RSA-509 - Protection & Advocacy of Individual Rights (PAIR) Program Performance Report

Michigan (MICHIGAN PROTECTION AND ADVOCACY SERVICES, INC. -- CLIENT ASSISTANCE PROGRAM) - H240A110023 - FY2011

General Information

Designated Agency Identification

NameMichigan Protection and Advocacy Service Inc.
Address4095 Legacy Parkway
Address Line 2Suite 500
CityLansing
StateMichigan
Zip Code48911
E-mail Addressecerano@mpas.org
Website Addresshttp://www.mpas.org
Phone517-487-1755
TTY 517-487-1755
Toll-free Phone800-288-5923
Toll-free TTY800-288-5923
Fax517-487-0827
Name of P&A Executive DirectorElmer L. Cerano
Name of PAIR Director/CoordinatorMark A. Cody
Person to contact regarding reportMark A. Cody
Contact Person phone517-487-1755
Ext.

Part I. Non-Case Services

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

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas1,483
2. Individuals receiving I&R outside PAIR priority areas1,322
3. Total individuals receiving I&R (lines A1 + A2)2,805

B. Training Activities

1. Number of trainings presented by PAIR staff23
2. Number of individuals who attended training (approximate)555

MPAS Training Activities (these were collaborative training activities, funded with PAIR dollars and other MPAS funding sources): 1) Special Education Rights, Q&A Webinar, 08/17/2011, Webinar -Train attendees on special education 2) Special Education Rights, Q&A Webinar, 09/13/2011, Webinar -Train attendees on special education 3) Special Education Rights Training — F2F, Hillsdale, 01/14/2011 - Presentation Train attendees on special education 4) Special Education Rights Training — F2F, Oakland Co., 11/15/2010 - Presentation Train attendees on special education 5) Special Education Rights Training — F2F, St. Johns, 10/18/2010 - Presentation Train attendees on special education 6) Special Education Rights Training — Redford, 11/20/2010 - Presentation Train attendees on special education 7) Special Education Rights Training — Warren, 11/12/2010 - Presentation Train attendees on special education 8) Special Education Rights Training F2F, Manistee, 04/11/2011 - Presentation Train attendees on special education 9) Special Education Rights Training, ARC Annual Conference, 06/17/2011 - Presentation Train attendees on special education 10) Special Education Rights Training, DHS Education Planners, 08/15/2011 - Presentation Train attendees on special education 11) Special Education Rights Training, Flint, 12/18/2010 - Presentation Train attendees on special education 12) Special Education Rights Training , Grand Rapids, 10/16/2010 - Presentation Train attendees on special education 13) Special Education Rights Training, Lansing, 04/19/2011 - Presentation Train attendees on special education 14) Special Education Rights Training, Madonna University, 06/22/2011 - Presentation Train attendees on special education 15) Special Education Rights Training, MI Assoc. Family Court Administrators, 05/19/2011, Presentation Train attendees on special education 16) Special Education Rights Training , Oakland County, 01/29/2011 - Presentation Train attendees on special education 17) Special Education Rights Training, Petoskey, 10/23/2010 - Presentation Train attendees on special education 18) Special Education Rights Training, Port Huron, 12/04/2010 - Presentation Train attendees on special education 19) Special Education Rights Training, Rights Officers Assoc. of Michigan, St. Ignace, 09/05/2011 - Presentation Train attendees on special education 20) Special Education Rights Training, Sault Ste. Marie, 10/22/2010 - Presentation Train attendees on special education 21) Special Education Rights Training, SEAC, 03/02/2011 - Presentation Train attendees on special education 22) Special Education Rights Training, Unitarian Universalist Church, East Lansing, 01/15/2011 - Presentation Train attendees on special education 23) Elder Law & Disability Rights Training, Legal Conference, 09/21/2011 - Presentation Train attendees on rights of elders

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff2
2. Newspaper/magazine/journal articles15
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website91,933
5. Publications/booklets/brochures disseminated11,933
6. Other (specify separately)0

Narrative

In addition to the trainings listed above, PAIR funding also supported 5 outreach events to homeless individuals.

