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

Louisiana (Advocacy Center) - H240A130019 - FY2013

General Information

Designated Agency Identification

NameAdvocacy Center
Address8325 Oak St
Address Line 2
CityNew Orleans
StateLouisiana
Zip Code70118
E-mail Addressadvocacycenter@advocacyla.org
Website Addresshttp://www.advocacyla.org
Phone504-522-2337
TTY
Toll-free Phone800-960-7705
Toll-free TTY
Fax504-522-5507
Name of P&A Executive DirectorLois V. Simpson
Name of PAIR Director/CoordinatorStephanie Patrick
Person to contact regarding reportStephanie Patrick
Contact Person phone504-522-2337
Ext.143

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 areas48
2. Individuals receiving I&R outside PAIR priority areas1,090
3. Total individuals receiving I&R (lines A1 + A2)1,138

B. Training Activities

1. Number of trainings presented by PAIR staff3
2. Number of individuals who attended training (approximate)90

1. Training on collaboration for attorneys — 15 attendees 2. Training on legal status for public interest attorneys — 45 attendees 3. Training on legal status for group home staff and management — 30 attendees

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff10
2. Newspaper/magazine/journal articles34
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website1,323,863
5. Publications/booklets/brochures disseminated14,627
6. Other (specify separately)1

Narrative

1. Radio and TV appearances by PAIR staff-10

April 26: Stephanie Patrick, “Legislative Issues for People with Disabilities and Seniors”

May 10: John Felt, “Technology for People with Disabilities and Seniors”

July 14: Nell Hahn, “American Disabilities Act Rights and Accommodations”

October 27: Lois Simpson and David Gallegos, “Disability Employment”

Louisiana homes could feel sequester cuts in education, food inspection 02/26/13 wwwltv.com

Advocates fight for LA Medicaid expansion 03/12/13 WDSU News — Channel 6 (and WGNO News — Channel 10)

Wheelchair users find rough travel in New Orleans 04/30/13 wwwltv.com

Lawsuit filed on behalf of man beaten at OPP 07/08/13 wwltv.com

Midnight deadline looms as disability advocates push for veto session 07/11/13 wwltv.com

Louisiana’s nursing home care ranks second worst in nation 08/15/13 wwltv.com

2. Newspaper/magazine/journal articles.

Medicaid question tops list on ballot 10/20/12 www.houmatoday.com

Disabled advocates hope Senate will again take up UN disability treaty 12/13/12 NOLA.Com/Times Picayune

Advocates for LA disabled push U.N. treaty 10/14/12 The Times Picayune

Excitement Mounts as Super Bowl Sunday Draws Near 12/17/12 AC Newsletter

AC’s Monitoring of Louisiana’s Managed Care Proves Effective 01/16/13 AC Newsletter

Medicaid Expansion Under the Affordable Care Act (ACA) 01/17/13 AC Newsletter

Accessibility at Mardi Gras - It’s Carnival Time! 01/17/13 AC Newsletter

The Super Bowl Has Ended, But the Memory Lingers On 02/19/13 AC Newsletter

Coalition Pens Open Letter to Gov. Jindal Urging Participation in Medicaid Expansion 02/20/13 AC Newsletter

AC Responds to DHH’s Request for Information About Managed Care Model for Long Term Services and Supports for Persons Enrolled in Louisiana Medicaid 04/18/13 AC Newsletter

AC Releases 2013 Legislative Agenda 04/18/13 AC Newsletter

AC Legislative Update 05/09/13 AC Newsletter

AC Awards Jazz Fest Ticket to Woman with Mental Illness and Mobility Impairments 05/20/13 AC Newsletter

Choosing or Changing Your Bayou Health Medicaid Plan 05/20/13 AC Newsletter

Bill protects institutions at the expense of the state: Letter to the Editor 05/25/13 NOLA.com/Times Picayune

AC Legislative Update 05/22/13 AC Newsletter

HB 533 sets a bad policy, is unfair 05/26/13 The News Star

Partner with the Advocacy Center in Supporting the Convention on the Rights of Persons with Disabilities! 05/28/13 AC Newsletter

Advocacy Center’s Legislative "Thumbs Up" and "Thumbs Down": 2013 Edition 06/15/13 AC Newsletter

Emergency Management Disability & Aging Coalition Seeks Volunteers 06/16/13 AC Newsletter

Death row inmates file federal case 06/27/13 The Advocate

Orleans Parish Prison abuse alleged in another lawsuit 07/09/13 NOLA.com

Louisiana health officials to shift disability waiver waiting list from first-come to needs-based 07/11/13 NOLA.Com/Times Picayune

Advocacy group sues Gusman on behalf of elderly, mentally ill inmate that was beaten in jail 07/11/13 The Advocate Citizens group reconvenes on CATS, questions contract procedure 07/14/13 The Advocate

Letter: Death row heat a matter of law 07/18/13 The Advocate

Changes to Medicaid Purchase Plan Could Devastate Workers with Disabilities 08/07/13 AC Newsletter

DHH Begins Transformation of Long-Term Supports and Services 09/09/13 AC Newsletter

Jindal looks to privatize health care programs 09/16/13 The Advocate

Man accused of defacing 9/11 memorial in Lafayette makes bail (video) 09/16/13 The Advocate

Accessible cabs open up options for residents 09/18/13 NOLA.com/Times Picayune

Disabled inmate wants large print documents, safe accommodations The Advocate 09/24/13

Vision-impaired inmate sues state for large-print documents 09/28/13 The Associated Press

Disabled inmate wants large print documents, safe accommodations 09/28/13 Daily Comet

3. PSAs/videos aired - 0

4. Website Visitors - 69,960

5. Publications/booklets/brochures disseminated - 14,627 • Bayou Health Basics — 428 • Bayou Health Eligibility — 187 • Medicaid — 658 • Legal Status booklet — 6,908 • Representation: Procuration and Mandate — 2,167 • Abuse and Neglect of the Elderly — 148 • Social Security — 136 • Age Discrimination in Employment — 676 • Disability Discrimination in Housing — 229 • Choosing a Nursing Home — 657 • SSI — 178 (Supplemental) • Higher Education Rights — 197 • Employment Rights — 601 • 10 Steps to Being an Effective Advocate — 214 • Fair Housing for Landlords — 170 • Fair Housing for Landlords (Spanish) — 103 • Fair Housing Fact Sheet — 115 • Fair Housing — 163 • Investigations of Serious Abuse and Neglect — 124 • Help with Other Medical Expenses for Nursing Home Residents — 233 • PAIR — 195 • Rights of Students with Disabilities — 140

= TOTAL 14,627

6. Press Release - Friday, August 16, 2013 — Changes to Medicaid Are Hardship for Workers with Disabilities, Many will be forced to stop working.

