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

District of Columbia (DC-RSA / UNIVERSITY LEGAL SERVICES) - H240A120059 - FY2012

General Information

Designated Agency Identification

NameUniversity Legal Services
Address220 I St NE 130
Address Line 2
CityWashington
StateDistrict of Columbia
Zip Code20002
E-mail Addressjbrown@uls-dc.org
Website Addresshttp://www.uls-dc.org
Phone202-547-0198
TTY 202-547-2657
Toll-free Phone877-221-4638
Toll-free TTY
Fax202-547-2662
Name of P&A Executive DirectorJane Brown
Name of PAIR Director/CoordinatorMarjorie Rifkin
Person to contact regarding reportMarjorie Rifkin
Contact Person phone202-547-0198
Ext.128

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 areas53
2. Individuals receiving I&R outside PAIR priority areas229
3. Total individuals receiving I&R (lines A1 + A2)282

B. Training Activities

1. Number of trainings presented by PAIR staff9
2. Number of individuals who attended training (approximate)127

ULS conducted a training about voter registration, Thorpe litigation and community transition options for 8 residents and staff at Carroll Manor Nursing Facility.

ULS participated in the Mayor’s Disability Expo and fielded questions from approximately 25 people about what ULS does, and individual attendees’ concerns.

ULS presented information to approximately 34 advocates about services for people with traumatic brain injuries and the prevalence of domestic violence among people with TBI, in conjunction with a local domestic violence support organization.

ULS shared information with 10 advocates at a roundtable held by the Long-term Care Ombudsman Office regarding systemic problems including termination of Medicaid waiver services and strategies for preventing and challenging the terminations.

ULS shared information about ULS and distributed know your rights information to 13 staff and people with disabilities at So Others May Eat, a transitional housing program for formerly homeless individuals with disabilities.

ULS shared information about ULS with 8 social workers at Mary’s Center.

ULS attended and shared information about transitional services and Thorpe litigation with 18 individuals at two support groups held at the National Rehab Hospital for people with TBI.

ULS presented to 11 members of a group of voting rights advocates about ULS’ strategies for improving the accessibility of DC polling places.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles8
3. PSAs/videos aired1
4. Hits on the PAIR/P&A website0
5. Publications/booklets/brochures disseminated12
6. Other (specify separately)16

Narrative

ULS’ Thorpe lawsuit was covered by the Washington Post in print and on the Post website when the federal court issued a 50-page decision in plaintiffs’ favor, denying the DC Government’s motion for summary judgment: http://www.washingtonpost.com/blogs/dc-wire/post/dc-class-action-nursing-home-lawsuit-to-go-forward/2012/02/14/gIQAp1MhER_blog.html.

ULS’ complaint filed with the U.S. Department of Education Office of Civil Rights on behalf of a public school student whom DC Public Schools failed to provide diabetes care was covered in the Washington Post, Washington Examiner, Washington City Paper and Forecast, the national publication by the American Diabetes Association:

http://www.washingtonpost.com/blogs/dc-schools-insider/post/feds-probe-treatment-of-diabetic-students/2012/07/05/gJQAFLt9PW_blog.htmlpagebreak

http://www.washingtonpost.com/local/education/dc-schools-reach-agreement-to-provide-aid-to-diabetic-students/2012/08/29/16c1128c-f20e-11e1-adc6-87dfa8eff430_story.html

http://washingtonexaminer.com/d.c.-to-train-school-staff-on-insulin-after-sending-away-student-with-diabetes/article/2501887

http://washingtonexaminer.com/d.c.-allows-non-nurses-to-treat-diabetic-students-after-incident/article/2505839.UD0Zh2ie6RI

http://washingtonexaminer.com/d.c.-to-increase-resources-for-diabetic-students-under-agreement-with-feds/article/2506223

http://forecast.diabetes.org/school-aug2012

http://www.washingtoncitypaper.com/blogs/citydesk/

In addition to this coverage in newspapers and magazines, ULS garnered additional media attention in a variety of web-based blogs:

http://www.winningdiabetics.com/index.html?entry=it-s-good-news-tuesday3

http://scottsdiabetes.com/2012/08/safe-school-outrage-education/ http://www.topix.com/forum/drug/insulin/T2HK7OFF8UCKPLUMP

http://news.100.com/?c=5177219b43aca44c

http://muckrack.com/link/8IdG/dc-to-train-school-staff-on-insulin-after-sending-away-student-with-diabetes

http://injurylaw.reganfirm.com/2012/07/articles/child-safety/feds-prob-potential-deadly-lack-of-treatment-for-diabetics-in-dc-schools/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+DCPersonalInjuryBlog+%28DC+Personal+Injury+Blog%29

http://www.davidcatania.com/content/view/509/1/

http://www.aje-dc.org/dcps-becomes-more-disability-friendly

http://www.dckidscount.org/2012/09/06/d-c-schools-to-offer-more-support-for-diabetic-students/

http://www.smartbrief.com/news/diabetespro/storyDetails.jsp?issueid=186726B1-1A31-4B2E-A9CC-CF58B8BADA1D©id=8A55B438-CCE3-49D4-835C-E35609D79737&brief=diabetespro&sb_code=rss&&campaign=rss

http://www.washingtonpost.com/blogs/dc-wire/post/dc-class-action-nursing-home-lawsuit-to-go-forward/2012/02/14/gIQAp1MhER_blog.html

http://nasga-stopguardianabuse.blogspot.com/2012/02/dc-class-action-nursing-home-lawsuit-to.html

http://disabilitylaw.blogspot.com/2012/02/ddc-issues-important-olmstead-decision.html

http://www.arentfox.com/newsroom/index.cfm?fa=pressReleaseDisp&content_id=3577

http://law.justia.com/cases/federal/district-courts/district-of-columbia/dcdce/1:2010cv02250/145810/41

http://dayinwashington.com/?p=934

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)14
2. Additional individuals served during the year26
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.)5

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 9

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility0
2. Employment0
3. Program access1
4. Housing5
5. Government benefits/services29
6. Transportation0
7. Education1
8. Assistive technology1
9. Voting0
10. Health care3
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse2
16. Neglect1
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor30
2. Other representation found1
3. Individual withdrew complaint1
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit2
9. Other1

Please explain

ULS opened a case for one new individual class member in our Thorpe litigation to determine if she might be a viable named plaintiff to represent the class. However, because she experienced a serious health setback, her needs were more intensive than the community-based service network would provide. As a result, we provided her with the tools to ask for transitional assistance and urged her to seek that help.

