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

Alabama (UNIV OF ALABAMA ALABAMA - DISAB ADVOCACY PROGRAM) - H240A150001 - FY2015

General Information

Designated Agency Identification

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

Part I. Non-Case Services

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

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas131
2. Individuals receiving I&R outside PAIR priority areas141
3. Total individuals receiving I&R (lines A1 + A2)272

B. Training Activities

1. Number of trainings presented by PAIR staff25
2. Number of individuals who attended training (approximate)947

1) Name of Training: 2015 Arc Annual Conference Training Topics Covered: Transitioning from school to work; the barriers and benefits of working Training Method: Q&A, Lecture Purpose of Training: To educate stakeholders and beneficiaries of SSA benefits about transitioning into the workforce Number Attending: 20 2) Name of Training: 2015 JBS Parent Support Group Training Topics Covered: Children’s mental health and behavioral needs Training Method: Q&A, Lecture Purpose of Training: To provide members of the Jefferson, Blount, St. Clair Mental Health Authority's parent support group with the advocacy skills they need to ensure their children's mental health and behavioral needs are met in school through proper implementation of the IDEA and Section 504. Number Attending: 11 3) Name of Training: 2015 NDRN Annual Conference Training Topics Covered: Sheltered workshop monitoring Training Method: Q&A, Lecture Purpose of Training: The P&A presented information on our collaboration with NDRN and other stakeholders about sheltered workshop monitoring in order to educate other P&A’s. Number Attending: 50 4) Name of Training: 2015 Raising the Standards Topics Covered: Understanding how the state uses its content standards to ensure access to the general curriculum as required under the IDEA. Training Method: Q&A and PowerPoint Purpose of Training: The P&A and the Alabama State Department of Education (ALSDE) co-presented at an annual conference sponsored by the Alabama Parent Education Center (APEC). The conference sought to educate parents on how to use the state's academic content standards to write IEP’s that ensure access to the general curriculum for students with disabilities. In a back-and-forth dialogue, the ALSDE laid out how one writes an appropriate IEP using the state's content standards and the P&A offered advocacy tips and explored common barriers it sees with IEP development. The conference broadcast via live webcam to three locations. Among the issues addressed were: 1) how IEPs should address functional needs (e.g., behavior and mental health concerns, daily living skills or transition needs (for which there aren't always identified content standards); 2) how the IEP team should consider the need for AT devices and services and what that consideration should look like; 3) how parents should keep track of their children's progress (via concrete, measurable data) and address a lack of expected progress in a timely way; 4) how parents can address disagreements through the IDEA's due process mechanisms; 5) eligibility and the IDEA's 13 disability categories and when/how pre-referral services can be skipped; and 6) how/when transition planning needs to start to ensure that youth are prepared for post-school independent living and secondary schooling/employment. Number Attending: 75 5) Name of Training: 504: The Red-Headed Stepchild Topics Covered: Using Section 504 to serve the learning needs of students with ADHD. Training Method: Q&A, PowerPoint, Lecture Purpose of Training: The P&A presented at the 7th Annual Southeastern ADHD Conference on how to use Section 504 to ensure that eligible students with ADHD are properly served and provided equal access to school programming. Because of having participated in this session, attendees — parents, teachers, clinicians, and vocational rehabilitation providers - understand the scope of Section 504 in relation to other laws supporting the rights of individuals with disabilities (including the Individuals with Disabilities Education Act (IDEA) and the Americans with Disabilities Act (ADA)). They understand what it takes to be eligible for the protections offered by Section 504 and how to use its enforcement mechanisms to protect the civil rights of children with ADHD. Number Attending: 165 6) Name of Training: ACT Waiver Training Topics Covered: The availability and nature of services available to persons with disabilities at risk of entering nursing homes through Alabama's ACT Medicaid waiver. Training Method: Q&A, PowerPoint, Lecture, Presentation Publication Purpose of Training: To educate clinical directors of Department of Mental Health (DMH) providers on the ACT waiver services available and how to connect potential waiver beneficiaries with the ACT waiver operators. Number Attending: 30 7) Name of Training: You don’t need a superhero to handle special education problems. You’re a super foster parent! Topics Covered: Focus on eligibility for special education services, ensuring that special education be used to support an eligible child's emotional needs, and effective transition planning, including employment supports for students on SSI. Training Method: Q&A Purpose of Training: The P&A presented at the annual meeting of the Alabama Foster and Adoptive Parent Association (AFAPA) using case examples to illustrate a school's "Child Find" obligations under the IDEA, how special education services can support the social and emotional needs of children with disabilities, and how to ensure that effective transition services are provided to older youth, including employment opportunities for youth on SSI and access to adult services through the state's home and community based Medicaid waivers. Number Attending: 19 8) Name of Training: Foster Parent Training - Birmingham Topics Covered: IEP’s and 504 plans; self-advocacy for foster parents and identification of behavioral needs within the Birmingham school system. Training Method: PowerPoint Purpose of Training: This training took place in order to give foster parents information about the P&A and to educate them to navigate issues with the public schools regarding their foster child's disability. Number Attending: 25 9) Name of Training: Guardianship Presentation Topics Covered: Alternatives to full guardianship Training Method: Q&A, Lecture Purpose of Training: To educate social workers, group home operators, and mental health and other associated professionals on the definition and availability of alternatives to full