Part II. Individuals Served

A. Individuals Served

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

1. Individuals still served as of October 1 (carryover from prior FY)44
2. Additional individuals served during the year33
3. Total individuals served (lines A1 + A2)77
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)2

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 25

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility4
2. Employment1
3. Program access4
4. Housing3
5. Government benefits/services3
6. Transportation1
7. Education1
8. Assistive technology0
9. Voting0
10. Health care49
11. Insurance0
12. Non-government services1
13. Privacy rights2
14. Access to records0
15. Abuse3
16. Neglect3
17. Other4

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor30
2. Other representation found0
3. Individual withdrew complaint3
4. Appeals unsuccessful3
5. PAIR Services not needed due to individual's death, relocation etc.3
6. PAIR withdrew from case4
7. PAIR unable to take case because of lack of resources1
8. Individual case lacks legal merit10
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-advocacy3
2. Short-term assistance20
3. Investigation/monitoring2
4. Negotiation3
5. Mediation/alternative dispute resolution0
6. Administrative hearings22
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 - 220
3. 23 - 5944
4. 60 - 6410
5. 65 and over23

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females37
2. Males40

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. Asian0
4. Black or African American44
5. Native Hawaiian or Other Pacific Islander0
6. White32
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent47
2. Parental or other family home7
3. Community residential home0
4. Foster care0
5. Nursing home18
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center5
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 impairment7
2. Deaf/hard of hearing5
3. Deaf-blind0
4. Orthopedic impairment23
5. Mental illness2
6. Substance abuse1
7. Mental retardation0
8. Learning disability0
9. Neurological impairment8
10. Respiratory impairment2
11. Heart/other circulatory impairment12
12. Muscular/skeletal impairment12
13. Speech impairment0
14. AIDS/HIV4
15. Traumatic brain injury1
16. Other disability0

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities7

2. Number of individuals potentially impacted by policy changes450,800

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

1. Objective: Ensure that fixed route and paratransit transportation in New Orleans is compliant with the ADA by periodically testing usage of the RTA and fixed route systems, by attending quarterly RTA Board meetings, and through participation on the RTA Special Transit Services Committee.

Result: Advocacy Center staff continue to monitor accessibility of the fixed route and paratransit systems in New Orleans. Staff continue to advocate for proper securement of mobility devices via the RTA Special Transit Services Committee and informal conversations with RTA management, as proper securement of wheelchairs is inconsistent. It appears that compliance is improving. Paratransit services also continue to improve with the recent addition of new low-floor buses and a 95% on time service history, according to recent reports from the program’s director. Monitoring will continue in Fiscal Year 2014.

Case Example: There were no individual cases related to this objective.

2. Objective: Pursue corridors of accessibility through the French Quarter and City of New Orleans.

Result: The Advocacy Center continues to advocate for increased accessibility in New Orleans. In the French Quarter, Advocacy Center staff assisted the Vieux Carre Commission and the Office of Public Works to implement 8 corridors of accessibility throughout the neighborhood. In addition, the Advocacy Center coordinated a removable barrier survey of the French Quarter with assistance from Louisiana State University students. The Uptown corridor from Julia down Convention Blvd to Canal Street is in progress, but has been delayed by funding issues. The Advocacy Center will continue to monitor this project. Case Example: There were no individual cases related to this objective.

3. Objective: Pursue accessible taxicabs in the City of New Orleans.

Result: This project faced numerous delays in 2013, mainly due to taxicab driver objections to parts of the reform effort not related to accessibility, including a lawsuit to block reforms. Unfortunately, at the end of Fiscal Year 2013, there were still no accessible taxicabs available in New Orleans. The director of the Taxicab Bureau expects that the first accessible taxicabs will be available in early 2014. The Advocacy Center will continue to monitor this implementation.

Case Example: There are no specific case examples related to this objective as the Advocacy Center believes this objective will be best accomplished via public policy advocacy. However, potential visitors to New Orleans often contact the Advocacy Center regarding accessible transportation options. This project will benefit visitors and residents alike.

4. Objective: Monitor proposed cuts, route reductions and Capitol Area Transit Services (CATS) system, which will impact fixed route and paratransit services in Baton Rouge.

Result: Advocacy Center staff members addressed three issues with CATS in 2013. The first issue concerned inoperable accessibility equipment (lifts, ramps, seats not folding up, and tie down harnesses not deploying properly). Staff filed written complaints and received no response. The second issue was the failure to respond to written complaints. The third issue related to inaccessible bus stops and sidewalks near bus stops during and after road construction. These issues have not been resolved and monitoring will continue in Fiscal Year 2014.

Case Example: There were no individual cases related to this objective.

5. Objective: Advocate for accessible streetcars in New Orleans.

Result: Advocacy for accessible streetcars in New Orleans continues. Advocacy Center staff met numerous times with Louisiana Department of Transportation, RTA’s General Manager, Deputy Mayor Grant, Director of State Historic Preservation office, Director of Historic District Landmark Commission and representatives of a national group which will provide ADA expertise on the changes to streetcar stops to make the St. Charles streetcar line accessible. The City has commissioned drawing of accessible streetcar stops and these are pending. Advocacy Center staff monitored the installation of the Loyola Ave streetcar line which was completed in early 2013. The majority of accessibility issues were resolved prior to the opening of the line. Staff continues to advocate for the removal of one remaining barrier. Advocacy will continue in FY 2014.

