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

Delaware (COMMUNITY LEGAL AID SOCIETY,) - H240A160008 - FY2016

General Information

Designated Agency Identification

NameCommunity Legal Aid Society Inc.
Address100 W. 10th Street Suite 801
Address Line 2
CityWilmington
StateDelaware
Zip Code19801
E-mail Addressbhartman@declasi.org
Website Addresshttp://www.declasi.org
Phone302-575-0660
TTY 302-575-0696
Toll-free Phone800-292-7980
Toll-free TTY
Fax302-575-0840
Name of P&A Executive DirectorDaniel Atkins, Executive Director
Name of PAIR Director/CoordinatorBrian J. Hartman
Person to contact regarding reportBrian J. Hartman
Contact Person phone302-575-0660
Ext.220

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 areas79
2. Individuals receiving I&R outside PAIR priority areas0
3. Total individuals receiving I&R (lines A1 + A2)79

B. Training Activities

1. Number of trainings presented by PAIR staff31
2. Number of individuals who attended training (approximate)4,998

DLP staff exhibited at NAMI Conference 2015 on October 7, 2015. Staff spoke to attendees about all DLP programs and services including the PAIR program. There were 200 persons in attendance. Staff distributed 69 brochures, pamphlets and booklets containing PAIR-related information.

DLP staff gave a presentation to a peer support group at the Milford State Service Center on October 20, 2015. Staff spoke to attendees about the ADA, Olmstead, US DOJ settlement agreement, patient’s bill of rights, community mental health treatment act, housing laws, voting, and guardianship. There were 16 persons in attendance and staff distributed 16 sets of materials containing information related to the PAIR program.

DLP staff exhibited at the 2015 Community Mental Health Conference on November 12, 2015. Staff spoke to attendees about all DLP programs and services. There were approximately 250 persons in attendance. Staff distributed 181 pamphlets containing PAIR-related information.

The DLP presented a seminar at Richards, Layton & Fingers Partners and Associates on November 16, 2015. Staff presented on DLP programs and services and on a solitary confinement case filed by the DLP. There were 40 persons in attendance. There were 40 sets of materials distributed.

DLP staff gave a presentation at Charlton School on January 14, 2016. Staff spoke to attendees about guardianship, alternatives to guardianship, SSI and SSDI benefits. There were 10 persons in attendance. Staff distributed 10 brochures and pamphlets.

The DLP served on the design team and exhibited at the LIFE Conference on January 20, 2016. Staff gave an overview of all DLP services. There were 409 registrants in attendance. Staff distributed an assortment of 1,029 brochures, pamphlets and booklets that included information related to the PAIR program.

The DLP Senior Project Director participated in a DDDS HCBS seminar on Medicaid at the LIFE Conference on January 20, 2016. There were 36 persons in attendance. There were no materials distributed.

DLP staff gave a presentation about HIPAA and confidentiality of health information to the DSAMH Governor's Advisory Council on January 21, 2016. There were 15 persons in attendance. Staff distributed 15 sets of materials.

DLP staff gave a presentation for the Office of Defense Services on January 22, 2016. Staff gave an overview of all DLP programs and services. There were 20 persons in attendance. There were 20 sets of materials distributed.

DLP staff gave a presentation at Wilmington University on February 26, 2016. Staff spoke to attendees about all DLP programs and services with an emphasis on voting rights. There were 30 persons in attendance. Staff distributed an assortment of 30 brochures and pamphlets.

The DLP exhibited at the 2016 Brain Injury Conference on March 11, 2016. Staff spoke to attendees about all DLP programs and services. There were approximately 150 persons in attendance. The DLP distributed an assortment of 52 pamphlets, booklets, and brochures that contained information related to the PAIR program.

DLP staff gave a presentation at the 2016 Brain Injury Conference on March 11, 2016. Staff spoke to attendees about Medicaid and Medicare benefits. There were 45 persons in attendance. Staff distributed 45 sets of materials that contained information related to the PAIR program.

DLP staff gave a presentation at the Christiana School District Transition Workshop on March 10, 2016. Staff spoke to attendees about all DLP programs and services. There were 20 persons in attendance and 20 sets of materials distributed.

The DLP Project Director gave a presentation to members of Delaware's congressional delegation on March 15, 2016. The Project Director spoke to attendees about all DLP programs and services, including the PAIR program. There were 7 persons in attendance. There were 7 brochures distributed containing information related to the PAIR program.

DLP staff gave a presentation to a peer group at a mental health center on March 21, 2016. Staff gave a general overview of all DLP programs and services. There were 9 persons in attendance. The DLP distributed 9 sets of materials that contained PAIR related information.

The DLP exhibited at the 2016 Blue and Gold Basketball tournament (a benefit for "Best Buddies Delaware") on March 17, 2016. Staff spoke to attendees about all DLP programs and services. There were approximately 2,000 persons in attendance. Staff distributed an assortment of 228 pamphlets, brochures and booklets that contained PAIR related information.

The DLP exhibited at the 2016 Transition Fair at Middletown High School on April 7, 2016. Staff spoke to attendees about all DLP programs and services with an emphasis on voting rights. There were 30 persons in attendance. There were 30 brochures distributed.

DLP staff gave a presentation to the Partners In Policymaking group on April 15, 2016. Staff spoke to attendees about Medicaid and Medicare rights. There were 21 persons in attendance. Staff distributed 21 sets of material containing PAIR-related information.

DLP staff participated in a panel discussion about Solitary Confinement in Delaware at the University of Delaware on April 18, 2016. Staff spoke to attendees about prisoner’s rights and answered questions. There were approximately 30 persons in attendance. No materials were distributed.

DLP staff gave a presentation to NAMI DE employees and volunteers who participate in the NAMI DPC monitoring program on April 27, 2016. Staff gave an overview of all DLP programs and services including the PAIR program. There were 6 persons in attendance. Staff distributed 6 sets of materials that contained PAIR-related information.

DLP staff gave a presentation to a mental health peer group on April 27, 2016. There were 18 persons in attendance. Staff gave an overview of all DLP programs and services including the PAIR program. Staff distributed 90 brochures and pamphlets containing PAIR-related information.

DLP staff exhibited at the Christina School District Transition Fair on April 28, 2016. Staff spoke to attendees about all DLP programs and services including the PAIR program. There were 50 persons in attendance. Staff distributed an assortment of 73 brochures and pamphlets that contained PAIR-related information.

The DLP exhibited at the 2016 Wilmington Wellness Day on April 30, 2016. Staff spoke to attendees about all DLP programs and services. There were approximately 1,000 persons in attendance. Staff distributed an assortment of 500 brochures and pamphlets that contained PAIR-related information.

The DLP exhibited at the 2016 Access Wilmington Resource Fair on May 12, 2016. Staff spoke to attendees about all DLP programs and services. There were approximately 100 persons in attendance. Staff distributed an assortment of 163 brochures and pamphlets.

DLP staff gave a presentation to the NAMI-DE program about planning for care of adult children after the death of parents on May 19, 2016. Staff gave an overview of all DLP programs and services. There were 30 persons in attendance. There were 30 sets of materials distributed containing PAIR-related information.

DLP staff gave a presentation to the Department of Education on May 19, 2016. Staff spoke to attendees about guardianship, alternatives to guardianship (e.g. powers of attorney; Social Security representative payees; trusts), age of majority legislation and supported decision making. There were approximately 100 persons in attendance. Staff distributed 100 sets of materials containing PAIR-related information.

DLP staff gave a presentation to a supervisory group from Delaware Social Services on June 14, 2016. Staff gave an overview of all DLP programs and services including the PAIR program. There were 12 persons in attendance. Staff distributed an assortment of 24 brochures and pamphlets that contained PAIR-related information.

DLP staff gave a presentation to the Victim Rights Task Force Disability Subcommittee on June 1, 2016. Staff provided information to attendees about all DLP programs and services including the PAIR program. There were 8 persons in attendance. There were 8 brochures distributed.

DLP staff gave a presentation to the Partners in Policymaking committee on July 15, 2016. Staff spoke to attendees about employment and vocational rights. There were 20 persons in attendance. There were 20 brochures distributed that contained PAIR-related information.

DLP staff gave a presentation to the New Castle County BIAD Support group on August 18, 2016. Staff provided information about all DLP programs and services with an emphasis on voting rights. There were 16 persons in attendance. Staff distributed 36 brochures containing PAIR-related information.

The DLP exhibited at the 2016 Military and Veterans Mental Health Summit on September 13, 2016. Staff spoke to attendees about all DLP programs and services, including the PAIR program. There were approximately 300 persons in attendance. Staff distributed an assortment of 177 brochures, pamphlets and booklets containing PAIR-related information.

