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

Alabama (UNIV OF ALABAMA ALABAMA - DISAB ADVOCACY PROGRAM) - H240A140001 - FY2014

General Information

Designated Agency Identification

NameAlabama Disabilities Advocacy Program
AddressBox 870395
Address Line 2
CityTuscaloosa
StateAlabama
Zip Code35487
E-mail Addressadap@adap.ua.edu
Website Addresshttp://www.adap.net
Phone205-348-4928
TTY 205-348-4928
Toll-free Phone800-826-1675
Toll-free TTY800-826-1675
Fax205-348-3909
Name of P&A Executive DirectorJames A. Tucker
Name of PAIR Director/CoordinatorJames A. Tucker
Person to contact regarding reportRosemary Beck
Contact Person phone205-348-7542
Ext.

Part I. Non-Case Services

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

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas145
2. Individuals receiving I&R outside PAIR priority areas149
3. Total individuals receiving I&R (lines A1 + A2)294

B. Training Activities

1. Number of trainings presented by PAIR staff43
2. Number of individuals who attended training (approximate)1,870

1. Name of Training: Head Start Disability Coordinators Training Topics Covered: Obligations of the Head Start agencies to meet the disability related needs of youth in their care, including issues related to non-discrimination, eligibility for special education services, and development of appropriate service plans Training Method: Q & A, PowerPoint, Lecture Purpose of Training: To provide education to the Head Start disability coordinators about the disability-related rights of youth in their care. Number attending training: 48

2. Name of Training: "My Client’s Been Suspended from School…What’s My Next Step?" Topics Covered: A presentation on IDEA’s discipline regulations to the Alabama Association of community Mental Health Boards (ACCMHB) and what to do if their clients are suspended or expelled from school and how to advocate for appropriate behavior planning to decrease the chance of misconduct. Training Method: Q & A, PowerPoint, Lecture Purpose of Training: To train case workers, therapists and other professionals associated with the ACCMHB to understand how federal and state law require schools to proactively address a child’s behavior problems, learn how to respond when their clients are subjected to school disciplinary actions, and learn how to ensure provision of school services during any disciplinary actions. Number attending training: 49

3. Name of Training: Alabama Foster and Adoptive Parent Association Annual State Conference Topics Covered: How the IEP and ISP process can assist youth transitioning to further education or employment. Training Method: Q & A, Panel Discussion, PowerPoint, Lecture Purpose of Training: To provide training to the AFAPA on the Individualized Education Process (IEP) and Individualized Service Plan (ISP) process to stakeholders of foster children, youth, and adults who are foster children, adopted children, or biological children. Number attending training: 90

4. Name of Training: Transition Training- Andalusia Topics Covered: Transitioning youth from school to post-high school education, work, and independent living. Training Method: Q & A, PowerPoint, Lecture Purpose of Training: To educate Children’s Rehabilitation and parents regarding transition. Number attending training: 35

5. Name of Training: “Special Education is More than ‘Reading, ’Riting, and ‘Rithmetic” Topics Covered: How to advocate for the special education needs of students with disabilities so they are successful in school. This training introduced the basics of federal and state special education law and provided participants with a road map for how to handle special educational concerns and conflicts. Training Method: Q & A, PowerPoint, Lecture Purpose of Training: To educate case workers, therapists and other professionals to advocate for the special education needs of students so that they are successful in school. Number attending training: 43

6. Name of Training: Shelby County Department of Human Resources (DHR) Overview of Transition Topics Covered: An overview of the P&A including its purpose and founding and information on the types of advocacy services it provides to children in DHR care, particularly those services for children transitioning out of foster care as young adults. Training Method: Q & A, Lecture, PowerPoint Purpose of Training: To provide DHR social workers with information on the types of advocacy services ADAP provides for transition age youth. Number attending training: 75

7. Name of Training: Raising the Standards Conference Topics Covered: A training program on the student harassment act in Alabama, identifying the potential of bullying issues for your child, addressing bullying within the IEP, and implementing a peer advocacy program. Training Method: PowerPoint Purpose of Training: To provide parents and teachers with the tools to deal with bullying in the school context. Number attending training: 200

8. Name of Training: Bully Webinar Topics Covered: A training program addressing Bullying of those with disabilities and ideas to combat. Training Method: PowerPoint, Q & A Purpose of Training: To provide skills to the Alabama Parent Education Center regarding bullying and how to fight the battle. Number attending training: 25

9. Name of Training: Butler - Choctaw County Senior Center Topics Covered: An overview of the P&A and the services it provides. Training Method: Q & A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 15

10. Name of Training: Camden Senior Center Topics Covered: An overview of the P&A and the services it provides. Training Method: Q & A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 20

11. Name of Training: Blount County Parent Support Group Topics Covered: The IEP process Training Method: Q & A, PowerPoint, Lecture Purpose of Training: To provide parents with advocacy resources to address their concerns with the IEP process. Number attending training: 3