guardianship in order to maintain individuals' choices to the extent possible. Number Attending: 55 10) Name of Training: Leadership Education in Adolescent Health (LEAH) Training Topics Covered: The rights that children with disabilities have to special education and Medicaid Training Method: Q&A, PowerPoint Purpose of Training: LEAH, funded by the Maternal and Child Health Bureau, provides interdisciplinary leadership training in adolescent health for five core disciplines including medicine, nursing, nutrition, psychology, and social work. The P&A educated the LEAH fellows about its work related to special education and Medicaid advocacy for children with disabilities, so they could support their patients' needs better. Number Attending: 10 11) Name of Training: Managed Care: Protecting Consumer Rights Topics Covered: Production of a pamphlet or similar handout for use by consumers in accessing the community advocacy rules applicable to Alabama's soon-to-be-implemented Medicaid managed care system. Training Method: Training Publication Purpose of Training: Alabama is transitioning from a fee-for-service Medicaid system to a managed care system. The P&A is committed to educating persons with disabilities about managed care options and their rights, responsibilities, and protections under Medicaid managed care. To prepare a consumer rights brochure, the P&A reviewed the state's Medicaid HCBS 1115 waiver application and the proposed contract between the state Medicaid agency and regional care organizations (RCO’s) which are going to be administering the managed care system throughout the state. 12) Name of Training: Home and Community Based Services (HCBS) Topics Covered: Production of a pamphlet or similar handout explaining Alabama’s Medicaid waiver programs to consumers. Training Method: Training Publication Purpose of Training: ADAP wrote and published a brochure designed to educate consumers about Alabama's seven home and community based waivers. The brochure included information about eligibility standards for each of the waivers; the application processes used by the administering state agencies; and consumer rights under the waivers, including how to appeal denials of eligibility and services. Approximately 5000 people are on waiting lists for waiver services in Alabama. Eight hundred copies of the brochure were initially printed. The brochure was also posted on the P&A website. 13) Name of Training: Medicaid Managed Care Presentation Topics Covered: Current Medicaid managed care reform in Alabama and what current reform efforts signal for managed care reform in Alabama more generally. Training Method: Q&A, Lecture Purpose of Training: To inform parents of Medicaid-eligible children about recent developments in managed care reform in Alabama and the implementation of the RCO reform throughout the state. Number Attending: 20 14) Name of Training: Rethinking Long-Term Care Topics Covered: The present state of LTC in Alabama and engage them to identify goals for the state's LTC system and mechanisms by which stakeholders could further influence enactment of LTC reform. Training Method: Panel Discussion, Q&A, Lecture Purpose of Training: In Alabama, nursing homes long have been the dominant force in long-term care (LTC). The 2013 Medicaid reform law requires a review of the state’s long-term care system but does not spell out consumers’ role in that process. At this training, the P&A helped more than thirty advocates 1) explore Alabama’s present LTC system, 2) envision what a consumer-driven LTC system would look like, and 3) develop plans for how to become meaningfully engaged in the LTC review process currently underway. The ideas generated by this work session will be used by the P&A and its stakeholder colleagues to develop a proposed plan for LTC that is consumer driven. Number Attending: 32 15) Name of Training: Special Education Tips Topics Covered: The top special education mistakes the P&A sees and what parents can do to fix them. Training Method: Q&A, Lecture, PowerPoint Purpose of Training: The P&A educated parents, clinicians and teachers about common special education procedural and substantive violations and how they can address them to ensure that a child's right to a free appropriate public education is protected. Number Attending: 34 16) Name of Training: Summer JPO Training Topics Covered: Participants will learn to protect their clients' right to a free appropriate public education by knowing how to use the IDEA and Section 504 to guard against inappropriate disciplinary actions that remove children from school. Training Method: Q&A, PowerPoint, Lecture Purpose of Training: The P&A educated a new class of juvenile probation officers on how to effectively advocate for their clients' special education needs to prevent inappropriate school removals and to ensure provision of adequate behavioral supports. Using a story about "Marcus," a middle school student who had been charged with disorderly conduct in school, the P&A explored various points in the student's school career where his school system neglected referral and evaluation obligations. The trainer helped the juvenile probation officers understand how Marcus's school should have addressed his behavioral issues and how those behavioral issues were affecting his school performance. The trainees learned how to respond to disciplinary actions taken by schools against their juvenile clients, including how to participate in a manifestation determination review and how to ensure the provision of needed behavioral support services. Number Attending: 11 17) Name of Training: Tuscaloosa Consumer Advisory Council Training Topics Covered: Assistive technology and Medicaid. The P&A has an interest in helping power chair using people living in nursing homes who are being refused new power chairs. Training Method: Q&A Purpose of Training: The P&A participated in the Tuscaloosa area Consumer Advisory Council training for the purpose of sharing its priorities and the work the P&A does and to hear from others what issues affecting them and other individuals with disabilities. The P&A was able to share its interest in assisting persons in nursing homes that use power wheelchairs get the assistive technology they need. Number Attending: 6 18) Name of Training: Meet an Attorney Topics Covered: An outreach activity for families of youth with sickle cell disease (SCD) to learn about their children’s right to a free, appropriate public education under both Section 504 and the IDEA. Training Method: Q&A Purpose of Training: Sickle Cell Disease (SCD) is a serious genetic blood disorder affecting