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

Georgia (Georgia Advocacy Office, Inc.) - H240A130011 - FY2013

General Information

Designated Agency Identification

NameGeorgia Advocacy Office Inc.
Address150 E Ponce de Leon Ave. 430
Address Line 2
CityDecatur
StateGeorgia
Zip Code30030
E-mail Addressinfo@thegao.org
Website Addresshttp://www.thegao.org
Phone404-885-1234
TTY 404-885-1234
Toll-free Phone800-537-2329
Toll-free TTY800-537-2329
Fax404-378-0031
Name of P&A Executive DirectorRuby K. Moore
Name of PAIR Director/CoordinatorJulie Kegley
Person to contact regarding reportCrystal Rasa
Contact Person phone404-885-1234
Ext.

Part I. Non-Case Services

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

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas332
2. Individuals receiving I&R outside PAIR priority areas136
3. Total individuals receiving I&R (lines A1 + A2)468

B. Training Activities

1. Number of trainings presented by PAIR staff76
2. Number of individuals who attended training (approximate)6,305

GAO co-hosted a one-day Housing Conference, “You Can Have a Real Home” at Georgia State University with People First of Georgia and the Center for Leadership in Disability. Seventy-five (75) people attended, including veterans and other people with disabilities, family members, and providers. A variety of topics were covered, including Housing Rights under the Law, how to do a Successful Housing Search, visitability, as well as presentations from people with disabilities who were successful in obtaining their own home and ensuring that their home was accessible.

The P & A is providing technical assistance to local education agencies on their obligation to provide services to students transitioning to college and career in the most integrated setting. For example, the P & A provided career, technical and agricultural teachers with guidance from the Office of Special Education and Rehabilitative Services on providing work experience and vocational evaluations in the community rather than in the school building or a segregated facility. Then, the P & A disseminated the recent landmark settlement agreement between the Department of Justice and Rhode Island prohibiting local education agencies from providing services to prepare students for college and career in segregated settings. The P & A followed up with over 100 career, technical and agricultural teachers at their annual conference with training on accessing integrated transition services for the students that they serve. The Department of Justice recognized the P & A’s influence in improving outcomes for people with disabilities in employment when issuing its press release on the settlement.

The P & A presented to 50 self-advocates, families, and support coordinators at “TAKE CHARGE! Discover the Possibilities with Participant-Direction” on the possibilities of integrated, customized employment. The participants self-direct their Medicaid waiver services and attended the conference to learn how to make the most of their waiver funds in accessing employment support services.

The P & A presented at the annual Georgia APSE (Association for People In Supported Employment) in various venues. The P & A presented to providers on accessing quality employment support services to live the good life. The P & A also presented to providers on “The Dartmouth Model: IPS Model Fidelity Scale.” Finally, the P & A concluded the conference with a presentation on the National Disability Rights Network Call to Action: Segregated and Exploited and the implications in Georgia.

The P & A is collaborating with the Opening Doors to Recovery Project to support over 100 individuals leaving Georgia’s State Hospitals to ensure employment is central to their transitions back to community life. This model system of care is hosted in the southeastern region of Georgia to reduce recidivism for adults with Serious Mental Illnesses who end up more than once in a year in the state hospital, jails, prisons and/or homeless. The P & A is part of the work group with detailed implementation plans called “Employment and Meaningful Day.”

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

In the spring, the P & A attended the Northeast Georgia Disability Expo and Transition Conference. The P & A shared information about employment advocacy and micro-enterprises with 120 students, families, and school staff. The P & A also disseminated materials for families to review at home and to use when accessing our advocacy services later.

The P & A supports a group of entrepreneurs, who also happen to have disabilities, in North Georgia. The P & A supports the entrepreneurs to promote their business through social marketing media. For example, Dr. Beckwith is supporting an entrepreneur to track her sales and set business goals while assisting another entrepreneur to print new business cards to improve marketing. The entrepreneurs participated in an arts and crafts festival in North Georgia where they sold their merchandise including jewelry.

The P & A was invited to participate in a community development gathering hosted by WSB-TV focusing on youth at risk. The mission of the gathering is to address issues of safety and career development. The gathering consists of television and radio personalities, political leaders, community law and safety officers, educators, and corporate CEOs. The P & A presented on the need for the inclusion of youth with disabilities and best practices surrounding career paths.

The P & A hosted trainings based on Social Role Valorization throughout the State for providers, individuals with disabilities, family members, specifically, individuals who are vulnerable or who have been denied effective communication. Advocates need a high level of awareness and advocacy practices aimed at establishing and maintaining positive social roles for people subject to all forms of exclusion.

The P & A hosted a PASSING (Program Analysis of Service Systems Implementing Normalization Goals) evaluation, to assess the quality of a human service provider for individuals with disabilities based upon the principles of Social Role Valorization. The P & A led the workshop and recruited individuals from the Department of Behavioral Health and Developmental Disabilities, Delmarva, and the DD Council to participate and provided thorough feedback to the human service provider to be able to make changes within its organization to better support the individuals it serves to obtain valued social roles.

The P & A has also provided training entitled, “The Power of Roles,” to introduce participants to the concept of Social Role Valorization (SRV) and some of its main elements. Participants leave understanding the power of social roles to counteract some of the effects of devaluation and to their importance in assisting people who have been marginalized to have a full and inclusive life. In the past year the P & A provided training to advocates, families, ordinary citizens, Delmarva staff, DBHDD staff, and our Developmental Disabilities Network partners.

The P & A engaged in conversations with DBHDD about the importance of ongoing SRV trainings in Georgia and supported the Department’s hosting of one day introductions to SRV in 7 locations. The P & A provided feedback to the Department about their invitation and hosting of the one day events and how to improve in the next year when we will partner together to bring SRV more often to Georgians.