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff0
2. Newspaper/magazine/journal articles10
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website25,459
5. Publications/booklets/brochures disseminated3,049
6. Other (specify separately)0

Narrative

N/A

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)66
2. Additional individuals served during the year65
3. Total individuals served (lines A1 + A2)131
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)7

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 77

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility6
2. Employment5
3. Program access2
4. Housing12
5. Government benefits/services67
6. Transportation4
7. Education0
8. Assistive technology0
9. Voting0
10. Health care12
11. Insurance5
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse1
16. Neglect0
17. Other17

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor53
2. Other representation found0
3. Individual withdrew complaint7
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case0
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit3
9. Other0

Please explain

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy11
2. Short-term assistance19
3. Investigation/monitoring13
4. Negotiation4
5. Mediation/alternative dispute resolution6
6. Administrative hearings10
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 - 221
3. 23 - 5997
4. 60 - 6418
5. 65 and over15

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females72
2. Males59

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race2
2. American Indian or Alaskan Native1
3. Asian1
4. Black or African American40
5. Native Hawaiian or Other Pacific Islander0
6. White87
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent99
2. Parental or other family home16
3. Community residential home1
4. Foster care0
5. Nursing home8
6. Public institutional living arrangement2
7. Private institutional living arrangement0
8. Jail/prison/detention center2
9. Homeless3
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 hearing11
3. Deaf-blind0
4. Orthopedic impairment37
5. Mental illness2
6. Substance abuse1
7. Mental retardation0
8. Learning disability0
9. Neurological impairment18
10. Respiratory impairment7
11. Heart/other circulatory impairment13
12. Muscular/skeletal impairment0
13. Speech impairment0
14. AIDS/HIV1
15. Traumatic brain injury1
16. Other disability36

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities103

2. Number of individuals potentially impacted by policy changes24,250

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 DLP had many non-litigation systemic successes. For ease of reference, legislative, regulatory, and policy achievements are compiled in Section V. A. by priority, i.e, Accessibility, Par. 4; Transportation, Par. 4; Housing/Independent Living, Par. 4; and Autonomy, Par. 4.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts30
2. Number of individuals named in class actions1

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.

The DLP collaborated with the Center for Health Law and Policy Innovation of Harvard Law School and an out-of-state law firm (Tycko & Zavareel, LLP) to prepare a federal class action complaint against the Delaware Division of Medicaid & Medical Assistance. The focus of the complaint was restrictive eligibility standards to receive a Hepatitis C direct acting antiviral drug (DAA) regimen which cures the disease. CMS had issued guidance in November, 2015 warning states that exclusions and limitations on DAAs could violate federal law. The DLP’s client had contracted Hepatitis C from a blood transfusion in the 1980s and she did not qualify for the DAA treatment under DMMA’s highly restrictive eligibility standards. The DLP shared the federal complaint and engaged in extensive pre-filing negotiations with DMMA which resulted in a favorable revision of the eligibility standards in June, 2016, and approval of the DAA regimen for the DLP’s client. The settlement was highlighted in national publications and press accounts. See, e.g., “Delaware changes hep C medication guidelines, avoids lawsuit, Delaware News Journal (June 7, 2016), published at http://www.delawareonline.com/story/news/health/2016/06/07/state-changes-hep-c-medication-guidelines-avoids-lawsuit/85554396/; “Delaware lifts restrictions on who can qualify for hepatitis C treatment”, www.Newsworks.org (June 9, 2016), published at http://www.newsworks.org/index.php/local/item/94432-elana-gordon; and “Help with the high cost of hepatitis C drugs”, USA Today (July 2, 2016), published at http://www.usatoday.com/story/news/2016/07/02/kaiser-help-with-high-cost-of-hep-c-drugs/86636294/. The DLP then publicized the new standards to encourage affected Medicaid beneficiaries to apply for treatment.

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. FIRST PRIORITY: ACCESSIBILITY

1. Identification

The PAIR program will promote and facilitate access to governmental programs and public accommodations.

2. Need, Issue or Barrier Addressed

Persons with disabilities are frequently denied services because they cannot “get in the door” or because they need accommodations (e.g. interpreters; service dog accompaniment). Safety-net public benefits programs may also present eligibility or standards-based barriers to effective access by persons with disabilities.

3. Outcome Indicators

Successful outcomes under this priority include the removal of architectural barriers, cessation of discriminatory practices, adoption of State standards conforming to federal law, and securing effective access to governmental programs and places of public accommodation by people with disabilities. As reflected in the PAIR FY16 Priorities, the outcome indicators for this objective were as follows:

a. As a result of DLP intervention, 55 persons will secure equal or improved access to governmental services or public accommodations.

b. As a result of DLP intervention, 10 laws, regulations, policies or other barriers to government services or public accommodations will be eliminated or reduced.

4. Collaborative Efforts

DLP staff participated in meetings of the following groups: Division of Vocational Rehabilitation State Rehabilitation Council, Architectural Accessibility Board, AT Loan Advisory Committee, Access Wilmington Committee, Victim Rights Task Force Disability Subcommittee, Victims Compensation Assistance Program Advisory Council, and HIV Planning Council. A DLP senior paralegal served as chair of the State Rehabilitation Council. DLP staff were members of the other organizations.

Delaware utilizes a managed care system with MCOs to implement its Medicaid program. Most of the State’s 230,000 Medicaid enrollees participate in this system. Consumer organizations (Delaware Managed Care Panel; Delaware Family Voices) sponsor regular teleconferences to address issues arising within the system. A DLP attorney participates in the calls and provides on-going technical assistance.

The DLP participated in an interview with the federal GAO in March, 2016 to provide information on Delaware’s Medicaid program. The DLP responded to questions about private duty nursing services, Medicaid notices, underserved populations, and operation of MCOs. The DLP provided a comprehensive set of materials documenting observations.

The DLP participated in an interview with the national Kaiser Foundation in June, 2016 to provide information on Delaware’s Medicaid long-term care program. The DLP responded to questions about the MCOs and responsiveness of program to beneficiary needs. The DLP provided a comprehensive set of materials in response to the Foundation’s specific questions.

The DLP routinely collaborated with the State Council for Persons with Disabilities (SCPD); Governor’s Advisory Council for Exceptional Citizens (GACEC), and other groups to address adoption of laws, regulations, and policies having a discriminatory or adverse effect on PAIR constituents. Concomitantly, the DLP promoted initiatives which enhanced access to government services and public accommodations. The following are illustrative:

LEGISLATION

Access to Health Care

Legislation (H.B. No. 400) was introduced to expand eligibility to qualify for medical marijuana to cover adults with a terminal illness, cancer, or seizure disorder. The DLP prepared a generally positive analysis which was adopted by multiple councils and shared with policymakers. The legislation was enacted and signed by the Governor on August 31, 2016.

Legislation (S.B. No. 142) was introduced to add dental coverage to the Medicaid State Plan. The bill was enabling legislation which would not have been effective until the appropriation of sufficient funds. The DLP prepared a favorable analysis which was adopted by multiple councils and shared with policymakers. The bill passed the Senate on June 14, 2016 but never received action in the House by the end of the legislative session on June 30, 2016..

Access to Financial Benefits

A high percentage of individuals enrolled in TANF are SSI beneficiaries. See http://www.ssa.gov/policy/docs/ssb/v65n3/v65n3p14.html [more than 1 in 6 families on TANF include individual on SSI]; and http://www.urban.org/publications/411883.html. Legislation (H.B. No. 365) was introduced to lift a statutory ban on TANF eligibility based on a drug conviction. The DLP issued a positive analysis of the bill which was adopted by multiple councils and shared with policymakers. The legislation passed the House and a Senate committee in June, 2016 but failed to receive a vote by the full Senate prior to expiration of the legislative term on June 30, 2016.

Access to Employment

The DLP had drafted a predecessor version of legislation to create a State tax credit for employers who hire persons with disabilities. In FY16, the DLP assisted legislative counsel with preparation of a revised bill (S.B. No. 221) providing up to a $1,500 State tax credit for employers who hire individuals with disabilities after January 1, 2017 referred by the Division of Vocational Rehabilitation (DVR) or the Division of Visual Impairment (DVI). DVR serves approximately 7,800 individuals annually. The DLP also issued a positive analysis of the bill which was adopted by multiple councils and shared with policymakers. The legislation was enacted and signed by the Governor on August 29, 2016.

The Division of Visual Impairment requested input on draft legislation to overhaul Delaware’s State Use Law which establishes preferences for State agency procurement of goods and services from the Delaware Industries for the Blind. The draft legislation also established a new “Commission for Statewide Contracts to Support Employment for Individuals with Disabilities”. The DLP provided a lengthy analysis prompting more than 15 amendments. The resulting, revised legislation (H.B. No. 393) was enacted and signed by the Governor on July 20, 2016.

Legislation (S.B. No. 214) was introduced to extend the time period for individuals to file an employment discrimination complaint under State law, including the DLP-authored “Persons with Disabilities Employment Protections Act”. Under the bill, Delaware’s 120-day statutory filing deadline would be extended to match the federal deadline of 300 days. The DLP prepared a positive analysis of the bill which was adopted by multiple councils and shared with policymakers. The legislation was enacted and signed by the Governor on July 19, 2016.

Legislation (H.B. No. 317) was introduced to add a new protected class to Delaware’s employment discrimination law, “family responsibilities”. The bill banned employer discrimination based on an employee’s need to care for a family member who would qualify as a covered family member under the Family and Medical Leave Act, including those with a “serious health condition”. The law would provide added flexibility to workers with disabilities who could retain health care coverage while taking time off to assist a family member. The DLP prepared a positive analysis of the bill which was adopted by multiple councils and shared with policymakers. The legislation was enacted and signed by the Governor on June 30, 2016.