multiple bodily functions. Children with SCD experience an array of complications, from minimal to severe, that substantially limit a broad range of major life activities. The University of Alabama/Birmingham (UAB) is Alabama’s primary provider of pediatric SCD services. UAB reported to the P&A multiple incidents of children with SCD being denied the school-based accommodations to which they were entitled under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act Amendments Act of 2008. The offending school districts were failing to identify and refer the students for evaluation to determine their eligibility as qualified students with a disability or, when the children had been appropriately identified, the districts developed inadequate Section 504 plans. Because of these reports, the P&A entered into collaboration with UAB that integrates a P&A attorney into the SCD patient clinics. During regular quarterly clinics, the P&A attorney meets with families to educate them about their children’s rights and to give the parents a chance to request direct advocacy services regarding his or her child’s school-based needs. SCD almost exclusively affects African American and Hispanic students. The disease affects such major life activities as walking, concentrating, thinking, and learning. Students with SCD typically need school accommodations like ready access to water; frequent bathroom breaks; modifications to physical education programming; rest periods; and accommodations to address learning problems resulting from their condition. Students with SCD may miss school time when they experience bouts of periodic pain and other complications associated with their disease, requiring homebound services and/or a waiver of regular attendance policies to allow for reduced days, shortened school day, late arrivals, doctor's appointments, etc. By failing to meet their obligations to identify and evaluate these students who need or are believed to need special education or related services, schools deny eligible students with disabilities access to instructional programs, supportive and related services, and the range of accommodations they need to enjoy the same opportunities to succeed as students without disabilities in violation of Section 504 of the Rehabilitation Act and Title II of the ADA, and their respective regulations. Number Attending: 60 families 19) Name of Training: Winter JPO Training Topics Covered: Participants will learn to protect their clients' right to a free appropriate public education by knowing how to use the IDEA and Section 504 to guard against inappropriate disciplinary actions which remove children from school. Training Method: Q&A, PowerPoint, Lecture Purpose of Training: The P&A educated a new class of juvenile probation officers on how to effectively advocate for their clients' special education needs to prevent inappropriate school removals and to ensure provision of adequate behavioral supports. Using a story about "Marcus," a middle school student who had been charged with disorderly conduct in school, the P&A explored various points in the student's school career where his school system neglected referral and evaluation obligations. The trainer helped the juvenile probation officers understand how Marcus's school should have addressed his behavioral issues and how those behavioral issues were affecting his school performance. The trainees learned how to respond to disciplinary actions taken by schools against their juvenile clients, including how to participate in a manifestation determination review and how to ensure the provision of needed behavioral support services. Number Attending: 13 20) Name of Training: Shelby County Outreach Fair Topics Covered: Set up exhibit and educate parents and service providers about the P&A and our services. Training Method: Exhibit, Q&A Purpose of Training: To make parents, youth, and relevant stakeholders aware of services the P&A can provide. Number Attending: 35 21) Name of Training: ADA 25th Legacy Tour Topics Covered: To organize and participate in outreach educational activities centered around how the Americans with Disabilities Act was created and improved access to people with disabilities over the last 25 years. Training Method: Exhibit, Q&A Purpose of Training: The P&A provided technical support for advertising, logos and photographing this event. The P&A had an exhibit and interacted with event participants about the P&A and its services. Number Attending: 85 22) Name of Training: Alabama Institute for Deaf and Blind Training Topics Covered: The P&A’s services and disability rights issues. Training Method: Q&A, Lecture Purpose of Training: The P&A participated in a training session on the rights of persons with disabilities. The P&A provided information about the rights to effective communication, assistive technology, interpreting services, reasonable accommodations, and voting rights. Number Attending: 12 23) Name of Training: Rotary Club Speech Topics Covered: The risks to persons with disabilities in the state as a result of the fact that the legislature has not approved a General Fund for FY16, just two months before the start of FY16. Training Method: Q&A, Lecture Purpose of Training: The P&A spoke to the Rotary Club (a civic club) in the state's capitol just two weeks after the Governor spoke to the same body, and just two months before the start of the new fiscal year. The P&A described the risk to persons with disabilities presented by proposed cuts to state services if FY16 budgets were not at least level-funded. Number Attending: 64 24) Name of Training: Songs for Sight Outreach Topics Covered: Information about the advocacy services the P&A provides to individuals with disabilities, their families, and how to contact the P&A if parents have concerns about special education rights. Training Method: P&A, Lecture, Exhibit, Training Publication Purpose of Training: To provide participants with information on how to access advocacy services of the P&A and to provide them with a copy of Special Education: A Right Not A Favor. Number Attending: 65 25) Name of Training: Low Vision Awareness Day Outreach Topics Covered: To inform participants about P&A services and how the P&A might help them or someone they know Training Method: Q&A, Exhibit Purpose of Training: The P&A exhibited information and brochures to the Low Vision Awareness day and spoke with individuals collectively about the P&A’s services, goals and priorities and handed out print information. Information was also shared with other agencies and vendors of low vision services and items. Number Attending: 50

