Webinar Transcript: Readily Accessible Lawyering for CARE Court Respondents
Presented on December 12, 2024 by Claudia Center and Kavya Parthiban
Disability Rights Education and Defense Fund

CLAUDIA: My name is Claudia Center. I am the Legal Director with Disability Rights Education & Defense Fund. And I'm here with my colleague, Kavya Parthiban, who's a staff attorney at Disability Rights Education & Defense Fund. And we're here to do a whirlwind tour of Readily Accessible Legal Services: How to Include and Communicate with CARE Court Respondents. And Kavya and I both have a lot of experience, as I'm sure many of you do, with communicating with clients with a broad array of disabilities, including mental and psychiatric disabilities. Next slide. 

In today's training we're gonna talk a little bit about what disabilities are for purposes of civil rights laws, including psychiatric disabilities. We're gonna talk about what is a covered disability for purposes of CARE Court. We're gonna talk about making things accessible and providing reasonable accommodations and how to think about those two concepts. We're gonna talk about the disability rights laws and requirements that apply to the different components of CARE Court. We're going to include some practical tips and tools for including people with psychiatric disabilities, including schizophrenia and other thought disorders. And for effective communication in these situations. And we'll have time for questions and answers. Next slide. 

Disabilities and psychiatric disabilities. Next slide. 

So just to sort of ground set level set, we're gonna review the definition of disability under the ADA. And this definition, if it applies, means that the person has certain rights under the ADA, which DREDF may be able to help you enforce as a support center. A person with a disability under the ADA is someone who has a physical or mental impairment that substantially limits one or more major life activities. And there's a lot of law on this, particularly beginning in 2008 when the ADA Amendments Act was passed. A person who has a record of such an impairment or who's regarded by others as having an impairment. Next slide. 

One thing people sometimes forget is that we have an independent body of state civil rights laws that have a different definition of disability. Before 2008, it was much broader than the ADA. And now that the ADA was clarified in 2008, they're different. They're not quite as different in terms of inclusivity. They're both quite inclusive now. So you can have a disability under state law if you have a physical or mental condition, doesn't have to be an impairment, that limits one or more major life activities. So it says limits, not substantially limits. This one is different from federal law, it has a condition that requires special education services, has a history or record of one of the above. In other words, if someone graduates out of special ed and as an adult they're considered to have a disability. Is regarded or treated as having a physical or mental condition that makes achievement of a major life activity difficult. Or is regarded or treated as having a physical or mental condition that may become a disability. So just to keep in mind all this other way to be covered. Next slide. 

Okay, so I think there's a chart. Yeah, there we go. Thank you. So this is a chart that kind of lists some of the common disabilities that are covered by the ADA and our state analogs to the ADA. So a broad variety of psychiatric disabilities, traumatic brain injury, autism, neurodiversity, intellectual and developmental disabilities, mobility disabilities, being deaf, being blind, learning disabilities, attention disabilities, mental impairments like dementia, and chronic illnesses are also covered, which may be more important these days given the impact of long Covid and Covid. Next slide. So we kind of did this one already. Here are some examples of psychiatric disabilities: Depression, bipolar disorder, PTSD, OCD, GAD, and schizophrenia, which is the one that comes up a lot in CARE Court. Next slide. Am I passing to you now, Kavya? 

KAVYA: Yeah. Great. So we're gonna talk about what psychiatric diagnosis count for CARE Court. CARE Court respondents must have a certain type of psychiatric disability, and for CARE Court it's a schizophrenia spectrum disorder or another quote unquote psychotic disorder. And these are in the same category as the DSM "Manual of Mental Disorders." And some of the words and phrases for these diagnoses include schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, schizotypical personality disorder, and other psychotic disorders. Next slide, please. 

We're gonna talk a little bit about schizophrenia. This diagnosis might be made when a person experiences auditory and/or visual hallucinations, like hearing voices or seeing things; disorganized thoughts or speech; Frequent topic changes, speech that cannot be understood; distorted or exaggerated ideas, this could be like delusions or preoccupations; or disorganized behavior or body movements. Something that's worth noting is that schizophrenia often overlaps with other disabilities including mood disorders like depression or bipolar disorder. It can overlap with anxiety disorders, post-traumatic stress disorder, intellectual developmental disabilities including autism, or traumatic brain injury and substance use disorders. Next slide. 

