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

Iowa (IOWA P and A SERVICES, INC.) - H240A130016 - FY2013

General Information

Designated Agency Identification

NameDisability Rights Iowa
Address400 East Court Avenue
Address Line 2Suite 300
CityDes Moines
StateIowa
Zip Code50309
E-mail Addressinfo@driowa.org
Website Addresshttp://www.driowa.org
Phone515-278-2502
TTY 515-278-0571
Toll-free Phone800-779-2502
Toll-free TTY866-483-3342
Fax515-278-0539
Name of P&A Executive DirectorJane Hudson, Executive Director
Name of PAIR Director/CoordinatorCynthia A. Miller
Person to contact regarding reportCynthia A. Miller
Contact Person phone515-278-2502
Ext.32

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 areas2
2. Individuals receiving I&R outside PAIR priority areas21
3. Total individuals receiving I&R (lines A1 + A2)23

B. Training Activities

1. Number of trainings presented by PAIR staff11
2. Number of individuals who attended training (approximate)802

The following were 11 trainings conducted by staff that related to the PAIR program:

Alternatives to Guardianship: DRI provided 4 trainings on alternatives to guardianship/conservatorship.

1. AEA Transition Conference: DRI presented at the AEA 12 “Broadening Our Horizons” conference to educate parents, educators and agency representatives about the alternatives to Guardianship and Conservatorships and promote the review of other lesser restrictive types of substitute decision making where appropriate to the individual’s need.

2. Teleconference Training: Provided a training opportunity for individuals, families and providers to better understand the rights of an individual who has a substitute decision maker and alternatives to guardianship. Purpose of training was to educate on rights in substitute decision making including review of self-determination, alternatives to guardianship/conservatorship, specific issues and rights in guardianship and what to do if a ward’s rights are violated.

3. DHS Case Managers Conferences (East and West retreats): DRI presented at 2 separate conferences for Department of Human Service case managers at their annual conferences. DRI trained on the topics of individual rights, rights under guardianship and employment issues. There were a total of 240 case managers trained. The training is designed to educate these case managers and supervisors so they are able to answer rights questions in the field and also advocate for persons with disabilities in having their rights upheld.

Transition Planning: DRI presented at the AEA 12 “Broadening Our Horizons” conference on how to transition from education to competitive employment using different service delivery systems including the IEP process, social security benefits and using a PASS (Plan to Achieve Self-Support), Vocational Rehabilitation, and customized employment with accommodations. The training utilized a success story of 2 individuals who have worked through all of these systems starting from special education services to being competitively employed with benefits.

Collaboration with Parent Educator Connection (PEC): DRI presented to the PEC to give a better understanding of the work of DRI and what services and supports are available to families that the PEC serves including students in special education. Our agencies are working to strengthen our collaboration efforts and provide the advocacy and representation to students who need assistance to obtain appropriate services in education.

AmeriCorps Human Rights Day: DRI provided 2 separate trainings for AmeriCorps volunteers at a breakout session in March and as the keynote speaker in July training session. The purpose of the training was to provide basic disability awareness and human rights training to AmeriCorps volunteers, ages 18 to 24, regarding the definition of disability, what challenges people with disabilities face, how the challenges of living with disability has changed over the years and how does the ADA protect the rights of individuals with disabilities.

Employment Rights: DRI provided employment law training for staff at Goodwill of Central Iowa in the Des Moines location. This training was the result of the Epilepsy Foundation having received 2 individual complaints from individuals with disabilities removed from Goodwill work site or program that should have had work accommodations. DRI and the Epilepsy Foundation met with Executive Director and HR personnel at Goodwill to discuss these issues and they requested ADA training from DRI. The training focused on employment law rights under the ADA and discussed the right to accommodations and the interactive process. The intended purpose was to reduce consumer complaints of rights being violated in the Goodwill work center.

Americans with Disabilities Act: DRI provided 2 separate trainings on the Americans with Disabilities Act (ADA). 1. DRI provided training at the request of a newly formed consumer advocacy group on what the laws are under the Americans with Disabilities Act. Purpose of training was to educate and inform the consumer group on what the law states in Title I, II and III so they can then use the laws in their future advocacy efforts.