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff0
2. Newspaper/magazine/journal articles15
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website25,069
5. Publications/booklets/brochures disseminated11,308
6. Other (specify separately)123

Narrative

ADAP Social Media Facebook postings: 103 with a circulation of 10,195 visitors ADAP Newsletter: 20 with a circulation of 2900 per issue from P&A mail list

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)34
2. Additional individuals served during the year31
3. Total individuals served (lines A1 + A2)65
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)4

B. Individuals served as of September 30

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

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility9
2. Employment1
3. Program access5
4. Housing1
5. Government benefits/services4
6. Transportation0
7. Education26
8. Assistive technology0
9. Voting0
10. Health care10
11. Insurance2
12. Non-government services1
13. Privacy rights0
14. Access to records0
15. Abuse0
16. Neglect6
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor18
2. Other representation found1
3. Individual withdrew complaint3
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.2
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit4
9. Other0

Please explain

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy2
2. Short-term assistance15
3. Investigation/monitoring3
4. Negotiation3
5. Mediation/alternative dispute resolution2
6. Administrative hearings2
7. Litigation (including class actions)1
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 42
2. 5 - 2223
3. 23 - 5929
4. 60 - 643
5. 65 and over8

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females22
2. Males43

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American29
5. Native Hawaiian or Other Pacific Islander0
6. White35
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent10
2. Parental or other family home32
3. Community residential home2
4. Foster care0
5. Nursing home4
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center17
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 hearing5
3. Deaf-blind0
4. Orthopedic impairment10
5. Mental illness0
6. Substance abuse0
7. Mental retardation1
8. Learning disability3
9. Neurological impairment11
10. Respiratory impairment1
11. Heart/other circulatory impairment6
12. Muscular/skeletal impairment3
13. Speech impairment1
14. AIDS/HIV0
15. Traumatic brain injury2
16. Other disability17

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities2

2. Number of individuals potentially impacted by policy changes179,000

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.

1) Parent Engagement/Transition Advocacy - The P&A worked collaboratively on a systemic effort with family support groups to advocate for improvements to the state's transition services provided to students with disabilities, by local school districts and overseen by the State Department of Education (ALSDE), and to enhance family participation in special education policymaking. Ineffective oversight by the ALSDE transition planning practices, inadequate employment development for youth, especially those with the most significant disabilities, and a weak parent voice in special education policymaking at the state and local levels were the problematic policies and practices prompting this activity. The P&A convened five self-advocacy groups to advocate for improvements to the state's rules related to special education transition service planning and delivery, including an emphasis on employment being the presumed school outcome for students with significant disabilities, better monitoring and oversight of transition services in the state, and greater parental engagement by schools . The committee drafted a statement of principles and recommendations and shared them with state policymakers, including the state's Special Education Advisory Panel (SEAP). As a result of this systemic advocacy the ALSDE revised its IEP transition planning page. 2) Due Process Regulations - As a result of the P&A's advocacy and those of other stakeholders and parents, the State Department of Education (ALSDE) withdrew proposed state special education regulations that would have violated the due process hearing rights afforded parents and children under the IDEA in fundamental ways. Among other things, the proposed changes would have shortened the special education statute of limitations to one year from two; instituted a summary-judgment like mechanism not allowed under the IDEA; and changed evidentiary rules. Further, the suggested changes would likely increase the number of complaints filed, lengthen the hearing process, involve more school staff time rather than less, and cause costs to rise. In addition, during the rule-making process, the state did not send the proposed regulations through the IDEA-mandated special education advisory panel (SEAP) to allow it to publicly comment on proposed regulations affecting children with disabilities, as required under federal law. As a result of this regulatory advocacy, the ALSDE better understands the role its SEAP must play in enacting policies affecting students with disabilities and because the evidentiary rules were not instituted, a parent and child's due process rights were protected.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts10,020
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.

1) Dunn, et al. (including ADAP) v. Dunn (DOC) The P&A and the Southern Poverty Law Center (SPLC) sued, alleging a systemic and unconstitutional deprivation of required medical and mental health care on behalf of the 26,000 individuals house in Alabama prisons. The suit also alleges the Department of Corrections (DOC) failed to comply with the Americans with Disabilities Act (ADA) on behalf of individuals with disabilities. More than 40 individual plaintiffs who represent all prisons in the state and exhibit a plethora of examples of unconstitutional care are named plaintiffs. The P&A represents plaintiffs on disability-related claims and is a named plaintiff to ensure appropriate representation of all affected groups. Plaintiffs seek class certification and obtained injunctive relief to restrain DOC from its practice of allowing unsupervised access to razor blades by inmates, including inmates who have a history of self-harm with razor blades. Discovery is underway. Phase One trial on ADA issues is set for June 2016. 2) The P&A filed suit against a provider of psychiatric residential treatment services for youth with disabilities in the Department of Human Resources (DHR) custody, claiming that the provider denied the P&A its statutory right to monitor one of the provider's Moderate Programs. After the U.S. Department of Justice (DOJ) filed a Statement of Interest supporting the P&A's right to monitor, the Court, in December 2014, granted the P&A's Motion for Summary Judgment and ordered the provider to give the P&A access to all Moderate Programs. The P&A is currently monitoring the all the programs for this provider and negotiating an Access Agreement with the DHR to monitor other Moderate Programs licensed by DHR across the State.

