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

Maryland (MARYLAND DISABILIITY LAW CENTER) - H240A130021 - FY2013

General Information

Designated Agency Identification

NameMaryland Disability Law Center (MDLC)
Address1500 Union Avenue
Address Line 2Suite 2000
CityBaltimore
StateMaryland
Zip Code21211
E-mail Addressvirginiak@mdlclaw.org
Website Addresshttp://www.mdlclaw.org
Phone410-727-6352
TTY 410-727-6387
Toll-free Phone800-233-7201
Toll-free TTY800-233-7201
Fax410-727-6389
Name of P&A Executive DirectorVirginia Knowlton
Name of PAIR Director/CoordinatorLauren Young
Person to contact regarding reportLauren Young
Contact Person phone410-727-6352
Ext.2498

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 areas256
2. Individuals receiving I&R outside PAIR priority areas70
3. Total individuals receiving I&R (lines A1 + A2)326

B. Training Activities

1. Number of trainings presented by PAIR staff22
2. Number of individuals who attended training (approximate)600

PAIR staff presented to the Laurel Advocacy and Referral Service (LARS) on fair housing act rights and enforcement and on housing oppoortunities for persons with disabilities.  LARS serves residents of Prince George’s, Anne Arundel and Howard Counties who are low income or homeless.  The presentation was oral and included a question and answer session.  Staff also distributed materials about MDLC services and lists of tax credit developments which have affordability restrictions and are prohibited from excluding persons who use vouchers.

Two PAIR staff made separate presentations at a "Fair Housing Matters" conference at Unversity of Maryland School of Law.  One presentation focused on housing rights of tenants with disabilities and used a power point; the other presentation focused on data, the lack of accessible housing in the Baltimore metropolitan area, and the experiences of a tenant who uses a wheelchair in public housing. The second presentation was a panel format that included a PAIR client.

PAIR staff made a presentation a a Tenant’s Association at a subsidized apartment complex in Baltimore. The oral presentation was about Maryland landlord tenant law, fair housing rights and tenant rights in government subsidized housing. General information brochures were distributed.

PAIR staff were asked to present to the Mayor’s Commission on Disabilities in Balitmore City, which presentation included a focus on the new Maryland Accessibility Code enforcement authorized by the Maryland General Assembly. The presentation also discussed the inclusion of students in out of school activities and MDLC’s work on this issue. Three different sets of materials were shared with participants.

PAIR staff were invited to present to the Baltimore County Commission on Disabilities. One focus on the presentation was the lack of accessible, affordable housing in the County. PAIR staff shared data they had collected as well as examples of harm to clients. Staff also discussed the Maryland Accessibility Code.

PAIR staff conducted outreach and training at the Baltimore City Weinberg Homeless Shelter. Staff spoke about various housing oportunities and distrbiuted materials including lists of subsidized housing developments, applications for certain project based voucher opportunities recently available as part of the Bailey Consent Decree (a PAIR activity) and material related to MDLC services. The presentation was followed by a question and answer session and individual case consultation.

Two PAIR staff provided outreach at Baltimore City’s second annual "Project Homeless Connect" held at the City Convention Center. PAIR staff distributed a brochure on housing rights of persons with disabilities; a brochure on reasonable accomodations in public housing; applications for subsidized housing, and; a locator guide for finding privately owned subsizied rental housing.

PAIR staff was asked to present to a limb difference support group of families with young children with physical disablilities. Staff provided a brief history of the Americans with Disabilities Act, discussed issues that can arise for their children, and potential actions if parents feel that their children’s rights have been violated.

PAIR staff was asked to provide the keynote presentation to the Annual Conference of the National Consortium for Physical Education and Recreation for Individuals with Disabilities. Staff used a powerpoint and a question and answer session to discuss inclusion of students with disabilities in school athletic opportunities. Staff also discussed the recent guidance from the U.S. Department of Education, Office of Civil Rights, which noted efforts in Maryland and requires inclusive opportunities for athletics, intramurals and club sports.

PAIR staff assisted in training twelve individuals who work with an Independent Living Center as peer outreach workers funded through the State’s federal Money Follow the Person Grant. These individuals provide support in the community for the first year after a person transitions from a nursing facility. The training focused on assistive technology and funding sources for nursing facility residents who are transitioning into their communities and developing more independence. The training also included demonstrations of a variety of assisted technology devises.

PAIR staff provided a series of ten trainings to Medicaid consumers. The trainings included oral presentations, handouts and question and answer sessions. The topics included: the role of the state long term care ombudsperson in nursing facility transition planning; housing rights of persons with disabilities; Medicaid due process rights; Community First Choice Medicaid options for long term care supports; models for self-direction in personal care; individual budget planning in Medicaid waiver programs; utility assistance programs; working with Independent Living Centers, and; effective communication strategies for nursing facility staff and residents’ families.

PAIR staff trained 26 long term care ombudspersons in Maryland on barriers facing individuals who want to transition from nursing facilities into the community. This was an oral presentation with PAIR staff and consumer outreach workers, who are mostly former MDLC clients who have transitioned from nursing facilitites.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles9
3. PSAs/videos aired1
4. Hits on the PAIR/P&A website21,830
5. Publications/booklets/brochures disseminated1,360
6. Other (specify separately)8

Narrative

A video produced under direction of PAIR staff was aired over fifty times to nursing facility resident councils and to individuals in nursing facilities and their families. The video described options to institutional living and show cased individuals who left nursing facilities to live in the community.The film also highlighted interactions with nursing facility residents who discussed planning to leave the facility. An estimated 300 individuals viewed the video.

MDLC’s facebook page had 1,092 followers and 34,060 face book post views.

MDLC has an electronic news list with approximately 650 contacts. It was used ten times this past year to share news of interest to the Maryland disability community.

PAIR staff created a brochure on tenant rights to modifications in rental housing for participants in the enhanced leasing assistance program created pursuant to the Bailey Consent Decree (see information below on the Bailey case). The brochure is provided to everyone who receives a tenant based voucher associated with the Bailey Decree (to date over 1800 individuals) and was generated after discovering that the modification fund established by the Decree was not being fully utilized.

PAIR staff commented on the Department of Housing and Urban Development’s (HUD) proposed rule on Affirmatively Furthering Fair Housing as related to persons with disabilites and then distributed copies of the comments to approximately twenty Maryland organizations interested in housing and disability issues.

PAIR staff contributed to two training booklets related to Maryland’s new federally funded 811 program for persons with disabilities. The booklets are being published by the state and will be provided to tenants participating in this new permanent supportive housing program.

PAIR staff developed and distributed a flier and accompanying fact sheet related to the changes to the Maryland Accessibility Code in the Maryland Buidling Code and the right to private enforcement of the code, which right was provided by the Maryland General Assembly this past year.

The ’Sunshine Folk’ initiative developed by PAIR staff as an outreach model using former nursing facility residents to connect with individuals in nursing facilities who may want to live in their communities, was honored with recognition at the National Long Term Care Ombudsman conference.

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)43
2. Additional individuals served during the year75
3. Total individuals served (lines A1 + A2)118
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)3

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 38

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility1
2. Employment0
3. Program access2
4. Housing84
5. Government benefits/services0
6. Transportation10
7. Education16
8. Assistive technology0
9. Voting0
10. Health care5
11. Insurance0
12. Non-government services1
13. Privacy rights0
14. Access to records0
15. Abuse0
16. Neglect0
17. Other1

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor53
2. Other representation found3
3. Individual withdrew complaint6
4. Appeals unsuccessful1
5. PAIR Services not needed due to individual's death, relocation etc.2
6. PAIR withdrew from case10
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit5
9. Other1

Please explain

Opposing party did not pursue action, so case closed for client.

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-advocacy14
2. Short-term assistance36
3. Investigation/monitoring2
4. Negotiation14
5. Mediation/alternative dispute resolution2
6. Administrative hearings9
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 - 2227
3. 23 - 5971
4. 60 - 6411
5. 65 and over9

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females60
2. Males58

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaskan Native0
3. Asian1
4. Black or African American78
5. Native Hawaiian or Other Pacific Islander0
6. White35
7. Two or more races2
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent71
2. Parental or other family home27
3. Community residential home4
4. Foster care0
5. Nursing home3
6. Public institutional living arrangement1
7. Private institutional living arrangement3
8. Jail/prison/detention center1
9. Homeless7
10. Other living arrangements1
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 impairment3
2. Deaf/hard of hearing2
3. Deaf-blind0
4. Orthopedic impairment45
5. Mental illness0
6. Substance abuse0
7. Mental retardation0
8. Learning disability2
9. Neurological impairment25
10. Respiratory impairment5
11. Heart/other circulatory impairment2
12. Muscular/skeletal impairment13
13. Speech impairment0
14. AIDS/HIV1
15. Traumatic brain injury1
16. Other disability19

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities39

2. Number of individuals potentially impacted by policy changes10,000

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.

