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

Georgia (Georgia Advocacy Office, Inc.) - H240A120011 - FY2012

General Information

Designated Agency Identification

NameGeorgia Advocacy Office Inc.
Address150 E Ponce de Leon Ave. 430
Address Line 2
CityDecatur
StateGeorgia
Zip Code30030
E-mail Addressinfo@thegao.org
Website Addresshttp://www.thegao.org
Phone404-885-1234
TTY 404-885-1234
Toll-free Phone800-537-2329
Toll-free TTY800-537-2329
Fax404-378-0031
Name of P&A Executive DirectorRuby K. Moore
Name of PAIR Director/CoordinatorJulie Kegley
Person to contact regarding reportCrystal Beelner
Contact Person phone404-885-1234
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 areas403
2. Individuals receiving I&R outside PAIR priority areas168
3. Total individuals receiving I&R (lines A1 + A2)571

B. Training Activities

1. Number of trainings presented by PAIR staff90
2. Number of individuals who attended training (approximate)7,189

The P & A and Employment First Georgia (EFG) hosted trainings on best practices in employment for people with disabilities to hundreds Vocational Rehabilitation counselors, local education agency staff, employment support providers, self-advocates, case managers, family members, and advocates.

The P & A and EFG assisted with planning the GAPSE (Georgia Association for Persons in Supported Employment) conference. Over 200 employment support providers and Vocational Rehabilitation staff attended this conference which included four presentations by P & A and EFG staff in partnership with members of Georgia employment collaboratives. “The Tipping Point” provided an in-depth discussion of the Discovering Jobs Pilot: Linking Discovery to Employment. Presenters included Southeast Technical Assistance & Continuing Education Center (SE TACE), Georgia Vocational Rehabilitation Services, the Institute on Human Development and Disability, EFG, and the P & A. “Working Smart through Employment Collaboratives: what they are and why they are important!” explained the "what" and "why" of creating local, multi-partner Employment Collaboratives that focus on resource sharing, system alliances, and capacity building within provider organizations. Examples of both micro-collaboratives and more formalized Memorandums of Understanding-based Employment Collaboratives were explored and discussed. Presenters included the Institute on Human Development and Disability, a service provider, and EFG. The P & A and EFG also did presentations on Evidence-Based Practices in Employment for People with Psychiatric Disabilities and presentations on current ADA litigation on a national level, pertaining to employment and sheltered workshops.

The Work Works for All South Georgia Initiative was completed this year. This capacity-building employment collaborative focuses on increasing employment for individuals with disabilities in the southern part of Georgia by partnering with citizens, advocates, advocate organization staff, business owners, educators at the secondary and post-secondary levels, provider organization staff, Vocational Rehabilitation counselors, the DD Council, the P & A, the Institute on Human Development and Disability, and the Department of Behavioral Health and Developmental Disabilities. Meetings were hosted three times with over thirty in attendance at each. The Initiative requested and received support, training and technical assistance through the Technical Assistance and Continuing Education Center-Southeast to assist us in first phase development of common practices based on what research has proven to lead to quality employment outcomes.

The P & A shared the status of employment initiatives in Georgia with the Georgia Independent Living Network. Approximately 30 employees from Centers for Independent Living across Georgia learned about what is available to the individuals that they serve. A similar training was provided for the staff of Citizen Advocacy Offices across Georgia, and 8 staff attended.

The P & A and EFG participates in numerous transition council meetings and transition fairs for students in high school throughout the state. The P & A presented to students, families, and school staff in Cobb County, Marietta City, Douglas County, Hall County, Walker County, Gwinnett County, and Liberty County (for military families). Approximately 1,000 individuals participated.

As the supporter for People First of Georgia, the P & A participates and provides training during the People First Annual Conference. As the supporter for People First of Georgia, the P & A participates and provides training during the People First Annual Conference. Approximately 120 self-advocates from across Georgia participated. The P & A and EFG presented an Employment Summit to kick off the conference. Employees, advocates, and certified peer specialists shared their personal stories and best practices.

Employment First Georgia and the P & A presented on what Georgians are doing and employment opportunities for Georgians with mental illness can be increased at The Drive to Work: Promoting Mental Health Recovery through Employment forum at the Carter Center. The day highlighted the special initiative between Substance Abuse and Mental Health Services Administration (SAMHSA) and its Center for Mental Health Services (CMHS) to assist states in planning and implementing activities to foster increased employment opportunities for people with mental health disorders, including Georgia. The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), in partnership with the Georgia Mental Health Consumer Network (GMCHN) hosted a forum for DBHDD contracted Behavioral Health providers, including CEOs, Clinical Directors, Directors of Supported Employment, Peer Support and Psychiatric Rehabilitation services; ACT Team Leads, Vocational Specialists and Certified Peer Specialists; DBHDD State & Regional Office staff; Vocational Rehabilitation State Office and Regional Office staff; Certified Peer Specialists, Mental Health Advocates; Consumers and Family Members.

The P & A hosted trainings based on Social Role Valorization throughout the State for providers, individuals with disabilities, family members, specifically, individuals who are vulnerable or who have been denied effective communication. Advocates need a high level of awareness and advocacy practices aimed at establishing and maintaining positive social roles, including those accessed through employment, for people subject to all forms of exclusion. The P & A also participated in and led portions of PASSING (Program Analysis of Service Systems Implementing Normalization Goals) which assesses the quality of human services for individuals with disabilities based upon the principles of Social Role Valorization. The P & A hosts continuing education for participants to sharpen their skills and to provide a forum for discussion of the application of these principles. The P & A has also provided a training entitled, “The Power of Roles,” to give participants a practical introduction to the concept of Social Role Valorization (SRV) and some of its main elements. Participants leave understanding the power of social roles to counteract some of the effects of devaluation and to their importance in assisting people who have been marginalized to have a full and inclusive life.

In addition, the P & A hosted David Pitonyak, an international expert in supporting individuals with “challenging behaviors” present “Beyond ‘Behaviors: Supporting Confidence, Competence, and Well-Being.” The P & A co-hosted the Georgia Winter Institute, a gathering of international experts on incorporating values-based, person-centered-philosophies, into our community building efforts.

The P & A was invited to participate in the 27th Annual Rosalynn Carter Symposium on Mental Health Policy: “Building Services and Supports for Children Exposed to Domestic Violence, Child Welfare, and Juvenile Justice.” Former U.S. First Lady Rosalynn Carter brought together more than 200 children’s welfare leaders, mental health leaders, stakeholders, and providers to discuss steps to be taken to build safe, inclusive communities for vulnerable children. The P & A Executive Director facilitated a strand on Policy and the Law, along with the Bazelon Center for Mental Health. Significant recommendations were crafted to be brought forward by the Carter Center.

The P & A presented to a group of approximately 35 family members and individuals with psychiatric disabilities in local chapter meeting of the National Alliance on Mental Illness. The P & A addressed questions about the United States v. Georgia, service gaps, the legislative agenda, and the P & A’s priorities and objectives.

The P & A provided information and responded to questions from the audience at the Georgia Mental Health Day at the Capitol. Over 400 individual joined the Georgia Mental Health Consumer Network in raising awareness about issues that affect the mental health community.

The P & A Legal Director presented at the NAMI Georgia Annual Statewide Membership Meeting and Conference on community-based mental health services for children. The P & A also maintained an exhibitor’s table where information about protection and advocacy services was disseminated to attendees from across Georgia.

The P & A collaborated with the Crossroads Program of the Dekalb County Community Service, Highland Rivers Community Service Board, and Community Friendship in an on-going role as a trainer. Approximately 80 self-advocates attend the trainings on topics such as People First language and internalized stigma, housing opportunities, employment and reasonable accommodations, and the Olmstead decision. The P & A also provides training for Certified Peer Specialists.

