|Name||Disability Rights California|
|Address||1831 K Street|
|Address Line 2|
|Name of P&A Executive Director||Catherine Blakemore|
|Name of PAIR Director/Coordinator||Andrew Mudryk|
|Person to contact regarding report||Andrew Mudryk|
|Contact Person phone||916-504-5800|
Multiple responses are not permitted.
|1. Individuals receiving I&R within PAIR priority areas||92|
|2. Individuals receiving I&R outside PAIR priority areas||0|
|3. Total individuals receiving I&R (lines A1 + A2)||92|
|1. Number of trainings presented by PAIR staff||102|
|2. Number of individuals who attended training (approximate)||2,842|
1. 10/04/2012 - Employment Rights Training (15 people)
2. 10/4/2012 - Bullying Law to Apoyo de Padres Para Padres (Support Group for parents by parents) (25 people)
3. 10/4/2012 - Special Education Rights Panel to Students at University of San Diego (14 people)
4. 10/16/2012 - Social Security and Work Incentives to Community College Students (15 people)
5. 10/17/2012 - Social Security and Work Incentives to Community College Students (10 people)
6. 10/18/2012 - Social Security to parents at the California State Foster Parent Association Conference (35 people)
7. 10/21/2012- Individualized Education Program Workshop for Cantonese Speaking Parents (20 people)
8. 10/25/2012 - Voting Rights at 3rd Annual Youth Transition Conference (20 people)
9. 10/26/2012 - Disability Awareness and Special Education to Elk Valley tribe members (35 people)
10. 10/30/2012 - Disability History and Identifying Discrimination to Elementary School Students at Disability Awareness Day (100 people)
11. 11/02/2012 - Disability Awareness and Special Education to Wintun Parents from the Colusa Tribe (25 people)
12. 11/06/2012 - Due Process for Community-Based Adult Services Participants’ Appeals (20 people)
13. 11/8/2012 - Social Security Overpayment to Legal Aid Society of San Mateo County (6 people)
14. 11/13/2012 - Navigating Through the Social Security System in Central Valley (1st training on Introduction to Eligibility and Application) at Exceptional Parents Unlimited (EPU) (parent support group) (15 people)
15. 11/16/2012 - Social Security to Deaf and Hard of Hearing Consumers at Norcal Services (12 people)
16. 11/19/2012 - Housing Options and Housing Rights Panel to Mental Health Consumers (65 people)
17. 11/28/2012 - Employment Discrimination at California Rural Legal Assistance (12 people)
18. 12/11/2012 - Navigating Through the Social Security System in Central Valley, 2nd training on Overpayments at Exceptional Parents Unlimited (15 people)
19. 12/14/2012 - In-Home Supportive Services (IHSS) Webinar (Proving Your Client’s Case) (46 people)
20. 01/15/2013 - Workshop on Conservatorships & DRC Services (50 people)
21. 01/03/2013 - Special Education to Feather River Tribal Youth (15 people)
22. 01/09/2013 - Disability Awareness of Benefits and Services for Native Americans with disabilities at American Indian Intervention Task Force (15 people)
23. 01/10/2013 - DRC Services and Benefits Awareness to Consumers of Southern California Rehabilitation Services (30 people)
24. 01/11/2013 - Personal Rights to ALIVE East (organization serving individuals with disabilities over eighteen years-old) (50 people)
25. 01/14/2013 - Navigating Through the Social Security System 3rd training on Work Incentives at Exceptional Parents Unlimited (9 people)
26. 01/25/2013 - Social Security Benefits (12 people)
27. 01/26/2013 - Let’s Talk Transition To Parents of Transition Age Youth (67 people)
28. 01/30/2013 - Bullying Training to Spanish Speaking Parents and Families (11 people)
29. 01/30/2013 Employment Rights and Americans with Disabilities Act (ADA) at Westview Job Development Center (8 people)
30. 02/07/2013 - DRC services and special education rights to Parent Support & Training Group (35 people)
31. 02/12/2013 - Navigating Through the Social Security System 4th training on Appeals Process at Exceptional Parents Unlimited (8 people)
32. 02/13/2013 - Special Education Rights to Temporary Assistance for Needy Families (12 people)
33. 02/15/2013 - Bullying Training to Spanish Speaking Parents and Families (10 people)
34. 02/15/2013 - Social Security to consumers of Interlink Self-Help Center (Goodwill Industries program) (18 people)
35. 02/16/2013 - Navigating the Social Security System to consumers of the San Diego Brain Injury Foundation (35 people)
36. 02/20/2013 - DRC Services and Special Education Rights to Parent Support & Training Group (30 people)
37. 02/20/2013 ADA and Rights in College to teachers, job developers and transition specialists (9 people)
38. 02/21/2013 - In-Home Supportive Services to Care Parent Network (parent support group) (17 people)
39. 02/21/2013 - Emerging Voting Trends & Civic Engagement Strategies to consumers of the California Foundation for Independent Living Centers (109 people)
40. 02/22/2013 - Benefits including Social Security, Medi-Cal & Social Security Disability Income to Center for Independence of Individuals with Disabilities (independent living center) (23 people)
41. 02/26/2013 - Special Education Overview to Redding Parent Support Group (60 people)
42. 02/26/2013 - Special Education and Transition to Butte Tribes (67 people)
43. 03/05/2013 - DRC Services and Special Education Rights to the Parent Support & Training Program (program to develop mental health services for children and their families) of the Riverside County Department of Mental Health (5 people)
44. 03/06/2013 - Fair Housing Overview to consumers and advocates at Access to Independence (9 people)
45. 03/07/2013 - Employment Rights and Benefits to Students at Computer Technologies Program (CTP) (provides technical training and coaching to people with disabilities) (35 people)
46. 03/07/2013 - Special Education to parents and staff of Pechanga Tribe (4 people)
47. 03/08/2013 - Employment Rights and Accommodations to Members at ProNet Job Club (chapter of State Employment Development Department’s job club) (50 people)
48. 03/14/2013 - Managed Care, Medicare and Medi-Cal to members of the Gray Panthers-East Bay Chapter (social advocacy group for youth and seniors) (35 people)
49. 03/14/2013 - Special Education to Parent Group in Coachella Valley (6 people)
50. 03/15/2013 - Housing Rights to Patients’ Rights Advocates (13 people)
51. 03/20/2013 - Special Education to consumers of Family 2 Family Community Partners (advocacy and services group for families and foster children) (40 people)
52. 03/23/2013 - Bullying Workshop to Support for Families Conference 2013 (25 people)
53. 03/28/2013 - Special Education Rights for Temporary Assistance for Needy Families (TANF) (8 people)
54. 04/03/2013 - Special Education to UCD law students (10 people)
55. 04/05/2013 - Benefits and In-Home Supportive Services to Relative Caregivers Group of High Desert (12 people)
56. 04/08/2013 - Special Education & Early Start Workshop to Spanish Speaking Parents (15 people)
57. 04/10/2013 - Reading Assessments Training to Special Education Advocates (13 people)
58. 04/10/2013 - Benefits Training to Children’s Blind Center (organization serving children who are blind or visually impaired) (12 people)
59. 04/12/2013 - Disability Etiquette to Department of Fair Employment & Housing (17 people)
60. 04/19/2013 - Fair Housing Act Amendments (FHAA) Training to attorneys at the 5th Annual Fair Housing and Public Accommodation Symposium (50 people)
61. 04/20/2013 - Benefits Workshop (1 of 2) Spring Into Health to participants with disabilities at Hillview Jr. High (10 people)
62. 04/20/2013 - Benefits Workshop (2 of 2) Spring Into Health to participants with disabilities at Hillview Jr. High (5 people)
63. 04/24/2013 - Domestic Violence & Victims with Disabilities to students at McGeorge School of Law (50 people)
64. 04/25/2013 - Assistive Technology Webinar for Skilled Nursing Facility Residents (300 people)
65. 04/26/2013 - Special Education to Parents and Staff of the California Rural Indian Health Board (CRIHB) (13 people)
66. 05/01/2013 - IHSS to Children’s Blind Center (12 people)
67. 05/07/2013 - Social Security Work Incentives and Medi-cal Work Incentives to College Students (24 people)
68. 05/08/2013 - Social Security & Work Incentives to College Students (16 people)
69. 05/08/2013 - IEP to Children’s Blind Center (23 people)
70. 05/08/2013 - National Voter Registration Act (NVRA) and California Equivalent to mandated state and local agencies in Orange County (35 people)
71. 05/15/2013 - National Voter Registration Act (NVRA) and California Equivalent to mandated state and local agencies in Orange County (18 people)
72. 05/16/2013 - Students’ Rights to Transition Planning (55 people)
73. 05/16/2013 - Special Education to the Yurok Tribe (30 people)
74. 05/17/2013 - Special Education For Latino Parents (29 people)
75. 05/18/2013 - IHSS to Mono-Lingual Korean Consumers at the Joy Disability Center (Korean advocacy group that primarily serves people with disabilities) (50 people)
76. 05/21/2013 - SSI & SSDI Benefits to Community Advisory Committee (CAC) (a committee that advises Sacramento’s Special Education Local Plan Area, or school district) (55 people)
77. 05/22/2013 - Webinar on IHSS and Settlement and Overview of Services (29 people)
78. 05/29/2013 - Americans with Disabilities Act to Children’s Blind Center (25 people)
79. 05/31/2013 - Medi-cal Managed Care to Hmong Women Heritage (20 people)
80. 05/31/2013 - Disability Awareness to the TACHI Tribe (10 people)
81. 05/31/2013 - Special Education and Advocacy Training to Parents at Owens Valley Career Development Center (OVCDC) (8 people)
82. 06/03/2013 - The Ticket to Work and Social Security Work Incentives to College Disabled Student Services (5 people)
83. 06/04/2013 - Managing P & A Investigations (45 people)
84. 06/04/2013 - Medi-cal Manage Care to Apoyo de Padres Para Padres (Support Group for parents by parents) (22 people)
85. 06/05/2013 - Medi-cal Managed Care to Participants at Lu-Mien Community Services (community center) (65 people)
86. 06/06/2013 - Disability and Voting Rights to Staff at Orange County Registrar of Voters (25 people)
87. 06/06/2013 - Special Education to the Hmong Community (18 people)
88. 06/07/2013 - Voting Rights to consumers at Southern California Rehabilitation Services (SCRS) (45 people)
89. 06/12/2013 - Special Education regarding Student Rights to parents in the Riverside County Office of Education Program (10 people)
90. 06/14/2013 - Public Accommodations to consumers of the Center for Independence of Individuals with Disabilities (13 people)
91. 06/18/2013 - Assistive Technology Webinar (14 people)
92. 06/21/2013 - SSI Eligibility and Benefits to Parent Support Group in Orange County (6 people)
93. 06/26/2013 - Student and Transition Presentation to Parent Support Group in Orange County (17 people)
94. 07/12/2013 - Special Education and Students Rights to students at University of San Diego-Project College Program (13 people)
95. 08/30/2013 - Medi-cal Managed Care to Consumer Support Group at Resource for Independent Living (RIL) (15 people)
96. 09/06/2013 - Special Education Eligibility to Spanish-speaking Parents of Westside Family Preservation (18 people)
97. 09/09/2013 - Service Dog Access to Businesses to Restaurant Managers and Employees (8 people)
98. 09/11/2013 - Special Education and Transition to consumers and parents at Redwood Coast Regional Center (17 people)
99. 09/14/2013 - Social Security and In-Home Supportive Services to Coachella Valley Group (12 people)
100. 09/17/2013 - Social Security to Family Resource Network (organization serving families from underserved communities) (38 people)
101. 09/25/2013 - Disability Discrimination Webinar (50 people)
102. 09/25/2013 - Special Education Due Process to School District (5 people)
|1. Radio and TV appearances by PAIR staff||3|
|2. Newspaper/magazine/journal articles||8|
|3. PSAs/videos aired||1|
|4. Hits on the PAIR/P&A website||362,253|
|5. Publications/booklets/brochures disseminated||150|
|6. Other (specify separately)||339|
We distributed 150 different publications to 24,234 individuals. We reached 25,407 individuals through 334 community clinics, events (booths and fairs), general presentations about DRC’s services, and network/collaboration events. DRC staff participated in the dissemination of information on disability-related issues to the public as follows:
1. Radio and TV Appearances by PAIR Staff:
1. 1/9/2013 - Which Way, LA? The Debate over Group Housing in Los Angeles Neighborhoods, http://www.kcrw.com/news/programs/ww/ww130109the_debate_over_grou?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+kcrw/ww+(Which+Way+L.A.?)
