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

Washington (Disability Rights Washington) - H240A150048 - FY2015

General Information

Designated Agency Identification

NameDisability Rights Washington
Address315 Fifth Avenue South
Address Line 2Suite 850
CitySeattle
StateWashington
Zip Code98104
E-mail Addressmstroh@dr-wa.org
Website Addresshttp://doesnotfit.org
Phone206-324-1521
TTY 206-957-0728
Toll-free Phone800-562-2702
Toll-free TTY800-905-0209
Fax206-957-0729
Name of P&A Executive DirectorMark Stroh
Name of PAIR Director/CoordinatorMark Stroh
Person to contact regarding reportMark Stroh
Contact Person phone206-324-1521
Ext.217

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 areas102
2. Individuals receiving I&R outside PAIR priority areas4
3. Total individuals receiving I&R (lines A1 + A2)106

B. Training Activities

1. Number of trainings presented by PAIR staff36
2. Number of individuals who attended training (approximate)1,397

The following are some examples of our training:

1. DRW was invited to speak on a panel to discuss job strategies for people with disabilities, specifically law student job applicants.To educate law students with disabilities about their rights under the ADA and WLAD when interviewing for jobs. DRW staff s servfed on a panel with two other presenters (a law student and an attorney from the EEOC) to discuss job strategies for people with disabilities. Specifically, the panel focused on if or when to disclose a disability during the pre-offer and post-offer periods.

2. A location where DRW conducted training was an assisted living facility designed to serve the special needs of individuals living with Alzheimer's disease, dementia, and other forms of memory loss. DRW conducted do a general outreach and training visit, focusing on any locked units. A particular focus for this visit was about decisionmaking: do people make their own decisions, have POAs, guardians, other forms of surrogate decisionmakers? Is surrogate decisionmaking limited to certain issues (financial vs. personal)?

On March 5, 2015 DRW conducted outreach/training at the assisted living facility in Bellingham, WA. DRW staff provided information about DRW and its activities to both residents and facility staff.

3. Some of the other groups trained include the Independent Living Center - North Sound; Long Term Care Ombudsman; Washington Coalition of Sexual Assault ProGRAMS; Access for All; and Certified Public Guardians; Office of Public Guardianship.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff2
2. Newspaper/magazine/journal articles4
3. PSAs/videos aired27
4. Hits on the PAIR/P&A website84,477
5. Publications/booklets/brochures disseminated1,064
6. Other (specify separately)1,833

Narrative

DRW has developed a video advocacy capacity to enhance our advocacy efforts. Some of the vides are designed to increase public awareness of disability rights related issues while others go a step further and are intended to support a specific advocacy objective. In the former category are videos we did in conjunction with the ADA anniversary this year. Three videos stand out as examples of the latter category. Our video, "Right to be Rescued", was used in our efforts to improved emergency preparedness training. Another video was used to train advocates serving long term care facilities about ways to prevent sexual assault and improve response to it. Then we did videos on rights related to service and companion animals. The videos are intended as guides to both animial and business owners and were done in conjuntion with the Traumatic Brain Injury Council and the Washington State Department of Veteran Affairs.

There were 18,503 views of the 27 videos documented above. The videos are available for viewing on DRW's Rooted in Rights YouTube and Facebook platforms. The service and companion animal videos are also on the website of the Washington State Department of Veteran Affairs. Work on voting related videos was begun in FY 2015 and will completed in FY 2016 and those videos will be available on our platforms as well as the platforms of the Washington State Secretary of State.

52 email blasts with news related to disability rights related issues were sent to the 1,833 people on DRW's email list.

Part II. Individuals Served

A. Individuals Served

Count individual once per FY. Multiple counts not permitted for lines A1 through A3.

1. Individuals still served as of October 1 (carryover from prior FY)12
2. Additional individuals served during the year366
3. Total individuals served (lines A1 + A2)378
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)22

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 10

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility14
2. Employment54
3. Program access17
4. Housing81
5. Government benefits/services71
6. Transportation5
7. Education15
8. Assistive technology5
9. Voting0
10. Health care32
11. Insurance6
12. Non-government services6
13. Privacy rights9
14. Access to records2
15. Abuse27
16. Neglect17
17. Other41

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor389
2. Other representation found0
3. Individual withdrew complaint1
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.0
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit1
9. Other1

Please explain

Investigation concluded and investigation report with findings and conclusions provided to th client after the client was released from prison and moved out of state.

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-advocacy390
2. Short-term assistance0
3. Investigation/monitoring2
4. Negotiation0
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)0
8. Systemic/policy activities0

Part III. Statistical Information on Individuals Served

A. Age of Individuals Served as of October 1

Multiple responses not permitted.