The P & A participated in the Georgia Mental Health Planning Council Feedback Tour. The tour provided an opportunity for the individuals in the community to give the planning council feedback on present services and service needs.

The P & A supported People First of Georgia to host the Welcome Room at the TASH (the Association for People with Severe Disabilities) conference. The Welcome Room gave attendees an opportunity to relax, refresh, and network during the activity-packed conference. People First distributed literature about the organization, self-advocacy, and self-determination. The P & A supported People First members to attend the conference and negotiated for accommodations at the conference.

The P & A played a significant role in making the TASH Annual Conference a success. The P & A presented on the Safe Schools Initiative, the Children’s Freedom Initiative, the Parent Leadership Support Project, Effective Use of Assistive Technology, Transition from School to Work, Work Incentives, and Employment of People with Significant Disabilities. The P & A also supported People First members to attend, sponsored an informational table on P & A’s core projects, provided technical assistance on reasonable accommodations, supported entrepreneurs with disabilities to participate and to showcase their new businesses, supported Concrete Change to have an informational table, and participated in other leadership roles throughout the conference. The P & A and EFG presented at the Employment for Youth in Transition pre-conference which featured live-streaming online. The P & A and EFG also participated in the National Council on Disability’s Listening Session during the conference.

The P & A also presented on a panel in the Employment Track entitled, “The Stars Are Aligning for Real Jobs, Real Lives” The panel addressed the national debate surrounding Employment First, the presumption that all working age individuals will work, return on investment that research concludes is available with competitive employment and lacking with sheltered work, and systems partnering for change that promotes employment as the preferred option.

During the TASH conference the P & A was also part of a roundtable discussion on Improving Transition Outcomes for Youth with Intellectual and Developmental Disabilities with Melody Musgrove, Director of the Office of Special Education Programs, Lynnae Ruttledge, Commissioner of the Rehabilitative Services Administration, Sharon Lewis, Commissioner of the Administration on Developmental Disabilities and Ralph Lollar, Director of Long Term Services and Supports, Centers for Medicaid and Medicare Services. The P & A Executive Director is also a member of TASH’s Employment Committee, working on promoting excellence in employment nationally.

Additionally, the P&A helped to provide a framework for, and gave testimony at an Employment Listening Session for National Council on Disability allowing the P & A the opportunity to add perspective to the national dialogue on employment with the purpose of advising the Council on non-legislative changes the Administration could implement that might have a positive impact on improving employment outcomes.

Over 2000 people joined at the 2012 Disability Day at the Capitol to remind the legislature of the importance of home and community-based services for people with disabilities. The event was covered by newspapers, journals, and television.

P & A continues to support the Georgia Microboard Association led by Ms. Nancy Vara. The group of approximately 35 self-advocates and family members meet monthly to discuss the creation and sustainability of microboards to support individuals with disabilities. Microboards provide an alternative to the traditional provider network. Individuals, most of whom are beneficiaries of Social Security, have started their own businesses through the support of the Georgia Microboard Association. The Association hosted a conference presented by Kathy Snow, Living Real Lives and Dreaming Big Dreams.

The P & A presented to the Columbus ARC, Macon ARC, Griffin ARC on Identifying Abuse & Neglect in home and community-based settings. Parents, self-advocates, direct care staff, and management staff attended.

The P & A and People First of Georgia hosted two “Housing FYI” Conferences with 70 self-advocates, family members, and State housing specialists in attendance. The P & A staff presented on how to successfully search for accessible rental and housing properties, how individuals with disabilities can successfully live in their own home, and how to advocate for accessible housing.

The P & A presented with two other special education attorneys, “Advocating for the Rights of Students with Dyslexia: What Every Parent Should Know” at the 22nd Annual Dimensions of Dyslexia Conference. The P & A presented on the basics of advocating for a student with dyslexia or other learning disabilities in reading in the public schools.

A P & A attorney presented during Jewish Disability Awareness Month at Temple Kehilat Chaim. She shared about the protection and advocacy system and the various initiatives that the P & A hosts.

The P & A Legal Director participated on a panel during a presentation entitled the “Empowered Patient” at the Health Care Ethics Consortium of Georgia Annual Conference at Emory University. The P & A shared our approach to supporting people with significant disabilities in participating in their own care. Over 100 health care professionals, academics in the healthcare field, and bioethicists were in the audience.

The P & A was invited to present at the Professional Development Workshop for Interpreters at Georgia Perimeter College on two occasions to approximately 15 interpreters. The P & A shared from an advocacy perspective as well as personal experience about the impact that an interpreter can have on the life of an individual who is deaf or hard of hearing.

The P & A answered questions at the Georgia Council on Developmental Disabilities in Savannah for an audience of 75 citizens, local municipal government officials, Citizen Advocates, self-advocates, family members, and the media.

The P & A presented at the “Rolling with EFMP Event/Information Fair at Moody Military Base in South Georgia” to families of students with disabilities. The P & A shared resources and information for families navigating school and home-based services.

The P & A presented to citizen advocates supported by the Oconee Citizen Advocacy Office on “How to communicate with individuals who do not use words.” The P & A shared techniques, services, and assistive technology that will facilitate communication between advocates and protégés, specifically when a protégé is expressing pain or fear without using words. The P & A presented at the Georgia Association of Medical Equipment Suppliers (GAMES) annual meeting. The focus of the presentation was Medicaid coverage for durable medical equipment. GAMES members wanted specific information about their role is assisting people to obtain the equipment they need. The P & A explained how people who use equipment experience barriers that are created by the state Medicaid agency and strategies to overcome those barriers. The purpose of the training was to educate durable medical equipment providers how they can assist individuals in obtaining the required equipment. GAMES is a statewide professional membership organization for medical equipment suppliers. These professionals work directly with people and Medicaid and other insurance companies to appropriate medical equipment for people across Georgia.

The P & A presented during two webinars sponsored by the Tools for Life (TFL) agency. The first Webinar concerned the Funding of Assistive Technology (AT). The P & A discussed what the P & A does and how it encourages self-advocacy and advocacy for others. In the context of AT, P & A discussed strategies people can use in order to advocate for the funding of needed equipment. The second Webinar concerned Assistive Technology (AT) and Nursing Facility Transition. The P & A discussed what the P & A does; why it is important for people to have real homes; how AT can help someone leave a nursing facility; and how AT can help someone achieve the “Good Life.” There were family members, service providers, peer supporters, and people who have disabilities who “attended” this Webinar. Approximately 70 people listened to the presentations.

The P & A participated in a Town Hall meeting that was co-sponsored by the Tools for Life (TFL) agency and the State Independent Living Council. The meeting was held by the two sponsors so that they could receive public input into their programs and their strategic planning. The P & A discussed what it is and what it does and participated in the discussions that occurred within the meeting. Service providers were, primarily, in attendance. In addition, there were persons with disabilities, advocates, and others. Approximately 30 people were in attendance.

The P & A Executive Director presented at the National Association for Rights Protection and Adovcacy (NARPA) 30th Annual Conference in Cincinnati. During the keynote, she shared “Evolutions in Advocacy: What Have We Learned and What Are We Fighting For” with attorneys and advocates across the country. Specifically, Ms. Moore shared her perspective on how advocacy for individuals with disabilities has changed over the years based upon her experiences in advocacy, provision of direct support, national policy work and systems change.