MPAS maintains a Facebook page. The number of friends of MPAS has steadily increased since the site was launched and we now have 397 friends/fans. This has proven to be an effective means of communicating with many individuals.

PAIR funding also supported the activities of the Great Lakes ADA Steering Committee, which hosted a conference on the Americans with Disabilities Act. The conference was held on the campus of Michigan State University in East Lansing, Michigan. 110 individuals attended the conference.

Part II. Individuals Served

A. Individuals Served

Count individual once per FY. Multiple counts not permitted for lines A1 through A3.

1. Individuals still served as of October 1 (carryover from prior FY)46
2. Additional individuals served during the year74
3. Total individuals served (lines A1 + A2)120
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)3

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 45

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility2
2. Employment7
3. Program access3
4. Housing6
5. Government benefits/services18
6. Transportation0
7. Education25
8. Assistive technology0
9. Voting0
10. Health care2
11. Insurance0
12. Non-government services0
13. Privacy rights3
14. Access to records0
15. Abuse9
16. Neglect45
17. Other3

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor37
2. Other representation found1
3. Individual withdrew complaint7
4. Appeals unsuccessful4
5. PAIR Services not needed due to individual's death, relocation etc.0
6. PAIR withdrew from case2
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit17
9. Other7

Please explain

Seven service requests were closed and new intakes opened to a different grant after additional information about the client’s eligibility and problem issues was gathered.

E. Intervention Strategies Used in Serving Individuals

List the highest level of intervention used by PAIR prior to closing each case file.

1. Technical assistance in self-advocacy4
2. Short-term assistance17
3. Investigation/monitoring29
4. Negotiation6
5. Mediation/alternative dispute resolution4
6. Administrative hearings1
7. Litigation (including class actions)14
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 40
2. 5 - 2228
3. 23 - 5958
4. 60 - 645
5. 65 and over29

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females52
2. Males68

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race3
2. American Indian or Alaskan Native0
3. Asian1
4. Black or African American34
5. Native Hawaiian or Other Pacific Islander0
6. White68
7. Two or more races0
8. Race/ethnicity unknown14

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent33
2. Parental or other family home29
3. Community residential home5
4. Foster care0
5. Nursing home33
6. Public institutional living arrangement2
7. Private institutional living arrangement4
8. Jail/prison/detention center13
9. Homeless1
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

Identify the individual's primary disability, namely the one directly related to the issues/complaints

1. Blind/visual impairment4
2. Deaf/hard of hearing6
3. Deaf-blind1
4. Orthopedic impairment19
5. Mental illness29
6. Substance abuse2
7. Mental retardation1
8. Learning disability8
9. Neurological impairment23
10. Respiratory impairment3
11. Heart/other circulatory impairment1
12. Muscular/skeletal impairment5
13. Speech impairment2
14. AIDS/HIV3
15. Traumatic brain injury4
16. Other disability9

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities6

2. Number of individuals potentially impacted by policy changes20,000

Describe your systemic activities. Be sure to include information about the policies that were changed and how these changes benefit individuals with disabilities. Include case examples of how your systemic activities impacted individuals served.

MPAS continued its participation in the Department of Natural Resources Accessibility Advisory Council. The work of the council expanded the opportunities for individuals with disabilities to participate in outdoor recreational activities.

As it has for several years, MPAS continues to work with the Disabilities Workgroup of the State Bar of Michigan. This workgroup addresses issues of accessibility to the judicial system by clients, lawyers, and judges. The workgroup was successful in convincing the State Bar to conduct a survey to determine the availability of reasonable accommodations to allow individuals with disabilities full participation in the courts. With the results of that survey in hand, the workgroup is exploring strategies to improve access to the courts.