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-advocacy6
2. Short-term assistance10
3. Investigation/monitoring1
4. Negotiation5
5. Mediation/alternative dispute resolution0
6. Administrative hearings12
7. Litigation (including class actions)2
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 - 221
3. 23 - 5918
4. 60 - 646
5. 65 and over15

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females23
2. Males17

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American37
5. Native Hawaiian or Other Pacific Islander0
6. White2
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent22
2. Parental or other family home2
3. Community residential home1
4. Foster care0
5. Nursing home15
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center0
9. Homeless0
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 impairment2
2. Deaf/hard of hearing0
3. Deaf-blind0
4. Orthopedic impairment31
5. Mental illness0
6. Substance abuse0
7. Mental retardation0
8. Learning disability0
9. Neurological impairment4
10. Respiratory impairment1
11. Heart/other circulatory impairment0
12. Muscular/skeletal impairment0
13. Speech impairment0
14. AIDS/HIV0
15. Traumatic brain injury0
16. Other disability2

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 changes66,000

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.

A. Waiver Termination without Notice or Due Process: Over 4,000 people with disabilities rely on the Medicaid Waiver Program for Persons who are Elderly and/or have Physical Disabilities (EPD Waiver) which provides up to 16 hours of daily home health services to assist them with their activities of daily living.

Following months of individual advocacy on behalf of individuals including many seniors facing termination of their Medicaid Waiver services without notice or due process and through no fault of their own, ULS sent a demand letter to District of Columbia Mayor Vincent Gray and Attorney General Irv Nathan, among others. The letter, signed jointly by the National Senior Citizens Law Center (NSCLC), sought the District’s rescission of all Waiver terminations due to administrative recertification lapses; retroactive review and offer to restore waiver services for everyone terminated for the prior year; a moratorium on terminations until the District developed legally sufficient notices and advance warning letters; and training of waiver provider agencies on proper, timely recertification procedures.

ULS and NSCLC met with high-level officials of the Attorney General’s Office and the DC Department of Healthcare Finance (DHCF) who readily acknowledged ULS’ allegations of unlawful EPD Waiver terminations and pledged to remedy the issues by meeting several of ULS’ demands. ULS got a commitment from DHCF to rescind the terminations of 484 people whose waiver services were terminated as of March 2012. ULS reviewed DHCF’s draft letter to be sent offering to restore waiver services to these 484 individuals. DHCF also agreed to issue 3 legally sufficient notices. ULS reviewed and commented on DC’s draft advance notice to be sent to waiver participants prior to termination and the draft 60- and 30-day termination notices designed to be sent to waiver participants. DHCF implemented the advance 90-day warning notice, as well as the 60-day notice letter explaining to EPD Waiver participants the steps they must take to contact their case managers to ensure they prepared and submitted the waiver recertification paperwork to DHCF.

ULS’ successful systemic reform effort to get restoration of EPD Waiver services and legally sufficient notice and due process enables people with disabilities including seniors the essential services they need to age in place in the community, rather than face placement against their wishes in nursing facilities. This legal advocacy work is especially crucial since the District had established a waiting list for EPD Waiver applicants seeking access to the program. Once terminated, the District attempted to place individuals on the waiting list in order to get their EPD Waiver services restored. ULS’ work to urge the District to adopt legally sufficient notice and due process could benefit all 66,000 people enrolled in DC Medicaid.

Case example: ULS represented Ms. B, a 75-year-old woman with mobility and vision disabilities as well as diabetes and seizures, in an administrative fair hearing to challenge the improper termination of Waiver services, re-start her Waiver services and enable her to move back to the community from a nursing facility. ULS drafted a brief justifying restoration of Ms. B’s waiver benefits pending appeal based on DHCF’s failure to provide adequate notice, due process, or administratively process the home health waiver provider’s recertification paperwork on Ms. Burns’ behalf before the establishment of an EPD Waiver waiting list. Just prior to Christmas 2011, the administrative law judge issued an order that entitled Ms. B to restoration of services, but the District sought a stay and reconsideration, which ULS opposed. Sadly, Ms. B consequently remained in the nursing facility. ULS conducted discovery, prepared witnesses, and drafted opening and closing statements for an evidentiary hearing. On the eve of the hearing, the District signed a settlement agreement to provide Ms. B with 16 hours per day of EPD Waiver services, case management and an emergency response system. Ms. B. finally returned home over the Martin Luther King Jr. birthday holiday weekend.

B. Diabetes Care in DC Public Schools: In February 2012, ULS, in collaboration with the American Diabetes Association, filed a complaint with the U.S. Department of Education’s Office of Civil Rights on behalf of LT, a 9-year-old public school student and other children with Type I Diabetes. The complaint cited the District of Columbia’s Public Schools’ (DCPS) and Public Charter Schools’ violations of Section 504 and the ADA for failure to provide daily ongoing diabetes care in DC schools. ULS’ complaint sought ongoing, daily diabetes care at schools and school-sponsored activities, assignment of two full-time trained staff at each school to perform diabetes care (glucose monitoring, insulin and glucagon administration) when the assigned school nurse is absent. ULS also challenged retaliatory conduct by the District against DC students and their family-advocates for urging proper diabetes care, as well as the District’s failure to provide legally sufficient notice or due process. Shortly after ULS’ complaint, the Department of Education issued a Notice Letter to DCPS detailing all of the allegations and demanding documentation of compliance with federal law. In June 2012, the U.S. Department of Education opened complaints against each individual DC Public Charter School (44 in total) based on ULS’ initial complaint regarding diabetes care and the public charter schools’ failure to comply with Section 504 requirements. In August 2012, DCPS and the US Department of Education signed a comprehensive Agreement (which ULS drafted) requiring the District to train 2 or more backup staff to administer insulin and emergency glucagon at each school that has a student with diabetes; to have trained staff present for all field trips and extracurricular activities; and to allow students who are capable of self-care to do so anywhere, anytime. The Agreement also required the District to create 504 accommodation plans for each student with diabetes; train all teachers with responsibility for students with diabetes on how to recognize a diabetes emergency; provide compensatory education for ULS’ client; send a letter to all DCPS families regarding DCPS’ new diabetes policy, and create 504 policies and procedures. In September 2012, the District held a comprehensive diabetes care training for designated lay staff for DCPS and DC Public Charter Schools. In order to demonstrate compliance to the Department of Education in its investigation of the 44 Public Charter Schools, all but two of the Public Charter Schools with students with diabetes enrolled also trained designated lay staff at this training. As detailed below, ULS’ work led to broad reforms on the systemic and individual levels for all students with diabetes, and for all students covered by Section 504. The estimated number of children with diabetes in public schools and charter schools is 230. There are over 12,500 students in disabilities in DC public and public charter schools who stand to benefit from ULS’ advocacy for improved policies and procedures.

