|Name||Kentucky Protection and Advocacy|
|Address||100 Fair Oaks Lane|
|Address Line 2||Suite 302|
|Name of P&A Executive Director||Marsha Hockensmith|
|Name of PAIR Director/Coordinator||Jan Powe|
|Person to contact regarding report||Jan Powe|
|Contact Person phone||502-564-2967|
Multiple responses are not permitted.
|1. Individuals receiving I&R within PAIR priority areas||386|
|2. Individuals receiving I&R outside PAIR priority areas||0|
|3. Total individuals receiving I&R (lines A1 + A2)||386|
|1. Number of trainings presented by PAIR staff||8|
|2. Number of individuals who attended training (approximate)||267|
Trainings were presented at transition fairs, the Sistah Conference, Summer camps and Activities fair, The ARC of KY conference, the Shelby County Rocket Games, the Western KY parent/professional conference and the KY office of the Blind
|1. Radio and TV appearances by PAIR staff||0|
|2. Newspaper/magazine/journal articles||14|
|3. PSAs/videos aired||5|
|4. Hits on the PAIR/P&A website||53,419|
|5. Publications/booklets/brochures disseminated||461|
|6. Other (specify separately)||0|
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)||33|
|2. Additional individuals served during the year||33|
|3. Total individuals served (lines A1 + A2)||66|
|4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)||66|
Carryover to next FY may not exceed total on line II. A.3 above 21
|1. Architectural accessibility||1|
|3. Program access||3|
|5. Government benefits/services||1|
|8. Assistive technology||15|
|10. Health care||8|
|12. Non-government services||1|
|13. Privacy rights||0|
|14. Access to records||1|
|1. Issues resolved partially or completely in individual favor||37|
|2. Other representation found||0|
|3. Individual withdrew complaint||2|
|4. Appeals unsuccessful||1|
|5. PAIR Services not needed due to individual's death, relocation etc.||3|
|6. PAIR withdrew from case||1|
|7. PAIR unable to take case because of lack of resources||0|
|8. Individual case lacks legal merit||2|
List the highest level of intervention used by PAIR prior to closing each case file.
|1. Technical assistance in self-advocacy||3|
|2. Short-term assistance||24|
|5. Mediation/alternative dispute resolution||1|
|6. Administrative hearings||3|
|7. Litigation (including class actions)||1|
|8. Systemic/policy activities||0|
|1. 0 - 4||28|
|2. 5 - 22||24|
|3. 23 - 59||2|
|4. 60 - 64||10|
|5. 65 and over||2|
Multiple responses not permitted.
|1. Hispanic/Latino of any race||1|
|2. American Indian or Alaskan Native||0|
|4. Black or African American||12|
|5. Native Hawaiian or Other Pacific Islander||0|
|7. Two or more races||4|
|8. Race/ethnicity unknown||1|
Multiple responses not permitted.
|2. Parental or other family home||34|
|3. Community residential home||1|
|4. Foster care||1|
|5. Nursing home||13|
|6. Public institutional living arrangement||1|
|7. Private institutional living arrangement||2|
|8. Jail/prison/detention center||5|
|10. Other living arrangements||1|
|11. Living arrangements not known||0|
Identify the individual's primary disability, namely the one directly related to the issues/complaints
|1. Blind/visual impairment||0|
|2. Deaf/hard of hearing||2|
|4. Orthopedic impairment||10|
|5. Mental illness||2|
|6. Substance abuse||0|
|7. Mental retardation||2|
|8. Learning disability||15|
|9. Neurological impairment||4|
|10. Respiratory impairment||0|
|11. Heart/other circulatory impairment||8|
|12. Muscular/skeletal impairment||3|
|13. Speech impairment||1|
|15. Traumatic brain injury||0|
|16. Other disability||19|
|1. Number of policies/practices changed as a result of non-litigation systemic activities||2|
|2. Number of individuals potentially impacted by policy changes||874,000|
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.
P&A became aware that residents of personal care homes were being charged a co-pay for prescription drugs even though they are exempted from this fee in KY. After a demand letter to stop this practice was sent to the Department of Community Based Services, this practice has stopped and the Cabinet is in the process of getting the fees reimbursed to the affected residents.
