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

Michigan (MICHIGAN PROTECTION AND ADVOCACY SERVICES, INC. -- CLIENT ASSISTANCE PROGRAM) - H240A150023 - FY2015

General Information

Designated Agency Identification

NameMichigan Protection and Advocacy Service Inc.
Address4095 Legacy Parkway
Address Line 2Suite 500
CityLansing
StateMichigan
Zip Code48911
E-mail Addressecerano@mpas.org
Website Addresshttp://www.mpas.org
Phone517-487-1755
TTY 517-487-1755
Toll-free Phone800-288-5923
Toll-free TTY800-288-5923
Fax517-487-0827
Name of P&A Executive DirectorElmer L. Cerano
Name of PAIR Director/CoordinatorMark A. Cody
Person to contact regarding reportMark A. Cody
Contact Person phone517-487-1755
Ext.628

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 areas201
2. Individuals receiving I&R outside PAIR priority areas1,636
3. Total individuals receiving I&R (lines A1 + A2)1,837

B. Training Activities

1. Number of trainings presented by PAIR staff5
2. Number of individuals who attended training (approximate)168

Training and Attendance: Disability Rights Training, Detroit Metro (75) June 9, 2015 Nursing Facility Transition (24) Center for Independent Living December 9, 2014 Special Education Rights Training (11) Benton Harbor, MI October 4, 2014 Special Education Rights Training (22) Traverse City, MI October 8, 2014 Forensic Nursing (36) April 27, 2015 NOTE: Not all of these trainings/webinars were funded 100% by PAIR. They were collaborative activities with other MPAS funding areas and staff.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff1
2. Newspaper/magazine/journal articles0
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website39,788
5. Publications/booklets/brochures disseminated4,340
6. Other (specify separately)0

Narrative

MPAS maintains an agencywide Facebook page. The number of “friends” of MPAS has steadily increased since the site was launched and we now have 1,372 Likes/Friends. This has proven to be an effective means of communicating with many individuals. PAIR funding also supports the activities of the Great Lakes ADA (GLADA) Steering Committee. GLADA distributes mini-grants that promote accessibility in the community.

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)33
2. Additional individuals served during the year25
3. Total individuals served (lines A1 + A2)58
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)0

B. Individuals served as of September 30

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

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility0
2. Employment3
3. Program access4
4. Housing2
5. Government benefits/services5
6. Transportation1
7. Education2
8. Assistive technology1
9. Voting0
10. Health care2
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse6
16. Neglect32
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor21
2. Other representation found0
3. Individual withdrew complaint1
4. Appeals unsuccessful8
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case3
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit7
9. Other1

Please explain

Closed and reopened to different funding source upon receipt of additional information.

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy0
2. Short-term assistance3
3. Investigation/monitoring26
4. Negotiation1
5. Mediation/alternative dispute resolution0
6. Administrative hearings3
7. Litigation (including class actions)9
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 40
2. 5 - 221
3. 23 - 5920
4. 60 - 644
5. 65 and over33

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females30
2. Males28

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 Native1
3. Asian1
4. Black or African American16
5. Native Hawaiian or Other Pacific Islander0
6. White39
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent16
2. Parental or other family home3
3. Community residential home2
4. Foster care0
5. Nursing home32
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center5
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 impairment4
2. Deaf/hard of hearing4
3. Deaf-blind0
4. Orthopedic impairment4
5. Mental illness2
6. Substance abuse0
7. Mental retardation0
8. Learning disability1
9. Neurological impairment18
10. Respiratory impairment2
11. Heart/other circulatory impairment15
12. Muscular/skeletal impairment1
13. Speech impairment0
14. AIDS/HIV4
15. Traumatic brain injury0
16. Other disability3

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities3

2. Number of individuals potentially impacted by policy changes74,447

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.

