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

Iowa (IOWA P and A SERVICES, INC.) - H240A140016 - FY2014

General Information

Designated Agency Identification

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

Part I. Non-Case Services

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

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas1
2. Individuals receiving I&R outside PAIR priority areas153
3. Total individuals receiving I&R (lines A1 + A2)154

B. Training Activities

1. Number of trainings presented by PAIR staff14
2. Number of individuals who attended training (approximate)641

The following were 14 trainings conducted by staff that related to the PAIR program in FY14:

Alternatives to Guardianship: DRI provided 6 trainings on alternatives to guardianship/conservatorship.

1. 2013 Iowa Transition Conference: DRI presented at this conference to educate parents, educators and education agency representatives about the alternatives to Guardianship and Conservatorships and promote the review of other lesser restrictive types of substitute decision making where appropriate to the individual’s need.

2. Iowa Association of Counties: DRI presented at the ISAC annual conference to educate case managers. DRI trained on the topics of individual rights, rights under guardianship and legal remedies when an individual needs to challenge their substitute decision maker. There were a total of 170 case managers trained. The training is designed to educate these case managers and supervisors so they are able to answer rights questions in the field and also advocate for persons with disabilities in having their rights upheld.

3. GAIN: DRI presented as a panelist at the Guardianship Association of Iowa Network Kickoff event. DRI discussed our services for representing individuals in relation to substitute decision making issues.

4. PTI Conference: DRI presented to parents and families on individual rights, substitute decision making and alternatives to guardianships and conservatorships at the Parent Training and Information Center Conference entitled “Together We Can.”

5. Mainstream Living: DRI presented to 25 team leaders at Mainstream Living, a provider agency who assists individuals in community livings skills. DRI reviewed self-determination, informed consent, types of substitute decision making in Iowa, legal rights under Iowa guardianship law and what to do if there are issues in a particular substitute decision making area.

6. PEC: DRI presented to the State Parent Educator Connection (PEC) on alternatives to guardianships and conservatorships. As the PEC works to develop and sustain effective partnerships between families, educators, and community providers to promote success for all children and youth with disabilities, this training will assist them in advocating for alternatives to guardianships or conservatorships when necessary.

Education and Transition Planning: DRI provided 3 trainings in the area of special education or transition in FY14. 1. 2013 Iowa Transition Conference: DRI presented at the 2013 Iowa Transition conference on how to transition from education to competitive employment using different service delivery systems including the IEP process, social security benefits and using a PASS (Plan to Achieve Self-Support), Vocational Rehabilitation, and customized employment with accommodations. The training utilized a success story of 2 individuals who have worked through all of these systems starting from special education services to being competitively employed with benefits.

2. 2014 Iowa Transition Conference: DRI presented at the 2014 Iowa Transition conference with a new presentation on transitioning from education to competitive, integrated employment and how to use accommodations in an employment setting. We reviewed the federal laws that discuss integration and the reasons to find employment in the community versus facility based employment for persons with disabilities.

3. PTI Conference: DRI presented as the panelist who represents parents and students t at the “Together We Can” Parent Training and Information Center conference. The panel also included a school attorney and an Iowa Department of Education attorney. The presentation reviewed a student’s rights under the disciplinary procedural safeguards under the Individuals with Disabilities Education Act (IDEA) from each panelist’s viewpoint and DRI provided each of the 40 participants a flowchart for discipline.

Employment Rights: DRI provided 2 employment law trainings in FY14.

1. Iowa Vocational Rehabilitation staff: DRI co-presented with the Iowa Epilepsy Foundation to case workers with the Iowa Vocational Rehabilitation via the ICN video network. The Epilepsy Foundation covered what seizures are and how to work with a person who has seizures. DRI then trained on employment law rights under the Americans with Disabilities Act (ADA) and discussed the right to accommodations and the interactive process.

2. PTI Conference: DRI presented at a session of the “Together We Can” Parent Training Information Center conference on rights of individuals in employment. The training focused on applicable state and federal laws that apply to employment, when to reveal a disability, and accommodations and interactive process under the ADA.