CLAUDIA: Let's wait for the interpreter to catch up. 

KAVYA: Thanks, Claudia. So some notes on schizophrenia and language. The currently accepted language for this disability is a person with schizophrenia, a person who has schizophrenia, a person diagnosed with schizophrenia, a person with a label of schizophrenia, or a person who experiences fear, voices, and visions. We want to avoid disability nouns like schizophrenic or the schizophrenic, and it might be helpful to mirror the language used by the individual who has the condition. So however they're referring to themselves, you can mimic that to sort of language to make sure you're centering what they prefer. Next slide. It's also important to note that there's a cycle of trauma and poverty and disability that are kind of a self-reinforcing system where each factor exasperates another, they're inextricably intertwined. To be more specific, poverty exposes individuals to chronic stress, violence, inadequate resources, and that increases the likelihood of trauma. And then trauma in turn can result in things like physical injuries or it can exasperate mental health conditions, and that contributes to disability. And then disability perpetuates trauma by limiting access to employment, maybe it increases medical expenses that puts strain on a family. And then poverty worsens disability. And so all of these things are kind of reinforcing each other, and they can be reinforced by other systemic barriers, and intergenerational biases and effects. So all that can make addressing disability specifically a bit complicated, but we're gonna kind of talk about how we can address it through readily accessible lawyering in a minute. Next slide. After the interpreter catches up. Sorry. 

CLAUDIA: So I think it's back to me Claudia. So I'm gonna run through some of the basics of disability rights laws and principles. Next slide. 

So there's an array of disability non-discrimination laws that cover different parts of our society. We have the ADA, which is our most famous law. And Title II is very important because it covers state and local government, including state courts, including county public defender offices, including county health and human services and public health departments. In the courts, people can get reasonable accommodations through the Cal. Rules of Court Rule 1.100. And Title III applies to private law firms and nonprofits like DREDF, like many of the legal services organizations that DREDF serves. We also have Section 504 of the Rehabilitation Act. Goes to federally funded entities. And then we have some state law analogs that I've listed here, and you'll get the slides, you can read them. Next slide. 

So what is disability non-discrimination? And it really is a somewhat different set of concepts compared to discrimination on other bases. So we start off, we think about non-discrimination. So people with disabilities have a right to non-discrimination. So what does that mean? And it means that you can't have garden variety intentional discrimination where you're mean to people with disabilities compared to non-disabled people, where you treat disabled people worse. But you also cannot have ways of doing things that have the effect of screening out disabled clients. Like you can't require things like let's say there's some rehab program and it requires that you volunteer 30 hours a week. Well, what if someone can't do that because of their disability? That would screen out the person based on disability. Sort of like disparate impact but a little different. You also have an affirmative right if you're covered to reasonable accommodation or reasonable modification. And that's basically changes to the usual way of doing things to include people with disabilities and to provide equality. Next slide. 

There's a right to effective communication under Title II of the ADA and Section 504. This is a robust requirement that requires affirmative steps, includes people who are deaf, hard of hearing, blind, and also people with IDD. There's also program access requirements, meaning that programs and services must be readily accessible to people with disabilities. I've been hearing about San Francisco's temporary housing for CARE Court respondents and that they are inaccessible to people who use wheelchairs. So that's a violation of program access. Next slide. And is it back to you Kavya or still me? 

KAVYA: I think so. 

CLAUDIA: Okay. 

KAVYA: So we're gonna talk about accessibility and accommodations to advance self-determination. And what that means is we're gonna take a step back a little bit from the legal definitions and framework to contextualize what it means to have a disability and what it means to increase access. Effective disability-centered advocacy requires us to have kind of an informed consciousness around what ableism is and how that intertwines with systemic marginalization. I don't think it's a surprise to anyone here that people with serious mental illness are often used as a scapegoat for societal problems. And we see punishment and dehumanization of these people through state systems because of that. Next slide. 

