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

Georgia (Georgia Advocacy Office, Inc.) - H240A150011 - FY2015

General Information

Designated Agency Identification

NameGeorgia Advocacy Office Inc.
Address150 E. Ponce de Leon Ave. 430
Address Line 2
CityDecatur
StateGeorgia
Zip Code30030
E-mail Addressinfo@thegao.org
Website Addresshttp://www.thegao.org
Phone404-885-1234
TTY 404-885-1234
Toll-free Phone800-537-2329
Toll-free TTY800-537-2329
Fax404-378-0031
Name of P&A Executive DirectorRuby K. Moore
Name of PAIR Director/CoordinatorJulie Kegley
Person to contact regarding reportJulie Kegley
Contact Person phone404-885-1234
Ext.N/A

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 areas199
2. Individuals receiving I&R outside PAIR priority areas283
3. Total individuals receiving I&R (lines A1 + A2)482

B. Training Activities

1. Number of trainings presented by PAIR staff55
2. Number of individuals who attended training (approximate)4,320

At the national TASH Conference, the P & A Executive Director facilitated a presentation by the United States Department of Justice, the University Center for Excellence in Indiana, and the Center for Public Representation to an audience of one hundred and twenty people (120) to discuss landmark civil rights ADA employment cases, as well as the collaborative roles and relationships — experts, masters, monitors- and how people fill these roles to implement the Integration Mandate of the Americans with Disabilities Act. The P & A presented the Keynote Speech to one hundred and thirty (130) people with disabilities and their supporters at the People First of Georgia’s annual conference. The Keynote Speech focused on the services and supports available to people with disabilities to enable them to work. The P & A supported People First of Georgia to organize self-advocates to speak about their employment experiences and to think about “what are the barriers to employment” and “how to overcome those barriers” as topics for their state conference. The P & A provided two one-day Self-Advocacy Mentoring (SAM) trainings to thirty-five (35) people with disabilities in Atlanta and Toccoa participating in the self-advocacy project and provided them with self-advocacy strategies and tips for networking, as well as education on basic rights. Training topics included practicing self-advocacy, developing achievable goals, grassroots organizing, and utilizing social media. The P & A plans to expand the SAM project to South Georgia over the next year. The Competitive Carriers Association (CCA) is an advocacy organization based in Washington, DC that represents over 100 wireless carrier members, as well as over 200 associate-vendor members that include equipment manufacturers and other supply chain companies that work to build the equipment and infrastructure for wireless voice and data networks. The CCA hosts a Global Expo once a year for its members and others in the industry to gather and discuss new products and services, business ideas, and policy trends. CCA invited GAO to participate in the Communications and Video Accessibility Act (CVAA) roundtable. Section 717 of the CVAA requires communications providers and manufacturers of communications equipment to record their efforts to consult with representatives of disability communities regarding accessibility features of products and services, and the compatibility of their products and services with peripheral devices or specialized customer premise equipment commonly used by individuals with disabilities to achieve access to advanced communications services (such as mobile wireless Internet service). The P & A PAIR Director participated on the roundtable with the State Director of the Georgia chapter of the Hearing Loss Association of America, the Executive Director of GACHI, and the Program Director for Tools for Life, Georgia's Assistive Technology Act Program. Roundtable topics for the audience of forty (40) attendees included the accessibility features for handsets and tablets, a hearing aid compatibility update, currently available features for mobile voice/data services, and the Text-to-911 update. The P & A presented to fifty (50) individuals with deafness at the Coastal Georgia Association for the Deaf (CGAD) and spoke about self-advocacy in a variety of settings, including requesting an interpreter in the medical setting and employment. The Savannah-area audience shared with the P & A that there is a lack of interpreters in the area. The number of interpreters in Savannah is very small, and most of those interpreters work in the school system. As a result, interpreters are not available to interpret at medical appointments or work-related activities during school hours. The P & A is working to assist CGAD with a self-advocacy project to remove barriers to effective communication in these situations. The P & A conducted a presentation for twenty (20) individuals at the Georgia Council for the Hearing Impaired (GACHI) along with the WIPA staff from Shepherd Center. During this presentation, a common thread ensued. People who are deaf/hard of hearing began to share their stories about applying for jobs electronically. Because a large number of individuals with deafness in Georgia utilize American Sign Language (instead of English) as their primary language, it is difficult for this population to complete job applications electronically as the applications are written in English. The P & A has now implemented some advocacy techniques to assist people who are deaf/hard of hearing to overcome this barrier. The P & A gave a presentation to twenty-five (25) Walton Options (a Center for Independent Living) staff and persons with disabilities who receive support and services from Walton Options. The presentation contained resources, information and advocacy to build a strong foundation for recognizing barriers to employment, and tips on how to combat barriers through direct professional advocacy and self-advocacy. The Walton Options EN contacts the P & A when they need support or assistance for someone who is experiencing difficulty in self-advocacy. The P & A collaborated with Tools for Life to present a training to eighty five (85) long term care nursing professionals regarding how to seek out funding for assistive technology for people with disabilities. The nursing professionals work with the Visiting Nurse Health system throughout the state of Georgia, including rural areas, and provide nursing services to people with disabilities living in the community, who are receiving services through Medicaid waivers and are at risk of becoming institutionalized. The P & A provided educational training, support, and technical assistance to five hundred and thirty one (531) persons with disabilities at over twenty (20) workshops in Atlanta and Rome in collaboration with Georgia Health Partners, Crossroads Community Services Board, Community Friendship Recovery program, and the Highland Rivers Day program. The workshops included education regarding issues such as self-determination, independent living philosophy, and community living. GAO supported and provided technical assistance to organizing six (6) “Long Road Home” events in Georgia. The goal of Long Road Home is to raise awareness about the rights of people with disabilities by holding multiple events both in Georgia and across the country on the anniversary of the US Supreme Court Olmstead decision. Long Road Home strives to highlight the meaning and importance of the Olmstead decision, in which people with disabilities were expressly given the right to live in and receive services in the community. All Long Road home events incorporated at least two things: (1) “I am Olmstead” Freedom stories, which are told by and about people who have transitioned out of nursing facilities and institutions and are now living successfully and happily in their community; and (2) Ensuring voter registration and education information is available, as well as voter registration forms to assist people to exercise a basic citizenship right - to vote. The P & A supported seven (7) other states, Alabama, Georgia, Minnesota, Nevada, North Dakota, South Carolina, and West Virginia, to organize and convene their Long Road Home events. In addition, the P & A presented (via Skype) to eighty one (81) people with disabilities at the People First of West Virginia Mid-year conference and trained them on events they can do for Long Road Home in their state. The P & A presented at two sessions at the Georgia Winter Institute titled, “Employer, Employee, and Provider,” and “Employment Policy Update.” Thirty (30) individuals with disabilities, family members, ordinary citizens, and providers attended each session. At the “Employer, Employee, and Provider” session, the P & A educated the audience how providers can better understand the supports (including reasonable accommodations) needed for people with disabilities to be successful in the workforce. The P & A also provided self-advocacy tips to persons with disabilities in the audience to self-advocate for reasonable accommodations. At the “Employment Policy Update” session, the P & A educated the audience about developments in employment for people with disabilities on a state and national level. The P & A supported People First of Georgia, a cross-disability organization, to host their annual statewide conference. One hundred and thirty two (132) people attended from across Georgia. Workshop topics presented, and supported by, the P & A included the following: What is Medicaid Buy-In?, Marriage Penalty, Starting Your Own Business, Project Vote, Self-Advocacy and Respect, Don't Give Up, Housing 101, Independent Living, and Self-Determination. A Micro-enterprise fair was held in the hallway between events giving small business owners a chance to sell their goods to attendees. The Georgia Vocational Rehabilitation Agency also set up a booth at the conference to share information and talk with people about pursuing employment. During the legislative session, the P & A participated in the first Employment First Advocacy Day at the Capitol. Over fifty (50) advocates participated, many of them young people who are either working or want to work. The P & A supported a young man to share why it is vital to him to have the supports needed to work as much as possible in his community of Newnan. As a result of Employment First Advocacy Day, Georgia House Resolution 642 was introduced — Creating the Joint Study Committee on Postsecondary Education and Employment Options for Individuals with Intellectual and Developmental Disabilities. Subsequently, a study committee was appointed. The P & A joined five members of the Georgia House of Representatives who attended the study committee meetings in August to learn more about Employment First and Inclusive Post-Secondary Education. The P & A and Employment First Georgia provided information, stories, and supported self-advocates to speak to legislators that signed onto this House Resolution that created the Study Committee to explore what is necessary for Georgia to have an Employment First policy that designates employment as the first and preferred option for all people, regardless of their disability, to be included in the regular workforce in jobs at or above the minimum wage, with maximum opportunities to interact with non-disabled co-workers. The P & A participated in Georgia’s 2015 Disability Day at the Capitol. The P & A informed and educated two thousand and five hundred (2500) self-advocates, families, caregivers, advocates, providers, and other interested community members about the role of the P & A to protect and advocate on behalf of Georgians with disabilities and to provide resources on waivers, employment, and voting. The P & A staff operated a display table at the event and provided educational materials to event participants. The P & A participated in the Independent Care Waiver Program (ICWP) “Raise the Rate” advocacy day at the Georgia Capitol. The P & A provided thirty (30) self-advocates, families, and caregivers the opportunity to visit with local legislators to educate them on the importance of home and community based services as a means for people with disabilities to live, work, and fully participate in community living. The presenting issue was the lack of competitive financial compensation for ICWP personal support staff who provide support in the community for people with physical disabilities or traumatic brain injuries. Multiple legislators reported not being aware that ICWP providers receive a lower reimbursement rate for staff than other waiver providers who provide comparable services and they stated they will request justification for the lower reimbursement rate from Georgia’s Medicaid agency, the Department of Community Health. Through the Unlock the Waiting List Campaign and the Children's Freedom Initiative collaboration, the P & A assisted the Georgia Council on Developmental Disabilities with "Children Need Real Homes, not Nursing Facilities" Day at the Capitol to advocate for children and youth to be serviced in their homes and communities instead of facilities. The P & A recruited individuals to attend and supported individuals in meeting with their legislators to express their desire for more waivers to be put into the budget. The P & A also presented at a session to educate fifty (50) participants about this issue and share stories of children whom we have supported to leave institutions. Legislators were educated about the children who live in skilled nursing facilities and intermediate care facilities in Georgia. Advocates shared stories and encouraged legislators to call on the Commissioners of the Department of Community Health and the Department of Behavioral Health and Developmental Disabilities to support these young people to receive home and community based services and move out of the facilities. The P & A partnered with Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD) to present Social Role Valorization (SRV) workshops around the state as a foundation for improving services to people with disabilities. The audience consisted of persons with disabilities, ordinary citizens, providers, and family members. Ninety (90) people attended the Tucker event; forty-five (45) people attended the Milledgeville event; forty (40) people attended the Savannah event; thirty-five (35) people attended the Dalton event; twenty-five (25) people attended the Warner Robins event; and twenty (20) people attended the Valdosta event. The SRV workshop is based on the work of the late Dr. Wolf Wolfensberger. The SRV workshops invited participants to explore the wounding experiences with which many individuals with disabilities live with as a result of being devalued by society. The workshop explored the goal of addressing devaluation by helping people with disabilities attain value social roles, such as employment. The P & A presented a one day introduction to Social Role Valorization (SRV) and some of its main elements at two locations around the state. Thirty (30) people attended SRV at the P & A’s office in metro Atlanta and thirty-three (33) people attended SRV in Columbus as part of the pre-conference to the Georgia Winter Institute. SRV is a theory that contains certain positive assumptions, principles, and practices which have proven to be important as a framework for supporting persons with disabilities who are at risk of being devalued by society. In particular, it is designed to help participants understand the devaluation process that society and even human service providers perpetuate upon people using services. The one-day workshop assisted participants to understand the power of valued social roles in an effort to counteract some of the effects of devaluation and the importance of assisting people with disabilities who have been marginalized to have a full, inclusive life. The P& A co-sponsored two one-day training events in Atlanta and Columbus with the Georgia Council on Developmental Disabilities and the Georgia Microboard Association to train sixty-three (63) persons with disabilities, family members, advocates who are supporting adults to find their careers, neighbors, friends, direct support staff, members of your faith community, vocational rehabilitation counselors, educators working with students transitioning into adult life, and others who want to better understand and interpret difficult behavior, and to develop and implement strategies for people to live more satisfying lives. Participants were taught a set of core competencies covering topics that include the importance of belonging, difficult behaviors as intentional communication, and understanding behaviors that result from unmet needs.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff3
2. Newspaper/magazine/journal articles11
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website3,000
5. Publications/booklets/brochures disseminated100
6. Other (specify separately)0