Americans with Disabilities Act: DRI provided 2 trainings on the Americans with Disabilities Act (ADA) and child care issues. The first was a teleconference training for parents and families through ASK Resource Center and the second was a session at the PTI Conference entitled “Together We Can.” Both presentations reviewed the legal obligations of day care and preschool centers under Titles II and III of the ADA and reviewed how parents can use the different laws of ADA, IDEA and 504 to obtain appropriate accommodations for their children.

AmeriCorps: DRI provided training for AmeriCorps volunteers and staff. The purpose of the training was to provide basic disability awareness and human rights training to AmeriCorps volunteers. The training discussed the history of the disability rights movement including what is a disability, what challenges people with disabilities face, how the challenges of living with disability has changed over the years and how do laws like the ADA, Olmstead decision, and FEMA protect the rights of individuals with disabilities.

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 website586,840
5. Publications/booklets/brochures disseminated1,162
6. Other (specify separately)2

Narrative

DRI created 2 new factsheets for distribution in FY14. The first was an overview of alternatives to guardianship and conservatorship in Iowa. The second reviewed legal obligations under the Americans with Disabilities Act with automatic door usage.

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)11
2. Additional individuals served during the year46
3. Total individuals served (lines A1 + A2)57
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)0

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 16

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility7
2. Employment19
3. Program access10
4. Housing1
5. Government benefits/services1
6. Transportation5
7. Education1
8. Assistive technology1
9. Voting0
10. Health care3
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse2
16. Neglect0
17. Other7

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor29
2. Other representation found2
3. Individual withdrew complaint2
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.0
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit7
9. Other1

Please explain

One file was closed due to no contact with the individual.

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-advocacy6
2. Short-term assistance21
3. Investigation/monitoring1
4. Negotiation9
5. Mediation/alternative dispute resolution2
6. Administrative hearings0
7. Litigation (including class actions)1
8. Systemic/policy activities1

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 - 224
3. 23 - 5941
4. 60 - 646
5. 65 and over6

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females25
2. Males32

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race0
2. American Indian or Alaskan Native1
3. Asian0
4. Black or African American0
5. Native Hawaiian or Other Pacific Islander0
6. White55
7. Two or more races1
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent43
2. Parental or other family home5
3. Community residential home1
4. Foster care0
5. Nursing home2
6. Public institutional living arrangement1
7. Private institutional living arrangement2
8. Jail/prison/detention center3
9. Homeless0
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment5
2. Deaf/hard of hearing3
3. Deaf-blind0
4. Orthopedic impairment11
5. Mental illness3
6. Substance abuse0
7. Mental retardation4
8. Learning disability0
9. Neurological impairment11
10. Respiratory impairment1
11. Heart/other circulatory impairment2
12. Muscular/skeletal impairment4
13. Speech impairment0
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 activities3

2. Number of individuals potentially impacted by policy changes99,000

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

Non-Emergency Medical Transportation (policy change): This is an ongoing systemic project that began in the previous year when DRI reviewed issues of the delivery of non-emergency medical transportation with the broker’s (TMS) contract with Department of Human Services and Iowa Medicaid Enterprise. In FY14, DRI met several times with member advisory council to discuss ongoing issues with NEMT in order to suggest improvements. DRI reviewed the RFP for new NEMT contract with input from stakeholders and then addressed gaps in service leading to denial of requests for service with NEMT broker staff and Medicaid agency. DRI also drafted and submitted comments in response to Request for Information from Medicaid agency addressing member education, grievance policies, and customer satisfaction surveys. This included researching implications of continued 1115 waiver of NEMT services under Medicaid expansion and educating Iowa’s Olmstead Task Force on NEMT and on 1115 waiver and discussed options for expanding NEMT services.

Accessibility Review of the Iowa State Fair (policy change in progress): This is an ongoing systemic project were DRI is working with the Iowa State Fair administration (ISF) to have the fairgrounds reviewed and to come to a negotiated settlement with the ISF for ADA compliance. This year ISF administration agreed to hire Disability Action Consultants (DAC) to complete a self-evaluation and transition plan to address accessibility issues. DAC completed their review of the fairgrounds and is working on the report which we will report on in FY15. DRI also had to negotiate with the ISF on a campground issue and expanded our advocacy to review ADA compliance of the campgrounds and policies for reservations when individuals request a modification to policies due to disability. ISF continued to refer to DRI for questions on service animal use within the fairgrounds during the 2014 Fair. The systemic collaboration towards the transition plan continues into FY 15.