The P&A participated in the Carter Center’s 28th Annual Mental Health Symposium, “Beyond Stigma; Advancing the Social Inclusion of People with Mental Illness.” Former U.S. First Lady Rosalynn Carter brought together more than 200 mental health leaders, stakeholders, and providers to discuss steps communities can take to build social inclusion of people living with mental illnesses. The P&A Executive Director co-facilitated the working group on Disability Law and Policy along with Lewis Bossing from Bazelon Center for Mental Health.

The P & A provided information and responded to questions from the audience at the Georgia Mental Health Day at the Capitol. Over 600 individual joined the Georgia Mental Health Consumer Network in raising awareness about issues that affect the mental health community.

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

Over 2,500 people joined at the 2013 Disability Day at the Capitol to remind the legislature of the importance of home and community-based services for people with disabilities. The Governor spoke, and the event was covered by newspapers, journals, and television.

The P & A conducted a presentation on “Advocating for the Funding of Assistive Technology (AT)” at the Abilities Expo in Atlanta, Georgia. It takes place in several cities within the United States and has become an anticipated event in Atlanta, Georgia. Exhibitors present a wide variety of Assistive Technology devices, services, products, art, and workshops. This Expo is an annual event that brings together people with disabilities, providers, and other interested people to see what is new and available to enrich peoples’ lives. Approximately 25 people attended this presentation. The audience included people who use assistive technology, advocates, and providers.

The P & A presented during a webinar that was hosted by the state’s lead Assistive Technology (AT) agency. The purpose of the webinar was to teach participants about the funding for AT, and the P & A spoke about how one can advocate on behalf of him/herself or on behalf of others in order to secure funding for needed equipment. 20 Professionals, advocates, and people who have disabilities attended the webinar.

The P & A hosted and presented at a “Self-Advocacy Discussion” for 30 self-advocates. The P & A provided technical support and expertise to self-advocates to start advocating for architectural accessibility, accessibility in public places, accessible transportation, and accessible services from the State. The P & A continues to support self-advocates as they develop their projects.

The P & A collaborates with People First of Georgia on key projects including the establishment of new chapters; the annual Long Road Home Olmstead celebration; Project Vote; providing support at their annual conference; and ongoing personal, professional, and organizational development support to People First of Georgia leadership, membership, and the network.

The P & A supported People First chapters to host Long Road Home events throughout the State to commemorate the Olmstead decision in June. Annually, the P & A supports People First of Atlanta to organize and host a Long Road Home event at the State Capitol. The Capitol event gave self-advocates a platform to share their personal stories of transition from an institutional setting to a place of belonging in the community.

The P & A participates in and contributes financially to Georgia Council on Developmental Disabilities’’ (GCDD) annual Disability Day event, disseminates information about key projects, and supports people with disabilities to attend. The P & A supports a board member to serve as Southeastern Regional Representative on the Self Advocate’s Becoming Empowered National Board. The P & A supported People First of Georgia in the planning and implementation of their annual self-advocacy conference. Presentations during the conference included: “I am Olmstead”, “Real Jobs, Real Pay”, Project Vote, “Moving into the Community”, and “Disability is Natural”. There were also workshops on recreation, health and wellbeing, and having a good life. The conference also provided an opportunity for a micro-enterprise fair where several people were able promote their own businesses. This was an election year for People First of Atlanta. The P&A supported People First in facilitating an election for new officers.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff2
2. Newspaper/magazine/journal articles28
3. PSAs/videos aired1
4. Hits on the PAIR/P&A website5,000
5. Publications/booklets/brochures disseminated18
6. Other (specify separately)3

Narrative

Award-winning filmmaker, Narcel Reedus, revealed the stories of children growing up without a childhood in the documentary, "Not Home" at Abilities Expo and the Georgia Winter Institute. The film examines the complex national phenomenon of children living in nursing homes and state-run institutions. The filmmaker was available for questions and answers after each screening. The P&A and GCDD were core sponsors of the development of this documentary.

10/23/2012 Deinstitutionalization: Unfinished Business National Council on Disability Highlights United States v. Georgia settlement and Children’s Freedom Initiative http://www.ncd.gov/publications/2012/DIToolkit/

11/1/2012 Beyond Stigma: Advancing the Social Inclusion of People with Mental Illness The Rosalynn Carter Symposium on Mental Health Policy Ruby Moore facilitated a strand on Policy and the Law, along with the Bazelon Center for Mental Health. Significant recommendations were crafted to be brought forward by the Carter Center. http://www.cartercenter.org/health/mental_health/symposium/index.html

Part II. Individuals Served

A. Individuals Served

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

1. Individuals still served as of October 1 (carryover from prior FY)39
2. Additional individuals served during the year50
3. Total individuals served (lines A1 + A2)89
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)9

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 24

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility6
2. Employment8
3. Program access3
4. Housing7
5. Government benefits/services15
6. Transportation5
7. Education5
8. Assistive technology1
9. Voting0
10. Health care29
11. Insurance0
12. Non-government services1
13. Privacy rights5
14. Access to records0
15. Abuse4
16. Neglect11
17. Other1

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor69
2. Other representation found1
3. Individual withdrew complaint2
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.3
6. PAIR withdrew from case1
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit0
9. Other0

Please explain

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy37
2. Short-term assistance9
3. Investigation/monitoring10
4. Negotiation15
5. Mediation/alternative dispute resolution2
6. Administrative hearings2
7. Litigation (including class actions)1
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 41
2. 5 - 228
3. 23 - 5962
4. 60 - 6410
5. 65 and over8