KY P&A became aware that certain groups of Medicaid recipients were being incorrectly charged a patient liability to obtain waiver services. These groups include individuals who are deemed to be otherwise eliglble for Social Security Insurance (SSI) payments for Medicaid purposes because they are disabled adult children who receive benefits from a parent. After reviewig the applicable laws, P&A sent a letter to the Department for Community Based Services detailing the law and asking that the practive of charging the liabillity be stopped. The Cabinet agreed that it had "inadvertently" assessed the patient liability and are in the process of reimbursing those affected individuals.
After P&A received numerous requests for representation at administrative hearings due to either denial or termination of Medicaid services, P&A developed a handbook on how to appeal Medicaid denials.
|1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts||874,000|
|2. Number of individuals named in class actions||0|
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 significant issue for education continues to disproportionality in discipline for students with disabilities and for African-American students with disabilities. A coalition of organization including P&A, the Children’s Law Center, the Southern Poverty Law Center and the Legal Aide Society, came together to discuss the issues and to develop solutions. Out of these meetings came the identification of the top ten worst offender school districts in KY. Those districts are Christian, Fayette, Jefferson, Hardin, Jopkins, Kenton, Madison, Paducah Independent, Scott and Warren. Agreeements were reached with all but one that concluded that the districts will use Positive Behavioral Inventions and Supports (an evidenced based practice), maintain data, review codes of conduct and involve the community to reduce disparities in discipline with students with disabilities and African-Amreican students with disabilities.
After receiving an increased number of calls from persons with disabilities requesting help after losing eligibility for the Supports for Community Living (SCL) Waiver, P&A opened several cases and assignrd atttorneys to represent persons in administrative hearings. In most cases, the person with the disability was denied SCL because Medicaid review doctors had determined, despite years of eligibility for SCL, these particular persons no longer met regulatory level of care to qualify. These denials were disconcerting aas many of the individuals had no significant changes in their need for support. P&A sent an open records request for recommended orders made by heaing officers concerning SCL denials over the last two years. Our goal was to see the big picture concerning the hearing officer’s intepretation and application of the regulation with real case facts and to be more prepared to analyze and evaluate SCL denial cases. In addition, the cases provide precedent for an appeal which we filed with the Franklin Circuit Court concerning an SCL denial of a client. The Medicaid hearings branch denied our open records request, so we filed an appeal with the Attorney General’s office. Soon after we filed our appeal, the hearings branch called to say that the records would be released.
P&A, Children’s Law Center, the Southern Poverty Law Center, and Legal Aid Society met with the Jefferson Public School District superintendent and staff several times to discuss disparate discipline of students with disabilities, African American students, and African American students with disabilities. The meetings did not lead to a resolution. The coalition organizations filed a class complaint with the U.S Department of Education, Office of Civil Rights (OCR) against the Jefferson County Public School District alleging disability discrimination under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act. The complaint is currently being investigated by OCR.
Kentucky P&A opposed a draft ordinance that would require providers of homes for persons with Intellectual and other Developmental Disabilities living in Kentucky’s largest metropolitan area to register their homes with the local government. P&A along with various other advocacy organizations, Kentucky’s ADA office, and providers of services met several times with city and other government officials regarding the proposed ordinance. P&A and the Commonwealth Council on Developmental Disabilities sent a letter to the Louisville mayor’s office expressing that the draft, “An Ordinance Providing Public Notice Requirements for Community Residences, Family Care Homes and Residential Care Facilities,” unlawfully targeted Kentuckians with disabilities by placing burdens on them that are not required of the general population. The ordinance was redrafted, but P&A still felt it violated fair housing laws. During the 2012 state legislative session, a bill passed which will greatly restrict city and local governments from passing such an ordinance.
Since 2009, Kentucky Protection & Advocacy has advocated for the regulation of the use of restraint and seclusion in Kentucky’s schools. When efforts to pass federal legislation failed, P&A contacted the Kentucky Department of Education (KDE) with our significant concerns arising out of our knowledge of over 80 children who have been injured as a result of improper or abusive restraint or seclusion. The KDE has responded to our concerns and has presented the first draft of a proposed regulation limiting the use of restraint and seclusion in Kentucky’s public schools.