12. Name of Training: Dothan — Children’s Rehabilitation Services (CRS) Staff Training Topics Covered: Special education rights Training Method: PowerPoint, Lecture, Q & A Purpose of Training: To provide CRS staff with advocacy resources to better serve their clients. Number attending training: 12

13. Name of Training: First Presbyterian Preschool Training Topics Covered: Section 504, IDEA, eligibility, and service plans Training Method: Lecture, PowerPoint Presentation, Q&A Purpose of Training: To provide teachers and staff with information to enhance communication and working relationships with parents of children with disabilities that attend the preschool. Number attending training: 40

14. Name of Training: SPED & Transition — Huntsville Children’s Rehabilitation Services (CRS) Topics Covered: Youth transitioning to work Training Method: Q&A, PowerPoint, Lecture Purpose of Training: To educate CRS parent group on transition issues Number attending training: 50

15. Name of Training: SPED & Transition Huntsville Foster Parents Topics Covered: Youth transitioning to work Training Method: Q&A, PowerPoint, Lecture Purpose of Training: To educate foster parents regarding transition services available to youth Number attending training: 30

16. Name of Training: Community College Human Resources (HR) Diversity Conference Topics Covered: The rights of persons with disabilities to be free from discrimination in employment and in accessing higher education. Training Method: Q&A, PowerPoint Purpose of Training: To educate HR staff on the rights of persons with disabilities under ADA. Number attending training: 75

17. Name of Training: COSEPTA Transition Training Topics Covered: Special education rights and advocacy related to transition Training Method: Q&A. PowerPoint, Lecture Purpose of Training: To educate and empower the Community Outreach Special Education Parent Teacher Association (COSEPTA) to advocate effectively for their children’s special education rights, especially as related to transition, the state’s new diploma scheme and adult services. Number attending training: 32

18. Name of Training: Medicaid Waivers CRS Mobile Topics Covered: Medicaid waivers, choice, ADA, and transition Training Method: Q&A, PowerPoint Purpose of Training: To provide information on the rights of persons with disabilities to choice of living in the community, decision making, access to government programs, and preparing older youth for transition. Number attending training: 30

19. Name of Training: Disability Rights and Resources Mock IEP Topics Covered: Self advocacy Training Method: Q&A, Panel Discussion, PowerPoint, Lecture Purpose of Training: To train parents so they can effectively advocate for their children’s special education needs in IEPs. Number attending training: 18

20. Name of Training: Empowerment: Tools for Self Advocates Topics Covered: IEPs, 504 plans, assistive technology Training Method: Q&A, PowerPoint, Lecture Purpose of Training: To inform and empower parents to advocate on behalf of their children. Number attending training: 17

21. Name of Training: Florence: Preparing for Independence Topics Covered: Transition workshop for parents Training Method: Q&A, PowerPoint Purpose of Training: Empower parents to be effective advocates for their transition-aged children so the children are prepared for independent living, work, and further schooling. Number attending training: 26

22. Name of Training: Full Life Ahead — Medicaid Topics Covered: Medicaid, waivers, guardianships, and special needs trusts Training Method: Q&A, PowerPoint Purpose of Training: To provide information at the Full Life Ahead 2014 Retreat on Alabama’s Medicaid system, including waivers and other eligibility issues. Number attending training: 30

23. Name of Training: Gee’s Bend Senior Center Wilcox County Topics Covered: An overview of the P&A and the services it provides. Training Method: Q&A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 20

24. Name of Training: Gilbertown Senior Center Butler/Choctaw Counties Topics Covered: An overview of the P&A and the services it provides. Training Method: Q&A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 15

25. Name of Training: Huntsville: Preparing for Independence Topics Covered: Transition workshop for parents Training Method: Q&A, PowerPoint Purpose of Training: To educate parents to effectively advocate for the transition needs of their children at IEP meetings; understand the state’s new diploma scheme; and how to use SSA work supports, and Medicaid Home and Community Based waivers. Number attending training: 31

26. Name of Training: Jacksonville: Preparing for Independence Topics Covered: Transition training workshop for parents Training Method: Q&A Purpose of Training: To empower parents to be effective advocates for their transition-aged children so the children are prepared for independent living, work, and further schooling. Number attending training: 24

27. Name of Training: Jefferson /Blount /St. Clair Mental Health Topics Covered: 504 and behavioral plans Training Method: Q&A, Lecture Purpose of Training: To provide skills for advocacy on behalf of children with disabilities. Number attending training: 20

28. Name of Training: Jefferson County — Head Start Topics Covered: Special education, early intervention, eligibility, and IEPs Training Method: Q&A, PowerPoint, Lecture Purpose of Training: Ensure that children with disabilities receive appropriate services by educating Head Start and Early Start home child care providers. Number attending training: 32

29. Name of Training: Lisman Senior Center Topics Covered: An overview of the P&A and the services it provides. Training Method: Q&A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 15