Part V. PAIR'S Priorities and Objectives

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

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

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

1. Identify and describe priority. Consumer and Self-Advocate Engagement — The P&A will strengthen the disability civil rights movement in Alabama by supporting and empowering persons with disabilities to speak for themselves and address policy and programming decisions that affect them. 2. Identify the need, issue or barrier addressed by this priority. The need addressed by this priority is for parents, consumers, self-advocacy groups, etc. to have a strong voice in policy and program decisions. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Advocate for enhanced parent engagement in special education policymaking. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. Arc of Alabama, People First of Alabama, Alabama Parent Education Center (APEC), Alabama Family Ties (AFT), Full Life Ahead Foundation, and the Autism Society of Alabama. These family support groups are uniting behind a common platform of needed changes to the state's transition delivery system to ensure better post school outcomes for students with disabilities and to enhance parent voice in special education policy planning. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. This priority was a systemic advocacy activity and no cases were proposed under this priority. 6. Provide at least one summary that demonstrates the impact of the priority. The P&A convened a committee of self-advocacy groups to advocate for improvements to the state's transition services provided to students with severe emotional disturbance (SED). The committee included representatives from one of Alabama’s independent living centers, the state Arc, People First of Alabama, Alabama’s parent training information (PTI) center, and a private non-profit whose mission is to provide planning support to families of youth with SED. The committee developed a set of transition principles it seeks to advance, including the fact that working in competitive, integrated employment, with or without supports, must be the presumed post-school employment goal for students with SED; students need opportunities for meaningful community learning; the State Department of Education (ALSDE) must hold schools to high standards and vigorously monitor them for outcomes and compliance, as the committee believes schools will only do the minimum required of them; and, finally, schools must do a better job partnering with families and helping them create connections with other provider agencies. The committee developed a series of recommendations, including: • The ALSDE should reinstate the 270 hours of required paid community work hours for students with significant SED. • The ALSDE should revise the state's electronic IEP form, including its template offerings for post-school outcomes which stifle meaningful individualized discussion and planning in IEP teams. • The ALSDE should move the mandatory start for transition planning back to age 14. • The ALSDE , in collaboration with stakeholders, including parents and consumer advocates, should refine its school monitoring mechanisms so that schools are held accountable for meaningful services, outcomes, and parent engagement, specifically incorporating the comprehensive NSTTAC I-13 checklist into its federally required monitoring of how schools implement the IDEA’s transition planning requirements for students with SED. • The ALSDE should mandate person-centered planning for students with SED. • The ALSDE should develop a specialist teacher endorsement in transition services and transition planning. These principles and recommendations were published and shared with relevant state leaders like policymakers at the ALSDE , the state’s IDEA-required special education advisory panel, and the Department of Mental Health. 1. Identify and describe priority. Well-Being in Facilities — Persons with disabilities in congregate and residential facilities will be free from abuse, neglect, and civil rights violations. 2. Identify the need, issue or barrier addressed by this priority. The need addressed by this priority is for persons with disabilities to be free from abuse, neglect, and civil rights violations. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Monitor residential treatment settings to ensure youth are receiving appropriate treatment settings related to allegations of abuse, neglect, and disability rights violations. 2) The P&A will advocate for its right to access facilities to monitor and investigate as provided for under its federal enabling statutes. 3) Ensure the Alabama Department of Corrections (DOC)complies with the American with Disabilities Act (ADA) and Constitutional standards for the provision of mental health treatment and physical and program access. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. The Southern Poverty Law Center (SPLC) is the P&A’s co-counsel in the Department of Corrections (DOC) lawsuit. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. The P&A provided two cases under this priority, both are for litigation purposes and the DOC lawsuit is a prospective class action case. 6. Provide at least one case summary that demonstrates the impact of the priority. Dunn, et al. (including ADAP) v. Dunn (DOC) The P&A and the Southern Poverty Law Center (SPLC) sued, alleging a systemic and unconstitutional deprivation of required medical and mental health care on behalf of the 26,000 individuals house in Alabama prisons. The suit also alleges the Department of Corrections (DOC) failed to comply with the Americans with Disabilities Act (ADA) on behalf of individuals with disabilities. More than 40 individual plaintiffs who represent all prisons in the state and exhibit a plethora of examples of unconstitutional care are named plaintiffs. The P&A represents plaintiffs on disability-related claims and is a named plaintiff to ensure appropriate representation of all affected groups. Plaintiffs seek class certification and obtained injunctive relief to restrain DOC from its practice of allowing unsupervised access to razor blades by inmates, including inmates who have a history of self-harm with razor blades. Discovery is underway. Phase One trial on ADA issues is set for June 2016. 