RSA-509 for FY-2016: Submission #101

North Carolina
9/30/2016
General Information
Designated Agency Identification
Disability Rights North Carolina
3724 National Drive
Suite 100
Raleigh
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27612
http://www.disabilityrightsnc.org
(919) 856-2195
(888) 268-5535
(877) 235-4210
(888) 268-5535
(919) 856-2244
Vicki Smith
Vicki Smith
Vicki Smith
(919) 856-2195
217
Part I. Non-Case Services
A. Individual Information and Referral Services (I&R)
0
397
397
B. Training Activities
17
736
Overview of State and Federal Fair Housing Laws." In October 2015, the attorneys of Disability Rights NC provided training to the staff of the North Carolina Human Relations Commission and local Human Relations staff members on the requirements of the Fair Housing laws of the North Carolina general Statutes and the federal Fair Housing Act. the presentation included specific guidance concerning a tenant's requests for accommodations and modifications, as well as the law governing a tenant's right to the use of a service animal.<p>"
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C. Information Disseminated to the Public
2
14
0
36775
132
0
Radio and TV Appearances = 2 specific to PAIR (concerning the class action settlement in Pashby v. Wos).<p>Newspaper Articles = 1 specific to PAIR (a Press Release).<p>Publications, etc. = 2 specific to PAIR (a newsletter mailed in May 2016 to a mailing list of 5,820 addressees and an eNews publication sent in June 2016 to 3,906 both included articles and information specific to PAIR).<p>Facebook likes/friends as of 9/30/2016 = 3,984<p>Twitter followers as of 9/30/2016 = 761<p>
Part II. Individuals Served
A. Individuals Served
21
229
250
2
B. Individuals served as of September 30
12
C. Problem Areas/Complaints of Individuals Served
4
16
8
8
8
16
11
0
0
171
0
1
0
0
0
2
7
D. Reasons for Closing Individual Case Files
221
0
2
0
0
1
0
0
15
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E. Intervention Strategies Used in Serving Individuals
0
217
3
3
4
2
10
0
Part III. Statistical Information on Individuals Served
A. Age of Individuals Served as of October 1
0
11
127
38
74
B. Gender of Individuals Served
157
93
C. Race/Ethnicity of Individuals Served
5
12
3
142
1
82
4
1
D. Living Arrangements of Individuals Served
205
34
0
0
2
1
2
1
1
3
1
E. Primary Disability of Individuals Served
8
11
0
84
5
1
0
11
21
7
25
63
0
4
0
10
Part IV. Systemic Activities and Litigation
A. Systemic Activities
0
0
{Empty}
B. Litigation/Class Actions
12359
7
Pashby v. Cansler was a federal class action challenge to changes made to Personal Care Services (PCS) under the States Medicaid plan. The suit alleged that NC DHHS was violating the ADA and Olmstead by restricting the eligibility criteria for In-Home personal care while leaving the criteria for Adult Care Home personal care unchanged, thus forcing people into adult care homes in order to receive any services at all.<p>In December 2011, District Judge Terrence Boyle granted the plaintiffs motion for a Preliminary Injunction, thus forcing the state to restore services to more than 2,000 recipients of In-Home PCS. The State appealed, and in March 2013, the Fourth Circuit issued its opinion, Pashby v. Delia, 709 F.3d 307 (4th Cir. 2013), affirming the district courts issuance of an injunction prohibiting the state from enforcing the new PCS policy.<p>After returning to the district court, the parties engaged in prolonged settlement discussions resulting in an agreement by which the state Medicaid agency agreed to administer the two PCS programs using equivalent standards.<p>Judge Boyle approved the terms of settlement in the case after a Fairness Hearing held on April 1, 2016. That approval began a monitoring period during which plaintiffs counsel is permitted to review all training materials used in the administration of the PCS program. At the conclusion of the monitoring period and if no additional violations occur the case will be finally dismissed.<p>In sum, more than 12,000 Medicaid recipients who were denied or terminated from PCS services were either reinstated or re-evaluated under the new, equivalent criteria.<p>
Part V. PAIR'S Priorities and Objectives
A. Priorities and Objectives for the Fiscal Year Covered by this Report
For each of your PAIR program priorities for the fiscal year covered by this report, please:
  1. Identify and describe priority.
  2. Identify the need, issue or barrier addressed by this priority.
  3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
  4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
  5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions.
