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

Nebraska (NEBRASKA ADVOCACY SERVICES, INC.) - H240A140028 - FY2014

General Information

Designated Agency Identification

NameDisability Rights Nebraska (formrly Nebr Advocacy)
Address134 South 13th St.
Address Line 2Suite 600
CityLincoln
StateNebraska
Zip Code68508
E-mail Addresstim@drne.org
Website Addresshttp://www.disabilityrightsnebraska.org
Phone402-474-3183
TTY 402-474-3183
Toll-free Phone800-422-6691
Toll-free TTY800-422-6691
Fax402-474-3274
Name of P&A Executive DirectorTimothy F. Shaw
Name of PAIR Director/CoordinatorTimothy F. Shaw
Person to contact regarding reportTimothy F. Shaw
Contact Person phone402-474-3183
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 areas129
2. Individuals receiving I&R outside PAIR priority areas7
3. Total individuals receiving I&R (lines A1 + A2)136

B. Training Activities

1. Number of trainings presented by PAIR staff5
2. Number of individuals who attended training (approximate)426

Public Guardianship report and ramifications; Civil Rights Conference; Success, Hopes & Dreams Conference; The Church and People with Disabilities (2 sessions). Guardianship and reasonable alternatives training that was subcontracted in collaboration with The Arc of Nebraska: 140 people trained, 4 trainers trained. See report on Priorities for FY 2014 in Part V for more info.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles2
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website11,821
5. Publications/booklets/brochures disseminated3,103
6. Other (specify separately)101,400

Narrative

Our Western Office Case Advocate accounted for almost half of publications disseminated; she has established an active presence in the community there and participated in over 3 dozen community events over the course of the year. 1,400 of the "Other" figure represents FB, Twitter and e-newsletter lists / followers. We have contracted with a Spanish-speaking advocate in the Omaha community and through her distributed over 200 pieces of print information in Spanish. 452 PAIR-specific pieces of material were downloaded through our website. The Argenyi v. Creighton University case spawned national coverage in print and blog spheres through the Associated Press, with articles appearing in the Omaha World-Herald (Circ. 125,000), Lincoln Journal--Star, Columbus Indiana Republic, NY Times and SF Gate. Circulation for those articles was not included here as the P&A is not specifically mentioned.

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)1
2. Additional individuals served during the year8
3. Total individuals served (lines A1 + A2)9
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 4

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility2
2. Employment0
3. Program access2
4. Housing0
5. Government benefits/services1
6. Transportation0
7. Education1
8. Assistive technology0
9. Voting0
10. Health care0
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse3
16. Neglect0
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor1
2. Other representation found0
3. Individual withdrew complaint0
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources1
8. Individual case lacks legal merit1
9. Other1

Please explain

Individual not responsive to agency.

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-advocacy0
2. Short-term assistance2
3. Investigation/monitoring2
4. Negotiation1
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)0
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 40
2. 5 - 221
3. 23 - 596
4. 60 - 640
5. 65 and over2

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females5
2. Males4

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American1
5. Native Hawaiian or Other Pacific Islander0
6. White6
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent6
2. Parental or other family home0
3. Community residential home0
4. Foster care0
5. Nursing home3
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center0
9. Homeless0
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment0
2. Deaf/hard of hearing3
3. Deaf-blind2
4. Orthopedic impairment1
5. Mental illness0
6. Substance abuse0
7. Mental retardation1
8. Learning disability0
9. Neurological impairment0
10. Respiratory impairment0
11. Heart/other circulatory impairment0
12. Muscular/skeletal impairment1
13. Speech impairment0
14. AIDS/HIV0
15. Traumatic brain injury0
16. Other disability1

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 changes45,480

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.

Systemic Change: Public Guardianship: As of October 1, 2013, Disability Rights Nebraska had selected as an objective for FY 2014: “Organize and/or support a statewide coalition to implement recommendations developed from previous research on State Office of Public Guardian Model laws and alternatives to guardianship/conservatorship.”

Little did we know that, just over a month and a half later, a questionable guardian whose name was well known in our office would hand us the means to accelerate the process through her own downfall.

On Monday, November 25, 2013, Mike Foley, State Auditor, released a report exposing significant problems in the management of the State Assistance to the Aged, Blind, or Disabled (AABD) program. He found the program to be “riddled with problems”.

The AABD program serves about 6,000 Nebraskans with direct cash assistance for their basic living needs and medical expenses. It is operated by the Nebraska Department of Health and Human Services (DHHS) and spends approximately $15 million in State tax dollars each year.

The Auditor’s report is based on a sample of randomly selected cases. It found that in 36% of those sampled cases, DHHS was making payments that were “unreasonable or in direct violation of State law”. The Auditor’s conclusion was that “DHHS’ inadequate control procedures failed to safeguard taxpayer funds.”

The most serious issue was related to apparent financial abuse of vulnerable adults with disabilities receiving AABD payments.

Judith Widener, of Scottsbluff, Nebraska and the Director of Safe Haven, Inc., was found to have served as a guardian or conservator for 688 vulnerable individuals in need of protection across Nebraska.

The auditing team became suspicious of her activities and asked the Nebraska State Patrol to interview her. Numerous examples appeared of Widener depositing payments intended for the vulnerable adults into bank accounts she controlled, and then taking funds from those accounts for her personal use. Judith Widener confessed to the auditors, in the presence of the State Patrol, that “she knowingly misappropriated monies belonging to wards” for whom she was a guardian.

Widener was arrested and charged with a felony for embezzlement and theft of her wards’ money on November 20, 2013. She hid her alleged embezzlement through a “complex array of credit cards and over 40 bank accounts containing more than $600,000.” Those bank accounts were spread out across Nebraska.

She posted money to cover the $500,000 bond set by the County Judge and was released from jail on Tuesday, November 26, 2013.