And I'm gonna highlight that by pointing out some statistics 'cause people love statistics. So one in four adults nationwide have disabilities. We see a higher rate of disabilities amongst Black and indigenous people, and higher rates of disabilities amongst people who are in our jail and prison population. There's two to three times the rate of disability compared to the general population, and there's also a higher rate of disability amongst unhoused people and people living in poverty compared to people without disabilities. Next slide. 

So I'm gonna start by defining ableism. And this is a definition based on Talia Lewis, who's a disability justice activist. And I'm going to leave the slide for you all to read on your own time, but summarize it by saying ableism is essentially a structure that divides bodies and minds into two categories: the norm and the deviant. It's not just based on what we typically think as discriminating against disability. Many disability justice and critical race scholars acknowledge that this belief that there is a norm is what allows us to humanize anyone who diverges from that norm. So ableism allows us to discriminate against people with disabilities, but it also allows us to see cis hetero male bodies as superior. It allows us to see whiteness as superior. And because it's enforcing a norm and then people who deviate from that norm are seen as less than. Next slide. 

And when we were defining disability before, we were kind of defining it through like a medical model of disability, which is what the legal definitions focus on. They're focusing on impairment and condition, and it's very individualized, but there's also a social model of disability. And the definition of disability under that model is that disability is not a divergence from what's normal or it's not an impairment, but it's an aspect of a person's identity, and it results from a mismatch between the disabled person in their environment. So it recognizes that the world is kind of created for the norm, and people who don't fit in the norm experience hardship because they're not able to access things the way that the folks who fit in the norm are able to access things. Next slide. 

Okay, so what do we mean by access and increasing accessibility then? Lack of access exists because, like I mentioned, a certain group of people were not considered or sometimes we're intentionally excluded when we created systems. So when we're talking about increasing accessibility, what that means is we understand that the world that we live in wasn't meant to include everyone, and we're proactively considering what certain disability related needs are and make services and information that are readily accessible to those needs so that everyone benefits, not just disabled people, but non-disabled people as well. Next slide. 

An accommodation is slightly different. An accommodation specific to the person that we are trying to accommodate. They are adjustments or changes that allow someone to be included based on their specific disability and able to participate equally. Reasonable accommodations is the term under our laws and it's what's required under disability law, and it's more reactive. So accessibility is us thinking ahead of time how do we increase access for people, and accommodations is how do we also tailor things to this person so they can participate equally. And increasing accessibility and providing accommodations ultimately allow us to combat ableism by saying that we're not just going to kind of stick to what feels comfortable for the norm. Next slide. 

And it's back to Claudia. 

CLAUDIA: Hi, Claudia here. We're gonna talk a little bit about capacity and self-determination, which is very relevant in the context of CARE Court. Next slide. 

So one of the things to remember is that capacity is a spectrum. It's not a yes/no question does a client have capacity. Whether a person has capacity can change with the context, it can change with their emotional or physical state, it can change based on what type of decision the person is trying to make. Capacity can often be strengthened. So some of the tools we use to strengthen capacity is using plain language, offering reasonable accommodations such as changing the time of the day, or the format of the communication, the duration where meetings are located, we think about breaks, we think about repetition. We think about something called supported decision-making, which was adopted in California in 2022, effective 2023, which is a formal recognition of a way that people with disabilities use trusted supporters to help them make decisions. And so we always wanna assess a person's capacity with the supports in place. Next slide. 

So with self-determination, we're giving people the autonomy to direct their care, their services, to tell their own story. And this can increase the person's experience of competency, autonomy, connectedness. It can help us get to better outcomes with the representation, and it's counter to how our system often works, our legal system, which is that people with significant mental disabilities are often subjected to procedures that take away their decision-making rights. So we're trying to combat that and help people make their own decisions with supports. One concept that I think is helpful to keep in mind is the concept of dignity of risk. That we all make decisions that have risks and benefits, that includes disabled and non-disabled people, and we wanna have respect for the right of disabled people to make that cost-benefit analysis. Next slide. 