1. 0 - 41
2. 5 - 227
3. 23 - 59242
4. 60 - 6437
5. 65 and over91

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females197
2. Males181

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race22
2. American Indian or Alaskan Native10
3. Asian9
4. Black or African American23
5. Native Hawaiian or Other Pacific Islander4
6. White230
7. Two or more races20
8. Race/ethnicity unknown60

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent258
2. Parental or other family home20
3. Community residential home15
4. Foster care0
5. Nursing home10
6. Public institutional living arrangement4
7. Private institutional living arrangement1
8. Jail/prison/detention center36
9. Homeless15
10. Other living arrangements1
11. Living arrangements not known18

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment20
2. Deaf/hard of hearing19
3. Deaf-blind0
4. Orthopedic impairment130
5. Mental illness22
6. Substance abuse5
7. Mental retardation4
8. Learning disability32
9. Neurological impairment42
10. Respiratory impairment14
11. Heart/other circulatory impairment27
12. Muscular/skeletal impairment47
13. Speech impairment0
14. AIDS/HIV3
15. Traumatic brain injury0
16. Other disability13

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities8

2. Number of individuals potentially impacted by policy changes45,400

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.

Disability Rights Washington (DRW) participated in a Medical Assistance Work Group (MAWG), including Columbia Legal Services, Northwest Justice Project, Northwest Health Law Advocates, and other attorney groups and advocates, to advocate, monitor and negotiate with the Washington State Department of Health Services Administration (DSHS) and Health Care Authority (HCA) regarding access to and funding of services, changes to rules, policies and laws applying to Medicaid funded services including durable medical equipment, especially regarding the impact of these services for people with disabilities. DRW worked during the 2015 fiscal year with the MAWG group to advocate, monitor and negotiate with DSHS and HCA regarding issues affecting persons with disabilities, including changes resulting from Medicaid expansion and the Affordable Care Act, the transition to managed care, eligibility rules, coverage for children, and proposed changed to fair hearing rules affecting persons with disabilities access to appeal and fair hearings. As a result of MAWG activities, people with disabilities were better able to access benefits and have their rights to medical assistance enforced and retained.

Other related activities are discussed in Part V under the abuse and Neglect Respone and Parity in Parity in Support Services priorities.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts56,610
2. Number of individuals named in class actions10

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.

Issues in the litigation categoy include health care reform, assistive technology, ADA physical access, conditions in residential centers and behaviroal support. There are no outcomes to reprot this period.

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.

A1. American Sign Language (ASL) and CART captioning for public services

A2. Need: Ability to communicate when seeking or using public services

A3. Activity Types: Technical assistance; individual advocacy; investigations; monitoring; and other systemic advocacy (the performance measures for each of these categories can found at the bottom of this section.

A4. Collaboration? We collaborated with a law student.

A5. Number of cases? 2 Number of class actions? 0

A6. Case summary:

The University of Washington’s ticketing process and pricing, parking, and seating for physical accessibility to its sports stadiums do not conform to the physical accessibility requirements of the Americans with Disabilities Act (ADA). Conrad Reynoldson, a University of Washington School of Law graduate, sent a demand letter to University of Washington on his own behalf and as pro se counsel. In response, the university agreed to discuss proposed remedies. Mr. Reynoldson requested Disability Rights Washington assist in negotiating remedies to all three issues and have begun negotiations with the university. Further results are pending.

B1. Americans with Disabilities Act (ADA): physical access

B2. Need: Compliance with the physical access requirements of the ADA

B3. Activity Types: Technical assistance; investigations; systemic litigation; educating policy makers; training; public awareness; and video advocacy

B4. Collaboration? No

B5. Number of cases? 28 Number of class actions? 2

B6. Case summary:

A student experienced discrimination when school refused him as a student on the pretext that he could not pass the competency exams, would pose a risk of danger to other students, would not be able to complete the required curriculum, and could not be provided reasonable accommodation.

Disability Rights Washington (DRW) conducted an investigation of a university medical school concerning possible systemic discrimination in not providing American Sign Language (ASL) and other accommodations such as CART services and other technology, for persons with hearing impairments, for students, applicants, faculty and staff. Although the investigation found that one student applicant was denied reasonable accommodation for his deafness, there was insufficient evidence to show a pattern of systemic discrimination. One person had rights enforced and expanded.

C1. Olmstead: right to live in community compliance

C2. Need: Accessible and accommodating communities

C3. Activity Types: Technical assistance; individual advocacy; investigations; monitoring; systemic litigation; educating policy makers; other systemic advocacy; H) outreach; I) training; and video advocacy.

C4. Collaboration? No

C5. Number of cases? 5 Number of class actions? 0

C6. Case summary:

No outcomes to report this period.

D1. Disability awareness: inclusive communities

D2. Need: Welcoming communities

D3. Activity Types: Technical assistance; other systemic advocacy; outreach; training; public awareness; and video Advocacy.