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

The following describe PAIR systemic activities to ensure access for persons with disabilities to: 1) equal opportunity to affordable and accessible housing, 2) reliable public transportation services, 3) access to community based services, and 4) equal educational opportunities for students with disabilities.

1. Activities to Ensure Equal Opportunity to Affordable and Accessible Housing:

PAIR staff negotiated with the Housing Authority of Baltimore City (HABC) and private attorneys representing public housing residents to obtain additional housing units in areas of opportunities for persons with disabilities. Federal funding was being used to create 100 new public housing units in various neighborhoods across Baltimore City. PAIR staff objected to the proposed plan as it did not provide sufficiently for persons needing one bedroom units, who are mostly people with disabilities. Such persons comprise the majority of the Hosuing Authority’s waiting list. PAIR staff negotiated for an additional ten one bedroom units and for the total project to provide 30% of units for non-elderly people with disabilties needing one bedroom housing and for 10% of the units to be accessiblefor persons using wheelchairs. A request for proposals was issued by HABC and a developer has been selected for this project, which should result in more affordable and accessible housing for people with disabilities.

PAIR staff connected with Independence Now, the Independent Living Center in Prince George’s County, Maryland. In the process of doing outreach in that area of the state, PAIR staff discovered that the Prince George’s County Housing Authority (PGHA) was advertising housing legally available for non-elderly people with disabilities and older adults as available only for seniors. PAIR staff sent a demand letter to PGHA to cease its illegal and discriminatory advertising practice. PGHA changed its web site to correctly advertise housing opportunities for non-elderly persons with disabilities. PAIR staff also submitted a public information request to PGHA to determine the actual occupany for the housing at issue. After repeated attempts to obtain the information, PAIR staff filed a court complaint to enforce the Maryland Public Information Act. The Complaint led to compliance by PGHA after months of refusing to provide such data. PAIR staff used the data to confirm that non-elderly persons with disabilities are obtaining access to public housing.

PAIR staff testified before the Baltimore City Zoning Appeals Board to suport the Board approving a waiver request from the Housing Authority of Baltimore City (HABC) to build a four-bedroom wheelchair accessible rental unit in an area of opportunity in Baltimore City. Pursuant to the Bailey Consent Decree, HABC must create 756 UFAS accessible units of varying bedroom sizes. While HABC has made progress in the creation of these units, it does not appear that all units will be created by December 2014 as required by the Consent Decree. To partially remedy this situation, HABC hired contractors to build new units on City owned properties. One of the units will be in Mt. Washington, a high-opportunity area of Baltimore City. Because the unit is a multiple bedroom accessible home, the contractor requested a waiver to allow the unit to be situated one-foot closer to the road. The neighborhood association objected, and concerns were expressed about the housing being for poor people in public housing. PAIR staff argued that the waiver should be approved as a reasonable accommodation based on the need for accessible housing to serve famlies with disabilities. The Zoning Appeal Board requested that PAIR staff submit a written legal argument, which was done. The request for the waiver was subsequently approved, and a construction permit issued in early July 2013. The housing will be available for a large family with a member who uses a wheelchair and who is on the public housing waiting list or is a current public housing resident living in inaccessible housing.

PAIR staff participate in the Maryland Partnership for Affordable Housing (MPAH), a statewide working group convened by the Department of Disabilities to ensure that Maryland takes advantage of opportunities to create new affordable housing for persons with disabilities. A goal of the group is to obtain funding through HUD’s new 811 program, which creates integrated, affordable housing opportunities for non-elderly persons with disabilities who are in need of permanent supportive housing. In February 2013, Maryland Department of Housing and Community Development (DHCD) Secretary Raymond A. Skinner announced that the State of Maryland will receive approximately $11 million from the U.S. Department of Housing and Urban Development (HUD) through HUD’s Section 811 Project Rental Assistance Demonstration Program (PRA). The PRA program provides rental assistance to extremely low-income persons with disabilities, many of whom are transitioning out of institutional settings or are at high risk of homelessness. The program is targeted to provide 150 voucher subsidies. PAIR staff have been involved in prioritizing how these vouchers get distributed and other aspects of the program. Maryland received a draft Cooperative Agreement from HUD on November 6, 2013 and must submit its comments on the draft Agreement to HUD by December 6, 2013. The Cooperative Agreement is a precursor to receipt of federal funds.

PAIR staff worked with the Maryland Civil Rights Commissioner and several other organizations to learn how the Maryland Accessibility Code applies to housing rehabilitation in Maryland and to understand how it is enforced. The Accessibility Code is part of Maryland’s Building Code. PAIR staff interviewed permit and building inspectors in various Maryland jurisdictions and learned that the Code is not necessarily enforced. PAIR staff provided information to members of the General Assmebly about the need for accessible housing in the state and the lack of enforcement by a governmental entity or private individual. The legislature amended the Accessibility Code to create a private cause of action for enforcement of the Accessibility Code. PAIR staff developed written materials and contacted building code inspectors in several jurisdictions to help explain the law and its consequences. Housing developments that undergo substantial renovations or alterations to their units will need to create accessible units or add accessible features. Maryland’s law is more restrictive than the Federal Fair Housing Act and should produce more accessibility in housing as enitites and developers learn more about the law.

PAIR staff contributed to the State Department of Housing and Community Development’s (DHCD) efforts to revise the guidelines by which it awards tax credits to developers of low income housing. PAIR staff testified at public hearings, provided comments at each stage in the process, and collaborated with other disability advocates to make sure the voice of the disability community was heard. Twenty disability based organizations signed on to a letter drafted by PAIR staff to DHCD commenting on the proposed changes. Examples of positive changes include that developers are required to have affirmative marketing plans that include: prohibition of minimum income requirements for prospective tenants; a requirement to ensure access to leasing offices for persons with disabilities; and encouraging property developers to relax credit references to take into account the needs of persons with disabilities. In addition, creation of housing for non-elderly persons with disabilities is one of four priority areas identified by the state for award of tax credits. Such housing must be in integrated projects so that people with disabilities comprise between 10-25% of the tenants using deep subsidies. The new state documents also provide incentives for housing developers to provide more accessible units than would be required by use of federal funds and to develop housing in ’areas of opportunity’ to avoid continued concentration of affordable and accessible housing in areas of high poverty and minority concentration. All of these policies were supported by PAIR staff. PAIR staff engaged in muliple discussions with state officials related to these proposals in addition to submitting written comments.

PAIR staff coordinated with several legal service providers to impact the plans of the Housing Authority of Baltimore City to privatize its "mixed population" buildings that are occupied by older adults and people with disabilities. The majority of tenants in many of such buildings are non-elderly people with disabilities.Thus far the work has resulted in obtaining assurances which will protect the rights of public housing clients who will be subject to a new funding and management structure. The Housing Authority has provided assurances, as requested by PAIR staff, that people with disabilities will not be excluded from such housing through designation of buildings or portions of the buildings exclusively for seniors. This work is continuing.

PAIR staff coordinated with Maryland Adapt, clients and the Image Center (an independent living center) to provide testimony and comments to the Baltimore County Planning Office supporting the need for more accessible housing and urging use of federal funding for such purposes. In its next allocation cycle, the Planning Office supported a capital fund increase for accesibility modifications from its federal funding. This was the only new funding increase offered by the County’s plan for use of federal Community Development Block grant funds.

PAIR staff learned from a client that an affordable housing developer was using unreasonable tenant selction critieria to deny potential tenants from obtaining housing. The provider rents housing to persons with ddisabilities who were adversely affected by the practices. After negotiations with the housing developer, the tenant seclection criteria was changed and due process protections were put in place for tenants subject to breach of lease claims.

2. Activities to Ensure Access to Reliable Public Transportation Services:

PAIR staff and a group of dedicated PAIR clients who use paratransit services meet periodically with Maryland Transit Administration (MTA) officials to discuss concerns with the service. PAIR staff also have direct access to the Director of Paratransit services who has encouraged PAIR staff to share concerns of riders directly with him. The meetings and communications have produced benefits for our clients and has resulted in stronger service monitoring by MTA. Examples of changes in policies or practices resulting from this collaboration include the following:

In January 2012 MTA announced a new certification process. The new process required applicants to call MTA Mobility to request a certification appointment after the applicant had the required paperwork on hand. Previously, applicants were able to submit their paperwork to MTA as soon as it was complete,but MTA instituted a new policy that required applicants to keep their paperwork until their certification appointment. This practice denied applicants the opportunity to apply for service. PAIR staff wrote and notified MTA of its concerns regarding the practical effect of the policy and legal requirements to provide service to applicants when eligibility determinations are not made within 21 days. In response to these concerns, MTA instituted a policy that appointments for paratransit certification or recertification would be provided within 7 days of an applicant’s request for service or to become recertified.