The P & A Legal Director serves as the Chairperson of the Legal Committee and A P & A Advocate also serves as the Co-Chairperson of the Community Education Self Advocacy Committee, subcommittees of the Project Advisory Committee of the Board of the National Disability Rights Network (NDRN). At the Annual NDRN Conference, the P & A Executive Director presented on “More Than Housing: A Holistic Approach to Community Integration” and presented on a panel explaining how protection and advocacy systems and Parent Training Institutes can collaborate more effectively. The P & A Legal Director gave the following presentation, “Communicating P & A Principles and Values across All our Work.” The Program Accountability Director of the P & A shared tips and experiences on “Using the PPR as a Year-Around Tool” in a presentation and a webinar follow up with over 40 participants. A P & A Investigator participated in a panel on the “Intersection between Review, Monitoring, and Investigations.” (Representative Payee Project and Abuse and Neglect Investigations)

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles30
3. PSAs/videos aired2
4. Hits on the PAIR/P&A website3,000
5. Publications/booklets/brochures disseminated18
6. Other (specify separately)8

Narrative

10/7/2011 Advocating for Inclusion iTunes http://talkingspecialneeds.com/the-inclusive-class

10/17/2011 “N.D. Ga: Threat of Institutionalization Sufficient for ADA Claims” Herbert Semmel Federal Rights Project National Senior Citizens Law Center

10/28/2011 Study of Facilitators and Barriers to Research Use Center on Knowledge Translation for Employment Research, funded by the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research The GAO and Employment First Georgia participated in the survey which will be disseminated

11/18/2011 Integrated Employment Toolkit United States Department of Labor, Office of Disability Employment Policy The GAO and Employment First Georgia participated in the creation of this Toolkit. The Toolkit offers a collection of resources, reports, papers, policies, fact sheets, case studies, and discussion guides from a variety of sources to accommodate the full range of users and increase capacity and understanding about the value and potential of integrated employment. http://www.dol.gov/odep/ietoolkit/

11/23/2011 “Thank You 2011 TASH Conference Sponsors” TASH Website The GAO provided significant support to the 2011 TASH Conference held in Atlanta http://tash.org/thank-you-2011-tash-conference-sponsors/

12/4/2011 Parent Leadership Support Project Graduate nominated the GAO for a social media makeover, providing visibility for the Georgia Advocacy Office on a non-traditional website http://www.brickfish.com/Pages/PhotosAlbums/PhotoView.aspx?picid=1360983_4496440&pid=4292717&scid=616&

12/6/2011 “TASH Conference takes aim at Restraint and Seclusion” http://tash.org/tash-conference-takes-aim-at-restraint-and-seclusion/ Highlighting a presentation by GAO staff

2/3/2012 “Students Learn About Health Policy and Lawmaking from Local Experts” Center News, Center for Law, Health, & Society http://law.gsu.edu/clhs/index/news_and_events/center_news/article?id=591 This year’s community partners include Children’s, Georgians for a Healthy Future, and the Georgia Advocacy Office

5/8/2012 “Social Security Advisory Board Minutes” Social Security Advisory Board Website http://ssab.gov/Portals/0/Documents/minutes/2012/May%20Minutes.pdf The GAO presented on a panel about the status of employment for beneficiaries in Georgia at the May 2012 Social Security Advisory Board meeting.

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)44
2. Additional individuals served during the year57
3. Total individuals served (lines A1 + A2)101
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)8

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 35

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility7
2. Employment7
3. Program access6
4. Housing14
5. Government benefits/services13
6. Transportation1
7. Education5
8. Assistive technology2
9. Voting0
10. Health care37
11. Insurance0
12. Non-government services0
13. Privacy rights2
14. Access to records0
15. Abuse9
16. Neglect10
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor69
2. Other representation found1
3. Individual withdrew complaint1
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.6
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit0
9. Other0

Please explain

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-advocacy31
2. Short-term assistance14
3. Investigation/monitoring14
4. Negotiation14
5. Mediation/alternative dispute resolution1
6. Administrative hearings1
7. Litigation (including class actions)1
8. Systemic/policy activities1

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 41
2. 5 - 2215
3. 23 - 5964
4. 60 - 646
5. 65 and over15

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females51
2. Males50

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American46
5. Native Hawaiian or Other Pacific Islander0
6. White52
7. Two or more races1
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent37
2. Parental or other family home15
3. Community residential home3
4. Foster care1
5. Nursing home29
6. Public institutional living arrangement2
7. Private institutional living arrangement5
8. Jail/prison/detention center6
9. Homeless3
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 hearing14
3. Deaf-blind1
4. Orthopedic impairment23
5. Mental illness8
6. Substance abuse0
7. Mental retardation2
8. Learning disability3
9. Neurological impairment24
10. Respiratory impairment3
11. Heart/other circulatory impairment3
12. Muscular/skeletal impairment5
13. Speech impairment0
14. AIDS/HIV4
15. Traumatic brain injury3
16. Other disability4

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 changes1,456,812

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.

The P & A continues to host Employment First Georgia (EFG). The work of EFG builds on several years of work at the state and local level to create consensus and participation regarding “who can work” and to develop examples of innovative practices to demonstrate customized approaches to employing people with significant disabilities. EFG receives funding primarily from the P & A and the Georgia Council on Developmental Disabilities. In addition to hosting EFG, the P & A continues to identify individuals who need employment services and provides protection and advocacy. We maintain the EFG website as a local and national resource regarding critical advancements and changes in our field, and highlighting individual stories of quality, customized employment, including self-employment.

Due to the limited number of providers and the priority for an approach that includes all of customized employment services, not just the Discovery Process; it was determined that VR needs to explore the creation of a new service. VR researched and drafted a “customized supported employment” service that will allow providers to complete the Discovery Process as part of supported employment for an additional fee. A draft of the document was created by VR and Southeast Technical Assistance and Continuing Education Center with technical assistance from Employment First Georgia and the Georgia Advocacy Office. We look forward to the implementation of this policy any day now.

JW is a young man with a history of being under-employed or unemployed due to the social and behavioral aspects of his disability. JW went to Vocational Rehabilitation for assistance to find a job. Vocational Rehabilitation paid EFG to complete the Discovery Profile and the Visual Resume. The Profile and Resume revealed that JW has a strong interest in Information Technology. EFG also collaborated with a business executive with strong strategic and Information Technology consulting background to coach JW. This business executive participates as a member of JW’s Customized Employment support team. EFG created a job for JW at Auto Traders. JW started working 40 hours per week with full benefits in February!

EFG provided technical assistance to MC. She has a unique business creating and selling original designs which can be purchased from her website at www.designsoncloud9.com. EFG provided technical assistance regarding self-employment and referred her to the Work Incentives Planning and Assistance project for Social Security benefits planning.

The Administration proposed a rule to Section 503 of The Rehab Act that requires all federal contractors to have people with disabilities be 7% of their workforce. Major business interests are putting pressure on the Administration not to publish the regulations. The P & A signed onto a letter to the President supporting the rule. In addition, we aim to serve as a role model for other employers in welcoming, recruiting, and supporting people with disabilities at every level of the organization. 73% of P & A staff are people with disabilities.

The P & A continued to host a group of stakeholders (State ADA Coordinator’s office, Georgia Council for the Hearing Impaired, Helen Keller National Center for the Blind, Georgia Association for the Deaf, interpreters, and persons with deafness) to address the issues facing persons who are deaf and hard of hearing in effectively communicating with their health care providers. One of the outcomes of the group has been the development of a presentation regarding the responsibilities of health care providers to provide effective communication to persons with deafness to be presented to health care providers.

The P & A actively participated in the Shut Out, Priced Out and Segregated (“SOPOS”) Coalition, which is a multi-disciplinary group of experts (architects, developers, builders, lenders, attorneys, disability advocates, and government agencies) committed to implementing the recommendations of the SOPOS report. The Coalition partnered with the State ADA Coordinator’s Office to develop training on the Fair Housing Act Amendment regulations for building code officials; held a Visitability train-the-trainer training; inspired the creation of a children’s book on Visitability co-authored by Coalition members; and requested data from the Georgia Department of Community Health as to the housing preferences of people with disabilities currently residing in nursing facilities in order to advocate for additional resources to support accessible, affordable, and integrated housing in the community for people with disabilities.

