RSA-509 for FY-2016: Submission #107

State name Nevada

Report through date 9/30/2016

General Information

Designated Agency Identification

Name Nevada Disability Advocacy & Law Center

Address 2820 W. Charleston Blvd.

Address 2 Suite 11

City Las Vegas

State {Empty}

Zip Code 89102

E-mail Address jack@ndalc.org

Website Address http://www.ndalc.org

Phone (775) 333-7878

TTY Phone (NVR) ela-y711

Toll-free Phone (800) 992-5715

Toll-free TTY Phone (NVR) ela-y711

Fax (775) 786-2520

Name of P&A Executive Director Jack Mayes

Name of PAIR Director/Coordinator Lynne P. Bigley

Person to contact regarding report Cheryl Katzmark

Contact Person phone (775) 333-7878

Contact Person phone ext 7205

Part I. Non-Case Services

A. Individual Information and Referral Services (I&R)

1. Individuals receiving I&R within PAIR priority areas 140

2. Individuals receiving I&R outside PAIR priority areas 331

3. Total individuals receiving I&R (lines A1 + A2) 471

B. Training Activities

1. Number of trainings presented by PAIR staff 4

2. Number of individuals who attended training (approximate) 126

Training Nevada Disability Advocacy & Law Center (NDALC) hosts a monthly training series called Lunch, Laugh, & Learn. On February 25, 2016, community providers and clients attended the NDALC training on Paratransit 101: Eligibility, service areas, and hearings. Ken Rodriguez, director of Paratransit services for the Southern Nevada Regional Transportation Commission (RTC) presented the information and answered questions. Twenty-four people attended the presentation and were provided with RTCs Paratransit Eligibility brochures and NDALCs service priority handout.On March 31, 2016, NDALCs Lunch, Laugh, & Learn provided information on How and When to File a Complaint. The NDALC advocate explained step-by-step how to write a complaint. Handouts were provided that outlined how to determine the who, when, and where of a complaint. Examples, of written complaints were provided as templates for such agencies as: NDALC, Bureau of Health Care Quality and Compliance, and Nevada Equal Rights Commission. Twenty-two people attended this presentation.On 2/18/2016 Alzheimer and Dementia Spanish Conference participants were educated about guardianship and substitute decision making options available in Nevada. Information about NDALC mission and service priorities were also provided. About 55 people attended the conference between family members, individuals with early signs of these conditions and community partners (LV Metropolitan Police Department, Medicare Rep., Mexican Consulate, GOVCHA, among others).The Mexican Consulate/ Penn wood Apartments Event on 6/22/2016 was in collaboration with the UNLV School of Medicine. NDALC presented about effective advocacy skills, our health care notebook for children/adults, and our Navigation Pathway documents were also provided. 25 people attended the event that included: UNLV- School of Medicine students & residents, parents of children with specials needs, and individuals with disabilities. NDALCs general brochure and service priorities were also distributed to the participants.

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C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff 0

2. Newspaper/magazine/journal articles 6

3. PSAs/videos aired 0

4. Hits on the PAIR/P&A website 629876

5. Publications/booklets/brochures disseminated 3749

6. Other (specify separately) 0

Narrative NDALC attended and had booth space at several large events with a wide range of focus from elementary students, transition students, homeless, disability specific, and the Hispanic community. Some examples include:Carpenter Union Resource Fair 100FEAT Family Picnic Resource Fair - 350Las Vegas Disability Awareness Day 100Nevada Early Intervention Services Resource Fair 200Desert Regional Center Community Fair 200Clark County School District STAR Event 250Amerigroup Wellcare Open House 100Best Buddies Walk 150FEAT Parents Nights 150Hollingsworth Elementary School 300Hope Counseling Services 150Hewetson Elementary School 250Matt Kelly Elementary School 200Mexican Consulate Fair 200JT McWilliams Elementary School Fair- 250Variety School Fair 100Cesar Chavez Resource Fair 250Southwest Medical Associates Resource Fair 300Back to School Health & Resource Fair- 200

Part II. Individuals Served

A. Individuals Served

1. Individuals still served as of October 1 (carryover from prior FY) 11

2. Additional individuals served during the year 29

3. Total individuals served (lines A1 + A2) 40

4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.) 0

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 13

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility 0

2. Employment 1

3. Program access 1

4. Housing 0

5. Government benefits/services 4

6. Transportation 7

7. Education 2

8. Assistive technology 1

9. Voting 0

10. Health care 19

11. Insurance 0

12. Non-government services 1

13. Privacy rights 0

14. Access to records 0

15. Abuse 0

16. Neglect 1

17. Other 3

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor 17

2. Other representation found 1

3. Individual withdrew complaint 1

4. Appeals unsuccessful 2

5. PAIR Services not needed due to individual's death, relocation etc 1

6. PAIR withdrew from case 0

7. PAIR unable to take case because of lack of resources 0

8. Individual case lacks legal merit 0

9. Other 5

Please explain Gave client legal advice about the PARing process and made contact with the office who had PARed for him. Hewlett Packard as well. Nothing more we can do.Client stopped responding to agency.Lost contact with client.No response from client. Client didn't follow through with referrals provided. Client was not happy because NDALC was not able to get benefits approved for his son.Client did not respond to advocate.

