What are Targets
People with disabilities have a great need for legal assistance. Consequently, DRNC receives far more requests for legal assistance than we have the resources to accept. We are far short of sufficient funding to hire the staff needed to address every disability-related legal matter in North Carolina. We understand how disappointing it is when people with disabilities contact us for help and we are unable to assist. To make the most of our limited resources, DRNC works with the disability community to identify the legal problems that are the most pressing, widespread, or that no one else is equipped to handle. By being strategic about how we use our funding and staff, we hope to make the biggest impact possible for the most people. Many people will never even know how they have been helped by our work but their lives will improve.
DRNC’s Advocacy Targets are the result of our continuous collaboration with the disability community. They are published to share the issues we are focused on resolving or improving based on the requests for help and community input we receive. We have found this to be the most effective way to respond to the tremendous demand on our resources and inform the public where we are focusing our work.
Read a summary of our targets.
DRNC’s core advocacy activities are listed at the end of this document. We also invite public comment on how we carry out this ongoing work.
DRNC also seeks private grants to increase our advocacy for disabled people. This work is defined in project proposals and is not subject to public comment.
DRNC’s advocacy targets for Fiscal Year 2025 are as follows:
Keep students with disabilities in school
Rationale
Students with disabilities are excluded from school more often than students without disabilities through suspensions, expulsions, homebound placements, modified day schedules, alternative school placements, and juvenile court involvement. For example, according to North Carolina’s 2023 school report cards, students with disabilities were short-term suspended at more than twice the rate of students without disabilities. Students with disabilities are susceptible to being excluded from school when they exhibit challenging behaviors, even when those behaviors are related to their disabilities. They are excluded at high rates even though students with disabilities are legally protected from long-term discipline for behaviors related to their disabilities. Black students with disabilities are suspended from school more often than white students with disabilities. Some forms of long-term exclusions are not tracked consistently, such as repeated shorter-term informal suspensions. Many students with disabilities in North Carolina are pushed out of school when they are told they can only come to school for a few hours a day, or that they must receive instruction only at home, due to disability-related behaviors. School exclusions may result in months or years of lost instructional time for students with disabilities.
Sometimes students with disabilities are excluded from school before being formally identified. Studies indicate that up to 85% of children in juvenile detention facilities have disabilities that make them eligible for special education services, yet only 37% received these services while in school. Black and Brown children are over-represented in juvenile justice facilities. DRNC has been expanding its education-related monitoring to include youth developmental centers. We have expanded our efforts again this fiscal year to include juvenile detention centers.
Target Populations
- Students with disabilities serving a lengthy homebound placement or modified school schedule who can be served in a less restrictive setting if the school provides an appropriate placement, supports and services
- Students with disabilities serving a long-term suspension, multiple short-term suspensions, repeated or long-term in-school suspensions, informal send homes, expulsion, or alternative school placement in violation of legal disciplinary safeguards, or who have been selected for discipline because of race or income in addition to disability
- BIPOC students with disabilities with an active juvenile court referral or at-risk of juvenile court involvement
- Students in NC’s youth development centers (YDCs) and juvenile detention centers (JDCs) who are not receiving appropriate special education services
Advocate for people with disabilities to have equal access to integrated jobs that pay at least minimum wage
Rationale
People with disabilities face many barriers to finding work, keeping their jobs, or getting better jobs. Some are unfairly screened out of opportunities, demoted, or even fired. Some cannot receive the accommodations they need. Others are not paid fairly and work in separate settings like sheltered workshops. Still others fear losing benefits if they return to work. We will help make sure people with disabilities have the chance to be trained for fair paying jobs, understand the impact of work on their benefits, and not experience discrimination.
Target Populations
- People with disabilities facing employment discrimination or other barriers to employment, including lack of reasonable accommodations or transition services
- People with disabilities who lack appropriate training resources to find, maintain, or advance in employment
- People with disabilities who experience workplace discrimination
- People with disabilities who lack adequate information about how work may impact their benefits
Enforce the right of people with disabilities to have equal access to their communities
Rationale
Equal access is a bedrock principle of civil rights and the Americans with Disabilities Act. People are regularly denied the full and equal enjoyment of the services offered by businesses, local municipalities, and the State because of their disabilities. Disability Rights North Carolina will work to eliminate public access inequalities by upholding the rights of people with disabilities to live and participate in their communities as equals.