Case example: There were no individual cases related to this objective.

6. Objective: Monitor and provide input into new Medicaid managed care initiatives.

Result: As part of the monitoring of Medicaid managed care companies, Advocacy Center staff reviewed the grievances, complaints and appeals sections of the Member Handbooks for the five managed care companies that are part of Bayou Health. An AC staff member wrote to the Department of Health and Hospitals (DHH) in May 2013 noting problems with the information in each plan’s handbook regarding these matters, including (but not limited to) incorrect addressees at which to file appeals, incorrect information as to when appeals must be filed, and omission of information as to how to file appeals via fax or by phone. We received a reply from the Department that they agreed with many of our corrections and would insure that the plans corrected their member services handbooks. The Department stated that our request for listing of the Advocacy Center and other sources of free legal assistance for people filing appeals was “under consideration.” They have made most of the changes they agreed to make, and we will do some limited follow-up on other issues in 2014. In addition, The Advocacy Center sent a letter to the Department of Health and Hospitals in April 2013 outlining best practices for managed care for long term services and supports, in response to an RFI issued to solicit information from managed care companies. The letter identified a number of issues that are key to this successful conversion: a. Inclusion of both institutional and home and community based services in the same managed care company. We believe that the inclusion of only home and community based services would create significant incentives for managed care companies to move higher need/higher cost individuals to institutions. b. Expectations that managed care companies take significant steps to reduce the waiting lists for home and community based services. The state should include clear benchmarks for this in the RFP and contract. c. Involvement of recipients of long-term services and supports and advocates in the design of the RFP and implementation. d. Inclusion of behavioral health and acute services within one managed care company. We believe this is the only way to ensure the needs of the entire person are considered and will improve coordination and use of preventative services. In addition, Advocacy Center staff met with a number of managed care companies that are interested in this contract to express similar concerns. Staff also discussed the issue in meetings with state officials throughout the year. The Advocacy Center is participating on a stakeholder group to provide input to the Department of Health and Hospitals throughout this effort.

Case Example: See Priorities for an example of advocacy under this objective.

7. Objective: Ensure people with disabilities on Medicaid can obtain the medication and durable medical equipment they need in a timely manner regardless of reimbursement by the managed care company.

Result: After receiving a complaint from an individual, Advocacy Center attorneys requested that the Department of Health and Hospitals (DHH) inform pharmacies and DME suppliers that Medicaid does not permit them to withhold prior-authorized items because of any delay in payment for previously-supplied items, and remind them that they should never be requesting payment from Medicaid recipients. DHH issued a notice to pharmacy providers that reminded them that their acceptance of Medicaid meant that they agreed to accept the Medicaid payment as payment in full for services rendered to Medicaid recipients, providing for the allowances for co-payments authorized by Medicaid. The Advocacy Center did not receive any additional complaints, and will continue to monitor this issue in Fiscal Year 2014.

Case example: Individual cases for this objective were funded by other grants, but PAIR eligible individuals are benefiting from the changes.

8. Objective: Advocate for policies and procedures that protect Medicaid recipients’ rights and are compliant with federal law by LA Cares, one of Louisiana’s managed care companies.

Result: The Advocacy Center addressed a number of issues with LA Cares in Fiscal Year 2013. Each is outlined below. After reports from people with disabilities of unclear notices sent by LACares, Advocacy Center staff obtained sample denial notices and recommended that the notices regarding home services, such as nursing, refer to the hours awarded per week rather than per day. LA Cares responded that they updated their home health authorization notices to reflect hours approved per week, as well as the timeframe during which services are authorized. They stated that it is LA Care’s practice to notify members and providers of any reduction in services prior to reduction; but that this is dependent upon receipt of a timely authorization request from a provider. Monitoring in this area will continue in Fiscal Year 2014, as we continue to see unclear and delayed notices. In another case related to this objective, the Advocacy Center notified LA Care of the illegality of its pharmacy provider’s denial of saline supplies for tracheostomy care. In response, LA Care stated that it had added saline to its formulary; identified 35 other members who had a denied claim for this medication; and sent each a letter, informing them that the medication is now covered and that future prescriptions would be filled at any participating pharmacy. The letter explained how to be reimbursed for any prescription which they paid cash. Finally, LA Care implemented a change in standards used to approve home nursing services in regard to medical necessity. The Advocacy Center pointed out that DHH guidance illegally states that in order to receive Extended Home Health services, a child must be medically fragile, which requires that the child have “most or all” of nine listed conditions. Yet under the federal EPSDT requirements, 42 U.S.C. § 1396d(r)(5), the Department must assist if a child has any one of these. LA Care also changed its written standard to recognize that, as the Advocacy Center pointed out, home health extended nursing services are not limited strictly to the home environment. In response to our follow-up letter, LA Care developed a checklist to assist home nursing agencies in submitting information necessary to support a request for home nursing hours. LA Care stated that it presented the idea of implementing a standardized home health authorization form for use across all Bayou Health plans at the January all-plan meeting with DHH. However, LA Care told us this proposition was not well received. The consensus was that agreement on a home health authorization form would prove even more difficult due to the intricacies of clinical and supplemental information required. Monitoring will continue in 2014.

Case Example: SC, a four year old child with disabilities uses a trach and PEG tube. His mother contacted the Advocacy Center after he did not receive his Medicaid funded supplies. AC investigated and found that the pharmacy refused to provide them because S’s Medicaid managed care plan hadn’t reimbursed the pharmacy for supplies provided in the previous month. The plan also told S’s mom that saline supplies were not covered. The Advocacy Center attorney communicated with the pharmacy, nursing agency, managed care company, and Department of Health and Hospitals (DHH) about fact (1) that pharmacy was withholding supplies because of delays in payment and (2) that saline supplies should be covered. S’s supplies were approved and delivered. The managed care plan also added saline supplies to the formulary and sent letters to the 35 other Medicaid recipients whose requests were denied, to inform them that saline was now covered and they could be reimbursed for past expenditures. DHH sent a directive to pharmacies prohibiting them from denying supplies because of payment delays of managed care companies.