30. Name of Training: Mobile Volunteer Lawyers Topics Covered: The basics of Title III of the Americans with Disabilities Act and how to identify access issues. Training Method: Panel Discussion, Q&A, Lecture Purpose of Training: To encourage lawyers to represent persons with disabilities who experience discrimination by Title III entities. Number attending training: 20

31. Name of Training: Montgomery County Juvenile Detention Center ADA Training Topics Covered: Disability rights training, anti-discrimination provisions of the ADA, Section 504 and the IDEA. Training Method: Q&A, PowerPoint Purpose of Training: To educate the Montgomery County Juvenile Detention Center that youth with disabilities are over-represented in the juvenile justice system and understand the anti-discrimination provisions of the ADA, Section 504 and the IDEA to help ensure that the rights of detained youth are protected. Number attending training: 14

32. Name of Training: Pine Apple Senior Center Topics Covered: An overview of the P&A and the services it provides. Training Method: Q&A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 20

33. Name of Training: Poverty Law Class - University of Alabama Topics Covered: Public interest and pro bono issues, systemic advocacy and reform including foster care and mental health issues. Training Method: Q&A, Lecture Purpose of Training: To train law students regarding public interest and pro bono practice, especially focused on P&A’s work in systemic advocacy. Number attending training: 45

34. Name of Training: Risk Management Class — University of Alabama Topics Covered: Title II & III of the Americans with Disabilities Act Training Method: Q&A, Lecture Purpose of Training: To educate college students who want to be event/meeting planners on Titles II & III of the Americans with Disabilities Act. Number attending training: 24

35. Name of Training: Juvenile Probation Officers (JPOs) Topics Covered: Special education rights of children with disabilities in school Training Method: Q&A, PowerPoint, Lecture Purpose of Training: To empower JPOs regarding the rights of children with disabilities so JPOs can be effective advocates for their clients’ needs. Number attending training: 13

36. Name of Training: Tuscaloosa: Preparing for Independence Topics Covered: Transition training workshop for parents Training Method: Q&A Purpose of Training: To empower parents to be effective advocates for their transition-aged children so the children are prepared for independent living, work, and further schooling. Number attending training: 13

37. Name of Training: Clinical Child Psychology Seminar — University of Alabama Topics Covered: Special education rights and advocacy, emphasizing eligibility, LRE issues, and disciplinary protections. Training Method: Q&A, Lecture Purpose of Training: To provide future child psychologists with an understanding of the role they can play in ensuring their patients’ access to special education services by training them on matters related to special education eligibility, placement issues, transition services, and disciplinary protections. Number attending training: 11

38. Name of Training/Outreach: White Cane Walk Topics Covered: A variety of legal issues within this consumer group Training Method: exhibit, Q&A Purpose of Training: To raise awareness of ADAP as a partner, protector, and advocate for the blind Number attending training: 38

39. Name of Training/Outreach: Pine Hill Senior Center Topics Covered: An overview of the P&A and the services it provides. Training Method: Q&A Purpose of Training: To educate seniors about the P&A and its services. Number attending training: 20

40. Name of Training/Outreach: People First Conference Topics Covered: Self-advocacy Training Method: Lecture, Panel Discussion, PowerPoint, Q&A Purpose of Training: How to self-advocate effectively to communicate your interests, needs, rights Number attending training: 200

41. Name of Training/Outreach: Black belt Outreach/Training Topics Covered: Self-advocacy awareness Training Method: Q&A Purpose of Training: To provide self-advocacy techniques and skills Number attending training: 30

42. Name of Training/Outreach: CRS Jackson County Orthopedic Clinic Outreach/Training Topics Covered: Self-advocacy awareness Training Method: Exhibit Purpose of Training: To increase awareness of the P&A and it’s services Number attending training: 40

43. Name of Training/Outreach Topics Covered: Self-advocacy Training Method: Training Publication Purpose of Training: To educate on how to use the computer to connect with other assist in finding information themselves in order to self-advocate Number attending training: 300

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff0
2. Newspaper/magazine/journal articles0
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website23,250
5. Publications/booklets/brochures disseminated39
6. Other (specify separately)1

Narrative

C.5.a: Number of individuals/entities to who all items in C.5. were distributed - 3139

C.6. Other

Newspaper Articles Mentioning ADAP - 11 1. Alabama Disabilities Advocacy Program Names James Tucker Executive Director 2. Advocacy Groups Sue Alabama Over Inadequate Prison Medical Care 3. Southern Poverty Law Center Sues Alabama Department of Corrections Over Inmate Healthcare 4. Disabled Veterans Lose Funds From Unpublicized Benefits 5. Young, Disabled and Stuck in a Nursing Home for the Elderly 6. The Human Rights We Stand to Lose From A Tory Government: The Institute of Employment Rights 7. Cruel Confinement in Alabama Prisons 8. SPLC Sues State of Alabama Over Prison Conditions 9. SPLC Files Federal Lawsuit Over Inadequate Medical, Mental Health Care in Alabama 10. Poor Healthcare in Alabama Prisons Contributed to Deaths 11. Report Details Medical Neglect in Alabama Prisons