D4. Collaboration?

D5. Number of cases? 19 awareness project 5 related to cases addressed under other priorities.

Number of class actions? 0

D6. Case summary:

On February 6, 2015, a version of the project entitled, "A Dream Deferred" was screened at the University of Washington Law School for its Statewide Diversity Conference. "People with disabilities have glass ceilings too" was the name of the final product of the Barriers to Employment for People with Disabilities Video.

The video was shared publicly on July 9, 2015 on YouTube and Facebook. The video was viewed 397 on YouTube and 18,416 on Facebook. The video was shared by 250 individual Facebook users.

E1. Disability inclusion in emergency preparedness

E2. Need: Inclusive plans for emergency preparedness

E3. Activity Types: Technical assistance; investigations; monitoring; systemic litigation; educating policy makers; other systemic advocacy; outreach; training; and public awareness.

E4. Collaboration? Yes. The Arc of Spokane and the independent living center in Spokane were involved in coordinating a training related to this project.

E5. Number of cases? 3 Number of class actions? 0

E6. Case summary:

In reviewing the plans for emergency response in several jurisdiction, DRW determined that they were not adequate to meet the needs of people with disabilities, and fall short of what is required by the Americans with Disabilities Act, and the recent settlements in New York and Los Angeles.

DRW set up a meeting with disability advocates from around Spokane on June 12.

DRW had conversations with centers for independence, and the new director of the State Independent Living Council. DRW contacted numerous disability advocates in Spokane, and had discussions with them about whether to engage in structured discussions with the emergency response agencies at the county and cities in the area. DRW ultimately decided against formal action, as the local groups indicated that the local progress was proceeding satisfactorily.

In conjunction with his project DRW development a series of emergency planning related videos entitled “The Right to be Rescued” which have been viewed over 2,500 times. These videos and other training activity sponsored by DRW has enhanced the efforts of disability advocates to improve the emergency preparedness plans of their communities. In addition the principle video in “The Right to be Rescued” has been used in conjunction training provided by FEMA in another state.

F1. Addressing abuse and neglect

F2. Need: Freedom from abuse and/or neglect

F3. Activity Types: Technical assistance; individual advocacy; investigations; monitoring; and systemic litigation.

F4. Collaboration?

F5. Number of cases? 10 Number of class actions? 0

F6. Case summary:

Disability Rights Washington (DRW) and Solid Ground (SG) sought to ensure that persons receiving Medicaid personal care services who have medical expenses for which Medicaid has not paid are allowed to deduct those expenses before their personal contribution to care is calculated by the Department of Health Services Administration (DSHS) Medicaid program. This calculation is called “participation”. Additionally, the individual should be able to pursue an appeal of a denial or reduction of services. DRW was advised that DSHS decision-making on whether to allow a medical expense is determined by an exception-to-rule (ETR) process and ETR Committee, allegedly without any hearing right, thus denying basic due process required by federal law.

SG represents an individual client who had been denied allowance for some medical expenses. DRW planned to co-counsel with Solid Ground, and act as an organization plaintiff, to pursue negotiation with DSHS about the lack of due process protections when challenging an ETR decision. The co-counsel agreement covered investigation, negotiation, and litigation. After initial investigation, DRW determined that the individual client had been provided with an opportunity to appeal, and did pursue an appeal. The individual planned to submit for additional expense deductions for a possible challenge to DSHS' participation determination.

DRW then agreed, instead of acting as co-counsel, to provide SG with technical assistance, including time-limited legal advice and counseling, regarding possible legal claims that people with disabilities might have against DSHS arising from its denial of due process rights. DRW provided SG with this limited technical assistance to assist SG in pursuing its advocacy for the individual.

G1. Improved conditions in residential treatment settings for people with disabilities

G2. Need: High quality care and conditions

G3. Activity Types: Technical assistance; investigations; monitoring; systemic litigation; other systemic advocacy; outreach; training; public awareness; and video advocacy.

G4 Collaboration? Yes. Assisted another organization in their advocacy

G5. Number of cases? 9 Number of class actions? 1

G6. Case summary:

H1. Court access and accommodation

H2. Need: Access to justice and due process

H3. Activity Types: Technical assistance; educating policy makers and training.

H4. Collaboration?

H5. Number of cases? 9 Number of class actions? 0

H6. Case summary:

Disability Rights Washington (DRW) sent a staff member to co-present at the National Association of Judicial Officers in Las Vegas in October (outcome noted elsewhere) The subject of the presentation was how to accommodate for people with disabilities. Also reported elsewhere in the report is a presentation for judges in King County. DRW made a written response to queries by Judge Craighead on January 8 regarding implementation of General Rule (GR) 33. DRW was not informed on the outcome of these written comments.