9. Objective: Educate legislators about the number of uninsured Louisianians with disabilities and the positive benefits of Medicaid expansion.

Result: Legislation to insure additional Louisianians via Medicaid did not pass. However, the Advocacy Center was instrumental in organizing a large coalition of advocacy groups to bring attention to this issue and advocacy will continue in Fiscal Year 2014.

Case example: There were no individual cases related to this objective, though the Advocacy Center shared a number of compelling stories about individuals who acquired disabilities or passed away at least in part due to a lack of health insurance.

10. Objective: Ensure government and volunteer agencies are prepared to meet the needs of people with disabilities before, during and after emergencies and disasters.

Result: The Advocacy Center (AC) continues to support and coordinate efforts of the Emergency Management Disability and Aging Coalition (EMDAC), a large group disability and emergency management organization to plan for and respond to the needs of people with disabilities during a disaster. Four Advocacy Center staff were trained to sit at the state’s Emergency Operations Center should a disaster strike Louisiana. AC, with assistance from EMDAC members, is in the process of developing guidelines regarding sheltering-in-place that will assist people with disabilities with personal preparedness as well as assist emergency managers. AC also assisted with updates to and distribution of a resource guide that was sent to American Red Cross shelter managers and shelter managers in the state-run shelters. This activity is ongoing.

Case Example: There are no case examples related to this priority. However, recent disasters have clearly demonstrated the importance of considering the needs of people with disabilities in disaster planning and management.

11. Objective: Ensure people with disabilities can access the Medicaid funded healthcare that they need.

Results: The Advocacy Center opposed a bill that would requires the Department of Health and Hospitals (DHH) to institute all Medicaid cost containment measures to the extent allowed by federal regulations this bill, including co-payments and limitations of coverage for the use of emergency rooms, regardless of the impact. The Advocacy Center educated legislators as to the potential negative impact of this legislation and need for greater flexibility regarding cost containment. The author withdrew the bill. In addition, the Advocacy Center submitted comments to the Center for Medicare and Medicaid Services regarding changes to federal regulations related the impact of co-payments for long term care services.

Case Example: There are no case examples related to this priority.

12. Objective: Ensure people with disabilities receiving hospice can access the personal care services that they need.

Result: The Advocacy Center (AC) commented on an emergency rule regarding exclusion of LTPCS (Long Term Personal Care Services) as a concurrent service with hospice which violated federal law and regulation. Individuals with disabilities who are dying need both services because LTPCS can cover personal care services beyond that which can be covered by hospice and hospice covers medication and medical equipment not otherwise covered by Medicaid. AC also advocated for changes to policy to allow people with disabilities to receive both. Advocacy will continue in 2014.

Case Example: In mid September 2013, the sister of KH contacted the Advocacy Center because she could no longer care for her brother who was dying of terminal colon cancer as she works full time. Mr. H. needs both long term personal care and hospice services to access the medical equipment, medication and personal care services he needs. At the end of Fiscal Year 2013, the Advocacy Center attorney had contacted the Department of Health and Hospital on behalf of Mr. H and was preparing to litigate.

13. Objective: Insure people with disabilities who are working can purchase Medicaid coverage.

Result: As part of a coalition of people with disabilities and agencies, the Advocacy Center advocated against changes to Louisiana’s Medicaid Purchase plan to exclude a number of people with disabilities by lowering the income threshold and resource limits and consideration of spousal income. Staff were particularly concerned about the impact on people receiving long term personal care services, as this is not available through the private health insurance market. At the end of Fiscal Year 2013, staff were planning to meet with the Department of Health and Hospitals to get additional information on their plan to mitigate the impact of these changes.

Case Example: ME, a man with quadriplegia, works full time at the one of the state’s Independent Living Centers and receives personal care services, which allow him to remain in his home and continue to work. Because of his income, he will no longer qualify for Medicaid Purchase plan when these changes are made. The Advocacy Center continues to advocate on his behalf.

14. Objective: Implement an income disregard in Louisiana’s home and community based services waivers to allow individuals with disabilities to contribute to the cost of their services and retain eligibility.

Result: The state implemented the income disregard in two waivers for people with developmental disabilities and plans to implement in the Community Choices waiver when it is renewed.

Case Example: There are no case examples related to this priority.

15. Objective: Ensure that regulations for Service Coordination agencies protect people with disabilities and ensure quality services.

Result: The Advocacy Center commented on a Notice of Intent in the April 2013 Louisiana Register dealing with Standards for Service Coordination Agencies. We addressed issues of licensing, sanctions, plan development, assistance with employment, involuntary discharge policies, staffing requirements, and grievance information. We received a response to our comments. The Department of Health and Hospitals stated that it would initiate rule changes to require agencies to provide discharge and transfer documents to the recipient, and to have a provision as to requirements on involuntary discharge. It did not make the other changes we suggested.

Case Example: There are no case examples related to this priority.

16. Objective: Ensure individuals with disabilities participating in permanent supportive housing can access crisis intervention and transition services to ensure they are safe and will be successful in the community.

Result: The Advocacy Center (AC) commented on a notice of intent in the April 2013 to include crisis intervention and transition services for clients leaving facilities and enrolling in Permanent Supportive Housing (PSH). AC suggested that these services be available for all persons who are transitioning, whether or not they are receiving PSH, because PSH slots are limited. We also suggested that the individual’s budget for the Community Choices Waiver be allowed to increase to provide for these services where necessary. We received a response that support coordinators would be trained and provided with technical assistance to provide those services to persons transitioning into non-PSH housing, and that waiver budget limits could be expanded if necessary to prevent a client’s institutionalization.

Case Example: There are no case examples related to this priority.

17. Objective: Ensure people with disabilities can access affordable housing in New Orleans.

Result: With a group of community housing advocates, the Advocacy Center participated in efforts to revise the City of New Orleans ’s Consolidated Plan, which dictates how the City will spend CDBG, HOPWA, and other federal housing dollars. The Consolidated Plan was revised significantly to include more data on housing needs in New Orleans and to tailor spending according to those needs. We succeeded in getting the City to again set aside funding that will assist Section 8 recipients in making structural modifications to their homes, which landlords often aren’t required to provide under the Fair Housing Act.