Narrative

The GAO is featured on websites and blogs as a legal advocacy resource. In addition, hundreds of websites feature events involving the GAO. The GAO, the Children’s Freedom Initiative, and the Parent Leadership Support Project maintain current Facebook pages and websites. Also, some of the Citizen Advocacy offices maintain websites and Facebook pages. In October 2014, Making a Difference magazine published an article written by P & A Staff Attorney, Crystal Rasa, titled, “A Call to Action to Ask for More” and discusses how Employment First begins a worthwhile path to success for people with disabilities. http://gcdd.org/images/MAD_Magazine/Fall2014_MAD/MAD_FAll_2014_Large_Print.pdf (pages 39-46) In December 2014, the Cross Plains Community Partner Winter Newsletter, 2014, published the following story: Person-Centered Employment: The Story of Ethan Womac The P & A created, with the Georgia Council on Developmental Disabilities, a Pilot supported by DBHDD (Department of Behavioral Health and Developmental Disabilities), GVRA (Georgia Vocational Rehabilitation Agency), providers, and local education agencies. The article highlights the customized employment story of a participant. In January 2015, the United States Department of Labor issued a Press Release regarding the Disability employment advisory committee, which added 17 public members, including the P & A Executive Director Ruby Moore: New members will help increase integrated employment opportunities http://www.dol.gov/opa/media/press/odep/ODEP20142331.htm.VKtBNEuWQOM.email In January 2015, the P & A participated in a vigil with the Columbus NAACP protesting the execution of Warren Hill http://m.wtvm.com/wtvm/db_330870/contentdetail.htm?contentguid=6nfzNQVq In July 2015, the United State Department of Labor, Office of Disability Employment Policy Releases Preliminary Reports and Recommendations from Federal Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities. The P & A Director is a member of the Federal Advisory Committee. http://www.dol.gov/odep/topics/date/20150713.htm In July 2015, the summer edition of DBHDD’s “Making a Difference” magazine included stories on The Children’s Freedom Initiative and an update on US v. GA settlement agreement. http://www.gcdd.org/news-a-media/making-a-difference-magazine/2774-making-a-difference-summer-2015.html In July 2015, the Atlanta Journal Constitution published an article titled, “Georgia misses federal mark on housing for the disabled” and quotes the P & A’s Legal and Advocacy Director, Joshua Norris. The article focuses on the State of Georgia’s failure to adhere to the terms outlined under the U.S. v. Georgia settlement agreement, to move Georgians with developmental disabilities out of state-run hospitals into the community. http://www.myajc.com/news/news/state-regional-govt-politics/georgia-misses-the-federal-mark-on-mental-health/nmqyt/ In July 2015, the Atlanta Journal Constitution published an article titled, “Georgia Illegally Segregates Disabled Students, Federal Inquiry Finds” appearing on the front page the day after the United States Department of Justice issued a Letter of Findings to Georgia regarding its illegal segregation of students with disabilities. The P & A Executive Director, Ms. Ruby Moore, is quoted and the article draws attention to the issues mentioned in the P & A’s press release on this topic. http://www.ajc.com/news/news/local/georgia-illegally-segregates-disabled-students-fed/nmzZ6/ In July 2015, P & A Executive Director Ruby Moore is quoted in an article in Fusion, which is owned by NBC/Univision and aimed at bilingual millennials. regarding the illegal segregation of students with disabilities. http://fusion.net/story/168056/georgia-is-illegally-segregating-special-ed-students-federal-investigation-says/ In July 2015, an Atlanta public radio affiliate quotes P & A program director and staff attorney Leslie Lipson regarding Georgia’s illegal segregation of students with disabilities. http://wabe.org/post/ga-special-education-segregates-lacks-programs-doj-says In July 2015, ProPublica, a New York-based investigative journalism non-profit group, published an article quoting P & A Staff Attorney Leslie Lipson. The article is titled, “Georgia is Segregating Troublesome Kids in Schools Used During Jim Crow.” https://www.propublica.org/article/georgia-is-segregating-troublesome-kids-in-schools-used-during-jim-crow In August 2015, P & A program director and staff attorney Leslie Lipson is quoted regarding the illegal segregation of Georgia students with disabilities. http://chronicle.augusta.com/news/education/2015-08-08/georgia-offers-no-plan-fix-schools-behavioral-and-emotional-disabilitiescomment-1452843 In August 2015, the Washington Post quotes P & A program director and staff attorney Leslie Lipson is quoted regarding the illegal segregation of Georgia students with disabilities. http://www.washingtonpost.com/local/education/us-probe-into-georgia-special-ed-program-could-have-national-impact/2015/08/05/07c1a44a-3630-11e5-9d0f-7865a67390ee_story.html In August 2015, Georgia Public Broadcasting (GPB) radio station interviewed P & A program director and staff attorney Leslie Lipson regarding the United States Department of Justice’s investigation into Georgia’s GNETS (Georgia Network for Educational and Therapeutic Support) program, which segregates students with disabilities from their peers without disabilities. http://www.gpb.org/on-second-thought/episodes/306 In August 2015, MSNBC, a national television network, featured P & A program director and staff attorney Leslie Lipson’s interview with host Melissa Harris-Perry regarding the segregation of students with disabilities in Georgia public schools. http://www.msnbc.com/melissa-harris-perry/watch/why-are-students-still-segregated-in-georgia--496198723803

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)23
2. Additional individuals served during the year101
3. Total individuals served (lines A1 + A2)124
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)14

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 24

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility8
2. Employment11
3. Program access6
4. Housing11
5. Government benefits/services23
6. Transportation2
7. Education4
8. Assistive technology10
9. Voting0
10. Health care36
11. Insurance1
12. Non-government services9
13. Privacy rights0
14. Access to records0
15. Abuse7
16. Neglect11
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor110
2. Other representation found0
3. Individual withdrew complaint2
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.3
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit0
9. Other0

Please explain

N/A

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-advocacy41
2. Short-term assistance46
3. Investigation/monitoring2
4. Negotiation25
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
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 - 40
2. 5 - 225
3. 23 - 5984
4. 60 - 6414
5. 65 and over21

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females66
2. Males58

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race5
2. American Indian or Alaskan Native0
3. Asian2
4. Black or African American51
5. Native Hawaiian or Other Pacific Islander0
6. White65
7. Two or more races1
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent73
2. Parental or other family home8
3. Community residential home3
4. Foster care0
5. Nursing home28
6. Public institutional living arrangement4
7. Private institutional living arrangement1
8. Jail/prison/detention center5
9. Homeless0
10. Other living arrangements2
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 hearing32
3. Deaf-blind1
4. Orthopedic impairment38
5. Mental illness2
6. Substance abuse1
7. Mental retardation0
8. Learning disability6
9. Neurological impairment24
10. Respiratory impairment6
11. Heart/other circulatory impairment3
12. Muscular/skeletal impairment3
13. Speech impairment1
14. AIDS/HIV1
15. Traumatic brain injury1
16. Other disability0