In addition, DRW has renewed its work with the Access to Justice Board on accommodation for individuals in fair hearings. This work is done in concert with Northwest Justice, Seattle University, and Columbia Legal Services. DRW joined these partners in a meeting with the Office of Administrative Hearings on January 13, where DRW provided testimony on the importance of counsel as an accommodation and its use in courts. This meeting was part of an ongoing effort to convince the Office of Administrative Hearings that they should provide representation in fair hearings as an accommodation.

Problem: After advocacy by DRW and others, in 2007 the Washington Supreme Court enacted General Rule 33, which provides a process for accommodating people with disabilities in court, including in certain instances providing for accommodation by counsel. Advocacy is now centered on the problem of implementing the rule. Also, fair hearings still have no equivalent of “GR 33” or the opportunity for accommodation by counsel. Advocacy also focuses on that effort.

Next steps: DRW will continue to work with our collaborators with the Access to Justice Administrative Justice subcommittee for implementation of General Rule 33, and an adoption of equivalent rules in the context of fair hearing.

I1. P&A Access enforcement

I2. Need: Access to federally mandated protection and advocacy services

I3. Activity Types: Technical assistance; individual advocacy; and video advocacy.

I4. Collaboration?

I5. Number of cases? 3 Number of class actions? 0

I6. Case summary:

Disability Rights Washington (DRW) enforced its access authority to a correctional facility which houses individuals with disabilities including mental illness. The facility denied DRW access to the facility and inmates during a visit to investigate allegations of abuse and neglect on 10/28/14. During its visit, DRW explained its federal access authority and provided a facility attorney with the statutory authority granting access. Additionally, the DRW Associate Director of Legal Advocacy sent the facility attorney an email outlining DRW's authority as the designated protection and advocacy agency (P&A). On 10/31/14, DRW sent a letter to the facility requesting written assurances that the facility will honor DRW's federally mandated access authority and allow it unrestricted access to the facility and inmates on 11/6/14.

On 11/4/14, DRW sent a follow-up letter to the facility in response to the facility's request for additional information and reiterated DRW's expectation of the facility's full cooperation with DRW's investigation on 11/6/14. DRW further corresponded with the facility attorney on 11/5/14 and provided additional clarification regarding DRW's 11/6/14 return to investigate allegations regarding the facility. On 11/6/14, DRW was provided full access to the facility and approximately 200 inmates. By enforcing its access authority, DRW preserved the rights of inmates to access DRW and DRW's ability to investigate allegations of abuse and neglect and as necessary, monitor the facility.

It is estimated that 5- 10 people with traumatic brain injuries reside in the jail at any given time.

J1. Fair personal assistance services (PAS) reform

J2. Need: High quality and dependable personal assistance services as determined by the person using the services

J3. Activity Types: Technical assistance; educating policy makers; other systemic advocacy; outreach; training; public awareness; and video advocacy.

J4. Collaboration? Yes. Project PAS-Port for Changes and all the independent living centers.

J5. Number of cases? 15 Number of class actions? 0

J6. Case summary:

Disability Rights Washington (DRW) developed written comments to the Legislature and attended a meeting on 12/23/14 with senior and disability advocates.

On 2/9/15 DRW assisted an advocate, Nathan Loose, who testified on HB 1725. Nathan explained the impact of the rule change - which will mean that there needs to be some flexibility in the authorization by the Department of Social and Health Services (DSHS) of overtime due to the difficulty in finding individuals to cover shifts. Nathan appeared at the House Labor committee, and on 2/17 he appeared at Senate Health Care.

Nathan urged the elimination of unnecessary barriers to hiring people - e.g., training requirements, and also needs adequate case management to arrange shifts, and access to the registry by home care consumers. DRW drafted written comments on this issue for the legislative hearings, which included specific language that would have ensured that DSHS would implement its control over overtime in a manner that would not result in loss of community placement or safety of individuals who need homecare services. The bill did not pass - which meant DSHS cannot control the hours of homecare users, but also does not contain the assurance that overtime controls would be implemented in a manner that resulted in no harm.

Problem: Changes in federal wage and labor law may result in increased difficulty for people who use homecare services to find enough workers to meet their support needs.

In 2014, the US Dept. of Labor changed the rules regarding workers identified as providing “companionship” services, applying the requirements that those who work more than 40 hours per week will be paid overtime. There were legal challenges, and through the year there was a stay on application of the rule. The impact of the rule, when applied, will be that all hours worked over 40 will be overtime, and since many workers work significantly over 40 this will be problematic for high-hour use clients. The Legislature sought legislation in 2015 that would allow the DSHS to control the number of hours each person works, rather than leaving control to the home care user and the worker.

Next steps: The federal overtime rule was stayed during appeal, but that decision was overturned and it now is in force, and the state must comply with overtime requirements by January 1, 2016. DRW is preparing a policy paper for use by other advocates in describing the situation, consequences for people who use homecare services, and possible responses.