Two riders reported that when their paratranist ride came to pick them up, the driver refused to transport them claiming they had too many bags. The riders had small bags attached to the back of their wheelchairs. The bags at issue were not grocery bags or luggage but were bags used to carry items of daily needs, including medical supplies. PAIR staff reported this concern to the Director of paratransit services who investigated the incident and agreed to instruct drivers on the correct policies related to the number of bags consumers may carry, including that small bags needed for personal use are not limited.

PAIR staff received complaints from several riders that they do not receive responses to their complaints about poor service. Riders left messages on MTA’s "complaint line" but did not receive return calls about their concerns. PAIR staff discussed this concern with MTA and the agency determined that the complaint line would be staffed by an individual to speak directly with callers and that a complaint tracking system would be established.

PAIR staff received a report from a rider that drivers were not providing her with assistance into the vehicle and did not appear to recognize that she is blind. PAIR staff shared this complaint with MTA and MTA agreed to retrain drivers and contractors about using notations on the driver manifest to indicate that a rider is visually impaired and needs assistance. PAIR staff also asked that MTA refresh instructions for drivers that they are required to call out the name of the rider when they arrive at a pick up location so that visually impaired riders know that the ride is present. Rider complaints indicated that this practice was not being uniformly followed. MTA agreed to provide such instruction.

PAIR staff received reports of long travel times on return trips from dialysis. In one case a rider who lives very close to her dialysis treatment spent two hours on aparatransit vehicle and reported that it often took her over an hour to get home. After receiving diaylsis treatments individuals often feel ill, which makes the long trip time especially difficult. One rider reported that on numerous occassions, her driver actually passes her home after picking her up from dialysis and drives across town to drop off other passengers before driving her back to her residence. After discussing this issue with MTA, the rider was placed into a taxi program that better serves dialysis patients. This service was coordinated with several dialysis centers and operates standing rides for customers. This began as a pilot program but has expanded due to its success.

PAIR staff received a complaint from a rider that their ride was very late and then when the vehiicle finally arrived it could not accomodate a wheelchair and was not useable for the rider. PAIR staff shared this incident with MTA and the Director of Paratransit wrote back to apologize for the mishap and to explain that the problem would be addressed by more training for the service provider. The Director invesitgated the problem and reported that the trip was moved several times between runs but was not done through the computerized scheduling wizard, the proper way to move a ride. Instead, the ride was manually dragged and dropped onto the wrong vehicle run resulting in a sedan being sent for a customer using a wheelchair. The MTA Director of Paratransit further informed PAIR staff that the MTA met with responsible staff and demonstrated the manner in which the error occurred and the proper way to handle moving trips.

PAIR staff worked collaboratively with MTA to draft a letter to riders informing them of the availbility of accessible taxis through MTA’s taxi access program. Previoiusly, riders who used wheelchairs that could be stored in the trunk of a taxi and who could not independently transfer into a sedan taxi, had no access to the taxi program available to paratransit customers. Last year PAIR staff and clients worked with MTA to ensure that accessible vehicles were addded to the taxi access fleets. However, riders were not aware of the changes so MTA agreed to send a letter to riders informing them about the availability of accessible vehicles in the taxi program.

PAIR staff received complaints that although riders had standing rides scheduled they were being required to call to confirm their trip. For example, riders who had a standing ride for dialysis three times a week were being told to call each time they needed the ride in order to ’confirm’ their standing trip. PAIR staff complained to MTA that this contradicted written policies. MTA interrvened to correct the problem by instructing contractors that riders need not call ahead when they have a standing ride.

PAIR staff and clients shared information with members of the General Assembly related to the MTA paratransit program. Information included that the paratransit system continues to face challenges because its available resources, especially personnel, consistently lag behind demand. Maryland’s system of allocating employees prevents MTA from hiring additional staff to meet the growth in service demand. MTA is not authorized to acquire more staff and is required to rely almost exclusively on part time positions for its reservation agents. The turn over in these positions is extremely high and PAIR staff shared details regarding MTA paratransit staffing. PAIR staff and clients have advocated for permanent full time positions or that MTA should consider contracting out the call center if they cannot operate without long telephone hold times due to continued personnel deficits. MTA agreed to review this situation.

PAIR staff provided MTA with a detailed letter expressing numerous concerns with the administration of the paratransit eligibility process. MTA responded and agreed to make several changes including: • The results of the MTA functional assessment would not be determinative but instead be used as one piece of information in conjunction with other information to determine an individual’s eligibility. • The individual administering the functional assessment, whose professional qualifications were challenged by PAIR staff, was replaced with an individual whose qualifications are more consistent with those needed to properly administer the assessment tool. • MTA initiated an internal review of its eligibility process and agreed to review specific resources identified by PAIR staff.

Based on client input, PAIR staff informed MTA that taxi services were requiring riders who needed accessible vehicles to schedule a ride a day in advance of their trips while such service is available as same day service for persons who do not use wheelchairs. PAIR staff provided examples of why same day service was needed by riders and MTA agreed the practice was “unacceptable” and would be changed.

3. Activities to Increase Community Integration of Persons with Disabilites:

PAIR staff support ’Sunshine Folks’ (SSF), a group of volunteer advocates with disabilities who have experience residing in nursing facilities and who now live in the community. PAIR staff train the SSF and provide legal back up for individual cases. SSF provided outreach to approximately 250 residents of nursing facilities and helped to connect 30 individuals with support services that enabled them to leave the facility and return to live in their communities.

Residents in nursing facilities who had community Medicaid prior to entering nursing facilities faced long delays in having their applications for Medicaid long term care processed. Until such applications were processed, the individuals were not entitled to apply for Medicaid waiver programs that fund health care services devlivered in the communnity as opposed to institutional care. PAIR staff spent time in the previous year pressing for correction to the delays through public comments and meeting with state officials. PAIR staff provided case examples of individuals who became known to staff through the outreach efforts of SSF. This year Maryland Medicaid began to streamline waiver applications for individuals newly admitted to nursing facilities who were receiving Medicaid in the community. A consequence of this change is that individuals are more likely to return to the community more quickly, which can enable them to maintain their leases and their homes. For example, individuals who use vouchers to rent their home risk loosing their voucher if they remain out of their unit for several months. Being able to apply promptly for Medicaid waiver programs provides these individuals with the opportuntiy to return home and to keep their housing. PAIR staff was invited to help draft the State’s application to expedite the eligibility for Medicaid long term care and commented on a new state form, policy, and procedures to implement the expedited eligibility.

PAIR staff collaborated with Maryland Legal Aid Bureau, Inc. to comment on state nursing facility regulations to ensure that individuals in facilities receive access to counseling on their community living options. PAIR staff provided comments to nursing facility regulations so that nursing factility residents are permitted to have a consumer advocate or support person of their choosing participate in the individuals’ plan of care meetings held at the nursing facility. PAIR staff negotiated for the adoption of such provision into the final regulations.

PAIR staff worked with Medicaid consumers to form a ’consumer caucus’ to respond to the State’s plans to use the Consumer First Choice (CFC) option to the State Medicaid State Plan under the Affordable CareAct (ACA). Caucus members and PAIR staff worked on proposals so that: 1. CFC regulations include access to services for building independence skills; 2. Participants are not required to pay a "retainer" to ensure that back up personal assistance services are available; 3. Assistive technology services will include maintenance contracts; 4. Participants will be able to exceed the cost cap for assistive technology when such services will reduce the ongoing cost of care or avert institutionalization; 5. The definition of "community" reflects the most integrated settings for participants; 6. Participants can receive personal care services in the work place or other community settings and not be limited to receving services in the home; 7. A CFC participant relative who is not a spouse, parent of a minor child, or guardian, is eligible to be a personal care assistant. The CFC program will be implemented in 2014 and is expected to impact approximately 10,000 individuals.

PAIR staff met a mother whose young child with physical disabilities was denied access to a skating rink. The family complained that during a girl scout event and a birthday party the child was denied access to the public skating rink because she uses a walker. The mother had filed a complaint with the Maryland Civil Rights Commission, which was unsuccessful in its attempts to mediate the dispute. PAIR staff conducted an independent investigation. The investigation included taking video at the skate rink of roller derby and jam skaters, which activities are at high risk for physical injury but were permitted by the skate rink. PAIR staff also took video of the client using an assistive device known as a ’skate-mate’ commonly used at other area skating rinks. The devices are used to help patrons balance as they learn to skate. The vidoes and a legal memorandum written by PAIR staff was shared with the Civil Rights Commission on behalf of the client and the attorney representing the skate rink. The case resolved with the skate rink purchasing several skate mate devises and permitting the client immediate access to the facility.