On the day following the audit, the Nebraska Supreme Court ordered the lower courts to do a systematic review of every guardianship assigned to Widener.

Another key player in the evolving situation was the recently-created Nebraska Supreme Court Commission on Guardianships and Conservatorships. The Commission had elucidated four priorities: 1. Laws and policies in regard to wards with limited income and assets 2. Qualifications for individuals to be appointed as guardians or conservators. 3. Availability of suitable guardians or conservators, and 4. Annual reporting requirement and forms. Also in place was a Public Guardian Subcommittee - a perfect fit.

Disability Rights Nebraska Public Policy Staff struck while the iron was hot. They had already laid the groundwork with a quantity of research and a draft report was in progress at the time of the Auditor’s revelation. The Public Policy staff, including our intern from U. Southern California (Sumerlyn Daywitt) provided information to the Supreme Court’s subcommittee on public guardianship, outlining the experiences of other states, fundamental issues that must be addressed within a public guardianship system, and recommending particular components. Public Policy staff and representatives from partner organization Arc of Nebraska held several meetings with Deb Brownyard, coordinator of the Nebraska Supreme Court public guardianship subcommittee and were invited to a meeting of the subcommittee in order to discuss our research and participate in the subcommittee’s discussion.

In the meantime, the Disability Rights Nebraska Legal Advocacy and Management Teams met and laid out a plan of support for those affected by Widener’s machinations. Disability Rights Nebraska publicly offered to assist existing clients who had Widener as guardian with finding a new guardian or exploring other decision-making options, including having a guardian only for limited types of decisions. In addition to live intake, resources were added to the Disability Rights Nebraska website to inform the public about guardianship issues. The resources included a form letter to use in requesting a temporary guardian.

Public Policy staff was invited to review and provide written comment on a preliminary draft of potential legislation on public guardianship by Senator Colby Coash. Given Sen. Coash’s desire to introduce legislation creating an Office of Public Guardian (LB 920) during the short legislative session, and the support from senators, efforts were adjusted from “Organize and/or support a statewide coalition” to the provision of information in this legislative session.

Public Policy staff conducted further research from a selected group of states’ Office of Public Guardian and the corresponding states’ Protection and Advocacy organizations. A survey and phone interviews were conducted to gather input on the experience of these states in the operation of those states’ public guardianship systems, including types of individuals receiving public guardianship, type of guardianships provided, and areas of potential reform. A brief report was created outlining the findings.

Public Policy Staff created a set of talking points on the need for a public guardianship system and a summary of LB 920. Staff also recommended amendment language regarding qualifications of the Office of Public Guardian director, which was adopted.

During the 4th Qtr of FY 2014, the Court Administrator’s office advertised the job announcement for the Director of the Office of Public Guardian. The first effort of hiring the Director did not yield any results, so the position was re-advertised. Disability Rights Nebraska intends to be active on the Advisory Committee to the Office of Public Guardian; however, establishment of the Advisory Committee has been put on hold until a Director of the office is hired.

Other systemic / legislative work: LB 854: To place a hold on action relating to managed care for long-term care services and support. Disability Rights Nebraska position: Support Status: Passed 46-0 vote; Signed by the Governor on March 28, 2014. Potential Impact: 45,000 individuals (some overlap with impact of LB 1076). LB 854 proposed a moratorium on managed care for long-term care services in order to solicit sufficient planning and meaningful input from stakeholders, including service providers and consumers, in order to establish an effective managed care system for Medicaid recipients.

Disability Rights Nebraska supported the bill, agreeing that input from stakeholders is critical to establishing a more effective long-term care system transformation.

LB 1076: Postpone changes in Medicaid authorization and payment for medically necessary home health services and reimbursement rates Disability Rights Nebraska position: Support Status: Passed 48-0; Signed by the Governor on April 16, 2014. Potential Impact: 43,000 individuals (some overlap with number of individuals impacted by LB 854.)

The Department of Health and Human Services communicated to Sen. Campbell that the Department would on its own agree to postpone home health care changes until the Balancing Incentive Payments Program was completed—thus achieving the intent of LB 1076.

Disability Rights Nebraska supported postponing changes in home health care until other state reforms and activities under the Balancing Incentive Payment Program can be evaluated. Reductions in home health care services and reimbursements would potentially have significant effects on those individuals with disabilities receiving home health care and would potentially decrease the ability for some individuals to retain community-based care and increase the number of individuals who would be institutionalized.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts100,000
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.

PAIR Litigation FY 2014

Once again in FY 2014, Disability Rights Nebraska PAIR staff focused their efforts on a potentially far-reaching piece of litigation: Michael Argenyi v. Creighton University.

Our client, a young man who is deaf, was a student at the Creighton University School of Medicine located in Omaha, Nebraska. He was diagnosed with a bilateral profound sensorineuoral hearing loss at the age of eight (8) months. He received a cochlear implant in the right ear in June of 2004 and in the left ear in June of 2009. Significant sound distortion (due to sensory nerve damage) remains even for sounds he is now able to “hear.” A rough analogy for a hearing person would be listening to a poorly tuned crackling radio station, in which only fragments of speech are heard and turning the volume up will not make the sound clearer or complete.

After receiving his acceptance letter in March of 2009, Michael reported to the school he would need auxiliary aids and services. During his undergraduate education, he was provided Computer Assisted Real-Time Captioning (“CART”), and also cued/oral speech interpreters. He requested the same auxiliary aids and services from Creighton and the school denied his request and offered instead a front row seat in lectures, the FM system and access to a note-taking service. After several attempts at negotiations with the University, a lawsuit was filed in Federal District Court on September 24, 2009, alleging discrimination under the Americans With Disabilities Act and §504 of the Rehabilitation Act. Michael continued to pay and schedule his own auxiliary aids and services, specifically oral/cued speech interpreters and Computer Assisted Real Time Transcription (“CART”).