Access to Voting Process

The DLP drafted legislation (S.B. No. 255) to reconcile inconsistent provisions in the Election Code. While Delaware civil statutes were amended a few years ago to incorporate federal requirements authorizing individuals with disabilities to be assisted in the voting booth, the criminal code had not be updated. As a result, assistance authorized by the civil code was still subject to criminal prosecution. The bill eliminated the prospect for prosecution. The legislation was enacted and signed by the Governor on August 1, 2016.

Legislation (H.B. No. 342) was introduced to establish the Voting Equipment Selection Task Force which would make recommendations by March 1, 2017 on the purchase or lease of new voting equipment. The accessibility of voting equipment is an important issue for persons with disabilities. The legislation was enacted and signed by the Governor on June 28, 2016. The bill designates a representative of the State Council for Persons with Disabilities (SCPD) as a member. In August, 2016 the SCPD nominated a DLP supervising attorney as its representative on the committee which will begin meeting in FY17.

Access to Support Services

The DLP prepared legislation to require the Family Court to consider support services when assessing whether parental rights should be terminated based on mental incompetency. The legislation would result in the following amendment: “‘Mentally incompetent’ shall be interpreted as referring to a parent who is unable to discharge parental responsibilities by reason of mental disorder or mental incapacity (when assessed in the context of available public and private services which the parent is amenable to receive.)” The legislation implemented recent guidance issued by the federal DOJ and HHS applying the ADA to child welfare agencies and proceedings. Multiple councils collaborated in a meeting with the Department of Services for Children, Youth & Their Families which eventually agreed to not oppose the initiative. The DLP engaged in meetings and dialog with the Attorney General’s Office which resulted in a June 3, 2016 communication that “the DOJ will take no position” on the legislation. Given the late date, action on the draft legislation was deferred until next year.

Legislation (H.B. No. 268) was introduced to address mothers with substance abuse addictions having babies undergoing opiate withdrawal upon birth. The legislation addressed reporting, family assessment, and development of a “plan of safe care”. The DLP prepared an analysis which highlighted several significant shortcomings in the bill. Multiple councils adopted the analysis which was shared with policymakers. The bill was stricken in April, 2016. A new bill (H.B. No. 319) was introduced which removed some, but not all, of the shortcomings identified in the earlier DLP analysis, including development of a plan of safe care with no parental input and no commitment to provide support services. The legislation did not receive a House or Senate vote by the end of the legislative session on June 30, 2016.

Legislation (H.B. No. 158) was introduced to facilitate the responsiveness of the State Adult Protective Services agency which provides intervention services to address allegations of abuse/neglect of persons with disabilities. The DLP prepared an analysis which identified several shortcomings with the legislation. The DLP analysis was adopted by multiple councils and shared with policymakers. The bill was stricken in January, 2016.

REGULATIONS & POLICIES

Access to Health Care

In FY15, the DLP and Division of Medicaid & Medical Assistance (DMMA) had engaged in dialog concerning Medicaid-funded private duty nursing standards resulting in an agreement to adopt more liberal eligibility standards. In FY16, DMMA formally published a proposed regulation based on the consensus reached with the DLP. The DLP prepared a generally favorable analysis which nevertheless included several concerns. Multiple councils adopted the analysis which was shared with DMMA. DMMA adopted a final regulation incorporating six (6) amendments prompted by the commentary, including clarification that cost of services must be weighed against the value of prevention of institutionalization. [19 DE Reg. 245 (10/1/15) (proposed); 19 DE Reg. 507 (12/1/15) (final)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering Medicaid-funded home health services. The DLP prepared an analysis which was adopted by multiple councils and shared with the Division. The Division adopted a final regulation incorporating one (1) amendment prompted by the commentary. [19 DE Reg. 253 (10/1/15) (proposed); 19 DE Reg. 627 (1/1/16) (final)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations deleting personal care services from the Medicaid State Plan. The DLP prepared an analysis which identified several concerns, including loss of flexibility in provision of support services. Multiple councils adopted the analysis which was shared with DMMA. The Division adopted a final regulation with no amendments. [19 DE Reg. 258 (10/1/15) (proposed); 19 DE Reg. 632 (1/1/16) (final)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering Medicaid outpatient prescription drugs. The DLP prepared a generally positive analysis which was adopted by multiple councils and shared with the Division. The Division adopted a final regulation which conformed to the proposed version. [19 DE Reg. 369 (11/1/15) (proposed); 19 DE Reg. 748 (2/1/16) (final)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering Medicaid nonprescription drug coverage. The DLP prepared an analysis which identified four (4) concerns with the initiative. The Division had not published a final regulation by the end of FY16. [20 DE Reg. 83 and 91 (7/1/16) (emergency and proposed)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering Medicaid prescription drug funding. The DLP prepared a generally positive analysis which was adopted by multiple councils and shared with the Division. The Division had not adopted a final regulation by the end of FY16. [19 DE Reg. 884 (4/1/16) (proposed)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering Medicaid mental health services. The DLP prepared an analysis which identified a few concerns. The analysis was adopted by multiple councils and shared with the Division. The Division adopted a final regulation which incorporated one (1) amendment prompted by the commentary, an authorization to provide services via telemedicine. [19 DE Reg. 377 (11/1/15) (proposed); 19 DE Reg. 759 (2/1/16) (final)]

The Division of Public Health (DPH) published a proposed regulation covering its Medical Marijuana program which authorizes the dispensing of medical marijuana to individuals with certain health care conditions, including cancer. The DLP prepared an analysis which was adopted by multiple councils and shared with the Division. The Division adopted a final regulation incorporating seven (7) regulatory amendments and clarifications prompted by the commentary, including authorizing coverage for seizures and access to marijuana oil for adults. [19 DE Reg. 116 (8/1/15) (proposed); 19 DE Reg. 409 (11/1/15) (final)]

The Division of Public Health (DPH) published a proposed regulation covering skilled home health agency licensing standards. The DLP prepared an analysis which identified two (2) concerns. Multiple councils adopted the analysis which was shared with the Division. The Division adopted a final regulation with one (1) amendment prompted by the commentary. [19 DE Reg. 391 (11/1/15) (proposed); 19 DE Reg. 849 (3/1/16) (final)]

The Division of Public Health (DPH) published a proposed regulation covering unskilled home health agency licensing standards. The DLP prepared an analysis which identified two (2) concerns. Multiple councils adopted the analysis which was shared with the Division. The Division adopted a final regulation with one (1) amendment prompted by the commentary. [19 DE Reg. 388 (11/1/15) (proposed); 19 DE Reg. 847 (3/1/16) (final)]

The Division of Medicaid & Medical Assistance proposed adoption of a Medicaid State Plan Amendment to add therapeutic horseback riding (hippotherapy) as a form of approved physical, occupational, or speech therapy. The DLP issued an analysis which identified 2 concerns: 1) only 1 therapist in the entire State met the State’s provider qualifications; and 2) the regulation literally disallowed coverage of occupational therapy unless linked to medical “improvement” to the exclusion of restoration of function or prevention of a worsening of a condition. Multiple councils adopted the analysis which was shared with the Division. The Division adopted a final regulation with one (1) amendment prompted by the commentary, deletion of the problematic medical improvement reference. [19 DE Reg. 164 (9/1/15)(proposed); 19 DE Reg. 513 (12/1/15) (final)]

The Division of Professional Regulation published a proposed regulation to amend nurse licensing and practice standards. The DLP issued an analysis which identified 4 concerns, including the consequences of medication errors and restrictions on the settings in which a clinical skills checklist could be completed. Multiple councils adopted the analysis which was shared with the Division. The Division adopted a final regulation with no amendments while noting that it would consider prospective revisions based on the commentary. [19 DE Reg. 125 (8/1/15) (proposed); 19 DE Reg. 432 (11/1/15) (final)]

For decades, the Department of Health & Social Services (DHSS) included a disclosure in public benefit notices to beneficiaries of the availability of free legal assistance through CLASI (the DLP’s umbrella corporation). For example, DSS included the recital in Food Supplement and Subsidized Child Care notices. DMMA included the recital in State-issued Medicaid notices. When DMMA operated its own Medicaid MCO (Diamond State Partners), the recital was included in its notices. In contrast, the current Medicaid MCOs (Highmark and United) omitted the disclosure. The DLP successfully negotiated with DMMA resulting in a requirement that the MCOs use an improved, uniform notice which includes a disclosure of the availability of free legal assistance through CLASI.

Under Delaware law incorporating DLP-authored protections, utilities (electric; water) may not terminate service for non-payment if a physician certifies that termination would jeopardize a resident’s health. However, the customer must make “good faith” payments to invoke the statutory protections. The Delaware Public Service Commission (PSC) convened public hearings and solicited comments on a proposal to issue regulations defining “good faith” payments. The DLP participated in a hearing, submitted standards adopted in other states, and shared recommendations. In September, 2016 the PSC decided that there was no widespread abuse by customers with disabilities and closed the initiative without issuing regulations.

The Division of Medicaid & Medical Assistance (DMMA) requested a DLP analysis of a draft manual covering long-term care Medicaid. In January, 2016, the DLP issued an analysis identifying fourteen (14) concerns. DMMA had not published a final manual by the end of FY16.