2. DRI provided the keynote at the “Training on self-advocacy and the Americans with Disabilities Act” conference held in Davenport, Iowa. This training evolved out of the ADA Coalition where we wanted to create a training for self-advocacy and have communities come together to promote ADA principles. DRI’s training provided consumers, providers, social workers and third party advocates information on the principles of the Americans with Disabilities Act and how to self-advocate for the rights under the ADA. Training also was to connect people in the same areas to form their own coalitions and move issues forward that effect their communities.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles0
3. PSAs/videos aired1
4. Hits on the PAIR/P&A website23,684
5. Publications/booklets/brochures disseminated2,410
6. Other (specify separately)1

Narrative

DRI produced one electronic newsletter in FY14 that provided information on rights of individuals with disabilities.

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)13
2. Additional individuals served during the year49
3. Total individuals served (lines A1 + A2)62
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)0

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 11

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility2
2. Employment26
3. Program access8
4. Housing2
5. Government benefits/services1
6. Transportation6
7. Education3
8. Assistive technology0
9. Voting0
10. Health care3
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse3
16. Neglect1
17. Other7

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor35
2. Other representation found2
3. Individual withdrew complaint7
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.0
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources2
8. Individual case lacks legal merit3
9. Other2

Please explain

One case was closed due to no contact from the individual. One case was closed due to case being outside of fiscal year priorities. DRI provided information on her rights under the law and referrals to other legal advocacy agencies.

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-advocacy7
2. Short-term assistance27
3. Investigation/monitoring1
4. Negotiation10
5. Mediation/alternative dispute resolution1
6. Administrative hearings1
7. Litigation (including class actions)4
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 40
2. 5 - 226
3. 23 - 5935
4. 60 - 6414
5. 65 and over7

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females27
2. Males35

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 Native2
3. Asian0
4. Black or African American3
5. Native Hawaiian or Other Pacific Islander0
6. White56
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent53
2. Parental or other family home6
3. Community residential home0
4. Foster care0
5. Nursing home2
6. Public institutional living arrangement1
7. Private institutional living arrangement0
8. Jail/prison/detention center0
9. Homeless0
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment8
2. Deaf/hard of hearing0
3. Deaf-blind0
4. Orthopedic impairment11
5. Mental illness0
6. Substance abuse0
7. Mental retardation4
8. Learning disability0
9. Neurological impairment13
10. Respiratory impairment2
11. Heart/other circulatory impairment1
12. Muscular/skeletal impairment4
13. Speech impairment0
14. AIDS/HIV0
15. Traumatic brain injury1
16. Other disability18

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities3

2. Number of individuals potentially impacted by policy changes11,000

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

Non-Emergency Medical Transportation: DRI reviewed the TMS contract with Department of Human Services and Iowa Medicaid Enterprise. TMS is the broker contracted by the State to provide non-emergency medical transportation to Iowans eligible for Title 19 insurance. DRI discovered several issues with this system including inadequate grievance system, inadequate member education, unilateral policy changes imposed by broker in violation of administrative rulemaking procedures, lack of availability of service to elderly people and people with disabilities, lack of member advisory council, and failure of the state to uphold promises made by broker resulting in adverse impact on Medicaid recipients. Through DRI’s involvement, Iowa Medicaid and broker have acknowledged some flaws in system, agreed to implement certain changes, and amend rules in accordance with required rulemaking procedures. This project is ongoing into FY14 as DRI continues to work on systemic changes with Iowa Medicaid Enterprise.

Accessibility Review of the Iowa State Fair: Iowa State Fair administration (ISF) allowed DRI staff and others to review the fairgrounds on 8/1/2012. DRI then presented a report of accessibility issues to the ISF in a meeting to review the initial findings. We collaborated with the University of Iowa legal clinic and Department of Human Rights Office of Persons with Disabilities in the review of the draft report and the initial meeting with ISF administration in order to make recommendations that comply with the ADA standards. DRI continues to work to come to a negotiated settlement with the ISF and have the ISF complete a self-evaluation and transition plan over the next several years to fix accessibility issues. The ISF did work with DRI over the summer prior to the 2013 State Fair on policy changes for service animals and mobility device use within the fairgrounds. The systemic collaboration towards the transition plan continues into FY 14.

Iowa High School Athletic Association: This systemic project began as way to get Iowa Girls High School Athletic Union (IGHSAU) aware their obligations under the Americans with Disabilities Act when working with athletes and spectators who have disabilities. DRI also reviewed students with disabilities and their level of participation in sports/PE in Iowa. DRI made recommendations to the IGHSAU who then did change their policies regarding service animals and right to accommodations to reflect the current Iowa and ADA law.