The lawsuit was joined by Marc Charmatz, counsel for The National Association of the Deaf Legal Advocacy Center, and Mary C. Vargas, of Stein & Vargas, LLP as co-counsel. Both lawyers are based in Maryland and have extensive experience advocating for individuals with disabilities.

On November 18, 2009, the University filed its Answer contending they were exempt from Title III of the ADA; that Michael is not a qualified individual with a disability; and that the accommodations requested are not reasonable and would create an undue hardship on the University. On November 30, 2009, both parties submitted their Rule 26 (f) Planning Conference Report to the Court, setting December 2010 as a tentative trial date. Furthermore, on January 15, 2010, Disability Rights Nebraska filed the First Amended Complaint to specifically request reimbursement for CART and interpreters. On April 1, 2010, the parties held a conference with United States Magistrate/Judge Gossett.

Prior to the scheduled trial date, the Department of Justice (DOJ) entered the case and commenced a comprehensive investigation of the University’s compliance with the ADA. As a result of the intervention of DOJ, a comprehensive settlement conference lasting all day ensued in which Disability Rights Nebraska actively participated. A tentative agreement had been reached with Disability Rights Nebraska, Creighton University and DOJ. However, Creighton rescinded its previous offers and the tentative settlement collapsed.

On September 22, 2011, Judge Laurie Smith Camp granted Summary Judgment for Creighton and dismissed our client’s complaint.

On October 2011, Disability Rights Nebraska, the National Association of the Deaf (NAD), Law and Advocacy Center and the firm Stein & Vargas, filed a Notice of Appeal to the Eighth Circuit Court of Appeals. The opening brief of Plaintiff-Appellant was filed on January 19, 2012.

On January 26, 2012, the United States Department of Justice, along with the United States Department of Education, filed an Amicus Brief in support of the appeal. On the same day, three additional Amicus Briefs in support were filed: The Alexander Graham Bell Deaf Advocacy Center (AG Bell), the National Disability Rights Network (NDRN), and the Association for Medical Professionals with Hearing Loss (AMPHL).

The Defendant-Appellee (Creighton) filed its answer brief on March 15, 2012. Disability Rights Nebraska filed its reply brief on April 17, 2012. Oral arguments were held November 14, 2012 before the Court of Appeals.

On January 15, 2013, the Eighth Circuit in a unanimous decision written by Senior Judge Diana Murphy reversed the District Court’s decision against Michael and sent the case back to the District Court for a jury trial. The Eighth Circuit summarily denied Creighton University’s Petition for Rehearing seeking a reconsideration of its decision.

(Michael Argenyi v. Creighton University. 8:09cv341 District of Nebraska, 11-3336 United States Court of Appeals for the Eighth Circuit.)

Disability Rights Nebraska on September 4, 2013 won a significant victory for Michael Argenyi when a jury in the United States District Court for Nebraska entered a verdict for Michael Argenyi, a deaf medical student, against Creighton University for Creighton’s failure to provide reasonable accommodations by denying him auxiliary aids and services in violation of Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA). United States District Court Judge Laurie Smith Camp presided over the two-week trial. Disability Rights Nebraska’s victorious trial team was staff attorney Dianne DeLair, then law clerk and now staff attorney Brian Craig, and legal assistant Patricia Nichelson. Mary Vargas of Stein & Vargas, LLP, from Maryland was co-counsel as was Caroline Jackson of the National Association for the Deaf Law and Advocacy Center. The Department of Justice (DOJ) has filed a statement of interest and support for the claims of Michael as advocated by Disability Rights Nebraska.

On December 19, 2013, the United States District Court entered judgment in favor of Plaintiff, Michael Argenyi after the favorable jury verdict. The key issue in this litigation was whether Creighton University violated Title III of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act when it refused to provide auxiliary aids and services to ensure effective communication with Plaintiff, Michael Argenyi. The federal court likewise awarded injunctive relief in favor of Michael to allow him to complete his medical education with the auxiliary aids and services that Michael has long sought through this litigation. United State District Court Judge Smith Camp in her order stated, “Beginning in the fall semester of 2014, and continuing until his graduation or the discontinuation of his enrollment as a medical student, Creighton University will provide Michael Argenyi with auxiliary aids and services for his effective communication, including Communication Access Real-time Transcription (CART) in didactic settings and sign-supported oral interpreters in small group and clinical settings.”

On January 17, 2014, Disability Rights Nebraska filed Michael’s Bill of Costs with the Court, requesting over $14,000.00 in taxable costs be awarded to him and Disability Rights Nebraska. On May 8, 2014, United States District Court Judge Smith Camp issued a final Order awarding fees and costs to the Plaintiff Michael Argenyi in his struggle to secure reasonable accommodations to complete his medical education at Creighton University.

Disability Rights Nebraska Board and staff were proud and happy to hear that, on July 2, 2014, Michael Argenyi returned to medical school at Creighton University. Creighton is providing Michael the auxiliary aids and services as ordered by the District Court and the matter has been resolved.

The significance of this case lies in the legacy of the almost 25-year- old Americans with Disabilities Act. Children who grew up with access to the accommodations made available through that act are now entering college and the workforce and as a result, are sometimes encountering previously invisible barriers to valued professions. Examples of these encounters can be found not only in the field of medicine, but also pharmacy and law, among others. Some of these barriers have been addressed by public institutions and Universities, but access to accommodations at private universities and full access across the board are still areas of contention. The decision by the courts to uphold this student’s right to accommodations to allow him to pursue a path to becoming a doctor has the potential to influence policies on accommodations at post-secondary institutions not just for deaf students but for any student with a disability who requires an accommodation to fully participate.

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.

Priority 1: PROTECTING AND ADVOCATING FOR HUMAN AND LEGAL RIGHTS Image of the Future / Need addressed: We protect and advocate for the human and legal rights that ensure the safety, personal integrity and self-determination of all people with mental or physical disabilities in the state of Nebraska and especially those who are isolated, vulnerable and at risk. We are committed to seeking justice for people with disabilities, including freedom from harm, abuse, neglect and financial exploitation.