Water Works Park Redesign (policy change): DRI participated in meetings with the City of Des Moines and Water Works Park planners to address accessibility in the new redesign plans for the park. Waterworks planners gave overview of design plan and how they intend to improve the park while keeping it accessible over the next 5-10 years. With DRI’s advocacy, the planners took note of concerns about street crossing access and parking in current design.

County Jails and Individuals with Mental Illness: DRI began an investigation project to review abuse or neglect of individuals with mental illness in county jails and specifically to review whether inmates are receiving appropriate or timely treatment for their mental health. DRI began attending Iowa Law Enforcement Academy Trainings and participated in Sheriff Association meetings to obtain information from sheriffs and their administrative staff on issues they encounter. DRI also began monitoring county jails all across the state to collect date from jail staff and individual inmates on what issues are being encountered. This project is ongoing into FY15 and is expected to produce a report next year on our findings.

ADA Compliance of Restaurant in East Village: DRI began advocating with a bakery/restaurant in Des Moines East Village that is inaccessible due to higher thresholds and steps into the building that prohibit anyone using a mobility device to enter the business. The bakery initially refused to address the issue and then later ended their business in that location. Another restaurant owner then moved into the space and DRI again addressed the lack of accessibility into the business. The new owner has agreed to install a ramp at one of the two entrances to the business and has hired a contractor to complete the project. DRI will be expanding this project to other businesses in the East Village in FY15 with plans to conduct accessibility surveys of all businesses and will be working with the East Village Board of Directors on assisting businesses to come into compliance.

Olmstead Task Force: DRI continues to participate on the legislatively created Olmstead Task Force which was designed to advocate for the state system to provide appropriate community supports for people who are threatened with being institutionalized or who require additional services to remain in their own home or in the least restrictive environment in the community.

Substitute Decision Making Task Force: Iowa Department of Aging and the Office of the Long Term Care Ombudsman reconvened a task force to continue working towards resolution of issues related to substitute decision making. DRI was asked to join the task force to give the individuals with a disability perspective and attended the quarterly meetings. The task force focused on re-establishing the Office of Substitute Decision Making and was granted partial funding by the Iowa Legislature. The task force next focused on what training materials exist and what needs updating and made goals for the next year.

Safe School Coalition (policy change): DRI sat on this coalition that serves in an advisory capacity to the safe school certification program and focused on building a framework to help guide school districts towards systemic changes to reduce bullying and harassment. The framework was designed to address two key components of creating safe schools: (1) Policy: Ensuring that schools have successfully adopted required safe school laws and (2) Practice: providing the technical assistance and support around a framework of eight elements that can create policy fidelity and sustain safe school climates: Buy-In; Leadership; Data; Family and Community Engagement; Programs and Practices; Training; Student Engagement; and Enforcement. This project was a continuation of the former Quality Education Alliance from the previous year.

Iowa Special Education Advisory Panel: DRI continues to sit on the IDEA mandated statewide advisory panel that provides advice/recommendations to the DOE. DRI staff participates in the meetings held six (6) times a year and advocates in internal subcommittees at the meetings concerning special education services.

Child Find Project with AEA and ASK Resource Center: DRI began collaborating with the State’s AEAs and Ask Resource Center on developing training materials to educate school staff and parents on appropriate child find evaluation procedures under the Individuals with Disabilities Education Act (IDEA). The collaboration will produce a PowerPoint training, booklets and other materials and will be completed in FY15.

Review of Iowa’s Implementation of New HCBS Regulations: CMS issued a final rule for HCBS that require states to review and evaluate HCBS settings including residential and nonresidential settings. States are required to ensure that all HCBS settings comply with the new requirements and analyze all settings where HCBS participants receive services to determine if current settings comply with the final rule. DRI began reviewing the State of Iowa’s actions to ensure that Iowa’s waiver plans are transitioning appropriately for individuals utilizing waiver services and is in compliance with the Final Rule. DRI started by submitting an open records request to IME for draft documents as they became completed ( in draft form); IME then kept ongoing, open communications with DRI as to their progress and plans on these documents. DRI has reviewed other states’ plans to compare plans and continued to educate ourselves via webinars on implementation of the regulations and new settings rules and how this will change the current landscape. This project will continue into FY15.