2. 9/11/2013 — Introduction to DRC in Spanish; Univision Communications Canal 61, http://www.merchantcircle.com/business/Kftv.Univision.Channel.21.559-222-2121
3. 9/17/2013 — Introduction to DRC in Spanish; Arriba Valle Central, Univision Communications Canal 61, http://www.merchantcircle.com/business/Kftv.Univision.Channel.21.559-222-2121
2. Newspaper/magazine/journal articles:
Articles (8) referring to DRC attorneys, advocates, and/or PAIR-related advocacy and legal work posted on our website:
1. 10/8/2012 - Disabled Prisoners’ Rights Scrutinized in California County Jails, http://www.huffingtonpost.com/2012/10/08/disabled-prisoners-rights_n_1948542.html
2. 1/8/2013 - California, Law School Test Council Spar Over Accommodations For Disabled, http://www.law.com/jsp/nlj/PubArticleNLJ.jsp?id=1202583770614&Californias_ban_on_flagging_disabled_LSAT_takers_draws_lawsuit&slreturn=20130010174741
3. 1/10/2013 - URGENT: Tell L.A.’s City Council the Community Care Facilities Ordinance is Stupid!, http://hardlynormal.com/blog/2013/01/06/tell-los-angeles-city-council-the-community-care-facilities-ordinance-is-stupid/?utm_source=January+2013-Breaking+News&utm_campaign=January+Breaking+News&utm_medium=email
4. 2/27/2013 - Limited Choices For Section 8 Tenants: Local Court Case Highlights Lack of Housing Options For Folks on Government Assistance, http://www.sdcitybeat.com/sandiego/article-11527-limited-choices-for-section-8-tenants.html
5. 3/19/2013 - Settlement of IHSS Lawsuit will Prevent Devastating Cuts to Home Care Services, http://www.disabilityrightsca.org/news/2013_newsaboutus/pressrelease_20130319.htm
6. 3/19/2013 - Deal Will Avoid Deep Cuts In Home Care For Elderly, Disabled, http://articles.latimes.com/2013/mar/19/local/la-me-home-care-20130320
7. 5/26/2013 - State’s Disabled Could Suffer If Home Care Rules Change, http://articles.latimes.com/2013/may/26/local/la-me-home-care-20130527
8. 9/30/2013 - Domestic Workers, Overtime Pay, and the Perceived ‘Cost Problem’, http://rhrealitycheck.org/article/2013/09/30/domestic-workers-overtime-pay-and-the-perceived-cost-problem/
3. PSA/videos aired:
1. Throughout the reporting period, DRC aired a 5.5 minute video featuring an overview of the advocacy and legal services, training in disability rights and self-advocacy, investigations, outreach events and publications provided by DRC. The video highlights our impact litigation challenging state budget cuts that threatened the rights of people with disabilities to remain in the community and to move people out of a large nursing facility into the community (See section IV.B. Litigation and Class Action below for description). The video provides information on DRC’s regional office locations, and how to contact us. The video received 1,709 views on YouTube, http://www.youtube.com/watch?v=atOumAIYAZ4
6. Other: In addition, we issued 5 press releases (see information below) posted on our website.
PRESS RELEASES (5), posted on our website:
1. 4/24/2012 - Join our Southern California Latino Conference, June 23, 2012 - 9:00 a.m. to 4:00 p.m., 701 South Mount Vernon Avenue, San Bernardino, http://www.disabilityrightsca.org/news/2012_newsabout%20us/pressrelease%202012-04-24%20latino.htm
2. 1/8/2013 - New Fair Employment & Housing regulations concerning Californians with disabilities, http://www.disabilityrightsca.org/news/2013_newsaboutus/pressrelease_20130108NewRegsFairEmployment.htm
3. 1/10/2013 - People with disabilities and the proposed 2013-14 budget: No cuts = first good news in years, http://www.disabilityrightsca.org/news/2013_newsaboutus/pressrelease_20130110budget.htm
4. 3/19/2013 - Settlement of IHSS lawsuit will prevent devastating cuts to home care services, http://www.disabilityrightsca.org/news/2013_newsaboutus/pressrelease_20130319.htm
5. 5/24/2013 - Settlement of Federal Lawsuit Means Youth with Muscular Dystrophy will Not Be Forced Out of Family Home Into Institution, http://www.disabilityrightsca.org/news/2013_newsaboutus/20130524PabloCarranza.htm
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)||282|
|2. Additional individuals served during the year||1,379|
|3. Total individuals served (lines A1 + A2)||1,661|
|4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)||144|
Carryover to next FY may not exceed total on line II. A.3 above 211
|1. Architectural accessibility||25|
|3. Program access||77|
|5. Government benefits/services||659|
|8. Assistive technology||8|
|10. Health care||344|
|12. Non-government services||108|
|13. Privacy rights||10|
|14. Access to records||0|
|1. Issues resolved partially or completely in individual favor||1,402|
|2. Other representation found||15|
|3. Individual withdrew complaint||109|
|4. Appeals unsuccessful||13|
|5. PAIR Services not needed due to individual's death, relocation etc.||2|
|6. PAIR withdrew from case||2|
|7. PAIR unable to take case because of lack of resources||68|
|8. Individual case lacks legal merit||17|
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||1,585|
|5. Mediation/alternative dispute resolution||0|
|6. Administrative hearings||21|
|7. Litigation (including class actions)||2|
|8. Systemic/policy activities||0|
|1. 0 - 4||1|
|2. 5 - 22||63|
|3. 23 - 59||971|
|4. 60 - 64||197|
|5. 65 and over||429|
Multiple responses not permitted.
|1. Hispanic/Latino of any race||255|
|2. American Indian or Alaskan Native||15|
|4. Black or African American||270|
|5. Native Hawaiian or Other Pacific Islander||3|
|7. Two or more races||54|
|8. Race/ethnicity unknown||41|
Multiple responses not permitted.
|2. Parental or other family home||286|
|3. Community residential home||15|
|4. Foster care||0|
|5. Nursing home||48|
|6. Public institutional living arrangement||8|
|7. Private institutional living arrangement||6|
|8. Jail/prison/detention center||41|
|10. Other living arrangements||0|
|11. Living arrangements not known||8|
Identify the individual's primary disability, namely the one directly related to the issues/complaints
|1. Blind/visual impairment||111|
|2. Deaf/hard of hearing||79|
|4. Orthopedic impairment||627|
|5. Mental illness||30|
|6. Substance abuse||3|
|7. Mental retardation||4|
|8. Learning disability||76|
|9. Neurological impairment||223|
|10. Respiratory impairment||46|
|11. Heart/other circulatory impairment||128|
|12. Muscular/skeletal impairment||73|
|13. Speech impairment||7|
|15. Traumatic brain injury||21|
|16. Other disability||204|
|1. Number of policies/practices changed as a result of non-litigation systemic activities||10|
|2. Number of individuals potentially impacted by policy changes||3,394,463|
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.
(1) Sacramento Amtrak Station Accessibility Project: When the ADA was passed, Amtrak sought extra time for compliance and the Department of Transportation gave Amtrak twenty years to bring its services into compliance with the ADA. As it is now 23 years since the ADA was passed, the National Disability Rights Network (NDRN) worked with advocacy groups to put together a study of Amtrak’s accessibility nationwide. As a member of NDRN, DRC completed an accessibility analysis of the Sacramento Amtrak Station, and submitted its report to NDRN. One of the major problems in Sacramento is that the platform has been moved in recent years from a location 50 yards from the station house to almost a quarter-mile away. This long distance makes access more difficult for people with and without disabilities. Other accessibility issues included accessible transportation to the platform, access issues with kiosks, access issues related to the multi-year construction and scaffolding in the station, and lack of audio announcements. DRC is planning on getting more information from Amtrak in a Freedom of Information Act Request (FOIA) and will use that information to decide next steps in addressing Sacramento’s Amtrak accessibility issues. (Approximately 47,198 PAIR-eligible individuals with disabilities in Sacramento would be impacted by this decision.)
(2) Pacific Shores v. City of Newport Beach; Newport Coast Recovery et al., v. City of Newport Beach: The City of Newport Beach enacted an ordinance targeting sober living homes by changes to the definitions used in its zoning ordinance. Under these new definitions, sober living homes - and other homes where people with PAIR-eligible disabilities share a supported living environment - were prohibited in most residential zones. As a result, the majority of sober living homes in Newport Beach disappeared. DRC joined an amicus brief asking the appellate court to overturn the lower court’s grant of summary judgment because the lower court had applied an erroneous legal standard. In September 2013, the court ruled in favor of DRC and other amici in the matter, stating that there was significant evidence that the city’s ordinance was discriminatory against people with disabilities. (Approximately 2,350 PAIR-eligible individuals with disabilities in the City of Newport Beach could be impacted by the outcome of this decision.)
(3) DRC joined the Disability Rights Education and Defense Fund (DREDF) and other California disability advocacy legal services programs in commenting on the physical, policy, and electronic access concerns regarding proposed mandatory e-filing and e-service rules. With a mandatory shift to electronic court filing and service, there will be a reliance on shared public computers at public and private libraries, court self-help centers, and legal services offices particularly by low income litigants and attorneys, including people with disabilities. DRC and others urged the Judicial Council to ensure the following: 1) the sites housing these shared public computers be physically accessible facilities with nearby public transit and disability-accessible parking; 2) the policies ensure disability-accessibility by allowing for the availability and willingness of staff to remove obstructions, reposition hardware, permit extended time and/or repeated access to e-communications for people with cognitive disabilities, allow the presence of companion or service animals and/or use of alternative forms of identification for individuals whose disabilities prevent them from obtaining a driver’s license. In addition, we noted the importance that all the electronic components of the e-filing and e-service system such as software, website features, and electronic interfaces are fully accessible to all people with disabilities. Finally, we urged the Judicial Council to consult with experts with technological knowledge of disability access issues, as well as seek public comment from and conduct technical system design testing with users who are people with disabilities. On June 28, 2013, the Administrative Office of the Court adopted the final rules which incorporate many of our proposals. (Approximately 27,200 PAIR-eligible Californians with disabilities would be impacted.)
(4) DRC sponsored Senate Bill 550 which aims to increase the supply of affordable, accessible housing for people with disabilities by requiring 10% of units to be accessible in housing that is newly built or substantially rehabilitated with public funds. Californians with disabilities, including people and seniors with physical disabilities, tend to have low-incomes and as a result have greater difficulty finding affordable housing. They want to live at home and in the community rather than residing in nursing homes and other institutions, but need housing that is accessible and meets their disability-related needs. California will have a new building code in effect in 2014, which will increase some accessibility requirements. However, it is not clear whether the access requirements will apply to all housing built or only those renovated with public money, and even then, only 5% of units would have to meet that standard. An expert is assisting DRC to conduct a comparison between different access standards, and a cost estimate of adding accessibility in newly built housing. DRC staff worked with the bill’s author, legislative staff, and various stakeholders in hopes of reaching a consensus of support for the bill, however ultimately, the bill did not pass. DRC did not use federal funds for lobbying purposes. (Approximately 1,700 PAIR-eligible Californians with disabilities would have been be impacted.)
(5) Housing Element Guide Project: At the request of the California Department of Housing and Community Development (HCD), and in collaboration with the Law Foundation of Silicon Valley and the Public Interest Law Project, DRC staff began work to prepare proposed updates to HCD’s materials regarding housing obligations related to people with disabilities. DRC staff are also providing technical assistance to HCD by providing materials and publications for HCD to post on their website and use to advise local governments. Specifically, HCD requested that DRC staff draft sections of “sample” housing element provisions addressing the disability requirements; provide background on the applicable housing laws, programs, and needs of people with disabilities; and 3) provide any additional data and organizational resources for HCD and local governments to continue to access and use in the future. (Approximately 642,367 PAIR-eligible individuals with disabilities in California.)
(6) Participation on HUD’s Disability Taskforce: A DRC staff member participates quarterly on the U.S. Department of Housing and Urban Development (HUD) Taskforce on behalf of people with disabilities in California. The purpose of the taskforce is to educate HUD on the disability-related issues that people with disabilities, including PAIR-eligible individuals, are facing with regard to access to affordable and accessible housing. The participants also discuss updates and changes regarding HUD’s work to address disability-related housing issues. This reporting year the taskforce discussed reasonable accommodations in housing, as well as HUD’s plan to assist with moving people out of institutions by providing designated Section 8 vouchers to those individuals. (Approximately 17,000 PAIR-eligible individuals with disabilities who access housing through HUD are impacted by the activities of this taskforce.)