Objective 1.1: Investigate and/or respond to 11 allegations of practices that cause or contribute to the physical and/or emotional abuse, neglect or death, or financial exploitation of any individual with a disability in Nebraska.

Objective 1.2: Investigate and/or respond to 3 allegations of rights violations.

Objective 1.3: Investigate and/or respond to 8 allegations of failure to provide for equal and complete access to a full range of services and support in the most integrated and socially inclusive environment(s).

Collaboration: Because of its sparse population and geographic spread, human service professionals in that part of the state find that the most effective way to get anything accomplished is to work personally and collaboratively. Our case advocate in Scottsbluff is part of a number of groups and coalitions that touch on disability issues and fosters those connections on a daily basis. Her connections with the Nebraska Commission for the Deaf and Hard of Hearing allowed for the collaborative efforts that made the following case example a success.

Number of cases handled: A total of nine (9) cases were addressed under this priority.

Case Example: A young woman who is deaf and lives in the western half of the state was involved in programs with Nebraska Health and Human Services, Probation and an educational program called Re-connect. The probation office sent over a family support worker to work with her to meet her needs and to help her access community resources. Unfortunately, the case worker was not fluent in sign language and was “self taught.” This did not provide effective communication for the woman. The Disability Rights Nebraska case advocate worked with the Nebraska Commission for the Deaf and Hard of Hearing to ensure auxiliary aids and services were provided and were effective for the woman.

Priority 2: LEADING CHANGE WITHIN THE COMMUNITY Image of the Future / Need addressed: We are a community-minded organization that partners with other like-minded organizations to help people learn and serve in order to create meaningful, authentic opportunities for all people with disabilities to be fully included in communities of their choice. We recognize that “community” has multiple meanings, but our understanding emphasizes: • Non-segregation • Having valued social roles • Accessing culturally-valued opportunities, and Honoring people’s individuality and meaningful choices based on their interests, desires, and wishes.

Objective 2.1: Organize and/or support a statewide coalition to implement recommendations developed from previous research on State Office of Public Guardian Model laws and alternatives to guardianship / conservatorship. This objective was altered when it became apparent that we could do far more than organize a coalition. See Section IV. A Systemic Activities for a detailed account of this objective.

Objective 2.2: Conduct one (1) training session on guardianships/ conservatorships from the perspective of a disability rights organization in each of the six (6) Developmental Disability and Behavioral Health Service Regions. A total of four trainings were conducted (2 in Grand Island, one in Elkhorn, one in Omaha), training 140 people. Four (4) people were trained at “Train the Trainer” workshop in Kearney, with participants providing feedback on the new curriculum.

Collaboration: Disability Rights Nebraska collaborated with the Arc of Nebraska to develop the curriculum for this training and for future “train the trainers” trainings. Also collaborated with directors of the Nebraska Transition Summit, Elkhorn Public Schools, and PTI-Nebraska.

Number of Cases: N/A Case Example: N/A

Priority 3: BUILDING RELATIONSHIPS IN THE COMMUNITY Image of the Future / Need addressed: We create tangible results and get things done while acting with courage, perseverance, tenacity, and flexibility. We act with integrity through respectful and honest communication and collaboration that reflects positive teamwork among the Board, Advisory Councils, staff, people who seek our assistance, community partners, and allies. We value connections with community resources outside the service world.

Objective 3.1: Organize a statewide collaborative work group to develop strategies and a plan to advocate for state legislation that addresses the issue of restraint and seclusion of students with disabilities in Nebraska’s schools.

Objective 3.2: Serve as a Disability Rights Nebraska liaison with local, state, federal and national organizations and the Nebraska Congressional delegation.

Collaboration: Working in conjunction with an intern that Disability Rights Nebraska shared with the Nebraska Chapter of the Multiple Sclerosis Society, Elliott Bulling, public policy staff conducted research on the incidence of restraint and seclusion in schools--drawing upon reports from National Disability Rights Network, Governmental Accountability Office, and reports from other states. Public Policy staff compiled the research into an internal report on the incidence of restraint/seclusion and issues that potential legislation should address. • The CEO’s Liaison work included relationship-building with representatives of a number of organizations: CEO attended a reception for the Nebraska Statewide Independent Living Council (NSILC) and the Mental Health Association- Nebraska. Collaborated with NDRN on the Convention for the Rights of People with Disabilities by posting on our website and creating a page dedicated to the Convention. Also, met with Nancy Johner and other Omaha and Washington, DC staffers of Sen. Mike Johanns to discuss the Convention. • CEO opened a dialog with Deb Brownyard, Dispute Resolution and Special Court Programs, State Court Administrator’s Office, to share information about the issue of guardianship abuses in Nebraska. Deb is a connection with the Chief Justice. • CEO participated in the NDRN CEO meeting (Oct 21 — 23) to discuss issues affecting the national network. • CEO had meetings with John Wyvill, new Executive Director of the Commission for the Deaf and Hard of Hearing; Jane Hudson, Executive Director of the Iowa P&A; and the directors of the Nebraska DD Network exploring possible collaboration between our organizations. Number of Cases: N/A Case Example: N/A

Priority 4: VALUING AND APPRECIATING DIVERSITY Image of the Future / Need addressed: We respect the strength of difference and diversity across disability and ethnicity. We promote awareness of the life experience of people with disabilities and the importance of diversity in creating strong communities. We recognize and incorporate people’s strengths and commit the time and resources necessary to enable all stakeholders to provide input, express their ideas, and support our mission. We value the energy, creativity and enthusiasm that all participants bring to achieving our shared vision. We seek to be a learning organization that assists our Board, Advisory Councils, staff and community partners in valuing and appreciating cultural diversity.