K1. Abuse response system reform

K2. Need: An abuse system that thoroughly investigates and responds to allegations of abuse and neglect in a timely and effective manner

K3. Activity Types: Technical assistance; educating policy makers; and other systemic advocacy.

K4. Collaboration? Yes. Abuse response task force put together by DSHS.

K5. Number of cases? 3 Number of class actions? 0

K6. Case summary:

Department of Social and Health Services (DSHS) convened a subcommittee in 2013 to gather recommendations from advocates and service providers on improvements to the abuse response system. In addition to legislative recommendations, the Abuse Neglect Workgroup Subcommittee on Response Improvement made recommendations to the Department on changes in practices and procedures that do not require change in statute. The subcommittee produced a report with specific policy recommendations. Disability Rights Washington (DRW) continues to advocate for implementation of those recommendations and other improvements to the abuse response system.

The following are relevant recommendations from the Adult Abuse/Neglect Response Workgroup Report by the Subcommittee for Response Improvement, October 2013 that implement would benefit thousands of PAIR eligible individuals with disabilities. The following discussion represents the progress made in Fiscal Year 2015 with regard to the recommendations. Recommendations that were implemented in previous fiscal years or for which there was not any progress are not included here.

Vulnerable Adults:

Recommendation 2 of the workgroup stated that criteria that must be met to substantiate incidents of abuse, neglect and exploitation should be defined in statute and all elements must be met to substantiate. It is acknowledged that this may be a barrier to protecting vulnerable adults. The recommendation stated that stakeholders should explore whether revisions to the definitions would result in substantiations that meet a “reasonable person” standard. DSHS convened a workgroup to explore amendments to the statutory definitions to improve clarity and objectivity. The workgroup reviewed the neglect definition to determine if an amendment paralleling the definition with the criminal mistreatment law will mitigate confusion.

On December 1, 2014 a DSHS representative met with several advocates regarding revisions in the abuse statute regarding neglect. DRW provided technical assistance to legislators and disability advocates who discussed the changes proposed by DSHS in response to the subcommittee recommendations. On 2/2/15 in the Senate and then again on 3/19/15 in the House - in an amended version - DRW provided information to the legislators regarding the impact of the bill. The bill (SB 5600) passed and was signed into law.

Intermediate Sanctions:

Recommendation 5 of the subcommittee notes that DSHS is unable to levy civil fines for all certified and licensed care settings. Allowing DSHS and the Department of Health (DOH) to level fines may deter providers and caregivers from committing any type of abuse. The recommendation was to provide DSHS and DOH authority to levy civil fines and set conditions (such as stop placements in the specific setting) for all certified and licensed settings including State Operated Living Alternatives (SOLAs) and Residential Habilitation Centers (RHCs). This was consistent with the recommendation from 2012 DRW/Columbia Legal Services report, “Too little too late: A call to end tolerance of abuse and neglect”.

DRW continued to work with DSHS on this issue during the intervening years, providing information to DSHS and legislators regarding the need to make intermediate sanctions available to Residential Care Services when they find deficiencies in supported living.

DRW worked with DSHS and Supported Living providers to come up with language that all parties could support. This was accomplished on 11/20/14.

DRW provided testimony to legislative committees explaining the need for intermediate sanctions on January 27 and February 18 2015. The bill passed this year and was signed into law.

Adequate Resources:

Recommendation 7 noted that there was a problem in that the number and complexity of investigations has increased significantly recently. This has caused delays in assigning and completing investigations in a timely manner. The recommendation was that DSHS should continue to request, and the Legislature should provide, adequate resources, taking into account population growth and caseload growth, to fund investigations, quality assurance and intake in Residential Care Services (RCS) and Adult Protective Services (APS) of abuse/neglect reports. DSHS forwarded a decision package to the Office of Financial Management for consideration in the Governor’s supplemental budget. There has been increased funding for investigators and Quality Assurance. RCS now has staff solely dedicated to Quality Assurance. The Residential Care Services budget was enhanced with 6.4 additional staff (FTEs), and an additional $1,000,000.

On Line Reporting and Quality Assurance:

This fiscal year the Department has begun progress toward an on-line reporting system for providers to file mandatory reports of abuse and neglect and has created a quality assurance team to review quality and consistency of their response to abuse. Both of these were recommendations made by the subcommittee.

Response System Realignment:

In addition the subcommittee had questioned the dual role of RCS investigations of provider practice and individuals accused of abuse. In November of 2014 the department realigned the abuse response system. APS now investigates all individuals and RCS focuses on provider practice.

Coordination of advocacy:

In recent years, the advocacy communities for seniors and people with disabilities have worked closely with each other and with DSHS and law enforcement to make improvements in the abuse response system.