Target Populations
There are many ways to deny persons with disabilities equal access to a public place, program, or service. While not an exhaustive list, the following are some specific examples of issues DRNC has addressed within this target:
- Healthcare and rehabilitation providers that refuse to treat patients due to their substance use disorders and/or use of medications.
- Summer camps or school extracurricular activities that refuse to modify rules to accommodate campers or students with special medical conditions
- Businesses that refuse to allow patrons to use service animals
- Courtrooms that refuse to provide sign language interpreters or braille materials
- Public streets that are not wheelchair accessible or do not provide audio descriptions for crosswalks
- Colleges and schools that refuse to permit classroom or testing accommodations
- Organizers of large, public events that fail to allow aides and companions
This target population is vast. We are only able to provide representation to a small percentage of people who contact us with legal issues that fall under this target. DRNC therefore prioritizes access issues that perpetuate inequalities for the broader disability community.
Reduce North Carolina’s Over-Reliance on Psychiatric Residential Treatment Facilities (PRTFs)
Rationale
On any given day, 700 North Carolina children are in an institution called a Psychiatric Residential Treatment Facility (PRTF). A study from UNC in 2023 showed that in the preceding five years, over $550 million in Medicaid spending has gone to PRTF placements. That’s about $100,000 per child per year. Many of these children are in crisis because they could not get the behavioral health services they needed in their homes and in their communities. Some of the reasons for this lack of available community-based behavioral health services include: (1) there are not enough providers in the community (2) providers do not have the necessary resources to serve kids with more than one type of disability (3) the child cannot get services for more than one type of disability (4) North Carolina does not prioritize community-based treatment.
These children already in crisis are then removed from their families and their communities, and sometimes sent out of state. Such placements often further traumatize already distressed kids. A disproportionate number of these children are people of color, or in the child welfare (foster care) system or living in poverty, making out of state placements an even greater strain on their families’ ability to meaningfully participate in their care.
We know through DRNC’s monitoring activities that PRTFs can be physically dangerous and emotionally traumatic for children. The kids receive little or no actual treatment there. And studies show that children have better outcomes, at a lower cost, when receiving services in the community. Yet North Carolina does not prioritize less costly, more effective community-based treatment. DRNC continue advocacy efforts to reduce reliance on these restrictive institutions and to shift resources back into the community for our youth.
Target Populations
- Children and youth placed in PRTFs or at risk for placement in PRTFs, particularly:
- Children and youth in DSS custody
- Children and youth of color
- Children and youth dually diagnosed with both mental health and intellectual/developmental disabilities or “complex needs”
- Children and youth who have been placed in PRTFs out of North Carolina
- Children and youth who are ready for discharge, but remain in a PRTF because of a lack of community services
- Children and youth placed in PRTFs because there are no community-based services available
Reduce unnecessary institutionalization of individuals with disabilities and improve access to home and community-based healthcare services and supports
Rationale
The current health and human services system in North Carolina is biased towards institutionalization over home and community-based services. It violates the rights of individuals with disabilities to receive services in the least restrictive environment under the Integration Mandate of the Americans with Disabilities Act and the Olmstead decision. Often, people with disabilities in NC who could successfully live in the community with sufficient services and supports are stuck in institutional settings. Others currently living in the community are put at risk of unnecessary institutionalization and segregation due to cost-cutting measures and a flawed implementation of the service delivery system. Inadequacies in the provider network also result in unwarranted hospitalizations and/or involuntary commitments for people with mental health and undesired placements in facilities for individuals with intellectual and developmental disabilities. People should not have to be hospitalized or institutionalized to receive medically necessary services; this system of care is expensive and creates additional trauma.