Emergency Preparedness: DRI continues to sit on the Iowa Disaster Human Resource Council to ensure that Iowans with disabilities are integrated into the State’s emergency planning and that they have equal access to emergency programs and services. DRI participated on calls where there was flooding or other disasters as a resource to review how to address individuals with disabilities unmet needs.

Department of Inspection and Appeals Incident Reports: DRI receives citation reports on residential and nursing home facilities in Iowa from the Iowa Department of Inspection and Appeals. DRI also uses these reports to identify any necessary investigation or monitoring that may arise from a pattern of incidents and conducted several follow ups to incidents to make sure corrective action was completed. For example, DRI conducted 16 secondary investigations in follow up to these incident reports to verify corrective action was completed. DRI also conducted its own separate investigation and monitored facilities noted in the incident reports if corrective action was not completed.

Monitoring of Correctional and Veterans Facilities: In FY14, DRI conducted monitoring activities at the Iowa Correctional Facility for Women, Anamosa State Penitentiary and the Iowa Veterans Home. The monitoring visits were to ensure individual rights are being upheld and no safety concerns. For example, at Anamosa DRI met with an inmate with one leg amputated above the knee who used crutches to get around at the prison. The chapel was located on the 2nd floor up a very steep flight of stairs, making the chapel inaccessible to anyone with a mobility issue. During DRI’s monitoring, we found that there was a service elevator that led up to an adjoining room on the same level as the chapel. Through conversations and advocacy with the Warden, DRI arranged to make the service elevator accessible to inmates with disabilities to go up to the chapel. The Warden arranged to have additional staff escort the individuals since the elevator was in a restricted area. DRI is continuing to conduct monitoring activities as each of these facilities in FY15 to focus on use of seclusion and individual rights.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts0
2. Number of individuals named in class actions0

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

DRI did not bring any class action lawsuits in FY 14.

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.

Abuse and Neglect: 1. Priority: Individuals with disabilities shall be free from abuse and neglect.

2. Need addressed: Individuals with disabilities may be subject to abuse, neglect, or financial exploitation. This is often due to the dependency that individuals with disabilities develop requiring assistance with food, personal cares, and personal safety. Individuals with disabilities may not understand how to report instances of abuse or neglect.

3. Description of Activities: DRI will collaborate with the Iowa Department of Inspections and Appeals, the Iowa Department of Corrections, the Iowa Long-Term Care Ombudsman and the Citizens Aide Ombudsmen to investigate the deaths of individuals with disabilities in facilities.

4. Collaboration: See description of facility closure collaboration with Long Term Care Ombudsman and Iowa Dept. of Inspections and Appeals in Section VI. DRI also reviews incident reports from DIA or the Dept. of Corrections for any patterns of abuse and neglect and will conduct follow up monitoring or investigations as necessary. DRI completed 16 secondary investigations in response to notices from these 2 agencies. In the case summary below, DIA completed a primary investigation and provided records and information to DRI to complete our review of the death.

5. Number of cases: 1 Number of class actions: 0

6. Case Summary: Individual was a 86 year old male diagnosed with Dementia, muscle weakness, history of persistent falls, abnormal gait, Parkinson’s, Anxiety, Depression and Anemia . His daughter reported to DRI that on April 13, 2014 she visited her father and observed numerous bruises on the side of his face and a bump the size of a golf ball on the top of his head. She was unable to get her questions answered regarding the injuries to her father. She then reports that her father passed away on June 9th, 2014 of internal bleeding. DRI investigated his death and collaborated with Iowa Dept. of Inspections and Appeals who conducted the initial investigation. The investigation found no correlation between the individual’s injuries from a fall in April to his death in June. In addition, no abuse or neglect was found as the facility had fall precautions and taken immediate steps to treat injuries from the fall. The individual died in June due to a medical issue related to a dead bowel.