1. Identify and describe priority. Medicaid and Managed Care — Adults and youth with disabilities will receive appropriate medical care and treatment. 2. Identify the need, issue or barrier addressed by this priority. The need addressed by this priority is for adults and youth with disabilities to receive appropriate medical care and treatment. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Educate policymakers of the need to incorporate long term services and supports (LTSS) benefits into the state’s Medicaid Managed care program. 2) Publish a brochure to educate persons about their rights under managed care. 3) The P&A will collaborate with the Disabilities Leadership Coalition of Alabama (DLCA) and Alabama Arise to train advocates to participate on regional care organization (RCO) governing boards and Citizen’s Advisory Committees. 4) The P&A will review RCO contracts, identifying issues of concern to consumers with disabilities including, e.g. providers and workforce adequacy. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. 1) The P&A is a subcontractor to Alabama Arise, a statewide anti-poverty advocacy group that received a grant from Community Catalyst to do health care advocacy in Alabama. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. This priority was project based and consisted of systemic advocacy and education / training/ outreach activities and no cases were proposed. 6. Provide at least one summary that demonstrates the impact of the priority. Alabama will transition from a fee-for-service Medicaid program to a managed care program in October 2016. This change will affect approximately 650,000 persons in the state. The P&A is working with two key advocacy groups to ensure the new system will adequately serve individuals with disabilities: the Disabilities Leadership Coalition of Alabama (DLCA) and Alabama Arise, a statewide anti-poverty group. The P&A and these partners educated consumer representatives to the advisory councils and boards of the Regional Care Organizations (RCO) which will be running the managed care systems in the five geographically defined service areas in the state. The education focused on positioning the representatives to effectively represent their communities’ needs. Education also kept the representatives abreast of developments in the rapidly changing programmatic and fiscal structures of the managed care system in the state, especially during the state’s budget crisis, which threatened to derail the managed care plan. The P&A reviewed legal documents being drafted to set up the managed care system, including the contract between the Alabama Medicaid Agency and the RCO. This review focused on provisions affecting network adequacy and consumer due process protections. The P&A met with representatives from each of the proposed RCO to address services for persons with disabilities. Regular meetings were held with the Alabama Department of Mental Health (DMH), the state’s Community Mental Health Centers, and the Alabama Council of Community Mental Health Boards (ACCMHB). The P&A was part of a work group convened by DMH to focus on the structure and financing of services for committed persons/persons at risk of commitment after the changeover to managed care. 1. Identify and describe priority. Nursing Homes — End unnecessary institutionalization of adults and youth with disabilities in nursing homes. 2. Identify the need, issue or barrier addressed by this priority. The need for adults and youth with disabilities to have alternatives to residing in nursing homes. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Advocate for individuals in nursing homes with allegations of abuse, neglect, and disability rights violations including access to the Alabama Community Transition (ACT) Waiver. 2) Monitor nursing homes facilities for abuse, neglect, and civil rights violations. 3) Publish a brochure describing home and community based services (HCBS) waivers, including the ACT waiver. 4) Provide education/training/outreach on nursing home alternatives in the state. 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. One individual case service was provided to an adult with a disability. 6. Provide at least one summary that demonstrates the impact of the priority. In our state, nursing homes have dominated long-term care (LTC). The state's recent Medicaid reform law requires a review of the state's long-term care system but doesn't spell out consumer's role in that process. At an Arise Policy Conference, the P&A helped more than thirty advocates: 1) explore the state's present LTC system, 2) envision what a consumer-driven LTC system would look like, and 3) develop plans for how to become meaningfully engaged in the LTC review process. The ideas generated by the conference helped the P&A and stakeholders develop a proposed plan for LTC that is more consumer-focused and driven. 1. Identify and describe priority. Community Access — Adults and youth with disabilities will have full physical and program access in all aspects of community life. 2. Identify the need, issue or barrier addressed by this priority. The need addressed by this priority is for adults and youth with disabilities to have the same access as those persons without disabilities. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Advocate for individuals with disabilities who have been denied access to services and programs in their community, including assistive technology. 2) Provide education/training/outreach on guardianship / conservatorship and alternatives. 3) Advocate for individuals with disabilities who have been subjected to unnecessary restriction of rights and/or freedom of choices, e.g. through guardianship/conservatorship. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. The P&A worked with the area Independent Living Center (ILC)- Disability Rights And Resources, as well as the Alabama Institute For Deaf and Blind (AIDB), People First, and other area businesses to plan and coordinate the ADA 25th Anniversary Legacy Tour education/training/outreach activity. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. The P&A provided 74 individual advocacy services to adults and youth with disabilities. 13 case services and 61 information and referral services were provided. 6. Provide at least one summary that demonstrates the impact of the priority. The P&A's client uses a walker and shops at her local CVS store. She had fallen while trying to access the store because she parks in the spaces closest to the entrance, though they are not accessible. (The accessible parking spaces are those furthest away from the door.) The client requested help from the P&A to have the accessible parking spaces moved to the front nearest the entrance. The P&A evaluated the parking lot and location of the spaces, and conducted a survey of the inside of the store, including the public restroom areas. The P&A send a letter to CVS outlining the barriers identified, and CVS corrected all the identified barriers. The client is please that she can now easily use her walker to get into the store and out with her purchases. 1. Identify and describe priority. Education — Youth with disabilities will receive a free appropriate education in their least restrictive environment. 2. Identify the need, issue or barrier addressed by this priority. The need addressed by this priority is for children with disabilities to have an appropriate education. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 1) Educate parents and policymakers about the rights of students with disabilities in public charter schools to safeguard the right to a free appropriate public education. 2) Track the Alabama State Department of Education’s (ALSDE) exercise of its supervisory authority to ensure that public agencies comply with state and federal special education laws. 3) Advocate on behalf of students with disabilities to ensure the provision of a free, appropriate public education (FAPE) in the least restrictive environment (LRE) with appropriate supports. 4) Train families and providers on special education rights and advocacy skills, including issues related to eligibility, provision of FAPE, right to assistive technology, behavior and discipline, transition, etc. 5) Track compliance with Alabama’s 2011 school seclusion and restraint regulations by reviewing state and local system data. 6) Advocate for better communication between schools and JPO’s to affect change regarding the number of children with disabilities detained and services that can be provided. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. 1) The P&A worked with the Bazelon Center to identify children with emotional disturbance (ED) and other behavioral issues in school. Bazelon is interested in helping the P&A put together an Office of Civil Rights (OCR) complaint and get it in the proper hands. 2) The P&A provided to the Administrative Office of the Courts (AOC) and Juvenile Judges aggregate data and information concerning report of serious occurrences in Psychiatric residential treatment facilities (PRTF), particularly involving youth in the welfare system who are appointed a Guardian Ad Litem (GAL). 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. The P&A provided 87 individual advocacy services to youth with disabilities. 19 individual case services and 68 information and referrals were provided. 6. Provide at least one summary that demonstrates the impact of the priority. The P&A filed a complaint with the Office of Civil Rights (OCR) on behalf of a high school student with cancer alleging her school failed to identify and evaluate her as a student with a disability and provide her with a free appropriate public education as required under Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act (ADA). The student’s mother had provided the school with extensive information about her condition and how it and the chemotherapy treatment she received affected her: nausea, vomiting, hair loss, fatigue, reduced stamina, pain, problems with sustained attention, speed in completing tasks, and problems with fine-motor skills. Despite having been advised of the student’s diagnosis and the substantial limitations it placed on numerous major life activities, the school took no action to consider the student as one with a disability under Section 504 and the ADA when it learned of her condition. Because the student was unable to attend school because of her treatment, and was not provided appropriate and individualized services to meet her needs, she was at risk of not graduating. OCR agreed to investigate the complaint. Negotiations between the P&A and the school district, with OCR’s involvement, led to the student’s being evaluated and provided an appropriate 504 plan. She then graduated from high school.