This current system also fails to deliver medically necessary services to children and adolescents that are mandated under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provisions of the Medicaid Act (Title XIX of the Social Security Act) and would allow them to remain in the least restrictive community setting. The lack of an adequate provider network leads to both children and adults being shipped out-of-state to receive services that should be available in North Carolina.
DRNC has successfully advocated for systemic improvements over the last few years; however, we will to take a holistic approach to address remaining issues to reduce institutionalization, promote community integration, keep beneficiaries in North Carolina, and promote access to medically necessary services so that adults and children with disabilities live where they want and have the services needed to enjoy full inclusion in the community.
Target Populations
- People with disabilities in institutions who have been denied transition to the community because of a lack of available home and community-based services
- People with disabilities in the community facing institutionalization or re–institutionalization due to a denial of services or lack of available home and community-based services
- Children and youth dually diagnosed with both mental health and intellectual/developmental disabilities facing increased risk of institutionalization because of a lack of coordinated services and/or inadequate home and community-based services
Protect the housing rights of people with disabilities under federal and state law
Rationale
For the past few years, disability discrimination has been the number one source of housing discrimination complaints in North Carolina. Predictably, DRNC has noticed a steady increase in requests for help from individuals experiencing housing discrimination. Callers have been denied reasonable accommodations or modifications to make sure their home is accessible for their needs, thereby denying them access to their homes equal to the level of access available to individuals without disabilities. Others have been harassed related to their disability, charged higher rent or mortgage rates due to their disability, and/or threatened with eviction due to their disability-related needs or behaviors.
Many individuals with disabilities do not know the housing rights provided by the ADA and Fair Housing Act and/or they do not understand the eviction process (called summary ejectment in North Carolina). They are often unaware of their rights and available defenses to evictions based upon their disabilities and are unable to adequately represent themselves in proceedings. Prior to the COVID-19 pandemic, which highlighted the importance of a safe and affordable home, North Carolina’s eviction rate was more than twice the national average. Eight cities in North Carolina are among the 100 cities in the country with the highest eviction rates. Five of those eight cities rank in the top 25 US cities with the highest eviction rates.
Preserving safe, affordable housing is critical due to housing shortages and increasing costs. North Carolina is facing a housing crisis. There is currently a 207,000-unit shortage for extremely-low-income families. Finding housing post eviction can be especially tough on individuals with disabilities, who make up 20% of individuals receiving federal rental assistance in NC, due to stigmas and discrimination that make finding safe, accessible, and affordable housing a challenge. It is an even greater challenge when individuals with disabilities have criminal records, are also people of color, LGBTQ+, and/or indigent.
DRNC is committed to combating housing discrimination and predatory practices, including discriminatory evictions, to ensure people with disabilities and their households may live independently in accessible homes in the communities of their choice. This goal will be achieved through education and training, individual representation, and systemic advocacy.
Target Populations
- People with disabilities who have been denied access to housing based on their disabilities
- People with disabilities whose housing providers have denied them reasonable accommodations or reasonable modifications
- Persons with disabilities and their households at risk of losing their housing due to discrimination related to their disability or a failure to accommodate their disability-related needs
Advocate for a safe, equitable and just criminal legal system for people with disabilities
Rationale
People with disabilities are overrepresented in North Carolina’s prisons and jails and face a higher risk of violent interactions with law enforcement. They are often denied access to equal treatment throughout the criminal legal system, including during transition back to the community. DRNC continues to identify gaps in treatment and services for people with disabilities and advocates for improvement, including ensuring compliance with the ADA in institutions. We continue to be a leading advocate for people with disabilities in prisons and jails.
Our efforts related to this target include investigating the experiences of people with disabilities at each step of the criminal legal process and identifying and advocating for reforms needed to ensure the system is safe and fair for people with disabilities.