The P & A is the lead partner on the Children’s Freedom Initiative (CFI) to ensure that all children live in permanent, loving homes, not in institutions. The CFI is a collaborative effort of the P & A, Georgia Council on Developmental Disabilities, Institute on Human Development and Disabilities, the Center for Leadership in Disability, People First of Georgia, and the Statewide Independent Living Network. The P & A has identified children in facilities, provided individual protection and advocacy, deflected institutional placement, provided technical assistance to facility administrators, state agencies, and child protection caseworkers regarding available community-based resources including early periodic screening and diagnostic testing (EPSDT), prepared necessary litigation, and provided oversight of discharge to homes in the community.

In early 2012, the CFI participated in a model coherency evaluation to determine who the young people are that CFI will specifically advocate for, what those young people specifically need, and how their needs will be met through the CFI. CFI set priorities and goals and decided to broaden the collaborative by inviting other child advocacy agencies to participate in order to strengthen our collective advocacy on behalf of children, and specifically to gain more allies in the prevention of institutionalization of children with disabilities.

CFI hosted several meetings with a larger group of child advocates and have developed a logic model to guide our process. CFI is currently scheduling a meeting with all of the State agency Commissioners to present our suggestions so that no child will have to grow up in an institution.

Also, the P & A has advocated to keep children out of institutions. The P & A monitors the two young people who are still stuck in state hospitals and is advocating for the discharge of many young people in nursing facilities. The P & A is shaping the “Not Home Documentary” to create a film that specifically fits the needs of CFI that we will use in a variety of venues to educate policy makers and others about the need for children to have permanent, loving homes, and the many effective strategies for making this happen.

The P & A participates on the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and the Elderly, which includes American Red Cross, Brain and Spinal Cord Injury Trust Fund, Disability Resource Group, Emory Center for Public Health Preparedness, Georgia Division of Human Services, Georgia Emergency Management Agency, State ADA Coordinator’s Office, GCDD, Southeast ADA Center, the SILC, and Tools for Life. Participation in this coalition is changing the way emergency management professionals design emergency response systems for individuals with disabilities, reducing the risk they face during times of natural disaster and crisis. This year, the Coalition disseminated 130 copies of the Coalition’s Get Ready Tool Kit (Household Emergency Plan, Emergency Plan Checklist and the instructions) at the People First of Georgia annual conference. The Emergency Preparedness brochure was revised by the Outreach and Technical Assistance and Training Committee and widely disseminated. The First Responders Tips Guides were revised and reformatted and widely disseminated also. In addition to the general emergency brochure, an Assistive Technology (AT) Brochure has been developed and is now accessible on the State ADA Coordinator’s website.

The P & A is a member of the Unlock the Waiting List campaign to address the State’s failure to implement the Olmstead decision by its low number of community based supports available to people with disabilities, including people with traumatic brain injuries. There are approximately 190,000 Georgians with disabilities who require assistance from a family member or caregiver every day, and thousands of people living in nursing facilities that would prefer to live in the community. The P & A, the DD Council, the University Centers for Excellence, All About Developmental Disabilities, the State Independent Living Network, and People First of Georgia formed a committee with the goal of expanding community based supports and services for Georgians with disabilities. The Unlock campaign currently has over 300 member organizations and over 500 individual members throughout the state.

The advocacy community asked the Governor to support a budget that will finance implementation of the provisions of the U.S. v. Georgia settlement and provide for additional home and community-based supports for individuals. UNLOCK the Waiting Lists is asking for additional funding for the 130 individuals on the ICWP waiting list. The House passed the 2013 budget. The Health Appropriations Subcommittee added 50 ICWP waivers, and the Human Services Appropriations Subcommittee committed Balancing Incentive Payments Program funds to cover the annualizations of waivers awarded to youth aging out of the Department of Family and Children Services.

The P & A provided peer support to individuals who are transitioning from nursing facilities under Money Follows the Person. Atlanta Legal Aid Society and the P & A are representing these individuals. The P & A is helping the individuals realize that they can live successfully in the community. The P & A is helping them connect with the disability community outside the nursing facility and helping them re-learn social skills that people lost while living in a nursing facility or institution.

The P & A provides technical assistance to the Money Follows the Person Steering Committee. The P & A also monitors the effectiveness of the contractor for Money Follows the Person in providing transition services to individuals transitioning from nursing facilities.

The P & A met with the Administration on Intellectual and Developmental Disabilities, the Transportation Security Administration, and other agencies to address the needs of travelers with disabilities. As a result of the advocacy, the Transportation Security Administration launched a toll-free hotline for passengers with disabilities to address concerns and to provide assistance and developed a new training curriculum for TSA employees.

The P & A participates in the Olmstead Planning Committee to oversee the State’s implementation of the Americans with Disabilities Act and Olmstead. The P & A participated in each work group: Mental Health, Developmental Disabilities, Substance Abuse, and Physical Disabilities/Aging. The P & A contributed to the 2012 Olmstead Plan Draft to ensure that there is a coherent and comprehensive Plan that is implemented with a focus on housing, employment, children, and services for people with substance abuse issues. The Plan has been submitted to the Governor for approval.

The P & A met MT, 67 years old, at the nursing facility where he had lived for five years. MT was very clear about wanting live in the community. A P & A advocate referred MT, who has a neurological disorder, to the Money Follows the Person program to link him to the supports he would need to live independently in the community. MT was quickly found eligible for supports but he did not have family locally that he could live with so finding an accessible home with supports was difficult. By working with MT, the nursing facility social worker, and the Money Follows the Person program, a home was found for MT and he moved into his new home. He is still living there and beginning to develop new relationships in his community.

In response to a complaint, the P & A negotiated with the Vice President and Legal Counsel of the Atlanta Braves organization regarding the accessibility of its parking lot, identification of available accessible seating, and equal opportunity for persons with disabilities to to purchase tickets for accessible seating at Turner Field. The Braves agreed to update all their printed and electronic materials to reflect the accessible seating in the stadium.

The Braves contacted Ticketmaster and arranged to be one of the first teams for which Ticketmaster debuted its interactive live chat with patrons with disabilities to help them identify the accessible seats and to do so within the same amount of time that it takes a person without a disability to purchase a ticket through Ticketmaster.

The Braves organization has convened a group of fans with accessible needs to survey the stadium and parking lots on a routine basis and to provide feedback on how they can better serve people with disabilities and has invited P & A to participate on this committee, in order to provide the Braves organization with feedback as to whether it is meeting its requirements under the ADA.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts0
2. Number of individuals named in class actions1,456,812

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.

The P & A represented a woman in an administrative hearing to appeal the Georgia state Medicaid agency’s, Department of Community Health, denial of Money Follows the Person benefits to her on the alleged basis that she did not receive Medicaid. The P & A filed multiple briefs and affidavits with the court. Two days before the hearing, the Judge ruled that the woman was entitled to summary determination and that Georgia’s state Medicaid agency could not terminate its Money Follows the Person services to her.

LP contacted the P & A to request assistance in removing her mother as her guardian and having her rights restored. LP’s mother placed LP in an assisted living facility even though LP could live independently. The P & A worked with LP and her doctor to conduct a series of evaluations showing that LP was legally competent and not in need of a guardian/conservator. The P & A filed a Petition for Restoration of Rights in probate court, attended LP’s court-ordered evaluation with her, and represented LP at the hearing where the Judge ordered the removal of her mother as guardian and restored her rights.

RW contacted the P & A when her podiatrists refused to provide a tactual ASL interpreter for her at her doctors appointments. The P & A wrote letters to the doctors which went unanswered. Then, the P & A filed a complaint with the United States Department of Justice (DOJ) against the doctors. DOJ referred the complaint to mediation.

The mediation was very successful as the doctors agreed to provide the following at all 5 of their offices:

1. Provide for a tactual ASL interpreter for RW at all appointments. 2. Develop an office wide policy regarding effective communication with patients who are deaf, hard of hearing, or deaf-blind. 3. Training for all office staff regarding the new policies.