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females42
2. Males47

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian1
4. Black or African American48
5. Native Hawaiian or Other Pacific Islander0
6. White37
7. Two or more races2
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent42
2. Parental or other family home10
3. Community residential home2
4. Foster care0
5. Nursing home21
6. Public institutional living arrangement0
7. Private institutional living arrangement6
8. Jail/prison/detention center4
9. Homeless2
10. Other living arrangements2
11. Living arrangements not known0

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment11
2. Deaf/hard of hearing9
3. Deaf-blind1
4. Orthopedic impairment20
5. Mental illness9
6. Substance abuse0
7. Mental retardation5
8. Learning disability3
9. Neurological impairment17
10. Respiratory impairment0
11. Heart/other circulatory impairment4
12. Muscular/skeletal impairment3
13. Speech impairment1
14. AIDS/HIV2
15. Traumatic brain injury3
16. Other disability1

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities8

2. Number of individuals potentially impacted by policy changes1,456,812

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

The P & A participates on the Deaf Services Advisory Panel hosted by the Department of Behavioral Health and Developmental Disabilities to ensure that individuals receiving services from the Department are also receiving effective communication. The P & A posted information and resources on a listserv for persons in Georgia who are deaf and hard of hearing regarding the “Responsibilities of Health Care Providers for Persons Who are Deaf or Hard of Hearing and A Guide for Persons Who Are Deaf or Hard of Hearing.“ At the request of the Atlanta Legal Aid Society (ALAS), the P&A reviewed ALAS’s Effective Communications Policy for persons who are deaf, hard of hearing, blind, and deafblind and provided technical assistance and guidance on the language of the Policy.

The P&A represented several individuals under a public guardianship (Division of Aging) to have their rights restored. In those cases, the P&A developed a working relationship with the Division of Aging guardianship case managers and their attorney. As a result, the Division began contacting the P&A to enlist the P&As support in the restoration of rights of persons under a guardianship that they had identified as no longer needing a guardian.

The P & A experienced denials for access to individuals and records from Adult Protective Services (APS) field workers. The P & A worked with the legal counsel for the Georgia Department of Human Services to resolve the issue by agreeing on a process for requesting records and getting a timely response.

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

CFI met with Department of Behavioral Health and Developmental Disabilities Commissioner this year regarding the mission of this initiative and how we can collaborate with the Department. The Commissioner agreed that the Behavioral Health Coordinating Council would urge all of the departments that are involved with children with disabilities to work together to ensure permanent, loving homes for children. Also, the P & A provided technical assistance to the Alabama P&A about the initiative: the beginning and lessons learned. The P & A distributed published materials to use as a guide in starting a similar initiative to free children from facilities. There are several children from Georgia in a pediatric nursing facility in Alabama.

The P&A provided CNN medical correspondent information about children living in nursing facilities and the Children’s Freedom Initiative. The P & A also spoke with People Magazine, Mother Jones magazine, Making a Difference magazine with the DD Council, and was featured on NPR’s Talk of the Nation segment.

Georgia LEND (Leadership & Education in Neurodevelopmental and related Disabilities) worked for two semesters with CFI and presented their outcomes from their research and data collection. As part of their work, the P & A learned how PASRR (Pre-admission Screening and Resident Review) process is intended to function, specifically related to how young people are being admitted to nursing facilities. LEND presented members of the initiative with clear flow charts and graphic illustrations of the current system in Georgia, what could be a more effective system, and assisted us with our strategic plan. The CFI engaged with the state Medicaid agency to obtain more accurate data regarding how many children are in nursing facilities in Georgia and expect the report any day now.

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

The P & A provides mentoring to employment support providers with the broad goal to support organizations’ shift from facility-based services to community-based supports for beneficiaries. The P & A collaborates with the Georgia Council on Developmental Disabilities, the University Centers for Excellence, VR, the Southeast Technical Assistance and Continuing Education, and the Department of Education to support staff in utilizing best practices in serving beneficiaries with the most significant impact of their disabilities.

The P & A also supports systemic litigation that will have an impact on beneficiaries throughout the country, including working with the United States Department of Justice and other national ADA litigators to bring cases to interpret the ADA as it pertains to employment of people with disabilities.

During this year, the P & A experienced an enormous barrier in advocating for individuals to receive appropriate services from VR. When the Georgia Vocational Rehabilitation Agency moved from the Department of Labor to become the first independent VR Agency in the nation, the Executive Director of GVRA closed all priority categories due to a funding crisis, which stopped services for all VR clients with the exception of those with a signed Work Plan. Essentially, during this fiscal year, GVRA did not provide services for clients unless they had a signed Work Plan. No new VR clients could receive services from GVRA. The P & A advocated for a speedy resolution to the problem. The P & A also advocated on behalf of individuals to utilize unique employment support services other than those provided by VR.

The newly formed VR Program requested that the P & A develop a foundational values-based training to inform the redesign of their services. The P & A provided training to their executive level staff and all of their program managers about the Rehab Act, VR’s funding legislation, and core values. P & A was also able to address our “match” needs for the Georgia Council on Developmental Disabilities, our funding partner for EFG.

The P & A assists entrepreneurs, who are also beneficiaries, to strengthen their businesses and develop marketing strategies. Dr. Ruthie Beckwith is supporting entrepreneurs with marketing, increasing sales, and meeting Internal Revenue Service regulations. Dr. Beckwith also supports entrepreneurs in Toccoa selling jewelry with marketing and increasing profits. Some of the support that the beneficiaries receive is in the form of self-advocacy: supporting beneficiaries in seeing the profits of their businesses and marketing them as such. Sometimes after years of being overshadowed or not valued, it is challenging to promote the worth of one’s work.