Newsletters Produced by Agency Staff for Distribution to ADAP Mailing List - 14 1. ADAP Public Meeting 2. ADAP Proposed Priorities FY 15-17 3. Special Education in Alabama: A Right Not a Favor 4. Disability Civil Rights Agency Opening in Selma: Free Legal Services to Protect Persons with Disabilities 5. ADAP Appoints a New Executive Director 6. ADAP Demands End to Segregated Subminimum Wage Workshop 7. Extended Medicaid Eligibility to Age 26 for Former Foster Care Youth 8. Children and Youth with Special Health Care Needs 9. End of Life Planning Workshop 10. Special Education for 18-21 Year Old Students: An Update on Their Right to Attend School 11. Guardianship is Always the Last Resort 12. Is Your Child Going to Lose His Right to Special Education Services after Age 18? 13. IEP Transition Training: Just in Time for Spring IEP Season! 14. Medicaid Managed Care

Social Media Posts - 5 1. ADAP Public Meeting 2. ADAP Proposed Priorities FY 15-17 3. VIP Group Works to Empower 4. ADAP Annual Survey 5. Disability Civil Rights Agency Opening in Selma: Free Legal Services to Protect Persons with Disabilities

Part II. Individuals Served

A. Individuals Served

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

1. Individuals still served as of October 1 (carryover from prior FY)30
2. Additional individuals served during the year41
3. Total individuals served (lines A1 + A2)71
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)5

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 34

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility14
2. Employment2
3. Program access8
4. Housing6
5. Government benefits/services3
6. Transportation0
7. Education18
8. Assistive technology2
9. Voting0
10. Health care11
11. Insurance2
12. Non-government services1
13. Privacy rights0
14. Access to records1
15. Abuse0
16. Neglect7
17. Other1

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor20
2. Other representation found1
3. Individual withdrew complaint5
4. Appeals unsuccessful1
5. PAIR Services not needed due to individual's death, relocation etc.3
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit9
9. Other0

Please explain

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy3
2. Short-term assistance25
3. Investigation/monitoring5
4. Negotiation4
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)2
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 - 42
2. 5 - 2215
3. 23 - 5935
4. 60 - 648
5. 65 and over11

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females30
2. Males41

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American24
5. Native Hawaiian or Other Pacific Islander1
6. White45
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent19
2. Parental or other family home27
3. Community residential home1
4. Foster care0
5. Nursing home4
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center19
9. Homeless0
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 impairment6
2. Deaf/hard of hearing8
3. Deaf-blind0
4. Orthopedic impairment9
5. Mental illness0
6. Substance abuse0
7. Mental retardation0
8. Learning disability2
9. Neurological impairment15
10. Respiratory impairment5
11. Heart/other circulatory impairment5
12. Muscular/skeletal impairment7
13. Speech impairment1
14. AIDS/HIV0
15. Traumatic brain injury0
16. Other disability13

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities4

2. Number of individuals potentially impacted by policy changes339,500

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

1. Policy/Practice Change: Alabama’s Governor and Medicaid Advisory Commission determined to reform Medicaid by improving financial stability and patient care during FY14. Ultimately, the decision was to reform through Alabama-based regional care organizations (RCOs) instead of through traditional managed care. Alabama Medicaid Agency services will be delivered through a new state-specific quasi-managed care system. How Change Benefits: Alabamians with disabilities who become eligible for Medicaid benefits can properly plan for future and needed services if they know their Medicaid eligibility status at the time of application and how to obtain needed services. This policy change will be launched into practice in FY16. Individuals Impacted: 120000 Example of Impact: The P&A worked with our advisory councils and other advocates in the state to monitor the work of various legislative and executive committees addressing the coming of managed care to Medicaid in our state and to advocate for the best possible version of Medicaid managed care.

2. Policy/Practice Change: The P&A provided guidance to state policymakers on a bill — eventually adopted into law - that would allow trained school personnel to provide diabetes care to students. This law was enacted shortly after the U.S. Department of Justice (DOJ) concluded a comprehensive statewide investigation of several Alabama school districts and state agencies, and determined that the state and its districts discriminate against students with diabetes, in violation of the Americans with Disabilities Act. How Change Benefits: With the new changes to how diabetes is handled in schools, children with diabetes will be treated as their non-disabled peers, especially as related to what school they can attend. Individuals Impacted: 194500 Example of Impact: The P&A provided guidance to state policymakers on a bill — eventually adopted into law - that would allow trained school personnel to provide diabetes care to students, including the administration of insulin and glucagon. Under prior state law, such injectable medications were only able to be administered by a school nurse, which had the effect of segregating students with diabetes in district schools where nurses were present, removing these students from their home schools. This law was enacted shortly after the U.S. Department of Justice (DOJ) concluded a comprehensive statewide investigation of several Alabama school districts and state agencies, and determined that the state and its districts discriminate against students with diabetes, in violation of the Americans with Disabilities Act.