Number of individuals impacted by systemic activities: According to the Kaiser Family Foundation, at the end of Fiscal Year 2014 there were 39,447 residents in Michigan's 434 certified nursing facilities. Each one of these residents is a beneficiary of the work of MPAS. The Michigan Assisted Living Association estimates that there are 35,000 residents of adult foster homes. While not all will be directly impacted by the Home and Community Based Services rules, those rules will lead to culture change for all residents. Description of systemic activities 1. Statewide Nursing Home Project: MPAS has assigned specific staff to review reports prepared by the state agency in Michigan that surveys nursing facilities and investigates complaints made of abuse and/or neglect. When there is probable cause to believe that a resident has been subjected to abuse and/or neglect, MPAS obtains relevant records, either using our access authority or with the consent of the resident or his/her authorized representative. When warranted, MPAS files complaints against the licenses of medical professionals whose acts or omissions contributed to the abuse/neglect. As a result of complaints filed by MPAS against the professional licenses of 22 nurses, they were placed on probation ranging from six months to three years. Collectively they were ordered to complete a total of 58 continuing education courses at their own expense, and were fined a total of $9,000. Complaints filed by MPAS against the certificates of three certified nursing assistants, resulted in three being permanently banned from working in nursing facilities that accept Medicaid or Medicare, and one was also criminally charged and placed on 6 months criminal probation. As a result of complaints filed by MPAS, one medical doctor was reprimanded and fined $3,500, and one nursing home administrator was placed on probation for one year and fined $1,500. These activities, which are also supported by PADD and PAIMI funding, require a significant investment of staff resources. Each case entails a detailed review of records, not only from the nursing facility, but from hospitals, community health care providers, emergency medical professionals, and so forth. The complaints filed against medical professionals by MPAS are therefore well-documented. This results in a far greater likelihood that a complaint will be substantiated. For example, in FY 2014, the state's data shows that, for all complaints filed against medical doctors, only 16% are substantiated. By contrast, 76% of the complaints filed by MPAS against medical doctors are substantiated. As this work continues, it will impact the culture of not only nursing facilities, but that of the state licensing agency, and the long term care ombudsman as well. These entities have for too long accepted the notion that some level of abuse and/or neglect is inevitable. MPAS does not share that belief. Our position is that no act of abuse/neglect should ever occur. 2. Home and Community Based Services MPAS is actively monitoring the state's proposed plans for implementation of the Home and Community Based Services final rules issued by CMS. When fully implemented, these rules will advance community integration and will do much to ensure that individuals with disabilities will live in settings that are typical of the community. However, in Michigan, group homes (Adult Foster Care facilities) are highly regulated and consumer choice is limited. Every aspect of life, from community outings to meals, is dictated by administrative rules or "house rules" imposed by the AFC provider. MPAS has advocated for the swift and comprehensive implementation HCBS rules, even though that will require shifting much of the licensing oversight from housing conditions to staff competencies and performance. Michigan's proposed transition plan has been returned by CMS for significant revision. CMS expects increased opportunity for consumer input and greater specificity of benchmarks. As the State proceeds with its rewrite, MPAS is working with community mental health services programs that are committed to full implementation of the HBCS rules. 3. Krusac v. Covenant amicus brief The PAIR enabling statute guarantees MPAS access to records pertaining to an eligible client, including peer review documents. However, there are limitations on the release of peer review records. Whether a particular record is a peer review document is a matter of state law. It has become an unfortunate practice in Michigan for health care providers to designate records containing descriptions of incidents of potential abuse or neglect as peer review documents. By labeling notes contemporaneously made by eyewitnesses as "peer review" documents, health care providers shield their misdeeds and frustrate the work of MPAS. One Michigan Court of Appeals found that providers had gone too far and determined that notes containing the description of an event should not be considered peer review documents. An appeal was filed and the case was accepted for review by the Michigan Supreme Court. MPAS filed an amicus brief, as did a number of other interested organizations. MPAS urged the Court to not expand the definition of peer review records. Unfortunately, the Supreme Court sided with the provider. The only remedy for this is a change in state law.

B. Litigation/Class Actions

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

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

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.