PAIR staff represented a woman who uses a wheelchair and whose bank was not accessible. The client had become trapped inside an area created for after hour use of ATM cards because there was no devise on the door to assist her in opening it after she entered the secured area. The client had tried to resolve the issue on her own but was not successful. After PAIR staff intervened and cited to applicable law, the bank fixed the area so that the doors could be automatically opened and would no longer trap a person using a wheelchair.

PAIR staff worked with a parent and child to try to convince a summer camp program to accept the child. The program rejected the child because she may require administration of diastat. The child’s doctor wrote statements supporting the inclusion of the child into the summer camp program, offering to help train camp employees, and offering to be an emergency back up for the camp. Lengthy negotiations were not successful so PAIR staff assisted the parent to file a complaint with the Department of Justice(DOJ). PAIR staff worked with DOJ, which has conducted an investigation and is trying to resolve the complaint by having the camp admit the child and change its policies.

4. Activities to Provide Equal Educational Opportunities to Students with Disabilities:

As a protection and advocacy agency, MDLC has prioritized the disparate impact of disciplinary actions and restraint and seclusion practices on students with disabilities. Working with other advocacy organizations such as the Open Society Institute (OSI), American Civil Liberties Union (ACLU) and Legal Aid Bureau (LAB), MDLC has advocated for strong due process rights for students, alternatives to suspension, and an end to “zero tolerance” measures. Recently the Maryland Board of Education promulgated draft disciplinary regulations that improved the opportunity for students to remain in school after infractions of a school’s code of conduct. MDLC has been involved in commenting and advocating for these positive changes. MDLC takes individual cases related to its educational priorities. Fifteen of such cases are PAIR cases.

PAIR staff successfully addessed use of a ’focus room’ at an elementary school where students were placed in seclusion for hours. PAIR staff represented two students and their families at this school. PAIR obtained different educational services and compensatory services for both students due to the punitive use of the seclusion room and for the time the student missed from the classroom. The local school system determined to provide professional development and support to the principal of the school to increase the school’s capacity to appropriately serve students with disabilties.

Students with disabilities are over-represented among students who are chronically absent. Students with disabilities lack equitable access to after-school and out of school time activities that are known to enhance school attendance outcomes. Therefore, MDLC determined that activities to increase participation of students with disabilities in out of school time activities would serve the goals of increasing access to activities for such students, and have a positive effect on school retention. This past fiscal year, MDLC has distributed approximately 3,000 booklets of “Together Beyond the School Day,” MDLC’s guide for parents, youth and out of school time (OST) program providers on including youth with disabilities in OST programs. PAIR staff contributed time and expertise to the development of this brochure, which has been used by several programs to include youth with disabilities into their services. (This activity is not included in the section of this report that solicits information on distributed materials because PAIR program staff were not directly involved in the distribution of the materials, which was arranged by other MDLC staff with whom PAIR staff collaborate.)

PAIR staff provided assistance to a young man with disabilities who was informed by his local school system that he could no longer participate in a sports program designed for students with and without disabilities after he turned nineteen. The school permitted the youth to practice with the team, but would not allow him to participate in games. The client is a special education student and is entitled to a free appropraite public education until he turns twenty-one. PAIR staff provided a letter detailing how this action conflicted with state law and also contacted the State Department of Education to inform the Attorney General’s office of the situation. The county school board subsequently changed its policy to permit students with disabilities participating in athletic activities for students with and without disabilities, to participate fully in such activities while in high school regardless of age.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts3,000
2. Number of individuals named in class actions3

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.

Litigation Activities: 1. Bailey Consent Decree. The Housing Unit continues to monitor the implementation of the Bailey Consent Decree by the Housing Authority of Baltimore City (HABC). The Bailey Decree is a federal court consent decree resulting from a class action filed by MDLC PAIR staff due to housing discrimination by the Baltimore City Housing Authority and the Mayor and City Council. Discrimination allegations related to the failure of the Housing Authority to provide reasonable accomodations; the unlawful exclusion of person with disabilites from public housing; and the failure of the Housing Authority to provide accessible housing and modifications for tenants.

The Decree has resulted in the creation of 655 accessible housing units as of September 2013 that are compliant with the uniform federal accessibility standards (UFAS) and another 66 units that are nearly fully UFAS complaint. The Housing Authority has awarded contracts for the construction of an 22 additional UFAS units. These units are projected for completion by December 2013.

In the past year, 34 households transferred to accessible public housing units from inaccessible apartments. A total of 436 tenants have completed transfers to UFAS units as a result of the Bailey Decree. 60 households are still living in inaccessible housing and waiting to transfer. There are 347 families on the Housing authority public housing waiting list who have requested a unit that is accessible to a wheelchair user.

Approximately 1,600 non-elderly persons with disabilities leased a unit with a voucher pursuant to the Bailey Decree. The Housing Authority has created 254 of the 500 project-based units that must be made available for non-elderly persons with disabilities. Eighty-one of those units became available during this past year.

Thirty-two public housing units were modified for tenants who needed accomodations due to being deaf or hard of hearing, or blind or visually impaired. All such modifications were made within 14 days of the request as required by the Bailey Decree.

During monitoring of the Bailey Decree, PAIR staff discovered a private developer was charging application fees to prosepctive tenants from the Housing Authority waiting list in violation of the Bailey Decree. PAIR staff reported the violation to the housing authority which required the developer to cease charging application fees for the project based units.

During monitoring of the Bailey Consent Decree, PAIR staff learned that prospective tenants from the Housing Authority’s waiting list were being denied access to accessible units at one housing development in violation of the law. This practice was corrected and the Housing Authority agreed to provide more oversight of the housing project.

PAIR staff reported to the Housing Authority that clients who need accessible units were not being properly placed on the list for UFAS units. The Housing Authority corrected the error and indicated that it would establish a process to avoid any similar oversights in the future.

After investigating an incident on behalf of a client, PAIR staff realized that tenants in certain privatley managed properties were not receiving notices required under the Bailey Consent Decree related to their rights to reasonable accomodations. The Housing Authority sent tenants and property managers proper notices and information about how to request accomodations. Prior to such notices being sent, PAIR staff reviewed and revised them to ensure accuracy.

PAIR staff, an expert and an attorney from the Department of Justice inspected certain housing that the Housing Authority certified as accessible pursuant to the Bailey Consent Decree. PAIR staff identified issues with the accessiblity certification. Some of the issues were corrected, some are still being negotiated.

PAIR staff toured newly developed units produced pursuant to the Bailey Decree by non-profit developers. The units offer excellent housing opportunities for clients, including a fully accessible unit for an individual using a wheelchair.

This past year, 511 persons with disabilites moved from the public housing waiting list into public housing as a result of the Bailey Consent Decree.

PAIR staff negotiated for an additional ten units to be developed for persons with disabilties and for such units to be dispersed into areas of the City with greater economic opportunity and less concentration of poverty.

A client who was famliar with the Bailey Consent Decree contacted PAIR staff to complain that there was no signage in her public housing building identifying the accessible trash rooms. She also complained that the weight of the trash room doors was too heavy for her to open, once she carted her trash to the designated room. HABC tested the trash door friction devices and found that one door closer needed to be adjusted. HABC fixed the door and also installed proper signage.

PAIR staff represented a client who needed to move from her unit because it was on the second floor and using the steps aggravated her chronic back pain. PAIR staff negotiated to have her obtain a tenant based voucher available through the Bailey Consent Decree so she could move from her existing housing and search for accessible subsidized housing.

2. HUD Complaint. PAIR staff continue to represent individuals with disabilities in an administrative complaint to the US Department of Housing and Urban Development (HUD). During this past year, PAIR staff have provided detailed memorandum to HUD in support of the clients’ position; participated in multiple conciliation sessions; drafted sections of a remedial agreement; negotiated specific issues with the county attorney and county officials; prepared and accompanied clients to interviews with HUD investigators, and; engaged in legal research related to clients’ claims. The complaint is broad and far reaching. As conciliation sessions are confidential, the progress and status of such meetings cannot be reported. One outcome that can be disclosed is that the jurisdiction recently announced that it is accepting proposals to use more of its federal funds to pay for modifications of rental units for persons with disabilities.