E. Intervention Strategies Used in Serving Individuals

1. Technical assistance in self-advocacy 14

2. Short-term assistance 10

3. Investigation/monitoring 0

4. Negotiation 1

5. Mediation/alternative dispute resolution 1

6. Administrative hearings 1

7. Litigation 0

8. Systemic/policy activities 0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

1. 0 - 4 0

2. 5 - 22 3

3. 23 - 59 27

4. 60 - 64 6

5. 65 and over 4

B. Gender of Individuals Served

1. Females 20

2. Males 20

C. Race/Ethnicity of Individuals Served

1. Hispanic/Latino of any race 8

2. American Indian or Alaskan Native 1

3. Asian 1

4. Black or African American 3

5. Native Hawaiian or Other Pacific Islander 0

6. White 25

7. Two or more races 0

8. Race/ethnicity unknown 2

D. Living Arrangements of Individuals Served

1. Independent 28

2. Parental or other family home 4

3. Community residential home 1

4. Foster care 0

5. Nursing home 3

6. Public institutional living arrangement 1

7. Private institutional living arrangement 0

8. Jail/prison/detention center 2

9. Homeless 1

10. Other living arrangements 0

11. Living arrangements not known 0

E. Primary Disability of Individuals Served

2. Deaf/hard of hearing 7

4. Orthopedic impairment 13

5. Mental illness 1

6. Substance abuse 0

7. Mental retardation 0

8. Learning disability 4

9. Neurological impairment 3

10. Respiratory impairment 0

11. Heart/other circulatory impairment 0

12. Muscular/skeletal impairment 1

13. Speech impairment 0

14. AIDS/HIV 3

15. Traumatic brain injury 0

16. Other disability 5

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities 4

2. Number of individuals potentially impacted by policy changes 2150

Describe your systemic activities. SOLITARY CONFINEMENT PROJECT:In 2016, NDALC, the American Civil Liberties Union of Nevada, and Solitary Watch continued working on their joint project to investigate and report on the discriminatory and abusive use of solitary confinement of prisoners with disabilities at Nevada prisons.The three agencies are concerned that Nevada inmates with disabilities are placed in solitary confinement and remain in solitary confinement for months or years. The agencies received approximately 200 completed surveys from inmates and NDALC conducted follow-up interviews with inmates with disabilities to obtain further details about the impact solitary confinement had on them. The final report is due to be released by the end of 2016.In April 2016, the state hired a new Director for the NDOC. NDALC believes the new Director was hired, in part, as a result of NDALC, ACLU, and Solitary Watchs joint investigation. The new Director announced the department is making significant changes to its use of solitary confinement of inmates to reflect guidelines from the U.S. Department of Justice. Some of these changes have already been implemented.Inmates in closed custody units at Nevadas maximum security unit are receiving a significant increase of out of cell time, from one hour to five hours daily, and structured activities will be available during the out of cell period.MANAGED CAREThe state of Nevada is evaluating whether or not to move all Medicaid Long Term Services and Supports (MLTSS) to a managed care model. As a part of that evaluation process, it has been conducting town hall meetings to receive input from stakeholders about concerns with moving MLTSS to a manage care model. NDALC has attended these meetings and has provided comments with its concerns about moving to a managed care model. Some of these concerns have to do with how the managed care companies are currently providing services to individuals.Under the Affordable Care Act, Nevada expanded its Medicaid to cover low income individuals, and it is provided through the managed care model. NDALC and other disability advocates are concerned that the services provided by the managed care organizations are inadequate.In March 2016, NDALC was invited by a state legislative committee to provide comments regarding moving all MLTSS into managed care.LEGAL CLINIC IN NORTHERN NEVADANDALC established a monthly legal clinic at Northern Nevada HOPES Clinic which is a nonprofit community health center in downtown Reno that offers integrated medical care and wellness services. A NDALC attorney is available to provide legal advice and assistance to persons with disabilities for 2 hours one day a month.SOUTHERN NEVADA MONTHLY TRAINING SERIES:Nevada Disability Advocacy & Law Center (NDALC) hosts a monthly training series called Lunch, Laugh, & Learn.COMMUNICATION SERVICES FOR INDIVIDUALS WHO ARE DEAF OR HARD OF HEARING:NDALC developed a booklet entitled The Duty of Public Entities and Public Accom

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts 0

2. Number of individuals named in class actions 0

Describe your litigation/class action activities. None.