The overuse of guardianships is a pervasive problem in Michigan. MPAS therefore welcomed the invitation of a prominent probate court judge to join a workgroup to explore alternatives to guardianship and the education of the bench and bar on those alternatives. The workgroup will continue into the coming year.

In Fiscal year 2011, the Michigan Department of Community Health announced that it will be developing a plan to integrate services and supports for individuals who are eligible for both Medicare and Medicaid. While this could be beneficial, there are great risks for vulnerable adults who rely on supports, particularly those provided by Medicaid. MPAS has expressed its concerns and has begun actively monitoring the development of the integrated service delivery model.

MPAS continued to participate in the Adult Foster Care Advisory Council. This council is an important vehicle for advancing policies and practices that will improve the lives of individuals with disabilities.

As the disability population ages, many are either turning to or are being forced into nursing homes. In response to this trend, MPAS has increasingly focused its attention on the conditions of nursing homes. In the last year, MPAS investigated four nursing homes and was able to advocate for improvements in those homes.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts2
2. Number of individuals named in class actions0

Describe your litigation/class action activities. Explain how individuals with disabilities benefited from your litigation activities. Be sure to include case examples that demonstrate the impact of your litigation.

While the case of MPAS. v. Caruso was primarily funded by PAIMI and PADD, PAIR eligible clients also benefited from the litigation. The lawsuit successfully brought about significant changes to the practices of the Michigan Department of Corrections that impact prisoners with disabilities. Those changes increased services for those individuals and improved the conditions for those prisoners. As an example, many prisoners with mobility impairments were at risk of assault. Many of those prisoners have now been moved to cell blocks that are more appropriate to their condition.

MPAS legal staff authored an amicus brief that has been submitted to the Sixth Circuit Court of Appeals in the case of Lewis v. Humboldt. A successful outcome in that case is critical to ensuring that all individuals living in the Sixth Circuit-including Michigan-have the full opportunity to be protected by the Americans with Disabilities Act in employment claims.

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.

A. Priority: Eliminate Abuse/Neglect

1. Describe the priority.

Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected.

2. Identify the need, issue or barrier addressed by this priority.

People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities that are virtually unregulated.

3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.

If abuse and/or neglect is confirmed, whether appropriate corrective measures are taken to prevent future incidents.

4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.

MPAS works collaboratively with the Office of Recipient Rights of the Michigan Department of Community Health, the State Long Term Care Ombudsman, as well as licensing and certification agencies.

5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions.

55 cases, no class actions.

6. Provide at least one case summary that demonstrates the impact of the priority. An 84 year old resident of a nursing home was found outside the nursing home, in the snow. She had been there for an undetermined amount of time. The staff brought her back inside, but did not properly treat her. After MPAS investigated the incident, two complaints were filed with the Bureau of Health Professions and ended with an RN being reprimanded and an LPN being placed on probation. The four remaining complaints did not end in substantiated allegations, though the files will remain with the Bureau of Health Professions for five years. The complaint filed with the Bureau of Health Systems was not substantiated. The director of nursing was "reprimanded" as a result of the complaint. The director of nursing and other staff left employment at the nursing home.

A. Priority: Improve Rights Protections Systems

1. Describe the priority.

Advocacy for effective systems and proceedings to safeguard the rights of consumers.

2. Identify the need, issue or barrier addressed by this priority.

People with disabilities frequently have their civil rights compromised by ineffective rights protection systems and overreaching guardians. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.

Whether the client received effective assistance from rights protection systems and/or whether the client was protected from a loss of personal rights as a result of a guardianship.

4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.

No significant collaboration.

5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions.

Four cases, no class actions.

6. Provide at least one case summary that demonstrates the impact of the priority.

A 19 year old young woman who is deaf and has some minor learning challenges had been appointed a guardian, even though she did not need one. Even her school believed that the guardianship was unnecessary. MPAS challenged the guardianship in probate court. Though not successful in terminating the guardianship, the terms were still changed to give the client greater freedoms. She is now working in the community, living independently, and attending community college.