Access to Financial Benefits

The Division of Medicaid & Medical Assistance published proposed regulations implementing the federal Achieving a Better Life Experience Act of 2014 (“ABLE Act”). The Act authorizes the establishment of a special account for the benefit of a qualifying individual with a disability which would be exempt resource for purposes of public benefits programs such as SSI and Medicaid. The DLP prepared an analysis which was adopted by multiple councils and shared with the Division. DMMA adopted a final regulation incorporating seven (7) amendments prompted by the commentary. [19 DE Reg. 982 (5/1/16) (proposed); 20 DE Reg. 283 (10/1/16) (final)]

Access to Employment

Based on CMS guidance, the Delaware Department of Health & Social Services (DHSS) prepared a plan to assess whether Medicaid waiver-funded services, including employment and vocational services, are provided in integrated settings. The Plan also contained several references to a goal of promoting employment paying at least “minimum wage”. In February, 2016 DHSS posted an updated Plan and solicited comments. The DLP submitted thirty-nine (39) comments which were endorsed by multiple councils. On April 22, 2016 DHSS published its responses to the DLP commentary which reflected more than a dozen amendments to its Plan.

Access to Adult Education

The Department of Education (DOE) published a proposed regulation covering institutions of higher education. The DLP prepared an analysis which identified lack of student protections in several contexts. Multiple councils adopted the analysis which was shared with the DOE. The DOE adopted a final regulation incorporating ten (10) amendments prompted by the commentary. [19 DE Reg. 809 (3/1/16) (proposed); 19 DE Reg. 1078 (6/1/16) (final)]

ARCHITECTURAL ACCESSIBILITY BOARD REVIEWS

A DLP Senior Attorney is a Governor’s appointee to the Architectural Accessibility Board (AAB) which must approve plans for new construction and renovations of buildings using State funding. In FY16, the DLP participated in formal reviews of 96 sites. The AAB disapproved 15 sets of plans, prompting revision to ensure conformity with accessibility standards.

5. Number of Cases - 43

6. Case Summaries

Physical Access

Seventy-two year old with overactive bladder (a/k/a urgency urinary incontinence) was observed urinating in retailer parking lot. Client explained his condition but management banned him from premises for 6 months. DLP convened meeting between client and retailer management and ban was lifted. [16-0084084]

Fifty-three year old Deaf individual registered for a training event and disclosed she would need interpreter. When she arrived at event, no interpreter had been scheduled and sponsor claimed it was a “private” event so there was no right to an interpreter. The DLP represented client in administrative complaint under Delaware’s Equal Accommodation law. Client accepted settlement offer of $500 and DVD of event with transcribed text. [15-0081530]

Forty-nine year old Deaf individual was required to complete a DUI course. Provider hired interpreter for initial evaluation but client cancelled at last minute. Reason for cancellation was in dispute. Provider then declined to pay for interpreter a second time but offered written evaluation. Alternatives were presented to client who opted to accept written evaluation. [15-0083438]

Fifty-eight year old Deaf individual requested interpreter be present when she arrived to be prepared for surgery. No interpreter was provided until after surgery. Client asked DLP for policy on interpreters. The DLP obtained the hospital’s policy and relevant medical records but client did not respond to further messages. [15-0080917]

Sixty-one year old Deaf individual was scheduled for mental health counseling session. She contacted DLP to determine if she could have a different interpreter than offered. She had no objective basis for preferring a different interpreter. The DLP contacted the provider agency which confirmed that the assigned interpreter was certified and that it had received no complaints from anyone concerning her work. Since the agency appeared to be meeting its ADA obligation to provide effective communication, the DLP recommended that the client use the interpreter for the initial session before “prejudging” interpreter she had never used before. [15-0083490]

Fifty-eight year old Deaf individual was being discharged from hospital. Social worker contacted several rehabilitation facilities, all of which declined to accept client since she needed interpreter services. The DLP obtained the corroborating hospital records and contacted the client to review the prospects of an administrative complaint. However, the client became unresponsive to contacts and discrimination complaint was obviated. [15-0080914]

Government Accommodations

Seventy year old with late onset deafness was defendant in small claims court. His former divorce attorney was suing him for non-payment of fees. He had requested communication accommodation from court which had been denied. After researching, the DLP prepared a letter outlining court’s duty to provide interpreter services (an oral transliterator) which was submitted to court. The court approved interpreter services. [15-0081300]

Health Care

Fifty-six year old with Hepatitis C had requested a Medicaid hearing to contest denial of curative DAA treatment by Medicaid MCO. The DLP prepared hearing and secured medical experts. In the meantime, the Medicaid hearing officer issued an opinion in a similar case denying eligibility for the treatment based on restrictive DMMA standards. Based on the opinion, the client opted to withdraw her request for hearing until the DMMA standards could be changed. After the DLP negotiated adoption of more liberal Hepatitis C treatment standards several months later, the DLP offered to facilitate client’s treatment through MCO. However, in the meantime the client had remarried and was no longer a Medicaid beneficiary. [15-0083419]

Sixty seven year old with multiple disabilities (Lyme Disease; diabetes; kidney failure; carpel tunnel syndrome; cardiac deficiencies) contacted DLP with 2 health benefits concerns: 1) qualification for Medicare-D “Extra Help” program; and 2) pending termination of private short-term disability due to inability to submit timely physician report. The DLP determined that the client was over the income limit for the “Extra Help” program and offered advice. The private disability insurer agreed to withhold termination to allow extra time to submit physician’s report. Health care benefits were preserved. [16-0085153]

Sixty-five year old SSDI beneficiary received bills from physicians. She thought Medicare would cover all medical bills. The DLP advised that Medicare only covered 80% of physician costs. The DLP also consulted DHSS who recommended that client apply for Medicaid for Workers with Disabilities (MWD) program which would provide Medicaid coverage retroactive for three months. Client was given application information for MWD program. [15-0081852]

Thirty-four year old Deaf SSI beneficiary was penalized by Division of Child Support Enforcement with suspension of Medicaid when she did not appear for appointment. The DCSE planned to file for child support against father of her child. Child was already receiving SSDI benefits on father’s record. The DCSE had not offered interpreter services for appointment. The DLP contacted the DCSE and arranged appointment with interpreter. SSI benefits were reinstated since client was no longer deemed to be uncooperative. [15-0082724]

Forty-nine year old with orthopedic impairments had filed administrative complaint against state agency (Division of Services for Aging & Adults with Physical Disabilities) since he generally wanted more, unspecified services. He received Meals on Wheels. He was SSDI beneficiary with Medicare. DSAAPD had assisted with Medicaid application but it was denied since he was “over-income”. The DLP provided information about applying for eligibility under a long-term care Medicaid waiver which offered more comprehensive services than available through DSAAPD. [15-0083138]

Forty-six year old Deaf individual had medical appointment with surgeon who refused to provide interpreter. DLP secured agreement to hire interpreter but client cancelled appointment at last minute. DLP then prompted Medicaid MCO to arrange for interpreter at next appointment which client kept. [15-0081227]

Fifty-eight year old with diabetes signed up with Medicare-D provider based on low quote for insulin. However, when she received initial supply, cost was triple the quote. The DLP provided information on switching plans after open enrollment within 2 months of discovering error in coverage. [16-0084825]

Thirty-seven year old with intercranial hypertension had been denied a prescription by Medicaid MCO. MCO claimed physician had failed to submit documentation necessary for approval. The DLP contacted physician who sent duplicate documentation to the MCO which approved prescription for a year. [15-0082985]

Sixty-nine year old with multiple health deficits was enrolled with Medicaid MCO. MCO was paying for home health services until 5 pm in evening and resuming at 10 am. Client was incontinent and wore diapers. He requested aide to change diaper at night. The DLP negotiated with MCO and secured approval of aide from 10-12 pm to clean and change diaper. [16-0084258]

Public Financial Benefits

Hospital social worker referred forty-seven year old homeless veteran to DLP to assist with SSDI claim. Veteran was currently hospitalized due to stroke. He also had diagnoses of Hepatitis C and heroin addiction. The DLP visited at hospital, obtained medical records, submitted application, and met with SSA representatives to facilitate processing. While application was being processed, the client died. [15-0083365]

Sixty-eight year old with orthopedic impairments contacted the DLP regarding a Social Security overpayment which she did not understand. The DLP convened 2 meetings with SSA staff and determined there were offsetting overpayments and underpayments resulting in no net reduction in benefits. The DLP explained the findings to the client who continued to receive her full benefit. [14-0078588]

Sixty-four year old dual SSI/SSDI beneficiary was assessed a $4,000 overpayment due to exceeding $2,000 in her bank account. The DLP assisted with filing a waiver request and represented in a meeting with the SSA which in which errors were reviewed. The overpayment was reduced to approximately $1,500 and the DLP negotiated a benign repayment arrangement of $10/month. [15-0083201]

Fifty-seven year old SSDI beneficiary contacted the DLP regarding 2 overpayments aggregating more than $10,000. The DLP reviewed the case through an in-person meeting at the local SSA office. The DLP determined that the client had already challenged the overpayments within the Social Security system, received an adverse decision, and failed to appeal within the allowable time period. The SSA decision appeared justified based on the underlying facts. Moreover, the client had already signed a benign repayment agreement of $40/month within the past 30 days. The DLP explained the lack of merit of further appeal and provided advice regarding repayment options. [16-0085184]

