Reasonable Accommodation and TEAP Andrew Berger, Ph.D., Region 6 Mental Health Consultant National Wellness Conference April 26, 2001

2 Accommodation Guidelines PRH 1: Danger to self, others, and grave disability PRH 1: Does not address drugs and alcohol specifically PRH 1: A direct threat to self or others that cannot be accommodated

3 PRH 1: Appendix 103 Guidelines for Review “A qualified individual with a disability must not be denied admission to the center for safety reasons unless his or her disability is determined to pose a direct threat. This term is defined as a significant risk of substantial harm to the health and safety of the applicant or others that cannot be eliminated or reduced by reasonable accommodation or modification.”

4 DSM IV--Guide For Admissions Substance abuse—definition Substance dependence—definition Detoxification and dependence

5 What Is Covered Under Disability Alcohol dependence and disability Alcohol abuse and disability Reasonable accommodations

6 Drug Disabilities Present drug use is not considered a disability History of drug dependence and rehabilitation with no present use is considered a disability

7 More Applicant Evaluations Past dependence, successful rehabilitation, relapse and presently using—not a disability Presently abusing, no dependence—do we accept; case-by-case basis

8 When To Separate Danger to self or others Substance use is beyond accommodation MSWR versus straight medical Fraudulent enrollments

9 Interactive Process Regardless of whether applicant appears to abuse or be dependent on a substance, the interactive process must take place to comply with Civil Rights. Your documentation is just as important as your conclusion. Conclusions without appropriate documentation are not in compliance with Civil Rights.

10 Themes/Summary Danger to self or others Dependence versus abuse--DSM IV Interactive accommodation process