We do wanna make some notes on how unhoused people with disabilities, psychiatric disabilities live with supports already in the community, even if on the streets. And I think sometimes people don't realize this, and it's something, for example, in San Francisco, the Coalition on Homelessness that's really tried to explain this, that if you're an unhoused person living in an encampment, you're in a group. So you're in a social group, and the group members can provide supports to people with psychiatric disabilities. So there could be, the group could provide some security against assault, including sexual assault and property theft. A group or supporters in an encampment can provide emotional and physical support, help with even dressing and getting food, sharing of resources. So sometimes the quote unquote system offers a residential program or some way to for someone to get inside, but it's really time-limited and there's no clear path to where it's going. So that can really disrupt these systems of support and it can seem like a bridge to nowhere, and that's why sometimes people don't jump on what's offered. Next slide. This one you, Kavya? 

KAVYA: I think. If you want, I can do it. 

CLAUDIA: Yeah, you're good at this one. 

KAVYA: Okay, cool. So one of the things that's important to remember for self-determination and dignity of risk is that people who have disabilities often know what's best for them and what works and what doesn't. Many people who don't have psychiatric disabilities believe that if a person has medication then that will be enough to support them with their psychiatric disability, and only medication can help. The reality is that it's a slew of things that can help support a person like therapy, self-care. Many folks with serious mental illness talk about the benefit of peer support. Routine and/or medication can help someone manage their condition, but most people do best by having like a combination of those things and a support network. And treatment can look different for everyone. and many people, when they're deciding to take their medication, they're weighing the costs and benefits of that medication. Sometimes medication can make people feel worse in other ways and so that's the reason they're choosing not to go through with certain medication, or the medication that's being provided to them exasperates other parts of their disability or doesn't really help manage their symptoms. So the solution to things, to the consequences of serious mental illness, isn't always just connection to medication, and making sure that we're talking to people and understanding why they're choosing what they're choosing can help us figure out a plan that's best for them. Next slide. 

And this part's going back to me. We're gonna talk about some tools that you can use to provide readily accessible legal services. I wanna quickly note that we're talking about CARE Court, and CARE Court was specifically created to address that overlap between homelessness, incarceration, and hospitalization, serious mental illness. And what all of us know is that many of the people who are going to be CARE Court respondents have already cycled through other court systems and services that have tried to kind of address some of these issues. But the way that they've tried to address serious mental illness is not by thinking about accommodations and accessibility and instead having a black-and-white thinking about does this person comply with the service or not and is that going to be enough to help them. Why Claudia and I are kind of going through the disability rights framework and then also ableism, accessibility, self-determination, is because what we know is that self-determination is what is best to help someone attain the outcomes that they want. And CARE Court, even though it doesn't provide that many new services and supports, by focusing in on serious mental illness, it gives us an opportunity to allow accessibility and accommodations be at the forefront and that increases people's self-determination and can potentially lead to better outcomes. So let's talk about what readily accessible legal services are. Next slide. 

Okay, so readily accessible services means you're making your default practices accessible for a wide range of clients regardless of whether if you know a client has a disability or not. What that looks like is plain language, which means avoiding legalese, and we'll go in depth in that in a bit, making the implicit explicit. So you don't assume that everyone has the same background knowledge. You make the links. Approaching clients with humility, curiosity, attentiveness, and compassion, which I'm sure everyone here is already doing. Having flexibility and responsiveness. Having trauma awareness, and being ready to implement common accommodations and practice asking people what support allows them to fully participate. Next slide. 

Now, when we're trying to make services readily accessible for people with mental disabilities, it's important to recognize that many mental disabilities are less visible than physical disabilities. So it might be less apparent what accommodations are needed. The way that we kind of make things accessible is we first ask a person what is most helpful for them, and then we tailor how we deliver information, how we set up space when we're interacting with people with mental disabilities, how we interact and ask questions are a little different, and then we engage with certain supports. Next slide. 