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities7

2. Number of individuals potentially impacted by policy changes1,456,812

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

The P & A has made a strategic effort to increase the number of people with disabilities that we support to move out of nursing facilities and into the community. Moving individuals with complex medical needs from a facility into the community can be challenging, as funding for appropriate supports and services is limited. In some cases, a Medicaid waiver may not provide the adequate support for a person and negotiation with the waiver program around its parameters becomes necessary. The P & A also works closely with Money Follows the Person (MFP), a program designed to transition persons with disabilities from facilities into the community and provides funding for one year following the transition for items such as environmental modifications to the home, coverage of the first month’s rent and utilities, peer support, and transportation. The P & A has successfully facilitated transitions of many individuals from nursing facilities into the community. The P & A will continue to facilitate successful transitions through individual and systemic advocacy and by developing our current relationships with the long-term care ombudsman’s office, MFP, and Medicaid waiver staff. The P & A recognizes that guardianship over a person with a disability is often unnecessary, can be very restrictive and in some cases, can result in abuse and/or neglect or unnecessary rights restrictions of the person under guardianship. Since 2012, the P & A has successfully represented four adults, throughout the state to have their guardian and conservator removed. As a result of gaining their own independence, all four individuals are now able to live in their own homes in the community and make their own decisions. During this fiscal year, the P & A has developed a relationship with the Public Guardianship Office (PGO) of the Georgia Division of Aging to collaborate on cases where the person is under state guardianship and wants a more independent life. PGO will refer individuals to us whom they believe may no longer need a guardian. PGO is also working with us to enrich the lives of persons under state guardianship, by ensuring that they have the right and the ability to receive appropriate services and supports and live in the community. This year, Ms. Ruby Moore, the P & A’s Executive Director, was named to the Federal Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities by the U.S. Secretary of Labor, Thomas E. Perez. The committee is tasked with advising the U.S. Secretary of Labor on ways to increase competitive integrated employment opportunities for individuals with significant disabilities and to develop strategies for addressing issues pertaining to subminimum wage. The Committee is receiving public comments on its interim report, which was submitted to Congress and the Secretary of Labor on September 15, 2015. The Employment First Coalition is a coalition hosted by the P & A and the Georgia Council on Development Disabilities (GCDD). The objective of the Coalition is for Georgia to become an Employment First state. As part of this Coalition, the P & A has undertaken many activities to achieve this objective. Specifically, the P & A and GCDD met with the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) to clarify how Vocational Rehabilitation and Medicaid funds can be blended to support employment. As a result of that meeting, DBHDD agreed to clarify the message of blended services to avoid interruption in employment services for persons with disabilities. During the legislative session, the P & A participated in the first Employment First Advocacy Day at the Capitol. Over fifty advocates participated, many of them young people who are either working or want to work. The P & A supported a young man to share why it is vital to him to have the supports needed to work as much as possible in his community of Newnan. As a result of Employment First Advocacy Day, Georgia House Resolution 642 was introduced — Creating the Joint Study Committee on Postsecondary Education and Employment Options for Individuals with Intellectual and Developmental Disabilities. Subsequently, a study committee was appointed. The P & A joined five members of the Georgia House of Representatives who attended the study committee meetings in August to learn more about Employment First and Inclusive Post-Secondary Education. The P & A and Employment First Georgia provided information, stories, and supported self-advocates to speak to legislators that signed onto this House Resolution that created the Study Committee to explore what is necessary for Georgia to have an Employment First policy that designates employment as the first and preferred option for all people, regardless of their disability, to be included in the regular workforce in jobs at or above the minimum wage, with maximum opportunities to interact with non-disabled co-workers. The P & A continues to oversee the State of Georgia’s planning and implementation of changes to transition from funding segregated day services to those that comply with Homes and Community Based Services standards and the new guidance issued from the Centers for Medicare and Medicaid Services. The P & A is providing technical assistance to a committee of stakeholders and providers that are writing the proposed definition for day services to ensure that they comply with the guidelines. The P & A attended the Statewide Independent Living Council meetings to receive reports on the trainings, outreach, and other activities conducted by each Center for Independent Living (CIL). The meetings provided the P & A opportunities to connect with each CIL about advocacy issues such as lack of transportation, access to effective communication in healthcare settings, and access to affordable and accessible housing. The CILs referred individuals with disabilities to the P & A for advocacy assistance when self-advocacy attempts were unsuccessful, and the CILs invited the P & A’s to conduct trainings in their offices. The P & A continued a strong relationship with the Georgia State ADA Coordinator’s office. The P & A and the State ADA Coordinator communicated several times each month regarding individual and systemic advocacy efforts, such as lack of accessible buildings at a major state university and lack of effective communication at a doctor’s office. As the State ADA Coordinator’s office is limited to providing information and education to people with disabilities, the State ADA Coordinator refers individuals with disabilities who needed direct advocacy assistance to the P & A. The P & A participated on the advisory council to assist Tools for Life, Georgia’s Tech-Act Project, in accomplishing its goal and mission with measurable outcomes. The Council serves as areas of support for the Tools for Life program, to make Assistive Technology accessible, usable, timely, and more affordable for Georgians with disabilities. The P & A attended council meetings and reviewed and provided input on programs and services. The P & A supported Tools for Life to be a statewide voice for public awareness and advocacy on increased access to Assistive Technology. The P & A provides ongoing support to People First of Atlanta and Georgia. People First is a cross-disability organization. The P & A also hosts their monthly meetings as well as serves as their fiscal agent. Advocacy skills were supported and enhanced within the membership of People First of Atlanta and Georgia. Inclusion, awareness, voter education, and outreach were increased as a result of this support. The P & A created a Self-Advocacy Mentoring Project led by P & A attorneys and a nationally-known self-advocate. Since its inception in 2013 with an initial group of 11 self-advocates, the P & A has now provided peer mentorship on self-advocacy strategies to over 100 people with disabilities, to expand knowledge of available methods to use when advocating for themselves. The P & A provided support to the individuals in the design and implementation of the advocacy projects. Several people created advocacy projects pertaining to issues in their own lives, and in some cases, to address systems issues such as working on Medicaid Buy-In. The P & A also provided a one-day self-advocacy training to the folks participating in the project and provided them with advocacy strategies and tips. The P & A has expanded this project outside of metro Atlanta to include people with disabilities in North Georgia and plans to expand to South Georgia over the next year. Other efforts by the P & A to support self-advocates include supporting People First and ADAPT to inform the public and policymakers about current laws that put the lives of people with disabilities at great risk and changes in laws that could be made to keep people safe. The P & A participates as an active member of the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults, which serves as a comprehensive clearinghouse between local advocacy groups serving individuals with disabilities and older adults, and Georgia agencies responsible for emergency preparedness under the Georgia Emergency Operations Plan. In addition, the Coalition provides subject matter expertise to emergency response planners to ensure that all emergency plans incorporate the needs of people with disabilities and older adults and organizations throughout Georgia that serve and advocate for people with disabilities and older adults enabling them to share disaster preparedness and response information with their constituencies. Specifically, the P & A is on the Training and Technical Assistance Committee. The Committee has provided train the trainer seminars around the State to stakeholder agencies who in return can train the individuals they serve (there are 75 Coalition network agencies serving people with disabilities) who provide emergency preparedness information to their constituents. Over twenty organizations, such as the American Red Cross of Georgia (ARC), Center for Advance Communication Policy, Georgia Institute of Technology, DeKalb Emergency Management Agency (DEMA), Federal Emergency Management Agency (FEMA), State ADA (Americans with Disabilities Act) Coordinator's Office, Gwinnett Coalition Emergency Preparedness Committee, and Gwinnett, Newton and Rockdale County Public Health Department, Office of Emergency Preparedness, are members of this Coalition. The Georgia Inclusive Postsecondary Education Consortium seeks to create opportunities for students with disabilities who have historically not had access to post-secondary educational opportunities. Members of the Consortium include the P & A, Georgia Vocational Rehabilitation Agency, Institute on Human Development and Disability (IHDD), GCDD, and DBHDD and are committed to providing information and training resources for individuals, families, colleges and universities, and agencies to achieve the goal of inclusive post-secondary opportunities for all. The P & A provides legal support to the consortium, reviews Requests for Proposals, and actively participates in meetings at post-secondary education facilities. The State Advisory Panel for Special Education (SAP) advises the Georgia Department of Education (GA DOE) Divisions for Special Education Services and Supports