Olmstead Task Force: DRI participates n the meetings of the legislatively created Olmstead Task Force which was designed to advocate for the state system to provide appropriate community supports for people who are threatened with being institutionalized or who require additional services to remain in their own home or in the least restrictive environment in the community. This year the task force focused on Medicaid Expansion under the Affordable Care Act (ACA) and Redesign of Iowa’s mental health and disability services system. The Olmstead plan has the potential to impact every Iowan with a disability.

Collaboration with Veterans Organizations: DRI attended meetings and collaborated with service officers and other employees of the Veterans Benefit Administration and other veteran organizations interested in issues facing returning veterans and veterans with disabilities. Major issues addressed were traumatic brain injury, suicide prevention, mental health treatment, resources for veterans with disabilities, and legal issues. Individuals were impacted when DRI collaborated with numerous other organizations to spread awareness of DRI as a resource for veterans with disabilities. DRI attended veterans lobbying day at the Iowa capitol and distributed literature on DRI’s mission and priorities, and answered questions from professionals. DRI also met with non-profit veteran assistance group and provided referrals for housing issues.

Iowa Disability Action Network: DRI sits on the IDAN committee which is made up of several agencies who come together to discuss policy, legislative priorities and issues related to the disability community including persons diagnosed with developmental disabilities, TBI, physical and mental health disabilities. Issues are typically related to medical, transportation, housing, employment, and community services, choice, and Olmstead. This year the committee focused its efforts to review the State’s proposed redesign of the service system. Iowa Special Education Advisory Panel: DRI sits on the IDEA mandated statewide advisory panel that provides advice/recommendations to the DOE. DRI staff participates in the meetings held six (6) times a year and advocates in internal subcommittees at the meetings.

Quality Education Coalition: DRI continued the Iowa Quality Education Coalition to address systemic issues that affect the quality of education for students in Iowa, particularly those with disabilities. Members of the coalition share information and focus on changing and improving policies and practices that support high achievement for all students. The coalition met this year and reviewed ongoing issues with restraint and seclusion and issues in the Iowa Juvenile Home.

ADA Coalition: DRI continued the coalition in FY13 to review issues within the American’s with Disabilities Act in Iowa. Collaborators attending include the DBTAC—Great Plains ADA Center, staff from Senator Harkin’s office, Iowa Department of Human Rights, University of Iowa Law Clinic, and six (6) local human rights commissions from metropolitan areas around the state. The coalition finalized collaborative factsheets outlining how to file complaints under Titles I, II and III of the ADA. The coalition also participated in the creation of a conference entitled Training on Self-advocacy and the Americans with Disabilities Act with members of the coalition presenting different sessions.

Emergency Preparedness: Disability Rights Iowa has a statement of understanding with the Iowa Disaster Human Resource Council (IDHRC) and participates as an active member of the Council. As a member, DRI agrees to work cooperatively to assist persons and families who have been adversely affected by a disaster. DRI attends meetings of IDHRC regularly and shared information regarding the requirement to provide information and emergency services in accessible formats. DRI is available to provide legal expertise and information on ADA questions and issues to state, county and municipal emergency management officials. Additional ideas for future collaboration included development of accessible materials for distribution before, during and after disaster, providing legal representation for rights and access violations for victims of disaster, developing monitoring protocols for mass shelters, collaborating on social medial to get the word out about emergency preparedness to persons with disabilities, developing training on emergency preparedness for persons with disabilities, and including reviews of facility emergency plans in DRI’s ongoing monitoring of facilities.

Department of Correction Incident Reports: Incident reports involving inmates diagnosed with disabilities were received from the Iowa Department of Corrections and reviewed by DRI to detect patterns or incidents of abuse or neglect. DRI monitors these incident reports to ensure procedures are followed and to help assure the rights of these inmates. DRI also uses these reports to identify any necessary investigation or monitoring that may arise from a pattern of incidents.

B. Litigation/Class Actions

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

DRI did not bring any class action lawsuits in FY 13.

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.

Accessibility: 1. Priority: Individuals with disabilities have the right to full participation of programs, services and activities of public entities and public accommodations. 2. Need, issue or barrier addressed: Individuals with disabilities may be excluded from participation in public services and public accommodations because of a failure to make facilities accessible or to provide reasonable accommodations.