Case example: ULS represents LT, a nine-year-old public school student with Type I Diabetes whose school violated federal law by failing to provide her diabetes care. Instead of assigning lay staff to monitor LT’s glucose levels and administer insulin and, if needed, glucagon, the school staff called LT’s mother demanding that she administer her child’s care or take her home from school. As a result, LT lost at least 10 days of school and was excluded from a field trip and her mother was barred from LT’s original public elementary school in retaliation for her advocacy, forcing her to transfer to another school. ULS brought the complaint with the U.S. Department of Education, and garnered substantial publicity calling attention to this issue in the Washington Post and a cover-page feature in Diabetes Forecast, the American Diabetes Association magazine. ULS continued fighting for LT’s right to return to her original school, which she did as of Fall 2012, when DCPS rescinded the bar against her mother.

C. Investigation of Olmstead Violations by DC government:

ULS continued to investigate and call public attention to the District’s violations of the rights of people with disabilities to access services and supports in integrated community settings, rather than in nursing facilities. ULS submitted testimony to the City Council Committee on Health regarding: rights violations by DHCF, the city’s Medicaid agency, highlighting the agency’s failure to comply with the ADA by reducing access to and the range and level of home health services; the Thorpe case decision, and illegal termination of Medicaid Waiver services for people who are elderly and/or have physical disabilities (EPD Waiver).

In May 2012, ULS provided comments on proposed Home Health Aide (HHA) regulations urging an expansion of tasks HHAs must be allowed to perform (medication administration, bowel and bladder care) in order for people with disabilities to be able to live in the community rather than in institutions. The DC Department of Health published final regulations that acknowledged ULS’ comments and added several new tasks to home health aides’ permissible duties, in response to some of ULS’ recommendations. The regulations provided for a new medication aide position to perform many additional functions. There are approximately 3,900 people with disabilities in nursing facilities plus an additional 4,000 people participating in the EPD Waiver Program plus approximately 4,000 people in the Medicaid State Plan Personal Care Assistance Program. All of these individuals stand to benefit from the expanded scope of home health aide services available to people with disabilities.

Case example: ULS represented EB, a 76-year-old woman with diabetes, limited mobility due to osteoarthritis, seizures, and low vision. As a result of ULS’ advocacy for changes to HHA regulations, Ms. B was safely discharged to the community with assistance from her HHA to take insulin at home. ULS urged the agency to come up with a plan that allowed Ms. B to get the assistance she needs to take her daily insulin without daily skilled nurse visits. Instead, the nurse provides written instructions and pre-filled insulin syringes in differing amounts to Ms. B’s home health aide, who assists Ms. B by reading instructions and handing her the correct syringe, which was not possible under the previous regulations which forbid home health aides from assisting with medication.

D. Visitability Regulations: “Visitability” in housing affords people with mobility, vision and other disabilities the opportunity to visit the homes of friends and family and thereby maintain social ties and achieve more robust integration in the community. This year, ULS worked toward achieving a mandate for visitability in the District of Columbia.

In the Fall 2011, two City Council representatives sought comments by ULS regarding proposed legislation that would require all residential properties that receive federal financial assistance to make their properties “visitable” to ensure access by people who use wheelchairs. Visitability requires at least one zero step entry and one accessible half-bathroom on the accessible floor of the residence.

In November 2011, ULS met with a coalition of advocates including Concrete Change, United Spinal, National Council on Independent Living (NICL), Equal Rights Center (ERC), Bazelon Center for Mental Health Law, American Association of Persons with Disabilities (AAPD), and Paralyzed Veterans Association (PVA) regarding the draft visitability bill. We developed a consolidated list of concerns and recommendations for revisions to the proposed legislation. A followup meeting was held with the Coalition of Non-Profit Housing Developers (CNHED) about concerns raised by the developers. In late November 2011, ULS testified at a City Council hearing on the draft Visitability bill. It was scheduled for mark-up by the Council in December 2012, but one of the bill’s sponsors was not re-elected, leaving in doubt the status of the proposed legislation.

ULS did not handle any individual cases on visitability.

E. Voting Access: Community integration includes the full inclusion of people with disabilities in the voting process as is required by federal law. In response to ULS’ reports of accessibility issues and the closure of some schools, the DC Board of Elections and Ethics (BOEE) relocated 12 inaccessible polling sites this year. With assistance from staff and 55 volunteers, ULS surveyed 99 polling sites during the April 2012 Presidential primary election to assess their accessibility for people with mobility and visual disabilities. ULS produced a report finding that 4% of the surveyed precincts were structurally inaccessible, and 68% of the surveyed precincts were operationally inaccessible. ULS testified about our findings at City Council and met with BOEE which addressed some, but not all, of ULS’ concerns. ULS did not represent any individuals under PAIR about voting access.

F. Accessibility of Store, Restaurants, Museum Exhibits: Accessible public accommodations such as museums and restaurants allow people with mobility, hearing and vision disabilities to fully participate in community living. To increase equal access and promote compliance with Title III of the ADA, ULS sent two complaints to the Director of the National Gallery of Art (NGA) regarding the lack of closed captioning at a film accompanying the exhibit about Andy Warhol. The NGA Director acknowledged the lack of captioning and made a transcript available three weeks after the show opened. The director committed to taking closed captioning into consideration for future films that accompany NGA exhibits. Despite this complaint, ULS contacted NGA again months later regarding the lack of closed captioning on a video produced by NGA about Chester Dale, an art collector. ULS advised NGA to develop and implement procedures that require staff to turn on closed captioning for all films shown at the Gallery.

ULS complained to the owner of a newly-opened Bethesda Bagels shop about the lack of wheelchair accessibility despite the fact that two prior businesses had installed a sturdy portable ramp at the same location. At first, the shop owner acknowledged he had disposed of the portable ramp that was previously in place, and denied any obligation under the ADA. After consulting a lawyer, he agreed to install a permanent concrete wheelchair ramp to fully comply with Title III ADA requirements. ULS later reviewed and commented on the architectural plans for the ramp. However, the DC government’s office that issues construction permits has delayed the progress of beginning construction. As of this report, the permit is scheduled to be issued in Winter 2012 and construction in early 2013.

ULS sent letters to four restaurants in the newly redeveloped H Street NE Corridor regarding their obligations under Title III of the ADA and ADAAG to make their businesses wheelchair-accessible, including removal of structural barriers to entry and making at least 1 bathroom fully accessible. As a result, two restaurants built concrete ramps over their thresholds to accommodate wheelchair riders.

There are no case examples to report under this systemic work.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts9,000
2. Number of individuals named in class actions16

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.