Okay, so we're gonna talk about how to deliver information first. Perfect. You wanna make sure that the information that you're providing is easy for many kinds of people to understand. So we talked about plain language briefly. What plain language means is we're communicating information at a typical fourth to fifth grade level. You should also have notepads handy to utilize visual aids to help people understand the information you're communicating visually. You can ask people if they would like speech-to-text during meetings so they can read and follow along. You can provide them large font notes beforehand or a pocket talker for hearing loss. You give information one piece at a time and give breaks to check back in and see if the person that you're talking to is understanding each piece of information. A lot of times, and I'm guilty of this too, we tend to give people all the information at once and then go like, "Does that make sense?" And it's hard for a person to say, "No, actually I got lost in the first part." So they'll just say yes, and then we actually miss opportunities for them to really participate equally. Next slide. 

So plain language that's readily accessible, it helps people with disabilities and everyone else. What it means is we're using concrete words instead of legalese. It's beneficial for a wide group of people if they're in stress and crisis, are struggling with information overload, or having withdrawal symptoms, and it's a good practice to do for everyone even before you've identified if they have a disability. The next slide is gonna show like an example of that. Great. So plain language doesn't mean that you're like avoiding giving information or taking away information. In fact, it might mean that you're actually spending extra time to explain something and giving more information. The goal of plain language communication is that the person who's getting the plain language description is getting exactly the same thing that a person without plain language is getting. So for example here, instead of saying, the court found that you may meet the criteria for CARE Act and order the county to investigate and submit a report to us whether you meet the CARE criteria. A plain language example of that would be, the CARE Act only focuses on some groups of people. The judge thinks you might be part of one of those groups. The judge asked a county agency called whatever to look into whether you fall under the CARE Court Act, the county will then try to contact you. After the county will write a report and give it to the judge. The report will tell the court if the county thinks you meet those requirements, and then the judge will decide if you do. Saying the same thing as the first one, but it's just a lot more clear about what's happening and is using concrete terms instead of legalese. Next slide. 

An app that I love using to help me with plain language is an app online that you can type in called Hemingway. And it's a platform that tells you what grade level you're speaking at and it highlights the text to show you what you can change to make it more accessible to fourth or fifth grade. I'll let this example be here for you all to look at, but I was working with the client with a cognitive disability and had a psychiatric disability, and for her the grade level that made the most sense was second grade. And so this is the prompt that helped us get to that level. I've also heard people using ChatGPT or Microsoft Word for readability. So you all can play with those things but practicing before you talk to your client and having a plain language script is really helpful. Next slide. 

I also love utilizing visual aids. Visual aids are a great tool 'cause they can support someone in comprehending complex information by understanding the context and following along with a visual. So, for example, sometimes court can be really confusing and there's so many different actors. So when you're explaining a process to someone, you can kind of draw out the courtroom and say, here's typically where we sit, here's where the judge sits, here's where county council sits, and this is the way in which the order of information is delivered to the judge, just so they can kind of visualize what's happening in the process. I've used visual aids to make sure, visual aids have helped determine whether someone has been competent or enough in trials that I've been in. And so I really recommend using visual aids when you're trying to describe something to a client. Next slide. And I'm going to pass it off to Claudia. 

CLAUDIA: Thanks, Kavya. So the next part is about setting up space for your readily accessible legal services and thinking about how to have meetings that might work better for the people you're communicating with. Next slide. 

So a lot of people with mental disabilities may have trouble with sort of stimulation and sensory processing, and setting up the space to reduce sensory input can be helpful. So for example, having a space that does not have bright lights, that does not have loud areas, avoid strong smells and so on. Of course, if someone's in jail, it may be limited what you can do, but if you have control over it, you can minimize the sensory overload. We try to provide breaks to allow the person to take space and come back to the topic. This means scheduling more time, which can be hard depending on someone's caseload. We offer to allow a support person or support animal to be near. Snacks and water can help people stay hydrated and have their blood sugar where they need it to be. We try to offer to reschedule appointments if the person can't focus. We offer to meet people outside or in an area where both people are comfortable. We, for some people, some people wanna see facial expressions, and so we think about allowing a Zoom meeting rather than a phone call and something like that. Next slide. 