3. Indicators: DRI will investigate and provide legally-based advocacy concerning physical or architectural accessibility issues involving both public entities and public accommodations. DRI will provide legally-based advocacy for qualified individuals with disabilities who are excluded from participation in or denied the benefits of the services, programs or activities of public entities because of their disability, including but not limited to the failure to allow service animals as required by law and the failure of public entities to provide reasonable accommodations in the process of applying for services. DRI will provide legally-based advocacy to individuals who are discriminated against on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation. DRI will provide legally-based advocacy to ensure Iowans with disabilities will be integrated into the State’s emergency planning, ensuring that their accessibility and functional needs are addressed and that they have equal access to emergency programs and services. DRI will provide legally-based advocacy to post-secondary students who are not receiving reasonable accommodations from their educational institutions. DRI will investigate whether entities administering standardized tests have failed to provide reasonable accommodations to test takers with disabilities and DRI will provide legally-based systemic advocacy if the service fail to provide such reasonable accommodations.

4. Collaboration: See Section IV for systemic collaboration descriptions of Iowa State Fair accessibility review project, ADA Coalition and Emergency Preparedness. DRI also collaborated with Senator Harkin’s office and the Three Rivers Independent Living Center in Sioux City to review accessibility issues in Sioux City and what actions could our agencies collectively do to begin addressing the lack of accessibility. Project is ongoing and will be reported on in FY14.

5. Number of cases: 11 Class actions -0-

6. Case summary: Individual is a 29 year-old woman who is partially blind. She was required to take an exam to seek admission to grad school and had made request for accommodations in advance. She encountered issues with the accommodations process, lack of requested accommodations when she arrived at the testing site and then her testing scores were held up due to being flagged for process irregularity. DRI contacted the testing service by a demand letter and outlined client’s experiences and suggestions to improve the process for persons with disabilities. General counsel for testing service initially responded and addressed client’s concerns in detail, outlined ways in which testing service is improving access for people with disabilities and promised to share concerns with relevant staff. DRI later received a second letter from the testing service general counsel stating they have altered their testing policy as a result of client’s complaint, and now make large print confidentiality statements available.

Individual is a 73-year old man with orthopedic impairments and uses a wheelchair. Client’s wife is his primary caretaker, and they regularly play Bingo at Hy-Vee. When he needs to use the restroom, his wife would take him to the women’s room to assist him. A manager had told them the store has received customer complaints, and they can no longer use the restroom together. The store has no unisex restroom. DRI wrote a letter to store director requesting ADA accommodations in the form of having an employee temporarily close one restroom when the client and his wife need to use it together. The store agreed to make this accommodation.

Community Integration: 1. Priority: Iowans with disabilities have the right to live in the most integrated and least restrictive settings appropriate to their choice and needs. 2. Need, issue or barrier addressed: Individuals with disabilities should be able to live as independently as possible and in the setting they desire. Barriers appear when the living situations are more restrictive than what is necessary to address safety or medical concerns, or considerations are not given to the use of reasonable accommodations, aids or services that could enable individuals with disabilities to reside where they choose. 3. Indicators: DRI will provide individual and systemic legally-based advocacy to individuals who have a disability and are inappropriately placed in overly-restrictive nursing facility settings. DRI will provide legally-based advocacy to ensure that individuals with disabilities, including but not limited to individuals with disabilities living in rural communities, have the community services to which they are entitled under federal and state law. DRI will collaborate with other veterans’ organizations and provide legally-based advocacy to veterans with disabilities who are in settings that are more restrictive than their medical needs require. 4. Collaboration: DRI continues to collaborate with the Money Follows the Person grant program and other state resources to review the numbers of transitioning consumers to the community in order to advocate for transition to community living resources when appropriate. DRI also met with Iowa Medicaid Enterprise who encouraged our agencies to work together to resolve issues prior to filing appeals. Other collaboration is listed in Section IV under systemic projects. 5. Number of cases: 11 Class actions -0- 6. Case summary: Individual is a 77 year old male with a primary diagnosis of COPD and also has a pacemaker. He had been receiving services through the HCBS elderly waiver for the last year which enabled to maintain living at home instead of a nursing home. In April, IME terminated him from all elderly waiver services stating he no longer met level of care. DRI collaborated with Iowa Medicaid Enterprise to try to resolve the issue before appeal. DRI contacted client’s doctors for them to provide letters describing client’s medical conditions and how that affects his life and to perform a new level of care certification for IME re-evaluation. IME reviewed new documentation submitted and the individual was approved for the elderly waiver and will again receive the services needed to remain living at home and out of nursing home care.