A. Thorpe v. District of Columbia

In late December 2010, ULS filed Day v. District of Columbia, a class action lawsuit under Title II of the Americans with Disabilities Act (ADA) against the District of Columbia for its failure to provide transitional assistance for 500 to 3,000 people with disabilities in nursing facilities who seek to move back to the community with the services and supports they need. The goal of the case, which now carries the name Thorpe v. District of Columbia, is to ensure the rights of people with disabilities in nursing facilities to live in the most integrated settings appropriate to their needs. People with disabilities who choose to move back to the community will benefit by being integrated into the community, rather than subjected to segregated nursing facilities.

ULS is litigating the case under the PAIR and PAIMI grants, as an estimated 10% to 20% of plaintiff class members with physical disabilities also have mental illness. ULS is co-counseling the Thorpe case with AARP Foundation Litigation and Arent Fox LLP.

ULS continues to litigate the case vigorously as is reflected in our work during this year. We filed our opposition to Defendant’s Motion to Strike the US Department of Justice’s (DOJ) Statement of Interest in support of Plaintiffs’ Opposition to the District’s Motion to Dismiss and for Summary Judgment. According to DOJ, the District’s opposition motion made arguments never before encountered in DOJ’s Olmstead litigation.

In November 2011, ULS filed a Motion for Leave to File for Class Certification. In December 2011, ULS accompanied plaintiffs’ medical experts to visit the named plaintiffs in nursing facilities following their comprehensive review of the named plaintiffs’ medical records.

On February 14, 2012, the District Court issued a comprehensive decision in Day v. District of Columbia denying the Defendant’s Summary Judgment motion. 2012 WL 456491 (D.D.C. Feb. 14, 2012). The Court rejected the District’s contention that its existing programs are sufficient to comply with its obligations under the ADA and the Supreme Court’s ruling in Olmstead v. L.C. to provide services to people with disabilities in the most integrated setting appropriate to their needs. In this ruling, the judge rejected the District’s argument that it complies with Title II of the Americans with Disabilities Act (ADA) which requires states and local governments to provide services to people with disabilities in the most integrated setting appropriate to their needs.

Judge Huvelle ruled that governing legal standards and undisputed facts undermine the District’s claims that it complies with the ADA & Supreme Court’s Olmstead decision. The District has no Olmstead Integration Plan or measurable commitment to deinstitutionalization of people with disabilities from nursing facilities. The court rejected the District’s claims based on the following, among other undisputed facts:

• The mere existence of some community-based programs, without outreach, information, and transitional assistance, does not constitute an Olmstead Integration Plan; • The District’s transition of only 3 people from nursing facilities under the federally-funded Money Follows the Person (MFP) Program (now in its 5th year), as compared with the initial goal of transitioning nearly 900 such individuals, does not reflect commitment to integration; • The District’s failure to seek an increase in the number of slots in the Home and Community-based Medicaid Waiver Program for People who are Elderly and/or have Physical Disabilities (EPD Waiver) or reserve slots for people in nursing facilities to meet the demand for services or track the waiver participants from nursing facilities undermines the District’s efforts to integrate people seeking to move out of nursing facilities; • The steady occupancy rate of nursing facilities at 90% since 2000 shows the District’s lack of effort to comply with the ADA’s integration mandate; • The failure to take steps to identify all DC residents in nursing facilities who want to move back to the community or to assist the undisputed 526 to 580 individuals who already expressed their preference to move back to the community reflects the District’s Olmstead violations.

At a subsequent status hearing, plaintiffs clarified the class definition, relief sought, and status of the parties’ settlement negotiations. The District filed an Olmstead Plan without details about transitioning people from nursing facilities. It has not relied upon the plan in subsequent filings. In April 2012, ULS filed a second amended complaint to name two additional PAIR plaintiffs CW and JT, and remove two named plaintiffs, one of whom discharged from a nursing facility, and the other determined he was not ready for community transition. We filed Plaintiffs’ Motion for Class Certification in mid-May 2012 and, following a delay in the District’s opposition, filed Plaintiffs’ Reply brief in late September 2012. The proposed class definition is "all persons with disabilities who are eligible for Medicaid funded services from the District of Columbia and who (1) with appropriate supports and services could and would live in the community; and (2) now or during the pendency of this litigation are receiving services funded by the District of Columbia in a nursing facility."

ULS negotiated a protective order with the Defendant in July 2012. The parties entered the Federal Court Mediation Program in early May 2012 and participated until late July 2012 after exchanging a series of proposals. In the Fall 2012, ULS participated in follow-up mediation sessions.

In July 2012, ULS developed and served a document request on the District that sparked discovery reviews beginning in Fall 2012. The parties are addressing and seeking to resolve numerous discovery disputes, some of which we have brought to the Court’s attention.

Case example: ULS successfully represented CW, a 49-year-old man with paraplegia and HIV who spent nine years in nursing facilities until his discharge in Fall 2012. Mr. W was a Thorpe class representative who ULS assisted in getting his public housing application completed and reinstated by the DC Housing Authority. Within six months, he was offered and leased a fully accessible one bedroom apartment to which he successfully transitioned to the community in September 2012 after several false starts. ULS provided CW and his social worker with the tools they needed to advocate strenuously for his access to an EPD Medicaid Waiver slot and eleventh hour start-up assistance by the MFP Program. Despite his name on the lawsuit, Mr. W faced many barriers in his efforts to transition back to the community. Following his discharge, ULS assisted Mr. W in securing the necessary medical orders and help by his Waiver home health agency to ensure his prescription medications and supplies were ordered and delivered timely.

B. Young v. DC Housing Authority ULS filed Young v. DC Housing Authority (DCHA) in 2001 seeking full compliance with Section 504 of the Rehabilitation Act of 1973 and the Uniform Federal Accessibility Standards (UFAS). The parties signed a consent order in 2002 requiring DCHA to renovate or build 565 fully wheelchair accessible public housing units. An amended consent order set a completion date of 2013 for the remaining 90 UFAS units. ULS reviewed monthly DCHA compliance reports regarding the status of construction of the UFAS units. In mid-September, we conducted inspections of the UFAS units to assess their accessibility. DCHA will likely complete the final units required under the consent order during 2012. Over 1,000 people with physical disabilities who rely on wheelchairs have benefited from this class action lawsuit by placement in wheelchair accessible, integrated public housing units. Over time, hundreds more people will benefit from the availability of the units in light of the movement of public housing tenants and applicants into and out of the completed units. Case example: ULS assisted CW, a 49-year-old Young class member who was also a class representative in the Thorpe case, to get his public housing application reinstated by DCHA upon completion of all the document requirements including a letter from the nursing facility administrator that verified his need for a wheelchair accessible unit. DCHA offered Mr. W. a fully-accessible public housing unit in a privately-managed development.