Case Example: The Advocacy Center assisted a number of PAIR-eligible individuals under this objective, as part of a project funded by the City of New Orleans, including the case of Ms. B, outlined below.

The daughter of Mrs. B, an elderly woman who has Muscular Dystrophy contacted the Advocacy Center for help. Prior to the assistance provided by the Advocacy Center, Mrs.B could only take sponge baths due to inaccessibility of her bathroom tub. In addition, she was using a wheelchair of an improper size as the one she needed did not fit through the doorways of her home. Through the Renter Owner Home Modification Program (ROHMP), Mrs. B received a new walk-in shower with grab bars, widened doorways to accommodate a new scooter, an electric wheelchair lift, and an accessible side entrance to her home. Mrs. B’s house is now accessible for her to bathe, to move around freely and to enter and exit as she pleases.

18. Objective: Support efforts to encourage the use of more positive interventions in school discipline for children with disabilities.

Result: The Advocacy Center, in collaboration with a variety of groups representing people with disabilities, civil rights leaders and educators, educated legislators on the benefits of positive interventions in school discipline. Unfortunately, the legislation did not pass. These efforts will continue in 2014.

Case Example: There were no individual cases supported by PAIR related to this objective; however, we represented many students under PAIMI and PADD funding.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts46,000
2. Number of individuals named in class actions6

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

1. Objective: Ensure the Mahalia Jackson Theater for the Performing Arts in New Orleans is compliant with accessibility laws.

Result: As of 9/30/13, the theater was renovated to increase accessibility with lowered ticket counters, improved access to back-stage areas, and accessible seating areas in accordance with the settlement agreement. Advocacy Center staff continues to monitor to ensure no additional modifications are required. The case will close in early FY 2014.

Case Example: The plaintiff in this case, a man who uses a wheelchair, and all other patrons with disabilities can access seating at a variety of price points and ticket counters. The backstage areas are also accessible.

2. Objective: Ensure that sidewalks in the City of Mansfield are accessible through monitoring of the settlement agreement in Rankin v. City of Mansfield.

Result: The Advocacy Center continues to monitor compliance with sidewalk accessibility in the City of Mansfield, as curb cuts are added as part of larger city improvement projects. There were no significant improvement projects completed in Fiscal Year 2013. The Advocacy Center will continue to monitor this case.

Case Example: An individual with physical disabilities who could not access the sidewalks in Mansfield is the plaintiff in this case, which benefits all Mansfield residents and visitors with disabilities.

3. Objective: Monitor cuts that the Department of Health and Hospitals may impose on home and community based services and be prepared to challenge any cuts that violate consumers’ rights under the ADA and the Rehabilitation Act to receive services in the most integrated setting.

Result: This case, Pitts v. Greenstein, was settled in 2012 with a Settlement Agreement that allows approximately 2000 people to apply for expedited waiver slots to obtain the home and community based services they need. These individuals can also appeal if their application is denied. The class members named in the litigation received emergency slots, and the one non-class member we described had an opportunity to apply. In total, 626 class members applied for expedited waiver slots, 72 received expedited slots, and 123 received waiver slots even though these were not designated as expedited slots. The state continues to follow the expedited slot procedure and retain the right to appeal denials. This case was closed in FY 2013.

Case Example: Ms. M, a 57 year old woman with significant disabilities requiring the use of a wheelchair and blindness, contacted the Advocacy Center when her long term personal care services hours were reduced from 32, the maximum, to 18. If these changes were made, Ms. M would no longer be able to stay in her home with her husband of many years. The Advocacy Center named Ms. M in the lawsuit described above. As a result, she received a Community Choices waiver slot and 54 hours of personal care services per week. She remains in her home and is happy to play such a key role in obtaining additional services for so many people.

4. Objective: Ensure people who are deaf receive necessary accommodations when seeking a commercial truck driver’s license.

Result: This case is ongoing. It is scheduled for trial in December 2013.

Case Example: Our client is a 32-year-old man who is deaf and wants to work as a commercial truck driver. He obtained a Commericial Drivers License in Florida, and, using that license, became licensed in Louisiana. He is currently training for an over-the-road trucking job, but is maintaining this suit for damages for the delay in pursuing his goal of becoming a truck driver, and to change the Louisiana DMV’s policy on testing and licensing Deaf truckers.

5. Objective: Ensure that employers are required to provide reasonable accommodations for people with disabilities in employment, when the disabilities do not necessary affect the person’s ability to perform “essential job functions.”

Result: The Advocacy Center, along with Disability Rights Texas, filed an amicus curiae brief in support of the appellant in the U.S. Court of Appeals for the Fifth Circuit. The Court reversed the trial court on this point, and remanded for trial. In addition to benefitting the named plaintiff, the positive development in the law will benefit all individuals with disabilities seeking accommodations in the workplace.

Case Example: The plaintiff in this case, Ms. F, a woman with physical disabilities, was fired from her job as an attorney after complaining that her employer failed to provide her with a needed accommodation, a parking space near her office building. She sued her employer and the court determined that her employer did not need to provide this accommodation because it did not affect her “essential job function.” She contacted the Advocacy Center to ask that we file an amicus brief on her behalf in her appeal. The AC attorney investigated her case and collaborated with Disability Rights Texas staff to file the brief. The 5th Circuit court reversed the trial court in a published opinion that established that reasonable accommodation is not limited to matters that affect essential job functions.

6. Objective: Demonstrate that the refusal of a nursing home to allow a resident with dementia to return after a hospitalization is an attempt to circumvent discharge requirements of the Federal Nursing Home Reform Act (The Act), 42 U.S.C. §§ 1395i—3 and 1396r.

Result: The case became moot when the resident and his family decided to move to a different nursing home.