3. Policy/Practice Change: No Order of Selection Policy had been written until after the P&A raised concerns. An Order of Selection has now been written and the criteria for selection in the event an Order of Selection is needed are the number of impairments. No area of disability will be preferred over another. How Change Benefits: Persons with disabilities will be provided Vocational Rehabilitation (VR) services to gain competitive employment especially to those individuals with the needs for more intensive services from VR. Individuals Impacted: 24000 Example of Impact: The P&A participates on the State Interagency Transition Team to provide input on school and employment issues. The Transition Team assists in the planning of goals for services, training, and outcomes for youth who are PAIR eligible. The transition team also assists in developing the state’s strategic transition plan. Goals for using existing data to drive policy recommendations have been adopted for the 2015 strategic plan. There are many youth in the state who would qualify for the P&A’s PAIR services being served by agencies on the state interagency transition team including the Department of Children’s Rehabilitation for youth with orthopedic impairments.

4. Policy/Practice Change: The Alabama State Department of Education (ALSDE) enacted regulations governing the state’s authority over treatment centers. How Change Benefits: The P&A will continue to push for the state to adopt appropriate policies to ensure that monitoring and oversight is provided as needed to ensure FAPE. As enacted, the regulations didn’t go far enough in that they didn’t address the P&A’s primary concern about oversight of special education services in the schools. Individuals Impacted: 2000 Example of Impact: The ALSDE enacted regulations governing the state’s authority over treatment centers but left two issues un-addressed: 1) who is responsible for ensuring the provision of a free appropriate public education (FAPE) for students enrolled at these facilities and 2) the SDE’s monitoring mechanism at these facilities. To ensure that FAPE is delivered to youth with disabilities attending these programs, the P&A will continue to provide input to the SDE regarding these matters. The P&A’s treatment center monitoring revealed common problems in the delivery of FAPE to students with disabilities which the P&A is addressing with the SDE: 1. Inappropriately shortened school days. 2. Child Find responsibilities are neglected. 3. Teachers don’t provide direct instruction; students are given packets of work to complete. 4. Instruction is not modified to meet individual needs. 5. The facilities’ behavioral levels programs carry over into school; individual behavior invention plans (BIP) developed by an IEP team are non-existent or, if created, are not implemented. 6. Students move around so much they fall woefully behind in school 7. Some students encouraged to quit school and seek a GED when realistically a GED is not attainable given the students’ disabilities.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts10,000
2. Number of individuals named in class actions0

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

Description of Litigation: The P&A, in conjunction with the Southern Poverty Law Center, filed suit in the Federal District Court of the State of Alabama against the Alabama Department of Correction(ADOC), the Commissioner, and the Associate Commissioner in charge of health care, alleging that the State of Alabama is illegally and unconstitutionally failing to provide appropriate medical and psychiatric care, along with violating the Americans with Disabilities Act (ADA)and section 504 of the Rehabilitation Act of 1973. How Change Benefits:The suit seeks injunctive relief requiring the State of Alabama appropriately care for individuals within their care. Example of Impact: The ADOC currently houses approximately 26,000 inmates in their facilities. They are currently running at approximately 190% of their designed capacity, making them the most overcrowded prison system in the entire United States. Compounding this astounding overcrowding issue is the fact that Alabama spending on prisoners is almost dead last on a per prisoner basis. The currently filed lawsuit seeks to require appropriate care mechanisms and support structures for inmates, including inmates with disabilities. The level of staffing is well below even the original request for services posted by ADOC for bid which it deemed the least amount necessary. As to medical care, Alabama spends nearly the least on medical care per inmate in the nation. As a result, the P&A has received, and has documented numerous failures in medical care in the ADOC resulting in death, serious impairment, loss of limbs, and other catastrophic failures. Finally, despite the requirement of the ADA, Alabama only currently has one of its seventeen major facilities ADA compliant. The P&A has uncovered shocking non-adherence to the requirements of the ADA from architectural deficiencies to a complete lack of program access. For instance, deaf individuals are not provided access to a sign language interpreter. Without a sign language interpreter, they cannot attend GED classes, a prerequisite for vocational classes. The lawsuit filed seeks at address each of these deficiencies in the ADOC.

Part V. PAIR'S Priorities and Objectives

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

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

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

1. Priority: Individuals with disabilities, residing in institutions, will be safe from abuse, neglect, and disability rights violations. 2. Identify need: The need for individuals residing in institutions to be free from abuse, neglect, and disability rights violations. 3. Describe indicators: a. Provide information to the Long-Term Care Ombudsman about the services ADAP provides, including advocacy for appropriate community placement. b. Advocate for the implementation of the Alabama Community Transition (ACT) and ACT II waiver. 4. Collaboration: a. Southern Poverty Law Center — co-counsel b. Alabama Medicaid Agency — P&A is serving on its Money Follows the Person Advisory Committee 5. Number of cases: No cases were proposed for this priority 6. Summary: The P&A served on the advisory committee to the state Medicaid Agency’s Money Follows the Person (MFP) grant. Through our work, we and other advocates urged the state Medicaid Agency to use the MFP grant to support more individuals with disabilities to move from restrictive settings such as nursing homes to more integrated community settings.