On October 8, 2014, DRW met with the Governor with a group of 8 other senior advocates. DRW and others told the Governor about the recommendations of the abuse response workgroup. DRW has worked for the implementation of other recommendations, described elsewhere in this report

Next steps:

DRW will continue to monitor the implementation of the recommendations. There remain concerns about response times in supported living and other settings. The times have fallen, but continue to be high.

L1. Self-advocacy training and support

L2. Need: Self-determination

L3. Activity Types: technical assistance; educating policy makers; other systemic advocacy; outreach; training; public awareness; and video advocacy.

L4. Collaboration?

L5. Number of cases? 14 Number of class actions? 0

L6. Case summary:

People with disabilities have the right to quality, funded, reliable in home personal assistance services. DRW supports and provides information and technical assistance to self-advocates so they may become effectively involved in educating policy makers about how public policies related to the service system affect their lives.

color:030A13">44,000 people with disabilities in Washington State receive in-home personal care services. A group of people who use in-home supports met on a regular basis to identify issues of concern, learn about the service system and discuss ways to educate policy makers about their concerns about the implementation of policies, which affect their health and safety. This group is called Pas-Port for Change, a grassroots organization that seeks to improve the quality, reliability and availability of Personal Assistance Services in Washington State.

As a result of Disability Rights Washington technical assistance and support of PAS-Port for Change, individuals with disabilities who use in-home personal assistance services have researched the following issues and voiced their concerns about:

• funding for in-home services,

• access to workers on an emergency basis,

• worker shortages, especially in rural areas of the state,

• need for increased training for consumer/employers,

• worker training which truly meets the needs of the consumer,

• barriers to care the training and certification requirements for workers have created,

• implementation of the Federal Department of Labor over time and travel rules for workers,

• implementation of an electronic timekeeping system and changes to worker payment system, and

• creation of an on-line worker registry for consumers to use to find workers

DRW provided extensive information on these topics related to personal assistance service and provided meeting facilitation services to PAS-Port. PAS-Port members have become educated about these systems, policies that present barriers to consumer-driven services and opportunities to advocate for changes in systems.

Worker training and certification:

Members have written and spoken to the state regulatory entities, the union which delivers much of the training and legislators in an attempt to improve the training and reduce barriers to access care. Regarding training content PAS-Port has given input to the state and the union about ways to tailor training that will better meet the needs of a specific consumer. PAS-Port advocacy will continue in the area of training content, evaluation and quality assurance with true stakeholder involvement. PAS-Port continues to advocate for greater consumer involvement in the development and delivery of the worker training as well as a training evaluation, which includes the people who receive the in-home services.

DRW provided research and technical assistance regarding training content, timeline requirements, and worker testing and certification fees to PAS-Port members who, in turn, used the information to inform their legislators and community members about the importance of a consumer-focused in-home support service system and the barriers to care the testing and certification timeline created.

Two PAS-Port members advocated at the state level with the Washington State Independent Living Council. They brought this issue to the Council. DRW also met with and discussed the barriers to care the current worker training and certification system creates for consumers. DRW and a PAS-Port member participated in a meeting to present these concerns to the union and to the Training Partnership.

DRW supported a consumer who wished to speak at a legislative hearing concerning the State Auditor’s report on its audit of the implementation of Initiative 1163, the initiative that created the current system of worker training and certification. The Auditor is require to perform a performance audit of the initiative every two years. The Auditor then presents its finding to the legislature and the legislature takes public comments on the audit results. DRW assisted the consumer in identifying the issues of importance to the consumer and draft key talking points. DRW also described the hearing process and ways to provide effective testimony. The State Auditor’s office contacted DRW to follow up on the issues presented in testimony. The Auditor wanted to collect information for possible use in the next audit. DRW identified several key issues of concern, including the relevancy of the training, the lack of individualized and evidence-based training, the timeline for training and certification and the lack of a feedback loop with consumers, and evaluation of the training from the consumer viewpoint. DRW also asked if the auditor wanted to speak with consumers who use in-home services. DRW contacted consumers to participate in a meeting with the State Auditor’s office. The meeting is scheduled to take place in FY 2016.

Worker registry:

Washington State Department of Social and Health Services (DSHS) has a contract with the in-home care worker union that spells out its obligation for in-home worker training and benefits. The Northwest Training Partnership delivers this worker training. DSHS began discussions with the union to develop a plan for an on-line worker registry. The purpose of the registry is to connect workers to consumers of service. DRW researched information about the proposed registry and presented it to PAS-Pot for Change. Consumers wanted to know more about the registry and give input into the design and set-up. DRW connected consumers to the Northwest Training Partnership. Several members and DRW met with a staff person in April 2015 to learn more the plans for a registry, talk about the needs of the consumer and voice concerns about the need for individualization to consumer, accessibility, privacy, access to complete information about a worker including status of background check, resume and references, and training completed. The worker registry is currently in the design phase. DRW and PAS-Port will continue to provide information to the Training Partnership and DSHS about the need for consumer input into the development and testing process.