  6. Provide at least one case summary that demonstrates the impact of the priority.
- Priority 1. Advance the right of people with disabilities to community-based services and supports that allow them to remain in their homes and integrated community settings, or to transition out of institutions into the least restrictive community setting appropriate to their needs.<p>- Need/issue/Barrier Addressed: Many people with disabilities are being denied their rights to access appropriate community based services. Too many people with disabilities who could successfully live in the community with sufficient services and supports are forced into institutional settings in violation of their right to receive services in the least restrictive environment as required by the integration mandate and by the Olmstead case. Individuals with significant disabilities cycle in and out of institutions due to gaps in the publicly-funded service delivery system. The system is biased towards institutionalization over home and community-based services, due in part to an inadequate provider network. Individuals face additional barriers due to a lack of robust due process in the managed care Medicaid system.<p>- Indicators of Successful Outcome: A settlement was reached in the longstanding class action concerning Medicaid Personal Care Services, Pashby v. Cansler. Under the agreement, people who receive these services in their own homes will be treated the same as those who receive the service in an Adult Care Home. Those who were terminated from the service will be reassessed; some (those with a cognitive impairment) will be immediately reinstated.<p>- Collaboration: In the Pashby case, the National Health Law Program and Legal Services of Southern Piedmont acted as co-counsel with Disability Rights NC. In addition, Disability Rights NC continues to collaborate with Legal Aid of North Carolina and other advocacy groups in the state such as the NC Children's Collaborative, Benchmarks (a provider membership group) and others.<p>- Number of Cases: 23 + 1 class action.<p>- Representative Case Summaries:<p>SS, a woman who had been caring for her 88-year old mother who has Alzheimer's Disease, called Disability Rights NC after she had received notice from the state Medicaid agency that her mother's Personal Care Services were to be terminated. The mother had been receiving the maximum number of hours of Personal Care permitted under the service definition - 80 hours per month. A Disability Rights NC attorney pursued a Medicaid appeal on behalf of the family. At mediation (as required by the appeal procedures) the need for the service was explained and certain mistakes made by the assessor were corrected. As a result of this advocacy, not only was the Personal Care Service restored, but the Medicaid agency also authorized an additional 50 hours per month as permitted for individuals with memory loss.<p>EW is 53-years old and uses a wheelchair. She had been struggling because her power chair, provided by Medicaid, had broken more than a year previous and not been replaced. A
B. Priorities and Objectives for the Current Fiscal Year
Please include a statement of priorities and objectives for the current fiscal year (the fiscal year succeeding that covered by this report), which should contain the following information:
  1. a statement of each prioirty;
  2. the need addressed by each priority; and;
  3. a description of the activities to be carried out under each priority.
- Priority 1. Advance the right of people with disabilities to community-based services and supports that allow them to remain in their homes and integrated community settings, or to transition out of institutions into the least restrictive community setting appropriate to their needs.<p>- Need Addressed: Many people with disabilities have their independence threatened by the diminishing amount of funds available for community-based services under the States Medicaid program. Many are denied necessary services by the seven managed care organizations contracted to administer that program. Although these seven entities operate under identical contracts with the Department of Health and Human Services, there is little uniformity in the authorization and administration of services under the State Medicaid Plan. Many people with disabilities who could successfully live in the community with sufficient services and supports are forced into institutional settings in violation of their right to receive services in the least restrictive environment as required by the integration mandate and by the Olmstead case. The system is therefore biased towards institutionalization over home and community-based services.<p>- Activities: Monitor the settlement agreement reached in the federal class action lawsuit to restore community-based personal care services litigated by Disability Rights NC (Pashby v. Wos). Educate families and people with disabilities about their rights and how to effectively self-advocate in the ever-changing managed care landscape. Work with other advocacy organizations to educate state policy-makers concerning the needs of those with disabilities when making choices about the future of Medicaid in the State. Provide direct legal services to individuals who meet case selection criteria.<p>- Priority 2. Advocate for the employment of people with disabilities in competitive and integrated jobs.<p>- Need Addressed: There is a continued reliance on sheltered work and the subminimum wage as a default for some workers with disabilities. Other people with disabilities face barriers to finding work and staying on the job. Some chose not to work more or earn higher wages for fear of losing benefits. Finally, post-secondary outcomes for students with disabilities improve when school systems engage in transition planning that is appropriate and timely. The Individuals with Disabilities Education Act (IDEA) requires schools to begin transition planning no later than age 14. Too often, however, transition planning is perfunctory and uncoordinated. Work is the foundation for economic stability. Our clients must have access to competitive employment, free from discrimination.<p>- Activities: Provide training and outreach to the disability and legal communities about the employment rights of people with disabilities. Educate policy-makers about the benefits of training and supports that put people with disabilities to work. For individual employment cases, ob
Part VI. Narrative
Narrative
At a minimum, you must include all of the information requested. You may include any other information, not otherwise collected on this reporting form that would be helpful in describing the extent of PAIR activities during the prior fiscal year. Please limit the narrative portion of this report, including attachments, to 20 pages or less.

The narrative should contain the following information. The instructions for this form outline the information that should be contained in each section.
  1. Sources of funds received and expended
  2. Budget for the fiscal year covered by this report
    Outline the budget for the fiscal year covered by the report (prior fiscal year), as well as a projection for the current fiscal year.  Be sure to include a breakdown of dollars expended/allotted for:  administrative costs (i.e., personnel salaries, equipment, etc.); services to individuals; and other expenses (i.e., staff training, travel, etc.)
  3. Description of PAIR staff (duties and person-years)
  4. Involvement with advisory boards (if any)
  5. Grievances filed under the grievance procedure
  6. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency
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Certification
Signed
Yes
Vicki Smith
Executive Director
Tue, 11/22/2016 - 00:00
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