Accessibility:

1. Priority: Individuals with disabilities have the right to full participation of programs, services and activities of public entities and public accommodations.

2. Need addressed: Individuals with disabilities may be excluded from participation in public services and public accommodations because of a failure to make facilities accessible or to provide reasonable accommodations.

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

4. Collaboration: See Section IV for systemic collaboration descriptions for Iowa State Fair, Waterworks Park, East Village restaurants and county jails projects.

5. Number of cases: 18 Number of class actions: 0

6. Case Summary: Individual is a 53 year old woman with arthritis, herniated disc, foot disease, depression. Individual and family member uses a wheelchair for mobility and cannot get into local gas station due to lack of accessible parking. She reported similar issues at other company locations. DRI reviewed 20 locations of this gas station chain in Des Moines metro are and noted 75% lacked accessible parking. DRI researched relevant laws, wrote a demand letter to CEO stating obligations under ADA and requested a timeline to bring stations into compliance. The company’s operations manager called and promised chain would install accessible parking and curb ramps where needed over the next year. The company later contacted DRI to report they had completed making their locations accessible with parking.

Individual is a 38 year old man with paraplegia, who uses a wheelchair for mobility. Individual used to regularly attend games for a local minor league hockey team, but last year they remodeled their restrooms and client can no longer get his wheelchair through the door, effectively barring him from attending. He attempted to contact team management, but got no response and asked for DRI assistance. DRI sent a demand letter with individual’s complaint to the team’s general manager who agreed to meet with DRI and the individual and we reviewed overall accessibility and areas in need of improvement at the hockey rink. DRI provided ADAAG guidance on accessible restrooms. Team owner and GM agreed to remodel an unused locker room into wheelchair accessible restroom, increase signage, announcements, and information on website about accessible services, provide better training to staff, repaint accessible parking spaces and install signs where needed, and repair broken cement in front of accessible entrance, and offered client five free tickets to game(s) of his choice.

Individual is a 26 year old man who has been blind in both eyes since birth. He was enrolled in community college and had accommodations in class and on exams, but experienced repeated failures by professors to adhere to his accommodations. His grades suffered, he was forced to drop classes, and had his financial aid eligibility threatened. After attempts at internal resolution, the individual filed a complaint with the Department of Education Office of Civil Rights. DRI represented the client at mediation. As a result, the College agreed to implement multiple changes to policies and practices to improve accessibility; reimburse client for dropped classes; lift financial aid warning; pay compensation for client’s extra work due to lack of accommodations; and they paid attorney’s fees to DRI.

Community Integration:

1. Priority: Iowans with disabilities have the right to live in the most integrated and least restrictive settings appropriate to their choice and needs.

2. Need addressed: Individuals with disabilities should be able to live as independently as possible and in the setting they desire. Barriers appear when the living situations are more restrictive than what is necessary to address safety or medical concerns, or considerations are not given to the use of reasonable accommodations, aids or services that could enable individuals with disabilities to reside where they choose.

3. Description of Activities: a. During Iowa’s implementation of the Mental Health and Disability Services Redesign, DRI will provide systemic and individual legally-based advocacy to ensure that individuals with disabilities have the community services to which they are entitled under federal and state law. DRI will not provide case-management services and will not represent individuals to remain in institutional placements. b. DRI will conduct an exploratory investigation regarding the lack of adequate transportation for individuals with disabilities, especially in rural areas. 4. Collaboration: See Section IV for systemic collaboration efforts including Non-emergency Medical Transportation (NEMT) project with Iowa Medicaid Enterprise. On other issues, DRI collaborates with facility staff, case management, and HCBS waiver program to review least restrictive placements for individuals.

5. Number of cases: 7 Number of class actions: 0

6. Case Summary: Individual is a 71 year old man with partial paralysis due to a brain injury, hearing loss. He lives in secure dementia unit at a nursing facility and complains his rights are being unduly restricted. He wanted to review his guardian’s actions and move to a less restrictive setting. DRI reviewed his recent medical records and spoke extensively with facility staff and social workers, and the individual’s guardian regarding his rights. The facility staff report he has the opportunity to leave the secure unit on outings and is re-assessed quarterly to see if he can relocate to less restrictive setting. His guardian is now responsive to individual’s needs and appears to be acting in his best interest.