on the provisions of special education and related services for students with disabilities. The SAP is comprised of parents, persons with disabilities, educators and administrators, as well as representatives from public and private agencies. This diverse group of stakeholders assists the Divisions in addressing a variety of special education issues and topics. Specifically, the SAP advises the Divisions on the unmet needs related to the education of children with disabilities within the State and provides feedback on any rules or regulations proposed by the State regarding special education. The SAP is a critical partner in the development of Georgia’s State Performance Plan (SPP) and Annual Performance Report (APR). The Panel also advises the Divisions on the improvement activities that need to be developed and implemented in order to improve outcomes for students with disabilities. Each year, members review data on the improvement activities included in the SPP and APR and make suggestions for updates to the activities and targets. The SAP advises the GA DOE in developing corrective action plans to address findings identified in federal monitoring reports under IDEA and advises the GA DOE in developing and implementing policies relating to the coordination of services for children with disabilities. The SAP participates in the Continuous Improvement Monitoring Process by recommending target areas for upcoming focused monitoring activities. The P & A participated in a Community of Practice to increase the vision and expectation of families regarding employment for transition-age youth. The Community of Practice consisted of local education agencies, VR, Employment First Georgia (EFG), Center for Leadership in Disability (CLD), Georgia Department of Education (DOE), post-secondary education entities, and organizations that support students with disabilities. This year, the P & A worked to finalize the Georgia Transition Manual. The State Employment Leadership Network (SELN) is a cross-state cooperative venture of state intellectual and developmental disability (I/DD) agencies that are committed to improving employment outcomes for adolescents and adults with intellectual and developmental disabilities. SELN is a forum to connect, collaborate, and create cross-community support for the pressing employment-related issues faced at the state and federal levels. SELN promotes new connections within and across states to establish effective collaborative relationships among states, learn from their experiences of other service systems, share costs, use data, and maximize resources. As a result of the P & A’s involvement with SELN, the State has invited the P & A to participate in a strategic planning session to increase employment of people with disabilities. The P & A assists entrepreneurs with disabilities, to strengthen their business and develop marketing strategies. The P & A supports Dr. Ruthie Beckwith to assist entrepreneurs with disabilities to build and expand their businesses. For example, Dr. Beckwith met with the owner of a small business of scanning photos onto a CD- a small business we helped the person to develop- to discuss issues the owner was experiencing with her job coach. Specifically, the job coach was not providing adequate support to the owner. Through Dr. Beckwith’s support, the entrepreneur is exploring the use of an iPad for scanning photos and expanding the business Facebook page. In addition, Dr. Beckwith is supporting an author with a Traumatic Brain Injury to write a chap book. Dr. Beckwith is also supporting this author to expand his Facebook page with a note about the book release coming up. Thirdly, Dr. Beckwith is also supporting a Certified Peer Specialist to fulfill her dream of starting an agency to help other peer specialists. The P & A is a member of the Children and Youth Subcommittee of the Statewide TBI Advisory Panel. Community partners such as P & A, Children’s Healthcare of Atlanta hospital system, the Georgia Department of Education, the Georgia Brain and Spinal Injury Trust Fund, ChildKind, and the Shepherd Center meet monthly to review the state of services in Georgia as related to children and youth who are at risk of, or experience, a brain or spinal cord injury. The purpose of the Subcommittee is to gather and disseminate information and resources to families, schools, community groups, hospitals, medical providers, and state agencies regarding the risks of brain and spinal cord injuries and how those injuries can be addressed. The Children and Youth Subcommittee has the following workgroups: school age workgroup, family support workgroup, prevention workgroup, and spinal injury workgroup. This year, the Subcommittee reviewed pending legislation in the Georgia State Legislature regarding potential changes to programs and services that support children and youth who experience brain or spinal cord injuries. For the 2014-2015 year, the Georgia State Legislature approved 75 waiver services for individuals with developmental disabilities, including people who experience TBI, pursuant to the Department of Justice Settlement Agreement. The State Legislature did not approve any new Independent Care Waiver Program (which provides services in the community for people who experience TBI) slots; instead, the Legislature approved a rate increase for the ICWP caregivers as their pay rate was severely low compared to the pay rates for caregivers under the other waivers. The P & A provides individual protection and advocacy, meets with leadership of the Department of Community Health, and provides support and technical assistance to individuals and families applying for waiver services and appealing denials. The P & A routinely monitors state hospitals, nursing facilities, and private residential treatment facilities where persons with disabilities are housed. The P & A responds to calls involving persons with disabilities subjected to abuse and neglect that are receiving community-based services including community living arrangements, pre-employment programs/sheltered workshops, and other day services. Through routine monitoring, the P & A has documented and responded to these situations involving abuse, neglect, and rights violations. This information has been reported to the appropriate oversight agencies for use in their investigations. Additionally, throughout the course of routine monitoring, the P & A advocates met people with disabilities, who expressed an interest in moving into the community. In response, the P & A assisted a number of these individuals to move into homes in the community and to gain access to supports such as waiver services, employment, and transportation. The P & A continues to take the lead on the Children’s Freedom Initiative (CFI) to bring all children, including those who have experienced a TBI, out of institutional settings and to keep them out through the cooperation of several state agencies. The CFI is a collaborative effort of the P & A, Georgia Council on Developmental Disabilities, Institute on Human Development and Disabilities, and the Center for Leadership in Disability at Georgia State University. The CFI expects to achieve its goal through changing legislation, telling children’s stories, coalition building, elevating the issue, and requesting resource allocation in the budgets of various state organizations. The P & A has identified children in facilities; provided individual protection and advocacy; deflected institutional placement of children; and provided technical assistance to facility administrators, state agencies, and child protection caseworkers regarding available community-based resources including early periodic screening and diagnostic testing (EPSDT), preparation of necessary litigation, and oversight of discharge to appropriate community settings. The P & A continues to educate families about resources for children, so that they can remain at home or in the community, even when their home of origin is no longer an option. On July 15, 2015, the U.S. Department of Justice (DOJ) issued a findings letter declaring that Georgia’s Network for Educational and Therapeutic Supports (“GNETS”) program violates Title II of the Americans with Disabilities Act. DOJ found that Georgia is illegally segregating students with behavioral-related disabilities in the GNETS program where they are denied opportunities to learn with their peers who are non-disabled and provided inferior educational opportunities. The P & A was instrumental in the DOJ’s investigation of the GNETS. The P & A provided historical documents, technical assistance about educational funding, and ongoing support during the entirety of the investigation and beyond the issuance of the Letter of Finding. We have facilitated a number of meetings between the DOJ and various stakeholders in children’s mental health, with our federal partners and many families. The GNETS is a statewide network created in 1970 that consists of two dozen centers serving about 5,000 children with at least $70 million in state and federal funds, plus additional locally- and federally-funded services. The State of Georgia has not formally responded to the DOJ Letter of Finding. The P & A, with other partners, are convening and leading a number of stakeholders in a strategic process to facilitate the negotiations or enforcement actions necessary to end segregation by GNETS. The P & A has increased its efforts to educate persons who are deaf whose primary language is American Sign Language (ASL) regarding the responsibilities of health care providers to provide effective communication such as sign language interpreters during medical appointments. The P & A continues to disseminate two brochures that it developed: “A Guide for Persons who are Deaf or Hard of Hearing” and “Responsibilities of Health Care Providers for Persons who are Deaf or Hard of Hearing.” The P & A represents two women who are deaf whose primary method of communication is American Sign Language (ASL). The two women attempted to receive medical treatment from a hospital and its affiliate clinic. At the time of making their medical appointments, the two women each requested that an ASL interpreter be provided. The hospital and clinic refused, saying that effective communication was happening via the exchange of written notes. However, written English is not the same language as ASL, and the women did not have effective communication when exchanging notes with the medical provider. The P & A contacted the hospital and the clinic to advise them of their obligation to provide effective communication via ASL during medical appointments. The CEO of the hospital responded to the P & A, again saying that writing notes was effective communication and that an interpreter was not needed. The P & A then filed two separate complaints with the U.S. Department of Justice (DOJ) on behalf of each woman against the hospital and the clinic. The DOJ agreed to open an investigation on each of the complaints and assigned the matter to the United States Attorney's Office for the Northern District of Georgia. In March, the P & A hosted a meeting for the two women to meet with a United States Attorney and an investigator to discuss their complaints. The complaints are still being investigated.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts750
2. Number of individuals named in class actions2