A. Priority: Eliminate Abuse and Neglect 1. Describe the priority. Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities that are virtually unregulated. Abuse/neglect is especially prevalent in nursing facilities. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. If abuse and/or neglect is confirmed, whether appropriate corrective measures are taken to prevent future incidents. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS works collaboratively with the Office of Recipient Rights of the Michigan Department of Health and Human Services, the State Long Term Care Ombudsman, as and licensing and certification agencies. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Twenty-nine cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. A 71 year old man was living in a nursing facility in mid-Michigan. He was known to have diabetes. Despite that knowledge, the RN responsible for overseeing his care neglected to have him transported to a local hospital. When he finally was taken to the hospital, he was in insulin shock due to his extremely low blood sugar levels. Within 48 hours after arriving at the hospital and despite being admitted to the ICU, he died. Upon learning of this event, MPAS made a request for records from the nursing facility. The facility was initially unwilling to provide the requested records. MPAS attorneys were involved and the records were provided pursuant to our federal enabling statute. After reviewing the records, a complaint was filed with the nursing home licensing agency for the State of Michigan. A decision was made to refer the complaint to the Office of the Attorney General. Ultimately, the RN entered into a Consent Order. The RN was placed on probation for one year and was fined $250 and required to take continuing education credits in each of the following: professional accountability and legal liability for nurses; sharpening critical thinking skills for competent nursing practice; and recognition and management of emergency situations, including deterioration of patient condition. A. Priority: Improve Rights Protection Systems 1. Describe the priority. Advocate for effective systems and proceedings to safeguard the rights of consumers. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities frequently have their civil rights compromised by ineffective rights protection systems and overreaching guardians. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client received effective assistance from rights protection systems and/or whether the client was protected from a loss of personal rights as a result of a guardianship. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. No collaboration. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Two cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. MPAS was contacted by the family of a woman in a nursing facility who was being told that a feeding tube would be inserted and that, if she objected, a petition would be filed with the probate court to obtain an order authorizing the forced inserting of the feeding tube. An MPAS attorney met with the woman to verify that she did not want the feeding tube. He then met with facility staff and convinced them to honor her choice. She was discharged home, without the feeding tube, which was her desire. A. Priority: Eliminate Employment Barriers and Protect Rights 1. Describe the priority. To ensure that consumers have access to competitive employment and their rights under state and federal law are protected. 2. Identify the need, issue, or barrier addressed by this priority. Nationwide, the data indicates that persons with disabilities continue to be underemployed and unemployed compared to persons without an identified disability. Although legal protections exist to address this issue, individuals with disabilities are most likely to receive assistance and representation from the private bar when they have been discharged from employment. For these individuals, legal assistance that is most effective focuses on negotiating reasonable accommodations with an employer prior to discharge. Unfortunately, many individuals with significant disabilities are unable to secure legal representation for any employment related issue. Finally, many individuals with disabilities are employed in settings that allow for deviated wages based on level of productivity and, as a result, they are not compensated as fully as is required by law for individuals in other settings. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to secure or maintain competitive employment. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. None. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. No cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. No closed cases on this priority in FY 2015. However, at the end of FY 2015, MPAS was actively pursuing employment claims for PAIR eligible clients. One example is a situation where a client disclosed to his employer that he is HIV+. Shortly thereafter, the client was fired. Suit has been filed in state court and MPAS alleges that the discharge was discriminatory. In another case, our client was providing home care services to an individual with significant impairments. Our client has a serious visual impairment. However, she has been able to provide hands on care for a number of years. When she asked the agency that pays her to provide her with a timesheet in large print, she was terminated. The agency documented that the reason for her termination was her visual impairment. The agency has entered settlement negotiations, which will hopefully result in a favorable outcome for the client. A. Priority: Improve Access to Necessary Services 1. Describe the priority. Advocacy for services to maintain consumers in the community and for accommodations in critical services. 2. Identify the need, issue, or barrier addressed by this priority. Particularly in a time of severe funding shortages, the availability of services and supports for consumers is being compromised. In addition, many providers of critical services, such as hospitals, units of local government, etc. are not making needed physical and/or programmatic accommodations. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to gain or maintain needed services . 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS worked with the State Long Term Care Ombudsman on cases involving termination of services provided through the Home and Community Based Services Nursing Facility Waiver. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Four cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. Our client was living in the community, but needed assistance on a 24/7 basis. He was receiving those services from the Home and Community Based Waiver nursing facility waiver program. The waiver agent proposed reducing his supports to 18 hours per day. This would have forced him to move into a nursing facility. The client contacted MPAS and we represented him at a Medicaid Fair Hearing. The Administrative Law Judge determined that supports are medically necessary on a 24/7 basis and directed the waiver agent to provide those services. In addition, the ALJ determined that supervision is a legitimate use of community living supports, a decision that could benefit other consumers. Access to necessary services also requires that government agencies make needed accommodations so that individuals with impairments are able to access those services. As an example, MPAS is representing a client who is visually impaired. He relies upon public benefits. Unfortunately, the forms (both paper and digital) are unavailable to him. Efforts to resolve this problem through discussions with the state proved futile. At the close of FY 2014, a decision was made to proceed to litigation. The goal of the lawsuit will be to not only resolve the problem for this client, but to compel the State of Michigan to make accommodations for all individuals with sight impairments. In another case, MPAS investigated allegations by an inmate in a correctional facility operated by the Michigan Department of Corrections (MDOC). The inmate's complaint was that MDOC was discriminating against him and other inmates due to their HIV+ status. Our client spent eleven months in administrative segregation as punishment for violation of an MDOC rule. Another inmate, found to have violated the same rule, but who was not HIV+, spent no time in administrative segregation. MPAS consulted with medical professionals with expertise in treating individuals who are HIV+, as well as attorneys who represent HIV+ clients. We attempted to resolve this matter through negotiations with MDOC. Those attempts proved futile and ultimately we filed suit in the United States District Court for the Western District of Michigan. The suit was pending at the close of the fiscal year. A. Priority: Ensure the Right to a High Quality Education 1. Describe the priority. Advocacy to ensure that students with disabilities will receive the highest and best education possible and they will be fully prepared for entry into the competitive workforce. 2. Identify the need, issue, or barrier addressed by this priority. Students with disabilities are too often placed in segregated learning environments, are suspended, or expelled for disability related conduct, or are not adequately prepared for work. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to gain or retain access to general education or is prepared to enter the workforce. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS is a founding member of the Michigan Alliance for Families (MAF). MAF is the federally funded parent training and information center. MPAS has historically partnered with MAF in training parents, educators, and service providers in special education rights. MPAS also provided technical assistance to MAF staff serving parents. Unfortunately, due to limitations imposed by MAF's state funding, MPAS' role in collaborating with MAF was greatly reduced. MPAS anticipates that its collaborative work with MAF will be limited to a general advisory role in FY 2016. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Two cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. Our client was frequently expelled from school. MPAS spoke with client's mother and reviewed records. Technical assistance was provided to the mother, who was able to ensure that supports and services were in place that would reduce the number of suspensions and procedural protections would be put in place.