C. Challenges to Termination of Waiver Services without Notice or Due Process ULS won restoration of Medicaid EPD Waiver services for 9 individuals with disabilities after litigating at Medicaid fair hearings on their behalf. Most, if not all, of the terminations resulted from the District’s or the waiver home health agencies’ failure to properly prepare and submit the recertification documents necessary to continue waiver services. In each case, ULS cited the District’s failure to administratively process the recertification, or sufficiently notify the waiver participant of the reasons for termination, or the right to appeal, with specific instructions for appeal. ULS cited the District’s federal Medicaid as well as due process violations in seeking benefits pending appeal through the Medicaid fair hearing process. The District resolved the recertification issues and restored waiver services after ULS filed for the hearings and briefed the issues; in some cases, after ULS conducted discovery, prepared witnesses and cross examination questions.

The majority of these waiver termination cases involved senior citizens who did not qualify for personal care assistance under the Medicaid State Plan due to their income levels. Without waiver services, they each faced the prospect of losing their homes and being forced into nursing facilities in order to get the services they needed to assist with their activities of daily living.

Case example: ULS represented EB, 75-yr-old woman with mobility, vision, and seizure disabilities, in addition to diabetes, in a Medicaid fair hearing to restore her EPD Waiver services and enable her to move back to her home from a nursing facility. ULS was alerted to Ms. B’s need for legal assistance by the nursing facility staff. ULS drafted and filed a comprehensive brief to justify restoration of her waiver benefits pending appeal based on DHCF’s failure to: process the waiver provider’s documentation for recertification of waiver services, or provide legally sufficient notice prior to termination, or due process. ULS won a court ruling that awarded Ms. B her waiver benefits pending appeal, but had to file a brief in opposition to the District’s Motion for a Stay/Reconsideration for benefits. Sadly, Ms. B. spent the 2011 Christmas holiday in the nursing facility while the District’s stay motion was pending. The administrative law judge re-ordered Ms. B’s benefits pending appeal and Ms. B finally transitioned back to her home in mid-January, 2012 on the Martin Luther King Jr birthday holiday.

ULS served a discovery request on the District in preparation for an early February evidentiary hearing. We reviewed documents produced witness and exhibit lists, prepared witnesses, cross examination questions, and opening and closing statements. Prior to the hearing, the District signed a settlement agreement with Ms. Burns to restore her 16 hours per day of EPD Waiver services, case management, and an emergency response system.

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.

Objective: Advocate on behalf of people with disabilities to ensure their access to DC government services and supports in the most integrated settings appropriate to their needs, public accommodations, and wheelchair-accessible, integrated, federally-subsidized housing.

1. A. Represent prospective class members in [Day] Thorpe v. District of Columbia to promote their rights under Title II of the Americans with Disabilities Act (ADA) to information about alternatives to nursing facility placement, transitional assistance, and quality home-based personal care services and supports through the Elderly and Physical Disabilities (EPD) Medicaid Waiver Program and the DC Medicaid State Plan to enable them to move out of nursing facilities.

ULS filed Day [now Thorpe] v. District of Columbia in December 2010 under Title II of the ADA seeking transition assistance for 500 to 3,000 people with disabilities in nursing facilities who would choose to return to the community with the services and supports they need. Plaintiffs seek a court order requiring the District to develop a system for transitioning people from nursing facilities who choose to live in the community with the services and supports they need.

In February, the District Court judge ruled in plaintiffs’ favor and denied the District’s Summary Judgment Motion. ULS continues to litigate the case while engaging in mediation in an effort to negotiate a class-wide settlement. We filed a Motion for Class Certification, opposed several motions filed by the District, and amended the complaint to add two new plaintiff class representatives under the PAIR grant including JT, the lead named plaintiff. This year, one named plaintiff under the PAIR grant transitioned out of a nursing facility after 9 years of segregation. The key indicators of success are the District’s rate of transitioning people from nursing facilities and the systemic reforms developed to honor individuals’ choice of community alternatives.

The total number of nursing facility residents discharged by the District under the MFP Program through Year 6 of the MFP Program is reportedly 22, 19 of whom were discharged during this fiscal year. Nationally, according to a July 2011 Mathematica Report, the District is ranked one of the lowest performing MFP grantees, having utilized only 17% of its allocated grant, primarily for consumers with intellectual disabilities who transitioned from intermediate care facilities. The District failed to hold a lottery in July 2012 to select MFP participants from among those screened and found eligible.

ULS met with approximately 50 Thorpe plaintiff class members in nursing facilities to explain the case and their rights to transitional assistance and services and supports. ULS urged them to request assistance from the District’s Aging and Disability Resource Center and Money Follows the Person (MFP) Program and the nursing facility social workers. For example, ULS assisted LC, a 42-year-old woman with a mobility disability in a DC nursing facility seeking to return to the community with services. We encouraged her to contact the ADRC and complete a public housing application. ULS also assisted HP, a 92-year-old woman who uses a cane and has a memory disability, a Thorpe class member. Ms. P sought to return to her home in the community.

ULS assisted several individual class members to surmount opposition to their community transition from family members and nursing facility staff. In some cases, ULS advocated on their behalf for the District and the nursing facilities to take critical steps precedent to their ultimate transition, such as access to motorized wheelchairs. For example, ULS assisted Thorpe class member CM, a 77-year-old man who uses a wheelchair due to an amputation, to apply for public housing and the Medicaid EPD Waiver. Despite the fact that CM’s needs could be met under the EPD Waiver, his nephew did not support his community transition. ULS participated in an Individual Services Plan meeting with Mr. M, his family, and nursing facility staff. Following this meeting, the social worker agreed to sign him up for the EPD Waiver and assist him in applying for public housing.

ULS collaborated with Thorpe co-counsel AARP Foundation Litigation and Arent Fox LLP, staff at several nursing facilities, several home health Medicaid waiver agencies, the DC Long-term Care Coalition, Long-term Care Ombudsman Office, DC Healthcare Ombudsman Office, DC Housing Authority, Legal Aid Society, Legal Counsel for the Elderly, George Washington University Health Insurance Counseling Project and National Rehabilitation Hospital, among others. ULS also partnered with and provided technical assistance to local legal services counsel who represented some of the individual Thorpe class members seeking public benefits and community-based services.

ULS handled 16 cases under this priority including the Thorpe class action lawsuit.