Electronic Timekeeping:

The Department of Social and Health Services (DSHS) is instituting in January 2016 an electronic timekeeping system for in-home workers. Consumers of service wanted to learn more about the system and identify what temporary and long-term benefits and risks this system will have for consumers. DRW researched and gathered information for PAS-Port about the system, made inquiries to the state and the shared information. Several consumers reported they were able to talk with their case managers about mitigating possible problems.

Over time and travel rules for workers:

As a result of changes in the federal Department of Labor rules concerning overtime and travel for in-home workers, DSHS must pay overtime to in-home workers who work more than 40 hours in a week. Enforcement of these rules may begin in January 2016. Consumers of in-home supports have long advocated for increased wages for their workers, however are concerned these rules may put them at risk of harm without an effective transition plan. Changes to comply with the overtime rules must not affect the consumers’ right to stay in their homes and community or increase risk of harm. DRW and PAS-Port members discussed the overtime issue at serval meetings. DRW gathered materials from various sources and shared the information with PAS-Port and other disability advocates. After analysis of the information with DRW, in December 2015 consumers identified a list of questions and considerations from the consumer perspective for DSHS, other policy makers and advocates. DRW distributed the list to DSHS and advocates. DRW provided support for a consumer by providing information on the legislative hearing process and how to testify about his concerns. The consumer testified and shared the list of questions and concerns with the legislature in February 2015. DRW and consumers met several times with DSHS, aging and disability advocates to present the questions, consideration and concerns from the consumer perspective. Consumers were able to give specific scenarios about how policy considerations would affect their lives. DRW and consumer groups will continue education policy makers and other advocates about this issue.

PERFORMANCE MEASUREMENTS

The following is a menu of performance measurements to be used in reporting accomplishments under DRW’s PAIR priorities. Not all will be used is any given year.

The End Outcomes could be used for cases pursued with any of the advocacy intervention types (Individual advocacy, abuse and neglect investigations, systemic litigation, other systemic advocacy and educating policy makers.)

The other performance measurements are specific to the advocacy types just listed.

End Outcomes:

Number of people with disabilities who are provided with appropriate community based services resulting in community integration and independence:

Number of people with disabilities who accessed benefits:

Number of people with disabilities who live in a healthier, safer or otherwise improved environment:

Number of people with disabilities who were able to stay in their own home:

Number of people with disabilities who work in safer and more humane conditions:

Number of people with disabilities who go to school in safer and more humane conditions:

Number of children with disabilities receiving appropriate services in most integrated settings:

Number of people with disabilities who had their other rights enforced, retained, restored and/or expanded:

Number of public and private places/services made more accessible:

Individual Advocacy:

People with disabilities who had their rights enforced and/or restored.

People with disabilities who were assisted in obtaining access to administrative or judicial processes.

Closed cases in which client objective was met or partially met.

Systemic Litigation:

Number of systemic or class action lawsuits handled for the benefit of people with disabilities:

Number of provisions in policy modified or prevented:

Number of provisions in regulation modified or prevented:

Number of provisions in law modified or prevented:

Number of lawsuits addressing systemic issues resolved by settlement:

Number of lawsuits addressing systemic issues resolved by judgment:

Number of Amicus briefs signed onto or filed:

Number of people whose rights were advanced as a result of amicus participation:

Investigations of Abuse and Neglect:

Number of abuse and neglect investigations (not death related):

Number of investigations of abuse and neglect completed with a finding or determination (not including death investigations):

Number of death investigations:

Number of death investigations completed with a finding or determination:

Number of people with disabilities who benefitted from the findings of investigations of abuse and neglect:

Number of provisions in policy added or prevented:

Educating Policy Makers:

Number of communications to people with disabilities explaining a policy initiative:

Number of people with disabilities supported in expressing their own viewpoint on a policy related matter:

Number of times written comments were submitted regarding proposed legislation or regulations:

Number of times testimony was provided at a legislative hearing:

Number of provisions in regulation modified or prevented:

Number of people with disabilities impacted by the regulation provision(s) modified or prevented:

Number of provisions in law modified or prevented:

Number of people with disabilities impacted by one or more provision(s) in law modified or prevented:

Number of provisions in ordinances modified or prevented:

Other Systemic Outcomes:

Number of changes in practices made or prevented:

Number or provisions in policy modified or prevented:

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.