Sixty-one year old SSDI beneficiary had amassed a $20,000 SSDI overpayment based on excess earnings. The DLP filed a waiver application and represented the client in administrative proceeding. The SSA determined that client was without fault since she had reported earnings but denied waiver since client had ability to repay. The DLP negotiated a benign repayment schedule of $10/month. [13-1046095]

Twenty-one year old SSI beneficiary contacted the DLP regarding SSA notices that suggested her benefits might be terminated. The DLP asked for the notices to facilitate a merit assessment. The beneficiary did not produce the notices so the DLP was limited to providing advice on the appeal process. [15-0083079]

Fifty-three year old with diabetes and orthopedic impairments received notice of discontinuation of his SSDI. The DLP obtained records, assessed, and determined that the SSA had erroneously computed effect of Worker’s Compensation benefits. SSDI was reinstated and beneficiary received $11,000 in back benefits. [15-0083588]

Fifty-two year old SSDI was dependant on oxygen due to COPD and had very limited ambulation ability due to orthopedic impairments. He lived in halfway house and his sole income was SSDI which was reduced by a child support order entered 18 years ago by an out-of-state court. He requested information about options to reduce the child support withholding. The DLP provided specific information about the Delaware Family Court form to file which would result in a Family Court review which would then be forwarded to the out-of-state court. [15-0083749]

Thirty-eight year old Deaf individual had amassed $30,000 SSI overpayment due to excess earnings over the years. Her SSI benefits had been terminated. Beneficiary thought she had applied for waiver but the SSA had no record of waiver application. DLP paralegal arranged meeting at local SSA office and submitted new waiver application. DLP secured updated information on calculation of overpayment which was shared with client. The client was also advised that she could apply for SSDI since she had amassed sufficient work history to apply for SSDI. [16-0084117]

Fifty-three year old with orthopedic impairments had amassed SSDI overpayments due to earned income above SGA. DLP assessed prospects for appeal or waiver and determined there was insufficient merit to pursue either option. Client was operating business and keeping few records resulting in attribution of earnings to her. [16-0084224]

Fifty-nine year old SSDI beneficiary had a $52,000 overpayment due to earnings showing she was not disabled for 3 year period. Client had been denied waiver and appealed to ALJ level. DLP determined there was lack of merit to appeal since client had not regularly reported earnings and recommended arranging a repayment schedule through local office in lieu of the ALJ setting a repayment rate. [15-0083132]

Sixty-five year old had SSDI suspended due to work over SGA which also resulted in $20,000 overpayment. The DLP represented in multiple meetings with SSA and negotiated benign $25/month repayment arrangement on the overpayment. SSDI benefits were also restored. Client died a month later. [14-0077967]

Fifty-two year old was referred by hospital social worker after amputation of leg and several toes. The DLP facilitated SSI application and provided Disability Determination Service with supporting medical records. Claim was approved. [16-0084149]

Seventy-four year old SSI beneficiary had benefits terminated based on determination that assets in special needs trust were countable resource. The DLP represented at reconsideration level but decision was affirmed. DLP developed a conflict and secured alternate free representation through Delaware Volunteer Legal Services for further appeals. [15-0082893]

Forty-seven year old dual SSI/SSDI beneficiary had overpayments in both programs. The DLP represented in multiple meetings with the SSA to facilitate waiver. The SSA approved waiver of both the SSI and SSDI overpayments aggregating approximately $1,100. [14-0079902]

Sixty-three year old assisted living resident contacted the DLP since her SSI check had been reduced and she believed there was an overpayment. The DLP represented in meeting at SSA and determined that reduced payment occurred since client had moved from Pennsylvania to Delaware resulting in loss of Pennsylvania supplement. The DLP also confirmed that a small overpayment had already been repaid. Information was supplied to resident. [16-0084666]

Forty-eight year old SSDI beneficiary had received concurrent worker’s compensation benefits. The SSA had incorrectly calculated the effect of the worker’s compensation award resulting in a $27.000 overpayment. The DLP represented the beneficiary in SSA proceedings and secured a waiver of the entire overpayment. [13-0076180]

Seventy-seven year old with dementia had SSI suspended when her bank account exceeded $2,000 resource limit. The DLP assisted with reducing countable resources and secured restoration of SSI benefits and accompanying Medicaid coverage. [15-0082662]

Fifty-year old with bilateral hip replacement, orthopedic impairments, and intellectual limitations was SSDI beneficiary. He received notice of termination of SSDI due to medical improvement. The DLP compiled supporting medical records and represented in ALJ hearing. However, hearing decision was unfavorable. The DLP reviewed appeal options and client opted to pursue employment assistance through Division of Vocational Rehabilitation. [14-0078228]

Forty-two year old with orthopedic impairments received notice of $5,600 overpayment after the SSA did not correctly calculate effect of worker’s compensation payments. The DLP represented in proceedings for waiver and secured waiver of entire overpayment. [14-0080617]

Fifty-three year old with cancer and orthopedic impairments requested assistance in completing SSA forms related to continuing disability review process. The DLP assisted with completion and submission of forms. The SSA determined that the client remained eligible for SSDI and benefits were preserved. [14-0080612]

Sixty-two year old SSDI beneficiary had received worker’s compensation in past. The SSA had miscalculated effect and reduced the client’s monthly benefit. The DLP represented in appeal and secured payment of $28,000 in back benefits and increased prospective monthly benefit. [15-0083353]

Employment Discrimination

Forty-one year old with asthma had filed employment discrimination complaint with Department of Labor regarding fellow employees wearing perfume and odors from roofing work in employer’s building. The DLP assessed and determined public employer provided employee with separate office, roofing work was short-lived, and environmental testing indicated air quality was fine. The DLP provided advice on claim but declined direct representation based on lack of merit. [15-0083011]

Fifty-three year old with asthma and orthopedic impairment contacted the DLP regarding options to obtain public employer accommodations, i.e., ergonomic desk and freedom from airborne chemicals. Employer provided employee with own office, posted signs deterring use of perfumes, and conducted assessment for ergonomic desk. The DLP provided technical assistance regarding reasonable accommodations and documenting requests. [15-0082926]

Fifty-two year old with orthopedic impairments had recently been determined able to return to work post surgery by short-term disability insurer. He sought information about right to reasonable accommodations from employer. A DLP attorney met with client and provided technical assistance and advice on reasonable accommodations. [16-0085419]

Forty-four year old with Graves Disease requested assistance with reduction in employer hours and reassignment of tasks. The DLP provided extensive technical assistance resulting in creation of favorable record and filing of employment discrimination complaint. [15-0083533]

B. SECOND PRIORITY: TRANSPORTATION

1. Identification

The PAIR program will promote a consumer-friendly public transportation system and reduction of barriers to constituent travel.

2. Need, Issue or Barrier Addressed

Persons with disabilities have difficulty commuting to work, traveling to medical appointments, and living independently when they cannot access the public transportation system. This inability to use the public transportation system has a disproportionate impact on less affluent persons with disabilities. Apart from the public transportation system, consumers are also affected by motor vehicle laws, parking ordinances, and private transportation providers. Finally, vehicular safety standards affect the incidence and exacerbation of injuries resulting in disability.

3. Outcome Indicators

Indicators of a successful outcome under this priority include gaining access to public and private transportation, enhanced access to designated parking options, and removal of barriers to pedestrian travel. As reflected in the FY16 Priorities, the outcome indicators for this objective were as follows:

a. As a result of DLP intervention, 5 persons will secure equal or improved access to transportation.

b. As a result of DLP intervention, 5 laws, regulations, or policies will be changed or barriers to transportation eliminated or reduced.

4. Collaborative Efforts

The DLP addressed transportation-related concerns through active participation in a DART paratransit advisory committee (EDTAC). The EDTAC reviewed and commented on proposed paratransit policies and participated in appeals of denials of paratransit eligibility. The DLP also addressed transportation matters through participation in the State Council for Persons with Disabilities (SCPD). The Council includes both a DLP representative and DART paratransit representative. Specific examples of collaboration with SCPD and DART are as follows:

The SCPD promoted improvements in the DART website so schedules would be published in accessible formats. DART updated its website to include current schedules in an accessible file.

The Governor issued Executive Order 54 establishing an “Advisory Council on Walkability and Pedestrian Awareness”. Membership included SCPD representation, the DelDOT and Dept. Of State ADA coordinators, and citizens with visual and physical impairments. The DLP participated in a review of the Council, its mission and expected activities at a November 15, 2015 SCPD meeting.

In June, 2016, the DLP provided a letter of support and commitment to assist with implementation of a DART pilot project using federal FTA Mobility on Demand grant funding. The proposal envisioned establishing a shuttle service for medical appointments using an accessible senior center vehicle in partnership with the VA and University of Delaware. The shuttle system would supplement paratransit service. A decision on the application by the FTA had not been issued by the end of FY16.