The P & A oversees the implementation of the United States v. Georgia settlement agreement with a key focus being on the mental health and developmental disabilities systems and oversight of the process of deinstitutionalization and significant development of community supports and services for people with psychiatric and developmental disabilities. P & A was appointed as amicus in a lawsuit filed by the Department of Justice Civil Rights Division against the State regarding the State’s failure to serve people with developmental disabilities and mental illness in the most integrated setting appropriate to their needs. P & A was an active participant in months of settlement negotiations that led to a comprehensive agreement greatly expanding services and other resources necessary to allow the successful transition of individuals in institutions to the community.

The P & A meets with the Court Monitor before, during, and after her visits to Georgia. As one of the Amici, the P & A participates in regular conference calls and meetings regarding the emerging issues associated with the hospital closures. The P & A relays its concerns to the Bazelon Center, Department of Justice, and the Court Monitor.

The emphasis during Fall 2011 was on an upcoming deadline for the state instituting a Quality Management System (a deadline the State missed) and adequately addressing the needs of the people leaving the hospital. The P & A monitors the lack of integration of critical incidents and reports of harm and deaths within the developmental disabilities system of oversight and the nearly complete lack of oversight of the mental health system.

During the legislative session, the P & A educated legislators about the impact that the proposed budget would have on implementation of the Settlement Agreement. The Governor’s proposed budget appeared to have cut the core funding for services for individuals with developmental disabilities which is outside of compliance with the Settlement. This proposal would further undermine the State’s ability to implement the provisions of the Settlement Agreement and the State’s ability to comply with the timeframes in the Settlement Agreement.

The Court Monitor has issued two reports. In August 2012, the parties asked the Court to make some modifications to Settlement Agreement regarding community based services (specifically ACT teams and the Quality Management System. The Amici filed comments asking that the court make the State and DOJ take additional steps before the court approved (delete-to) the modifications.

The P & A sued the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) for violations of the protection and advocacy system’s access authority to people, facilities, and records. As a result of mediation in 2011, a detailed partial settlement agreement was entered as a temporary order of the Court. The agreement embodies a commitment by the parties to design and implement joint trainings to ensure that staff at all levels of DBHDD and the P & A share a common understanding of access protocol. Representatives of DBHDD and the P & A met to discuss the development of training materials to be presented by both entities to DBHDD Regional Hospital Administrators. The sole remaining issue that was not resolved by the settlement agreement was the P & A’s full access to inspect and copy peer review materials. The court affirmed the P & A’s access to inspect and copy peer review materials. Later,, the Court awarded the P & A attorney fees. The P & A continues to implement the provisions of the mediated settlement agreement in what the P & A believes is a good faith effort to resolve any barriers to access as they arise.

Two individuals who have psychiatric and developmental disabilities and who are deaf sued the Department of Behavioral Health and Developmental Disabilities for failure to provide accessible home and based community services. The Court issued an opinion granting the plaintiffs’ motion for summary judgment. The P & A is supporting the plaintiffs’ counsel to craft a settlement agreement that provides accessible home and community based services to individuals who are deaf. The plaintiffs’ sought a home in which the service providers effectively used American Sign Language.

The P & A facilitated a meeting to ensure that the settlement agreement is comprehensive and addresses barriers to statewide, accessible services. The P & A wants to ensure that the settlement agreement includes accessible employment, housing, crisis response, and clinical services to individuals that are deaf and hard of hearing. The director of deaf and hard of hearing services from the Georgia Vocational Rehabilitation Agency, the P & A legal director, one of our advocates who is deaf, a physician, and other stakeholders provided input into the settlement agreement. The P & A continues to monitor the settlement agreement.

The Southern Poverty Law Center filed a civil rights complaint with the U.S Department of Justice against the State of Georgia and the Georgia Department of Education under the Americans with Disabilities Act and Section 504. The Georgia funding scheme incentivizes the segregation of children with disabilities in highly restrictive settings, while creating barriers to full funding of supportive services in inclusive classrooms. The Department of Justice opened an investigation into the complaint. The P & A provided technical assistance to the Southern Poverty Law Center and the Department of Justice.

The P & A currently has 2 cases filed in federal court against Georgia’s Medicaid agency regarding the provision of private duty nursing services to children who have medically complex conditions. In the Moore case, the Eleventh Circuit Court of Appeals held that both the treating physician and the State have roles to play in determining what is medically necessary for Moore, a Medicaid-eligible child, and where there is disagreement, a trial is necessary. A trial was held in the spring of 2012.

The Court issued a decision in favor of CM. Based upon the facts, the Court found that the State made its decision to reduce CM’s in-home nursing hours based upon policy.

The Court explained that CM’s needs are constant. The Judge had the discretion in making findings of fact, and he used this discretion to make extensive findings. The Court laid out the law from the second Moore case (Moore 2) stating that he had the discretion to review both doctors’ opinions (CM’s doctor and the State’s doctor). The Court awarded declaratory relief for the Plaintiff. The P & A petitioned for attorney fees.

The Hunter case was filed on the same basis as Moore, Georgia’s Medicaid agency denied the provision of in-home nursing hours to a child with medically-complex conditions. The United States District Court granted four similarly-situated children to, among other things; add claims under the Americans with Disabilities Act.

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.

1. Identify and describe the priority.

The first priority is to protect individuals with disabilities in Georgia from abuse and neglect. Individuals with disabilities are vulnerable to mistreatment, exploitation and neglect. GAO investigates and, where possible, seeks to rectify the situation and ensure it does not recur.

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

Georgians with disabilities are at risk of institutionalization due to the lack of appropriate community-based services and supports. People who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Children are at the greatest risk due to their heightened vulnerability. Community-based supports are needed to end the institutional bias in Georgia.

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

The indicators of success for this priority are as follows: to investigate and positively address instances of abuse and neglect of persons with disabilities, especially children, reported to PAIR. To intervene to protect any persons with disabilities from circumstances of abuse and neglect, and to assist in their transfer to circumstances they prefer and in which abuse and neglect is less likely to occur.

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

The P & A receives Type I critical incident reports from the DBHDD Director of Incident Management and Investigations based upon reports received from state institutional staff. P & A makes case-by-case determinations as to which reports warrant further investigation by the P&A and other entities.

The P & A contributed to the report that the National Disability Rights Network (NDRN) is publishing to highlight best practices in the states and advancements that have been made in the past year to move beyond segregation and subminimum wages for people with disabilities.

“Beyond Segregated and Exploited” examines the issue of segregating working people with disabilities in sheltered workshops and the use of the subminimum wage to exploit their disability for the financial gain of employers. The new report is an update on progress to end those practices and move toward a system that encourages integrated employment options that pay competitive wages. This report includes stories from Georgia about advocacy and collaboration on behalf of students transitioning from school to work, testimony presented to the Equal Employment Opportunities Commission and the United States Senate Committee on Health, Education, Labor, and Pensions about the benefits of integrated employment for people with disabilities at minimum wage or better, collaboration in rural Georgia to increase integrated employment for individuals with significant disabilities, and the implementation of United States v. Georgia which provides evidence-based supported employment for people with psychiatric disabilities statewide.

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

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HA wrote a letter to the P & A from a jail in rural South Georgia. He wrote that the detention facility could not provide the type of medical attention he needed. He was experiencing excruciating pain. HA also stated that a physician from a medical prison sought for a medical reprieve which was denied. HA has diabetes, experiences seizures, and has extensive medical needs including insulin, a catheter, and a peg tube. Since his arrival at the rural jail, his blood sugars were difficult to manage. The physician recommended that HA have an endocrinology consultation which never happened. The P & A reviewed HA’s medical records to ensure he was receiving safe, appropriate, quality medical care based on evidence of standard practice. The P & A visited HA and spoke with his mother about his medical conditions. The P & A determined that much of HA’s medical complications were due to his diet. The P & A stressed the importance of maintaining healthy eating habits while in the facility. As a result of the P & A’s advocacy, HA was permanently transferred to a medical prison that can provide the medical attention needed.