(7) Section 8 Live-In Aide Project: DRC staff are reviewing the policies of housing authorities throughout the state to ensure that they include provisions for live-in aides for low-income Section 8 housing recipients who need them as a result of their disabilities, that is compliant with HUD rules and regulations. DRC staff is also looking at how the housing authority handles the role of a family member serving as a live-in aide for people with disabilities. In an effort to focus our advocacy efforts, DRC staff reviewed the administrative policies of housing authorities within 200 miles of our Los Angeles and Bay Area Regional offices. We have determined that there are five housing authorities with problematic administrative plans that do not allow family members to serve as a live-in aide, or place unreasonable restrictions on allowing family members to do so. After collecting and reviewing the records, DRC staff successfully advocated for changes to the policies of one of the public housing authorities. We are planning our next steps to pursue compliance of the additional housing authorities regarding live-in aides under Section 8. (Approximately 1,974 PAIR-eligible individuals with disabilities who access Section 8 housing.)
(8) Maureen K. v. Tuschka: In a state court case, the decision included an excellent analysis of state statutory definitions of “disability” in determining that the plaintiff, who had AIDS, was a person with a disability for purposes of suing on her discrimination claim. However, in its discussion of federal discrimination law, the court failed to note that the ADA Amendments Act had overruled certain federal cases, which were therefore no longer good law. Also, certain electronic legal search engines widely used by lawyers did not capture the correct information about these cases. DRC joined other amici in signing on to a letter brief drafted by Disability Rights Education & Defense Fund seeking modification of the decision. Amici requested that the court clarify its discussion on its interpretation of certain federal cases, but the court denied this request. Although not successful in getting amendments to the written decision, the work on the case helped educate courts and legal research services about the correct legal standards when determining whether someone has a disability for purposes of a discrimination claim. The potential impact of this amici work affected the roughly 210,667 adults with physical and sensory disabilities between ages 18-24 employed in California.
(9) Harris v. City of Santa Monica: After being terminated from employment, the Plaintiff brought action against her employer under the Fair Employment and Housing Act (FEHA) for pregnancy discrimination. At trial, the jury found that her pregnancy was a motivating factor in her termination, and therefore, she had a claim against her employer for discrimination. However, the Court of Appeal reversed the decision based on the “same decision” defense, meaning if the employer would have made the same decision to terminate in the absence of the pregnancy, it would be a defense to the claim of discrimination. DRC appeared as one of the Amici before the California Supreme Court. On February 7, 2013, the Supreme Court affirmed, in part, the Court of Appeal’s decision, holding that under the FEHA, when a jury finds that unlawful discrimination was a substantial factor motivating a termination of employment, but the employer proves it would have made the same decision absent such discrimination, a court may not award damages, back pay, or an order of reinstatement. This decision would apply to all employment discrimination claims including those regarding physical disabilities. However, the employer does not escape liability. In light of the FEHA’s express purpose of not only redressing but also preventing and deterring unlawful discrimination in the workplace, the plaintiff in this circumstance could still be awarded, where appropriate, declaratory relief or injunctive relief to stop discriminatory practices. In addition, the plaintiff may be eligible for reasonable attorney’s fees and costs. Further, the unavailability of noneconomic damages under FEHA does not preclude the possibility of tort liability for intentional infliction of emotional distress. (An estimated 210,667 individuals with PAIR-eligible disabilities are potentially affected by this decision.)
(10) Carter v. City of Los Angeles: DRC became aware of a problematic proposed settlement in the consolidated cases of Carter v. L.A. and Fahmie v. L.A. regarding the accessibility of the City’s sidewalks. The two main problems with the proposed settlement are that it only requires the City to spend up to $4 million per year on curb cuts for 25 years, considerably less than what the City already spends, and that it waives statutory damages for class members. DRC, along with other legal advocacy groups, filed objections to the settlement arguing that it does not benefit the proposed class of individuals. Ultimately, the court approved the settlement. However, the plaintiffs in a similar case in Los Angeles with a certified class also objected to the settlement and have filed a notice of appeal of the settlement decision which is pending. (Approximately 200,000 PAIR-eligible people will be impacted by the decision.)
(11) Navarro and Ms. Wheelchair California Pageant, Inc. v. Starline Tours of Hollywood, Inc.: DRC joined an amicus brief in a case filed on behalf of people who use wheelchairs and who were not allowed to ride a tour bus. The staff of the tour bus company told the plaintiffs that the bus was inaccessible, but gave them no specific information about the barriers to access. In March 29, 2011, the plaintiffs filed a lawsuit in federal court. Relying on a recent decision in Oliver v. Ralphs, the U.S. District Court dismissed the case on the grounds that the pleadings did not specifically address all accessibility barriers. DRC joined with other legal services organizations to file an amicus brief in September 2012 challenging the dismissal. We are awaiting a decision. (Approximately 6,333 PAIR-eligible individuals with disabilities would be impacted by this decision.)
(1) Alvarez v. Betlach: DRC joined other organizations in signing an amicus brief written by the National Assistive Technology Center in support of Medi-Cal recipients who challenged the state program’s rule that for adults, incontinence briefs would only be authorized if needed to treat a secondary condition, but not as a preventative measure. By law, Medi-cal recipients who would qualify for Medi-cal funded nursing facility services have a mandatory right to home health care which includes medical supplies such as those necessary for incontinence. The trial judge at the district court rejected the State’s claims by ruling that the State must provide medically necessary home health services to individuals entitled to those services regardless of cost. If Alvarez is upheld in the 9th Circuit, California Medi-Cal recipients will have a right to expanded access to incontinence supplies at home, despite the Legislature’s exclusion of them from the Medi-Cal program. (Approximately 34,000 PAIR-eligible Medi-Cal recipients who need incontinence supplies were impacted by this decision.)
(2) Managed Pharmacy Care v. Sebelius: In 2011, Medi-Cal providers successfully challenged a 10% reduction in Medicaid rates. However, the Ninth Circuit reversed the District Court’s decision and allowed the reductions to go forward. California’s Medicaid rates are already among the very lowest in the country, so these reductions will have a significant impact on the access to services for people with disabilities, including PAIR-eligible individuals. In February 2013, DRC joined disability legal services organizations in filing an amicus brief urging an en banc review and reversal of the Ninth Circuit panel’s opinion. The amicus brief affirmed an important principle in working with Medicaid managed care entities - that federal approval is not a conclusive determination that the state’s actions are consistent with federal law. The Ninth Circuit panel did not modify its opinion, and retained its discussion of the deference owed to CMS approval. Although unfortunate, DRC is not barred from arguing that little deference is due in the future based on facts unique to the case. (Approximately 160,000 PAIR-eligible individuals with disabilities were affected by this decision.)
(3) Since October 2011, throughout select counties in California, the state has been implementing mandatory enrollment in Medi-Cal Managed Care for seniors and people with disabilities who receive Medi-Cal. Medi-Cal Managed Care is a managed care plan, or public or private network of health care providers focused on primary and preventative care. DRC, along with many other disability advocacy organizations, is actively participating in various stakeholder groups, committees, and task forces to review and comment on the policies and procedures for the implementation of Medi-Cal Managed Care, and report and provide advocacy and solutions regarding issues that individuals with disabilities are already facing due to the mandatory transition from Medi-Cal to Medi-Cal Managed Care. In part due to the work of DRC and other disability advocacy and legal organizations, in April 2013, the Department of Health Care Services (DHCS) announced that the mandatory enrollment of individuals who are dually eligible for Medi-Cal and Medicare would be delayed until January 2014 in order to facilitate proper coordination, and avoid risking the health of hundreds of thousands of people with disabilities by preventing a lapse or loss of services during transition. See specific example of work completed by stakeholder group in Section V under Community Integration, Indicator 6. There are an estimated 1,120,000 seniors and people with disabilities affected. An estimated 380,000 are recipients of only Medi-Cal and were already enrolled in Medi-Cal Managed Care. Approximately 740,000 who are dual eligible (through Medi-Cal and Medicare) will be enrolled through the Coordinated Care Initiative program. (Approximately 225,000 PAIR-eligible individuals with disabilities will be impacted.)
(1) Law School Admissions Council (LSAC) v. State of California: LSAC administers the Law School Admissions Test (LSAT) in California, and has a history of not providing reasonable accommodations to students with disabilities, including people with physical disabilities, registered to take the exam. California passed Assembly Bill 2122 which requires LSAC to provide test takers with disabilities necessary reasonable accommodations. The law also prohibits LSAC from “flagging” test scores by alerting law schools that a test taker received reasonable accommodations. In the trial court, LSAC requested a preliminary injunction blocking the State from implementing AB 2212 on the basis that the legislature did not have the jurisdiction to implement a policy for LSAC. DRC joined disability legal organizations including The Law Legal Aid Society - Employment Law Center, Disability Rights Advocates, Disability Rights Education and Defense Fund (DREDF), Disability Rights Legal Center (DLRC), in an amicus brief opposing the preliminary injunction, and stating that LSAC should be required to provide reasonable accommodations to test takers with disabilities. Further, we expressed the need to establish and publish a policy regarding reasonable accommodations. Unfortunately, the Court issued the preliminary injunction on February 13, 2013. The State appealed on February 26, 2103, and requested a stay blocking the trial court’s preliminary injunction. On March 5, 2013 the Appellate Court granted a stay of the preliminary injunction, and required LSAC to comply with the provisions in AB 2212 until the appeal is resolved. On August 27, 2013, DRC and other amici filed their amicus brief in the Court of Appeal supporting appellants’ brief on the merits. The case was granted expedited status, and parties are waiting for a hearing date to be set. (Approximately 450 PAIR-eligible applicants to law schools in California with disabilities will be impacted.)
(2) In December 2012, the Office of Administrative Law approved the disability provisions of regulations under the Fair Employment and Housing Act (FEHA). In addition to clarifying the scope of coverage and an individual’s right to reasonable accommodations in the workplace such as assistive technology, medical leave time, flexible or part-time schedule, and telecommuting opportunities among others. In addition, the final regulations affirm the medical privacy rights of all employees, including individuals with physical disabilities. DRC staff, along with other disability services organizations, provided commentary and recommendations throughout the revision of these regulations. (Approximately 1,273,846 PAIR-eligible individuals with disabilities in California were be impacted.)
(3) DRC engaged in systemic advocacy efforts to improve employment options for individuals with disabilities, including PAIR-eligible individuals. For example, a DRC staff member has joined, as a public member, the California Committee on Employment for People with Disabilities, including PAIR-eligible individuals. The committee exists to consult with and advise the Secretary of the Labor and Workforce Development Agency and the Secretary of the California Health and Human Services Agency on all issues related to the employment of people with disabilities. (Approximately 50,000 PAIR-eligible individuals with disabilities in California were be impacted.)
Rights in Facilities/Abuse & Neglect
(1) Peralta v. Dillard: DRC joined three other public interest law firms in this 9th Circuit amicus brief regarding an issue of prisoners’ rights. In the underlying case, the 9th circuit panel held that for a prisoner’s damages claim against a prison doctor, the jury must consider the fiscal situation of the doctor (and his employer). In cases of injunctive relief, the 9th circuit has rejected a fiscal defense. This is the first case in which the court has permitted a fiscal defense for damages claims by prisoners. DRC drafted and filed the amicus brief on behalf of Disability Rights Legal Center and other disability legal organizations. The amicus urged en banc review and reversal of the 9th Circuit panel’s opinion. The brief explained that DRC and the other law firms bring class actions for injunctive relief because they have limited resources, and cannot assist all the prisoners who contact us for help. We rely on the deterrent effect of damages claims to correct illegal jail, prison and law enforcement practices that affect people with disabilities. For example, PAIR-eligible prisoners with disabilities can file claims to ensure equal access to facilities, programs and services such as to be able to use prison showers and toilets and to be protected from injury or the risk of injury. Prisoners who are deaf or hard or hearing may file claims to get sign language interpreters for disciplinary hearings, classification decisions, counseling, and educational or vocational programs. If the decision is not in our favor, our clients, including PAIR-eligible individuals, will be affected in that fewer private attorneys will be willing and able to represent individual prisoners in damages claims. On June 27, the 9th Circuit issued an order for rehearing en banc, as we had requested in our amicus. Oral argument was held in September 2013, and we are awaiting a decision on the matter. (Approximately 300 callers per year who are prisoners or detainees, or family members of prisoners or detainees, with physical disabilities.)