3. Hill v. Hampstead Lester Morton Court. PAIR staff represent an elderly woman with physical disabilities who was denied accessibility modifications by her subsidized housing provider in Baltimore City. The client lived in the subsidized housing development for over 33 years and developed disabilities in the past eight years. In March 2013, the U.S. District Court found for the Defendants, finding that because our client had requested accomodations of a ramp and an accessible bathroom and should have known that her claim was being denied in 2006, she should have brought her legal action within three years of being denied. PAIR staff recruited the assistance of Wiltshire & Grannis, LLC, as pro bono co-counsel and has appealed the case to the United States Fourth Circuit Court of Appeals. This case demonstrates that the factual circumstances of landlords and property owners change over time to include acquisition of additional properties; renovations, and; improved financial returns. Our client’s position is that what may not be financially reasonable at one time may become reasonable in the future. As long as the tenant makes a request and files her complaint within the statutory period, the client should be able to make more than one request, especially when the landlord continues to receive the federal subsidy and the client continues to pay her rent. A new request for accomodations should trigger a separate evaluation of what is reasonable and a new limitations period in which to file a claim. The case was briefed this past year and will be scheduled for oral argument in the next fiscal year.

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.

MDLC envisions a world where people with disabilities are fully included in all aspects of community life. The protection of civil rights of persons with disabilities to participate in public life is a priority for PAIR work. Specifically, MDLC focuses on a) housing, b) transportation, c) access to community based services and programs, and d) equal opportunities in education.

a) Housing. 1. PAIR priority: Expanding access to accessible and affordable housing and targeting discrimination so persons with disabilities can obtain or maintain such housing. This priority is accomplished through: monitoring and implementation of the Consent Decree in Bailey v. Housing Authority of Baltimore City; pursing an administrative complaint against a jurisdiction that lacks affordable, accessible housing for people with disabilities; and individual case representation.

2. Need. PAIR staff filed a federal court complaint against Baltimore City and the Housing Authority of Baltimore City after trying to work with the Housing Authority for over two years. At the time the Complaint was filed, there was only one fully accessible public housing unit in the entire inventory of public housing. The occupancy of persons with disabilities in housing which is legally required to be equally available to senior citizens and non-elderly persons with disabilities was only 4% even though non-elderly persons with disabilities out numbered elderly persons on the housing authority’s waiting list by a ratio of 3:1. Persons with disabilities comprise approximately 30% of the housing authority waiting list. This statistic is consistent with national statistics that demonstrate that the percentage of households with members with disabilities is higher among those renters who live in subsidized housing (38.1%) than those living in market housing (14.5%).

As people with disabilities have a poverty rate that is twice of that of their non-disabled peers, there is a unique stress on their ability to obtain housing. A 2012 study released by the U.S. Department of Housing and Urban Development (HUD) demonstrates the correlation between rent burden and the incidence of disabilities based on HUD’s American Housing Survey. One finding of the study is that lower income households are much more likely to include one or more members with a disability than are high-income households. 30% of households with members having one or more disabilities are extremely low income, a rate that is three times greater than the percentage among households with extremely high incomes (9.8%).

The study also demonstrates that rent-burdened households (those paying more than 30% of their income for rent) are significantly more likely than non rent burdened households to include one or more residents with a disability. Among households whose rent exceeded their gross income, the incidence of disability was 27%.

In addition, persons with disabilities are more likely to reside in older homes: 19% of homes built between 1950 and 1969 had one or more member with a disability compared with only 13% of homes built after 1990. In Baltimore County, almost all homes that are rented with voucher subsidies were created before the effective date of the Fair Housing Act, which means that the accessibility requirements of the act are not effective for low income persons with disabilities who rent housing with federal subsidies.

A report issued by the Technical Assistance Collaborative, "Priced Out in 2012," documents that the HUD fair market monthly rent for a one-bedroom rental unit in Baltimore is more than the entire monthly Supplemental Security Income (SSI) benefit check issued to a person with a disability. A person with a disability relying on SSI would have to pay 164% of his or her monthly income to rent a modest one bedroom apartment in Maryland. Compared with other states, only Hawaii and the District of Columbia have higher rent burdens for people on SSI. People with disabilities who receive SSI payments continue to be the nation’s poorest citizens. In 2012, the annual income of a single individual receiving SSI payments was $8,436.00, which is equal to only 18.7% of the national median income for a one person household and is over 20% below the 2010 poverty level of $10,830. The value of SSI payments compared to median income has declined precipitously - from 24.4% of median income in 1998 to 18.7% in 2012 - all while national average rents have risen over 50% during this same time period.

HUD has confirmed that non-elderly persons with disabilities face a worst case housing need based on the amount of income they are required to spend for housing. In the Baltimore region, persons with disabilities are much more likely than persons without disabilities to live in poverty. In 2000, among all persons with a disability in the Baltimore region, 16.7% lived below the level of poverty, compared to 8.4% of persons without disabilities. In Baltimore County, 10.4% of persons with disabilities live in poverty compared to 5.4% of persons without disabilities who are living in poverty. In Baltimore City, 27% of persons with disabilities live in poverty. Baltimore City has a disproportionate number (27.5%) of residents with disabilities.

The economic reality is that persons with disabilities on fixed incomes need a subsidy to be able to rent a place to live. Yet there is a critical lack of housing subsidies and affordable housing. As of December 2011, there are a total of 32,597 people on the Housing Authority of Baltimore City’s (HABC’s) waiting list for subsidized housing. HABC provides subsidies through the provision of vouchers and public housing units. Almost 40% of the subsidized housing waiting list is comprised of non-elderly persons with disabilities, and 98% of the households waiting for public housing have incomes below 30% of the area median income.

The need for accessible housing is indisputable. The Baltimore City Consolidated Housing Plan and the Baltimore City Housing Authority Annual and Five Year Plan identify the lack of accessible housing as an issue for the region. In Baltimore County, the County’s Analysis of Impediments (2011) and the County’s 2013 fiscal year Annual Action Plan both report the need for more accessible housing in the County. The Mayor’s Commission on Disabilities in Baltimore City and the Baltimore County Commission on Disabilities have both identified the lack of accessible housing as a major problem for people with disabilities. The regional study of impediments to fair housing identified the lack of accessible housing as a barrier for people with disabilities in the entire Baltimore metropolitan area. Baltimore City’s housing presents special challenges as it is home to the largest concentration of poor people in the state, including a large concentration of persons with disabilities, but is a City replete with row houses, which poses significant challenges to accessibility. The City’s public housing stock was not accessible and was one of the causes of action in the Bailey lawsuit. PAIR staff discovered that the Housing Authority had identified over 900 of public housing units as accessible in reports to the federal government, but after further analysis it was determined that only one housing unit was fully accessible out of a housing stock of over 10,000 units.

Baltimore County offers no public housing thus there is no County owned subsidized housing stock that must offer accessible units to persons who use wheelchairs. Baltimore County is also home to a significant number of people with disabilities. In the County, over 18% of individuals are reported to be people with disabilities. Approximately half of the persons on the county housing choice voucher waiting list have disabilities. A third of voucher holders are persons with disabilities. The waiting list for a voucher in the County is estimated to be 8-9 years. Over 90% of persons on the Housing Choice voucher waiting list are estimated to have incomes below 30% of the area median income. The need for affordable housing for persons with disabilities is severe.

A number of recent reports and publications, including the Baltimore County Analysis of Impediments (AI), identify the County’s supply of affordable, accessible housing units as inadequate to meet demand and recommend expansion of such housing. According to the AI, “in 2000, among all persons with a disability, 12.3% lived below the level of poverty. However, among all persons without a disability, only 5.4% of persons were living in poverty.” Thus the need for affordable housing for persons with disabilities is clear. A recent study by the Brookings Institution found that suburban poverty in the Baltimore area grew 58% between 2000 and 2011. In addition, fully half of the persons who use vouchers in Baltimore County are families with disabilities. The Baltimore County Commission on Disabilities Housing Work Group recently prepared a report confirming the unmet housing need for people with physical disabilities and recommending the creation of more accessible, affordable housing. The problem is compounded by the lack of any public housing in the county, as public housing carries an explicit requirement that some units be accessible. The majority of the affordable rental housing stock in the county is older housing and not accessible, or is targeted to senior citizens. Most rental units developed in the county in the past decade are high rent units, which do not provide access for low income families with disabilities, or are developed for senior citizens. Persons with disabilities seeking to secure affordable and accessible housing face many obstacles. People are forced to live in conditions where they do not have use of bathrooms or showers; may be forced to limit their involvement in activities of daily living because they cannot independently get in and out of their units; and are unable to use kitchen or laundry facilities and other benefits of their housing units. Some individuals have suffered injuries from falls or kitchen accidents due to the lack of accessible units. Some individuals remain in nursing facilities due to the lack of affordable, accessible housing. This is fundamentally a civil rights issue.

