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3. Definitions: The following definitions apply for purposes of this Directive and the <br />associated processes and procedures: <br />3.1. Accommodations include the following: <br />1) Any change or adjustment in detention facility operations or any modification to <br />detention facility policy, practice, or procedure that permits a detainee with a <br />disability to participate in the facility's programs, services, activities, or requirements, <br />or to enjoy the benefits and privileges of detention programs equally to those enjoyed <br />by detainees without disabilities. Examples include, but are not limited to, proper <br />medication and medical treatment; accessible housing, toilet, and shower facilities; <br />devices like bed transfer, accessible beds or shower chairs; wheelchairs, walkers or <br />canes; and assistance with toileting and hygiene. <br />2) Auxiliary Aids and Services that allow for effective communication by affording <br />detainees with impaired sensory, manual, or speaking skills an equal opportunity to <br />participate in, and enjoy the benefits of, programs and activities. Such aids or <br />services include interpreters, written materials, note -takers, video remote interpreting <br />services, or other effective methods of making aurally delivered materials (i.e. <br />perceived through hearing) available to detainees with hearing impairments; readers, <br />taped texts, materials or displays in Braille, secondary auditory programs, or other <br />effective methods of making visually delivered materials available to detainees with <br />visual impairments; acquisition or modification of equipment or devices; and other <br />similar services and actions. <br />3.2. Communication and Mobility Impairments. For purposes of this Directive, detainees <br />with "communication impairments" include detainees with physical, hearing, visual, and <br />speech impairments (e.g„ detainees who are deaf or hard of hearing, blind, or nonverbal). <br />Detainees with "mobility impairments" include detainees with physical impairments who <br />require a wheelchair, crutches, prosthesis, cane, other mobility device, or other <br />assistance. <br />3.3. Denial. A decision to deny a detainee's request for an accommodation, unless the <br />detainee is provided an equally effective alternative accommodation. <br />Permissible reasons for a facility to -deny an accommodation to a detainee who has been <br />determined to have a disability include: (1) the detainee is not denied access to the <br />facility's programs or activities because of a disability; (2) there is not a nexus between <br />the disability and the requested accommodation; (3) the requested accommodation would <br />fundamentally alter the nature of the program, service, or activity; (4) the requested <br />accommodation would result in an undue financial and administrative burden; or (5) the <br />detainee poses a direct threat to staff or other detainees. <br />Both "fundamental alteration" and "undue financial and administrative burden" are <br />generally high standards that are difficult to meet. Further, if a particular accommodation <br />Assessment and Accommodations for Detainees with Disabilities <br />