Individual is a 49-year old man with multiple disabilities, including a kidney disorder requiring regular dialysis, who lives in the community. He has no means of transportation and has been receiving services under an exception provided by Medicaid transportation broker, TMS. The individual was facing termination of this exception to policy in May and will die without dialysis, or a means to get to treatment. DRI collected relevant documentation and contacted TMS and Medicaid and requested additional exception as accommodation for individual’s disabilities. An exception was provided for the next six months and the individual was able to get to his dialysis appointments.

Employment: 1. Priority: DRI will provide legally-based advocacy for the disability rights of Iowans who are experiencing disability-based discrimination in employment. 2. Need, issue or barrier addressed: Individuals with disabilities may be excluded from the workplace due to fear and inflexibility with accommodation requests, and are likely to be terminated from employment because of the disability. 3. Indicators: DRI will provide legally-based advocacy for individuals requesting accommodations related to their disability in the hiring process or during employment. DRI will provide legally-based advocacy for individuals who encountered disability discrimination in gaining or maintaining employment. 4. Collaboration: DRI consults with and refers cases with the members of the Iowa Bar Association when appropriate. DRI has also received case referrals from Senator Harkin’s office and Iowa Legal Aid. 5. Number of cases: 27 Class actions -0-

6. Case summary: Individual is a 59 year old male with arthritis, asthma and allergies. He is a bus driver for a local school district and needed an accommodation for his back by using an air-ride seat and air conditioning for pulmonary issues. He received a bus at the beginning of the year without these accommodations and was advised by his supervisor that he needs to see a specialist in order to get the accommodation. DRI assisted this individual in requesting accommodations from his employer and advising the employer that its request for the individual to see a specialist violated the ADA. The employer responded that it would drop the request to see a specialist and then stated they would try to accommodate his requests but if they could not meet both needs, they may have to place him on administrative leave. DRI responded and advised their proposed solutions were again in violation of the ADA unless they can show undue burden. The employer then advised they would provide the individual with a new bus that had an air ride seat and air conditioning. The individual was provided the requested accommodations and he continues to be employed.

The individual is a 40 year old female with a diagnosis of Epilepsy. The individual was terminated from her job due to her disability after she requested an accommodation of additional leave time for seizure management. DRI assisted the individual in filing an appeal review of the termination in-house with the employer but they upheld the termination stating the individual missed too much work. DRI then assisted the individual in filing a complaint with the Iowa Civil Rights Commission for failure to provide an accommodation under the Americans with Disabilities Act. The parties came to a settlement agreement in mediation that included the individual receiving monetary damages and forgiveness of PTO overpayment and forgiveness of tuition reimbursement loan. DRI was also paid attorney fees.

Guardianship & Other Legal Decision Makers 1. Priority: To provide advocacy for the disability rights of Iowans to pursue alternatives to guardianships and conservatorships, to end guardianships and conservatorships when it is no longer necessary, to change guardians and conservators in cases of abuse or neglect, and hold other legal decision makers accountable for violating the rights of the person with a disability. 2. Need, issue or barrier addressed: Individuals with disabilities may be subjected to unnecessary guardianships and conservatorships and have the right to have an appropriate guardianship that is as narrowly tailored as possible. 3. Indicators: -DRI will provide legally-based advocacy for individuals who want to challenge imposition of a guardianship/conservatorship when it is unnecessary, including promoting alternatives. DRI will provide legally-based advocacy to terminate guardianships/conservatorships for those who are no longer in need of a guardian/conservator. DRI will provide legally-based advocacy to individuals whose representative payees are failing to act in their best interests as required by the Social Security Administration. DRI will provide legally based advocacy service to individuals who are aging out of foster care or transitioning in education, and where the systems are promoting or attempting to impose guardianship/conservatorship as the only option. 4. Collaboration: See trainings provided in Part I. 5. Number of cases: 9 Class actions -0-

6. Case summary: Individual is a 22 year old man with Asperger’s and ADHD. His biological mother was his guardian and was non-responsive to attempts to contact her to change individual’s services through case management and providers. The individual wanted to terminate the guardianship and make decision on his own. DRI represented the individual in a termination of guardianship action, filed motion with court and appeared at hearing. The court terminated the guardianship and the individual is living in the community with appropriate third party supports.