The P & A is providing technical assistance to local education agencies on their obligation to provide services to students transitioning to college and career in the most integrated setting. For example, the P & A provided career, technical and agricultural teachers with guidance from the Office of Special Education and Rehabilitative Services on providing work experience and vocational evaluations in the community rather than in the school building or a segregated facility. Then, the P & A disseminated the recent landmark settlement agreement between the Department of Justice and Rhode Island prohibiting local education agencies from providing services to prepare students for college and career in segregated settings. The P & A followed up with over 100 career, technical and agricultural teachers at their annual conference with training on accessing integrated transition services for the students that they serve. The Department of Justice recognized the P & A’s influence in improving outcomes for people with disabilities in employment when issuing its press release on the settlement.

The P & A is providing technical assistance to providers completing Discovery Profiles to students with the support of SE TACE for the purpose of creating customized employment. The P & A is advocating on behalf of students transitioning from school to work in a collaborative process with the Georgia Vocational Rehabilitation Agency, the local education agencies, providers, and the Division of Developmental Disabilities.

LM requested assistance from P & A in advocating that the Environmental Protection Agency (EPA) implement the recommended accommodations of telework from home 1-2 days a week. LM had extensive documentation from her treating medical professionals supporting this request. The P&A attended an informal mediation with LM and three EPA supervisors. At the conclusion of that mediation, the EPA supervisors declined to implement the recommendations of the treating professionals. The P & A then provided technical assistance in self-advocacy to LM in crafting an internal EPA complaint and attended formal EPA mediation with LM. At the mediation, the EPA declined to provide LM with her requested accommodation despite the fact it was supported by her treating professionals and the EPA had a policy of allowing its employees to telework. The P&A then assisted LM in drafting and filing an EEOC complaint.

The P & A is a member of the Unlock the Waiting List campaign to address the State’s failure to implement the Olmstead decision by its low number of community based supports available to people with disabilities, including people with traumatic brain injuries. The P & A, the DD Council, the University Centers for Excellence, All About Developmental Disabilities, the State Independent Living Network, and People First of Georgia comprise a committee with the goal of expanding community based supports and services for Georgians with disabilities. The Unlock campaign currently has over 300 member organizations and over 500 individual members throughout the state.

The advocacy community asked the Governor to support a budget that will finance implementation of the provisions of the U.S. v. Georgia settlement and provide for additional home and community-based supports for individuals. Unlock the Waiting Lists asked the legislature for increased home and community-based services. The legislature approved 500 more slots for Family Support services and 250 Medicaid waivers for individuals with developmental disabilities.

The P & A supported self-advocates to testify before the House Appropriations Subcommittee for Health regarding the FY2014 Budget and Unlock’s request to fund 100 additional ICWP waivers to reduce the current wait list of 109 individuals. The legislature funded 20 more Independent Care Waiver Program slots and increased consumer choice for other community-based services recipients.

The P&A was contacted by a nursing facility administrator regarding one of her 32-year old residents with disabilities. TJ wanted to move out of the nursing facility, but had been denied services through the ICWP (Independent Care Waiver Program) waiver for several reasons, including that she was non-compliant with her treatment plan; she required 24 hours of care; and that her care exceeded the cost of care allocated by the ICWP budget. The P & A referred the woman to the Money Follows the Person (MFP) program and attended the MFP meeting with the woman. The P & A also requested a new ICWP evaluation and provided TJ and the nursing facility with tips and strategies to refute the reasons why the ICWP waiver had previously been denied. TJ was able to successfully move out of the nursing facility to live with her boyfriend and was approved for services through ICWP.

The P & A participates on the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and the Elderly, which includes American Red Cross of Georgia, (ARC), Atlanta Area School for the Deaf (AASD), Center for Advanced Communications Policy-Georgia Institute of Technology, DeKalb County Emergency Management Agency (DEMA), Federal Emergency Management Agency (FEMA), Friends of Disabled Adults & Children (FODAC), GACHI-Serving the Deaf & Hard of Hearing, Georgia Association of the Deaf (GAD), Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), Georgia Department of Human Services (DHS), Georgia Department of Public Health (DPH), Georgia Emergency Management Agency (GEMA), Georgia Radio Reading Service (GaRRS), Georgia State Financing and Investment Commission-State ADA Coordinator’s Office, Gwinnett Coalition for Health and Human Services Emergency Preparedness Committee, Gwinnett, Newton, Rockdale County Health Departments, Portlight Strategies, Inc., Shepherd Center, Southeast ADA Center, and Tools for Life-The Alternative Media Access Network-Georgia Institute of Technology- Enterprise Innovation Institute. Friends of Disabled Adults and Children (FODAC) and the Georgia Emergency Management Agency (GEMA) have partnered to provide medical equipment in the event of any state disaster. Typically, the state agency coordinates with the local communities and does not do any purchasing of products. With this partnership the state agency purchases any medical relief equipment needed and has the ability to store it in the FODAC facility. This allows the state agency to better accommodate people with disabilities.

Portlight Strategies, Inc. brought a national conference to Georgia (hosted by a Coalition member). Three (3) other Coalition agencies presented at the conference (American Red Cross of Georgia (ARC), Friends of Disabled Adults & Children (FODAC), Tools for Life-The Alternative Media Access Network-Georgia Institute of Technology- Enterprise Innovation Institute) as well as Marcie Roth, from FEMA. The Coalition has provided “Train the Trainer” sessions around Georgia to provider agencies who support individuals with disabilities and older adults. The materials were produced by the Coalition and provide participants receive training in emergency preparedness specifically designed for individuals with disabilities and older adults. Attendees learn techniques and are provided tools to use when delivering this training to the individuals they serve. Laura George with Portlight Strategies, Inc. and the P & A are working on a project with the City of Decatur Fire Department to arrange a “mock evacuation drill” at the P & A. The Coalition will receive a summary of “lessons learned” after the drill so other local Emergency Management Agencies (EMAs) can learn about our project and use the report to better prepare their communities in the event of a disaster.