In the prison context, the Department of Adult Correction (DAC) continues to fail to identify and accommodate people with disabilities. DAC houses people with mental health disabilities in solitary confinement without providing adequate treatment. DAC also fails to identify and accommodate thousands of people with intellectual and developmental disabilities (I/DD) and/or traumatic brain injuries (TBI), leaving them at risk of abuse and ill prepared for successful reentry into the community. DRNC’s goal is to ensure that people in NC prisons and jails are no longer discriminated against and receive necessary accommodations and access to programs and services while in jail or prison and during transition back into the community as provided for by the ADA.
Within NC Jails, suicides continue to occur at an alarming rate as do deaths from substance use withdrawal or overdose. Jails are neither designed nor funded to provide mental health treatment yet have increasingly become de facto mental health facilities due to the erosion of public mental health services. DRNC is advocating to ensure jail administrators appropriately respond to a person’s mental health needs as well as their need for adequate health care. Jails (and prisons) also fail to protect the increasing numbers of arrestees in crisis due to substance use disorders and are not providing medications for opioid use disorder. DRNC is one of the few organizations monitoring conditions in our NC jails, and DRNC is confident that our monitoring will have a meaningful impact on the quality of care for people with disabilities in jails and prisons.
DRNC’s work on this target has included innovative cross-team projects and collaborations with other agencies, including filing multiparty and class action lawsuits. In April 2024, DRNC, along with ACLU and Arnold and Porter filed a lawsuit in federal court to ensure that people found incapable to proceed (ITP) to trial receive restoration assessments and/or treatment within a reasonable timeframe. We are advocating for: policies focused on improving conditions and reentry services, such as assisting recently released people in obtaining state identification and Medicaid services when they re-join their communities; the right to treatment for opioid use disorder in jails and prisons; and the abolition of long-term solitary confinement in NC prisons. We also advocate with other coalition partners for the removal of barriers to compassionate release for incarcerated elderly people with serious disabilities who have served large portion of their sentences and are eligible for medical release. We will continue these efforts in FY2025 as well.
DRNC recognizes that there are many other issues related to the treatment of people with disabilities within the criminal legal process. We have chosen to focus our limited resources on issues within our targets where we believe we can affect the most positive systemic change for people with disabilities in the criminal legal system.
Target Populations
- People with disabilities confined in NC jails who are found incapable to proceed to trial while awaiting evaluation and restoration services
- People with disabilities in prisons and jails who are not receiving appropriate treatment or accommodations for their disability
- Disabled people who are not receiving accommodations or are denied equal access to prison/jail programs and services
- People with disabilities facing barriers to restoration of services upon reentry to the community
Enforce the right of disabled people to control their own lives
Rationale
People with disabilities routinely have the right to make decisions about their lives forcibly taken away from them through guardianship and commitment proceedings. Guardianship permits an individual, a corporation, or the government to stand in the shoes of a person with a disability and make decisions on their behalf. This relationship results in the loss of some or all decision-making authority belonging to a disabled person under the notion that many adults with disabilities cannot engage in decisions about their lives and need a protector. North Carolina does not appoint attorneys to individually represent and advocate for people with disabilities during these proceedings, which has contributed to the misuse and overreliance of guardianships in our state. People of color, LGBTQ+, and indigent face additional challenges navigating guardianship proceedings.
Involuntary commitment is used to forcibly hold persons against their will when they have a mental health condition and are found to be a danger to themselves or others. North Carolina’s ongoing failure to provide affordable, quality community mental health services has perpetuated the state’s overuse of involuntary commitments, especially since they do not consider less restrictive alternatives to confinement as part of these proceedings. Forced commitments are highly traumatic, stigmatizing, and disruptive to the daily lives of people with disabilities. These proceedings are rooted in fears that people with mental health needs are different and dangerous to society.
People with disabilities have the same right to self-determination as everyone else. They are entitled to be informed, exert control in their lives, receive respectful support from those they choose to turn to for help, make decisions free from coercion, to act on their own behalf, and to direct their healthcare decisions. Self- determination is one of our most fundamental rights.