P&A successfully completed a settlement agreement with the US Army to allow for the administration of Diastat, a medication used to control epileptic seizures, in Army day care centers. We represented a young man in a lawsuit in federal court who was unable to attend day care on base at Ft. Campbell because the daycare refused to agree to administer the medication if he should have a seizure. Settlement was reached after the Army agreed to change its interpretation of an Army regulation regarding the administration of medicines at daycare programs
For each of your PAIR program priorities for the fiscal year covered by this report, please:
Abuse/Neglect The internal abuse/neglect team (IAN) will review type A/B citations, incident reports, and other notices of alleged abuse/neglect/exploitation that we receive and determine further action, including conducting primary or secondary investigations.
P&A completed 37 investigations using information provided by the facilities abuse/neglect teams, the Office of the Inspector General and the Department of Community Based Services.
P&A staff will participate in regional meetings on a quarterly basis with agencies charged with investigating abuse/neglect. These agencies include the Office of the Inspector General, the Department for Community Based Services, Long Term Care Ombudsman, the Attorney General’s office and the State Guardianship office.
P&A attende 4 regular meetings and 1 special call meeting.
P&A will educate the public, including legislators, stakeholders and advocacy organizations about the need for an Adult Abuse Registry.
P&A attended 4 meetings and will continue advocating for this registry.
P&A will participate in Project Safe and Accessibility for Everyone (SAFE) through planning/education/outreach events and implementation of a needs assessment. P&A will represent eligible clients related to disciplinary actions, including use of restraint/seclusion/time out and cages arising out of the failure of the school to implement or follow a child’s behavior plan.
P&A attended 4 meetings and will continue this priority in 2013.
P&A will advocate for the adoption and implementation of rules/policies/procedures by the Kentucky Department of Education (KDE) and/or each school system regarding minimal standards to guide the use of Restraint/Seclusion/Time out in schools
P&A attended 7 meetings and produced a well received report on the use of restraint/seclusion in KY public schools.
P&A will monitor the failure by the Department of Community Based Services (DCBS) and the Office of the Inspector General (OIG) to interview persons with disabilities whether they are victims or witnesses
22 investigations were conducted.
Case story J H is a 17 year old W/M in Mercer County with a diagnosis of Oppositional Defiant Disorder and anxiety. J’s parents contacted P&A after J was arrested and sent to detention for scratching his name in a bookshelf with a paperclip. At the hearing following his release from detention, the judge told J’s parents that he would be removed from the home if he got into any more trouble at school. KY P&A provided representation during Admission and Release Committee (ARC) meetings to advocate for a more appropriate Individualized Education Plan (IEP) and Behavior Intervention Plan (BIP). J did not have an individual BIP, but teachers used the PASS program (which provides additional support in the classroom and the use of time outs). The Emotional Behavior Disorder teacher, responsible for implementing the PASS program, had discussed behavioral interventions with teachers, but these had never been put into a BIP and were generally ignored by J’s teachers. Following the ARC meeting to draft a new BIP, both the Principal and the School Psychologist expressed their appreciation for the assistance given by P&A in creating an appropriate BIP for J and asked if we provide trainings on drafting BIPs. J finished the school year successfully without further incident. He turned 18 at the beginning of the following school year and was released from the jurisdiction of the juvenile court.
Olmstead P&A will represent persons institutionalized or at risk of institutionalization to ensure they have access to services and supports in the most integrated living arrangement. P&A will work with other legal advocacy agencies that provide services for children in reference to the Office of Civil rights complaint filed against the Jefferson County Public School system, the largest such group in KY. P&A will track children/youth placed out of state, including those at risk of being placed out of state and represent those children when lack of availability of services within the State is the reason for the out of State placement.
P&A worked collaboratively with other agencies to publicize the Office of Civil Rights complaint filed against the Jefferson County Public School system. P&A and these partners presented a conference on this topic and individuals, including a representative from the Mayor’s office, shared their concerns about the situation. P&A released 12 census reports concerning children placed out of state.