For unhoused people, they may be stressed out about their belongings and wanting to have a place to put them to be safe and secure. And so we recommend that people think through this ahead of time and to provide a secure safe space for people to temporarily store their belongings and to make Zoom or Google Meet options available if that works for the client. Next slide. 

So some people may not want to be on the phone. I mean lots of us don't do phone calls very much anymore. And so for some clients this may be because of information overload, or a fear of confidential information being shared, or an inability to find a quiet place where the person can focus. So there are steps that we can take to make a call more accessible. One idea is to make a plan before the phone call to support access needs. Letting the person know when the phone call's gonna happen and sort of planning out how they're gonna be in a place that will work for them for the phone call. You can provide plain language questions or an agenda ahead of time. Remind clients to try and find a quiet, comfortable place to have the phone call. Ask the person if they'd like to have the a supporter with them while they have the phone call, and we'll talk about attorney-client stuff in a minute, and again offer video call if that works better. Next slide. Goes back to you, Kavya. 

KAVYA: Thanks, Claudia. So we're gonna talk about some tips when it comes to interacting with clients with a serious mental illness. Next slide. 

So first and foremost, things that you all are already doing is expressing compassion and empathy. We just need to say it though. The next thing you do is quite simple: You ask them proactively how best you can support them. And I try not to ask a broad how do I support you question, I think I try to give people examples of ways that we can support them. So instead of saying like, "How can I support you in this meeting?" You can say, "How best do you remember things? What type of reminders are helpful? Would text reminders be helpful?" Giving people options usually helps them kind of elicit more. Another really important point is to not dispute the person's understanding of their mental health or situation. It's supported to meet people where they're at. I can never say the word, but I think it's called anosognosia, and it's basically a neurological condition where a person with a disability is maybe unaware or unable to acknowledge their condition. So if you're thinking of people who are having paranoid thoughts or delusions, this can maybe be a part of that, and denying or minimizing the existence or the severity of their disability can make that person feel like a desire to withdraw more. And the thing that makes these conditions worse is isolation. And so what that means is not that you have to tiptoe around mental illness with a person, or avoid that topic of mental illness, but it does mean that you're creating a space where you're allowing the person to kind of talk about what feels true for them and then working from there about how do we reorient the space so you feel good. For example, I had a client recently, they're very paranoid about people listening into their conversations and thinks that the social worker that they have to work with often is secretly listening in on their conversations. And so in our meeting, when we were trying to talk about next steps, they kept kind of worrying about the social worker listening in. And so instead of saying like "The social worker's not here, like this is a delusion or a paranoid thought," we switched the call to a Zoom call and I was able to kind of show them the space that I was working in that no one was in there and then locked the door. And said, "Okay, I also want to make sure this person's not listening into the conversations 'cause that's something that you're worried about." And doing that piece and it kind of allowing them to express their fear and not disputing it then allowed us to have a more productive meeting. And so that creating that support, not disputing their experience of the world is helpful to kind of move to the next step. You can also make sure that you ask open-ended questions to identify their preferences, values, and decision points too. I'm waiting for interpreter and then we'll do the next slide. 

It's also important to include more of a time cushion when you're working with folks with serious mental illness. So for example, if a interview or that you typically do takes half an hour, maybe plan for an hour, and that's because you wanna allow for some level setting in the beginning, allow for breaks and going back and forth with the person to make sure that they understand. Level setting at the beginning means you're providing in plain language what your main questions are and what you would like to be answered. You can offer a schedule or agenda to the person beforehand and tell them how long you're typically planning to talk about each time so that you both can kind of keep on track. You can ask about accommodations and be ready to employ them earlier. For example, if you're meeting your client and it's hard for them to sometimes follow the conversation, you can offer Zoom and say, "There's closed captioning texts, so if you're able to read, we get lost, you can refer back to those Zoom captioning notes." You can offer breaks ahead of time to them and let them know that they should ask for pauses whenever they're feeling a bit overwhelmed, because that they keep pushing through when they're not ready, it makes the meeting not as productive and you'll have to revisit things anyway, and let them know ahead of time too that you might take pauses at certain points and ask them to explain what you told them in their own words just to make sure that you both are on the same page. Something I like to say to clients is I might ask you to repeat back what I said and it's not because I'm trying to test you, I do this with all clients, it's just because I wanna make sure I'm being clear when I'm telling you what I need so that we're on the same page. Next slide. 