Case example: In addition to the cases described above, ULS assisted T.D., a 77-year-old woman with a mobility disability, regarding her rights as a Thorpe class member to return to the community with services and supports. ULS successfully advocated for her to get physical therapy in the nursing facility to increase her independence and advocated for her during discharge planning meetings and throughout the on-going discharge process. Ms. Drayton successfully transitioned to a wheelchair accessible apartment with 16 hours of daily EPD Waiver services and diabetes supplies and pre-filled syringes that she could self-administer. ULS also assisted her to expedite reinstatement of her full SSDI check quickly once she was in the community. *******************

1. B. Advocate and litigate on behalf of people with disabilities to challenge improper Medicaid home health service terminations and reductions.

The District terminated the Medicaid Waiver services for nearly 500 individuals without legally sufficient notice or due process. The terminations arose from the District’s failure to properly recertify waiver services—a process that by regulation can only be done by case managers, not by the waiver participants. These illegal terminations jeopardized individuals’ health and ability to continue living at home. ULS sent a demand letter to the Mayor and Attorney General, among others. The letter, signed jointly by the National Senior Citizens Law Center (NSCLC), sought the District’s rescission of all Medicaid waiver terminations due to administrative recertification lapses; retroactive review and restoration of waiver services for everyone terminated; a moratorium on terminations until the District developed legally sufficient notices and advance warning letters; and training of waiver provider agencies on proper, timely recertification procedures.

ULS and NSCLC met with high-level officials of the Attorney General’s Office and the DC Department of Healthcare Finance (DHCF) who readily acknowledged ULS’ allegations of unlawful EPD Waiver terminations and pledged to remedy the issues by meeting several of ULS’ demands. ULS got a commitment from DHCF to rescind the terminations of 484 people. ULS reviewed DHCF’s draft letter to be sent by DHCF offering to restore waiver services to these 484 individuals. DHCF also agreed to issue 3 notices prior to termination, one of which has been implemented thus far.

In addition to the nine individual cases ULS successfully litigated under the Medicaid fair hearing process described above under Section IV.B., ULS resolved waiver terminations and restored services on behalf of an additional four individuals without litigating their claims.

ULS handled 17 cases under this priority.

ULS collaborated with the DC Healthcare Ombudsman’s Office, several nursing facilities, Legal Aid Society, Legal Counsel for the Elderly, George Washington University Healthcare Counseling Project, American University Disability Rights Clinic, National Senior Citizens Law Center (NSCLC).

Case example: ULS filed a complaint seeking a Medicaid Fair Hearing for JMG to challenge the District’s unlawful reduction of home health waiver services from 16 hours per day to 8 hours per day under the Medicaid State Plan Personal Care Assistance Program following Ms G’s discharge from a brief hospital stay and a three week stay for rehabilitation in a nursing facility. Ms. G had received a legally deficient notice from her waiver agency that advised her she had the right to request a “fear hearing” and provided an erroneous telephone number with which to request a hearing. Following ULS’ representation at several court hearings, DHCF preserved Ms. G’s waiver benefits pending appeal and ultimately on a permanent basis at the original level of 16 hrs per day, seven days per week. ULS also won a back payment of over $5,500 in SSI benefits for Ms G and restored her food stamp benefits.

****************************** 1. C. Pursue legal advocacy to enforce Section 504 of the Rehabilitation Act in federally-funded housing developments in the District of Columbia to make them wheelchair-accessible to individuals with mobility disabilities.

ULS collaborated with three advocacy organizations to address violations of the Fair Housing Act Amendments and Section 504 by privately-managed, subsidized residential properties that adhere to ‘first-come, first-served’ in-person application and selection requirements to identify tenants to fill vacancies. This practice excludes people with disabilities who may not be able to stand in line or show up in person just to pick up a housing application. We developed strategies for educating landlords about best practices in other jurisdictions, and HUD directives about their obligations to adopt application and selection procedures that provide equal access to people with disabilities. ULS also participated in the development and submission of demand letters to two landlords who planned to hold ‘first-come first-served’ events. In both cases, the landlords expanded their selection process to accommodate for people with disabilities. As described below, ULS also continued to advocate on behalf of individuals who needed reasonable accommodations from their landlords in order to ensure their tenancy in subsidized housing continued.

ULS collaborated with the DC Housing Authority, subsidized housing property management companies, the U.S. Office on Housing and Urban Development, Bread for the City, and the Bazelon Center for Mental Health Law.

ULS handled 4 cases under this priority.

Case examples: ULS sought reasonable accommodations for M.T., a 50-year-old woman with multiple sclerosis living in the community with a subsidy voucher through the DC Housing Authority (DCHA). Ms. T’s landlord threatened to bill her for thousands of dollars in rental subsidies that DCHA failed to pay the landlord. ULS demanded that DCHA retroactively extend the term of her subsidy voucher which had apparently lapsed due to the District’s delay in transitioning MT from a nursing facility to the community. At ULS’ insistence, DCHA extended the term of the voucher and paid the landlord for the 16 months of subsidy due for MT’s apt. DCHA also recalculated a lower rental amount for MT.

ULS sent a complaint on behalf of EM, a 59-year-old woman living with obesity, mobility and respiratory disabilities, to the landlord of her subsidized apt building. ULS urged the landlord to accommodate her in the renewal of her lease by bringing the lease renewal to her in light of the fact that she could not access the landlord’s office due to the size of her wheelchair and the structural barriers within the landlord’s leasing office. ULS cited the landlord’s violations of Section 504 as well as the Fair Housing Act. As a result of ULS’ intervention, the landlord acknowledged their failure to accommodate Ms. D and made arrangements to bring the new lease to Ms. D for her signature. ******************* 1. D. Work to ensure that public accommodations, polling sites, and governmental facilities are accessible to people with mobility, hearing and visual disabilities in the District of Columbia under the Americans with Disabilities Act.

In response to ULS reports of accessibility issues and the closure of some schools, the DC Board of Elections and Ethics (BOEE) relocated 12 inaccessible polling sites. ULS recruited staff and 55 volunteers to survey and report back on the accessibility of the polling precincts for people with mobility and visual disabilities. ULS posted information on Facebook encouraging people with disabilities to work as Election Day Voter Accessibility Guides and via email to volunteers and organizations. ULS provided guidance regarding accessibility barriers and voting rights issues for people with mobility disabilities and mental disabilities and information for poll worker training, including the Election Day Voter Accessibility Guide training.