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.

Priority: Eliminate Abuse and Neglect 1. Describe the priority. Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities where regulations are ineffective in curtailing these practices. 3. Description of the activities to be carried out. Educate policymakers in an effort to establish better measures to protect consumers and to eliminate the use of restraint and/or seclusion; investigate suspected abuse/neglect cases and follow-up as needed; and file appropriate litigation. B. Priority: Increase the protection of individual rights, independence, and self-determination. 1. Describe the priority. Advocate for effective systems and proceedings to safeguard the rights of consumers. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities frequently have their civil rights compromised by overreaching guardians. 3. Description of the activities to be carried out. Advocacy in individual cases involving allegations of interference with the exercise of the right to vote, denial of marriage, or the loss of other civil rights by a guardian. Advocacy to challenge the refusal by a court to recognize the validity of an alternative to guardianship. Advocacy in cases where there are allegations of abuse, neglect, significant financial exploitation, or forced treatment by a guardian. Efforts to educate consumers, advocates, and family members on alternatives to guardianship, such as supported decision-making. B. Priority: Eliminate Employment Barriers and Protect Rights 1. Describe the priority. Ensure that consumers have access to competitive employment and their rights under state and federal law are protected. 2. Identify the need, issue, or barrier addressed by this priority. Nationwide, the data indicates that persons with disabilities continue to be underemployed and unemployed compared to persons without an identified disability. Although legal protections exist to address this issue, individuals with disabilities are most likely to receive assistance and representation from the private bar only when they have been discharged from employment. For these individuals, legal assistance that is most effective focuses on negotiating reasonable accommodations with an employer prior to discharge from employment. Furthermore, many individuals with significant disabilities are unable to secure legal representation for any employment related issue. Finally, many individuals with disabilities are employed in settings that allow for deviated wages based on level of productivity and, as a result, they are not compensated as fully as is required by law for individuals in other settings. 3. Description of the activities to be carried out. Provide technical assistance to clients to assist them in securing needed accommodations prior to termination from employment or as applicants for employment. Advocate for full implementation of the Workforce Innovation and Opportunity Act (WIOA); challenge the use of sheltered workshops, particularly those that rely on 14c waivers; and advocate for supported employment. Representation in individual or systemic litigation. B. Priority: Improve Access to Services 1. Describe the priority. Advocate for services to maintain consumers in the community, for accommodations needed to access critical services, and for discharge planning including access to services in facilities (e.g. nursing homes). 2. Identify the need, issue, or barrier addressed by this priority. Particularly in a time of severe funding shortages, the availability of services, supports for consumers is limited. In addition, many providers of critical services, such as hospitals, units of local government, etc. are not making needed physical and/or programmatic accommodations. 3. Description of the activities to be carried out. Representation in individual and systemic cases involving denial or termination of critical services needed to avoid institutionalization or to secure discharge to the community. Advocate for full implementation of the Home and Community Based Waiver rules issued by CMS that will result in more integrated living for individuals with disabilities. B. Priority: Ensure the Right to a High Quality Education 1. Describe the priority. Advocate to ensure that students with disability-related behavior remain in school and students will receive appropriate transition services to be fully prepared for entry into the competitive workforce. 2. Identify the need, issue, or barrier addressed by this priority. Students with disabilities are too often placed in segregated learning environments, suspended, or expelled for disability related conduct, or are not adequately prepared for work. 3. Description of the activities to be carried out. Advocacy in systemic and individual cases and policy advocacy, with a focus on elimination of restraint and seclusion in schools; effective transition services; elimination of disability related removals; and effective child find practices.