Individual is a 40 year old female with a diagnosis of Multiple Sclerosis. She contacted DRI with the complaint that her representative payee had not been paying her bills on time and her objective was to manage her own benefits check and no longer have an assigned representative payee. DRI provided information to the individual regarding the process of becoming her own payee and that she would need to provide a doctor’s statement to Social Security that there had been a change in her condition and that she was able to manage her own Social Security benefits. The doctor did provide a statement to Social Security regarding the individual’s capabilities. Social Security informed the client that as of April 2013, she would no longer require a representative payee and that her benefit checks would be deposited into her own bank account.

Education: 1. Priority: Students with disabilities have the right to enforce and protect their rights for special education and related services under the Individuals with Disabilities Education Act (IDEA) and Rehabilitation Act Section 504. 2. Need, issue or barrier addressed: Students with disabilities are at risk of not being educated, being restrained or secluded, or subjected to the use of law enforcement for disciplinary purposes. 3. Indicators: DRI will provide legally-based advocacy for students who are suspended, expelled, constructively expelled, restrained or secluded, arrested or forced to have a shortened school day for behavior related to their disability. DRI will investigate whether there is a lack of transition planning and services for youth with disabilities between ages 14 and 21 at the Iowa Juvenile Home in Toledo, Iowa, and provide legally-based advocacy to those not receiving appropriate transition services. DRI will pursue legally-based advocacy to prevent and stop bullying and harassment based on disability that contributes to a denial of free and appropriate public education (FAPE) or that constitutes illegal harassment under state or federal law. DRI will provide outreach, education and legally-based advocacy for families of students with disabilities who are underserved due to economic and/or cultural factors. Trainings will be focused in geographical areas where local education agencies and area education agencies have unacceptable levels of over-identification of students of color and/or students who are socioeconomically disadvantaged in special education. DRI will provide training and information to individuals with disabilities, parents, pro bono attorneys and law students to increase their skills and knowledge with respect to the enforcement of the IDEA and Section 504. Lack of Medicaid and other health services for resident of the Iowa Juvenile Home who have disabilities and/or mental illnesses and are aging out of the foster care system. DRI will conduct an investigation and provide advocacy to the youth at Toledo who are aging out to ensure that they have the Medicaid services to which they are entitled. 4. Collaboration: See collaborative projects and coalitions in Part IV. DRI also has strengthened our collaborations with the Parent Training Information Center/Ask Resource. DRI was a part of a Point/Counterpoint training at the PTI annual conference where a school attorney, Department of Education attorney and DRI attorney (as parent/student representative) all answered questions from each of our practice perspectives. DRI is also meeting with the PTI and cross referring cases where PTI can do lower level advocacy and then transfers a case back to DRI if it requires legal advocacy. 5. Number of cases: 3 Class actions -0-

6. Case summary: Individual is a 9 year old student with Asperger’s with significant behavior needs related to her disability. She had been inappropriately secluded by her associate at school. Of particular concern is that the supervising teacher was not present in the building during half of the day. DRI contacted the Department of Education regarding appropriate supervision of associates and our concerns regarding the use of seclusion. In response to DRI complaint, the Department of Education intervened and the District now has the teacher in place all day in the building and has hired and trained two new paraprofessionals. The parent reported that the student is doing exceptionally well.

Abuse and Neglect: 1. Priority: Individuals with disabilities shall be free from abuse and neglect. 2. Need, issue or barrier addressed: Individuals with disabilities may be subject to abuse, neglect, or financial exploitation. This is often due to the dependency that individuals with disabilities develop requiring assistance with food, personal cares, and personal safety. Individuals with disabilities may not understand how to report instances of abuse or neglect. 3. Indicators: -DRI will collaborate with the Iowa Department of Inspections and Appeals, the Iowa Department of Corrections, and the Iowa Ombudsman to investigate the deaths of individuals with disabilities in facilities. DRI will provide protection and advocacy services to residents in HCBS waiver homes to ensure that they are safe, and that their rights are protected. DRI will investigate and take appropriate actions to improve the grievance systems in state-operated facilities including the mental health institutes, the psychiatric medical institutes for children, the state resource centers, and the state juvenile facilities. 4. Collaboration: See collaboration description with Long Term Care Ombudsman and Department of Inspection and Appeals in Section VI. DRI receives incident reports from the Iowa Department of Correction regarding inmates with disabilities and reviews for any patterns of abuse or neglect. Iowa Department of Inspection and Appeals also sends all citation reports indicating what facilities have been reviewed and had findings. DRI reviews these citation reports to identify any necessary monitoring and investigation.