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.

Hunter v. Cook: This case was brought in federal court pursuant to the Medicaid Act and the Americans with Disabilities Act on behalf of five children with complex medical conditions. The P & A challenged the practices of the Georgia Department of Community Health in its determination of the amount of in-home nursing services to be provided to the plaintiffs pursuant to Georgia’s Pediatric Program (GAPP). The Court granted the P & A injunctive relief and the P & A then filed a request for attorneys’ fees. In September 2015, the Court awarded fees to the P & A. The state has appealed the decision to the Eleventh Circuit Court of Appeals. M.H. v. Reese: The P & A filed a class action complaint against the Georgia Department of Community Health (state Medicaid agency) in federal court on April 29, 2015, alleging systemic violations of the Medicaid Act. This litigation is a continuation of our efforts for the state to reform its Medicaid program in providing support to some of Georgia’s most vulnerable children. The state filed a motion to dismiss. Each side has filed briefs, and we are awaiting a decision from the Court. We expect the motion to be denied. We will be seeking to have the case certified as a class action for approximately 750 children after the motion to dismiss is resolved. Georgia Advocacy Office v. Reese: The P & A brought an action pursuant to 42 U.S.C. ยง1983 for injunctive and declaratory relief against the Georgia’s Department of Community Health (DCH), to redress DCH’s violations of the P & A’s rights under the federal laws governing the activities of the designated protection and advocacy systems (“P&A Acts”) to conduct investigations and access records. DCH violated the P & A’s rights by refusing to provide access to investigatory records related to individuals with disabilities. The complaint alleges that DCH refused P & A’s requests for records related to two individuals, both of whom authorized P & A to access their records. United States v. Georgia: The P & A is co-lead counsel for the amici in this case along with the Bazelon Center. The amici are comprised of a variety of mental health stakeholders and the P & A. The amici have been an active and integral participant in this case between the state and the United States Department of Justice (DOJ). The P & A was directly involved in negotiating the first Settlement Agreement, and have been providing constructive feedback to the state, DOJ, and the Independent Reviewer during implementation of the Settlement Agreement. The Independent Reviewer recently issued her annual report and found as of July 1, 2015 (Year 5 of the Agreement), that the state had failed to comply with the provisions regarding community-based services (including crisis services) for people with developmental disabilities and the provisions regarding supported housing capacity for people with mental illness. DOJ has presented the state with a letter of non-compliance which will set the stage for any enforcement action DOJ might take. The P & A in conjunction with the Bazelon Center has been working with the DOJ and the Independent Reviewer to attempt to constructively resolve the issues of non-compliance with the state. In the Interest of C.P: The P & A represents a mother who acquired a significant physical disability and was placed in a nursing facility. As a result of the mother’s placement in the facility, the state seeks to have the mother’s right to her daughter terminated. The P & A assisted the mother to move out of the nursing facility with support from the Money Follows the Person program (MFP). The mother continues to live in a three-bedroom residence and has support 12 hours a day through the Independent Care Waiver Program (ICWP), a Medicaid Waiver program. One of her ICWP aides was approved by the state as a caregiver, so the mother can have unsupervised visits with her daughter without anyone in attendance. The state and the mother have requested that the parties pursue a guardianship option, which would allow the mother to remain involved in her daughter’s life, such as school and sports events, and continue their regular visits. In the Interest of V.L: The P & A represents a mother who had her child removed from her custody due to assumptions about her ability to care for her child, not for an actual lack of care. The P & A was granted the right to intervene in the case to seek appropriate support for the mother and reunification with the child. The mother’s appeal of the NOW/COMP waiver denial was not successful. The mother now agrees for her child to be raised by another family and would like to remain involved in the child’s life. The Division of Family and Children Services (DFCS) is not opposed to the mother’s involvement in the child’s life.