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:

Identify and describe priority.
Identify the need, issue or barrier addressed by this priority.
Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions.
Provide at least one case summary that demonstrates the impact of the priority.

Priorities and Objectives A. Health Care1. Persons with disabilities will have increased access to Health Care Services.2. This priority area addresses the need for representation of individuals to retain health care services to allow them to remain independent and living in the least restrictive setting.3.Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.Address systemic issues in Medicaid program that decrease access to services.Advocate to ensure access to Health Care coverage and services for people with disabilities.4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.NDALC collaborates with private providers, the Centers for Independent Living, legal services and other non-profits for referrals of clients who are facing termination, reduction, or suspension of Medicaid services. NDALC also has a working relationship with Medicaid staff and its counsel to troubleshoot procedural issues when they arise.5. Provide the number of cases handled under the priority.12 ; no class actions.6.Provide at least one case summary that demonstrates the impact of the priority.WF is a 57 year-old male with genitourinary and orthopedic/physical Impairments. He called NDALC after his PCA time was reduced from 18.5 hours to 5 and because he had a disastrous fair hearing preparation meeting at which he failed to discuss matters germane to Medicaids determination. A NDALC attorney was able to request another fair hearing preparation meeting for WF which she attended and for which she helped WF prepare new and more comprehensive documents for Medicaid to review. At the meeting, WFs hours were increased to 10 which he thought was fair and therefore accepted.RC is a 58 year old woman with end-stage ovarian cancer. RC contacted NDALC when she was unable to get her medications approved by Nevada Medicaid. The NDALC advocate worked with RC, her oncologist, and Medicaid and was able to get Medicaid to cover the necessary medications needed for her oncology visits.LR is a 48-year-old woman with significant physical disabilities who contacted NDALC because Medicaid reduced her Personal Care Assistance (PCA) services following a reassessment. NDALC supplied the client with a comprehensive overview of the fair hearing process, relevant regulations, and provided technical assistance in filing an appeal. As a result of NDALCs assistance, LR was able to effectively participate in the administrative hearing process.B. Disability Discrimination1.Identify and describe the priority.Priority 1: Public entities and places of public accommodation will not discriminate on the basis of disability in violation of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act.2. Identify the need, issue or barrier addressed by this priority.Physical access to buildings and programmatic access into activities

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:

a statement of each prioirty;
the need addressed by each priority; and;
a description of the activities to be carried out under each priority.

B. Priorities and Objectives for the Current Fiscal Year Community IntegrationGoal: People with disabilities will live in the community of their choice with the supports they need for successful integration.Need Addressed: This priority area addresses community integration and preventing unnecessary institutionalization by assisting individuals with disabilities in accessing appropriate support services to maintain living in community settings.Additionally, this priority will enforce the Olmstead decision in which the U.S. Supreme Court declared it a violation of Title II of the Americans with Disabilities for individuals with disabilities to live in segregated settings when those individuals wish to live in community based settings and treating professionals believe that such community settings are appropriate.Priority 1: Assist people with disabilities to remain in the least restrictive environment possible.Priority 2: Assist people with disabilities to move from an institutional placement to living in the community.Priority 3. Ensure access to adequate community-based treatment and services for people with disabilities.Disability DiscriminationGoal: Public entities and places of public accommodation will not discriminate on the basis of disability in violation of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act.Need Addressed: Physical access to buildings and programmatic access into activities and services is the starting point for ensuring the ADA (and other disability laws) is meaningful for individuals with disabilities in their effort to be fully integrated into the society and communities in which we all have a right to live, to work, to be free of abuse, neglect and discriminatory or unfair practices based upon false stereotypes, stigmatization, and other peoples fear of what they do not understand.Priority 1: Identify and address instances of alleged illegal discrimination by a place of public accommodation or by a state or local government entity.Health CareGoal: Persons with disabilities will have increased access to the health care services they need.Need Addressed: This priority area addresses the need for representation of individuals to retain health care services to allow them to remain independent and living in the least restrictive setting.Priority 1: Address systemic issues in the Medicaid program that decrease access to services to individuals with disabilities.Priority 2: Ensure access to Health Care coverage and services, including managed care, for people with disabilities.NDALC 2016 Case Selection Criteriaa. The applicant must meet the program eligibility guidelines and the legal problems must fall within a Priority or priority for services.b. Services will be provided only to persons whose legal problems are related to their status as an individual with a disability, whose legal problems are susceptible to resolution by NDALC staff, and whose claims have legal merit.c. Services will generally only be provided

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.

Sources of funds received and expended
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.)
Description of PAIR staff (duties and person-years)
Involvement with advisory boards (if any)
Grievances filed under the grievance procedure
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

Signed? Yes

Signed by Jack Mayes

Title Executive Director

Signed date Fri, 12/16/2016 - 00:00

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