5. Number of cases: 1 Class actions -0-

6. Case summary: The individual was a 92 year old male with partial blindness and orthopedic disabilities. At the time of this allegation was a resident of a free standing nursing facility/skilled nursing facility. The individual’s son reported to DRI that the subject was assaulted by a nurse and that he received bruises and a cut on the arm during the altercation. DRI conducted a secondary investigation and obtained records from Iowa Department of Inspections and Appeals (DIA). DIA conducted an investigation of the incident and found the facility appropriately responded to the injury and did not substantiate other allegations in the complaint. DRI received a copy of the DIA investigation and concluded that the primary investigative agency, DIA conducted a timely, thorough and objective investigation of the alleged incident of abuse.

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.

Abuse and Neglect: 1. Priority: Individuals with disabilities shall be free from abuse and neglect. 2. Need addressed: Individuals with disabilities may be subject to abuse, neglect, or financial exploitation. This is often due to the dependency that individuals with disabilities develop requiring assistance with food, personal cares, and personal safety. Individuals with disabilities may not understand how to report instances of abuse or neglect. 3. Description of Activities: DRI will collaborate with the Iowa Department of Inspections and Appeals, the Iowa Department of Corrections, the Iowa Long-Term Care Ombudsman and the Citizens Aide Ombudsmen to investigate the deaths of individuals with disabilities in facilities.

Accessibility:

1. Priority: Individuals with disabilities have the right to full participation of programs, services and activities of public entities and public accommodations. 2. Need addressed: Individuals with disabilities may be excluded from participation in public services and public accommodations because of a failure to make facilities accessible or to provide reasonable accommodations. 3. Description of Activities: a. DRI will investigate and provide legally-based advocacy concerning physical or architectural accessibility issues involving public entities. b. DRI will provide legally-based advocacy for qualified individuals with disabilities who are excluded from participation in or denied the benefits of the services, programs or activities of public entities because of their disability, including but not limited to the failure to allow service animals as required by law, and the failure of public entities to provide reasonable accommodations in the process of applying for services. c. DRI will provide legally-based advocacy to individuals who are discriminated against on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to) or operates a place of public accommodation. d. DRI will provide systemic legally based advocacy to ensure Iowans with disabilities will be integrated into the State’s emergency planning, ensuring that their accessibility and functional needs are addressed and that they have equal access to emergency programs and services.

Community Integration:

1. Priority: Iowans with disabilities have the right to live in the most integrated and least restrictive settings appropriate to their choice and needs. 2. Need addressed: Individuals with disabilities should be able to live as independently as possible and in the setting they desire. Barriers appear when the living situations are more restrictive than what is necessary to address safety or medical concerns, or considerations are not given to the use of reasonable accommodations, aids or services that could enable individuals with disabilities to reside where they choose. 3. Description of Activities: a. During Iowa’s implementation of the Mental Health and Disability Services Redesign, DRI will provide systemic and individual legally-based advocacy to ensure that individuals with disabilities have the community services to which they are entitled under federal and state law. DRI will not provide case-management services and will not represent individuals to remain in institutional placements. b. DRI will conduct an exploratory investigation regarding the lack of adequate transportation for individuals with disabilities, especially in rural areas.

Education:

1. Priority: Students with disabilities have the right to enforce and protect their rights for special education and related services under the Individuals with Disabilities Education Act (IDEA) and Rehabilitation Act Section 504. 2. Need addressed: Students with disabilities are at risk of not being educated, being restrained or secluded, or subjected to the use of law enforcement for disciplinary purposes. 3. Description of Activities: a. DRI will provide legally-based advocacy for students who are suspended, expelled, constructively expelled, restrained or secluded, arrested or forced to have a shortened school day for behavior related to their disability. b. DRI will pursue legally-based advocacy to prevent and stop bullying and harassment based on disability that contributes to a denial of free and appropriate public education (FAPE) or constitutes illegal harassment under state or federal law. c. DRI will provide outreach, education and legally-based advocacy for families of students with disabilities who are underserved due to economic and/or cultural factors.

Employment:

1. Priority: DRI will provide legally-based advocacy for the disability rights of Iowans who are experiencing disability-based discrimination in employment. 2. Need addressed: Individuals with disabilities may be excluded from the workplace due to fear and inflexibility with accommodation requests, and are likely to be terminated from employment because of the disability. 3. Description of Activities: a. DRI will provide legally-based advocacy for individuals who encountered disability discrimination in gaining, maintaining or regaining employment, including failure to provide reasonable accommodations. b. DRI will collaborate with other organizations to provide training to employers and individuals with disabilities about the benefits of employing individuals with disabilities and the employment protections for individuals with disabilities under state and federal law.