The Coalition developed a poster "Communication Access Options for Individuals who are Deaf, Hard of Hearing or who have Speech Difficulties" which has now been disseminated to local emergency management agencies (EMAs)and shelter agencies throughout the State of Georgia and posted on the State ADA Coordinator’s website. Also, 2,205 Tips Guides and 4,300 new/updated emergency management preparedness brochures were distributed throughout the State. The P & A participates in a cross-disability stakeholders group convened by the Georgia Council on Developmental Disabilities reviewing the State’s plans for managed care and Medicaid reform. The P & A contributes to the stakeholders group to ensure that there are qualified and responsive Medicaid providers and that people with disabilities do not lose services in the process of the State’s change. The stakeholder group had a significant impact upon the RFP that was issued by Georgia’s Medicaid Agency and will be providing active feedback to the company awarded the managed care contract for children in foster care.

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

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

The P & A participated in an Allies reception in Washington , D.C. at the Little People of America annual conference, with approximately 100 advocates including members from the U.S. International Council on Disability, the Administration on Intellectual and Developmental Disabilities (AIDD), and the National Disability Rights Network (NDRN). There were also representatives from the Social Security Administration, the Rehabilitation Services Administration, the U.S. Secretary of State’s Office, the National Council on Disability, Gallaudet University, and the Washington, DC ADA Office.

The P & A, along with other advocacy disability rights organizations, called upon the Georgia Legislature to change the law relating to the death penalty. In 1988, Georgia became the first state to ban executions of individuals with intellectual disabilities (formerly “mental retardation”). In 2002, the United States Supreme Court banned such executions nationwide. However, Georgia is the only state in the national to require capital defendants to prove their disability beyond a reasonable doubt, the most difficult burden of proof in our courts. The P & A continues to educate legislators on the inhumane practice and the need for a legislative change.

Georgia House Bill 1166 allows parents who do not qualify for other benefits to purchase health benefits for their children. However, they must purchase the benefits before the end of January. Children with pre-existing conditions can enroll. The P & A provided information to parents who contacted the P&A about the benefit.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts1,456,812
2. Number of individuals named in class actions0

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

The P & A represented CH, a woman with multiple disabilities, in an appeal of the Georgia Department of Community Health’s Money Follows the Person (MFP) program denial of services to her. The P & A filed multiple briefs in support of CH’s position that she was entitled to MFP services because she was Medicaid-eligible and she had resided in a long-term care setting for at least 90 days. On the day of the hearing, the Department contacted the P & A to settle the case and provided CH with the specific MFP services she wanted: $8000 of home modification services. The P & A drafted a Settlement Agreement for CH to enter into with the Department and that Agreement approved by the Judge.

The P & A oversees the implementation of the United States v. Georgia settlement agreement with a key focus being on the mental health and developmental disabilities systems and oversight of the process of deinstitutionalization and significant development of community supports and services for people with psychiatric and developmental disabilities. P & A was appointed as amicus in a lawsuit filed by the Department of Justice Civil Rights Division against the State regarding the State’s failure to serve people with developmental disabilities and mental illness in the most integrated setting appropriate to their needs.

The P & A met with the Commissioner of the Department of Behavioral Health and Developmental Disabilities and his staff regarding the implementation of provisions governing Assertive Community Treatment (ACT) and Quality Management (QM). In February, the United States issued a letter to the Commissioner asking the State to complete a list of tasks. Then, the amici, including the P & A, met with the State regarding the tasks and missed deadlines. The Commissioner articulated that all people with developmental disabilities in state hospitals would be moved into the community. The Independent Reviewer recently issued her annual report, and the parties met on September 30, 2013, to discuss the report and issues going forward. The P & A, as part of the amici, had a number of concerns. The most significant concern relates to the DD service system. There is a fundamental lack of understanding about what people need and the supports and services that create meaningful opportunities for people to have lives of true social integration and inclusion. As a result, the State’s efforts at compliance under the Agreement have been misguided and have led to poor outcomes. The Independent Reviewer has been raising these issues with the State and has been documenting them in previous reports. In order to give the State some time to address these issues, the parties and the Independent Reviewer agreed to give the State an additional six months before she would issue a report on developmental disabilities services. The P & A is providing specific feedback to the State regarding the challenges and barriers in our current system of services. The P & A’s other primary concern relates to the poor practice of discharge planning and implementation in both the developmental disabilities and mental health systems. The P & A is still seeing very poor discharge planning and discontinuity in service between the hospitals and community services. This is most evident in situations involving people with significant support needs and people who are dually diagnosed with a mental illness and a developmental disability or a brain injury. In particular, the P & A continues to have great concern about the people being discharged from Craig nursing facility at Central State Hospital. The State has failed to develop a plan to assure that all of the people confined to Craig are afforded a meaningful opportunity to live in the community with appropriate support. People with mental illness and significant physical support needs are particularly at risk of being sent off to other nursing facilities. The P & A continue to voice our concern with all parties and made clear that we are prepared to intervene, if necessary, on behalf of individuals not afforded appropriate community-based support.

Hunter v. Cook is the second case the P&A has litigated in federal court regarding in-home nursing services for medically complicated children that asserted the same Medicaid claims as Moore and added a claim under the Americans with Disabilities Act. The P & A was successful on both the Medicaid and ADA claims and obtained a permanent injunction for one of the Plaintiffs in 2012. The State settled with two of the plaintiffs for the amount of nursing hours their doctors had ordered. The P&A was also successful in obtaining a permanent injunction for the final two plaintiffs in September of 2013.