Target Populations
- People with disabilities who would like to restore their competency or prevent guardianship
- People with disabilities who are under guardianship but want to retain some of their decision-making rights, such as the right to spend time with or marry who they want
- People with disabilities who have been denied help from their guardians to transition from institutions to the community
- People with disabilities who were involuntarily committed without consideration of less restrictive mental health services
Core Advocacy Activities
Monitoring and Investigations
As the Protection & Advocacy organization for North Carolina, DRNC is federally mandated and empowered to conduct monitoring and investigations in facilities where people with disabilities live and receive services. We monitor in and investigate facilities to ensure that disabled people are treated fairly and are not abused or neglected. At times, we may focus on particular issues and settings based upon issues that meet with our attention, like making sure schools are providing the right support for students with disabilities and not using inappropriate restraint and seclusion. Another example is our focused monitoring and investigations related to the care of children in psychiatric residential treatment facilities (PRTFs). By periodically changing our focus based on community comment, reports, monitoring, or changing laws and policies, our small staff can most efficiently address the most current issues, prevent emerging problems from worsening, and improve services through systemic and individual advocacy. This work has been and always will be a critical part of DRNC’s efforts. Within our resources and priorities, we will:
- Regularly visit various types of facilities, talk with students, residents, and staff; monitor whether the places are safe from abusive treatment and neglect; and ensure legal compliance, safe conditions, and appropriate services
- Identify individuals who could live in the community with supports and advocate for their safe transition to the community with appropriate services
- Investigate deaths and complaints of abuse, neglect, or civil rights violations in facilities
- Advocate for systemic reforms to improve the quality of care and protect the rights of individuals in facilities
Outreach
DRNC’s outreach work engages and builds relationships with disabled people, communities, organizations, and other key stakeholders to increase awareness of DRNC’s services, provide education on disability rights, and connect individuals to the opportunities, resources, and supports they need to overcome barriers to living independently in communities of their choice. Our outreach aims to build, cultivate, empower, and maintain relationships with disability communities in all 100 NC counties, with a focus on rural areas, communities of color, older adults, and LGBTQ+ people. Through our outreach work, DRNC intentionally collects input from people with disabilities across NC to help inform our advocacy targets.
In addition to our ongoing efforts, DRNC’s outreach previously focused on people with disabilities who have been affected by disasters or pandemics. Currently, with support from USAging, DRNC’s outreach priority is Project ACCESS (All Communities Count Equitably for Safety and Support). Project ACCESS seeks to provide equitable access to COVID-19 and flu vaccines for disabled people and older adults 60 across NC, especially people who live in rural and/or historically marginalized communities.
Voting Rights
People with disabilities still vote at disproportionately lower rates than non-disabled people. Reasons for this disparity include significant structural and procedural barriers, and lack of focus on the needs of disabled voters by policy-makers, boards of elections, political parties, funders, voter engagement advocates and volunteers, and others. DRNC maximizes our voting rights impact by ensuring that coalition partners who work on voter engagement and mobilization make their efforts and information accessible and explicitly consider the needs of voters with disabilities in their planning. DRNC emphasizes the benefits of early voting, identify and address barriers at polling sites, and dismantle access barriers to voting, including absentee voting.
Information, Referral and Self-Advocacy Support
Another important part of the work we do at DRNC is to support self-advocacy among people with disabilities. We continually offer information and referral services, conduct outreach and education, help direct disabled people to community resources, and provide self-advocacy materials to help people with disabilities and other advocates learn about and enforce disability rights.
Public Policy Advocacy
DRNC engages in public policy advocacy with funds we raise from individual donors to support our scope of work. In accord with our important role as the state’s Protection and Advocacy organization, this work keeps the perspective of people with disabilities at the forefront of policies in administrative agencies, state rules, and state laws.
Representative Payee Reviews
DRNC is charged with ensuring that disabled people with a representative payee that receives and manages their Social Security benefits are not abused, neglected, or exploited. Our rep payee reviews include:
- An interview with the individual or organizational representative payee
- A review of the representative payee’s financial records for the requested beneficiary or sample of beneficiaries served
- A home visit and interview for each beneficiary included in the review
- An interview with legal guardians and third parties when applicable
Read a summary of the targets.