P&A will continue monitoring the roll out of Money Follows the Person (MFP) and associated waivers for the MFP population
Case Story Aaron is a 27 year old young man with cerebral palsy and intellectual disabilities. A P&A advocate met Aaron in a nursing home, an 85 mile drive for his grandmother to visit. Aaron has spent most of his life in bed, and in and out of facilities, according to his grandmother. When his grandmother became guardian we worked together to secure Money Follows the Person (MFP) funding. Aaron now lives in the community much closer to his family, and he regularly receives physical therapy which helps with his contractions. He has a new wheelchair which was designed to make him much more comfortable. Aaron attends an adult day center a few days a week and regularly attends community outings. He recently attended his first prom.
Education of children and youth Children with disabilities will be provided a free and appropriate education (FAPE)
P&A will hold two Individualized Education Plan (IEP) clinics in the Eastern part of the State and one in the Western part of the State. Additionally, P&A will participate in education related transition fairs and deliver the brochure Right or No Right, self-directed IEP training to eligible clients and identify strategies for distributing/show casing the P&A DVD produced in FY2011 P&A will represent children/youth with disabilities by attending IEP or 504 meetings, reviewing records and assisting them in transitioning from school to the adult world
7 meetings/workshops were convened, 12 fairs attended, the brochure was delivered and the DVD was distributed. However the clinic in the Western part of the State was canceled and it was not rescheduled despite repeated efforts on our part of work with that group. Five cases were opened.
P&A will revise agency publications for Partners, How to Negotiate and the one pagers about Functional Behavior Analysis, Developing an IEP, and comparisons between IDEA and 504.
All of the above brochures were revised.
P&A will provide training and assistance to the newly established parent group in Scott County, KY
Two trainings were held.
Case Story LS is a 13 year old African-American make attending school in Jefferson County. During this school year, he was suspended in school 12 times and suspended home 5 times because of his behavior; the school never referred him for an evaluation. At the last suspension, the school recommended that he be sent to the Alternative school. P&A was contacted and with our help, LS was evaluated and found to have multiple learning disabilities. The mother reports that the school is now working productiviely with LS and the notion of sending him to the Alternative school has been taken off the table. He now has a behavior intervention plan in place that the school is following.
Rights of eligible clients in the criminal justice system P&A will represent adults housed at jail or prison whose rights are violated due to their disability
P&A will provide technical assistance on cases to Department of Public Advocacy lawyers representing youth or adults with disabilities who interface with the criminal justice system.
P&A gave technical assistance on 7 cases.
P&A will participate with members of the Citizen’s Review Panel and other legal and advocacy agencies to bring about legislative or other changes to the Status Offender Stature specific to children/youth interfacing with the court system but not receiving services from either the Department of Community Based Services of the Department of Juvenile Justice.
six meetings were held and while there has been no legislative change in the Status Offender Statute at this time, P&A will continue its involvement in this effort.
P&A, in collaboration with the Department of Corrections, the CMHC, ex-offenders, faith based organizations and other interested stake holders, will develop a directory of resources geared toward assisting ex-offenders with disabilities a more successful return to their home community.
The directory has been completed and is awaiting distribution.
P&A will negotiate an agreement with the Department of Corrections, the Community Mental Health Centers and other interested stake-holders regarding the distribution of a resource manual for persons with disabilities re-entering the community from incarceration
The Memorandum of Understandings have been signed and P&A anticipates holding a press conference in the early New Year.
P&A will deliver presentations about IDEA, and 504 to the Public Defender’s office in an effort to give them information that will help them to represent their children/youth clients when the client is interfacing with the justice system because the schools have failed to provide reasonable accommodations under IDEA or 504 to children/youth and that failure results in the client entering the criminal justice system.
Two presentations were done.
P&A will provide information and feedback to law enforcement officers participating in the Crisis Intervention Training held in Jefferson County
2 meetings were held. P&A was invited to participate on a panel for the CIT and critique the performance of members of the Louisville Metro Police Department and other local law enforcement agencies.