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

Note: While the number of individuals represented decreased from FY 2014, the number of investigations of nursing facilities increased from 21 to 51. Investigation activities are largely supported with PAIR funding and are an effective means of addressing issues at specific facilities. A. Sources of funds received and expended: U.S. Dept. of Education (FY 2013-2014) ($0) No carryover U.S. Dept. of Education (FY 2014-2015) $458,363 MPAS Unrestricted Funds Total Available for FY 2015 $458,363 Total expended for FY 2014 $435,356 B. Budget 2015 Actual 2016 Projected Admin $43,798 $ 44,000 Services $381,169 $395,000 Other $ 10,389 $ 11,000 Total $435,356 $450,000 C. Description of PAIR staff (duties and person-years) 1. Duties PAIR supports both advocates and attorneys who provide information and referral, direct advocacy and legal representation to PAIR eligible clients. The advocates who provide information and referral services discuss a variety of legal issues related to the disability of the client. Advocates and attorneys providing direct advocacy and legal representation do so in these areas: (1) Community integration and community supports; (2) Abuse and Neglect; (3) Discharge Planning; (4) Rights Protection; (5) Employment; and (6) Education. 2. Person Years PAIR had 5.21 FTEs of direct advocacy staff during FY 2015. PAIR pays a federally approved indirect cost rate of 11.4%, which funds administration, finance, human resources, and information systems. PAIR funded staff have focused on the condition and treatment of individuals in nursing facilities. Staff have developed an expertise in reviewing records and identifying instances where it is appropriate to file licensing complaints. Multiple complaints were filed with state licensing agencies. Unfortunately, discrimination against individuals with disabilities still exists in many places of employment. Some employers simply refuse to hire individuals with impairments. Others refuse to provide needed accommodations. As a result MPAS staff have developed expertise on advocating for the employment rights of PAIR eligible individuals. D. Involvement with advisory boards (if any) MPAS staff was actively involved with the Statewide Independent Living Council, the Michigan Disability Housing Workgroup, the Michigan Disability Network, the Transition and Education Advisory groups of the Michigan Department of Career Development, the Community Housing Network, and the Juvenile Justice Waiver Workgroup. E. Grievances filed under the grievance procedure MPAS received no grievances from PAIR eligible consumers. 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 CAP is part of MPAS. MPAS works in cooperation with the State Long Term Care Ombudsman.

Certification

Signed?Yes
Signed ByMark A. Cody
TitleLegal Director
Signed Date12/11/2015