Objective 4.1: Continue to build collaborative partnerships with Lakota Lutheran Center and Winnebago Tribe to share information and provide outreach and services to people with disabilities. Two key staff members from Disability Rights Nebraska worked with Lakota Lutheran Center director and Board Member Will Voss to plan a disability-focused workshop for Native American women. The collaborative efforts of Disability Rights Nebraska and the Lakota Lutheran Center culminated in a Disability Awareness Workshop for 31 Native American women on February 13, 2014. They came to the Lakota Lutheran Center for a day of talking about disability issues and how Native women can identify these issues and how they can be advocates for those in the community with disabilities. This event was made possible by the generosity of the Women of the Evangelical Lutheran Church in America (ELCA) who granted monies to complete this project. Ten volunteers from the Lakota Lutheran Center helped with the success of the Disability Awareness workshop. The volunteers decorated the Center in a festive Valentine theme, conducted games with prizes during the breaks, prepared a delicious lunch and led a prayer that emphasized generosity and the caring for others. Will Voss of the Lakota Lutheran Center started off the day with a reflection on Luke 4 and Isaiah 61 which lays out the groundwork for ministry and reaching people of all backgrounds. Angie Hoff from the Scottsbluff office of the Commission for the Blind and Visually Impaired was the first speaker of the day. She explained about the many services available through her organization for people who are blind or visually impaired. She also made her presentation interactive by showing specially designed equipment to assist people and passed the equipment to the audience for a closer look. Some of the equipment was large print calendars, alarm clocks and calculators. The audience asked about the causes of blindness and related stories about loved ones who were blind and could benefit from the services offered by the Commission. The second presenter of the day was Rebecca Christian from the Fair Housing Center- Chadron. She explained the rights of people under the Fair Housing Act which covers not only people with disabilities but also people of color. The audience learned about housing discrimination, the use of testers and providing accommodations to people. Ms. Christian was so excited about the event that she stayed for most of the day. Tania Diaz from Disability Rights Nebraska led the lunch crowd, which had now grown to 65 individuals, in a discussion about disability etiquette. She read scenarios involving people with disabilities and asked the group how they would react in the situation- such as is it okay to use a handicap bathroom stall if you don’t have a disability or should you give the waiter the lunch order of a friend because she is blind? These scenarios were well received and the group wanted Ms. Diaz to keep giving them more scenarios. A few individuals responded to the scenarios talking about their loved ones with a disability and how they would respond to the situation. Also, a prize was given to the person who could say the word of the day- Advocate- in the Lakota language. The day ended with Mindy Nepper of Disability Rights Nebraska talking about Special Education and how to advocate for your child at an Individualized Education Plan meeting. She explained your rights as a parent and also the many different processes in Special Education. The group responded well to the presentation and people asked questions and also related some of their personal stories about their own children in Special Education. Mindy Nepper, through her relationships in the community, also brought donated new books for the children and families at the event. 150 books were handed out as well as 20 book bags. The children were so excited to be able to pick out their own books. Another part of the grant was to foster leadership between Native American women of the Lakota Lutheran Center and people with disabilities. Tania Diaz of Disability Rights Nebraska attended the Native American Wellness Conference to meet leaders in the Native American community and to bring back ideas on future collaboration between the Lakota Lutheran Center and Disability Rights Nebraska. The conference was an excellent example of how issues intertwine between Native Americans and people with disabilities. Examples of how these groups intersect: • Session on the high incidence of sexual assault of Native American women and how this may result in Post-Traumatic Stress Disorder and/or Depression from these abusive situations. • Session on Fetal Alcohol Syndrome- the effects on children and how to communicate prevention in an easy and understandable way. • Session on train the trainer- how to teach Native Women about breast cancer awareness and HIV prevention. • Session on Environmental Justice for Native Americans- how pollution is causing cancer and other disabilities on native lands. The use of digital story-telling to get your message into the media. • Session on obesity and the perception of obesity among Indian female youth. Tania Diaz and Will Voss will use these examples as a guide on how to shape future collaborative activities between Native Americans and people with disabilities. One referral from Lakota Lutheran Center also resulted in Disability Rights Nebraska opening a PAIR case involving a 16 year old female who is deaf and was not being provided an interpreter when dealing with the Dept. of HHS and her newborn child.