The P & A received a call from a Registered Nurse at Atlanta Medical Center who reported that FK was admitted to the hospital from the emergency room with septic shock and approximately thirty (30) pressure sores. FK, who is ninety-two (92) years old, was admitted to a long term care facility with many health conditions.

Upon his admission to the nursing facility, the pressure sores varied in their stages, and many of these wounds were unstageable. While at the nursing facility, he received aggressive treatments to the pressure areas with many areas healing but within a couple of weeks, the pressure sores were returning. A few months after admission, FK was in considerable pain and his temperature was elevated. There were multiple wounds with red areas noted and his right arm was swollen. After being admitted to the hospital, FK continued to receive IV antibiotics, hydration and a blood transfusion. The P & A visited FK at the hospital several times to ensure that he was receiving necessary care. Physical therapy and nursing continued to treat the pressure wounds as ordered.

The P & A notified the Health Care Facility Regulation of FK’s condition and requested an additional investigation into the care that was provided to him in the nursing facility. As a result of the HFRD investigation, the long term care facility was cited for failing to provide and document all of the wound treatments as ordered. The facility submitted a plan of correction that was approved by HFRD for training to all medical staff to document the wound treatments as ordered by the physician. The P & A received the documentation showing that all medical staff had attended the training. Unfortunately, FK passed away at the hospital.

A concerned citizen contacted the P & A when they learned that AS’s life was in danger. The P & A met AS following a car accident that caused paralysis from the neck down and required his use of a ventilator. AS is a person who is deaf and uses American Sign Language (ASL) to communicate. Because of the accident, AS was no longer able to sign but still understood ASL. Hospital staff informed P & A that AS had requested to be removed from the ventilator the following day. Hospital staff informed P & A that they used a remote interpreting service to communicate with AS P & A knew that remote interpreting was not an effective way to communicate with AS as he is unable to respond via ASL.

The P & A brought in the proper interpreters who knew AS well and understood his method of communication. Through those interpreters, AS made it very clear that he did not want the ventilator to be removed and he was shocked to learn that the hospital thought that was his wish. However, by the end of the day, it was clear to everyone, including hospital staff and family, that AS wanted to live and that the use of remote interpreters was an ineffective way to communicate with AS. P & A continues to work with AS to find supports in the community and to be evaluated for a communication device that would allow him to communicate effectively with others.

A man requested assistance from the P & A in moving out of the VA Hospital. He wanted to live by himself but the VA would not assist him to find independent housing. The only thing the VA would agree to do was to assist him in locating housing in the VA network of personal care homes or assisted living facilities (not independent housing). The P & A met with the man and encouraged him to contact Walton Options for Community Living in order to ask for their assistance in locating available accessible housing. The man was able to negotiate his discharge with the VA and move to California to be with his family.

The P & A received a call that a nursing facility was discharging a woman to her husband’s home without appropriate services and supports. The P & A negotiated with the husband’s attorney and the attorney for the nursing facility to halt the pending discharge to the community until an appropriate location with services and supports could be identified for the woman. After the P & A’s negotiation, the facility agreed to stay the pending discharge. Unfortunately, while appropriate community supports were being explored, the woman passed away shortly afterward.

1. Identify and describe the priority.

The second priority is to address instances of discrimination and legal rights violations against persons with disabilities.

Discrimination persists, sometimes, through disdain and fear, but also through indifference and the failure to accommodate. This priority seeks to remedy discrimination against persons with disabilities by state and local government and by the private sector in the areas of healthcare, housing, transportation, and employment. Also, this priority seeks to remedy legal rights violations against persons with disabilities who are subject to fiduciary relationships against their will.

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

Priority 2 addresses the need of individuals with disabilities to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services, and public accommodations. Persons with disabilities are subject to discrimination in essential services and domains of life, particularly with respect to healthcare, housing, transportation, and employment. Public and private accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. People with disabilities are more likely to have their rights restricted based upon the perception that they are not able to make decisions regarding their own lives.

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

The indicators of success for this priority are as follows: to investigate and reverse the effects of reliable reports of overt deprivation of fundamental rights for individuals; to avert discrimination against persons with disabilities by achieving equal opportunities from employers, housing providers, healthcare providers, transportation providers, public entities, and public accommodations through reasonable accommodations and removal of policy barrier; and to obtain appropriate restitution for persons with disabilities who have suffered from financial abuse.

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

The P & A has aggressively advocated for the housing provisions set forth in U.S. v. Georgia. At conferences and meetings, the P & A reminds advocates and stakeholders that individuals with disabilities want to live in typical, integrated housing. There is an initiative called the Georgia Supportive Housing Association that is largely promoting the continuation of congregate models of housing. The P & A advocates for individuals to live in integrated housing in spite of the bias toward congregated, segregated housing. Many providers are unclear about the mandates of Olmstead and U.S. v. Georgia. The P & A has been working with a diverse group of stakeholders to build more consensus and momentum around integrated supported housing models, to offer people with disabilities options that are culturally normative and afford a real choice.

As reported last year, the Executive Director of the P & A testified before the Senate Committee on Health, Education, Labor and Pensions during a roundtable discussion regarding the future of employment for people with disabilities and how to best expand job opportunities for individuals with the most significant disabilities. The Committee issued a paper this year to further disseminate the message that individuals with disabilities can work in competitive employment for minimum wage or more and how various government agencies can support individuals to work, with the aim of increasing the employment of people with disabilities by a million people nationally, over the next couple of years.

Following an audit by the Rehabilitation Services Administration in 2011, there was a push to move Vocational Rehabilitation Services from the Department of Labor to the Department of Human Services. The P & A attended the House Human Relations & Aging Committee Meetings and called for an impact analysis of the proposed transfer and public hearings throughout the State. The initial bill did not pass, and a new bill was introduced which would create a separate Vocational Rehabilitation Agency. Only administrative functions of the Agency are housed within the Department of Human Services. The P & A expressed grave concern about any impact that this change would have upon recipients of Vocational Rehabilitation Services. At the P & A and advocacy community’s urging, public hearings were hosted by the State Rehabilitation Council.

The P & A supports the ratification of the Convention on the Rights of Persons with Disabilities (CRPD) and has worked locally and nationally to make that happen. The CRPD protects and ensures the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and promotes the respect for their inherent dignity. The CRPD is consistent with United States laws that protect the rights of individuals with disabilities. The P & A is supporting the Disability Rights Education & Defense Fund (DREDF) and the United States International Council on Disabilities (USICD)’s efforts in support of the ratification of the CRPD.

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

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

BC’s daughter contacted the P & A when her mother’s Conservator filed an Expedited Petition for Court Order Authorizing Access to Ward’s Residence and to Authorize Retention and Payment of Outside Caregivers in Lieu of Family Member. In that Petition, the Conservator requested the Probate Court enter an order to remove BC, who is 90 years old, from her home to an assisted living facility or to the home of another family member or friend for 30 days so that Conservator could enter the home to determine what repairs needed to be made to the home. The conservator also requested that BC be removed from her home for an additional 60 days so that the repairs could be made.

The P & A met with BC and her son at her home and BC stated she did not want to be removed from her home. She said she would allow the Conservator to enter the home to assess, and make, any repairs necessary.

The P & A contacted the Conservator to advocate that BC not be sent to an assisted living facility so that repairs could be made but the Conservator was not willing to negotiate with the P & A. The P & A then contacted BC’s guardian, Adult Protective Services, to let them know of the situation. Adult Protective Services agreed with the P & A that BC did not need to be removed from her home. At the hearing, Adult Protective Services shared the P & A’s written concerns with the court. The court agreed with the P & A and Adult Protective Services that BC did not need to be removed from the home to an assisted living facility so that repairs could be made.