Individual is a 47 year old woman with Epilepsy and fibromyalgia. She had been denied transportation rides through the state’s NEMT broker, despite having a suspended driver’s license due to seizures. She needed assistance obtaining NEMT. DRI contacted TMS questioning the denial and TMS agreed to provide transportation upon receipt of DOT documentation confirming individual’s license suspension. Individual is now receiving her non-emergency medical transportation through TMS.

Education:

1. Priority: Students with disabilities have the right to enforce and protect their rights for special education and related services under the Individuals with Disabilities Education Act (IDEA) and Rehabilitation Act Section 504.

2. Need addressed: Students with disabilities are at risk of not being educated, being restrained or secluded, or subjected to the use of law enforcement for disciplinary purposes.

3. Description of Activities: a. DRI will provide legally-based advocacy for students who are suspended, expelled, constructively expelled, restrained or secluded, arrested or forced to have a shortened school day for behavior related to their disability. b. DRI will pursue legally-based advocacy to prevent and stop bullying and harassment based on disability that contributes to a denial of free and appropriate public education (FAPE) or constitutes illegal harassment under state or federal law. c. DRI will provide outreach, education and legally-based advocacy for families of students with disabilities who are underserved due to economic and/or cultural factors.

4. Collaboration: See collaborative education projects in Section IV. DRI also has increased our collaboration with the Parent Training Information Center (PTIC)/ASK Resource Center by have bi-monthly meetings to review cases and present education topics to each other’s staff. This has allowed us to also cross-refer cases appropriate to each agency’s goals/priorities. DRI continues to have a strong working relationship with our Iowa Department of Education and has worked on education concerns in juvenile justice facilities.

5. Number of cases: 1 (ongoing) Number of class actions: 0

6. Case Summary: The individual is as 12 year old student with ADHD and behavioral issues. The student may have been inappropriately secluded for almost 6 hours at his local school for behavior related to the disability. DRI is currently advocating with the parent to review options for the student’s needs including whether residential treatment may be medically needed. DRI continues to advocate in this current case and does not have an outcome yet.

Employment:

1. Priority: DRI will provide legally-based advocacy for the disability rights of Iowans who are experiencing disability-based discrimination in employment.

2. Need addressed: Individuals with disabilities may be excluded from the workplace due to fear and inflexibility with accommodation requests, and are likely to be terminated from employment because of the disability.

3. Description of Activities: a. DRI will provide legally-based advocacy for individuals who encountered disability discrimination in gaining, maintaining or regaining employment, including failure to provide reasonable accommodations. b. DRI will collaborate with other organizations to provide training to employers and individuals with disabilities about the benefits of employing individuals with disabilities and the employment protections for individuals with disabilities under state and federal law.

4. Collaboration: See training completed in Section IB. See collaborative systemic projects in Section IV.

5. Number of cases: 19 Number of class actions: 0

6. Case Summary: Individual is a 41 year old man with epilepsy. He worked as a manager at a fuel processing plant and following an at-work seizure, his employer placed him on leave. Individual’s doctor cleared him to return to work several months later, but employer refused to reinstate him citing safety concerns while working at heights. Individual claims he was never required to work at heights. He was recently informed his position would be filled by another employee. However, the individual wanted DRI’s assistance to get his job back. DRI negotiated with the employer to return him to work. The parties agreed to return the individual to work in a different position in employer’s supply chain which did not require work at heights. This new position included a higher salary and promise of accommodations in the future if necessary.

Supportive Decision-Making & Alternatives to Guardianship

1. Priority: DRI will provide advocacy for the disability rights of Iowans to pursue alternatives to guardianships or conservatorships, to end guardianships or conservatorships when no longer necessary, to change guardians or conservators in cases of abuse or neglect, and hold other legal decision makers accountable for violating the rights of the person with a disability.

2. Need addressed: Individuals with disabilities may be subjected to unnecessary guardianships and conservatorships and have the right to have an appropriate guardianship that is as narrowly tailored as possible.