Case Example: Mr. J, a 52 year old nursing home resident with dementia, was involuntarily hospitalized after the nursing home staff became concerned about his behaviors. The nursing home staff refused to allow him to return from the hospital. In response, Mr. J, with the help of the Advocacy Center (AC), filed an administrative appeal with the Division of Administrative Law (DAL) challenging the nursing home’s refusal. Following the filing of the appeal the Administrative Law Judge issued a written order staying the discharge pending the conclusion of the appeal process. In response, the nursing home filed an action in state court and obtained a temporary restraining order preventing Mr. J from being readmitted. In an effort to overturn the state court order, AC filed a notice of removal in federal court contending the state court action was nothing more than an illegal attempt to circumvent the comprehensive remedial scheme established by the Federal Nursing Home Reform Act (The Act), 42 U.S.C. §§ 1395i—3 and 1396r, to resolve disagreements regarding transfers and discharges from the nursing homes. Before the federal court was able to act on the case, the family found another nursing home for Mr. J that was willing to accommodate his needs. As a result, the parties agreed to dismiss the case as moot.

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.

(1.1) Statement of Priority: Priority 1, Goal 1: People are able to remain in their homes, with the provision of Medicaid Home and Community Based Services (HCBS).

(1.2) Need(s) Addressed: • Historically, Louisiana has devoted the majority of its long-term care budget to institutional services: nursing homes, ICF’s/DD, and State psychiatric hospitals. • Over the last decade, LA has increased community-based options, but these options remain inadequate. • The criteria for awarding services in existing programs are complex and often overly restrictive, resulting in problems for people who try to use the system without the help of an advocate. • In the past two years, CDD has attempted to effect budget cuts by reducing individual services without due process. • The Department of Health and Hospitals has not fully complied with orders and stipulations in Chisholm v. Greenstein that would enable children on the NOW waiting list full access to home and community-based services.

(1.3) Description of Activities: Through the provision of TA and Direct Representation, obtain or preserve Medicaid funded HCBS for 15 PAIR eligible clients. The Advocacy Center represented 27 people in 29 cases who were at risk of losing their home and community based services in this area. • Review and comment upon rules, policies and practices relative to the Medicaid HCBS program. • Monitor compliance with settlement agreement in Pitts v. Greenstein to insure that people on LT-PCS who need more services receive expedited waiver offers.

(1.4) Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration: Through the pursuit of this objective, the Advocacy Center collaborated with a number of groups and organizations including Families Helping Families, AARP, ALS Society, Autism Society, Steve Gold and members of the Home and Community Based Services Re-design Group.

(1.5) Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions: The Advocacy Center represented 27 people in 29 cases under this objective in FY 2012-2013.

(1.6) Provide at least one case summary that demonstrates the impact of the priority: Ms. K, a 41-year-old single parent with significant physical disabilities, contacted the Advocacy Center for assistance with a denial of eligibility for Medicaid’s Long Term Personal Care Services (LTPCS) Program because she did not meet the nursing home level of care. Losing these services would have forced Ms. K into a nursing home and her daughter into foster care. The Advocacy Center attorney investigated and represented Ms. K at an administrative hearing where she proved that the DHH assessor failed to comply with procedures. The administrative law judge found in Ms. K’s favor. Ms. K was re-assessed and found eligible for 22 hours of services per week. As a result, she remains in her own home with her young child.

(2.1) Statement of Priority: Priority 1, Goal 3: People with disabilities have access to required health care through Bayou Health and Louisiana Behavioral Health Partnership (Magellan) Managed Care Programs.

(2.2) Need Addressed: • Louisiana is rolling out managed care systems for both physical and behavioral health. • The systems are untested. We need to monitor access to quality services and advocate with the State in order to insure that people get what they need.

(2.3) Description of Activities: • Update or create one set of informational materials about changes to and/or rights related to Bayou Health. Advocacy Center staff created and distributed 3 flyers regarding Bayou Health: Bayou Health Basics, Bayou Health Eligibility, and Picking a Plan.

• Disseminate at least three bulletins, alerts, or other general informational materials about rights under Bayou Health and/or the Louisiana Behavioral Health Partnership. Materials as described above were distributed to: Families Helping Families of Southeast LA Families Helping Families of Greater Baton Rouge Families Helping Families of Acadiana Bayou Land Families Helping Families Families Helping Families of Southwest LA Families Helping Families at the Crossroads of LA Families Helping Families of Northeast LA Families Helping Families Region 7 Safe Streets, Strong Communities Ekhaya Youth Project Together Baton Rouge

• Comment on proposed regulations that would bring additional populations within Bayou Health. These activities are outlined in Part IV.

• Conduct outreach to target population. In addition to the outreach described above, the Advocacy Center published several newsletter articles related to Bayou Health and the Louisiana Behavioral Health Partnership. Staff also discussed Bayou Health and the Louisiana Behavioral Health Partnership at trainings throughout the year.

• Assist at least 1 PAIR eligible client who contacts Intake with complaints about access to services through TA and direct representation. The Advocacy Center represented 1 individual who was facing barriers to accessing services via Bayou Health and Louisiana Behavioral Health Partnership (Magellan) Managed Care Programs in FY 2012-2013.

• Bring systemic flaws in the system to the attention of DHH with the goal of improving the system. Advocacy Center staff met three times with the Assistant Secretary of the Office of Aging and Adult Services to discuss problems facing Bayou Health participants and corresponded by email and telephone in between meetings. Systemic problems included: • Barriers to disenrollment • Access to durable medical equipment and supplies, particularly when there are delays in payments to the pharmacy • Notices • Access to correct information regarding grievances and appeals More detail on these specific issues is provided in Part IV.

(2.4) Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration: The Advocacy Center collaborated with a number of groups and organizations to achieve this objective, including AARP and Families Helping Families and a number of groups representing agencies providing home and community based services to people with disabilities.

(2.5) Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions: The Advocacy Center represented 1 individual in this area in FY 2012-2013.

(2.6) Provide at least one case summary that demonstrates the impact of the priority: The Advocacy Center continues to focus on systemic problems with the Medicaid funded managed care programs in Louisiana as addressed above. These are typically addressed via public policy advocacy and outreach to individuals with disabilities.