FB has received Vocational Rehabilitation services (VR) for several years. As a result of advocacy from the P & A, VR agreed to pay for FB to attend the Certified Peer Specialist training last year. This year, her work plan included job readiness and job development. FB was receiving services from a VR vendor to obtain job readiness and job development skills. FB was successfully working on job interviewing and sending out applications for job leads she was given as well as some she found on her own. However, FB lost trust in her VR counselor. The VR counselor recommended closing her case because of FB’s failure to keep in contact with the counselor and to keep scheduled meetings. FB did not agree with the counselor’s interpretation of why scheduled meetings were broken as she had been hospitalized, had doctor appointments that were scheduled unexpectedly, and had IEP meetings to attend on behalf of her son. The P & A attended a VR meeting with FB to facilitate a better relationship between FB and her VR counselor. New objectives were proposed and accepted and FB was reassigned to a new VR counselor.

The P & A was contacted at the request of a juvenile court judge regarding how to get a young man back in school. The school system had expelled the student from alternative school and had refused to provide any educational services to him at all. The P & A reviewed the student’s most recent psychological evaluation and provided technical assistance in self advocacy to the student’s foster care case manager on strategies/documents she could present at the school’s tribunal hearing. As a result, the student was allowed to return to alternative school and will be eligible to attend regular school in the Spring of 2013.

The P & A filed a complaint with the United States Department of Justice (USDOJ) in 2007 alleging that Cherokee County Sheriff’s Office failed to provide a qualified sign language interpreter on behalf of a person who was deaf and they were forced to use a minor child to interpret for them while they were being interrogated by an officer. The P & A received notice on August 15, 2012, that USDOJ investigated the complaint and found that the Sheriff’s Office has adopted an Effective Communication policy, distributed the policy to employees, posted the policy in public locations, and provided training to staff on the provisions of the Effective Communication Policy and the requirements of Title III of the ADA.

1. Identify and describe the priority.

The third priority is to promote self-determination and integration of persons with disabilities in the community. GAO seeks to support persons with disabilities and families to apply for home and community-based supports and other government services. GAO also supports persons with disabilities, family members, and concerned citizens to advocate for competitive employment, education, healthcare and other services that are appropriate to the person’s needs.

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

Priority 3 addresses the need of people to live fully integrated lives in their communities. Persons with disabilities have been continually isolated and segregated from the community. Starting when they are young, they are placed in classes separate from everyone else. It continues when opportunities to be in the community are limited because of inaccessibility. Most significantly, too many persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for individuals with disabilities is to be involved and connected with their communities.

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

The indicators of success for this priority are as follows: to support graduates from the Parent Leadership Support Project to advocate on behalf of children throughout Georgia to obtain an inclusive education, to support individuals and concerned citizens to obtain equal opportunities from employers, housing providers, healthcare providers, transportation providers, and to support individuals and concerned citizens to obtain home and community-based supports for individuals to live and fully participate in their communities.

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

The Parent Leadership Support Project (PLSP) was created to increase the capacity of the community to respond to students with disabilities being excluded from the neighborhood classroom, denied high quality instruction, and excluded from the experience from being a student in school community. PLSP seeks to address this issue on a local level, one student at a time, by recruiting and training volunteer advocates to attend school-based meetings for students with disabilities who have been denied an appropriate education. The P & A continues to support over 200 graduates throughout the State.

A graduate of the Parent Leadership Support Project, sponsored by the P & A, requested that the Georgia Department of Education include an information section called “Parental Request for Evaluation” in the Department Liaison Update (Department of Education Newsletter to Special Education departments within local education agencies). The Georgia Department of Education removed this helpful information from the update, and due to the graduate’s advocacy, the information has been placed back in the DL Update so that parents know how to access appropriate evaluations for their students.

The P & A supported Parent Leadership Support Project graduates to advocate for their inclusion in State Advisory Panel meetings by phone. Parent Leadership Support Project graduates and State Advisory Panel members who cannot attend the meetings in person are now offered the option to participate in meetings and provide public input via phone. This ensures equal access for all State Advisory Panel members.

The P & A hosted the Georgia Microboard Association (GMA) from its inception through the first two years of development. We continue to support the GMA, host meetings at our office, and to work with GMA to address systemic obstacles to people with disabilities exercising more self-determination and to getting the supports needed to live good lives in the community. The Georgia Microboard Association supports microboards and micro-enterprises with technical assistance as well as hosting relevant training.

We collaborate with the Statewide Independent Living Council (SILC) to identify and advocate on behalf of individuals living in nursing facilities who require assistive technology in order to live and work in their community. The P & A collaborates regarding “Money Follows the Person,” housing for individuals leaving state hospitals and nursing facilities, and re-establishment of the Disability Law and Policy Network.

The P & A participated in the Statewide Independent Living Council (SILC) meetings this year. Attendees of the SILC meetings included representatives from each of Georgia’s eight Centers for Independent Living. The P & A contributed to the discussions surrounding ensuring that Georgians with disabilities have access to, among others, accessible housing, transportation, living alternatives, and assistive technology.

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

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

A father contacted the P & A on behalf of his son to request assistance in appealing Medicaid’s denial of speech therapy to his son. The P & A reviewed current evaluations and made recommendations as to the additional information and evaluations that could be helpful at the hearing. The P & A also made suggestions to the father as to the strong points he could make to the Judge at the hearing. The father was successful at the hearing and and the son’s speech therapy services were restored.

An artist/vendor contacted P&A to report that he was not provided the accommodations he needed in order to fully participate in a festival. The artist was supported in his self advocacy efforts and as a result he received an apology from the festival organizers and was offered a refund of his entrance fee.

A gentleman contacted P&A to request assistance with housing modifications at his apartment complex. He had previously had an accessible apartment, and following a fire at the apartment complex had to move to another unit within the complex. His repeated requests to apartment management to make his new apartment equally accessible were not being met in a timely manner. Through supporting his self-advocacy efforts the apartment modifications were accomplished.

A homeowner contacted P&A to request assistance with accessibility to her own home and a denial by her home owner’s association to allow her install a retractable screen door. Through supporting her self-advocacy efforts the home owner was able to get prompt approval by her association to make requested modification to her home.

A student contacted P&A to request assistance with receiving accommodations at her university. She had been working with student learning services to obtain accommodations around adaptive software for over a year. Through supporting her self-advocacy efforts appropriate adaptive software was installed on one computer on each floor of the library at the university.

Employment First Georgia supports JH, a 17 year-old-young man with a gift for small engine repair. He maintains a small engine repair shop at his home in middle Georgia. This year, he placed first in the Georgia Skills Competition and went to the national competition this summer. Also, he was invited to interview with Northern Tools based upon his reputation in the area. Although he was too young to accept the position, Employment First Georgia supported JH to interview, visit the store, and update his resume, as an accommodation to his disability. Employment First Georgia also supported JH to write his business plan to present to Vocational Rehabilitation. Next stop for JH, college!

B. Priorities and Objectives for the Current Fiscal Year

Please include a statement of priorities and objectives for the current fiscal year (the fiscal year succeeding that covered by this report), which should contain the following information:

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

Priority 1

A. Priority 1: Protect individuals with disabilities in Georgia from abuse and neglect.

Objective 1: Investigate and address allegations of abuse or neglect, including the suspicious or unexplained deaths of persons with disabilities.

Objective 2. Advocate for appropriate home and community-based supports and services for persons with disabilities residing in facilities, with a focus on monitoring the State’s compliance with Olmstead and the Americans with Disabilities Act.

B. Needs

Georgians with disabilities are at risk of institutionalization due to the lack of community-based services and supports. People who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Children are at the greatest risk due to their heightened vulnerability. Community-based supports are needed to end the institutional bias in Georgia.