(2) Since August 2012 DRC has participated on the Dementia Care Collaborative led by representatives from the Department of Public Health and Centers for Medicare and Medicaid Services addressing the inappropriate use of antipsychotic medication for residents with dementia residing in skilled nursing facilities. This interagency project brings together representatives including state and federal licensing officials, long term care ombudsmen, and advocates for seniors and people with disabilities. This fiscal year the collaborative has developed a detailed action plan to meet the goal set in fiscal year 2012 of reducing the use of antipsychotics and improving dementia care by June 30, 2013. Four key focus areas have been identified by the collaborative including behavioral alternatives to dementia care, informed consent for the use of antipsychotics, enhanced enforcement and consumer awareness. DRC participated on the two workgroups to improve dementia care and consumer awareness. Changes to the policies regarding the use of antipsychotic medications in nursing facilities will benefit individuals with disabilities who reside in these facilities by protecting them from the unwarranted and potentially harmful use of antipsychotic medications. The collaborative continues to meet quarterly to monitor implementation of the work plan and measure reduction in use of antipsychotics. (Approximately 100,000 PAIR-eligible individuals with dementia who are prescribed antipsychotic medication to address behavioral challenges and who are residents of nursing facilities with are impacted).
(3) DRC’s Investigations Unit (IU) facilitated the continuing development of the “Room and Board Coalition” (Coalition) to form consumer-focused networks that oversee room and board homes that adhere to coalition-mandated resident rights standards. The Coalition provides resources, such as an online listing of good homes, conflict resolution processes, and unannounced on-site inspections to ensure that consumers are protected, empowered, and can make informed decisions about where and with whom they live, in an effort to reduce the risk of abuse or neglect. The coalition has recruited almost 20 room and board operators, some who run several homes. This reporting year, the coalition created an online database that makes accessing information about the quality of any member room and board homes much easier for consumers. DRC staff also presented the coalition model at the NDRN annual conference in June, so that NDRN staff could disseminate the information for other states’ protection and advocacy systems to use. (Approximately 3,335 PAIR-eligible individuals with disabilities who reside in board and care homes in California are impacted by this coalition).
(4) DRC sponsored Assembly Bill 961, which improves the timeliness of licensing investigations into complaints of patient abuse and neglect and better informs the public of the investigation findings. The Department of Public Health (DPH) redacts citations issued to facilities for incidents involving people with psychiatric and developmental disabilities, citing confidentiality restrictions. There are no similar restrictions on incidents involving people with other types of disabilities or seniors. In addition, there have been significant delays by DPH in issuing citations involving the most grave and/or dangerous practices. Too often, years have elapsed before DPH issues a citation, imposes a fine and requires a facility to take appropriate corrective action. This leaves other residents at risk for similar incidents during the intervening time period. DRC sponsored legislation that addressed both of these issues. It authorizes DPH to publish unredacted citations involving facilities larger than 15 beds. It also required DPH to issue survey findings and citations within an established timeframe, with more critical incidents (those involving death or serious injury) receiving priority. DPH estimated extremely high costs to comply with meeting the timeframe requirements, which resulted in the bill stalling in the Appropriations Committee. The bill has been amended to address cost issues and will be reintroduced this legislative session (Federal Funds were not used for lobbying). (This bill will impact an estimated 300,000 PAIR-eligible individuals a year who are served by one of these facilities/community programs.)
(1) American Nurses Association v. O’Connell: In 2011, DRC joined school districts and other disability groups in filing an amicus brief supporting the American Diabetes Association, to argue that properly trained staff, not just licensed nurses, should be able to administer insulin to children with diabetes while at school and child care. In a decision dated August 12, 2013, the California Supreme Court unanimously held that California law permits unlicensed school personnel to administer insulin, and the California Nursing Practice Act (NPA) does not require otherwise. Therefore, children who need to have medications given during the school day can be provided that medication from appropriately trained staff who are not licensed nurses. (Approximately 30,408 PAIR-eligible children with disabilities potentially affected by this decision.)
(2) C.W. v. Capistrano Unified School District: DRC, along with several other advocacy groups, submitted an amicus brief that informs the Ninth Circuit Court of Appeals regarding the negative impact of the district court’s decision holding parents liable for attorneys’ fees in certain cases. The very broad interpretation of the provision permits courts to order parents to pay school districts attorney’s fees when they are the losing party. Faced with the potential burden of paying attorneys’ fees, many low-income families with children with disabilities will not pursue a complaint against a school district in court. These cases will have an impact on the 686,000 special education students in California and their parents, (60,000 of whom are PAIR eligible).
(3) Los Angeles Unified School District (LAUSD) v. Garcia: M.G. is a young prisoner with disabilities who sought special education services while he was detained in the Los Angeles County Jail. M.G. had been eligible for and received special education services from early childhood through his detention in the jail at age 18. Under state and federal special education law, M.G. has a right to special education services until he reaches age 22. However, most jails in California do not provide special education services to youth with disabilities, including PAIR-eligible disabilities, between the ages of 18 and 22. M.G. filed requests for special education services, which the jail and local school districts ignored. Disability Rights Legal Center represented M.G. in a successful special education hearing, which held that LAUSD was responsible for providing his special education. The school district appealed, and the issue went before the Supreme Court of California. The suit seeks to establish the school district was responsible for providing special education services to eligible youth while they are in jail, consistent with the Individuals with Disabilities Education Act (IDEA) and corresponding state laws. DRC joined five other public interest law groups in an amicus brief in the California Supreme Court in support of M.G. The appeal was argued in September 2013 and we are awaiting a decision. (This case will impact the rights of the approximate 335 youth with PAIR-eligible disabilities ages 18-22 who are incarcerated in jails and prisons.)
|1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts||570,209|
|2. Number of individuals named in class actions||360,000|
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.
(1) R.C. v. Maxwell-Jolly: (not a class action) R.C. has muscular dystrophy and was able to live in the community with his family with the support of Medi-Cal-funded nursing hours. Unfortunately, when R.C. turned 21, his nursing hours were reduced by almost half, putting him at risk of institutionalization and possible death. The reduced services also forced him to drop out of college at the University of California, Los Angeles. DRC filed suit challenging the denial of necessary nursing services under the Medi-Cal nursing facility waiver. After DRC successfully resolved a federal complaint for R.C.’s brother, P.C., DRC sent a new demand letter to the state, enclosing an amended complaint raising broader issues of the state’s discriminatory policy of not providing for sufficient nursing services after young adults age out of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program to allow them to remain in the community. As a result, the state agreed to provide R.C. with appropriate nursing services. DRC is in settlement discussions with the state to try to resolve this case. R.C.’s case is especially critical because he is not a recipient of state services for people with developmental disabilities and therefore had no alternative when waiver services are denied. (Approximately 100 PAIR-eligible individuals with disabilities are impacted by this issue.)
(2) Darling v. Douglas (class action): DRC continued its litigation and settlement efforts in Darling v. Douglas, a class action lawsuit that challenged the cuts and elimination of a Medi-Cal funded service called Adult Day Health Care (ADHC) for thousands of low income seniors and people with disabilities, which provided center-based skilled health and nursing care, therapies, transportation, and other services. DRC obtained preliminary injunctions to stop the cuts and termination of ADHC temporarily. In January 2012, the court approved a settlement of the case under which the ADHC program was converted into a new program using different funding but offering the same services, known as Community Based Adult Services (CBAS). The settlement provided that there is no enrollment cap on the number of individuals who can be served under the program and that services would be provided at no cost to recipients. The approximately 35,000 current ADHC participants were reassessed for CBAS eligibility and by February 2013 approximately 80% of ADHC participants were found eligible for CBAS and transitioned to the new program. Plaintiffs have worked intensively to assist the 2,400 class members who filed for administrative hearings challenging denial of CBAS. DRC represented some individuals, many of whom are clients with physical disabilities, and coordinated a network of over 40 pro bono attorneys to represent other individuals. In addition, DRC continued to disseminate training materials developed regarding CBAS services to advocates, attorneys, and consumers. Under the settlement, the Court retained jurisdiction and Plaintiffs’ counsel are monitoring implementation until August 2014. Last reporting period, DRC filed two compliance motions with the trial court and began monitoring. DRC staff continued to monitor compliance this fiscal year through receipt of data and reporting requirements by the state. In addition, DRC assisted class members in obtaining payment for penalties from the state due to delayed hearings. Since CBAS is provided through Medi-Cal managed care plans in most parts of the state, DRC staff will continue to monitor the transition of all services from previous plans into managed care plans, including CBAS services. (An estimated 19,000 PAIR-eligible individuals will benefit from the settlement.)
(3) Oster v. Lightbourne (class action): In 2009 and 2011, the State of California proposed reductions to the In-Home Supportive Services (IHSS) program that would drastically cut necessary home care services such as preparation of meals and house cleaning for hundreds of thousands of people with disabilities, including physical disabilities. DRC has worked with other disability rights law firms to prevent cuts to the IHSS program over the past several years. In 2009, we obtained a preliminary injunction that stopped proposed cuts to IHSS hours based on the recipients’ functional index score. In 2011, we obtained a second preliminary injunction stopping a 20% across-the-board reduction in IHSS hours. The injunctions prevented any cuts to IHSS until the settlement of the case. We successfully resolved the case in early 2013 allowing for the gradual stabilization of the IHSS program with new revenue, and possibly eliminating all cuts to IHSS hours, as well as providing the rights for IHSS consumers to request a reassessment of hours. DRC continues to monitor the terms of the settlement. (Approximately 160,000 PAIR-eligible individuals with disabilities are impacted.)
(4) Independent Living Center of Southern California v. City of Los Angeles: (not a class action) In 2012, DRC and co-counsel filed suit against the City of Los Angeles and the Community Redevelopment Agency of Los Angeles for failing to ensure that apartments built with state, federal, and community development funds are accessible to people with disabilities, including PAIR-eligible individuals who use wheelchairs and/or who are blind or visually impaired. The plaintiffs in this lawsuit, the Independent Living Center of Southern California, Fair Housing Council of San Fernando Valley, and Communities Living Independent and Free, are asking the court to order the defendants to survey all projects that received federal housing and community development funds, report on the extent of noncompliance, bring all buildings into compliance, and implement procedures for future compliance. In fiscal year 2013, DRC staff defeated the city’s motion to dismiss the case. The plaintiffs have engaged in settlement discussions with all defendants, and some of the housing units involved have already made their complexes accessible. In addition, DRC staff are monitoring the dissolution of community redevelopment agencies throughout California to ensure future accessibility compliance, particularly with regard to uncertainty about the entity responsible for providing similar housing services. (Approximately 389,158 PAIR-eligible individuals with disabilities that need accessible housing in the City of Los Angeles could be impacted by this case.)
(5) Siebert v. Zangari (not a class action): M.Z. is a person with disabilities who uses a motorized wheelchair, and has a full-time caregiver and a service dog. She lives in the downstairs unit in a duplex pursuant to a lifetime lease that is deeded with the property. Since 2009, M.Z. has been in a lawsuit with the landlord for failing to maintain accessible features of the apartment. The landlord purchased the property with full knowledge of the lifetime occupancy agreement and contractually agreed to its terms. However, she made repeated efforts to unlawfully evict M.Z. and her caregiver. The landlord’s removal of an accessible roll-in shower to M.Z.’s apartment and her placement of disability-based conditions on the tenancy, as well as the refusal to allow M.Z. to modify the property on her own, violate the disability discrimination provisions of the Fair Housing Act and related California laws. A five-day bench trial was held on plaintiff’s declaratory relief cause of action and DRC obtained a favorable ruling on M.Z.’s behalf. However, the landlord took no action to comply with the Court’s order. The court later granted a motion for preliminary injunction requiring the landlord to provide a wheelchair accessible roll-in shower for M.Z. The landlord appealed the ruling and a decision is pending. In January 2013, M.Z. broke her foot due to the inaccessible shower, and the complaint was amended to include this claim. Before the trial, the landlord filed for bankruptcy and the court issued a stay of proceedings regarding the case. (This case impacts 1 PAIR-eligible individual with a disability.)
(6) Stringfellow, et al. v. McGinness, et. al. (not a class action): Sacramento County Jail had a blanket policy requiring restraints during dialysis even if inmates did not present a threat to themselves or others. DRC filed suit against Sacramento County and settled the case in 2010, with an agreement that contained a two-year monitoring period. Pursuant to the settlement agreement, the Sacramento County Jail moved the dialysis room within feet of the nursing station and provided written details of the settlement to its staff. At the conclusion of the monitoring on December 17, 2012, the Jail had complied with all of the terms of the settlement agreement and had not restrained a single inmate during dialysis treatment for over two years. (Approximately 750 PAIR-eligible individuals with disabilities will be impacted.)