CASE STORY An attorney from KY’s public defender office contated P&A about a client with disabilities who was in jail. The client had a community based provider that was willing to serve him. A P&A advocate worked with the defender and attended court to explain community sevices to the judge. The individual left jail and is now successfully back in the community.
Discrimination Persons with disabilities will have access to goods/services/programs as defined under the American Disability Act (ADA)
3 clients were represented
P&A will represent eligible clients who allege discrimination in housing, education, employment, government services programs and financial exploitation.
3 clients were represented
P&A will provide technical assistance and/or legal representation to eligible clients seeking partial or complete restoration of their rights
1 client was represented
P&A will provide rights training and information about education, guardianship and voting to eligible clients who live in facilities/institutions. Additionally, P&A will deliver presentations about individual rights to guardianship field workers
23 trainings were held and 7 clients were represented CASE STORY JB is a 44 year old W/M in Bourbon County who has mobility deficits following a car accident. He is able to ambulate independently, but does use a scooter at times. J and his family took a trip to the Lost River Cave in Bowling Green, Kentucky, but he was denied admission to the cave’s boat tour. P&A made multiple site visits to the cave. In order to access the boat tour, visitors must traverse a short trail system and then walk down a paved road that is approximately ¼ mile long and at an approximately 30% grade. Cave policy provided a blanket limitation that prohibited access to any individual with mobility problems. This policy arose after an individual slipped and fell at the cave and, subsequently, sued. P&A advocated for a change in the cave admission policy and highlighted readily available accommodations that could be provided to individuals who had mobility problems and could not access the cave via the trail. P&A suggested that individuals with disabilities could ride on one of many golf carts used by staff to transport around the grounds (and of which the cave had purchased several for the purpose of transporting wedding guests to the cave entrance) or that staff or visitors could access the cave site by driving to the cave entrance (commercial vehicles and the Executive Director used cars to get to the cave entrance on all of our multiple visits). As a result of our advocacy, the cave revised its policy to provide a description of the physical layout of the trail system and road to the cave entrance and allow individuals to determine if equipment (i.e. scooters, electric wheelchairs) were appropriate/capable or arrangements can be made for individuals to drive to and park at the cave entrance.
Outreach Outreach to un/underserved areas that provide services to eligible clients P&A will represent individuals who want their right to vote restored and assist them in getting their status as a ward of the State changed
2 clients represented
P&A will represent eligible clients from underserved disability, minority or geographic groups/populations
1 client served
P&A will provide information to patients and staff at the Patriot Support Center at Brook Hospital, the Veteran’s unit at Lincoln Trail Hospital and the newly established unit for veterans at Cumberland Hall Hospital. These facilities offer behavioral health services and treatment interventions to help members of the military
6 trainings were held
P&A will participate in one outreach event targeted to elderly persons with disabilities
8 events were held CASE STORY Thirty-four year old CN, who has a diagnosis of Bipolar disorder, contacted P&A for assistance in getting her rights restored and thus her ability to vote. The original guardianship order had been issued in the State of Missouri and the State of KY was insisting that CN return to MO for the modification. Such a return would cause a financial hardship for CN. With the assistance of P&A, the original order was received and accepted, however, the clerk in KY told CN that she would have to pay the $53.00 filing fee. Again, P&A intervened and the fee was waived. Then the court clerk refused to accept the petition and P&A had to call the county judge and make him aware of the situation. With the assistance of P&A, CN had her rights restored and was able to vote in the 2012 election.