Mirror the individual's level of communication when possible. This is using the same language that they're doing. If a person talks in shorter sentences or uses one word answers to explain something, that might mean you might need to build pauses or ask more questions so that they can give you more. The thing that's really important is to be aware of baby talk. Sometimes people think the way to be accessible to people with mental disabilities is to talk to them like they're a baby, and that's not the case. You might just have to enforce more breaks or explain things a bit more, but don't talk to this person like they're a child. When asking for more information, you should also give examples of what's helpful. That's kind of like what we were saying about giving specific accommodation points to them beforehand. So for example, let's say you're trying to access services through the regional center, and you need to gather information about whether this person had a qualified disability for the application, instead of asking, "Did you have a qualified disability?" You can say, "Do you have any records or history of a disability?" For example, some clients are able to look at an IEP record from when they were in school or an SSI record in the past that diagnosed them with certain disabilities, and that would be helpful for the application. Those examples will help like elicit more information. Next slide. 

Plan to ask the client to repeat in their own words a question like I mentioned before. A suggestion could be I wanna do my best for you, I wanna make sure that we understand what each other's saying. So can you let me in your own words what we talked about for this section. And sometimes people will give you a bunch of information at once and only a piece of that is what you wanna go into. So you how to kind of like acknowledge what someone said fully and then also kind of zone in on what you need is you can repeat back the specific point that the client made that you need and say, "Thank you for all that information. You said that you remembered being in a smaller classroom while you were a kid. I kind of wanna ask you a bit more about that. You also said someone was assigned to you. I can explain why this information is important for us to know if you had a disability later, but I want to kind of dive more into that." And then again, don't question a person's understanding of their mental health or disability. 

Next slide. And then talk generally when diagnoses feel wrong to a person. So if a person disagrees with a schizophrenia diagnosis, you can ask them why are they telling you to come to CARE Court, so then they can say why other people are telling them to come to CARE Court. You can ask them what medications would you want, what has worked for you in the past? Who do you want in life? What would help you with this problem that you named? And not pigeonhole them into what other people are telling them to do. Don't pressure someone to agree with a plan of action immediately. You can always give them time to consult with trusted sources or a person before saying yes to a certain service that you might be connecting them with in CARE Court. You can also consider psychiatric advance directives. We're not gonna go into that much detail about it, but it's a legal tool that's similar to a living will that allows a person with a psychiatric condition to state their treatment preferences in advance of a crisis or hospitalization. And then also consider supportive decision-making, which Claudia talked about. Next slide. 

And then figuring out accommodations. Next slide. 

So you wanna ask about disability accommodations in a simple, concrete, non-judgmental way. For non-disabled people, sometimes talking about disability-related needs feels uncomfortable, but accommodations and support needs are something that none of us have to be ashamed of. And for many people with serious mental illness and other disabilities, asking for and accommodating their disability is part of their everyday life. So you can ask them directly, is there something that can help you understand this information? You can offer accommodations. Sometimes people have trouble keeping tracks of dates and times. Would it help if we did X, Y, Z with you? Listen to what the person says, they often know what works best, and be ready to ask them more detailed questions and come up with alternatives. Many people don't know the word accommodation is what they're using in their life. So you can ask like, "What supports do you use? What has helped you in the past? How does this support or accommodation help you?" Next slide. 

And if people don't know of accommodations or supports that can help them, a resource that I like to look at that suggests accommodations is a website called askjan.org. It's a website that gives examples of job accommodations for various disabilities. Like you can look up a disability, click it, and it'll give you job accommodations. But oftentimes those job accommodations can also be used in real life. So if a person doesn't know what accommodations could be helpful for them, you can go to askjan.org and brainstorm with them. Next slide. And we're giving it back to Claudia. 