The DLP Project Director presented testimony on the FY17 Division of Services for Aging & Adults with Physical Disabilities (DSAAPD) budget in an OMB hearing in November, 2015 and a legislative hearing in February, 2016. The testimony was presented on behalf of the Developmental Disabilities Council, State Council for Persons with Disabilities, and the Governor’s Advisory Council for Exceptional Citizens. The testimony focused on the need to provide sufficient funding to the State’s attendant services program in which attendants provide support services, including transportation, escort, and transferring to and from wheelchairs and vehicles. In the past year, the waiting list had grown from 126 to 228 individuals. The DLP provided statistical and consumer-satisfaction data which highlighted the value of the program. The Governor’s proposed budget proposed funding with a slight reduction ($35,300) for FY17 which was eventually incorporated into the final budget.

LEGISLATION

At SCPD request, the DLP had drafted accessible parking legislation (H.B. 200) which was introduced in FY15. During FY16, the DLP participated in extensive dialog with stakeholders, prepared a substitute bill and amendments, and provided technical assistance. The bill would have established a local government permit process for construction and renovation of parking lots to ensure conformity with ADA standards. County governments acknowledged widespread non-conformity of parking lots with ADA standards but balked at establishing a simple permit process. The legislation was approved by a House committee but did not receive further action prior to the end of the legislative session on June 30, 2016. It will be reintroduced in 2017.

Legislation (S.B. 134) was introduced to establish a bill of rights for homeless persons. It included a ban on discrimination in the use of public sidewalks and public transportation as well as occupation of a motor vehicle or recreational vehicle provided that the vehicle is legally parked on public property. There is a high correlation between homelessness and disability. In 2016, the DLP prepared analyses of the original and substitute bills which were adopted by multiple councils and shared with policymakers. The legislation was approved by a Senate committee but received no vote by the full Senate or House prior to the end of the legislative session.

Legislation (H.B. 302) was introduced to deter distracted driving which is correlated with accidents and injuries resulting in or exacerbating disability. Delaware’s minimum penalty ($50 civil assessment) for texting and hand-held cell phone use was lower than 34 of 40 states banning texting and hand-held cell phone use. The DLP prepared an analysis of the legislation with an overview of penalties in surrounding states. Multiple councils adopted the analysis which was shared with policymakers. An amended version of the legislation (doubling the minimum civil penalty to $100) was enacted and signed by the Governor on August 31, 2016.

REGULATIONS

The Division of Public Health published a proposed regulation implementing legislation establishing a “medical order for scope of treatment” (DMOST) system. An individual with a disability could collaborate with a physician to obtain a medical order defining scope of treatment for emergency medical personnel to honor. A DMOST order is similar to an advance health care directive but its primary use is in emergency transportation (e.g. ambulance and paramedic contexts). The DLP issued an analysis of the proposed regulation which was adopted by multiple councils and shared with the Division. The Division incorporated six (6) amendments in the final regulation prompted by the commentary. [19 DE Reg. 388 (11/1/15) (proposed); 19 DE Reg. 637 (1/1/16) (final)]

The Delaware Interscholastic Sports Association (DIAA) published a proposed high school regulation which barred: 1) public schools from transporting student athletes to off-campus programs such as Special Olympics; and 2) PTAs and support groups from providing or paying for transportation to Special Olympics. The regulation provided a transportation barrier to participation in Special Olympics by students with disabilities, including PAIR-eligible students with mild disabilities not meeting PADD eligibility standards. The DLP issued a critique which was adopted by multiple councils and shared with the DIAA. The DIAA adopted a final regulation which removed the ban as applied to students with disabilities. [19 DE Reg. 100 (8/1/15) (proposed); 19 DE Reg. 462 (12/1/15) (revised proposed); 19 DE Reg. 745 (2/1/16) (final)]

The Delaware Interscholastic Sports Association (DIAA) published a proposed junior high school /middle school regulation which barred: 1) public schools from transporting student athletes to off-campus programs such as Special Olympics; and 2) PTAs and support groups from providing or paying for transportation to Special Olympics. The regulation provided a transportation barrier to participation in Special Olympics by students with disabilities, including PAIR-eligible students with mild disabilities not meeting PADD eligibility standards. The DLP issued a critique which was adopted by multiple councils and shared with the DIAA. The DIAA adopted a final regulation which removed the ban as applied to students with disabilities. [19 DE Reg. 111 (8/1/15) (proposed); 19 DE Reg. 461 (12/1/15) (revised proposed); 19 DE Reg. 743 (2/1/16) (final)]

5. Number of Cases 4

6 Case Summaries

Eighty-five year old with visual impairment and incipient Alzheimer’s used paratransit to attend Medicaid-funded day program. Paratransit agency objected to driving up narrow driveway for pick-up. The DLP prompted guardian to explore transportation via Medicaid program which would also be free of charge. Guardian did not respond to follow-up communication. [15-0083557]

Seventy-two year old with hearing and mobility impairments used paratransit. He requested information about the paratransit agency’s “no show” policy. The DLP compiled “no show” policy standards to share with client. [15-0083224]

Thirty-four year old with spina bifida had been denied driver’s license by the Division of Motor Vehicles. She had started but never completed driver’s education program using hand controls. The DLP provided technical assistance on options. [15-0080971]

Sixty-nine year old bilateral leg amputee with no driver’s license purchased a new van with a loan and then regretted the transaction. The DLP contacted dealership which was not sympathetic. The DLP explored options with client who decided to pay off loan with other funds and sell vehicle. [16-0084259]

C. THIRD PRIORITY: HOUSING; INDEPENDENT LIVING

1. Identification

The PAIR program will promote freedom from disability-based discrimination in housing and the reduction of barriers to independent living.

2. Need, Issue, or Barrier Addressed

Without adequate housing and support services, persons with disabilities are unable to live independently in the community. When a landlord, mobile home park owner, or zoning board refuses to make accommodations in its policies or practices, it denies the person with a disability the right to live in a setting of the individual’s choice.

3. Outcome Indicators

Factors used to determine a successful outcome under this priority include gaining access to an accessible residence or landlord accommodations; retention of a residence in the community; enjoyment of all the rights/privileges related to tenancy or home ownership; safety and quality of services within congregate living settings; and acquisition of home health and other supports to facilitate successful community living. As reflected in the FY16 Priorities, the outcome indicators for this objective were as follows:

a. As a result of DLP intervention, 10 persons with disabilities will secure equal access to or maintain housing or independent living supports.

b. As a result of DLP intervention, 10 laws, regulations, or policies will be changed or other barriers to housing eliminated or reduced.

4. Collaborative Efforts

The DLP Project Director served on the State Council for Persons with Disabilities Housing Committee and attended the majority of meetings convened in FY16.

LEGISLATION

Twelve states and D.C. have enacted laws banning discrimination in housing based on source of income (e.g. SSDI; SSI; vouchers). The DLP co-authored legislation (S.B. No. 179) to add “source of income” to the list of protected classes in Delaware’s fair housing law. The DLP highlighted the benefit of the legislation for Delaware’s 192,000 Social Security and SSI beneficiaries. Landlords generally opposed the bill, preferring to rent to tenants with employment income. Anecdotally, some landlords opposed renting to Social Security and SSI beneficiaries since there are federal restrictions on execution on Social Security and SSI funds. At State request, the DLP assisted with preparation and analysis of amendments. The legislation was enacted and signed by the Governor on August 3, 2016.

Legislation (S.B. No. 134) was introduced to establish a bill of rights for homeless persons. It included a ban on discrimination for persons “seeking or maintaining housing due to the individual’s lack of a permanent address” and banned discrimination by shelters based on disability. The DLP prepared analyses of the original and substitute bills which were adopted by multiple councils and shared with policymakers. The legislation was approved by a Senate committee but received no vote by the full Senate or House prior to the end of the legislative session.

In FY15, the Division of Long-term Care Resident Protection (DLTCRP) had sent a draft of a complete (55-page) revision of the Delaware Code long-term care licensing standards to policymakers who, in turn, requested a DLP analysis. The proposal would have had a significant impact on admission and discharge standards, use of funds derived from provider penalties, composition of group homes for persons with AIDS, frequency of facility inspections, use of former employees to conduct facility inspections, penalties for failure to report suspected abuse/neglect, posting of information in small facilities, and the scope of criminal background checks. The DLP issued an analysis identifying 22 concerns. In FY16, at DLTCRP request, the DLP provided extensive technical assistance on revisions resulting in several amendments, including resident protections from involuntary discharge. The Division intends to introduce the legislation in 2017.

Legislation (S.B. No. 186) was introduced to establish a fund to assist veterans with disabilities with realty taxes as follows: 1) $200 for veteran with V.A. disability rating of 10%-20%; 2) $350 for veteran with a V.A. disability rating of 30%-50%; and 3) $500 for a veteran with a V.A. disability rating of 60% or higher. The DLP prepared an analysis of the bill which was adopted by multiple councils and shared with policymakers. The bill had a $3 million fiscal note resulting in lack of enactment in 2016.

REGULATIONS & POLICIES

In the Spring of 2016 the Division of Vocational Rehabilitation published its proposed State Plan for Independent Living for 2017-2019. The DLP submitted written comments on June 10, 2016. The DLP addressed identification of underserved populations (including individuals with brain injuries), training initiatives, and the value of consumer driven services.

Based on CMS guidance, the Delaware Department of Health & Social Services (DHSS) prepared a plan to assess whether Medicaid waiver-funded services, including residential services, are provided in integrated settings. In February, 2016 DHSS posted an updated Plan and solicited comments. The DLP submitted thirty-nine (39) comments which were endorsed by multiple councils. On April 22, 2016 DHSS published its responses to the DLP commentary which reflected more than a dozen amendments to its Plan.