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:
2013 PAIR PRIORITIES ABUSE, NEGLECT AND EXPLOITATION The internal abuse neglect team will review all Type A/B Citations, Incident Reports and other notice of alleged abuse/neglect/exploitation to determine further action, including conducting primary or secondary investigations. P&A will participate in project SAFE (Safety and Accessibility for Everyone) planning/educational/outreach efforts and implementation of the strategic plan. P&A will participate in regional meetings held quarterly between the Office of the Inspector General, the Department for Community Based Services, the office of the Long-term Care Ombudsman, the Attorney General’s Office and state Guardianship services. P&A will convene a forum on bullying to obtain information from individuals with disabilities who have been bullied and their family members, school personnel, other disability and civil rights agencies, including the KY Commission on Human Rights, KY SPIN and other interested parties. OLMSTEAD/COMMUNITY INTEGRATION P&A will work with other legal advocacy agencies for children, the Children’s Law Center, Access to Justice and others to develop and implement strategies, including litigation, to ensure children and youth with mental illness and co-occurring diagnoses receive needed community services and supports. EDUCATION P&A will attend IEP or 504 meetings for 2 youths with disabilities. P&A will advocate for the passage of a regulation regarding the use of Restraint/Seclusion in schools. P&A will develop publications about 504 and psycho-educational testing and revise the “Tips for IEP” one pager. P&A will work with the Prichard Committee to hold at least two (Scott County and Paducah Independent) programs that use facilitated conversations between parents and teachers to address concerns and to create action plans that are implemented by teachers and by parents. P&A will increase parent and educator knowledge of inclusive education practices across KY HEALTH CARE P&A will represent one Medicaid eligible individual who is denied medical, dental and other health services or whose services are reduced or terminated. P&A will revise the 1 pager about the Supports for Community Living Waiver, Michelle P. Waiver, Home and Community Based Waiver, Hart-Supported Living Waiver, the Traumatic Brain Trust Waiver, Participant Directed Waiver, and develop an educational tool about the process for obtaining Medicaid services for a child. P&A will work with the KY Commission on the Deaf and Hard of Hearing nursing home focus group to explore grant opportunities for assistive technology in nursing homes for the deaf and hard of hearing residents. CRIMINAL JUSTICE P&A will deliver 2 presentations about IDEA, 504 when failure to implement IEP/504 or failure to provide reasonable accommodations results in children/youth interfacing with the criminal justice system, to public defenders who represent children/youth in criminal proceedings. PROTECT, PROMOTE AND EXERCISE RIGHTS P&A will represent 6 individuals with disabilities who are discriminated against due to their disability in matters related to housing, post-secondary education, employment and other issues, including access to services/goods/ programs provided by governmental agencies or entities. SELF-ADVOCACY P&A will provide rights training and information about self-advocacy, education, voting and guardianship to 50 youth. P&A will provide a rights training to youth attending Insight, an event held in conjunction with KY School Boards, the Office for the Blind and others. OUTREACH P&A will represent 2 individuals from underserved disability, minority or geographic groups/populations whose issue does not fall within the above stated priorities. P&A will work in collaboration with the KY Commission on Human Rights (KCHR) to identify healthcare issues impacting individuals with Sickle Cell Disease. P&A will participate in one outreach opportunity to increase our visibility to the Latino population in KY. P&A will participate in one outreach event targeted to veterans and their family members. P&A will participate in one outreach event targeted to persons with Parkinson’s disease including support and family groups for persons with Parkinson’s disease. P&A will increase their presence and visibility, including providing client representation to individuals living in the eastern part of KY, an underserved geographical area and increase our presence at facilities and community programs providing services and supports to individuals with disabilities in the eastern part of the state.
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.
Total personnel costs $221,923.17 Rentals n/otherwise class-1099 $574.99 Advertising $293.34 Ser-n/otherwise class $916.42 Expenses rel t/ shows, fairs, exp Office supplies $56.60 Janitorial Food products $122.22 Films and video cassettes In-state travel $3925.73 Out of state travel $1545.81 Travel for non-state employee $5.76 Filing fees and court cost $128.00 Dues/subscription $1258.10 Telephone Computer services Employee training $1582.45
Total expenses $232,332.60
There are a total of 3.5 full time PAIRsupport staff persons. While P&A staff members participate on a number of advisory boards and councils via other state agencies, P&A does not have a board or council that is solely devoted to PAIR related activities.
There were no grievances filed under PAIR during this last fiscal year.
KY P&A and CAP work collaboratively on a number of issues and freely share information that help both agencies better represent our mutual clients.
KY P&A meets quarterly with the long term care program and any other time where there is a mutual interest.
|Signed By||Jan Powe|
|Title||Federal Program Coordinator|