(7) Chambers, et al. v. City and County of San Francisco (class action): DRC filed this lawsuit on behalf of six residents of Laguna Honda Hospital and the Independent Living Resource Center (ILRCSF) in San Francisco alleging discrimination in the form of unnecessary institutionalization under the ADA. The Parties reached a settlement agreement in September 2008 which enhanced community-based living options to class members through the provision of services and housing. The named plaintiff in this lawsuit, Mark Chambers, moved out of Laguna Honda and continues to live in the community with sufficient supports. In September 2011, the parties filed a stipulation with the Court regarding the aspects of the settlement that DRC plans to monitor until September 2013 including the Laguna Honda Hospital Rental Subsidy Program (LHHRSP). This part of the settlement requires San Francisco to secure housing for 500 individuals at Laguna Honda who prefer to live in the community by leasing and subsidizing housing units with supports and accessible modifications. In fiscal year 2013, DRC continued to monitor the implementation of the settlement. San Francisco has provided subsidies for 251 class members since 2008. The people who are currently housed in the rental subsidy units are guaranteed their housing, but the City is not required to maintain the additional 249 units if they are not filled. DRC completed its monitoring of the case on September 18, 2013. (The certified class is approximately 2,000 individuals with disabilities. This settlement impacts an estimated 1,200 PAIR-eligible individuals with disabilities.)
For each of your PAIR program priorities for the fiscal year covered by this report, please:
Priority 1 - Access / Discrimination
PRIORITY DESCRIPTION: Discrimination against people with disabilities in California exists in many areas including attitudes, stigma, and stereotypes; disability-based discrimination, harassment, and retaliation; inadequate and inaccessible transportation; lack of affordable, accessible housing; barriers to a full range of employment and self-employment opportunities; inadequate training and supports necessary to enter and stay in the workforce; and lack of access to supports needed to participate fully in the community. People with disabilities face challenges in their right to full participation in electoral and governmental systems. People with disabilities encounter barriers to physical access and reasonable accommodations, as well as stigmatization while residing in the community.
NEED, ISSUE AND/OR BARRIER: People with disabilities need information and representation regarding discrimination and physical access issues in order to ensure they can remain and participate in all aspects of their community, and avoid institutionalization.
INDICATOR 1: Improve disability access and reduce discrimination in private, public and government programs and services so that all people with disabilities are able to use them effectively by providing direct representation or systemic advocacy to eliminate access barriers and discrimination and improve access to technology and assistive technology in places of public accommodations and businesses and in government programs, such as benefit offices, services and websites.
EXAMPLE: S.X. is a monolingual Hmong-speaking woman who is blind and also has a respiratory disorder. S.X. went to a Department of Social Services (DSS) hearing to challenge her reduction of In-Home Supportive Services (IHSS) hours. As requested, S.X. was provided with a Hmong interpreter at the hearing, but the interpreter was not certified. As a result, the client experienced significant barriers to arguing her need for additional hours. At the hearing, the administrative law judge (ALJ) recognized that not everything was being interpreted accurately, yet he allowed the hearing to continue. DRC filed a complaint with the state Health and Human Services (HHS) Civil Rights Bureau, and the federal HHS Office for Civil Rights on behalf of S.X. to address the inadequate and erroneous interpretation provided by DSS. DRC also negotiated with DSS to obtain a new IHSS hearing date for which the ALJ made a specific request that a certified Hmong interpreter be provided. At the subsequent hearing there was a Hmong interpreter present, but not a certified interpreter. S.X. was given the option to go forward with the non-certified interpreter and chose to reschedule the hearing due to the language barriers she faced at the initial hearing. Ultimately, the second hearing caused the parties to reach a mutual settlement under which S.X. received all the hours that she initially requested, and nearly twice the hours she was going to receive based on the initial hearing decision. Despite the settlement in S.X.’s matter, DRC staff expressed additional concerns regarding changes to the process for setting up certified interpreters at hearings, as well as how to handle hearings where an individual is not provided a certified interpreter, so that people with limited English proficiency can have equal access to the appeals process, and ultimately the IHSS program as a whole. DSS indicated that it was planning on requiring certification for all interpreters moving forward.
Also see description of Stringfellow v. McGuinness in Section IV.B above, and LSAC v. State of California, the Alameda County Voting Access project, Navarro and Ms. Wheelchair California Pageant, Inc. v. Starline Tours of Hollywood, Inc., Carter v. City of Los Angeles, Harris v. City of Santa Monica, and Maureen K. v. Tuschka in Section IV.A. above.
INDICATOR 2: Through direct representation or systemic advocacy, improve access to transportation in areas such as sidewalk access, bus stops and paratransit.
EXAMPLE: S.H., who is blind, reported incidents to DRC where his paratransit driver either had dropped him off without necessary assistance in the middle of the route or did not pick him up on time. On one occasion, the paratransit driver picked up S.H. from a local medical clinic and dropped him off a block away because the driver informed S.H. that he needed to pick up someone else. The driver had S.H. get out of the vehicle and left him without assistance to return to the medical clinic. When S.H. attempted to find his way back to the medical clinic he almost stepped into a busy street, but staff from the medical clinic saw him and came out to assist him back to the clinic. In another incident, S.H. had a dispute with the paratransit driver and requested to be dropped off in a safe location so he could call for a cab. The paratransit driver dropped S.H. off along a busy street but made no effort to help him get to a safe place. S.H. began walking and almost walked into traffic until a nearby business owner came out to assist S.H. to a safe location. DRC filed a complaint with the Department of Transportation on S.H.’s behalf, which is currently being investigated.
Also see description of Sacramento Amtrak Accessibility project in Section IV.A. above.
INDICATOR 3: Increase and maintain affordable, accessible housing by providing direct representation and systemic advocacy to reduce housing discrimination in private housing, in a variety of continuum of care housing types and in homeless and transitional housing settings; to ensure that licensing restrictions in housing do not inhibit community living; and to ensure that laws and regulations against housing discrimination effectively address the needs of people with disabilities. This work includes our continuing litigation such as Doe v. San Diego Rescue Mission and other housing discrimination cases.
EXAMPLE: D.L. has undergone multiple back surgeries due to her physical disabilities. She was provided a doctor’s recommendation to use a large service dog to assist her to keep her balance and not fall down while performing daily activities. D.L. contacted DRC because her apartment property manager told her that she could not have a dog that was over the weight limit specified by the property’s pet policy. Although she did not have a service dog yet, DRC staff advised D.L. to submit a reasonable accommodation request to the manager along with a note from her doctor. After multiple delays due to changes in management, ultimately the manager agreed to D.L.’s reasonable accommodation request. D.L. was able to remain in her home with the service dog of her choice.
Also see description of Siebert v. Zangari in Section IV.B. above and, the description of the Housing Element Guidance and HUD’s Disability Task Force projects in Section IV.A above.
INDICATOR 4: Through direct representation and systemic advocacy, reduce discrimination in local government planning and regulation of housing and land use and improve local government planning for affordable, accessible housing and a variety of living arrangements, for example, by continuing to litigate Independent Living Center et al v. City of Los Angeles et al.
EXAMPLE: G.C. is a 61 year-old man with quadriplegia who receives a Section 8 housing subsidy. Due to his disability, G.C. is approved to have a live-in aide and requires the use of large medical equipment in his home. About a year before contacting DRC, G.C.’s Section 8 subsidy was reduced from a two bedroom rate to a one bedroom rate. At his Section 8 annual review, G.C. asked to have his two bedroom subsidy restored, but the City of Pasadena denied his request. When G.C. appealed the denial by requesting a hearing, the City of Pasadena refused to grant the hearing. G.C. contacted DRC because he wanted assistance with obtaining a hearing and restoring his subsidy to the two bedroom rate. DRC staff met with the City of Pasadena’s attorney to investigate why G.C. was not granted a hearing after his reasonable accommodation request for a second bedroom was denied. The attorney said the denial of a hearing was an administrative error, and additionally, agreed to restore G.C.’s subsidy to the two bedroom rate retroactive to his last annual review.
Also see description of Independent Living Center v. City of Los Angeles in Section IV.B. above as well as the description of the LA City Group Home Ordinance and Housing Element Guidance projects, and Pacific Shores v. City of Newport Beach in Section IV.A above.
INDICATOR 5: Through direct representation and systemic advocacy, expand the availability of public and subsidized housing programs for people with disabilities, by reducing discrimination and expanding accommodations in the programs, requiring more accessible units, expanding the use of the programs for people with disabilities and advocating for the development of permanent affordable, accessible housing fund sources.
EXAMPLE: J.D. is an individual with physical impairments who had been on a waitlist for Section 8 housing, and been participating in the HOME program (HOME Investment Partnership — a housing grant that funds two programs under J.D.’s housing authority, the Tenant-based Rental Assistance program which provides a rent subsidy for lower-income residents, and the Residential Rehabilitation program which provides grants and loans to lower-income households to repair their homes) through the city’s housing authority. J.D. was near the top of the wait list for Section 8 housing, and did not want to lose the reduced rent she was paying under her current program. J.D. contacted DRC because she was concerned about changes to her rent and Section 8 housing benefits after the housing authority told her that she needed to relocate in order to keep participating in the HOME program. DRC contacted the county Housing Commission and city housing authority on behalf of J.D. Staff informed DRC that J.D. was already on Section 8, and was no longer participating in the HOME program as a result. In addition, DRC staff received clarification that J.D. did not have to relocate when she received Section 8 housing. J.D. was pleased with the assistance provided, and has signed a rental agreement under Section 8 in the place of her choice.
INDICATOR 6: Preserve disability civil rights laws, including the ADA and the Unruh Act by developing and beginning to implement a strategy for addressing attacks on disability discrimination laws and/or addressing effective implementation of physical accessibility requirements.
EXAMPLE: DRC has taken steps to develop a strategy or media campaign to address attacks on disability discrimination laws. For example, in Fiscal Year 2014, staff appeared on a television news program to discuss the failure of businesses to comply with access requirements and to explain why discussion of a small number of attorneys who file many access lawsuits distorts the real issue of businesses’ failure to comply with laws that have existed for decades.
INDICATOR 7: Enforce rights by ensuring that individuals with disabilities have access to courts, administrative agencies and legal services by responding to proposed constraints on access through amicus briefs or regulatory comments as needed.
EXAMPLE: C.W. v. Capistrano Unified School District: DRC joined an amicus brief regarding the negative impact of a decision holding parents liable for attorneys’ fees in cases where they are the losing party, potentially deterring parents from pursuing a warranted complaint due to the possibility of these fees. These cases will have an impact on all special education students in California and their parents or guardians. See description of case in Section IV.A. above.
COLLABORATION: DRC worked with the following organizations under the access and discrimination priority area: the Legal Aid Society — Employment Law Center; Disability Rights Education and Defense Fund (DREDF); Disability Rights Legal Center (DLRC); Disability Rights Advocates; Association on Higher Education and Disability; California Association of Post-Secondary Education and Disability; the National Association of Law Students; the Civil Rights Education and Enforcement Center; Council of Parent Attorneys and Advocates; Edge Foundation; Everyone Reading, Inc.; the National Federation of the Blind; AIDS Legal Referral Panel, the Health Legal Services Project of the Law Foundation of Silicon Valley; the National Disability Rights Network (NDRN); Legal Services of Northern California; Hunton and Williams, LLP (pro bono); Relman, Dane, and Colfax, LLC.; the National Autism Association; Public Counsel Law Center; Children’s Rights Clinic at Southwestern Law School; Pepperdine University School of Law Special Advocacy Clinic; and the Stanford Education and Law Project.
NUMBER OF CASES HANDLED: 69
Priority 2 — Community Integration
PRIORITY DESCRIPTION: People with disabilities face barriers to living their daily lives, on their own terms, and in communities of their choice. People with disabilities do not always live in the community placement that is the most appropriate, least restrictive setting chosen and in some cases are forced to live in institutions. When living in the community, people with disabilities cannot obtain the proper accommodations, services, and supports they need and/or are entitled to. Due to budget cuts and reorganization of the departments, people with disabilities often face unexpected cuts in their services, health benefits, and supports including In-Home Supportive Services (IHSS), Community Based Adult Services (CBAS), Medi-Cal, Medicaid, and Social Security.