Objective 4.2: Continue to build and/or maintain relationships with key stakeholders/gatekeepers in the Nebraska Panhandle. In November, Legal Services Director Tania Diaz travelled to Scottsbluff and conducted activities with Western Office Advocate Mindy Nepper in Scottsbluff office. In addition to voter registration drives focusing on Native Americans with Disabilities (Lakota Lutheran Center) and youth with disabilities (Community Action and Transitional Living Program), they also met with a number of community contacts there: Rev. Tim Stadem, St. John’s Lutheran, Alliance Rev. Ann Sundberg, Immanuel Lutheran, Chadron Ms. Nancy Steele, president, Calvary Lutheran, Scottsbluff. Mr. Craig Stirtz, Lutheran Planned Giving, Omaha Pr. Tom Smith, United Church of Christ, Bayard Rev. Ron Nuss-Warren, First Presbyterian Church, Scottsbluff Rev. William Voss, Lakota Lutheran, Scottsbluff Andrea Miller, JD., Simmons law firm, commissioner, Nebraska Commission on Indian Affairs, Scottsbluff Sabrina Sosa, Transitional Living Program Coordinator, Scottsbluff Linda Redfern- Current Director of Region 1 DD Services Benjamin Patch- Retired Director of Region 1 DD Services One referral from the Transitional Living Program Coordinator resulted in a number of resources being shared with the coordinator to assist a young man who is deaf and had been homeless for a time. The Western Office Advocate, Mindy Nepper, participates monthly in meetings of Balance of State Continuum of Care coalition, Panhandle Partnership for Health and Human Services, and the Developmental Disabilities Council. The Panhandle Partnership for Health and Human Services (PPHHS), Inc. is a non-profit membership based organization serving the eleven counties of the Panhandle. For the past fifteen years, PPHHS has served as a catalyst for collaboration in the development of creative opportunities for enhancing sustaining family and community life in Western Nebraska. PPHHS does not provide services. Rather it brings people from diverse backgrounds, disciplines, and sectors together to assess, plan, implement and evaluate systems, policies, practices, and programs which strengthen communities and increase protective factors for families, children, youth, families, and seniors. The existence of PPHHS as a relationship based, well -structured neutral collaborative infrastructure has poised the Panhandle to not only significantly change Panhandle systems and services but also to provide leadership at state and national levels, and to be able to readily respond to new opportunities. PPHHS believes as a group, they can develop human and fiscal resources that better meet the service needs of the people in the panhandle. The board of directors is responsible for the management and administration of PPHHS and is elected from the general membership of the organization. Several subgroups have formed from PPHHS as funding opportunities have occurred. At this time, Mindy is involved with System of Care ages 0-8, System of Care for Youth, Home Visitation Program, Panhandle Prevention Coalition, State System of Care for Behavioral Health Planning, Circle of Security, Disproportionate Minority Contact, Community Response Team, and Juvenile Justice Team. Some of these teams/groups overlap onto each other as well as stand-alone when expertise is needed on specific topics. In the System of Care for ages 0-8, we are working on providing the availability of Circle of Security to all parents that are interested in participating in this reflective parenting course. Mindy has advocated for having instructors who are trained to work with adults and children with intellectual disabilities to also be trained facilitators in the Circle of Security curriculum. Many of the current facilitators are licensed therapists and very familiar with working with individuals with mental illnesses but no one at the time this started worked with children or adults with other disabilities. At this time, there are now 2 individuals trained who have a background in Special Education that are trained to facilitate the training of this program throughout the panhandle. The System of Care has incorporated the question regarding disability into their intake forms as well as increased their knowledge of the programs that are available for children and families with disabilities. We have incorporated the Community Response Team work into this subgroup. We have had a huge response from the community in families that are in need that qualify for this program. In the first group alone of 20 applicants that were served with this program, 19 of the families had a family member with a disability. The group has asked for our agency to sit on this subcommittee to review the referrals and assist with resource acquisition so that the families can find the resources that they need to assist them. Another objective we have been working on is mental health assessments for children at risk ages 0-5 with the early intervention teams. We find that this is critical as there are so many children that are coming to kindergarten that have fallen behind their peers academically due to trauma, undiagnosed learning disabilities or behavioral health issues that are manifesting but not being recognized by anyone in their environment. Continuum of Care for Homelessness (CoC): Mindy is a member of the Continuum and also serves as the Vice President of the board. Her focus is serving the population of homeless individuals that have a disability. Statistics show that the majority of individuals that are homeless also have some type of disability. The Committee’s focus is to raise awareness to this issue in our community, put a face and give a voice to those who are homeless, streamline the referral process so that individuals seeking assistance can have a process that is easy to navigate through, and work with the community providers in educating them on what is the driving force behind homelessness as well as disability awareness. As the Vice-President of Region 1 CoC, Mindy sits on the State CoC committee. They have a conference call every month to talk about state and regional issues as well as participate in the funding process for homelessness grants that are given to every region. As part of their activities, the CoC created a homelessness PR campaign that will educate the community on homelessness in the community and the underlying issues of mental health issues that accompany many individuals that face homelessness but also reduced the stigma of this issue. They also staged a movie night that featured the movie Pursuit of Happyness, accompanied by two speakers from the community to speak on homelessness. Everyone will be given information regarding homelessness in the panhandle as well as resources available in the community. A variety of community agencies were represented at the viewing and provided information on their services. Additional “events” are still being coordinated that will continue to work on educating the community on the issue of homelessness, reducing the stigma of homelessness, and what the faces of homelessness are in the panhandle. This has included a media campaign as well as creating brochures and other informative pamphlets. Region I Developmental Disabilities Planning Council: Mindy sits on this Advisory Council for Region 1. The Council discusses issues that are relevant to our group as well as approve funding requests from a small amount of money that Region 1 receives each year from the Nebraska Developmental Disabilities Planning Council. This also gives Mindy the opportunity to network with other disability organizations on a monthly basis. Youth Network meeting: Organized by Region 1 Behavioral Health Services, this group has significantly dwindled in participation and does not seem to be working on anything productive at this time. They have resisted work with the Panhandle Partnership (PPHHS) as they do not want to lose their ability to get providers outside their agency around the table to discuss community issues. They have taken an approach in the last year where they are just having people come in and give presentations about their organization or program as well as have everyone share upcoming events in their agency. Mindy’s attendance this next year will be based on availability and if she is asked to come speak since this group meets at the same time as a System of Care meeting for PPHHS. Mindy also has periodic contact and has established relationships with over 70 additional agencies and entities including local hospitals & care providers, schools (grade school, middle school, high school and local community colleges), local law enforcement & corrections, service providers, churches, and community development organizations. During the 3rd Quarter, Mindy began work with volunteers from DOVES to educate their volunteers about the basics of disabilities starting with people first language and disability vocabulary. They are also interested in being exposed to the basics as well as information about some of the more specialized populations and see Disability Rights Nebraska as a resource. The DOVES Program provides services for victims of Domestic Violence, Dating Violence, Sexual Assault, and Stalking. There are a number of service providing agencies that want to know more about disabilities and are interested in training their workers on how best to serve those with disabilities. Over the course of the summer, Mindy staffed information booths at over a dozen community events including the Minority Health Fair at the Guadalupe Center in Scottsbluff and Oregon Trail Days. In September, the CEO and Executive Assistant traveled to Scottsbluff to meet with the western office Case Advocate and participate in the United Way Rubber Duck Dash. Approximately 400 people attended the event. Disability Rights Nebraska had a table offering information. All three staff members did their best to satisfy the steady demand for application of water-based temporary tattoos from the younger members of the crowd. The CEO and Executive Assistant also made an outreach visit to the Methodist Church in Gering, NE to meet members of the congregation and talk about the work we do.