CLAUDIA: Okay, so this is Claudia. I'm gonna talk a little bit about supporters in the context of supported decision-making, which I mentioned before, was recognized in California in our statutes in 2022. It's called AB 1663. Next slide. 

So what role can supporters play to help people with disabilities in representation and proceedings like CARE Court proceedings? So a supporter, as requested by the client, a supporter can help the client with logistics like scheduling meetings or remembering what time something is, arranging transportation. A supporter can help the client communicate. For example, a supporter could respeak a client's words if the speech is difficult to understand for someone who doesn't know them really, really well. A supporter can help the client understand legal or other complex concepts. We want to do what we can to make what we say about legal concepts accessible. But it's also true that a supporter who really knows the client may be able to put it in words that they understand. The supporter can help implement supported decision-making plan, a decision that was made through supported decision-making. And so throughout all this, we always wanna remember who's the client and who's the supporter. And when we have supporters that work regularly with our clients, we actually have the supporter sign at the end of the retainer saying, well, we put in the retainer that so and so is supporting. And then we have that person sign the retainer to say, "I understand that I'm the supporter, I'm not the client. The client makes all the decisions." Next slide. 

So I'm gonna talk a little bit about attorney-client privilege. This is gonna be a little bit of a whirlwind because it can be a longer topic. But when you want to think through attorney-client privilege, you wanna consider the rules of professional conduct Rule 1.6 and California Business and Professions Code 6068, which are about attorney-client privilege. And then you might wanna look at the evidence code. There's an evidence code that excludes, so it defines attorney-client privilege as being when it's only the attorney and the client. But then it says the privilege is not extinguished if someone is present there to further the interest of the client in the consultation or those to whom disclosure is reasonably necessary for the consultation or the communication. And if you look at the Law Revision Commission comments which have been quoted in published case law, state case law, the examples in those Law Revision Commission comments are having a spouse or parent present to support the client does not extinguish attorney-client privilege. So we do have some tools for how you may want to strengthen or protect attorney-client privilege when you're using a supporter. But there are a lot of authorities that you can use to say it does not extinguish it. You can also look at ABA Model Rule 1.14, the comments, which also says that when necessary to assist in representation, the presence of family members or other supporters generally does not affect privilege. Next slide. 

I probably should have put this one earlier. So what is supported decision-making? You could read the bill AB 1663 which describes supported decision-making, but basically it's an individualized arrangement in which disabled adults choose other adults to support them in understanding, making, communicating choices, acting on their choices. Supportive decision-making can strengthen capacity, can avoid the need for conservatorship or CARE Court proceeding. It can be formal, written, or informal. And it again recognized under California law. Those are the citations from AB 1663. Next slide and I think it's back to Kavya. 

KAVYA: Yeah, we gave some examples of how you can incorporate accessibility and reasonable accommodations within the CARE Court process. So these slides are gonna be given out to you all at the end and you can look at those examples. But for example, if we can go to the next slide, they talk about how you can use plain language or visual aids at each point of the CARE Court process. So this is a tool for all of you to maybe consider how you can increase accessibility and accommodations once you're working with CARE Court respondents. But I think with the last three minutes we can move it to questions and answers just so that we can go in on and on any specific thing that feels most relevant for folks. 

CLAUDIA: Kavya and I are also easy to find if you want to email us. 

KAVYA: Just also wanna offer if people want support in plain language or like making translations of things into plain language, that's something that DREDF can support with, or we can give examples of visual aids, or if there was something specific there that you're like, "I want more information on this," please contact us. 

CLAUDIA: And again, I mentioned this earlier, this is Claudia, that if your clients who are CARE Court respondents are facing disability barriers and you think it would be helpful for DREDF to get involved to send a demand letter to a county where that's our role as a support center, we're ready to do that. And that could be that housing arrangements are not allowing reasonable modifications, they're not accessible to wheelchairs, no effective communication, maybe excluding support animals and so on. Allie put the evaluation in the chat, I believe, and we definitely appreciate the evaluations. We'll be doing three more CARE Court trainings over the next few months, and we really urge CARE Court representatives to let us know the problems you're seeing.