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations covering residential treatment facilities to conform to CMS standards. The DLP prepared an analysis which did not identify any shortcomings. Multiple councils adopted the analysis which was shared with the Division. The Division acknowledged the commentary and adopted the regulations which conformed to the proposed version. [19 DE Reg. 380 (11/1/15) (proposed); 19 DE Reg. 763 (2/1/16) (final)]

CMS regulations allow states to make “bed hold” payments to long-term care facilities during a resident’s temporary absence due to hospitalization or other specified reasons. The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations to extend the “bed hold”) from 7 days to 14 days. This benefits residents who do not lose their residence due to temporary, off-site medical care. The DLP prepared an analysis which was adopted by multiple councils and shared with the Division. The Division incorporated one (1) amendment prompted by the commentary in the final regulation. [19 DE Reg. 888 (4/1/16) (proposed); 19 DE Reg. 1092 (6/1/16) (final)]

Federal law authorizes a “disregard” of some countable resources when one spouse resides in a Medicaid-funded long-term care facility so the spouse residing at home can maintain the home and not be “impoverished”. States can also disregard some resources based on a determination of “undue hardship”. DMMA proposed an “undue hardship” standard in which the DLP identified two (2) concerns: 1) it retained a $25,000 cap adopted in 1993 with no increase based on inflation; and 2) it could be invoked only if the spouse would otherwise risk death (“his/her life would be endangered”). The DLP noted that CMS standards and a neighboring state authorized an “undue hardship” disregard based on any endangerment of health. Multiple councils adopted the DLP analysis which was shared with the Division. The Division declined to incorporate any amendment in adopting the final regulation. [19 DE Reg. 987 (5/1/16) (proposed); 20 DE Reg. 52 (7/1/16) (final)]

The Division of Medicaid & Medical Assistance (DMMA) published proposed regulations increasing the personal needs allowance for residents of long-term care facilities. CMS standards require “an allowance that is reasonable in amount for clothing and other personal needs of the individual while in the institution”. Delaware’s monthly allowance had not changed in 14 years. DMMA proposed an increase from $44 to $50 for individuals and from $88 to $100 for couples. The DLP issued an analysis which was adopted by multiple councils and shared with the Division. The DLP analysis included statistics showing the increases were less than half the inflation rate. Multiple councils adopted the analysis which was shared with the Division. A final regulation had not been adopted by the end of FY16. [19 DE Reg. 893 (4/1/16) (proposed)]

5. Number of Cases 8

6. Case Summaries

Division of Vocational Rehabilitation referred fifty-nine year old who had suffered stroke leaving him deaf. Electric utility had terminated his electricity service due to non-payment which prompted local government to declare house uninhabitable. Indeed, client had been arrested for criminal trespassing for continuing to reside in his house. The utility arrears occurred due to the fraud of the client’s boarders. The utility had declined to offer a repayment plan. The DLP negotiated with the utility and secured reinstatement of electricity based on a repayment agreement in which the arrears would be repaid over a 6 month period. Housing was preserved. [16-0085659]

Sixty-two year old SSDI beneficiary had executed a power of attorney while temporarily in nursing home authorizing daughter to deal with financial matters. Daughter allowed other relative to live in client’s home who refused to leave when client was ready to return. DLP prepared revocation of the power of attorney and facilitated removal of other relative. Client was able to return to home after arranging for repairs and cleaning of the home due to damage caused by relative and dogs. [16-0084290]

Fifty-seven year old with congestive heart failure and orthopedic impairments lived in subsidized housing. She requested relocation to 1st floor unit as accommodation but landlord declined request unless tenant paid exorbitant fee. The DLP provided preliminary advice on options but tenant did not follow up on subsequent requests to schedule appointment. [15-0082958]

Forty-six year old homeless person had received severe leg injuries in car accident. He was Medicaid beneficiary. Most shelters could not accommodate him due to special bed needs. The DLP provided information about other residential programs as well as option for physician to authorize admission to rehabilitation facility. [15-0082837]

Fifty-five year old residing in nursing home contacted DLP regarding with intermittent complaints regarding care. With client’s permission, DLP contacted State long-term care Ombudsman who agreed to meet with client and assess allegations. [15-0082161]

Sixty-one year old resident of State nursing home requested assistance to be discharged to community setting. He had diabetes, dementia, multiple health deficits., and suicidal ideation With approval of his Public Guardian, the DLP met with resident and explored options but was unable to identify a realistic community alternative. He was offered a community-based day program but declined that option. [15-0081075]

Fifty-five year old with diabetes, fibromyositis, and asthma had long shared driveway to her home. New neighbor was erecting fence which cut off client’s access to part of the driveway. DLP researched and determined there had been 2 parallel driveways in recent past and deeds did not provide for shared driveway. The DLP provided advice but did not identify any viable legal recourse. [15-0083538]

Fifty-four year old with cancer moved into new home with homeowner association fees. Fees were not paid and homeowner’s association requested full payment plus late fees. The DLP provided advice on options, including sources of payment assistance. [15-0082677]

D. FOURTH PRIORITY: AUTONOMY

1. Identification

The PAIR program will promote constituent autonomy and self-assurance through training, information dissemination, and assistance with substitute or advance consent documents.

2. Need, Issue, or Barrier Addressed

The PAIR program promotes consumer self-advocacy through both group training and answering individual inquiries. Autonomy is also enhanced by DLP preparation of advance health care directives and powers of attorney for clients on a limited basis. This facilitates implementation of consumer choice in health care and financial matters.

3. Outcome Indicators

Factors used to determine success include the number of individuals trained in group settings, the number of individuals provided with individual technical assistance, and the number of individuals obtaining advance health care directives or powers of attorney. As reflected in the FY16 Priorities, the outcome indicators for this objective were as follows:

a. The DLP will provide information and referral services to 100 individuals and agencies.

b. The DLP will provide training to 10,000 individuals through articles, seminars, training events, and dissemination of training materials.

c. The DLP will prepare a minimum of 12 powers of attorney, advance directives, and similar authorizing documents.

4. Collaborative Efforts

Consistent with PPR, Part 1, Section B, the DLP conducted 31 group training events. Collaborating agencies included the State Council for Persons with Disabilities, Department of Health & Social Services, and Center for Disabilities Studies.

Since State law requires the Long-term Care Ombudsman to witness execution of advance health care directives (AHCDs) by residents of long-term care facilities, the DLP often collaborated with the Ombudsman in finalizing such documents.

The DLP Project Director is a Governor’s appointee to the State Guardianship Commission. During FY16 the Commission addressed guardianship pleading and forms. The DLP recommended multiple amendments to physician forms which were adopted by the Commission.

The DLP addressed multiple bills affecting autonomy. The following four (4) bills are illustrative. Most DLP legislative and regulatory analyses are issued at SCPD and GACEC request.

Federal agencies have recently promoted “supported decision-making” as an alternative to guardianship. For example, the President’s Committee for People with Intellectual Disabilities issued an October 6, 2016 report with several pages devoted to fostering supported decision-making - “A New Path: 2016 PCPID Report to the President (10/6/16) (pp. 61-66), published at http://www.acl.gov/Programs/AIDD/Program_Resource_Search/docs/PCPID-Report-2016.pdf . At State request, the DLP co-authored supported decision-making legislation (S.B. No. 230), prepared amendments, provided extensive technical assistance, and responded to inquiries about the legislation. Other collaborating agencies included the Office of the Public Guardian and Department of Health & Social Services. The legislation was enacted and signed by the Governor on September 15, 2016. Delaware became the second state in the country to adopt supported decision-making legislation.

Legislation (S.B. No. 52) was introduced to facilitate implementation of discharge planning from hospitals through “lay caregivers”. Hospitals would be required to solicit a patient’s optional designation of a lay caregiver; notify the lay caregiver of planned discharge; provide the lay caregiver with guidance on aftercare tasks; and share the proposed discharge plan with the lay caregiver. The bill promoted autonomy by requiring hospitals to honor a patient’s choice of a designee to obtain information and assist with discharge planning. The DLP prepared a generally positive analysis which was adopted by multiple councils and shared with policymakers. The legislation was enacted and signed by the Governor on August 3, 2016.

Legislation (H.B. No. 310) was introduced to make persons aging out of the foster care system with any mental health diagnosis subject to judicial oversight, including outpatient commitment, until age 26. The DLP prepared a comprehensive analysis which addressed due process deficiencies and outdated approaches to limiting choices of young adults with disabilities through judicial oversight of every conceivable aspect of a young adult’s life for 8 years. Multiple councils adopted the analysis which was shared with policymakers. The legislation was amended to address some deficiencies but never received a House or Senate vote prior to the end of the legislative session.

5. Number of Cases 2

6. Case Summaries

Seventy year old stroke survivor was resident of nursing home. She requested power of attorney and advance health care directive. DLP interviewed her in facility and prepared forms conforming to client’s wishes. [16-0084297]

Forty year old with acute pancreatitis and perforated bowel requested a power of attorney and advance health care directive. DLP prepared forms and client made appointment to sign. However, she did not appear and subsequently ignored messages to reschedule appointment. [15-0082539]

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.