1. Priority: Individuals with disabilities will be able to exercise freedom of choice. 2. Identify need: The need for individuals with disabilities to be able to exercise freedom of choice. 3. Describe indicators: a. Provide individual advocacy services to individuals with disabilities in situations where their freedom of choice is threatened. b. Provide education/training on the right to freedom of choice for persons with disabilities. c. Monitor the Regional Care Organizations (RCO) established by Alabama Medicaid to ensure persons with disabilities receive appropriate medical care. 4. Collaboration: a. Children’s Rehabilitation Services office — co- presenters. b. People First of Alabama, Ability Alliance, Tri-County Agency on Developmental Disabilities, Self-Advocates Becoming Empowered (SABE), Governor’s Office on Disabilities (GOOD) — Collaboration with these agencies was combined to create a printed program and an interactive document which is located on each agency’s website and social media. 5. Number of cases: 13 Cases / 45 I&R’s 6. Summary: PM experienced a stroke and partial paralysis. The P&A represented PM in a Probate Court proceeding in which PM was subject to a guardianship and wanted her guardian removed and replaced with a different family member. Before the P&A intervened, PM’s guardian (her brother) tried to prevent PM’s daughter from seeing PM and refused to allow PM to go to lunch with friends. After the P&A filed a petition to have the guardian removed, the guardian sought to resign. The Court granted the relief, and removed and replaced the guardian with the family member chosen by PM.

1. Priority: Individuals with disabilities will be able to exercise their rights to access state and local government services and places of public accommodation. 2. Identify need: The need for individuals with disabilities to be able to exercise their right to access state and local government services and places of public accommodation. 3. Describe indicators: a. Provide individual advocacy services to individuals with disabilities who have been denied access under Titles II and/or III of the Americans with Disabilities Act (ADA). b. Provide education/training on the rights of persons with disabilities under Titles II and III of the ADA. c. Improve access for persons with disabilities to a specific public accommodation and/or state/local government service. d. Monitor a municipality for accessibility, including sidewalks, city buildings, and other municipal-operated structures. 4. Collaboration: a. US Attorney for the Southern District of Alabama — co-presenter b. Southern Poverty Law Center — co-counsel 5. Number of cases: 19 Cases / 33 I&R’s 6. Summary: A P&A client who is deaf asked a national organization that was presenting a two-day training session to provide an interpreter for the client. After the organization refused, the P&A communicated with the organization to clarify that under Title III of the ADA the organization was required to provide effective communication such as an interpreter service, and that the organization was obligated to pay for such services. Through the P&A’s advocacy, the client received sign language interpretive services for the two-day conference, paid for by the presenter. The client wrote the P&A to say: “I’ve learned a lot through this process and I’m truly thankful for agencies like ADAP!”

1. Priority: Persons with disabilities will have access to Medicaid waiver services. 2. Identify need: The need for persons with disabilities to have access to Medicaid waiver services. 3. Describe indicators: a. Provide individual advocacy services to individuals with disabilities who need or are at risk of losing Medicaid waiver or other community services. b. Advocate for Alabama’s Department of Mental Health to expand waiver services provided to persons with developmental disabilities. c. Provide education/training on Medicaid waiver services. d. Advocate for an eligibility determination at the time an individual applies for Medicaid waiver. e. Advocate for persons with disabilities to receive appropriate Medicaid services under Alabama’s new managed care systems. 4. Collaboration: a. Disabilities Leadership Coalition of Alabama (DLCA) Alabama Arise — collaborate to advocate for the needs of persons with disabilities who will be served by the Alabama Medicaid Agency and its new managed care system. 5. Number of cases: 3 Cases / 5 I&R’s 6. Summary: Where the P&A client, PJ, had a stroke and dementia and needed increased care, PJ’s husband asked the P&A to assist when the state Medicaid Agency decided PJ did not qualify for benefits. The P&A contacted the Area Agency on Aging and Medicaid, and advised PJ’s husband how to apply for Medicaid so PJ could obtain needed services. PJ was made eligible for Medicaid benefits and placed in a nursing home as desired.