3. Description of Activities: a. DRI will provide trainings to judges, providers, and individuals with disabilities and their family members on less restrictive alternatives to guardianships and conservatorships. b. DRI will provide legally-based advocacy to prevent or terminate guardianships and conservatorships for those who are no longer in need of a guardian or a conservator. c. DRI will provide legally based advocacy for individuals whose representative payees fail to act in their best interests as required by the Social Security Administration.

4. Collaboration: See trainings in Part I.

5. Number of cases: 8 Number of class actions: 0

6. Case Summary: Individual is a 22 year old female with Asperger’s. A guardianship was established in 2009 with her mother named as guardian. The individual’s aunt filed a motion to intervene and petitioned the court to become the guardian and conservator. Individual contacted DRI for legal representation in the proceedings and her desires to possibly terminate or limit the guardianship. DRI represented the individual in several informal negotiations of the parties where it was agreed that the individual’s rep payee will be changed from mother to aunt due to concerns about how money was being used in the home. The parties then moved to formal mediation for the remaining issues pending a trial date. The parties reached an agreement where her mother will remain guardian but allow for the aunt to have access to providers and information to assist in obtaining necessary services. Individual and mother agree to work on skills for independence and will review termination of guardianship in near future. Individual provides DRI updates and has been attending college classes and expects to move out to her own apartment this year.

Individual is a 42 year old woman with hydrocephalus. She had a long term guardian (her mother) who recently moved out of state. Individual believed she was ready to be her own guardian and says her mother agrees, but needed assistance with the court. DRI negotiated the consent to terminate and obtained a court order terminating the individual’s guardianship. Her individual rights have been restored to her.

Individual is a 54 year old female who is blind. Her objective was to obtain assistive technology devices such as an electronic reader so that she may access more materials and achieve greater independence. Her payee had not provided her the use of her benefits for this purpose. DRI provided the individual with information on resources available to assist in paying for assistive technology. The individual was able to apply for a grant with Tri-State Blind. She received the grant and was able to purchase the assistive technology device that she needed. The individual is now a Board Member for Tri-State Blind and is completely familiar with available resources for assistive 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.

Abuse and Neglect: 1. Priority: Individuals with disabilities shall be free from abuse and neglect. 2. Need addressed: Individuals with disabilities may be subject to abuse, neglect, or financial exploitation. This is often due to the dependency that individuals with disabilities develop requiring assistance with food, personal cares, and personal safety. Individuals with disabilities may not understand how to report instances of abuse or neglect. 3. Description of Activities: DRI will collaborate with the Iowa Department of Inspections and Appeals, the Iowa Department of Corrections, the Iowa Long-Term Care Ombudsman and the Citizens Aide Ombudsmen to investigate any deaths, abuse, neglect or systemic rights violations of individuals with disabilities or mental illness. DRI will also provide technical assistance to individuals who call asking for assistance about how to handle individual rights violations. Priority will be given to investigations in facilities.

Accessibility:

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

Community Integration:

1. Priority: Iowans with disabilities have the right to live in the most integrated and least restrictive settings appropriate to their choice and needs. 2. Need addressed: Individuals with disabilities should be able to live as independently as possible and in the setting they desire. Barriers appear when the living situations are more restrictive than what is necessary to address safety or medical concerns, or considerations are not given to the use of reasonable accommodations, aids or services that could enable individuals with disabilities to reside where they choose. 3. Description of Activities: a. DRI will provide individual and systemic legally based advocacy to individuals with disabilities or mental illness and are inappropriately placed in overly-restrictive nursing facilities or community settings. b. DRI will provide systemic and individual legally-based advocacy to ensure that individuals with disabilities are being served in the most integrated settings possible and have the community services to which they are entitled under federal and state law. DRI will not provide case-management services and will not represent individuals to remain in institutional placements. c. DRI will provide individual and systemic advocacy to individuals who are not receiving transportation services to which they are legally entitled. d. DRI will conduct systemic advocacy to ensure that Iowa Medicaid Enterprise/DHS develop and implement a transition plan to become fully complaint with CMS HCBS Settings Final Rules.