Aggravating the shortage of affordable and accessible housing in the Baltimore region is the fact that both Baltimore City and Baltimore County have lost significant units of low income housing in the past decade, which have not been replaced. In contrast, between 2000 - 2008, over 27,000 high-rent units were added to the housing stock in Baltimore City and 45,000 in Baltimore County. These two jurisdictions also experienced their largest decline in affordable housing within those units renting for $500 or less. A 2007 report estimates that the number of occupied HABC units dropped 42% in 15 years, from 16,525 units in 1992 to 9,625 in 2007. The effect of the loss of affordable or subsidized housing units is devastating. The loss contributes to homelessness, instability, more restrictive living environments, and worsening of health conditions.

PAIR staff undertook a survey of existing housing in Baltimore County that is available for persons using vouchers. Property owners who market to voucher holders list their properties on one of two web sites. Both web sites provide sections that describe what type of accessibility features are in the housing unit. PAIR staff surveyed the listings for most of a year and discovered that there were no units that offered features meeting the uniform federal accessibilty standards.

The rights of persons with disabilities to obtain or maintain affordable housing has become more critical as funding for such housing is reduced through federal budget action. Since 2010 there has been continued funding cuts to HUD housing assistance programs. Funding cuts for the major affordable housing development sources since 2012, adjusting for inflation, show a 4% loss in 2011; a 10.3% loss in 2012; and, a 13% loss in funding in 2013. While funding has diminished, the need for affordable and accessible housing has increased.

The Maryland Department of Housing and Community Development estimates that there will be a shortage of 29,000 rental housing units for people with disabilities over the next 10 years. According to the Department of Health and Mental Hygiene, of all barriers facing people seeking to transition from nursing facilities, group residential programs and those who are homeless and eligible for community based services, the most prevalent barrier is finding an affordable place to live. The need for affordable housing has increased along with rising demand for more community based health care, according to a study by the Kaiser Commission on Medicaid and the Uninsured. In Maryland, the Department of Health and Mental Hygiene reported that one reason for growth in community based health care services was the state’s receipt of 112 housing vouchers in FY2011, which afforded individuals in instittutions who could not previously overcome housing placement challenges with the opportunity to transition to the community. The successful use of such vouchers is evidence that the lack of subsidized, affordable housing prohibits individuals with disabilities from living in integrated community settings.

3. Outcome Indicators. i. There has been an increase in the number of persons with disabilities using both housing vouchers and leasing public housing in Baltimore City as a result of the Bailey Consent Decree (over two thousand individuals and families with disabilities obtained subsidized housing). ii. There has been an increase in the number of accessible public housing units in the City (675). iii. More common areas, including sidewalks, management offices, and playgrounds have been made accessible. iv. More hard rental housing units have been developed and are available to extremely low income persons with disabilities (255 project based units). v. A housing developer relaxed its tenant selection processes such that more tenants using vouchers, including tenants with disabilities, qualified for such housing. vi. The Department of Housing and Urban Development took jurisdiction of the discrimination complaints filed by PAIR staff and co-counsel. HUD investigators conducted several interviews with PAIR clients who are Complainants. HUD is also facilitating conciliation with Complainants and the County. These steps are positive as they are necessary prerequisites to a successful resolution in the matter and to the elimination of housing discrimination. vii. Baltimore County announced in the fall of 2013 that it would offer increased federal funds to pay for modifications to rental properties to accomodate persons with disabilities. viii. The state made changes to its plan for distribution of low income housing tax credits, which provides incentives and requirements for the development of housing for people with disabilities. ix. Maryland was awarded 110 vouchers and other financial support to develop affordable housing for non-elderly persons with disabilites.

4. Collaboration. PAIR staff collaborates with the U.S. Department of Justice which represents the United States in the Bailey case. PAIR staff collaborate with several legal service providers that have an interest in housing (Homeless Persons Representation Project, Legal Aid Bureau, Public Justice Center, ACLU) to keep one another informed about issues related to housing services in Maryland and to coordinate on policy reforms. The legal service advocates, including PAIR staff, have monthly meetings with the Baltimore City Housing Commissioner to discuss common issues or concerns. The legal services collaboration extends to sharing comments on housing plans developed by various jurisdictions, including plans required by the Department of Housing and Urban Development such as CON Plans, Annual Plans, and Analysis of Impediments to Fair Housing. PAIR staff participate in the National Low Income Housing Coalition’s Housing Justice Network, which provides staff with the opportunity to dialogue with legal services providers across the country on local and national issues affecting our clients. PAIR staff has been appointed to serve on the State Department of Disabilities Commission on Affordable Housing. PAIR staff is on the advisory committee of the National Low Income Housing Coalition. PAIR staff have collaborated intensively with co-counsel from the ACLU, NAACP, Public Justice Center and Legal Aid in filing an Administrative Complaint to HUD against a local jurisdiction. PAIR staff represent clients with disabilities who use vouchers but cannot locate any accessible housing units in the jurisdiction and who cannot locate housing outside of areas of poverty and minority concentration. PAIR staff has joined a housing committee of Independence Now, the local center for independent living in order to expand our housing advocacy to other jurisdictions.

5. Cases handled. There were 84 individual housing cases handled under this priority in addition to the continued monitoring and implementation of the Bailey Consent Decree and the administrative investigative and conciliation processes involved in the HUD Administrative Complaint.

6. Case example: PAIR staff represented a client who lived in inaccessible public housing to obtain a transfer to a three bedroom accessible unit and to also obtain a roll-in shower.

b) Transportation. 1. PAIR priority: Expanding access to reliable public transportation service.

2. Need. Persons with disabilities who are unable to use the public bus system must have an alternative public transportation system on which they can rely. In 2002, the Federal Transit Administration found that the Maryland Transit Administration’s (MTA) paratransit service did not comply with the requirements of the Americans with Disabilities Act (ADA) and in 2006 MDLC settled a class action lawsuit with MTA which established reforms to improve aspects of this state-run service. The lawsuit ended in early 2011. However, important aspects of the reforms have not been maintained or have re-emerged. For example, in 2008 Mobility announced the implementation of service provider liquidated damages to ensure certain levels of performance were met by the companies contracted to provide Mobility service. However, PAIR staff recently learned that MTA has failed to fully enforce the liquidated damages clauses due to fears that the penalties would be cost prohibitive to the providers, whose performance is lower than anticipated. Other aspects of Mobility’s service have deteriorated, including travel time. In 2006, 11% of rides lasted more than 61 minutes, but MTA’s recent data shows that in 2013, 17% of rides took more than 61 minutes. In 2006, 52% of all trips were completed in 30 minutes or less, in 2013,only 39% of trips are completed in this time. Mobility has also consistently reported high levels of staff turnover, in part due to the near exclulsive reliance on part-time staff positions for the MTA call center. In May of this year Mobility reported 29 call center agent vacancies, 3 bus operator vacancies, and 5 management level vacancies. Additional management level vacancies occurred throughout the summer, making staffing of critical concern. The level of vacancies have a serious adverse impact on Mobility operations resulting in long telephone hold times, a high percentages of unanswered customer calls, and poor trip quality, all of which negatively impacts customers and has the additional effect of suppressing ridership.

PAIR staff and six clients met with approximately 60 paratransit riders at the League for Persons with Disabilities in Baltimore City. PAIR staff and clients discussed rider experiences and conducted a survey of paratransit riders. 58% of respondents indicated that in the past 3 months they had experienced a problem with telephone hold times and ride times, with only 8% reporting that those aspects of Mobility’s service were “good.” Two-thirds of respondents indicated that they do not feel they can depend on the MTA.

The need for the service can be demonstrated by its demand. Compared with other modes of transportation, including bus, light rail, MARC train, contracted commuter bus or Metro service, the paratransit system is the only service to sustain double didgit growth in demand over the past seven years. Clearly paratransit is an essentila service for many persons with disabilities.

3.Outcome Indicators. PAIR staff review data related to paratransit on-time performance, telephone hold time, trip length and missed trips to monitor the outcome of the service. In addition, PAIR staff surveyed riders at a forum on paratransit services to learn of their concerns. While problems have been identified, there have also been positive interventions including:

i. For much of the year on time performance was at least 90%. During a service transition to a new contractor there were significant problems and on time performance fell. PAIR staff and the MTA Mobility Director spoke numerous times during this transition to share concerns and strategies. The on time performance eventually improved.

ii. MTA agreed to changes in the certification process including to schedule application appointments within seven days of a request and to provide provisional service if a determination is not made within 21 days of the request for an appointment when a complete application is submitted.

iii. MTA agreed that the individual performing portions of the eligibility assessment needed to have different credentials to perform the assessments and new staff were hired.

iv. MTA agreed to revisit its use of an assessment tool and agreed not to rely exclusively on the findings from such assessment.

v. MTA expanded its taxi program for dialysis patients to provide more direct service.

vi. MTA provided written notice to inform customers of the availabilty of accessible taxis as an alternative or complement to riders who use paratransit.