The P & A continues to work toward implementation of its settlement with the Department of Behavioral Health and Developmental Disabilities (DBHDD) regarding access authority. DBHDD is to develop training materials for their employees regarding P&A access authority. The P & A is reviewing and revising the Department’s storyboards and materials to be used during training for DBHDD staff.

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

Part V. PAIR'S Priorities and Objectives

A. Priorities and Objectives for the Fiscal Year Covered by this Report

For each of your PAIR program priorities for the fiscal year covered by this report, please:

  1. Identify and describe priority.
  2. Identify the need, issue or barrier addressed by this priority.
  3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
  4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
  5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions.
  6. Provide at least one case summary that demonstrates the impact of the priority.

1. Identify and describe the priority.

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

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

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

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

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

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

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

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

35

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

The P & A received a letter from IC who explained that he was an inmate at a detention center within the State. IC noted that he has a traumatic brain injury due to the physical abuse he received from law enforcement several years ago. IC also notes that he is legally blind. IC noted in his letter that he has been denied access to medical treatment to treat his health issues for over thirty one (31) months of confinement. IC reported that he was having severe headaches but was having trouble getting the medical staff to make an appointment for him to see a physician outside of the detention center. IC said that he visited a neurologist back in 2009 when he was released from the hospital but claims that he is currently being denied the physician ordered treatment. The medical staff provided him with medication, but he got not relief from the medication. The P & A made an on-site visit to see IC in June of 2012, reviewed his medical records, and met with the Health Services Administrator regarding the headaches that IC was having. IC was scheduled to see a neurologist. The Health Services Administrator sent the P & A a copy of the neurologist’s report which shows some changes in IC’s medication. In April of 2013, IC sent another letter to P & A indicating the current medication was not relieving his headaches. He stated that he had submitted grievances to get his medication changed to another medication that would be more effective but most of his grievances were turned down by the detention center ombudsman or the warden himself. The P & A made an onsite visit to see IC on April 30, 2013 to check on his health status and to talk with the Health Services Administrator. Neither the Health Services Administrator nor the Warden was available during my visit. As a result, P & A wrote a letter to the Health Services Administrator explaining how IC continues to have the headaches and that the medication is no longer being effective per IC. Also, the P & A attached a copy of the physician’s order.

As a result of P & A’s involvement with IC, the medication was changed without any further problems. The P & A followed up with a call to the Health Services Administrator to send documentation that the medication changes has been made. The P & A received the document which shows the medication was changed to address the on-going headaches.

FL is a 64 year old veteran in a general hospital. His sister contacted the P & A in a panic. She was told by the social worker that FL needed to be discharged. If she could not take him into her home they would bring him to a homeless shelter. Sister was advised by P & A that this violated COBRA - “dumping” FL in a homeless shelter was not an appropriate discharge and she should contact risk manager at the facility. Sister was distraught and felt she had been ambushed by the staff. Although she loved her brother, caring for him at home was not a reasonable option. FL had complex medical needs and was receiving hospice care. P & A attorney was able to intervene on behalf of FL and his family. The hospital contacted the Veterans Administration to determine his benefits and the hospital legal representative assured P & A attorney that they would be providing an appropriate discharge plan for FL. A week later, FL’s sister reported that the hospital staff did a “180” and FL and his sister have been included in FL’s discharge planning.

The P & A met DB, a 23 year old man in a nursing facility where he lived for past 2 years. DB sustained a spinal cord injury when he was 19 and was placed in a nursing facility because his family was unable to provide all the supports he needed. He applied for Money Follows the Person (MFP) to access Independent Care Waiver Program (ICWP) services to move out. With MFP, the man’s mother rented an accessible home for the two of them to live together. Upon discharge, DB went to Shepherd Center for 7 weeks of rehabilitation to relearn how to use his arm and hands that he lost use of while in the nursing facility. DB moved into the home with his mother and has attendant care 8 hours a day for support. The man was featured in a NPR “Talk of the Nation” segment about young people living in nursing facilities.

1. Identify and describe the priority.

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

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

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

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

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

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

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

The P & A referred DBHDD to national experts in housing for people with developmental disabilities. The P & A provided information regarding people owning their own homes, developing housing co-ops, and better utilizing microboards for home ownership. The State put out a White Paper about housing. The P & A is providing feedback about inclusive housing.

The Executive Director of the P & A was invited to and participated in “Building a More Inclusive Workforce: A National Summit to Boost Education and Employment Outcomes for Americans with Disabilities,” a summit hosted by Delaware Governor Jack Markell, the Council on Foundations and the US Business Leadership Network (USBLN). Summit participants included national leaders in disability employment, including Senators Harkin and Chris Coon. The Summit’s goal was to engage members of the philanthropic and business sectors, in partnership with federal and state governments, to address the chronic under-participation of adults and youth with disabilities in the American workforce.

On September 26, 2013, the U.S. Equal Employment Opportunity Commission (EEOC) and the U.S. Department of Labor (DOL) celebrated "The Past, Present, and Future of the Rehabilitation Act" on its 40th anniversary. This event highlighted where disability law started, where it currently stands and where it might be headed. The celebration took place at EEOC. Leaders such as Judy Heumann, EEOC Commissioner Chai Feldblum, and Senator Harkin presented and facilitated the celebration of the 4oth Anniversary of the Rehabilitation Act. The Conference was broadcast nationally. P&A Executive Director, Ruby Moore, was invited and presented on the future of the Rehabilitation Act.