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. The first priority is to protect individuals with disabilities in Georgia from abuse and neglect. The P & A will investigate and address allegations of abuse or neglect, including the suspicious or unexplained deaths of persons with disabilities. 2. Identify the need, issue or barrier addressed by this priority. Georgians with disabilities are at risk of institutionalization due to the lack of appropriate community-based services and supports. People with disabilities who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Community-based supports are needed to end the institutional bias in Georgia. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. The P & A investigates and positively addresses instance of abuse and neglect of persons with disabilities. The P & A intervenes to protect any persons with disabilities from circumstances of abuse and neglect, and to assist in their transfer to community settings, in which abuse and neglect is less likely to occur. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. The P& A receives Type I Critical Incident Reports from the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)’s Director of Incident Management and Investigations based upon reports received from state institutional staff. The P & A makes case-by-case determinations as to which reports warrant further investigation by the P & A and/or other entities. The P & A monitors the discharge of individuals leaving state hospitals, with particular emphasis on compliance with the United States v. Georgia settlement agreement, and the “fit” between what people with disabilities need and what they are actually receiving in terms of supports and services and real choices. The P & A reports findings to the United States Department of Justice (DOJ) and the Court Monitor as part of its investigation into the State hospital system. The P & A has participated in facility transition meetings and individual service plan (ISP) meetings. The P & A has helped to identify barriers to discharge and advocates for services within the ISP that will bring more self-determination and full inclusion to people’s lives. During the P & A’s visits, the P & A has discussed current census and inquired as to any developments regarding transition planning specifically to certain individuals and to the population as a whole. The P & A also attended planning sessions for family members to provide information about community resources upon discharge from the hospital. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. 23 6. Provide at least one case summary that demonstrates the impact of the priority. M.P., a young woman in her thirties who experienced a brain stem stroke, ended up in a nursing facility where she did not want to live. The P & A advocated for M.P. to be included in the Money Follows the Person (MFP) program so that M.P. could transition from the facility to the community. When the MFP Transition Coordinator was not timely following through on transition planning, the P & A successfully negotiated with MFP at the state level to provide timely transition services to M.P. The P & A also advocated for M.P. to be evaluated for the Independent Care Waiver Program (ICWP). The P & A negotiated with ICWP for M.P. to receive twelve hours per day, seven days per week, of personal support services. As a result of the P & A’s advocacy, M.P. moved out of the nursing facility into a three-bedroom home with support from both MFP and ICWP. S.M., a man with neurological disabilities in South Georgia, applied for services through Money Follows the Person (MFP) in order to transition out of the nursing facility into the community. S.M.’s MFP caseworker was not responsive to S.M., so S.M. requested assistance from the P & A in advocating that MFP move forward with S.M.’s transition process. The P & A consistently maintained contact with MFP to ensure that MFP was moving forward with S.M.’s transition plan. As a result of the P & A’s advocacy with MFP on behalf of S.M., S.M. moved into his own apartment and is now living successfully in the community. M.S., a man with physical disabilities, was under a temporary guardianship by the Public Guardianship Office (PGO). During that time, PGO placed M.S. in a facility with a leg band, preventing him from going anywhere beyond his unit without facility staff. The P & A advocated on behalf of M.S. by encouraging his court-appointed attorney, the guardian ad litem, the court-ordered evaluator, and the facility’s social worker to support M.S.’s desire to remove the restrictions placed on him by PGO. As a result of P & A’s advocacy, a strong case was presented to the Probate Court Judge, who ruled in M.S.’s favor, freeing him from the restricted movement he had been experiencing and allowing M.S. to make his own decisions. C.M., a woman with a mobility disability living in a nursing facility, was under guardianship by the state Public Guardianship Office (PGO). C.M. received regular visits at the facility from the local Center for Independent Living (CIL) staff. However, C.M.’s PGO case worker told CIL staff they could no longer visit C.M. The P & A successfully negotiated with the state PGO Director for PGO to allow CIL staff to resume visits with C.M. 1. Identify and describe the priority. The second priority is to respond to allegations of discrimination and legal rights violations of persons with disabilities. The P & A will advocate for appropriate home and community-based supports and services, including healthcare and educational, for people with disabilities at risk of institutionalization. The P & A will also advocate for people with disabilities subject to legal rights violations and discrimination in any of the following areas: fiduciary relationships, local and state government, healthcare, housing, transportation, and employment. 2. Identify the need, issue, or barrier addressed by this priority. This priority addresses the need of individuals with disabilities to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services and public places. Persons with disabilities are subject to discrimination in essential services and domains of life, particularly with respect to healthcare, housing, transportation, and employment. Public and private accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. People with disabilities are more likely to have their rights restricted based upon the perception that they are not able to make decisions regarding their own lives. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. The indicators of success for this priority are as follows: to investigate and reverse the effects of reliable reports of overt deprivation of fundamental rights for individuals; to avert discrimination against persons with disabilities by achieving equal opportunities from employers, housing providers, healthcare providers, transportation providers, public entities, and public accommodations through reasonable accommodations and removal of policy barriers. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. The P & A works closely with the Money Follows the Person (MFP), a program designed to transition persons with disabilities from facilities into the community and provides funding for one year following the transition, for items such as environmental modifications to the home, coverage of the first month’s rent and utilities, peer support, and transportation. Since 2012, the P & A has successfully facilitated transitions of several individuals from nursing facilities into the community. The P & A will continue to facilitate successful transitions by developing our current relationships with the long-term care ombudsman’s office, MFP, and Medicaid waiver staff. The P & A actively participated in the quarterly MFP stakeholder meetings held throughout the state. The P & A heard reports from the state Division of Aging and the Department of Behavioral Health and Developmental Disabilities regarding information about its nursing facility transitions for the previous quarter. During this fiscal year, the P & A has developed a relationship with the Public Guardianship Office (PGO) of the Georgia Division of Aging to collaborate on cases where the person is under state guardianship and wants a more independent life. PGO will refer individuals to us whom they believe may no longer need a guardian. PGO is also working with us to enrich the lives of persons under state guardianship, by ensuring that they have the right and the ability to receive appropriate services and supports and live in the community. The P & A works closely with the Statewide Independent Living Council (SILC) and each of the nine (9) Center for Independent Living (CIL) offices. The P & A contributed to the discussions surrounding ensuring that persons with disabilities have access to, among others, accessible housing, transportation, living alternatives, and assistive technology. The P & A provided a training to the CIL in Augusta regarding self-advocacy strategies in pursuing employment. The P & A also worked closely with the CIL in Savannah regarding an issue that arose when CIL staff were prohibited from visiting a woman in the nursing facility by the woman’s guardian (the state). 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. 30 6. Provide at least one case summary that demonstrates the impact of the priority. M.S., a man with a physical disability as a result of a stroke, contacted the P & A. M.S. had recently moved out of a nursing facility into the community with the assistance of Money Follows the Person (MFP). M.S. was receiving four (4) hours of support a day through the Community Care Service Program (CCSP) Medicaid waiver. However, M.S. was at risk of returning to a nursing facility as he was not receiving enough support to remain in the community. The P & A requested that M.S. be evaluated by the Independent Care Waiver Program (ICWP) and supported M.S. during his ICWP evaluation. Because of ICWP’s waiting list, the P & A contacted MFP to remind them that M.S. was still within the one year MFP coverage and advocated for M.S.’s name to be placed at the top of the ICWP waiting list to receive a slot. As a result of the P & A’s advocacy on M.S.’s behalf, M. S. now receives eight (8) hours of support services a day through ICWP and he is no longer at risk of returning to a nursing facility. J.P., a man with deafness who communicates via American Sign Language (ASL) is the director of GACHI (Georgia Council for the Hearing Impaired). J.P. contacted the P & A to request advocacy assistance in negotiating with the Georgia Center for Nonprofits (GCN) as they had failed to provide sign language interpreters for J.P. during an Organizational Leadership class. J.P.’s attempts at self-advocacy were unsuccessful as GCN said they would provide J.P. with another accommodation of CART (Communication Access Realtime Translation) in lieu of providing interpreters. CART was not an effective method of communication for J.P. as CART cannot express in class what J.P. wants to say. The P & A contacted GCN on J.P.’s behalf to request that GCN provide interpreters instead of CART for J.P.’s effective communication and participation in the class. The P & A negotiated with GCN’s attorney by explaining the difference between CART and interpreters and as a result, GCN provided interpreters for J.P.’s class. A.M., a woman with physical disabilities and a Medicaid-recipient, was unable to locate a participating provider to be her primary care physician, causing her to obtain medication orders through the local hospital. As a result of the P & A’s negotiation with the State Medicaid Director on behalf of A.M., a primary care physician was identified who accepted A.M. as a patient. 1. Identify and describe the priority. The third priority is to promote the integration and self-determination of persons with disabilities in the community. The P & A seeks to empower people with disabilities, family members, and concerned citizens to advocate for competitive employment, educational, healthcare, and other services that are appropriate to the person’s needs. 2. Identify the need, issue, or barrier addressed by this priority. This priority addresses the need of people to live fully integrated lives in their communities. Persons with disabilities have been continually isolated and segregated from the community. Starting when they are young, they are placed in classes separate from everyone else. It continues when opportunities to be in the community are limited because of inaccessibility. Most significantly, too many persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for persons with disabilities is to be involved and connected with their communities and to develop and practice self-advocacy skills. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. The indicators of success for this priority are as follows: to support individuals and concerned citizens to obtain equal opportunities from employers, housing providers, healthcare providers, transportation providers, and to support individuals and concerned citizens to obtain home and community-based supports for individuals to live and fully participate in their communities. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. The P & A supported the Georgia Council on Developmental Disabilities (GCDD) with Georgia’s first “Employment First Advocacy Day” at the Capitol. The P & A educated self-advocates on the importance of Georgia legislators adopting an Employment First policy The P & A then supported the self-advocates to meet with legislators to share their stories of why employment supports and opportunities are important. For many legislators, this was their first experience to learn about Employment First. The P & A provides ongoing support to People First of Atlanta and People First of Georgia. The P & A also hosts their monthly meetings as well as serving as their fiscal agent. The P & A sends a supporter to monthly meetings and also provides support to the chapter and the Board in the planning and execution of the annual Long Road Home event and the annual People First of Georgia conference that all People First chapters attend. The P & A sponsored the Long Road Home event that was held on June 22, 2015, at the Capitol building in downtown Atlanta. The anniversary of the Olmstead decision was celebrated and Lois Curtis, one of the Olmstead plaintiffs, spoke about her life since the decision. Powerful freedom stories were shared to the people gathered at the event. Local artists displayed their work. The P & A, in partnership with Atlanta Legal Aid, spoke about their work with the Disability Integration Project resulting in people leaving institutional settings to live in their own home. The P & A participated in Georgia's 2015 Disability Day at the Capitol. The P & A staff operated a display table at the event. The P & A informed and educated self-advocates, families, caregivers, advocates, providers and other interested community members about role of the P & A within Georgia to include protection from abuse and neglect as well as providing resources regarding employment and voting. Collaborators included the following: Georgia Council on Developmental Disabilities, Southeast ADA Center, Center for Leadership and Disability at Georgia State University, the Statewide Independent Living Council, and disAbility Link-Atlanta's Center for Independent Living. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. 62 6. Provide at least one case summary that demonstrates the impact of the priority. L.B., a woman with deafness whose primary method of communication is American Sign Language (ASL), contacted the P & A regarding her doctor’s refusal to provide a sign language interpreter to L.B. during her medical appointments. The P & A provided technical assistance in self-advocacy to L.B. regarding her doctor’s responsibility to provide her with effective communication and suggested she write a letter to her doctor requesting a sign language interpreter in order to ensure effective communication. The P & A provided L.B. with copies of the P & A’s brochures titled, “Responsibilities of Health Care Providers for Persons Who Are Deaf or Hard of Hearing” and “A Guide for Persons Who Are Deaf or Hard of Hearing. L.B. is now better informed of her right to effective communication when meeting with her doctor and is better equipped to self-advocate. R.S., a man with a neurological disability, contacted the P & A to request assistance in filing a complaint against the Georgia Insurance Commission regarding discrimination against him by their staff. R.S. drafted the complaint and the P & A provided technical assistance in self-advocacy to R.S. in reviewing and filing the complaint. N.C. is a man with multiple sclerosis who received vocational rehabilitation services through the Veterans Administration (VA). Because of his difficulty remembering, N.C. asked his VA vocational rehabilitation counselor if he could record their sessions so that he could play back their meetings to refresh his memory. The VA denied his request. The P & A provided technical assistance in self-advocacy to N.C. in reviewing a draft email that N.C. sent to the VA, requesting a different VA counselor who would allow him to record their sessions. N.C.’s self-advocacy efforts were successful.