1. Priority: Eligible students with disabilities will be identified for services and educated in their least restrictive environment with appropriate support. 2. Identify need: The need for students with disabilities to be educated in their least restrictive environment with appropriate support. 3. Describe indicators: a. Provide individual advocacy services to students with disabilities to ensure the provision of a free, appropriate public education (FAPE) in the least restrictive environment with appropriate support. b. Provide education/training on special education rights and advocacy skills of youth with disabilities. c. Monitor the Alabama State Department of Education’s (ALSDE) exercise of its supervisory authority to ensure that public agencies comply with state and federal special education laws. d. Produce a series of webinars in collaboration with the Alabama Parent Education Center (APEC) on matters related to special education. 4. Collaboration: a. Disability Rights and Resources — Planned and implemented a mock IEP b. Alabama Parent Education Center (APEC) — Collaborated to develop joint trainings 5. Number of cases: 10 Cases / 73 I&R’s 6. Summary: The P&A filed a complaint with the U.S. Department of Education, Office for Civil Rights, alleging discrimination by a public school system regarding a high school student who was diagnosed with Hodgkin’s Lymphoma. The complaint alleges the system violated Section 504 of the Rehabilitation Act and Title II of the ADA by failing to identify and evaluate the student as one with a disability and provide her with a free appropriate public education. Despite having been advised of the student’s diagnosis and the substantial limitations it places on numerous major life activities, the system failed to provide the student a free appropriate public education, through homebound instruction individualized in scope, frequency and duration to her needs and instructed by a qualified professional. As a result of the system’s failure, the student was denied access to the benefits of the services, programs and activities of the system. OCR has accepted the complaint for investigation.

1. Priority: Youth with disabilities will have effective school and community-based transition services to ensure successful movement from school to post-high school education, work and independent living. 2. Identify need: The need for youth with disabilities to have effective school and community-based transition services to ensure successful movement from school to post-high school education, work and independent living. 3. Describe indicators: a. Identify and provide policy recommendations regarding barriers in the provision of vocational rehabilitation services, school-based transition services, employments services and other support services that impede access to employment in integrated settings. b. Provide education/training about transition rights, planning, and services for youth with disabilities. 4. Collaboration: a. The Alabama State Department of Education (ALSDE) and the Alabama Parent Education Center (APEC) — The P&A collaborated with these agencies to jointly plan and implement trainings. 5. Number of cases: No cases were proposed for this priority. 6. Summary: To support the transition of students with disabilities to integrated and supported employment, the P&A researched whether an Order of Selection would help individuals who need services from the state Department of Vocational Rehabilitation (DVR). Understanding that no Order of Selection policy had been written, the P&A attended DVR’s State Rehabilitation Committee and urged the adoption of an Order of Selection. An Order of Selection has now been written. The criteria for selection, in the event an Order of Selection is needed, will be the number of impairments. No area of disability will be preferred over another.

1. Priority: Youth with disabilities in schools or daycare centers will have appropriate mental health supports and services, protection from illegal disciplinary measures, and protection from the use of seclusion and restraint. 2. Identify need: The need for youth with disabilities in schools or daycare centers to have appropriate mental health supports and services, protection from illegal disciplinary measures, and protection from the use of seclusion and restraint. 3. Describe indicators: a. Monitor compliance with Alabama’s new school seclusion and restraining regulations by reviewing state and local system data. b. Provide education/training on special education rights and advocacy related to behavior, discipline, and seclusion and restraint issues. 4. Collaboration: a. Bazelon Center for Mental Health Law — co-counsel 5. Number of cases: No cases were proposed for this priority. 6. Summary: To address the use of physical restraint and seclusion by public schools in the state, the P&A surveyed 123 randomly selected school districts. 68 responded. Of those who responded, 23/68 districts reported using physical restraint in the past two years, 28/68 reported they had no incidents of physical restraint/did not use physical restraint, and 17/68 did not provide information about their use of physical restraint. A total of 53/68 responding districts were able to provide a written policy that was in place at the time of their response, including those who developed a written policy after receiving the survey and those who had a deficient policy. Only 5 of the 68 districts that responded did not provide documentation of staff and faculty training in the use of positive interventions, prevention, de-escalation techniques, and physical restraint. The remaining districts provided documentation of appropriate training, including names of the staff and faculty trained. The districts were also asked to provide copies of the annual or monthly summaries of their use of seclusion and restraint, which the state law requires the districts to report to the state. 43 of the 68 districts either provided annual or monthly summaries for both years asked about or reported they had no incidents of physical restraint or seclusion during those times.

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. Priority: The P&A will strengthen the disability civil rights movement in Alabama by supporting and empowering persons with disabilities to speak for themselves and address policy and programming decisions that affect them. Identify Need: The need for the civil rights movement in Alabama to be strengthened to support and empower persons with disabilities to speak for themselves. Objectives: a. Advocate for enhanced parent engagement in special education policymaking.

2. Priority: Persons with disabilities in congregate and residential facilities will be free from abuse and neglect and civil rights violations. Identify Need: The need for persons with disabilities to be free from abuse, neglect, and civil rights violations. Objectives: a. Monitor the well-being of three youth with disabilities in residential treatment settings to ensure youth are receiving appropriate treatment services and are free from abuse, neglect, and disability rights violations. b. The P&A will advocate for its right to access facilities to monitor and investigate as provided for under its federal enabling statutes. c. Ensure the Alabama Department of Corrections (DOC) is in compliance with the ADA and Constitutional standards for the provision of mental health treatment and physical and program access.