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

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

36

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

JW contacted the P & A and the State ADA Coordinator’s office regarding several concerns he had regarding discrimination at the facility he was in. The P & A attorney and the State ADA Coordinator collaborated together and had an initial meeting with JW at the Hall County Jail with a certified ASL interpreter. The P & A provided JW with technical assistance regarding his legal rights (right to a certified ASL interpreter during certain times at the facility - for example, medical appointments where there is an exchange of new information; providing an effective means to contact security in case of emergency or evacuation; provide access to video relay or TTY as other inmates on his POD have, etc.). The P & A attorney/advocate coordinated with the State ADA Coordinator and Georgia Council for the Hearing Impaired, Inc. (GACHI) (who helped JW file a Department of Justice complaint) so the 3 organizations did not duplicate services to JW.

JP, a man with deafness, contacted the P&A regarding the refusal of Emory University Healthcare Clinic’s ("Emory") refusal to provide a qualified sign language interpreter for him during the post-operative/recovery portion of his outpatient procedure. In addition, JP informed the P&A that the interpreter who was present during the admissions process was accompanied by a man and a child and heard communications between the front desk/admissions personnel, which was a violation of the Health Insurance Portability and Accountability Act (HIPAA). The P&A negotiated with Emory’s attorney for the following solutions: 1. Emory agreed to provide a qualified sign language interpreter for the entire duration of any future appointments or medical procedures/surgeries that may occur for the man. 2. Emory agreed to ensure that patients with deafness have their right to privacy safeguarded in that extraneous persons will not be privy to confidential information. 3. P & A provided Emory with the Joint Commission’s requirements for hospitals to ensure effective communication with patients who are deaf/hard of hearing, as well as the most recent settlement agreement between the United States Department of Justice and a hospital to incorporate within Emory’s own effective communication policy.

JM, a woman with deafness who communicated via American Sign Language, contacted the P & A to request that the P & A educate her medical doctor of his responsibilities to provide effective communication to her at medical appointments with him. The P & A wrote the doctor a letter explaining his obligations under the Americans with Disabilities Act. The doctor responded by agreeing to provide an interpreter at the next appointment with JM.

RW, a woman with deaf-blindness, contacted the P & A to request assistance in filing a complaint against the Medical Center of Central Georgia for failure to provide an American Sign Language (ASL) Tactile interpreter to her during two separate visits to the Medical Center. The P & A contacted the Medical Center’s attorney on RW’s behalf and negotiated the following solutions: 1. The Medical Center agreed to provide a qualified tactile ASL interpreter for the woman at any future Emergency Room visits or medical procedures/surgeries that may occur; 2. The Medical Center agreed to ensure effective communication by having an interpreter remain with a person with deaf-blindness from the time the person arrives at the emergency room and/or appointment until the person is discharged from medical treatment. 3. The Medical Center has been advised to work to create a plan to obtain more interpreters trained in tactual signing (training is available through the American Association of the Deaf-Blind); 4. The Medical Center agrees to contact the P&A for training Medical Center staff about effective communication with persons with deaf-blindness, if necessary.

The P & A intervened in a 3 hour Friday night meeting with the Department of Family and Children Services (DFCS) wherein DFCS threatened to take custody of DC’s one year old child if she did not agree to go to the transitional housing with HIV positive residents. After intense negotiations with DFCS, the P & A was able to negotiate a deal whereby the P & A would work with DC to identify appropriate assistive technology and community supports available for DC to utilize in safely raising her child. The P & A wrote a comprehensive letter to DFCS outlining all the strategies and supports, which included the following: contact with other parents who are visually impaired and raising children; iPad with 17 apps downloaded specifically for persons with visual impairment; GREAT DAY (Mental Health resources for people who are deaf); Georgia Chapter for National Federation of the Blind; Georgia Council for the Blind; Georgia Association of the Deaf-Blind; Center for the Visually Impaired; and Georgia Department of Vocational Rehabilitation.

CC, a man with physical disabilities, contacted the P & A to request assistance in advocating that Georgia’s Independent Care Waiver Program ensure that its contractor provided modifications to his house. The P & A contacted ICWP on CCs behalf and was able to successfully ensure that the modifications were completed to CC’s satisfaction.

1. Identify and describe the priority.

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

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

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

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

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

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

The P & A continues to support the Georgia Microboard Association (GMA) by hosting meetings at our office and working with GMA to address systemic obstacles to people with disabilities exercising more self-determination and to getting the supports needed to live good lives in the community. The Georgia Microboard Association supports microboards and micro-enterprises with technical assistance as well as hosting relevant training.

The GMA director took a leave after being hospitalized for several months following an automobile accident and sustaining a brain injury. The P & A supported the Interim Director and the group of approximately 35 self-advocates and family members. The group meets monthly to discuss the creation and sustainability of microboards to support individuals with disabilities. The group hosted an informational session at the P & A this year where new participants attended to learn how to start their own microboard.

The Parent Leadership Support Project (PLSP) was created to increase the capacity of the community to respond to students with disabilities being excluded from the neighborhood classroom, denied high quality instruction, and excluded from the experience from being a student in school community. PLSP seeks to address this issue on a local level, one student at a time, by recruiting and training volunteer advocates to attend school-based meetings for students with disabilities who have been denied an appropriate education. The P & A continues to support over 200 graduates throughout the State. Graduates recruited families and supported then to tell their stories of segregation and exclusion to the United States Department of Justice as part of their investigation into the funding formula that incentivizes educational practices that favor segregation.

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

The P & A collaborates with People First of Georgia on key projects including the establishment of new chapters; the annual Long Road Home Olmstead celebration; Project Vote; providing support at their annual conference; and ongoing personal, professional, and organizational development support to People First of Georgia leadership, membership, and the network.