In the one case under this objective, the client contacted the Advocacy Center for assistance with a denial of a request for pain medicine. The AC attorney reviewed extensive medical records and spoke to the client’s doctors and nurses. She was unable to find medical evidence to support the appeal of the managed care company’s decision and declined representation.

(3.1) Statement of Priority: Priority 1, Goal 4: Elimination of barriers to exercising autonomy and living independently in the community.

(3.2) Need Addressed: • Individuals with disabilities often encounter barriers to living independently and autonomously that can only be addressed with legal assistance. These include: a Continuing Tutorship law that deprives them of rights based on improper criteria and without due process; overly restrictive or unnecessary interdictions; and illegal discrimination in critical benefits, services, and programs.

(3.3) Description of Activities: • Pursue litigation against Louisiana Office of Motor Vehicles to redress discrimination against deaf individual who sought commercial drivers’ license. Additional information on this goal is provided in Section IV. • Through provision of direct representation, eliminate barriers to independence and autonomy (such as overly restrictive or unnecessary interdictions and illegal discrimination in critical benefits, services, and programs) for 13 eligible PAIR clients. The Advocacy Center assisted 7 individuals to exercise their autonomy and live independently under this objective.

(3.4) Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration: The Advocacy Center collaborated with People First of Louisiana to achieve this priority.

(3.5) Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions: The Advocacy Center assisted 7 individuals in this area in 2012-2013.

(3.6) Provide at least one case summary that demonstrates the impact of the priority: Ms. W, a woman with significant medical issues due to complications from HIV/AIDS, contacted the Advocacy Center after she received a notice that the Housing Authority was terminating her Section 8 voucher because she was unable to attend a meeting to re-certify eligibility, an annual requirement. Ms. W. was unable to attend the meeting because she was very sick. She attempted to reschedule the meeting, but the Housing Authority refused and instead mailed a notice of Informal Hearing to terminate her from the program. The AC attorney investigated the issue and represented Ms. W at the Informal Hearing to request reasonable accommodations for her. The Housing Authority agreed to allow Ms. W. to complete her re-certification and maintain her eligibility for Section 8 housing and she was able to stay in her home in her community.

(4.1) Statement of Priority: Priority 4, Goal 3: Correct egregious conditions of neglect or abuse in prisons.

(4.2) Need Addressed: • Adequacy of Funding • Prison Administration incompetence • Public indifference • Lack of oversight • Use of prisons as holding facilities for persons with MI due to lack of available community resources • PLRA (legal barrier) • Deference to prison officials (legal barrier)

(4.3) Description of Activities: • Initiate an investigation in one parish jail involving the rights of a prisoner to adequate treatment or the denial of other important civil rights. The Advocacy Center investigated conditions at one facility, Rayburn Correctional Center on behalf of an individual who was deaf and could not access TTY equipment.

In addition, although we did not anticipate serving clients who were threatened with illegal discharge from nursing homes, we responded to 15 cases where this was the major issue.

(4.4) Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration: The Advocacy Center collaborated with the ACLU in furtherance of this goal.

(4.5) Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions: The Advocacy Center conducted one investigation under this priority. In addition, as noted above, we assisted 15 PAIR eligible individuals with illegal discharges from nursing home.

(4.6) Provide at least one case summary that demonstrates the impact of the priority: For the one investigation funded by PAIR, the partner of CW, a man who is deaf and has other physical disabilities, contacted the Advocacy Center on CW’s behalf. He was incarcerated and the jail officials were limiting CW’s access to the TTY device. The AC attorney immediately investigated the situation and filed a grievance on behalf of CW Upon further investigation, the attorney found that the prison was in compliance with Americans with Disabilities Act. CW was released and no further advocacy was required.

However, through investigations under other funding sources, conditions in Louisiana jails and prisons have improved significantly. These include widespread policy changes addressing communication access for people who are deaf or hard of hearing including contracting with an interpreting service to provide interpreters as needed, increased access to the TTY, access to medications and improvement of general conditions.

In addition, the Advocacy Center assisted Mr. V, a 46 year old man with quadriplegia who was facing a discharge from his nursing facility and did not want to leave. The Advocacy Center attorney investigated the discharge notices and represented Mr. V in a hearing. The administrative law judge dismissed the discharge and Mr. V is able to remain in the nursing home, near his friends and family.

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.

(1.1) Statement of Priority: Priority 1, Goal 1 — Community Integration: People are able to remain in their homes, with the provision of Medicaid Home and Community Based Services.

(1.2) Need(s) Addressed: • Historically, Louisiana has devoted the majority of its long-term care budget to institutional services: nursing homes, ICF’s/DD, and State psychiatric hospitals. • Over the last decade, LA has increased community-based options, but these options remain inadequate. • The criteria for awarding services in existing programs are complex and often overly restrictive, resulting in problems for people who try to use the system without the help of an advocate. • In the past two years, the state has attempted to effect budget cuts by reducing individual services without due process.

(1.3) Description of Activities: • Through the provision of TA and Direct Representation, obtain or preserve Medicaid funded HCBS for 15 PAIR eligible clients. • Review and comment upon rules, policies and practices relative to the Medicaid HCBS program. • Consider litigation or other systemic advocacy strategies to address the violation of rights related to due process and/or access to services for legacy Medicaid recipients.

(2.1) Statement of Priority: Priority 1, Goal 3 — Community Integration: People with disabilities have access to required health care through Bayou Health and Louisiana Behavioral Health Partnership (Magellan) Managed Care Programs.

(2.2) Need(s) Addressed: • Louisiana is rolling out managed care systems for both physical and behavioral health. • The systems are untested. We need to monitor access to quality services and advocate with the State in order to insure that people get what they need. • The Affordable Care Act will create new health insurance products and provide access to health care for people with disabilities. It is important to monitor developments to make sure people with disabilities have the opportunity to participate fully in programs under the ACA.

(2.3) Description of Activities: • Comment on proposed regulations regarding bringing additional populations within Bayou Health or other managed care issues. • Conduct outreach to target population. • Assist at least 1 PAIR eligible client who contacts Intake with complaints about access to services through TA and direct representation. • Bring systemic flaws in the system to the attention of DHH with the goal of improving the system. • Provide input into managed care for long-term supports and services. • Monitor the implementation of the Affordable Care Act, especially health exchanges, and its impact on people with disabilities.