A. Priority: Eliminate Employment Barriers and Protect Rights

1. Describe the priority.

To ensure that consumers have access to competitive employment and that their rights under state and federal law are protected.

2. Identify the need, issue or barrier addressed by this priority.

Nationwide, the data indicates that persons with disabilities continue to be underemployed and unemployed compared to persons without an identified disability. Although legal protections exist to address this issue, individuals with disabilities are most likely to receive assistance and representation from the private bar when they have been discharged. For these individuals, legal assistance that is most effective focuses on negotiating reasonable accommodations with an employer prior to discharge. Unfortunately, many individuals with significant disabilities are unable to secure legal representation for any employment related issue. Finally, many individuals with disabilities are employed in settings that allow for deviated wages based on level of productivity and they are not compensated as fully as is required by law.

3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.

Whether the client was able to secure or maintain competitive employment.

4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.

No significant collaboration.

5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions.

Six cases, no class actions.

6. Provide at least one case summary that demonstrates the impact of the priority.

A 31 year old man developed multiple sclerosis. He worked on servicing cars. His employer was clearly aware of his condition and eventually discharged him. No reasonable accommodations were made available to him. Private attorneys were not willing to represent him, as his income was not high enough to generate claims for significant damages. MPAS filed a complaint was filed with the Equal Employment Opportunity Commission (EEOC), a fact finding was held, and the matter is now in settlement discussions.

A. Priority: Improve Access to Necessary Services

1. Describe the priority.

Advocacy for services to maintain consumers in the community and for obtaining accommodations in critical services.

2. Identify the need, issue or barrier addressed by this priority.

Particularly in a time of severe funding shortages, the availability of services and supports for consumers is being compromised. In addition, many providers of critical services, such as hospitals, units of local government, etc. are not making needed physical and/or programmatic accommodations.

3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.

Whether the client was able to gain or maintain needed services.

4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.

No significant collaboration.

5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions.

Six cases, no class actions.

6. Provide at least one case summary that demonstrates the impact of the priority.

A 38 year old with significant mobility impairments needed to use a wheelchair. However, the apartment complex that he was living in was not accessible. As he lived in a rural community, there were limited options. Citing the Fair Housing Act, MPAS was able to convince the landlord to install the needed ramp to make the apartment accessible for our client.

A. Priority: Ensure the Right to a High Quality Education

1. Describe the priority.

Advocacy to ensure that students with disabilities will receive the highest and best education possible and that they will be fully prepared for entry into the competitive workforce.

2. Identify the need, issue or barrier addressed by this priority.

Students with disabilities are too often placed in segregated learning environments, are suspended or expelled for disability related conduct, or are not adequately prepared for work.

3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.

Whether the client was able to gain or retain access to general education or is prepared to enter the workforce.

4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.

MPAS has worked extensively with the Michigan Alliance for Families to provide training for parents of children with disabilities and to identify systemic issues.

5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions.

24 cases, no class actions.

6. Provide at least one case summary that demonstrates the impact of the priority.

A 14 year old with mild impairments had been expelled by her school district. After MPAS filed a complaint, the client was determined to be eligible for special education. An IEP was convened and the client returned to school.

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.

B. Priority: Eliminate Abuse/Neglect

1. Describe the priority.

Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected.

2. Identify the need, issue or barrier addressed by this priority.

People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities where regulations are ineffective in curtailing these practices.

3. Description of the activities to be carried out.

Advocacy with policy makers for better measures to protect consumers and to eliminate the use of restraint and/or seclusion; investigations into suspected abuse/neglect case and follow-up as needed; and appropriate litigation.

B. Priority: Improve Rights Protections Systems

1. Describe the priority.

Advocacy for effective systems and proceedings to safeguard the rights of consumers.