A1. CART and ASL in Jails, Prison and SCC

A2. Need: Ability to communicate for individuals at jails, prisons and other places where people with disabilities are involuntarily confined

A3. Activity Types: Technical assistance; individual advocacy; investigations; monitoring; and other systemic advocacy

B1. ADA Curb Cut Compliance

B2. Need: Compliance with physical access requirements of the ADA

B3. Activity Types: Technical assistance; investigations, systemic litigation; educating policy makers; training; public awareness; and video advocacy

C1. Disability Friendly Emergency Preparedness Plans

C2. Need: Inclusive plans for emergency preparedness

C3. Activity Types: Technical assistance; investigations; monitoring; systemic litigation; educating policy makers; other systemic advocacy; outreach; training; and public awareness

D1. Olmstead: Right to Live in Community Compliance

D2. Need: Accessible and accommodating communities

D3. Activity Types: Technical assistance; individual advocacy; investigations; monitoring; systemic litigation; educating policy makers; other systemic advocacy; H) outreach; I) training; and video advocacy

E1. Disability Awareness: Inclusive Communities

E2. Need: Welcoming communities

E3. Activity Types: Technical assistance; other systemic advocacy; outreach; training; public awareness; and video Advocacy

F1. Abuse and Neglect Response and Effectiveness

F2. Need: An abuse system that thoroughly investigates and responds to allegations of abuse and neglect in a timely and effective manner

F3. Activity Types: Technical assistance; educating policy makers; and other systemic advocacy

G1. Bettering Sexual Assault Response in Long Term Care Facilities

G2. Need: Sexual assault response and prevention services for people with disabilities in long-term care facilities

G3. Activity Types: Technical assistance; educating policy makers; and other systemic advocacy

H1. Improved Conditions in Residential Treatment Facilities

H2. Need: High quality care and conditions

H3. Activity Types: Technical assistance; investigations; monitoring; systemic litigation; other systemic advocacy; outreach; training; public awareness; and video advocacy

I1. Improved conditions in Juvenile Detention Facilities, Jails, Prisons, and the Special Commitment Center

I2. Need: High quality care and conditions

I3. Activity Types: Technical assistance; investigations; monitoring; systemic litigation; other systemic advocacy; outreach; training; public awareness; and video advocacy

K1. Quality, available advocacy

K2. Need: Quality of advocates serving people with disabilities on matters related to their disabilities

K3. Activity Types: Technical assistance; educating policy makers; other systemic advocacy; outreach; training; public awareness; and video advocacy

L1. Protect Due Process Rights

L2. Need: Due process

L3. Activity Types: Technical assistance; educating policy makers and training

M1. Court Access and Accommodation

M2. Need: Access to justice and due process

M3. Activity Types: Technical assistance; educating policy makers and training

N1. P&A Access Authority

N2. Need: Access to federally mandated protection and advocacy services

N3. Activity Types: Technical assistance; individual advocacy; and video advocacy

O1. Fair Personal Assistance Services

O2. Need: Quality personal assistance services

O3. Activity Types: Technical assistance; educating policy makers; other systemic advocacy; outreach; training; and public awareness

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

FY2016

2014 Award carry forward 45,954

2015 Award 322,914

Total 368,868 408,785

Litigation Revenue None

A Sources of funds received and expended:

Federal (Section 509) 282,997

State 0

Program Income 0

Private 0

All other funds 0

Total (from all sources) 282,997

B. Budget for the fiscal year covered by the report

Actual FY2015 Budget FY2016

WAGES 153,663 221,964

FRINGE BENEFITS 59,090 85,355

SUPPLIES 1,894 2,736

POSTAGE 723 1,044

TELEPHONE 3,236 4,674

RENT 16,672 24,082

TRAVEL 6,183 8,931

COPYING 24 35

INSURANCE 1,966 2,840

EQUIP RENT/PUR 5,280 7,627

LEGAL SERV (LIT & COPIES) 528 763

MISCELLANEOUS 33,738 48,734

Total EXPENDITURES

PPR FORMAT 282,997 408,785

C Description of PAIR Staff

Type of Position FTE % of year Person

Filled Years

Professional

Full time 1.475 100% 1.475

Part Time 0.230 100% 0.230

Vacant 0.125 0.125

Support

Full time 0.293 0.293

Students

Part Time 1.320 1.320

D. None.

E. No grievances.

F. Disability Rights Washington and the Client Assistance Program work together to assure that there is not a duplication of effort and that appropriate referrals are made between the two organizations. Because of CAP's narrow focus it is relatively easy to draw the lines between the programs. DRW generally does not make priorities of issues that are within CAP's realm so there is not alot of the common ground to be found. DRW's role is to make accurate referral to CAP and to let CAP know how people who call them can access our services when appropriate.

Coordination of DRW and Long Term Care Ombudsman legislative education activities, sharing information on issues effecting people who live in adult family homes, nursing homes and boarding homes, discuss ways to work together for common goals of improving conditions and enforcement of rights.

Certification

Signed?Yes
Signed ByMark Stroh
TitleExecutive Director
Signed Date01/16/2016