Education:

1. Priority: Students with disabilities have the right to enforce and protect their rights for special education and related services under the Individuals with Disabilities Education Act (IDEA) and Rehabilitation Act Section 504. 2. Need addressed: Students with disabilities are at risk of not being educated, being restrained or secluded, or subjected to the use of law enforcement for disciplinary purposes. 3. Description of Activities: a. DRI will provide legally-based advocacy for students who are repeatedly suspended, expelled, constructively expelled, restrained or secluded, arrested or forced to have a shortened school day for behavior related to their disability. b. DRI will provide systemic advocacy for students who do not have transition plans that comply with the IDEA. This will include systemic advocacy to improve transition planning in facilities that serve court-involved juveniles with disabilities or mental illness. c. DRI will partner with other organizations to increase the number and quality of attorneys representing families and students in special education cases.

Employment:

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

Supportive Decision-Making & Alternatives to Guardianship

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

Part VI. Narrative

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

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

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

A. Sources of Funds received and expended: Received: 171,598 Expended: 133,761

B. Budget for the fiscal year covered by this report FY14 FY15 projected Salaries 95,380 117,907 Fringe Benefits 20,093 22,155 Materials/Supplies 817 1,040 Postage 479 322 Telephone 1,043 1,212 Rent 12,200 14,696 Travel 1,377 1,663 Copying 2,476 949 Insurance 2,310 3,130 Legal Svcs 568 948 Misc. 5,612 8,943 Prof. Services 4,265 3,743 TOTAL 146,620 176,708

C. Description of PAIR Staff Attorneys 42% Advocates 22% Paralegal 7% Mgmt/Finance 29%

D. Involvement with advisory boards (if any)

DRI sits on the following boards or workgroups:

Iowa Developmental Disabilities Council Iowa Special Education Advisory Panel Iowa Disability Action Network Money Follows the Person workgroup Olmstead Task Force Mental Health Conference Planning Committee Judicial workgroup for Redesign Family Support Council with the Parent Training Information Center APSE Iowa (Association for Persons in Supported Employment) Iowa Commission of Persons with Disabilities

E. Grievances filed under the grievance procedure

DRI had one (1) grievance filed in FY14.

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

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

CAP: DRI has coordinated in the past with the CAP by making certain that we cross-refer cases. Due to staff changes at CAP, we have not had as much contact this year but have advocated with new CAP staff to refer cases to DRI that need legal representation related to vocational rehabilitation program issues. We will continue to build our relationship with the new CAP staff in FY15.

LTCOP: DRI continues to have a strong collaboration with the LTCOP during this fiscal year. DRI continued working on a project with LTCOP and our state’s Department of Inspections and Appeals (DIA) to review and coordinate monitoring or investigations of facilities. We continued writing the Iowa Health Facility Closure Procedures book that outlines state procedures for health facility closures. This year had an increase in the number of both voluntary and involuntary facility closures and DRI worked collaboratively on 5 facility closures with the team including Iowa Medicaid that would involve weekly calls, identifying what agency will provide individual advocacy to the individuals affected by the facility closure and coordinated monitoring of the facilities.

DRI and LTCOP began reviewing sexual expression rights in facilities together with Dept. of Inspections and Appeals. This will be an ongoing project in FY15 likely with the goal of facility training on individual rights and avoiding abuse and neglect.

In addition to the above, DRI and LTCOP have increased our working together on guardianship and community integration issues for individuals living in facilities. The regional LTCO have been reporting directly to DRI when an individual may need legal representation to substitute, modify or terminate inappropriate guardianships or conservatorships and have we have conducted collaborative monitoring at facilities such as the Iowa Veterans Home and nursing facilities. DRI and the regional LTCO are increasing their requests for technical assistance between agencies and continue to meet regularly to discuss which agency can best assist for specific issues.

DRI and LTCOP also sit on several task forces or advisory boards together and advocate for rights of disabilities and elder issues together. These include the Substitute Decision Maker Task Force (substitute decision making issues in Iowa) and the Iowa Department of Aging Legal Assistance Grant Committee (legal issues facing older Iowans) and Elder Law committee with the Iowa Bar Association.

Certification

Signed?Yes
Signed ByJane Hudson
TitleAuthorized Certifying Official
Signed Date12/12/2014