NEED, ISSUE AND/OR BARRIER: People with disabilities need information and representation to ensure they receive necessary and appropriate services and supports to allow them to reside in, or return to, the community, and avoid institutionalization. Due to California state budget issues and reorganization of disabilities services programs such and Medi-Cal and CBAS services, there is an overall need to systemically address ongoing changes to the services and programs that assist people with disabilities.
INDICATOR 1: Advocate to transition people out of facilities to the community consistent with the principles of the Supreme Court’s Olmstead decision by conducting systemic advocacy to ensure that people with mobility and other physical and sensory disability needs live in the least restrictive environment, including providing legal analysis regarding improved nursing transitions and nursing facility waivers.
EXAMPLE: DRC staff have developed a workgroup to work on making several changes to DRC’s website, including adding a nursing facility transition page. The page will include resources for individuals with disabilities within facilities who want to know their rights and/or are preparing to transition into the community. For example, we will provide information regarding rights in facilities, hospitals, and Residential Care Facilities for the Elderly (RCFE). In addition, we are working to develop a set of discharge planning resources that will include information on transition rights and services available in the community to prevent re-institutionalization. The workgroup will continue to convene and develop a nursing transition page in fiscal year 2014.
INDICATOR 2: Monitor implementation of the settlement in Chambers v. City and County of San Francisco.
EXAMPLE: See description of monitoring of settlement regarding Chambers v. City and County of San Francisco in Section IV.B. above. As part of the Chambers case, this reporting period DRC assisted B.A., a class member who is currently in the discharge planning process at Laguna Honda Hospital (LHH). B.A. will be transitioning from LHH to a scattered site apartment with services which will be coordinated by the city of San Francisco. She contacted DRC for assistance and advocacy to ensure she received the benefits of the Settlement Agreement (see above). With DRC’s involvement, she will be returning to the community.
INDICATOR 3: Ensure that people with disabilities have access to a full range of community services and supports to enable them to live in the community and avoid institutionalization, consistent with the principles of the Supreme Court’s Olmstead decision through direct representation and systemic advocacy, to ensure that people with disabilities have access to essential health care services, including continuing to litigate cases to secure Medi-Cal funded shift nursing for youth aging out of the Early Periodic Screening, Diagnostic and Treatment program (EPDST).
EXAMPLE: In September 2012, P.C. turned 21. As a part-time community college student with muscular dystrophy, P.C. can only move one finger independently, but he uses it all day to type assignments for his online courses or to tweet about his favorite sports teams. Because he can no longer breathe or swallow on his own, P.C. needs skilled nursing care. Nurses monitor his ventilator, feeding tube, and oxygen levels, clear fluids from his lungs and tracheotomy tube, transfer him between bed and wheelchair, and bathe and reposition him. This kind of 24-hour care is often provided in a hospital or high-level nursing facility. However, P.C. has been able to stay at home with his family since he was 14, because of the one-to-one skilled nursing care the state provided under the EPSDT Medicaid Waiver program (like his brother R.C. discussed in Section IV.B above). Home care is better for P.C. and his brother, and it costs considerably less than placing him in an institution. However, when P.C. turned 21, his EPSDT services terminated and, as a result, the state Department of Health Care Services (DHCS) placed him on a lower level of care (LOC) which effectively decreased his licensed vocational nursing (LVN) hours by 40%. P.C.’s doctors and home health agency care providers have testified that he needs this LOC for his safety. Because of the shared living situation, the family was in a critical situation with two young men with severe and complex needs who each require one-to-one nursing services 24 hours a day, which DHCS refused to provide for either one.
DRC represented P.C. at an administrative hearing in October 2012, where the ALJ ordered that P.C.’s services remain at 615 hours per month until a decision was rendered by DHCS. DHCS challenged that determination, but ultimately agreed to abide by the aid paid pending order. Also, DHCS retroactively amended the Acute LOC criteria in its NF/AH Waiver (for Medi-Cal recipients who need ongoing medical attention, in particular when transitioning from a hospital to home), which applies to P.C., so that an individual must already be on the acute waiver or must be hospitalized in an acute setting for 90 or more consecutive days, before it will find an individual meets the Acute LOC criteria. Due to this change, it was likely that P.C. would lose his administrative hearing. As a result, DRC filed a lawsuit on P.C.’s behalf against DHCS for violations of Title II of the ADA and 504 (Olmstead claims), as well as violations for failing to provide written notice and aid paid pending prior to the outcome of the lawsuit. Ultimately, DHCS issued an administrative hearing decision which alternated (when a Presiding Judge makes a decision not to adopt the decision of an administrative judge) the ALJ’s decision, but placed P.C. at the Acute LOC, allowing him to continue to receive the 615 hours per month of LVN services that he had received prior to his 21st birthday. The parties entered into a settlement agreement and the lawsuit was dismissed. Subsequent to the lawsuit, DRC continued to negotiate and work with DHCS and the County to provide P.C. with 720 hours of LVN services per month, which equates to coverage 24 hours a day effective August 2013. The remedy obtained was solely for P.C., however, resolution of his case has paved the way for DRC to settle some related cases more easily with DHCS.
Also see description of Carranza v. Maxwell-Jolly in Section IV.B. and Alvarez v. Betlach in Section IV. A.
INDICATOR 4: Through direct representation, ensure that people with disabilities who receive Social Security benefits maintain access to those benefits to allow them to remain in the community.
EXAMPLE: R.S. contacted DRC after he had made numerous attempts between 2003 and 2011 to apply for Social Security benefits, but had experienced problems with the Social Security Administration (SSA) providing accommodations. R.S. is deaf and requires an ASL interpreter. Although he had set an appointment with SSA regarding his application and requested that an interpreter be provided, on the day of the appointment an interpreter was not available. SSA encouraged RS to write notes at the meeting, and indicated that an interpreter was not necessary, but R.S. disagreed and left. R.S. contacted DRC for assistance in ensuring that SSA fulfills its requirement to provide a necessary interpreter. During the course of talking to SSA about R.S.’s need for accommodations, DRC staff obtained an update from SSA on R.S.’s application for SSDI benefits and provided it to R.S. With the assistance of DRC, R.S. was able to set up a subsequent meeting and an ASL interpreter was provided.
INDICATOR 5: Continue litigation and direct representation to protect existing long-term care services, such as In-Home Supportive Services, Community Based Adult Services and in-home nursing including continued litigation of Oster v. Lightbourne and Darling v. Douglas.
EXAMPLE: See description of ongoing class action cases Oster and Darling above in Section IV.B. DRC continued the direct representation of 93 PAIR-eligible individuals with regard to their denial of Community-Based Adult Services (CBAS) related to implementation of the settlement in Darling v. Douglas. For example, J.S. is a 64 year-old man who, as a result of a stroke, has memory loss. The Department of Healthcare Services (DHCS) found J.S. ineligible for CBAS services. We represented J.S. at a fair hearing and received a decision finding J.S. eligible for the CBAS program. DRC continues to work to make sure that CBAS services remain available to all eligible individuals with disabilities.
Also see description of Beckwith v. Wagner in Section IV.A above.
INDICATOR 6: As Managed Care Organizations assume more responsibility for Medicaid-funded services, ensure that they continue to provide full access to essential health care benefits to people with disabilities by conducting systemic advocacy to ensure that efforts to integrate the financing, coordination or delivery of long-term services and supports are done in a way that ensures that consumers receive services in the most integrated setting appropriate.
EXAMPLE: DRC staff joined numerous disability rights organizations in a letter to the Medicare-Medicaid Coordination Office regarding California’s Coordinated Care Initiative (CCI) implementation documents. The CCI has aims to require all Medi-Cal eligible adults to enroll into Medi-Cal Managed Care in order to retain their Medi-Cal benefits (including Long Term Care Services such as IHSS and Home and Community Based Services), and encourage dually eligible individuals to enroll into a plan that will integrate their Medi-Cal and Medicare benefits and services into a single care model. DRC commented on the proposals, guidance documents and Memoranda of Understanding (MOU) that outline the policies under which County Medical Services (CMS) and DHCS will work in partnership. Our overall concerns included state and plan readiness, quality measures such as oversight and evaluation, and most importantly, continuity of care including transitions of services. The letter placed most emphasis on the need for the MOU to include explicit language requiring that an independent ombudsman is established in each county to respond to complaints and identify systemic problems within the county, as well as provide individual assistance and representation to enrollees on those systemic issues. DRC’s participation led to policy changes in MOU, including care coordination, the continuation of home and community based services (HCBS) which were originally planned to be closed out, and establishing the role of an ombudsman to address and resolve issues between Medi-Cal managed care members and managed care plans. Specifically, under the MOU, CMS and the State Ombudsman office will be responsible for conducting investigations of complaints by consumers about managed care health plans, assisting with individual advocacy and systematic oversight to ensure the lease restrictive, community-based care. Finally, the ombudsman will be required to gather and report data regarding complaints to the State and CMS. Through stakeholder involvement DRC staff members continue to provide input related to CCI implementation in an effort to ensure that the rights of people with disabilities are protected throughout the changes to the California Medicare system.
Also see description of Managed Care v. Sebelius in Section IV.A above.
INDICATOR 7: Conduct direct representation or systemic advocacy to oppose the denial of Medi-Cal benefits and due process protections by managed care organizations.
EXAMPLE: E.G. is a person with diabetes that experiences physical complications with her kidneys, eyes, and feet, and has undergone surgery as a result. E.G. must monitor her blood glucose levels 24 hours a day and sees multiple specialists through her current provider for post-kidney transplant care and for treatment of pulmonary hypertension. E.G. received a notice that she was going to transition to Medi-Cal managed care and was provided a brochure with information regarding exemptions that may apply to her. E.G. filed for a medical exemption but was denied in July 2013. E.G. filed for hearing to appeal the denial, and contacted DRC because she was very concerned about losing access to services through her current doctors. DRC represented E.G. at her appeal hearing, and the decision approved her request for a medical exemption so she was not required to transition to Medi-Cal managed care.
COLLABORATION: DRC worked with the following organizations under the community integration priority area: Hawaii Disability Rights Center, Disability Rights Idaho, Disability Law Center of Alaska, Nevada Disability Advocacy and Law Center, Arizona Center for Disability Law, Western Center on Law and Poverty, Disability Rights Legal Center, Service Employees International Union (SEIU)-United Healthcare Workers West, SEIU-United Long Term Care Workers, SEIU Local 521, SEIU California State Council, United Domestic Workers, California United Homecare Workers; Law Office of Charles Wolfinger; Morrison & Foerster, LLP; National Senior Citizen Law Center; Hogan Lovells LLP; National Health Law Program; and the Department of Healthcare Services.
NUMBER OF CASES HANDLED: 133
Priority 3 - Employment
PRIORITY DESCRIPTION: People with disabilities face discrimination and other barriers to the opportunity to engage in integrated employment with competitive wages and benefits. People with disabilities do not always receive the supports and reasonable accommodations they need to enable them to enter and remain in the workforce and encounter discrimination throughout the employment process.
NEED, ISSUE AND/OR BARRIER: People with disabilities need information, direct representation, and systemic advocacy to ensure that they do not encounter discrimination and have integrated, competitive employment opportunities, and receive the services and reasonable accommodations necessary for them to remain in the workplace.
INDICATOR 1: Address discrimination, enforce discrimination laws and increase access to integrated competitive employment through direct representation or systemic advocacy to advocate for the rights of people with disabilities to be free from discrimination in the workplace and other discriminatory barriers to employment, including their right to receive reasonable accommodations.
EXAMPLE: L.J. contacted DRC after being involuntarily transferred to a different position with a local school district following return from her leave of absence after cancer surgery and follow-up treatment. When L.J. returned to work, her supervisor advised L.J. about co-worker complaints about L.J.’s wig, which she wore due to hair loss from chemotherapy, and her failure to wear a bra due to side effects from radiation. L.J.’s school district also involuntary transferred L.J. to a different position, claiming that it would be in her best interest. DRC negotiated with the school district on L.J.’s behalf and then represented her before the California Department of Fair Employment and Housing (DFEH). DRC was able to resolve L.J.’s case in an agreement under which she received a monetary settlement and attorney’s fees.
Also see description of LSAC v. State of California, Harris v. City of Santa Monica and Maureen K. v. Tuschka in Section IV.A. above.
INDICATOR 2: Advocate for the successful employment and removal of barriers to employment for people receiving Social Security Benefits by directly representing beneficiaries of Social Security on issues such as work incentives, barriers to employment and problems with representative payees, including in negotiations, mediations, or administrative proceedings.