ULS surveyed 99 polling sites during the April 2012 Presidential primary election to assess their accessibility for people with mobility and visual disabilities. We produced a comprehensive report finding that 4% of the surveyed precincts during the primary election were structurally inaccessible, and 68% of the surveyed precincts were operationally inaccessible. This rate of operational inaccessibility exceeded ULS’ prior polling surveys, which revealed 41% of the 122 precincts surveyed were operationally inaccessible in the 2010 Primary Election, and 65% of the surveyed precincts were operationally inaccessible in the 2011 Special Election. Prior to the election, ULS met with members of the BOEE regarding ULS’ recommendations for relocating some of the inaccessible polling places and surveyed the sites prior to the election. Despite ULS’ recommendations, many of the schools failed to prop open their doors to enable people with limited mobility enter the polling places independently. In addition to our polling site accessibility advocacy, ULS took several steps to advocate for DC’s restaurants and museums to comply with their obligations under Title III of the ADA to make their businesses accessible. For example, we filed two complaints with the National Gallery of Art about its failure to provide closed captioning on films accompanying two exhibits. In both cases, the gallery acknowledged its failure and offered alternative formats to visitors who are deaf and hard of hearing. We also notified four newly renovated restaurants of their obligations to afford people with disabilities access as required under the ADA and ADAAG. We will continue to monitor their compliance.

ULS collaborated with the DC Board of Elections, American Association of People with Disabilities, American Diabetes Association, Juvenile Diabetes Research Foundation, Howard University Hospital, US Department of Education Office of Civil Rights, DC Center for Independent Living, DC area law schools, and 55 DC advocates from several organizations, business owners, the Washington Council of Lawyers, ADAPT, AAPD, District Alliance for Safe Housing, Equal Rights Center, American University College of Law, Georgetown University Law Center, DC Quality Trust, Marshall Heights Community Development Organization, the DC Center for Independent Living, the Washington Legal Clinic for the Homeless, the Equal Justice Center, Mehri and Skalet PLLC, Families USA, NDRN, DC Fiscal Policy Institute.

ULS represented one individual under this priority.

Case example: ULS represents LT, a nine-year-old public school student with diabetes who was denied care and sent home when the school nurse was unavailable because DCPS failed to train or authorize lay staff to monitor her blood glucose levels, administer insulin or glucagon. To make matters worse, LT’s school formally banned LT’s mother when she advocated for her daughter’s care, which required LT to transfer to another school. ULS filed a formal complaint with the US Department of Education Office of Civil Rights which resulted in a comprehensive settlement that garnered significant media attention. In the wake of this advocacy, including hard-hitting testimony before the City Council, ULS successfully negotiated for DCPS to lift the ban on Ms. T so that her daughter could return to her original school in time for the first day of school in September 2012. ULS represented LT at a school meeting to create a 504 Plan with accommodations in line with the OCR Agreement. **********************

1. E. Represent plaintiff class members with mobility disabilities under the Young v. DC Housing Authority case to ensure the completion of the remaining 90 accessible public housing units pursuant to the July 2008 Amended Consent Order.

ULS continued to review monthly construction compliance reports from the DC Housing Authority (DCHA) regarding the status of construction of the wheelchair-accessible UFAS-compliant units. ULS compared DCHA’s lists of completed units with units inspected by ULS to determine which units need inspections. In September 2012, ULS inspected six UFAS units pursuant to the Young Amended Consent Decree. We fully expect DCHA to complete all 565 accessible units prior to the December 2013 deadline.

ULS collaborated with DCHA and private residential management companies.

ULS handled one individual case under this priority in addition to the Young class action lawsuit. Case example: ULS advocated on behalf of F.J., a 38-year-old woman with rheumatoid arthritis who resides in a wheelchair-accessible public housing unit. DCHA had erroneously stopped deducting F.J.’s utility allowance from her rent, resulting significant rental arrears. Through ULS advocacy, F.J., received $598 in a retroactive payment for her utility allowance. In addition, DCHA also recalculated and reduced F.J.’s rental amount and acknowledged their error. ********************

1.F. Investigate and remedy allegations of abuse and/or neglect against people with disabilities who transition from nursing homes and/or live in the community.

ULS handled an access issue under this priority on behalf of H.P., a 96-year-old woman with a physical disability in a nursing facility who was denied access to any visitors other than her court-appointed guardian. ULS provided HP and the nursing facility administrator with information regarding her rights as a Thorpe class member to return to the community with services and supports. ULS also wrote a letter to the administrator of the nursing facility after the facility staff attempted to bar a ULS advocate from visiting with H.P. outside of the presence of the nursing facility social worker or HP’s court-appointed guardian.

ULS collaborated with local nursing facilities, Long-Term Care Ombudsman, Providence Hospital, ADRC, Adult Protective Services, healthcare providers including the waiver home health agency, and the Social Security Administration.

ULS represented 4 individuals under this priority.

Case examples: In addition to the case described above, ULS advocated on behalf of TB, a 47 year old man with ALS at a nursing facility who was not receiving the requisite personal needs allowance from his SSI benefits. ULS complained to the Social Security Administration which restored his $70 monthly allowance and issued a retroactive check to make up for the improper reduction of his allowance to $30 monthly. ULS also investigated an allegation of neglect on behalf of M.H., a 55-year-old woman with Alzheimer’s disease. M.H.’s family alleged that her assisted living provider was negligent in caring for her. When the family attempted to remove M.H. from the home, the provider withheld the medications and threatened to call the police if the family did not pay the provider. After investigating the allegations, ULS could not substantiate the neglect allegation, but did get the provider to return MH’s medications and other belongings. ULS investigated an allegation of neglect on behalf of C.B, an 83-year-old man with dementia, diabetes and a physical disability at a nursing facility. C.B.’s family sought ULS assistance in transitioning CB back to his home with services under the EPD Waiver. The nursing facility initially refused to discharge C.B. without conducting a home assessment until ULS advised that CB’s family supported his choice to return to his inaccessible home, and the nursing facility lacked standing to obstruct this decision. ********************** 1.G. Provide outreach and education to administrative and policy-making bodies, advocates and under-served individuals to promote self-determination, consumer choice, and high quality services for people with disabilities in the most integrated, appropriate settings. ULS, with the American Diabetes Association as co-signer, submitted comments on DOH’s emergency regulations implementing the Student Access to Treatment Act. These regulations were designed to track the Department of Education Office of Civil Rights’ agreement with DCPS to train backup staff to administer diabetes medications. ULS recommended that DOH incorporate the terms of the Agreement in the regulations to comply with Section 504 and make clear several points to ensure students with diabetes can provide self-care in the classroom. In July 2012, ULS testified at a DC Committee on Health Council hearing regarding our diabetes complaint about DCPS’ failure to provide diabetes care and retaliatory banning of our client’s parent from the school where she advocated for her child’s rights. The Council members chastised the leadership at DCPS and DOH for failing to train lay school staff to administer diabetes care in the nurse’s absence, causing ULS’ client to miss school. The Council also cited DCPS’ and DOH’s numerous inconsistencies in their alleged reasons for not providing the child’s care and for banning the parent.