(3.1) Statement of Priority: Priority 1, Goal 4 — Community Integration: Elimination of barriers to exercising autonomy and living independently in the community.

(3.2) Need Addressed: • Individuals with disabilities often encounter barriers to living independently and autonomously that can only be addressed with legal assistance. These include: a Continuing Tutorship law that deprives them of rights based on improper criteria and without due process; overly restrictive or unnecessary interdictions; and illegal discrimination in critical benefits, services, and programs.

(3.3) Description of Activities: • Through provision of direct representation, eliminate barriers to independence and autonomy (such as overly restrictive or unnecessary interdictions and illegal discrimination in critical benefits, services, and programs) for 13 eligible PAIR clients. • Insure that the City of New Orleans is accessible to people with disabilities.

(4.1) Statement of Priority: Priority 4, Goal 3 — Rights Protection: Correct egregious conditions of neglect or abuse in prisons.

(4.2) Need(s) Addressed: • Adequacy of Funding • Prison Administration incompetence • Public indifference • Lack of oversight • Use of prisons as holding facilities for persons with disabilities due to lack of available community resources • PLRA (legal barrier) • Deference to prison officials (legal barrier)

(4.3) Description of Activities: • Monitor compliance with the provision of ASL interpreters and other communication devices and services in St. Tammany Parish jail.

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. Sources of funds received and expended.

The primary source of funding for the PAIR program comes from the federal Section 509 grant, including carryover from the prior year:

Sources of funding amount received and spent Source of Funding Amount Received Amount Spent Federal Funds (includes carryover) $ 240,096 $ 240,096 State Funds $ 0 $ 0 Program Income $ 705 $ 705 Private $ 0 $ 0 All other funds $ 0 $ 0 Total $ 240,801 $ 240,801

B. Budget for the fiscal year covered by this report.

The chart below provides a breakdown of the PAIR program budget for FY 2013, the period covered in this report. In general, the Advocacy Center’s budget is driven by staff hours as charged to its various programs. When Administrative and Support staff salaries are not charged directly, they are allocated among programs in a pro-rata share of total agency staff hours worked.

Category Budget FY 2013 Wages & Salaries $ 141,053 Fringe Benefits $ 33,871 Travel $ 6,415 Bonding/ Insurance $ 513 Materials/ Supplies $ 3,527 Postage $ 1,679 Duplicating $ 1,607 Rent $ 14,623 Telephone/ Cell Phone/Internet $ 2,635 Legal Costs $ 1,500 Services Contracts/Consultants $ 16,358 Equipment $ 1,088 Indirect Costs $ 0 Miscellaneous $ 2,535 TOTAL $ 227,404

C. Description of PAIR staff (duties and person-years).

The majority of time allotted to PAIR services in FY 2013 was spent providing representation to individual clients, systems advocacy, impact litigation, outreach and training and other agency support activities, including intake and I&R for those clients whose issues did not fall under case selection priorities.

The Advocacy Center organizes its professional staff by teams related to each priority and goal in the agency plan. Team members specialize in areas of law across multiple programs and collaboration between teams is encouraged. No staff members are assigned solely to the PAIR program. Rather, of the full time professional staff, each person spends a percentage of his time serving PAIR clients. Each group’s individual representation services parallel one of the PAIR program’s priorities and goals, already described in this report.

The annual plan for PAIR estimates how much of the time each individual staff member will spend providing services to PAIR eligible clients. Staff time is then budgeted accordingly. These estimates are based upon prior year records and are adjusted to reflect expected increases or decreases resulting from changes to case selection priorities or new initiatives. On a daily basis, staff members record how their time was spent, allotting it to the programs for which their services were performed. Thus, all time spent providing individual representation to PAIR eligible clients is charged to PAIR. The information is reported bi-weekly, and is compiled monthly to monitor how closely actual time spent tracks staff time budgeted. If necessary, adjustments are made during the year to insure that the hours budgeted under PAIR are not used at a rate that is significantly higher or lower than anticipated.

Professional staff include the following positions: Compliance Specialist, Client Advocates, Legislative & Systems Advocacy Support Specialist, Intake Coordinator, Legal Interns, Paralegals, Staff Attorneys, Supervising Attorneys, Managing Attorney, Director of Litigation, Director of Legal Services, Executive Director, and Director of Policy & Planning. Their duties include planning, managing, supervising and performing individual client representation, systems advocacy, and litigation on behalf of PAIR clients. Administrative Support or Clerical staff include the following positions: Chief Information Officer, Systems Administrator, Director of External Relations, Executive Assistant, Chief Financial Officer, Intake Specialists and Administrative Assistants.

The Person-Year chart below was prepared by combining staff time for all employees who performed services under PAIR during the fiscal year. Positions filled for any fraction of the year are expressed as full-time equivalents. Positions filled throughout the year are expressed as person-years.

PAIR staff in Person-Years Type of Position Full-time equivalent % of year position filled Person-years Professional full-time 1.8584 100% 17 Professional part-time 0.3260 100% 3 Professional Vacant 0 0% 0 Administrative full-time 0.2176 100% 9 Administrative part-time 0.1629 0% 1 Administrative vacant 0 0% 0 TOTALS 2.5649 100% 30

D. Involvement with advisory boards (if any). Not applicable

E. Grievances filed under the grievance procedure.

There was one grievance filed in 2013 involving a denial of representation. The grievance surrounded a PAIR eligible individual who requested assistance to file a complaint with the Department of Justice about a police department. The Advocacy Center could not assist due to limited resources. This was resolved by the Executive Director.

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

The Client Assistance Program (CAP) is part of the P&A. The Long-Term Care Ombudsman Program (LTCOP) is not a part of the P&A, but has a formal relationship with one of the attorneys on our staff. She provides legal backup to the ombudsmen across the state.

Certification

Signed?Yes
Signed ByLois V. Simpson
TitleExecutive Director
Signed Date12/23/2013