The P & A supported People First chapters to host Long Road Home events throughout the State to commemorate the Olmstead decision in June. Annually, the P & A supports People First of Atlanta to organize and host a Long Road Home event at the State Capitol. The Capitol event gave self-advocates a platform to share their personal stories of transition from an institutional setting to a place of belonging in the community.

The P & A participates in and contributes financially to GCDD’s annual Disability Day event, disseminates information about key projects, and supports people with disabilities to attend. The P & A supports a board member to serve as Southeastern Regional Representative on the Self Advocate’s Becoming Empowered National Board. The P & A supported People First of Georgia in the planning and implementation of their annual self-advocacy conference. Presentations during the conference included: “I am Olmstead”, “Real Jobs, Real Pay”, Project Vote, “Moving into the Community”, and “Disability is Natural”. There were also workshops on recreation, health and wellbeing, and having a good life. The conference also provided an opportunity for a micro-enterprise fair where several people were able promote their own businesses. This was an election year for People First of Atlanta. The P&A supported People First in facilitating an election for new officers.

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

31

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

AK, a woman with deafness who communicated via American Sign Language, had been asking Family Healthcare Clinic to provide a sign language interpreter during her appointments with their chiropractor. AK requested assistance from the P & A. The P & A provided technical assistance in self-advocacy to the woman by reviewing, and making suggestions, to her draft complaint with the United States Department of Justice against Family Healthcare Clinic for their refusal to provide an interpreter at her appointment with one of their chiropractors.

B. Priorities and Objectives for the Current Fiscal Year

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

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

A.

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

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

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

B. Needs

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

C. Activities

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

Priority 2

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

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

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

B. Needs

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

C. Activities

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

Priority 3

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

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

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

B. Needs

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

C. Activities

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

Part VI. Narrative

At a minimum, you must include all of the information requested. You may include any other information, not otherwise collected on this reporting form that would be helpful in describing the extent of PAIR activities during the prior fiscal year. Please limit the narrative portion of this report, including attachments, to 20 pages or less.

The narrative should contain the following information. The instructions for this form outline the information that should be contained in each section.

  1. Sources of funds received and expended
  2. Budget for the fiscal year covered by this report
  3. Description of PAIR staff (duties and person-years)
  4. Involvement with advisory boards (if any)
  5. Grievances filed under the grievance procedure
  6. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency

A. Source of Funding

Federal (section 509): Amount Received = 446,602

Federal (section 509): Amount Spent = 480,461

State: Amount Received = 0

State: Amount Spent = 0

Program income: Amount Received = 0

Program income: Amount Spent = 0

Private: Amount Received = 0

Private: Amount Spent = 0

All other funds: Amount Received = 0

All other funds: Amount Spent = 0

Total (from all sources): Amount Received = 446,602

Total (from all sources): Amount Spent = 480,462

B. Budget for the fiscal year covered by this report

Wages/salaries: Prior Fiscal Year = 336,210

Wages/salaries: Current Fiscal Year = 288,145

Fringe benefits (FICA, unemployment, etc): Prior Fiscal Year = 76,530

Fringe benefits (FICA, unemployment, etc): Current F/Y= 74,819

Materials/supplies: Prior Fiscal Year = 5,000

Materials/supplies: Current Fiscal Year = 4,331

Postage: Prior Fiscal Year = 1,000

Postage: Current Fiscal Year = 906

Telephone: Prior Fiscal Year = 5,000

Telephone: Current Fiscal Year = 3,919

Rent: Prior Fiscal Year = 32,000

Rent: Current Fiscal Year = 31,955

Travel: Prior Fiscal Year = 19,000

Travel: Current Fiscal Year = 13,781

Copying: Prior Fiscal Year = 3,100

Copying: Current Fiscal Year = 3,147

Bonding/insurance: Prior Fiscal Year = 500

Bonding/insurance: Current Fiscal Year = 550

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

Equipment (rent/purchase): Current Fiscal Year = 1,708

Legal Services: Prior Fiscal Year = 22,571

Legal Services: Current Fiscal Year = 24,710

Indirect costs: Prior Fiscal Year = 0

Indirect costs: Current Fiscal Year = 0

Miscellaneous: Prior Fiscal Year = 23,750

Miscellaneous: Current Fiscal Year = 32,029

Total Budget: Prior Fiscal Year = 532,790

Total Budget: Current Fiscal Year = 480,000

C. Description of PAIR Staff

Professional position: 13 FTE filled 100% of year Professional full-time positions: 11 FTE, 11 person-years Professional part-time positions: 2 FTE, 1 person-year Professional vacant positions: 5 FTE, 1 person-year Clerical position: 5 FTE filled 100% of year Clerical full-time positions: 5 FTE, 5 person-years Clerical part-time positions: 0 FTE, 0 person-years Clerical vacant positions: 0 FTE, 0 person-years

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

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

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

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

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

Leslie Lipson is an attorney who has been with P & A for twelve years. She specializes in education law and devoted a portion of her time this year to the coordination and continued development of the Parent Leadership Support Project (PLSP). The Comptroller and his assistant, all members of the Administrative Support team, as well as the Executive Director have all contributed to and participated in support for the PAIR program.

D. Involvement with Advisory Boards

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

E. Grievances filed under the grievance procedure

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

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

This year, the P & A continued to provide advocacy to individuals with disabilities trying to access appropriate services from Vocational Rehabilitation. The P & A receives referrals from CAP and the Ombudsman program and often provides advocacy and technical assistance to individuals not served by the CAP.

Certification

Signed?Yes
Signed ByCrystal Rasa, JD
TitleProgram Director
Signed Date12/23/2013