Objective 4.3: Identify two (2) new ethnic-based groups or organizations to begin conversations and participate with in community activities to increase awareness about Disability Rights Nebraska. With our limited resources and stronger connections in the community, we decided to focus on efforts on western Nebraska. Case Advocate Mindy Nepper was asked to assist and participated with the planning of the Annual Fort Robinson Intertribal Celebration. She also staffed a table at the powwow and distributed materials about the P&A. Over 1,000 people attended the Celebration.

Conversations are ongoing with leaders in the African American and Hispanic communities. An outreach effort is underway in the Omaha Hispanic community that is raising awareness of our work and building a strong connection with Hispanic groups and leaders.

Objective 4.4: Use a variety of media and community events to celebrate diversity and share stories of individuals within the disability community and information about policies affecting people with disabilities. Our web site and Face Book page are updated regularly. The Media Team posts news articles and other disability rights-related items several times during the week. The number of followers on Facebook has grown from 409 to 526 at the end of the fiscal year. We have purchased a new data base system for managing our mailing list and donor list. The new program allows us to create e-newsletters and mailings easily to increase our public awareness efforts. Two press releases and e-newsletters were distributed; guardianship challenge and victory in the Michael Argenyi case against Creighton University Medical School.

The CEO and Executive Assistant researched utilizing marketing interns and met with a representative of the Advertising / Marketing Department Student group from UN-L to discuss possibilities.

Website hits reached 11,821 this year. We made a concerted effort to update the website on a regular basis. During the first quarter, the CEO wrote a blog and created a separate website page for the Convention for the Rights of People with Disabilities. Other timely features included a feature on Veteran’s Day and a feature on Service Animals and a local business that trains them. The service animal feature resulted in the initiation of a discussion about conducting self-advocacy training for people with disabilities acquiring new service animals.

Collaboration: See above. Number of Cases: N/A Case Example: N/A

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.

PAIR Priorities for FY 2015

PRIORITY 1: PROTECTING AND ADVOCATING FOR HUMAN AND LEGAL RIGHTS

Image of the Future / Need Addressed: We protect and advocate for the human and legal rights that ensure the safety, personal integrity and self-determination of all people with mental or physical disabilities in the state of Nebraska and especially those who are isolated, vulnerable and at risk. We are committed to seeking justice for people with disabilities, including freedom from harm, abuse, neglect and financial exploitation.

Objective 1.1: Investigate and respond to 3 allegations of practices that cause or contribute to the physical and/or emotional abuse, neglect or death, or financial exploitation of any individual with a disability in Nebraska.

Objective 1.2: Investigate and respond to 14 allegations of rights violations.

PRIORITY 2: LEADING CHANGE WITHIN THE COMMUNITY: Advocate for the elimination of segregated, congregated, and isolated programs, services, and facilities as well as the development of socially inclusive programs and person-centered services that are based on an individual’s preferences, choices, and desires.

Image of the Future / Need Addressed: We are a community-minded organization that partners with other like-minded organizations to help people learn and serve in order to create meaningful, authentic opportunities for all people with disabilities to be fully included in communities of their choice. We recognize that “community” has multiple meanings, but our understanding emphasizes: • Non-segregation • Having valued social roles • Accessing culturally-valued opportunities, and • Honoring people’s individuality and meaningful choices based on their interests, desires, and wishes.

Objective 2.1: Analyze and educate individuals about new and current regulations regarding Long-term Care and Home and Community-Based Services waiver(s) from the Centers for Medicare and Medicaid. Objective 2.2: Expand Inclusion Workgroup to a Coalition for Community Inclusion to advocate for the elimination of identified barriers to providing inclusive services and supports in integrated community settings.

Objective 2.3: Monitor the development and implementation of the Office of Public Guardian, including commenting on implementing regulations and attendance at regular meetings of the Advisory Council on Public Guardianship.

Objective 2.4: Conduct one (1) training for attorneys and judges to provide Continuing Legal Education credits on guardianships in Nebraska and one (1) educational presentation for law students.

PRIORITY 3: EMPOWERING OTHERS TO ACHIEVE FULL PARTICIPATION: Enable individuals to become strong advocates by providing individual advocacy and systems advocacy trainings, including ongoing support and follow-up to participants after the trainings.

Image of the Future / Need Addressed: Empowering people who have been devalued strengthens communities and we commit ourselves to the call, “nothing about us without us.” We affirm our belief that people who experience disabilities are the experts when it comes to living with a disability. We seek justice and empowerment in partnership with people who experience disabilities. Visible action and the power of positive expectations enable us to collaborate with others to create meaningful results. Through compassion, really listening to others, and building trusting relationships, we share a common purpose to support people’s hopes, dreams, and things not yet imagined.

Objective 3.1: Develop the third module (self advocacy skill development) of a self-advocacy education curriculum for people with mental illnesses in Assisted Living Facilities, Community Mental Health Centers, Day Treatment Programs, Day Rehabilitation Programs and Adult Day Programs.

Objective 3.2: Develop a final proposal and submit to potential funding sources to re-establish a Pathfinder Volunteer Lay Advocacy Network across the state to support people in the community.

Objective 3.3: Facilitate greater self-determination of people with mental illness by creating opportunities for shared decision-making. Through collaboration with the University of Nebraska’s Department of Psychology--Serious Mental Illness Research Group, develop a model educational program on shared decision making for use specifically by people with serious mental illnesses.

PRIORITY 4: BUILDING RELATIONSHIPS IN THE COMMUNITY: Create collaborative partnerships with other organizations to address issues which affect people with disabilities who are vulnerable, isolated, and/or at-risk.