EXAMPLE: W.P. is an individual with neurological disorders who, as a result of a spinal cord injury, receives SSDI benefits. In April 2012, W.P. received notice of an overpayment of about $21,000 due to substantial gainful activity (SGA). Due to W.P.’s SGA, the Social Security Administration (SSA) determined that she was not eligible for SSDI and her benefits were terminated. Because of the SSDI termination W.P had no other alternative, but to be placed on Supplemental Security Income (SSI) benefits. Although W.P. filed a waiver of overpayment on her own behalf, the SSA began to recoup $89 out of her SSI check toward the SSDI overpayment. W.P. contacted DRC for assistance regarding her request for expedited reinstatement (EXR) of SSDI benefits because she had concerns that her overpayment was affecting the request. EXR would provide W.P. with up to 6 months of provisional benefits without having to reapplying for SSDI benefits while SSA determines if she continues to be disabled. DRC staff contacted SSA on behalf of W.P. and was informed that her initial request for EXR was sent back to Disability Determination Services (DDS) for a determination of the onset date, which resulted in a delay in determining W.P.’s continuing eligibility. DRC staff continued communication to follow up with SSA who ultimately confirmed DDS returned W.P.’s file with an eligibility determination and onset date of December 2011. SSA stated that they would reevaluate the overpayment amount based on the changed onset date. As a result of DRC’s involvement, W.P.’s overpayment amount was decreased due to a later onset date, and her SSDI benefits were reinstated.
COLLABORATION: DRC worked with the following organizations under the employment priority area: the Legal Aid Society — Employment Law Center; Disability Rights Education and Defense Fund; Disability Rights Legal Center; Disability Rights Advocates; Association on Higher Education and Disability; California Association of Post-Secondary Education and Disability; the National Association of Law Students; the Civil Rights Education and Enforcement Center; Council of Parent Attorneys and Advocates; Edge Foundation; Everyone Reading, Inc.; the National Federation of the Blind; AIDS Legal Referral Panel, and the Health Legal Services Project of the Law Foundation of Silicon Valley.
NUMBER OF CASES HANDLED: 15
Priority 4 - Rights in Facilities/Abuse and Neglect
PRIORITY DESCRIPTION: People with disabilities are at disproportionate risk of abuse and neglect. Caregivers are frequently the perpetrators of abuse. In addition, the abuse reporting and response system is complex and confusing. Investigators lack sufficient training and expertise in working with people with disabilities. There is inadequate oversight of the abuse system’s response to allegations of abuse and neglect, from initial report to investigation and response by the criminal justice system. People with disabilities who reside in facilities are at risk of abuse, neglect, and improper administration of medications and/or restraints. People with disabilities who reside in facilities do not have the services they need to lead fulfilling lives and enable them to transition into the community.
NEED, ISSUE AND/OR BARRIER: People with disabilities need information, direct representation, and systemic advocacy to ensure protection of their rights and safety with regard to abuse and neglect issues, within facilities and in the community, as well as to reduce the number of incidents of abuse and neglect. In addition, many people with disabilities need information and direct representation to make sure they receive services and treatment within facilities to allow them to transition into the community.
INDICATOR 1: Reduce criminal victimization and serious and life-threatening injuries caused by abuse and neglect of people with disabilities in facilities by conducting select investigations and make recommendations regarding corrective action to prevent likelihood of abuse, neglect or criminal victimization.
EXAMPLE: R.C. is an individual with orthopedic impairments and traumatic brain injury who has experienced ongoing threats from police officers at the San Luis Obispo Police Department (SLOPD). In a particular incident in May, the police came to R.C.’s house and threw him against the police car causing him to fall onto the ground. The officer held his head down with his shoe and proceeded to kick R.C. repeatedly. A neighbor was witness to the incident and called 911. The paramedics came and treated R.C., but left immediately when the deputy officer who was physically mistreating R.C. told them to leave. The police then arrested R.C. and put him in jail. R.C. contacted DRC for representation in a lawsuit against the SLOPD, and for assistance to file a report regarding the abuse DRC staff filed a report with the SLOPD Office of Internal Affairs and provided R.C. with referrals to attorneys who specialize in police brutality claims.
INDICATOR 2: Issue an advisory on patient directed Physician’s Order for Life-sustaining Treatment (POLST).
EXAMPLE: In February 2013, DRC’s Investigations Unit developed the report, “The Deadly Failure of a Hospital to Follow a Patient’s Decisions about his Medical Care,” which details a hospital’s failure to comply with M.T.’s well-documented end of life wishes. When M.T. became incapacitated, medical staff disregarded his instructions regarding all life sustaining treatment, terminating his life sustaining dialysis, and drafting a new Physician’s Order for Life-sustaining Treatment (POLST) which ordered comfort care only. The report recommends that the medical staff document any patient decisions regarding changes in their POLSTs, and seek court review where there are questions about a patient’s withholding and withdrawing life-sustaining treatment. The hospital agreed to appoint at least one member from the disability community who is independent of the hospital or medical staff to the staff ethics committee. The report received considerable interest from outside media, including several local reporters and a bio-ethics professor researching an article for the New England Journal of Medicine.
INDICATOR 3: Improve the response and involvement of agencies in the abuse response, oversight and criminal justice systems to reported criminal victimization, abuse and neglect of people with disabilities by conducting select investigations into adequacy and timeliness of responsible entities, including law enforcement, licensing, criminal justice, regional centers, developmental centers, and other protective services agencies to incidents of abuse, neglect and criminal victimization of people with disabilities.
EXAMPLE: DRC’s Investigations Unit was notified of an incident involving D.S., an individual who uses a wheelchair, who was discharged from a hospital to a homeless shelter without adequate notice, a process referred to as “hospital dumping”. Although we were unable to interview DS because he had left the homeless shelter after DRC staff were notified of the incident, we were able to interview D.S.’s conservator and obtain consent for records. DRC staff reviewed all of D.S.’s hospital records, and conducted a site investigation of both the hospital and the homeless shelter which included interviews with staff at the facilities. Neither D.S.’s medical records nor the results of the on-site investigation could confirm allegations of improper discharge. As a result, DRC staff met with hospital administrators to review proper discharge policies, and also informed the shelter about how to file a licensing complaint against a hospital if they believed that patients were being illegally brought to them. DRC staff will watch for future incidents of “hospital dumping” involving this hospital.
Also see description of Room and Board Coalition in Section IV.A. above.
INDICATOR 4: Issue a report regarding the responsiveness of licensing to substantiated complaints of abuse perpetrated by certified nurse assistants.
EXAMPLE: In December 2012, DRC’s Investigations Unit published a report entitled, “Victimized Twice: Abuse of Nursing Home Residents, No Criminal Accountability for Perpetrators” regarding the failure of the state licensing agency to conduct timely investigations into abuse of patients by certified nursing assistants (CNAs) and delays in the facility licensing division to make referrals to the CNA certification division regarding confirmed CNA abusive conduct. DRC met with the Department of Public Health’s (DPH) Professional Certification Branch (PCB) to review the report’s findings and recommendations and continues to meet quarterly to monitor implementation of corrective action. The licensing division agreed to implement a centralized intake process for notifications of CNA misconduct issues, to develop monitoring tools to track facilities that have high incidents of CNA misconduct, to revise the written policies and procedures of CNA investigations, to set a potential benchmark of 60-90 days to complete investigations, and to implement a quality assurance audit system to ensure compliance with benchmarks for investigation completion. DRC staff have established an agreement to meet with DPH several times a year regarding follow-up on these issues.
INDICATOR 5: Improve the quality of life for people with disabilities in institutions, by protecting their rights and ensuring that they have effective, client-centered, culturally competent services that will help their transition into the community through direct representation to enforce the rights of individuals in county jails to receive appropriate services and accommodations, including continuing to litigate Johnson v. County of Los Angeles and Hall v. Mims.
EXAMPLE: E.M. is a person with a visual impairment who resides in Fresno county jail. E.M. made a request to jail staff to obtain his reading glasses from his stored property. When staff refused to provide the reading glasses to E.M., he contacted DRC. DRC staff assisted E.M. by making a request to the facilities’ captain to retrieve E.M.’s reading glasses as a necessary and reasonable accommodation for his disability. Although there was not a pair of reading glasses in E.M.’s stored property, DRC staff assisted to obtain reading glasses from the jail at no cost.
In the Hall and Johnson cases, we filed a suit on behalf of prisoners with disabilities at the Fresno County Jail and Los Angeles County Jail, respectively, to address the denial of necessary services and accommodations to prisoners with disabilities. The Hall case also addresses the use of excessive force by the staff and other prisoners at the jail. DRC staff have represented individuals in both jails, and are currently discussing settlement in both cases. This reporting year, staff made significant progress in Hall, and if the county does not agree to a reasonable settlement, DRC staff will move forward with discovery and proceed to trial in 2014. (These cases are not funded by PAIR, but potentially affect PAIR-eligible individuals).
Also see description of Peralta v. Dillard in Section IV.A. above.
COLLABORATION: DRC worked with the following organizations under the rights in facilities/abuse and neglect priority area: Rosen Bien Galvan & Grunfeld LLP; Disability Rights Legal Center; and the Prison Law Office.
NUMBER OF CASES HANDLED: 10
Priority 5 — Information, Training, Outreach and Publications
PRIORITY DESCRIPTION: People with disabilities in California, as well as their family members, service providers, and friends, face disability-related legal issues daily, and lack the knowledge and resources they need to advocate on behalf of themselves.
NEED, ISSUE AND/OR BARRIER: People with disabilities need information, training, and publications to enable them to navigate complicated systems and to advocate for themselves when advocates and attorneys are not available to represent them. People with disabilities need resources in a variety of formats and languages.
INDICATOR 1: Counsel and Advice—Regional office staff will provide counsel and advice on at least 1,000 service requests to people with disabilities as well as their advocates, family members and/or other relevant groups of people on disability related legal issues.
EXAMPLE: T.Y.’s mother contacted DRC because T.Y., an elementary school student who performs well, had recently been diagnosed with Attention Deficit Hyperactivity Disorder. T.Y.’s mother spoke to the school psychologist about the possibility of special education services under an individualized educational program, but the school indicated that it could only provide a Section 504 plan because T.Y. received good grades. DRC staff advised explained the difference between the two options and advised T.Y.’s mother of what she should prepare to take to the meeting to demonstrate T.Y.’s eligibility and need for services.
INDICATOR 2: Publications—DRC will develop, or revise and distribute publications and/or training materials to people with disabilities, their family members, advocates, service providers and/or other relevant groups of people, which may include the following: a fact sheet on the Medi-Cal transition to managed care; a publication about how to get good transition planning that includes issues such as independent living, voting, driving, services, education and employment; and/or a fact sheet regarding the transfer of parental rights so that students and parents are prepared for transition.
EXAMPLE: DRC staff developed the publication, “Extra Services for Children and Youth under the Medi-Cal Early and Periodic Screening, Diagnosis, and Treatment (EPDST) Program.” The publication is an easy to understand, 5 page publication that provides information regarding what services are available under the EPDST program, as well as the differences between the EPDST program and Medi-Cal. It also informs consumers regarding the EPSDT medical necessity standard, Medi-Cal Managed Care, and how EPDST coverage may change under Medi-Cal Managed Care. This publication can be found on the Health Benefits Publications page: http://www.disabilityrightsca.org/pubs/PublicationsHealthBenefits.htm
INDICATOR 3: Outreach and Training- DRC will provide training and/or outreach to people with disabilities, their family members, advocates, service providers and/or other relevant groups of people on disability related legal issues.
EXAMPLE: In April 2013, a DRC staff member participated on a panel at the 5th Annual Fair Housing and Public Accommodation Symposium. DRC staff sat on a panel in front of approximately 50 consumers, advocates, and law students at the Golden Gate University School of Law to answer questions regarding the Fair Housing Act and rights to reasonable accommodation in housing statewide. The goal of the panel was to inform participants of the laws and rights regarding housing and accommodation in California so that participants could advocate on behalf of themselves or others regarding housing discrimination issues and ultimately increase integrated community living options for people with disabilities, including physical disabilities.
COLLABORATION: Our outreach, training, and publication efforts include collaborators such as the Department of Rehabilitation, Centers for Independent Living, high schools and community colleges, Temporary Assistance for Needy Families, parent groups, and staff and consumers at disability advocacy and services organizations statewide. (Also see list of Training provided in Section II, B above)
NUMBER OF CASES HANDLED: DRC staff have provided counsel and advice to 1,244 PAIR-eligible individuals regarding 1,359 disability-related issues. DRC staff have developed, revised, and/or translated 10 publications this reporting year. DRC staff have conducted 495 outreaches and/or training events reaching 29,725 individuals with disabilities regarding disability-related issues including networking/collaboration, resource tables at disability awareness and advocacy events, substantive trainings, and presentations about DRC services.