2. Identify the need, issue or barrier addressed by this priority.

People with disabilities frequently have their civil rights compromised by ineffective rights protection systems and/or overreaching guardians.

3. Description of the activities to be carried out.

Advocacy in individual cases of abuse/neglect, financial exploitation, or forced treatment by guardians and education of policy makers.

B. Priority: Eliminate Employment Barriers and Protect Rights

1. Describe the priority.

To ensure that consumers have access to competitive employment and that their rights under state and federal law are protected.

2. Identify the need, issue or barrier addressed by this priority.

Nationwide, the data indicates that persons with disabilities continue to be underemployed and unemployed compared to persons without an identified disability. Although legal protections exist to address this issue, individuals with disabilities are most likely to receive assistance and representation from the private bar when they have been discharged. For these individuals, legal assistance that is most effective focuses on negotiating reasonable accommodations with an employer prior to discharge. Furthermore, many individuals with significant disabilities are unable to secure legal representation for any employment related issue. Finally, many individuals with disabilities are employed in settings that allow for deviated wages based on level of productivity and they are not compensated as fully as is required by law.

3. Description of the activities to be carried out.

Representation in individual or systemic litigation, and as needed, assistance to consumers in asserting their rights.

B. Priority: Improve Access to Necessary Services

1. Describe the priority.

Advocacy for services to maintain consumers in the community and for accommodations needed to access critical services.

2. Identify the need, issue or barrier addressed by this priority.

Particularly in a time of severe funding shortages, the availability of services and supports for consumers is being compromised. In addition, many providers of critical services, such as hospitals, units of local government, etc. are not making needed physical and/or programmatic accommodations.

3. Description of the activities to be carried out.

Representation in individual and systemic cases involving denial or termination of critical services needed to avoid institutionalization or to secure discharge to the community.

B. Priority: Ensure the Right to a High Quality Education

1. Describe the priority.

Advocacy to ensure that students with disability related behavior will remain in school and that students will receive appropriate transition services to be fully prepared for entry into the competitive workforce.

2. Identify the need, issue or barrier addressed by this priority.

Students with disabilities are too often placed in segregated learning environments, are suspended or expelled for disability related conduct, or are not adequately prepared for work.

3. Description of the activities to be carried out.

Advocacy in systemic and individual cases and policy advocacy.

Part VI. 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
  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

A. Sources of funds received and expended

U.S. Department of Education (FY 2009-2010) (Carryover) $183,870

U.S. Department of Education (FY2010-2011) $485,871

Total Available for FY 2011 $669,651

Total expended for FY 2011 $626,569

B. Budget for the fiscal year covered by this report $643,250 C. Description of PAIR staff (duties and person-years)

1. Duties

PAIR supports both advocates and attorneys who provide information and referral, direct advocacy and legal representation to PAIR eligible clients. The advocates who provide information and referral services discuss a variety of legal issues related to the disability of the client. Advocates and attorneys providing direct advocacy and legal representation do so in these areas: (1) Community Integration and community supports; (2) Institutional conditions; (3) Discharge Planning; (4) Rights Protection; and (5) Employment.

2. Person Years

PAIR had 6.5 FTEs of direct advocacy staff during FY 2011. PAIR pays a federally approved indirect cost rate of 10.3%, which funds administration, finance, human resources, and information systems.

D. Involvement with advisory boards (if any)

MPAS staff was actively involved with the Statewide Independent Living Council, the Michigan Disability Network, the Transition and Education Advisory groups of the Michigan Department of Career Development, the Community Housing Network, the Juvenile Justice Waiver Workgroup, and the NISH Institute on Economic Empowerment for People with Severe Disabilities.

E. Grievances filed under the grievance procedure

MPAS received no grievances from PAIR eligible consumers.

F. 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.

The CAP agency is part of MPAS. MPAS works in cooperation with the State Long Term Care Ombudsman.

Certification

Signed?Yes
Signed ByElmer L. Cerano
TitleExecutive Director
Signed Date12/12/2011