Image of the Future / Need Addressed: We create tangible results and get things done while acting with courage, perseverance, tenacity, and flexibility. We act with integrity through respectful and honest communication and collaboration that reflects positive teamwork among the Board, Advisory Councils, staff, people who seek our assistance, community partners, and allies. We value connections with community resources outside the service world.

Objective 4.1: Analyze federal and state Department of Education guidance, directives, regulations, etc. regarding school zero-tolerance policies and collaborate with school districts about the effects of these policies on special education students and other students with disabilities.

Objective 4.2: Develop language for, and identify senator to introduce, a legislative study resolution that addresses the issue of restraint and seclusion of students with disabilities in Nebraska’s schools.

Objective 4.3: Identify members and organize a statewide collaborative work group to develop strategies and a plan to advocate for systemic improvements in the quality of mental health services provided in Nebraska prisons, re-entry planning and specialized community-based re-entry services. Objective 4.4 Collaborate with appropriate state agencies to ensure greater accessibility of state computer systems and applications by state employees and Nebraska citizens.

Objective 4.5: Collaborate with other organizations and state agencies to advocate for the establishment of the position of an ADA Coordinator for the State of Nebraska.

PRIORITY 5. PUBLIC AWARENESS AND OUTREACH

Image of the Future / Need addressed: We respect the strength of difference and diversity across disability and ethnicity. We promote awareness of the life experience of people with disabilities and the importance of diversity in creating strong communities. We recognize and incorporate people’s strengths and commit the time and resources necessary to enable all stakeholders to provide input, express their ideas, and support our mission. We value the energy, creativity and enthusiasm that all participants bring to achieving our shared vision.

Objective 5.1: Establish collaborative partnerships with ethnic, linguistic, and minority community organizations to share information and provide outreach and services to people with disabilities. Do this through: • Continuing to build and/or maintain relationships with key stakeholders/gatekeepers in the Nebraska Panhandle, and • Continuing conversations with two (2) ethnic-based groups or organizations to strengthen the relationships and increase participation and awareness building between Disability Rights Nebraska and these groups.

Objective 5.2: Participate in workgroup to plan and organize the 25th anniversary celebration of the Americans with Disabilities Act.

Objective 5.3: Produce content for, update and maintain Disability Rights Nebraska website, Facebook page, Twitter account and email newsletter. Identify, develop, update and/or maintain Disability Rights Nebraska public awareness materials and activities.

Part VI. Narrative

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

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

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

A. Source of Funding - Amount Received : Amount Spent Federal (section 509) 159,210 : 202,064 State 0 : 0 Program income 26,000 : 99,148 Private 0 : 0 All other funds 0 : 0 Total (from all sources) 185,210 : 301,212

B. Budget for the fiscal year covered by the report: Outline the budget for the fiscal year covered by the report (prior fiscal year), as well as a projection for the current fiscal year. Prior Fiscal Year : Current Fiscal Year Wages/salaries 99,690 : 116,069 Fringe benefits (FICA, unemployment, etc.) 22,054 : 29,925 Materials/supplies 531 : 691 Postage 328 : 365 Telephone 673 : 780 Rent 11,447 : 15,608 Travel 3,127 : 1,977 Copying - included w/ supplies & rental 0 : 0 Bonding/insurance 1,381 : 1,461 Equipment (rental/purchase) 2,257 :3,361 Legal services 6,246 : 9,436 Indirect costs 5,125 : 5,422 Miscellaneous 6,351 : 8,362 Total Budget 159,210 :193,457

C. Description of PAIR staff: Type of Position FTE : % of year filled : Person-years Professional Full-time 12 : 100% : 12 Part-time 3 : 100% : 1 Vacant 0 : 0 : 0 Clerical Full-time 4 : 100% : 4 Part-time 3 : 100% : 1 Vacant 0 : 0 : 0

D. Involvement with Advisory Boards: PAIR is represented on a joint advisory council along with Assistive Technology, Beneficiaries of Social Security, Traumatic Brain Injury and Voting Access funding sources. The Advisory Council meets 2-3 times a year to review and suggest new objectives, and review and recommend adoption of budgets and specific objectives. The composition of the PAIR/PAAT/PABSS/PATBI/PAVA Advisory Council includes individuals with disabilities, members of the Disability Rights Nebraska Board of Directors, and representatives from collaborating organizations such as the Division of Medicaid & Long-Term Care, CAP, Statewide Independent Living Council, Commission for the Blind, Commission for the Deaf and Hard of Hearing, and the Assistive Technology Partnership.

E. Grievances filed under the grievance procedure: 2 Grievance 1: Client wanted to sue doctor for verbal abuse. Service Request was responded to with I&R and advice. Grievance filed. CEO spoke with client by phone and suggested that a lawsuit against doctor would not be successful. Suggested that client consider filing a written complaint to the Chief Medical Officer at the hospital, also provided contact info to file a complaint with the network the doctor worked for. CEO followed up with written referrals.

Grievance 2: Client who uses a walker wished to sue store for lack of accessible entrance because store policy was to keep one of a pair of double doors locked. CEO investigated, researched ADA requirements, visited store and talked with staff about the policy and communicated his progress to the client in writing. As of the end of FY 2014, CEO was awaiting a return call from the owner of the store regarding amending the policy to allow for greater accessibility.

F. Coordination with the CAP: P&A staff and CAP staff have periodic case consultation throughout the year. The CAP Director is a member of the Disability Rights Nebraska Board of Directors. The Director of the Client Assistance Program (CAP) and the Director of the Long-Term Care Ombudsman’s office from the Nebraska Division of Medicaid & Long-Term Services serve on the PAIR Advisory Council.

Certification

Signed?Yes
Signed ByTimothy Shaw
TitleAuthorized Certifying Official
Signed Date12/19/2014