B. Priorities and Objectives for the Current Fiscal Year

Please include a statement of priorities and objectives for the current fiscal year (the fiscal year succeeding that covered by this report), which should contain the following information:

  1. a statement of each prioirty;
  2. the need addressed by each priority; and;
  3. a description of the activities to be carried out under each priority.

1. a statement of each priority; Abuse/Neglect — Individuals with disabilities will be free from abuse and neglect and live in healthier, safer, or otherwise improved facility or community setting. 2. the need addressed by each priority; and; The need addressed by this priority is for individuals with disabilities to be free from abuse and neglect and live in safer housing. 3. a description of the activities to be carried out under each priority. 1) The P&A will ensure the safety and well-being of individuals with disabilities residing in a facility or community setting by providing three individual advocacy services. 2) The P&A will conduct three investigations in facilities and/or community settings serving individuals with disabilities to ensure they are receiving appropriate treatment services and are free from abuse, neglect, and disability rights violations. 3) The P&A will ensure the Alabama Department of Corrections (DOC) complies with the ADA and Constitutional standards for the provision of appropriate treatment services and physical and program access for adult inmates with disabilities. 1. a statement of each priority; Community Access — Individuals with disabilities will have access to appropriate and individualized community-based services that will enhance their ability to live independently. 2. the need addressed by each priority; and; The need address by this priority is for individuals with disabilities residing in the community to have access to appropriate services. 3. a description of the activities to be carried out under each priority. 1) The P&A will provide three advocacy services to individuals with disabilities seeking to live in a less restrictive residential setting or improve their access to services to enable them to participate more fully in community life. 2) The P&A will work to ensure Medicaid waiver services are preserved and persons with disabilities are met by the long-term service and support (LTSS) benefit package to be included in the state’s developing Medicaid managed care program. 3) The P&A will conduct 10 education/training/outreach activities to persons with disabilities about the state’s new managed care health system. 4) The P&A will foster consumer participation in managed care governing boards and citizen’s advisory committees, and advocate for consumer protections and service expansion for persons with disabilities. 5) The P&A will provide state policymakers with two analyses of the state’s ability to plan for and provide appropriate, individualized services that align with the mandates of the new Home and Community Based Services (HCBS) waiver regulations and the Achieving a Better Life Experience Act (ABLE). 1. a statement of each priority; Employment — Persons with disabilities will have meaningful access to integrated employment and be paid at least minimum wage. 2. the need addressed by each priority; and; The need addressed by this priority is for persons with disabilities to have meaningful employment. 3. a description of the activities to be carried out under each priority. 1) Advocate for individuals with disabilities where improper or inadequate services by an Employment Network, service provider, employer or other entity have occurred with regard to their return to work effort. 2) Advocate for individuals with disabilities where their rights to services and assistance in securing, maintaining, or regaining employment have been violated. 3) Provide information, referral, and advice to individuals with disabilities about work incentives and employment. 1. a statement of each priority; Supported Decision Making — With needed supports, individuals with disabilities will be able to make everyday decisions about their lives, including matters related to where they live, how their money is managed, and their healthcare. 2. the need addressed by each priority; and; The need addressed by this priority is for individuals with disabilities to be able to make their own decisions about their lives. 3. a description of the activities to be carried out under each priority. 1) The P&A will advocate for two individuals with disabilities who have been subjected to unnecessary restrictions of rights and/or freedom of choices (e.g. guardianship / conservatorship) to have increased personal decision-making with supports as necessary. 2) The P&A will conduct six education/training/outreach activities to consumers, their families, and providers about how supported decision-making and other tools can be used as alternatives to guardianships/conservatorships. 3) The P&A will advocate for the expansion of peer support systems for individuals with disabilities. 4) The P&A will assist self-advocacy groups to advance their participation in legal advocacy, policy, and program decisions that affect them. 1. a statement of each priority; Education — Youth with disabilities will be provided a free appropriate public education (FAPE) in their least restrictive environment (LRE) to move them toward independent living and, depending on their individual goals, secondary schooling or employment upon graduation. 2. the need addressed by each priority; and; The need addressed by this priority is for youth with disabilities to be provided FAPE in their LRE and transition services toward independent living. 3. a description of the activities to be carried out under each priority. 1) The P&A will advocate on behalf of three students with disabilities in schools or daycare centers to ensure protection from illegal disciplinary measures and the use of inadequate behavioral planning including the use of seclusion and restraint. 2) The P&A will advocate on behalf of five students with disabilities to ensure the provision of a free, appropriate public education (FAPE) in the least restrictive environment (LRE) with appropriate supports. 3) The P&A will advocate on behalf of two older students with disabilities to ensure the provision of appropriate transition planning and services. 4) The P&A will conduct ten education/training/outreach activities to families and providers on special education rights and advocacy skills, including issues related to eligibility, the provision of FAPE, the right to assistive technology, behavior and discipline, transition, etc. 5) The P&A will educate parents and policymakers about the rights of students with disabilities in public charter schools to safeguard the right to a free appropriate public education. 6) The P&A will advocate for the adoption of a school-to-court diversion protocol in one Alabama county to decrease the number of students with disabilities referred to the juvenile justice system by their school district.

Part VI. Narrative

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

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

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

A. Sources of funds received and expended Source of Funding Amount Received Amount Spent Federal (section 509) 223,897 161,798 State 0 0 Program Income 0 0 Private 0 0 All other funds FY 2014 Carryover 83,076 83,076 Total (from all sources) 306,973 244,874 B. Budget for the fiscal year covered by this report Category Prior Fiscal Year Current Fiscal Year Wages/salaries 135,553 139,620 Fringe Benefits 43,558 45,708 Materials/supplies 977 2,000 Postage 223 750 Telephone 1,630 8,500 Rent 0 0 Travel 3,973 10,000 Copying 214 1,000 Bonding /Insurance 959 2,000 Equipment (rental purchase) 0 0 Legal Services 0 5,356 Indirect Costs 53,553 62,562 Miscellaneous 4,234 8,500 Total Budget 244,874 285,996 C. Description of PAIR staff (duties and person-years) Type of Position FTE % of year filled Person-years Professional Full-time 2.01 .96 1.93 Part-time Vacant 1.25 .04 .05 Clerical Full-time .55 1.00 .55 Part-time Vacant D. Involvement with advisory boards (if any) n/a E. Grievances filed under the grievance procedure n/a F. 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. The P&A works closely with the Client Assistance Program (CAP), housed in the state Department of Rehabilitation Services (DRS), and the state Nursing Home Ombudsman Program, which serves as the state’s long-term care ombudsman program and is housed in the state Department of Senior Services (DSS). During this fiscal year, the P&A met with the Director of DSS to address how the Ombudsman program may be strengthened or expanded as the state’s long-term care services are reformed through the emerging Integrated Care Network (ICN) that was approved by the Legislature in spring 2015. The CAP and DSS use the P&A as a resource for case referrals and the P&A refers persons with disabilities to the CAP and Ombudsman as well. Clients who need employment services, especially services other than sheltered work, and do not feel their needs are being met are referred to the CAP. Several P&A clients who reside in nursing homes and seek community placement have been referred to the P&A by the Ombudsman. In addition, the P&A serves on several state-wide committees with staff from the CAP and the Ombudsman.

Certification

Signed?Yes
Signed ByJames Tucker
TitleExecutive Director
Signed Date12/23/2015