Supportive Decision-Making & Alternatives to Guardianship

1. Priority: DRI will provide advocacy for the disability rights of Iowans to pursue alternatives to guardianships or conservatorships, to end guardianships or conservatorships when no longer necessary, to change guardians or conservators in cases of abuse or neglect, and hold other legal decision makers accountable for violating the rights of the person with a disability. 2. Need addressed: Individuals with disabilities may be subjected to unnecessary guardianships and conservatorships and have the right to have an appropriate guardianship that is as narrowly tailored as possible. 3. Description of Activities: a. DRI will provide trainings to judges, providers, and individuals with disabilities and their family members on less restrictive alternatives to guardianships and conservatorships. b. DRI will provide legally-based advocacy to prevent or terminate guardianships and conservatorships for those who are no longer in need of a guardian or a conservator. c. DRI will provide legally based advocacy for individuals whose representative payees fail to act in their best interests as required by the Social Security Administration.

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.Federal Section 509 - Rec’d $166,132 - Expended $171,976 B. Prior Fiscal Year Current Fiscal Year Salaries 105,183 95,380 Fringe Ben 20,546 20,093 Mat/Supplies 1,071 817 Postage 442 479 Telephone 1,046 1,043 Rent 12,658 12,200 Travel 2,024 1,377 Copying 1,208 2,476 Insurance 1,999 2,310 Legal Svcs 612 568 Miscellaneous 8,746 5,612 Prof Services 3,654 4,265 TOTAL 159,189 146,620 C. Professionals 92% FTE’s 100% Support Staff 8% FTE’s 100%

D. Involvement with advisory boards (if any)

DRI sits on the following boards or workgroups:

Iowa Developmental Disabilities Council Iowa Special Education Advisory Panel Iowa Disability Action Network Money Follows the Person workgroup Olmstead Task Force Mental Health Conference Planning Committee Judicial workgroup for Redesign Family Support Council with the Parent Training Information Center Quality Education Coalition

E. Grievances filed under the grievance procedure

None for FY13

F. Coordination with the Client Assistance Program (CAP) and the State long-term care program (LTCOP), if these programs are not part of the P&A agency

In Iowa, the CAP and LTCOP are not part of DRI.

CAP: DRI coordinates with the CAP by making certain that we cross-refer cases. Cases related to vocational rehabilitation program issues are referred to CAP. In addition, the CAP coordinator regularly invites DRI to trainings regarding the ADA and other CAP or PAIR related topics. DRI met with the former program coordinator for CAP to review caseloads and what cases could be cross-referenced between our agencies at the beginning of the fiscal year. The program coordinator for CAP has now changed and we have a good working relationship with the new coordinator as he was a member of our ADA Coalition and former employee of the Iowa Department of Human Rights, Office of Persons with Disabilities. We have already met with him regarding working together on vocational rehabilitation cases and what cases to refer to our agency for legal advocacy.

LTCOP: DRI has seen the benefits of strengthening our collaboration with the LTCOP during this fiscal year. Last year we were meeting quarterly with LTCOP and our state’s Department of Inspections and Appeals (DIA) to review and coordinate monitoring or investigations. This year the collaboration went further and DRI is currently working on a project with DIA and LTCOP to develop state procedures for health facility closures and worked on creating an Iowa Health Facility Closure Procedures book. This book is ongoing and will be continued into FY14. In addition to the procedures book, all 3 agencies began implementing the ideas and worked collaboratively on several facility closures that would involve weekly calls, identifying what agency will provide individual advocacy to the individuals affected by the facility closure and complementary monitoring of the facilities. This collaboration continues into FY14.

In addition to the above, DRI and LTCOP have worked to better frame what agency provides what advocacy in order for individuals with disabilities living in facilities to have their concerns addressed by the appropriate agency in a timely manner. Inappropriate referrals to the wrong agency have significantly decreased. Plus the regional LTCO are increasing their requests for technical assistance or collaboration on individual cases in many of our priority goal areas including guardianship and community integration which is increasing our case referrals.

Certification

Signed?Yes
Signed ByJane Hudson
TitleExecutive Director of Disability Rights Iowa
Signed Date12/23/2013