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communication involved, and the context in which <br />the communication is taking place. In determining <br />what types of auxiliary aids or services are necessary, <br />the facility shall give primary consideration to the <br />request of the detainee with a disability. <br />Use of other detainees to interpret or facilitate <br />communication with a detainee with a disability <br />may only occur in emergencies. <br />F. Reasonable Accommodations Process <br />The facility's process to appropriately accommodate <br />a detainee with a disability will differ depending on <br />the nature of the impairment or disability being <br />addressed. However, in certain cases, the facility <br />administrator or his or her designee shall <br />automatically convene a multidisciplinary team, as <br />described in section 4 below. <br />1. Immediate Accommodations <br />The facility shall provide detainees with disabilities <br />with necessary accommodations in an expeditious <br />manner. In many situations, the facility will be able <br />to immediately grant a detainee's request for an <br />accommodation. Where a request for <br />accommodation is immediately granted and <br />provided, and the accommodation fully addresses <br />the detainee's ability to access the facility's programs <br />and activities, the facility's response will not . <br />ordinarily involve referral to a multidisciplinary <br />team. <br />2. Medical and Mental Health Treatment <br />Many detainees with disabilities will receive medical <br />and/or mental health treatment from the facility's <br />clinical medical authority. Where a detainee with a <br />disability is fully able to access the facility's <br />programs and activities through the provision of <br />appropriate medical or mental health treatment, <br />further interactive process may not be necessary. <br />However, where the provision of accommodations <br />depends on medical expenditures requiring ICE <br />authorization, the facility shall consider whether <br />there are any interim accommodations that would <br />afford the detainee access to its programs and <br />activities pending ICE authorization (for example, <br />providing a wheelchair as an interim <br />accommodation to allow for mobility while a <br />prosthesis is repaired), and shall provide to the <br />detainee any such interim accommodations it <br />identifies. <br />3. Detainees with Cognitive, Intellectual, or <br />Developmental Disabilities <br />Referral to the multidisciplinary team may be <br />appropriate for detainees who are identified as <br />having a cognitive, intellectual, or developmental <br />disability, including a traumatic brain injury. Such <br />detainees may face difficulties navigating the <br />detention environment, including disciplinary, <br />grievance, and other processes. Additionally, such <br />detainees may not understand the process for <br />requesting an accommodation or be aware of <br />limitations on their access to facility <br />programs. Facility staff should not require the <br />detainee's participation in the assessment process, <br />and should be sensitive to the fact that some <br />detainees in this category may not perceive <br />themselves as having a disability. However, facility <br />staff should provide appropriate assistance to a <br />detainee with a cognitive, intellectual, or <br />developmental disability, even if not explicitly <br />requested (for example, reading and explaining a <br />form to a detainee with limited cognitive abilities). <br />Pursuant to Standard 4.3 "Medical Care,'" the facility <br />is also required to report the identification of <br />detainees with certain cognitive, intellectual, or <br />developmental disabilities to the ICE/ERO Field <br />Office. <br />4. Multidisciplinary Team <br />Requests or referrals that require an evaluation by a <br />multidisciplinary team include (1) detainees with <br />mobility impairments; (2) detainees with <br />communication impairments; (3) detainees whose <br />initial requests for accommodations or assistance <br />have been denied; (4) detainees who have fled <br />4.8 1 Disability Identification, Assessment, and 349 PBNDS 2011 <br />Accommodation (Revised December 2016) <br />