In October 2011, ULS attended two DC Board of Nursing meetings to advocate for expansion of DC’s nursing delegation regulations in order to meet the requirements of the Americans with Disabilities Act (ADA). For years, ULS has urged the Board to allow delegation of tasks to home health aides such as administering medication. In late May 2012, ULS provided comments on proposed home health aide regulations urging the District to lift the prohibition on tasks that home health aides are allowed to perform such as medication administration, bowel and bladder care. Such reforms are needed in order for home health aides to assist people with disabilities in the community, enabling them to move out of nursing facilities. In mid-July 2012, the DOH published final regulations that acknowledged ULS’ comments, added several new tasks to what home health aides may do in line with ULS’ recommendations and created a new medication aide position to perform many of the remaining functions recommended by ULS.

In the Fall 2011, ULS shared comments with the DC Council regarding proposed legislation that would require all residential properties that receive federal financial assistance to make their properties “visitable” i.e., to ensure that people who use wheelchairs, walkers and canes can enter the homes and utilize the features of the accessible level of the home. Visitability requires at least one zero step entry and one accessible half-bathroom on the accessible floor of the residence. In November 2011, ULS met with a coalition of advocates regarding the draft visitability bill. We developed a consolidated list of concerns and recommendations for revisions to the proposed legislation. A follow-up meeting was held with the Coalition of Non-Profit Housing Developers (CNHED) about concerns raised by the developers. In late November 2011, ULS testified at a City Council hearing on the draft visitability bill. It was scheduled for mark-up by the Council in December 2012, but one of the bill’s sponsors was not re-elected, leaving in doubt the status of the proposed legislation.

Collaborated with: Concrete Change, United Spinal, National Council on Independent Living (NICL), Equal Rights Center (ERC), Bazelon Center for Mental Health Law, American Association of Persons with Disabilities (AAPD), and Paralyzed Veterans Association (PVA).

ULS did not handle individual cases under this priority.

In February 2012, ULS submitted written testimony to the City Council Committee on Health regarding issues about the DC Department of Healthcare Finance (DHCF) in conjunction with the Council’s oversight of DHCF’s performance. ULS highlighted DHCF’s failure to comply with the ADA, the status of ULS’ Thorpe and DHCF’s improper termination of EPD Waiver services.

ULS participated in the following nine events and coordinated the distribution of ‘know your rights’ information about ADA accommodations, fair housing, diabetes care in schools and community-based service options to 127 individuals:

October 2011: Presented to residents and staff at Carroll Manor Nursing Facility about the rights of individuals with disabilities to transitional assistance and services in the community. October 2011: DC Mayor’s Disability Expo October 2011: DC hospital pediatric clinics and Juvenile Diabetes Research Foundation (JDRF). November 2011: ULS conducted a presentation for 34 participants about symptoms of and services for people with traumatic brain injuries, and the prevalence of TBI among survivors of domestic abuse and sexual assault. March 2011: Attended a TBI conference on Capitol Hill and distributed materials. April 2012: ULS presented and answered Medicaid and public benefits questions to individuals with disabilities and staff of So Others May Eat (SOME). May 2012: ULS presented to Mary Center to 8 social workers about P&A services and distributed PAIR fliers. July 2012 and September 2012: ULS presented to consumers at the National Rehabilitation Hospital’s TBI Support Group monthly meeting. August 2012: ULS, with NDRN, presented to advocates affiliated with civil rights and voting rights groups in a panel during a nationwide voting conference regarding ULS’ methods to improve polling place accessibility in the District. Case examples: ULS assisted H.R., a 79-year-old woman with a physical disability in completing a power of attorney authorizing her daughter to make certain specified decisions on her behalf. ULS also assisted S.R., a 42-year-old woman with a physical disability, in completing a power of attorney authorizing her mother to make certain decisions on her behalf. Following her mother’s death, ULS referred Ms. R to the proper DC government agencies to assist with the funeral arrangements. **************************************

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.

OBJECTIVE

Advocate on behalf of people with disabilities to ensure their access to DC government services and supports in the most integrated settings appropriate to their needs, public accommodations, and wheelchair-accessible, integrated, federally-subsidized housing.

Priorities:

A. Represent class members in Thorpe v. District of Columbia to promote their rights under Title II of the Americans with Disabilities Act (ADA) to information about alternatives to nursing facility placement, transitional assistance, and quality home-based personal care services and supports through the Medicaid Waiver Program for People who are Elderly and/or have Physical Disabilities (EPD Waiver) and the DC Medicaid State Plan to enable them to move out of nursing facilities.

B. Advocate and litigate on behalf of people with disabilities to challenge the District’s improper termination of Medicaid home health services.

C. Work to ensure that public accommodations, polling sites, and governmental facilities and programs are accessible to people with mobility, hearing and visual disabilities in the District of Columbia under the Americans with Disabilities Act.

D. Represent plaintiff class members with mobility disabilities under the Young v. DC Housing Authority case to ensure the completion by December 31, 2013 of and inspect all the remaining 90 accessible public housing units pursuant to the July 2008 Amended Consent Order, which brings the total completed accessible units to 565.

E. Investigate and remedy allegations of abuse and/or neglect against people with disabilities who transition from nursing homes and/or live in the community.

F. Provide outreach and education to administrative and policy-making bodies, advocates and under-served individuals to promote self-determination, consumer choice, and high quality services for people with disabilities in the most integrated, appropriate settings.

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. Source of Funding Received Spent Federal (sec509) 175,632.00 193,668.19 State 0 0 Program Income 0 0 Private 0 0 All other funds 0 0 Total (all sources) 175,632.00 193,668.19 B. Category Prior FY Current FY Wages/salaries 114772.13 138055 Fringe benefits 34431.65 41417 Materials/supplies 2668.41 3803 Postage 310.70 327 Telephone 1900.98 1889 Rent/occupancy 22589.90 25022 Travel 1854.98 1724 Copying 0.00 0 Bonding/insurance 1384.81 1344 Equipment(rent/buy) 5305.17 3727 Legal services 0 0 Indirect-Consultants 3369.10 2390 Misc/Other 5080.36 11125 Total Budget 193668.19 230823 C. Type of Position FTE % yr filled Person-yr Professional Full-time Part-time 5 100% 5 Vacant Clerical Full-time Part-time 4 100% 4 Vacant

D. There are no PAIR advisory boards. E. There were no PAIR grievances filed. F. ULS coordinated with the Long-term Care Ombudsman Program on behalf of individual Thorpe class members, and regarding the illegal termination of waiver services by DHCF.

Certification

Signed?Yes
Signed ByJane Brown
TitleExecutive Director
Signed Date12/17/2012