill development that often occurs over time through increased experience. The Bureau is committed to long-term support for staff development. The Bureau's goals are guided by eight principles:
1. No qualified person with a disability shall on the basis of their disability be excluded from participation, be denied the benefits of, or otherwise be subjected to discrimination under any program, service activity or employment opportunity provided by programs under or licensed by the Massachusetts Department of Public Health, Bureau of Substance Abuse Services.
This non-discrimination principle is a reinstatement of the thrust of ADA and Section 504 regulations and provides the starting point for all other principles. Employees and clients of all programs shall be notified of the agency non-discrimination policy and the availability of accessible services.
2. Each provider will designate an Access Coordinator as specified in the Executive Office of Health and Human Services programmatic access and affirmative action equal opportunity certification.
The Access Coordinator is responsible for the development and implementation of the program's ADA/504 Self-Evaluation Plan and Annual Updates. The Access Coordinator is also responsible for ongoing submission of information on accessibility improvements to the Statewide Access Coordinator for inclusion in the Bureau of Substance Abuse Services Directory of Accessible Services. Coordinators will also respond to any complaints of unequal access, establish grievance procedures, promote trainings for individuals with disabilities, participate in the Substance Abuse and Disabilities Task Force and promote entry to services. Because of the critical nature of this position, it should be filled by a senior management person within the organization.
3. The Bureau of Substance Abuse Services require all programs to submit a complete ADA/504 Self-Evaluation Plan and Annual Update forms each fiscal year as a pre-qualification requirement for contracting.
The ADA/504 Self-Evaluation Plan is the starting point for a comprehensive analysis of the Agency and its services. Self-evaluations are also required for compliance with the 504 regulations. The purpose of the ADA/504 Self-Evaluation Plan is to identify barriers to access and develop a transition plan with timelines for removing those barriers. This is a departmental requirement for all contracts.
4. Programs funded or licensed by the Department of Public Health must modify policies, practices and procedures to enable consumers with disabilities equal access to services and programs.
Program policy modifications must be initiated where feasible in all services and should be included as part of staff orientation and training.
5. Programs that relocate must find space that is accessible. Programs that renovate their existing space must meet accessibility standards in order to maintain funding.
Renovations must meet current architectural standard for accessibility. If a program moves into an inaccessible location, the agency will no longer meet contract prequalification requirements and will not be eligible for contract renewal.
6. Agencies that provide services in inaccessible facilities must ensure that services are provided for clients with disabilities.
If services are not accessible, services shall be provided through alternative methods. Inaccessible outpatient programs must provide individual and/or group counseling and intervention services at an alternative accessible site within the geographical area. Residential programs must make all reasonable efforts to serve individuals with disabilities. Referrals do not satisfy the ADA/504 accessibility requirements. Programs are expected to meet facility modifications timelines specified in their ADA/504 Self-Evaluation Plan.
7. Agencies that have not previously contracted with the Department of Public Health must have completed ADA/504 Self-Evaluations and have Accessible facilities as prequalification requirements.
All new providers will be required to ensure that the services will be provided in accessible facilities and that appropriate policies and procedures are in place to ensure communication access.
8. Individuals with disabilities have priority status on program admissions.
Federal Regulation 45 CFR Part 96 specifies that three groups must be admitted to addiction treatment before all others: pregnant women who are injection drug users, injection drug users and pregnant women. In Massachusetts individuals with disabilities must also be given priority status and admitted promptly.
This information is provided by the Bureau of Substance Abuse Services within the Department of Public Health.