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. The first goal is to protect individuals with disabilities in Georgia from abuse and neglect. The first priority of this goal is to investigate and address allegations of abuse or neglect, including the suspicious or unexplained deaths of persons with disabilities. The second priority of this goal is to advocate for appropriate home and community-based supports and services for persons with disabilities residing in facilities, with a focus on monitoring the State’s compliance with US v GA, the ADA and Olmstead. 2. Needs: Georgians with disabilities are at risk of institutionalization due to the lack of community-based services and supports. People who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Children are at the greatest risk due to their heightened vulnerability. Community-based supports are needed to end the institutional bias in Georgia. 3. Activities: The P & A monitors state hospitals, nursing facilities, and private residential treatment facilities. The P & A responds to calls involving community-based services including community living arrangements, sheltered workshops, and other day services. Children and other individuals residing in facilities will be considered more vulnerable than those living in community settings and will receive priority response from the P & A. The P & A will investigate deaths and cases of severe abuse and neglect against people with disabilities. The P & A will seek the full range of remedies for individuals through protection and advocacy from abuse and neglect. 1. A statement of each priority. The second goal is to respond to allegations of discrimination and legal rights violations of persons with disabilities. The first priority of the second goal is to advocate for appropriate home and community-based supports and services, including healthcare and education, for people with disabilities at risk of institutionalization. The second priority of the second goal is to advocate for people with disabilities residing in the community who are subject to legal rights violations and discrimination in any of the following areas: fiduciary relationships, local and state government, healthcare, housing, transportation, and employment. 2. Needs: People with disabilities often face discrimination in areas such as healthcare, transportation, housing, and employment. People need to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services and public accommodations. Public accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. Additionally, persons with disabilities can be subjected to financial exploitation by family members or acquaintances or by other persons upon whom they are dependent. 3. Activities: The P & A will seek the full range of remedies for individuals who have been subjected to discrimination and rights violations. The P & A will address discrimination in healthcare, transportation, housing and employment by negotiation, mediation, and litigation. The P & A collaborates with a wide range of agencies, such as the State ADA Coordinator’s office, the Centers for Independent Living, Atlanta Legal Aid Society, Georgia Legal Services, and private attorneys to assist people whose rights are being violated and who are being subjected to fiduciary relationships. 1. The third goal is to promote self-advocacy and self-determination of persons with disabilities in the community. The first priority of the third goal is to empower people with disabilities, family members, and concerned citizens to advocate for competitive employment, educational, healthcare, and other services that are appropriate to the person’s needs. 2. Needs: Persons with disabilities have been continually isolated and segregated from the community. Opportunities to be in the community continue to be limited because of inaccessibility. Most significantly, persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for persons with disabilities is to be involved and connected with their communities. 3. Activities: The P & A supports persons to be involved in their community by teaching self-advocacy skills and mentoring persons with disabilities on their individual self-advocacy plans. The P & A provides information to individuals with disabilities about their human and legal rights to ensure that individuals secure the accommodations and services they are entitled to under the law. The P & A also provides technical assistance in self-advocacy by assisting individuals and their families in applying for community-based supports and also refers individuals and families to local independent living centers for information about transitioning into community life.