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) Priority: Access/Discrimination
(2) Needs Statement: Discrimination against people with disabilities in California exists in many areas including attitudes, stigma, and stereotypes; discrimination, harassment, and retaliation because of their disability and other protected categories; inadequate and inaccessible transportation; lack of affordable, accessible housing; and lack of access to supports needed to participate fully in the community. People with disabilities face challenges in their right to full participation in electoral and governmental systems. People with disabilities encounter barriers to physical access and reasonable accommodations, as well as stigmatization while residing in the community.
(3) Description of Activities:
Goal 1: Increase and maintain affordable, accessible housing.
Objective A: Through direct representation or systemic advocacy, reduce housing discrimination in private housing, in a variety of continuum of care housing types and in homeless and transitional housing settings; ensure that licensing restrictions in housing do not inhibit community living; and ensure that laws and regulations against housing discrimination effectively address the needs of people with disabilities. This work includes our continuing litigation such as Doe v. San Diego Rescue Mission, Siebert v. Zangari, and other housing discrimination cases.
Objective B: Through direct representation or systemic advocacy, reduce discrimination in local government planning and regulation of housing and land use and improve local government planning for affordable, accessible housing and a variety of living arrangements, for example, by continuing to litigate Independent Living Center et al v. City of Los Angeles et al.
Objective C: Through direct representation or systemic advocacy, preserve or expand the availability of public and subsidized housing programs for people with disabilities, by reducing discrimination and expanding accommodations in the programs, requiring more accessible units, expanding the use of the programs for people with disabilities and advocating for the development of permanent affordable, accessible housing fund sources.
Goal 2: Improve disability access and reduce discrimination in private, public and government programs and services so that all people with disabilities are able to use them effectively.
Objective A: Through direct representation or systemic advocacy, eliminate access barriers and discrimination and improve access to technology and assistive technology in places of public accommodations and businesses and in government programs, such as benefit offices, services, websites, and doctors’ offices.
Objective B: Through direct representation or systemic advocacy, improve access to public transportation systems, streets, and sidewalks.
Objective C: Through direct representation, enforce the rights of individuals in county jails to receive appropriate services and accommodations, including continuing to litigate, or monitor settlements in, Johnson v. County of Los Angeles and Hall v. Mims.
Goal 3: Preserve disability civil rights laws, including the ADA and the Unruh Act. Objective A: Develop and begin to implement a strategy for addressing attacks on disability discrimination laws and/or addressing effective implementation of physical accessibility requirements.
Goal 4: Reduce criminal victimization, abuse, and neglect of people with disabilities and improve response and involvement of oversight agencies and the criminal justices system.
Objective A: Conduct select investigations and make recommendations regarding corrective action to prevent likelihood of abuse, neglect, or criminal victimization.
Objective B: Conduct select investigations into adequacy and timeliness of responsible entities, including law enforcement, licensing, criminal justice, regional centers, developmental centers, and other protective services agencies to incidents of abuse, neglect, and criminal victimization of people with disabilities.
Objective C: Contact agencies when appropriate to report instances of abuse and neglect.
Goal 5: Enforce rights by ensuring that individuals with disabilities have access to courts, administrative agencies and legal services.
Objective A: Respond to proposed constraints on access through amicus briefs or regulatory comments as needed.
(1) Priority: Community Integration
(2) Needs Statement: People with disabilities face barriers to living their daily lives, on their own terms, and in communities of their choice. People with disabilities do not always live in the community placement that is the most appropriate, least restrictive setting chosen by that individual and many people with disabilities are forced to live in institutions. When living in the community, people with disabilities cannot obtain the proper accommodations, services, and supports they need and/or are entitled to. Due to budget cuts and reorganization of the departments, people with disabilities often face unexpected cuts in their services, health benefits, and supports including In-Home Supportive Services (IHSS), Community Based Adult Services (CBAS), Medi-Cal, Medicaid, and Social Security.
(3) Description of Activities:
Goal 1: Ensure that people with disabilities have access to essential health care services and a full range of community long term services and supports to enable them to live in the community and avoid institutionalization, consistent with the principles of the Supreme Court’s Olmstead decision.
Objective A: Conduct systemic advocacy to ensure that people with mobility and other physical and sensory disability needs live in the least restrictive environment, including developing a one-stop clearinghouse with state-of-the-art materials to assist clients and advocates regarding hospital and nursing facility waivers and discharge planning rights.
Objective B: Through direct representation and systemic advocacy, ensure that people with disabilities have access to essential health care services and long-term services and supports, including continuing to litigate cases to secure Medi-Cal funded shift nursing through Home and Community Based Waivers.
Objective C: To monitor class action settlements regarding In-Home Supportive Services and Community Based Adult Services in Oster v. Lightbourne and Darling v. Douglas.
Objective D: Conduct systemic advocacy to ensure that efforts to integrate the financing, coordination or delivery of long-term services and supports are done in a way that ensures that consumers receive services in the most integrated setting appropriate.
Objective E: Conduct direct representation or systemic advocacy to ensure that Medi-Cal managed care organizations provide full access to essential health care benefits to people with disabilities.
Objective F: Engage in systemic advocacy regarding the reduction of antipsychotic use for nursing facility residents with dementia.
(1) Priority: Employment
(2) Needs Statement: People with disabilities face discrimination and other barriers to the opportunity to engage in integrated employment with competitive wages and benefits. People with disabilities do not always receive the supports and reasonable accommodations they need to enable them to enter and remain in the workforce and often face discrimination throughout the employment process.
(3) Description of Activities:
Goal 1: Address discrimination, enforce discrimination laws, and increase access to integrated competitive employment.
Objective A: Through direct representation or systemic advocacy, advocate for the rights of people with disabilities to be free from discrimination in the workplace and other discriminatory barriers to employment, including their right to receive reasonable accommodations.
Goal 2: Advocate for the successful employment and removal of barriers to employment for people receiving Social Security Benefits.
Objective A: Through direct representation, ensure that people with disabilities who receive Social Security benefits maintain access to those benefits to allow them to remain in the community.
(1) Priority: Information, Training, Outreach and Publications
(2) Needs Statement: Thousands of people with disabilities in California face legal issues related to their disabilities daily. They need information, training, and publications to enable them to navigate complicated systems and to advocate for themselves when advocates and attorneys are not available to represent them. People with disabilities need resources in a variety of formats and languages.
(3) Description of Activities:
Goal 1: Counsel and Advice: DRC staff will provide counsel and advice to people with disabilities as well as their advocates, family members and/or other relevant groups of people on disability related legal issues.
Objective A: Provide counsel and advice on at least 1,000 service requests.
Goal 2: Publications- DRC will develop, or revise and distribute publications and/or training materials to people with disabilities, their family members, advocates, service providers and/or other relevant groups of people.
Objective A: Develop or revise, translate and distribute publications and/or training materials to consumers and clients, their family members, services providers, advocates, and other relevant groups of people.
Goal 3: Outreach and Training- DRC will provide training and/or outreach to people with disabilities, their family members, advocates, service providers and/or other relevant groups of people on disability related legal issues.
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.
A. Sources of funds received and expended
SOURCE OF FUNDING / AMOUNT RECEIVED / AMOUNT SPENT
Federal (section 509) / $1,715,017 / $741,678
Federal (section 509) FY 2012 Carryover / $926,968 / $926,968
State / $0 / $0
Program Income - FY 2013 / $0 / $0
Program Income - FY 2012 Carryover / $15,000 / $15,000
Private All Other Funds ** / $0 / $0
Total (from all sources) / $2,656,985 / $1,683,646
B. Budget for the fiscal year covered by this report
CATEGORY CURRENT FISCAL YEAR FY13 BUDGET W/ PAIR PROGRAM INCOME
CATEGORY / CURRENT FISCAL YEAR FY13 BUDGET W/ PAIR PROGRAM INCOME
Administrative Program Wages/Salaries / $170,866 / $864,156
Fringe Benefits (FICA, UI, etc.) / $56,407 / $374,812
Professional Services / $4,026 / $26,753
Legal Services / $8,220 / $54,620
Materials/Supplies / $2,366 / $15,721
Telephone / $3,322 / $22,076
Postage / $914 / $6,071
Rent / $27,150 / $180,409
Bonding/Insurance / $1,146 / $7,612
Equipment Rental/Purchase/Depreciation / $3,628 / $24,108
Equipment Maintenance / $334 / $2,216
Copying & Printing / $1,732 / $11,508
Subscriptions & Publications / $3,050 / $20,266
Legal Data Base Services / $920 / $6,114
Recruiting & Personnel Advertising / $509 / $3,384
Software & Software Maintenance / $1,671 / $11,107
Travel / $8,028 / $53,345
Staff Training & Registrations / $1,394 / $9,266
Sponsored Trainings & Events / $523 / $3,477
Dues / $1,740 / $11,561
Staff Disability Accommodations / $3,041 / $20,208
Indirect Costs / $0 / $0
Miscellaneous / $610 / $4,057
Total Budget / $301,598 / $1,732,846
C. Description of PAIR Staff (Duties and Person-Years)
Type of Position / FTE / % of Yr Filled / Person Years
Full -Time / 0.00 / 0% / 0.00
Part-Time / 16.0233 / 0.7830 / 10.9762
Full -Time / 0.00 / 0% / 0.00
Part-Time / 6.9118 / 0.7577 / 5.5667
D. INVOLVEMENT WITH ADVISORY BOARDS
DRC has no separate Advisory Committee. However, a majority of DRC’s board members are persons with disabilities, including those with PAIR eligible disabilities.
E. GRIEVANCES FILED UNDER THE GRIEVANCE PROCEDURE
J.C. was dissatisfied with services received from DRC regarding the loss of a Section 8 voucher as a reasonable accommodation for her disability. She was also concerned that the attorney assigned to her would not be able to assist her because of his “difficulties with verbal communication." Staff declined to represent J.C. at a hearing based on a lack of resources, but offered to prepare an opinion letter for submission at the hearing. J.C. declined that assistance. The Executive Director agreed with staff’s assessment that DRC did not have the resources to represent J.C. at hearing. J.C. filed an appeal to the Board of Directors Executive Committee, which upheld the Executive Director’s decision.
R.M. was dissatisfied that DRC declined to represent him regarding an appeal of an adverse hearing decision terminating his Section 8 voucher. The Executive Director agreed with staff’s decision since there was overwhelming evidence supporting the Section 8 voucher termination. 3. N.K. requested representation by DRC to appeal a denial of his food stamp allocation and his Medi-Cal Share of Cost. The Executive Director agreed with staff’s decision that DRC lacked the resources to assist with N.K.’s share-of-cost issue and food stamp issue. DRC gave N.K. referrals to other agencies that could possibly assist him.
F. COORDINATION WITH THE CLIENT ASSISTANCE PROGRAM (CAP) AND THE STATE LONG-TERM CARE PROGRAM, IF THESE PROGRAMS ARE NOT PART OF THE P&A AGENCY
During the reporting period, DRC contracted with the California Department of Rehabilitation (DOR), which houses CAP, to provide CAP services to CAP-eligible clients in all ten regions in the State of California. CAP provides advocacy to persons with disabilities who are seeking or receiving vocational rehabilitation (VR) services from DOR, as well as individuals who are seeking or receiving services from independent living centers and other federal rehabilitation-funded partners. DRC CAP and PAIR staff refer cases to each other where appropriate and routinely share expertise on issues affecting their clients. Effective October 1, 2013, RSA has designated DRC as the CAP for California.
DRC participated in an interagency workgroup, convened by CMS to reduce the inappropriate use of antipsychotic medication with nursing home residents with dementia, some of whom also have physical disabilities. DRC, the Long Term Care Ombudsman (LTCO), and other advocates have developed four core strategies: improving dementia care through milieu programming and individual behavioral plans; enhancing consumer awareness; ensuring informed consent; and enhancing regulatory oversight.
DRC also continues to partner with the LTCO, state health care licensing, and other advocates to develop quality of care indicators used as an incentive/reward to exemplary nursing homes. Such activities include measuring staff turnover, staffing levels, and consumer satisfaction measures. No referrals from LTCO were received this year.
|Signed By||Katherine Philbin|