4. Collaboration. Pursuing the transportation priority requires collaboration with former class representatives, riders, and MTA. In addition, PAIR staff consult with community service providers who advocate for people with disabilities to learn more about problems in the paratransit system. PAIR staff have continued to work with several kidney dialysis centers to learn about service issues. PAIR staff also collaborated with the League for People with Disabilities in conducting a forum for riders to discuss their concerns and learn about their rights to paratransit service. The League for People with Disabilities is a large provider of rehabilitation services in Baltimore City. PAIR staff also receive individual service complaints from riders, forward them to MTA officials and review responses. This activity keeps PAIR staff in touch with paratransit riders in order to better address their needs. These communications with riders are not opened as case services and are not reflected in the case numbers submitted in this report.

5. Cases handled. PAIR staff submitted 12 written complaints to MTA from individual riders. These complaints are not opened as cases and are not refelcted in the case statistics presented in previous portions of this report. There were also 10 transportation cases handled under this priority. The focus of our transit activity was not individual complaints or cases, but to gather information from riders and to negotiate system issues with MTA officials. We had no class action activity.

6. Case example. PAIR staff investigated a rider’s concern about MTA’s Taxi Access program. Taxi Access is a program that provides limited taxi service for persons eligible for paratransit service. The Taxi program alleviates stress on the paratransit system and is cost effective for the MTA. It also provides a good service to riders as it is frequently faster and more reliable and is available as same day service, whereas paratransit requires 24 hour advanced booking for a shared ride. A rider contacted PAIR staff to report that she had become ill and ended up at a hospital where she was admitted for a few days. On the day her doctor authorized her discharge from the hospital she contaced Taxi Access. She was informed that because she used an electric wheelchair, she was required to book her rides 24 hours in advance. PAIR staff investigated and learned that persons who use wheelchairs were subject to different rules for the program than were persons who did not use wheelchairs. The policy applied regardless of the availability of accessible vehicles. PAIR staff reported this issue directly to the Director of Mobility who determined that the polciy needed to be immediately reversed.

c. Access to Community Serivces. 1. Priority. People with disabilities have a legal and civil right to equal access to community programs and to live in their communities. Nursing facility residents who wish to return to live in their communities are a particular priority of the PAIR program.

2. Need. Nationally, Medicaid is the primary payer for two-thirds of nursing facility residents, financing over 65% of nursing facility long term care costs. Serving persons with long term care needs through Medicaid funded community services will reduce health care expenditures, is consistent with the desires of individuals with disabilities, and is consistent with civil rights laws. Maryland’s percentage of expenditures on long term care institutional services remains well above the national averages. Although most individuals prefer to receive their long term services and supports in their own home rather than in nursing facilities, Maryland spends 85% of its long term care dollars on facility stays.

Despite state efforts, there has not been a significant shift from Medicaid long term care expenditures for nursing facilities to expenditures for persons receiving Medicaid funded in-home and community based services. Maryland ranks among the ten worst states comparing the ratio of institutional with community long term care dollars spent on older adults and persons with physical disabilities. Comparing the number of home and community based service participants per 1,000 persons among the states, Maryland ranks even worse. From 2004 — 2009, most states made progress towards less reliance on nursing facility care for older adults and persons with physical disabilities; however, Maryland lost ground. Maryland’s system of Medicaid services is not designed to keep people out of nursing facilities.

The 2010 and 2011 Kaiser Commission Annual Reports on Medicaid Programs demonstrate the relative inadequacy of Maryland’s personal care services. Of the thirty-three states opting to provide personal care services, Maryland’s rate appears to be the lowest. With one exception, the other states listed have an hourly rate ranging from $9.39 to $63 per hour with the average Medical Assistance Personal Care (MAPC) rate being $17.60 an hour. Maryland is listed as having a $33.98 per day rate and Louisiana has a rate of $214.87 per visit. With the one exception, Maryland appears to be the only state not to base personal care on hourly rates. Maryland needs to change the current system and establish an hourly rate sufficient to allow people with significant disabilities to remain at home or in their communities rather than a nursing facility or institution.

People in nursing facilities need to receive information and support for decisions to transition out of facilities and back home to their communities. Independent research corroborates that people in facilities want to live in their communities.

3. Outcome Indicators. Indicators of success include: i. Outreach to persons in nursing facilities to ensure that they learn about their right to use Medicaid funds for care in the community. The "Sunshine Folk", peer volunteer advocates recruited and trained by PAIR staff, provided outreach to 250 individuals in nursing facilities. ii. PAIR staff supported comments of an independent living center to make a state web site on long term support services and community options accessible to individuals with vision impairments and to comply with Section 508 of the Americans with Disabilities Act. The State has engaged a technical consultant and has promised improved accessibility in January, 2014. iii. PAIR staff provided technical assistance to the "Sunshine Folk" as they supported 30 individuals transition from nursing facilities to their own homes in the community. iv. PAIR staff trained individuals under contract with an Independent Living Center to provide peer outreach to nursing facility residents, a model based on the "Sunshine Folk" project. PAIR staff supported a change to the state’s peer outreach model contract so that mentorship from peers continues through the first year after the resident’s transition to the community. This change was adopted by the State. v. Maryland implemented a policy to expedite processing Medicaid long term care applications of nursing residents who had Medicaid in the community prior to entering the nursing facility. Eligibility for Medicaid long term care provides access to Medicaid waiver programs that allow nursing facility residents to transition back into their communities with more supports and services than is available under community Medicaid. vi. PAIR staff advocated for and obtained a regulatory change to ensure that nursing facility residents are permitted to have an advocate of their choice attend their plan of care meeting in the factility.

4. Collaboration. PAIR staff collaborated with the following organizations to increase community options for persons in nursing facilities: Legal Aid Bureau, Inc.; the Image Center; Friends and Family Ties-Shared Supports; The Coordinating Center; Maryland ADAPT; and the Department on Aging Statewide Long Term Care Ombudsman. PAIR staff is appointed to the Money Follows the Person Grant and Balanced Incentives Payment Program Stakeholder Group, and monitors the Community First Choice Development and Implementation Council and the Living at Home Waiver Advisory Committee. PAIR staff is appointed to the Medical Assistance Long Term Care Eligibility Task Force. PAIR staff participates on the Statewide Independent Living Council as a Governor-appointed member and works with the Centers for Independent Living to develop and monitor the State Plan for Independent Living.

5. PAIR staff worked on 5 cases for individuals in nursing facilities who wanted to leave the facility and move home to the community. PAIR staff also trained and provided technical assistance to the Sunshine Folk who assisted 20 individuals in transitioning from facilities to the community.

6. PAIR staff assisted a client who lived for three years in a nursing facility. She wanted to return to live in the community with her teenage son. When PAIR staff met her in the nursing facility, she explained that she had tried to apply for a Medicaid waiver program to get health care services at home, but she did not know what happened to her paperwork. PAIR staff investigated and requested that she receive services from a waiver case manager who processed needed paperwork. The client had obtained a bousing voucher to assist her in living in the community. However, she was not able to find accessible housing and after receiving two extensions of her voucher, she was told that it expired. PAIR staff intervened with the local housing office and aruged that she needed an accomodation as she was trying to find accessible housing. The client kept her voucher and ultimately obtained housing in the community

d) Education. 1. Priority. Increasing educational opportunities for students with disabilities by increasing their participation in school.

2.Need. Students with disabilities are disproportionately excluded from educational opportunities due to disciplinary actions of school systems, failure to provide appropriate services, and high drop out rates. PAIR staff collaborate with other MDLC staff to address these issues. Maryland has one of the highest rates of suspension or expulsion of students with disabilities in the country. Baltimore County was recently identified as one of the country’s "hot spots" by study conducted by the Civil Rights Project at UCLA. A quote from the executive summary of this report states: "Perhaps the most distrubing finding is that nationally, on average, 36% of all black male students with disabilities enrolled in middle schools and high schools were suspended at least once in 2009-2010." Other studies demonstrate the correlation between suspension and drop out rates and contact with the juvenile or criminal justice system. Given the high rate of unemployment among people with disabilities, and the high rate of persons with disabilities in our juvenile and criminal justice systems, MDLC has prioritized students with disabiltlies who are subject to suspension, expulsion and restraint or seclusion. The goal of PAIR staff is to obtain appropriate educational services that keep a child in school as opposed to interventions of a school system that exclude a student from educational opportunities.