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 Federal (section 509): Amount Received = 462,835 Federal (section 509): Amount Spent = 469,000 State: Amount Received = 0 State: Amount Spent = 0 Program income: Amount Received = 0 Program income: Amount Spent = 0 Private: Amount Received = 0 Private: Amount Spent = 0 All other funds: Amount Received = 0 All other funds: Amount Spent = 0 Total (from all sources): Amount Received = 462,835 Total (from all sources): Amount Spent = 469,000 B. Budget for the fiscal year covered by this report Wages/salaries: Prior Fiscal Year = 296,000 Wages/salaries: Current Fiscal Year = 292,000 Fringe benefits (FICA, unemployment, etc): Prior Fiscal Year = 70,000 Fringe benefits (FICA, unemployment, etc): Current F/Y= 72,000 Materials/supplies: Prior Fiscal Year = 5,300 Materials/supplies: Current Fiscal Year = 5,300 Postage: Prior Fiscal Year = 1,000 Postage: Current Fiscal Year = 1,000 Telephone: Prior Fiscal Year = 3,000 Telephone: Current Fiscal Year = 3,200 Rent: Prior Fiscal Year = 35,000 Rent: Current Fiscal Year = 36,000 Travel: Prior Fiscal Year = 7,900 Travel: Current Fiscal Year = 8,000 Copying: Prior Fiscal Year = 2,600 Copying: Current Fiscal Year = 2,500 Bonding/insurance: Prior Fiscal Year = 2,000 Bonding/insurance: Current Fiscal Year = 2,400 Equipment (rent/purchase): Prior Fiscal Year = 4,000 Equipment (rent/purchase): Current Fiscal Year = 4,500 Legal Services: Prior Fiscal Year = 10,000 Legal Services: Current Fiscal Year = $10,000 Indirect costs: Prior Fiscal Year = 0 Indirect costs: Current Fiscal Year = 0 Miscellaneous: Prior Fiscal Year = 32,035 Miscellaneous: Current Fiscal Year = 32,000 Total Budget: Prior Fiscal Year = 462,835 Total Budget: Current Fiscal Year = 469,000 C. Description of PAIR Staff Professional position: 14 FTE filled 100% of year Professional full-time positions: 12 FTE, 12 person-years Professional part-time positions: 2 FTE, 1 person-year Professional vacant positions: 5 FTE, 1 person-year Clerical position: 5 FTE filled 100% of year Clerical full-time positions: 5 FTE, 5 person-years Clerical part-time positions: 0 FTE, 0 person-years Clerical vacant positions: 0 FTE, 0 person-years Julie Kegley is the PAIR program director and a staff attorney who has been with the P & A for seven (7) years. Among other things, Ms. Kegley represents people with disabilities to have their guardian/conservator removed, represents people with deafness to ensure they have effective communication in places of public accommodation and in the court system, and represents parents with disabilities whose children are at risk of being removed from them by the state due to their disability. Josh Norris is the Director of Legal and Advocacy Services and has been with the P & A for eleven (11) years. He supervises all legal and advocacy services and coordinates with program directors and staff regarding targeted and systemic advocacy strategies. Crystal Perry is the Director of Program Accountability and an attorney who has been with the P & A for thirteen (13) years. She has experience in employment discrimination and the Americans with Disabilities Act. Denise Quigley is the Director of the Resource Advocacy unit and an attorney who has been with the P & A for eighteen (18) years. Naomi Walker is an attorney and a Resource Advocacy who works part time and has been with the P & A for twenty-one (21) years. She has extensive experience with Medicaid and Assistive Technology litigation. Stacey Smith is an advocate who has been with the P & A for eleven (11) years. Ms. Smith advocates on behalf of individuals transitioning into the community from facilities, as well as on behalf of individuals experiencing employment discrimination. The Executive Director, Comptroller, Accountant, and all members of the Administrative Support team have contributed to, and participated in support of, the PAIR program. D. Involvement with Advisory Boards The P & A serves on the following boards and committees: Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities; Georgia’s Council on Developmental Disabilities; State Traumatic Brain and Spinal Cord Injury Steering Committee; Unlock the Waiting List Steering Committee; Georgia’s taskforce to oversee the planning, design, and implementation of the state’s transition plan to divest from segregation and come into compliance with the ADA, Olmstead, and CMS ‘settings guidance;’ National Disability Rights Network Employment Committee, TASH Employment Committee; National Disability Rights Network Continuing Education and Self-Advocacy Committee; Money Follows the Person stakeholders committee. The P & A is an advisor to People First of Georgia. The P & A serves on several Boards and Committees at the local, state, and national levels related to employment representing the protection and advocacy system. E. Grievances filed under the grievance procedure. The P & A did not receive any grievances filed under the grievance procedure this year. F. Coordination with the Client Assistance Program and the State long-term care program, if these programs are not part of the P & A agency. This year, the P & A worked with the Client Assistance Program (CAP) program in a wider capacity to bring robust advocacy efforts to support people with disabilities and help them to understand their rights relating to Georgia Vocational Rehabilitation Agency (GVRA). The P & A and CAP spent more time communicating with each other about a person’s needs and the best way to support a person individually as they sought to resolve issues with GVRA. Both the P & A and CAP discovered that it is essential to work together to support people with disabilities who seek services from GVRA in a way that promotes strong advocacy and employment opportunities. The P & A has received referrals from the Long Term Care Ombudsman regarding individuals residing in nursing facility who have experienced abuse and/or neglect in the facility and/or who want to transition from the facility into the community.

Certification

Signed?Yes
Signed ByJulie C. Kegley
TitleStaff Attorney/Program Director
Signed Date11/16/2015