3. Priority: Adults and youth with disabilities will receive appropriate medical care and treatment. Identify Need: The need for persons with disabilities to receive appropriate medical care and treatment. Objectives: a. Educate policy makers of the need to incorporate long term services and supports (LTSS) benefits into the state’s Medicaid Managed care program. b. Publish a brochure to educate persons about their rights under managed care. c. Provide ten education/training sessions to persons with disabilities, their families and other stakeholders on consumer rights under managed care. d. The P&A will collaborate with the Disabilities Leadership Coalition of Alabama and Alabama Arise to train advocates to participate on RCO governing boards and Citizen’s Advisory Committees. e. The P&A will review RCO contracts, identifying issues of concern to consumers with disabilities including, e.g. providers and workforce adequacy.

4. Priority: End unnecessary institutionalization of adults and youth with disabilities in nursing homes. Identify Need: The need to end unnecessary institutionalization in nursing homes for persons with disabilities. Objectives: a. Advocate for individuals in nursing homes to ensure access to the Alabama Community Transition (ACT) Waiver. b. Monitor two nursing home facilities for abuse, neglect, and civil rights violations. c. Publish a brochure describing HCBS waivers, including the ACT waiver. d. Provide education/training on nursing home alternatives in the state.

5. Priority: Adults and youth with disabilities will have full physical and program access in all aspects of community life. Identify Need: The need for persons with disabilities to have full physical and programmatic access in the community. Objectives: a. Provide three education/training sessions on guardianship/ conservatorship and alternatives. b. Advocate for three individuals with disabilities who have been subjected to unnecessary restriction of their rights and freedom of choice through guardianship/ conservatorship.

6. Priority: Youth with disabilities will receive a free appropriate education in their least restrictive environment. Identify Need: The need for youth with disabilities to receive FAPE in their least restrictive environment. Objectives: a. Advocate for enhanced teacher certification standards related to meeting the needs of diverse learners. b. Track the Alabama State Department of Education’s (ALSDE) exercise of its supervisory authority to ensure that public agencies comply with state and federal special education laws. c. Advocate on behalf of five students with disabilities to ensure the provision of a free, appropriate public education (FAPE) in the least restrictive environment with appropriate support. d. Provide ten education/training sessions to families and providers on special education rights and advocacy skills, including issues related to eligibility, provision of FAPE, right to assistive technology, behavior and discipline, and transition. e. Track compliance with Alabama’s 2011 school seclusion and restraint regulations by reviewing state and local system data. f. Advocate for better communication between schools and JPOs to affect change regarding the number of kids with disabilities detained and services that can be provided.

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

Sources of Funding Amount Received Amount Spent Federal (section 509) $224,958 $141,153 State 0 0 Program Income 0 0 Private 0 0 All other funds - FY 2013 99,014 99,014 Total (from all sources) 323,972 240,167 ($83,805 FY 2014 funds carried over to FY 2015)

B. Budget for the Fiscal Year Covered by the Report

Category Prior Fiscal Year Current Fiscal Year Wages/Salaries $135,341 $116,500 Fringe benefits (FICA, unemployment, etc.) 42,673 38,250 Materials/Supplies 580 1,500 Postage 353 648 Telephone 1,245 3,000 Rent 0 0 Travel 3,116 7,000 Copying 0.00 500 Bonding/insurance 1,304 1,600 Equipment (rental/purchase) 0 0 Legal services 134 1,750 Indirect costs 52,536 49,210 Miscellaneous 2,885 5,000 Total Budget 240,167 224,958

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

Type of Position FTE % of year filled person-years Professional Full-time 16 95 15.17 Part-time Vacant 1.87 5 .09 Clerical Full-time 4 98 3.92 Part-time Vacant .66 2 .01

D. Involvement with advisory boards (if any) N/A

E. Grievances - 4

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

The P&A works closely with the Client Assistance Program (CAP), housed in the Alabama Department of Rehabilitation Services (DRS), and the Alabama Nursing Home Ombudsman Program, which serves as the state’s long-term care ombudsman program and is housed in the Alabama Department of Senior Services. Each of the other two agencies use the P&A as a resource for case referrals and the P&A refers persons with disabilities to the CAP and Ombudsman as well. Clients who need employment services, especially those including services other than sheltered work, and do not feel their needs are being met are referred to the CAP. Several P&A clients who reside in nursing homes and seek community placement have been referred to the P&A by the Ombudsman. In addition, the P&A serves on several state-wide committees where staff from the CAP and Ombudsman Program also serve.

Certification

Signed?Yes
Signed ByJames A Tucker
TitleAuthorized Certifying Official
Signed Date12/27/2014