3. Outcome Indicators. Indicators of success include: i. Students are provided with additional support services as necessary to obtain full educational opportunities; ii. Additional evaluations are undertaken by a school system to properly assess a student’s needs; iii. Compensatory services are provided to students who have been wrongfully excluded from school; iv. Use of seclusion is replaced with behavioral intervention plans that avoid loss of school time; v. Training on inclusion of students with disabilities and behavioral interventions provided to school districts; vi. Maryland State Department of Education (MSDE) promulgated a new draft revised the student code of conduct to provide more services and less exclusion from school for student misbehavior to regulate responses to students that result in high leves of suspension and exclusion from school.

4. Collaboration. PAIR staff collaborate with the State Department of Education; Maryland Coalition for Inclusive Education; American Civil Liberties Union; Office of the Public Defender; and City Wide, a coalition of over forty service providers in Baltimore City who have met for over a decade to increase educational opportunities to students with disabilities.

5. Sixteen cases were handled under this priority, none of them were class actions.

6. Case example. PAIR staff intervened in a case where a kindergarten child was not readmited to his school after a hospitalization. The student had been excluded from school on numerous occasssions, including by use of police action, but did not have an individual education plan or a behavioral intervention plan. PAIR staff worked to ensure such plans were appropriately provided for the student and the school system agreed to obtain outside training recommended by PAIR staff.

PAIR staff represented a student who was repeatedly placed in a seclusion room at school. PAIR staff reviewed the student’s records and convinced the school to obtain a neuropsychological evaluation of the child. The evaluation revealed undiagnosed learning disabilities in addition to the child’s previously detected attention deficit disorder. PAIR staff successfully argued for a more appropriate individualized education plan and obtained extra tutoring for the student, extended school year services and an assessment for assitive technology.

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. MDLC’s areas of advocacy for PAIR staff include access for persons with disabilities to: affordable and accessible housing; reliable transportation; community services, especially for residents in nursing facilities and; education.

2. The need addressed by each priority is stated separately in Part V. A. 2. above.

3. Activities to implement the priorities include the following: a. Access to Affordable and Accessible Housing: i. Continue to monitor implementation of the federal court Consent Decree in Bailey et al. v. Housing Authority of Baltimore City (HABC). The lawsuit alleged that HABC discriminated against people with disabilities by refusing to allow them to live in certain housing, make public housing accessible, and provide reasonable accommodations. Current emphasis is on negotiations to obtain the Decree remedies to: create project based and long term affordable housing opportunities for non-elderly persons with disabilities, provide timely accommodations, and develop accessible housing. ii. Individual case representation on issues relating to alleged discrimination in housing programs which prevent access to affordable or accessible housing. iii. Resolution of conciliation process through the HUD administrative Complaint to obtain creation of accessible affordable housing in Baltimore County, Maryland. Continue legal research and advocacy to urge development of a plan to create accessible and affordable rental units for individuals using vouchers. Advocacte for a fund to provide modifications for extremely low income tenants who need accessible features added to their homes so they may safely use their bathrooms, kitchens, exit and entry ways. Negotiate obtain other reforms to the voucher program to include: an assessment of people needing accessible units, changes to the County housing application, and creation of a program to help voucher holders use the voucher to lease units in areas of opportunity. iv. Collaboration with Independence Now, an Independent Living Center to identify need for accessibile housing in the Prince George’s County Housing Authority’s public housing and voucher program. v. Provide outreach and education on the Maryland Accessibility Code to increase understanding of its provisions and protections for persons with disabilities. vi. Engage in oral argument in Hill v. Hampstead before the 4th Circuit Court of Appeals.

b. Access to Reliable Transportation: i. Formalize and expand the role of PAIR clients who have been active in meeting with Maryland Transit Administration officials, into a consumer advocate group to focus on transportation for persons with disabilities; ii. Communicate with state and federal officials regarding the significance of transit services for persons with disabilities; iii. Establish regular meetings with the new Maryland Transit Administration management to include provision of data; iv. PAIR staff will provide legal education and technical assistance to the consumer group and support its organizational development, strategic action planning, and outreach to state agencies responsible for the provision of transportation in Baltimore; iv. Identify and affect changes to the Maryland Transit Administration’s paratransit services, including due process protections for riders and protections for applicants for service. v. Identify changes needed in the Public Service Commission’s (PSC) taxicab regulatory policies, which currently require taxis to be "a four door sedan type" vehicle, which are not accessible for persons who use wheelchairs. Negotiate with the PSC for regulatory changes to increase accessible taxis, particularly in Baltimore County as there are no accessible taxis in that jurisdiction. vi. Receive complaints related to transit services for persons with disabilities in order to share service issues with state officials and the consumer advocate group to assist with focusing on service improvements. vii. Obtain external resources to enable PAIR staff to provide more focus on transit issues in the next fiscal year.

c. Access to Community Based Services: i. Support the "Sunshine Folk" volunteer peer mentors who provide information to nursing facility residents about health care options and rights. ii. Provide legal support to assist a limited number of individuals in nursing facilities transition into the community. iii. Collaborate with consumers and other legal service providers to successfully advocate for expanded community options for Medicaid community services, including nursing services and increased cost limits to allow persons with more complex needs access to community services. iv. Develop a brochure for nursing facility residents describing the experiences of individuals who have transitioned from facilities to their communities and providing resources and contact information.

d. Access to Educational Opportunities: i. Produce a manual on the educational rights of students with disabilities as required by Section 504 of the Rehabilitation Act. The manual was drafted, but not finalized this past fiscal year. The manual will be a resource for families, advocates and educational personnel and will provide a needed tool for better understanding and implementing the rights of students with disabilities. ii. Provide case services to students with disabilities to reduce their exclusion from school or to reduce the use of restraint or seclusion as disciplinary reactions by a school system. iii. Provide case services to secure the rights of students with disabilities to full inclusion in school based athletic activities.

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 Source of Funding Amount Received Amount Spent Federal (section 509) 265,193 200,756 State 0 0 Program income 39,527 39,527 Private 0 0 All other funds 0 0 Total (from all sources) 304,720 240,283

B. Budget for the fiscal year covered by the report: Prior Fiscal Year (FY 2013) Current Fiscal Year (FY 2014) Wages/ salaries 166,702 192,105 Fringe benefits 43,771 48,809 Materials Supplies 1,748 1,669 Postage 240 805 Telephone 1,589 3,820 Rent & occupancy costs 8,575 29,017 Stipends 0 2,500 Travel 2,324 3,180 Printing & copying 784 317 Bonding/insurance 1,825 2,728 Equipment & maintenance 746 1,666 Audit 1,575 2,422 Expert fees 1,781 4,000 IT consultant & licensing 4,761 9,844 Payroll processing 428 1,640 Library/subscriptions/reference 333 1,403 Dues 2,229 2,012 Cost of Records 45 500 Training 826 4,000 TOTAL 240,282 312,437

C. Description of PAIR Staff Type of Position FTE % of Year Filled Person-years Professional Full-time 1.71 100 1.71 Part-time .06 100 .06 Vacant 0 0 0 Clerical Full-time .26 100 .26 Part-time 0 0 0 Vacant 0 0 0

PAIR duties for attorney staff include providing individual case representation; outreach and training; public policy work; supervision of paralegal staff; professional development; working with client based coalitions; and class action litigation as applicable. PAIR duties for paralegal staff include intake screening and follow up; provision of information and referral services; outreach; individual case work assistance; following supervision of attorney; professional development; support for projects such as nursing facility "Sunshine Folk".

D.Involvement with Advisory Boards.

PAIR staff is appointed to the Money Follows the Person Grant and Balanced Incentives Payment Program Stakeholder Group.

PAIR staff serves on the Department of Health and Mental Hygiene, Medicaid Long Term Care Eligibility Task Force.

PAIR staff serves by Gubanatorial appointment as a Commissioner for the Department of Disabilities Advisory Commission.

PAIR staff participates on the Statewide Independent Living Council as a Governor-appointed member and works with the Centers for Independent Living to develop and monitor the State Plan for Independent Living.

PAIR staff is on the National Low Income Housing Advisory Committee.

PAIR staff serves on the Department of Disabilities Housing Task Force.

PAIR staff is a member of the Statewide Long Term Care Ombudsman Stakeholder’s Committee.

E. Grievances filed: None.

F. Coordination with the Client Assistance Program (CAP) and the State long-term care program. MDLC has a long-standing relationship wiht the Client Assistance Program and will routinely make appropriate referrals to that office. PAIR staff also serves alongside the Director of the CAP program on the Board of the Statewide Independent Living Council, which enhances the collaboration between the programs. PAIR staff have a close relationship with the State and local Ombudsman programs.

Certification

Signed?Yes
Signed ByLauren Young
TitleDirector of Litigation
Signed Date12/29/2013