C. Activities

GAO monitors state hospitals, nursing facilities, and private residential treatment facilities. GAO responds to calls involving community-based services including community living arrangements, sheltered shops, and other day services. Children and other individuals residing in facilities will be considered more vulnerable than those living in community settings and will receive priority response from GAO. The Investigations Team will investigate deaths and cases of severe abuse and neglect against people with disabilities. GAO will identify people on the waiting list for community-based services and advocate for the provision of these services. GAO will seek the full range of remedies for individuals through protection and advocacy from abuse and neglect.

Priority 2

A. Priority 2: To respond to allegations of discrimination and legal rights violations of persons with disabilities.

Objective 1: Advocate for appropriate home and community-based supports and services, including healthcare and educational, for people with disabilities at risk of institutionalization.

Objective 2: Advocate for people with disabilities subject to legal rights violations and discrimination in any of the following areas: fiduciary relationships, local and state government, healthcare, housing, transportation, and employment.

B. Needs

People with disabilities often face discrimination in areas such as healthcare, transportation, housing, and employment. People need to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services and public accommodations. Public accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. Additionally, persons with disabilities can be subjected to financial exploitation by family members or acquaintances or by other persons upon whom they are dependent.

C. Activities

GAO will seek the full range of remedies for individuals who have been subjected to discrimination and rights violations. GAO will address discrimination in healthcare, transportation, housing and employment by negotiation, mediation, and litigation. GAO refers individuals to and hosts Employment First Georgia which is a collaborative effort that seeks to protect and empower individuals through real employment opportunities. GAO advocates for and collaborates with Atlanta Legal Aid Society, Georgia Legal Services Program, the State ADA Coordinator, and private attorneys to assist people whose rights are being violated and who are being subject to fiduciary relationships.

Priority 3

A. Priority 3: Promote the integration and self-determination of persons with disabilities in the community.

Objective 1: Support people with disabilities, family members, and concerned citizens to advocate for competitive employment, educational, healthcare, and other services that are appropriate to the person’s needs.

Objective 2: Recruit ordinary citizens to advocate for the full inclusion of Georgians with disabilities in their communities.

B. Needs

Persons with disabilities have been continually isolated and segregated from the community. Starting when they are young, they are placed in classes separate from everyone else. It continues when opportunities to be in the community are limited because of inaccessibility. Most significantly, too many persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for individuals with disabilities is to be involved and connected with their communities.

C. Activities

GAO will provide training and technical assistance to the more than 200 Parent Leadership Support Project (PLSP) graduates located throughout the state who advocate on behalf of students receiving special education services. GAO refers families that contact GAO to PLSP graduates who successfully obtain inclusive education for students each year. GAO supports individuals to participate in ADAPT, the largest national grassroots organization of people with disabilities. Through information and referrals, GAO provides information to individuals about their human and legal rights to ensure that individuals secure the accommodations and services that they are entitled to under the law. GAO also assists individuals and families in applying for community-based supports and refers individuals and families to local independent living centers for information about transitioning into community life.

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

Federal (section 509): Amount Received = 469,433

Federal (section 509): Amount Spent = 514,821

State: Amount Received = 0

State: Amount Spent = 0

Program income: Amount Received = 3,264

Program income: Amount Spent = 3,264

Private: Amount Received = 0

Private: Amount Spent = 0

All other funds: Amount Received = 0

All other funds: Amount Spent = 0

Total (from all sources): Amount Received = 472,697

Total (from all sources): Amount Spent = 518,085

B. Budget for the fiscal year covered by this report

Wages/salaries: Prior Fiscal Year = 349,731

Wages/salaries: Current Fiscal Year = 336,210

Fringe benefits (FICA, unemployment, etc): Prior Fiscal Year = 79,608

Fringe benefits (FICA, unemployment, etc): Current F/Y= 76,530

Materials/supplies: Prior Fiscal Year = 5,823

Materials/supplies: Current Fiscal Year = 5,000

Postage: Prior Fiscal Year = 956

Postage: Current Fiscal Year = 1,000

Telephone: Prior Fiscal Year = 6,960

Telephone: Current Fiscal Year = 5,000

Rent: Prior Fiscal Year = 31,678

Rent: Current Fiscal Year = 32,000

Travel: Prior Fiscal Year = 18,516

Travel: Current Fiscal Year = 19,000

Copying: Prior Fiscal Year = 1,123

Copying: Current Fiscal Year = 3,100

Bonding/insurance: Prior Fiscal Year = 400

Bonding/insurance: Current Fiscal Year = 2,000

Equipment (rent/purchase): Prior Fiscal Year = 1,553

Equipment (rent/purchase): Current Fiscal Year = 4,000

Legal Services: Prior Fiscal Year = 22,571

Legal Services: Current Fiscal Year = $25,000

Indirect costs: Prior Fiscal Year = 0

Indirect costs: Current Fiscal Year = 0

Miscellaneous: Prior Fiscal Year = 33,422

Miscellaneous: Current Fiscal Year = 23,750

Total Budget: Prior Fiscal Year = 552,341

Total Budget: Current Fiscal Year = 532,790

C. Description of PAIR Staff

Professional position: 14 FTE filled 100% of year

Professional full-time positions: 12 FTE, 12 person-years

Professional part-time positions: 2 FTE, 1 person-year

Professional vacant positions: 5 FTE, 1 person-year

Clerical position: 5 FTE filled 100% of year

Clerical full-time positions: 5 FTE, 5 person-years

Clerical part-time positions: 0 FTE, 0 person-years

Clerical vacant positions: 0 FTE, 0 person-years

Josh Norris is the Director of Legal Advocacy. He has been with P & A for eight years. He supervises all legal advocacy at the P & A and coordinates with program staff regarding targeted advocacy strategies.

Crystal Beelner Rasa is the Director of Program Accountability and an attorney. She has been with P & A for ten years. She has experience in employment discrimination and the Americans with Disabilities Act.

Denise Quigley is the Director of Resource Advocacy. She has been with P & A for fifteen years.

Naomi Walker works part of her time as a PAIR attorney. She has been with P & A for eighteen years and has extensive experience in Assistive Technology litigation and Medicaid law.

Leslie Lipson is an attorney who has been with P & A for eleven years. She specializes in education law and devoted a portion of her time this year to the coordination and continued development of the Parent Leadership Support Project (PLSP).

Julie Kegley is the PAIR attorney who has been with the P & A for four years. She has expertise in the Americans with Disabilities Act (ADA) issues and nursing facility issues. She comes from the Virginia protection and advocacy system where she specialized in special education and worked with the Client Assistance Program.

Nicole Smith is an advocate who has been with P & A for eight years. She works part of her time for PAIR clients, especially those in nursing facilities and personal care homes.

The Comptroller and his assistant, all members of the Administrative Support team, as well as the Executive Director have all contributed to and participated in support for the PAIR program.

D. Involvement with Advisory Boards

The P & A serves on the following boards and committees: Georgia’s Council on Developmental Disabilities, the State Traumatic Brain Injury Steering Committee, Unlock the Waiting List Steering Committee, Employment First Georgia Steering Committee, National Disability Rights Network Employment Committee, National Disability Rights Network Continuing Education & Self-Advocacy Committee, Money Follows the Person Stakeholders Committee, and the P & A is an advisor to People First of Georgia. The P & A serves on several Boards and Committees at the local, state, and national levels related to employment representing the protection and advocacy system.

E. Grievances filed under the grievance procedure

GAO did not receive any grievances filed under the grievance procedure.

F. Coordination with the Client Assistance Program and the State Longterm Care Program

The P & A works cooperatively with CAP, particularly in urging Vocational Rehabilitation to appropriately serve individuals with developmental disabilities. The P & A makes and receives referrals from CAP and the Ombudsman program.

Certification

Signed?Yes
Signed ByCrystal Rasa
TitleProgram Director
Signed Date12/19/2012