DISABILITIES LAW PROGRAM

FY 2017 P&A FOR INDIVIDUAL RIGHTS (PAIR) PRIORITIES

INTRODUCTION

The Disabilities Law Program (“DLP”) of the Community Legal Aid Society, Inc. (“CLASI”) provides services to individuals consistent with the following authorizing legislation:

1) Protection & Advocacy for Individual Rights (PAIR);

2) Protection & Advocacy for Individuals with Mental Illness (PAIMI);

3) Protection & Advocacy for Individuals with Developmental Disabilities (PADD);

4) Protection & Advocacy for Assistive Technology (PAAT);

5) Protection & Advocacy for Beneficiaries of Social Security (PABSS);

6) Protection & Advocacy for Individuals with Traumatic Brain Injury (PATBI); and

7) Protection & Advocacy for Voting Access (PAVA)

This document defines the priorities for FY 2017 (October 1, 2016 - September 30, 2017) of the first component, PAIR.

INTERAGENCY COORDINATION

The focus of the PAIR program is to provide services to individuals with disabilities ineligible under traditional advocacy projects, i.e., PAIMI, PADD, and client assistance programs (CAPs). See 29 U.S.C. §794(e). However, federal law envisions that the PAIR will coordinate advocacy with such organizations as well as the Long-term Care Ombudsman.

In deference to this mandate, the PAIR program closely coordinates with the DLP’s PAIMI and PADD components as follows:

1) PAIMI, PADD, and PAIR program priorities are designed to be complementary;

2) intraoffice referrals among programs are routinely made to ensure that applicants are screened for eligibility by the appropriate DLP subdivision;

3) reference materials and training resources are routinely shared; and

4) the DLP Supervising Attorney coordinates advocacy across the three programs to minimize duplication of effort.

Likewise, the CAP director serves on the DLP’s PAIR advisory council and the DLP supplements CAP advocacy in the vocational rehabilitation context as follows:

1) DLP staff member serves as the Chair of the Dept. of Labor’s Division of Vocational Rehabilitation [“DVR”] advisory council;

2) DLP staff serve on the DVR Client Services Policy Committee, Membership Committee; Government Relations Committee; State Plan Committee, and Annual Report Committee;

3) DLP Director and CAP Director serve together on the State Council for Persons with Disabilities;

4) DLP Project Director and CAP Director serve together on the State Council for Persons with Disabilities Policy & Law Committee which acts on the DLP’s monthly critiques of legislative, regulatory, and policy initiatives;

5) DLP staff responds to CAP requests for technical information on matters within the DLP’s particular expertise;

6) DLP staff screens CAP referrals on matters outside the CAP’s mandate; and

7) DLP staff offers independent or collaborative training on the vocational rehabilitation system on request.

Finally, the DLP supports and supplements Ombudsman advocacy as follows:

1) DLP responds to Ombudsman requests for technical assistance;

2) DLP staff offers independent and collaborative training on abuse, neglect, and rights of constituents.

3) DLP staff and the Ombudsman serve together on the State Nursing Home Residents Quality Assurance Commission.

4) DLP Project Director and Ombudsman representative serve together on State Council for Persons with Disabilities Policy & Law Committee.

SCOPE OF ADVOCACY

The scope of PAIR program advocacy includes a broad array of activities, including information and referral, counseling and technical assistance, community education, negotiation, litigation, and legislative and regulatory analysis. Given relatively modest funding, the PAIR program is guided by these priorities in determining the type and scope of services provided to eligible constituents.

SPECIFIC PRIORITIES AND OBJECTIVES

I. ACCESSIBILITY

GOAL: The PAIR program will promote and facilitate access to governmental programs and public accommodations.

OBJECTIVES:

0100 A. Provide direct advocacy services if an individual has been prevented from effectively accessing important governmental programs based on systemic policy or barrier(s) contrary to federal or state law.

0102 B. Provide direct advocacy services to individuals prevented from effectively accessing important public accommodations because of barriers or discrimination proscribed by federal or state law.

OUTCOME INDICATORS:

A. As a result of DLP intervention, 55 persons will secure equal or improved access to governmental services or public accommodations.

B. As a result of DLP intervention, 10 laws, regulations, policies or other barriers to government services or public accommodations will be eliminated or modified.

RATIONALE: This priority encompasses enforcement of both Titles II and III of the ADA, as well as Delaware’s equal accommodations law, Title 6 Del.C. Ch. 45. Both public sector and private sector compliance with the ADA will be promoted. This priority also extends to promotion of effective constituent access to “safety-net” public benefit programs.

In the public sector, the DLP contemplates legal assistance to protect the rights of Medicaid beneficiaries, particularly those enrolled in the DSHP managed care system. Access to basic health care is a high priority among PAIR constituents and Delaware’s Medicaid MCOs have historically denied, in whole or part, valid claims for services. The transition to a DSHP Plus system effective April, 2012 has significantly increased the number of Medicaid beneficiaries subject to MCO oversight. The DLP anticipates the provision of legal assistance to DSHP and DSHP Plus participants whose eligibility for services has been improperly denied. The DLP expects to support continued implementation of a Medicaid Buy-in program [a/k/a Medicaid for Workers with Disabilities (“MWD”) program]. The DLP will collaborate with the SCPD to educate policymakers on the merits of expanding access of adult Medicaid beneficiaries to acute and preventative dental services. The DLP will facilitate full implementation of recently enacted S.B. No. 230 (authorizing supported decision-making agreements) and S.B. No. 221 (authorizing a State tax credit for businesses hiring individuals with disabilities). The DLP will support continued implementation of the Money Follows the Person program. The DLP contemplates supporting the work of the Home and Community-based Services Ombudsman (HCBSO). The DLP anticipates continuing efforts to support State planning and implementation of the federal Affordable Care Act. Apart from health care, the DLP routinely receives requests for assistance with “safety-net” income-maintenance programs (e.g. preservation of SSI in State child support reimbursement context; preservation of SSI/SSDI benefits through overpayment waivers or incremental repayment agreements). The DLP expects to deter constrictive enforcement of the Delaware Equal Accommodation law through both litigation and collaboration with the SCPD on remedial legislation. The DLP will continue efforts to deter utility terminations affecting individuals reliant on utilities (e.g. electricity; gas) for health-related conditions (e.g. oxygen-dependent), including provision of input to the Public Service Commission on proposed regulations defining a customer’s “good faith” effort to pay utility charges. Finally, a DLP senior staff attorney will address accessibility of public buildings through participation in the Architectural Review Board and assist with implementation of polling site accessibility legislation codified at 15 Del.C. §4512(b).

In the private sector, the DLP anticipates addressing complaints regarding both policy and physical barriers to community integration.

Selected long-term care concerns will be addressed in both public and private sector contexts.

II. TRANSPORTATION

GOAL: The PAIR program will promote a consumer-friendly transportation system and reduction of barriers to constituent travel.

OBJECTIVES:

0200 A. Collaborate with advocacy organizations and councils [e.g. Elderly & Disabled Transportation Advisory Council (EDTAC); State Council for Persons with Disabilities (SCPD)] to promote improvement in Delaware paratransit system through both systemic and individual constituent advocacy.

0201 B. Collaborate with the SCPD to promote:

1. consumer-oriented motor vehicle license, operation and parking laws, regulations, and policies;

2. enhanced access to State subsidized vehicle modifications; and

3. safety-related transportation laws, regulations, and policies to prevent or reduce injuries to “at risk” individuals with disabilities.

0202 C. Provide direct advocacy services to individuals prevented from effectively accessing public and private vehicular transportation systems or otherwise experiencing significant barriers to travel contrary to Federal or State law.

OUTCOME INDICATORS:

A. As a result of DLP intervention, 5 persons will secure equal or improved access to transportation.

B. As a result of DLP intervention, 5 laws, regulations, or policies will be changed or barriers to transportation eliminated or reduced.

RATIONALE: This priority is intended to facilitate travel both within the State and to regional transportation centers. Advocacy contexts would include improving the public transportation system (including DelDOT paratransit capacity, policies, and practices); promoting the availability of accessible parking; supporting initiative to promote availability of accessible taxi service; and enhancing pedestrian travel through barrier removal (e.g. curb cuts). The DLP will collaborate with the SCPD to educate policymakers on the merits of reintroduced DLP co-authored accessible parking legislation. The DLP envisions spearheading a systemic initiative to document and remediate pervasive nonconformity with ADA parking standards. The DLP anticipates monitoring implementation of recently enacted S.B. No. 262 which requires transportation network companies to implement non-discrimination policies, including accommodation of service animals and ban on surcharges for serving travelers with disabilities. DelDOT is implementing changes to the paratransit system (e.g. fare hikes; geographical zones) which compromise its responsiveness to rider needs. The DLP envisions collaborating with the DelDOT ADA Coordinator to promote conformity with the ADA in DelDOT programs. The DLP will continue to serve on a DelDOT advisory and appeals council (EDTAC) to promote constituent rights. Since many long-term injuries are transportation-related, the DLP also envisions supporting traffic safety related legislation and regulations. Transportation affects access to employment, medical services, shopping, and recreation.

III. HOUSING; INDEPENDENT LIVING

GOAL: The PAIR program will promote freedom from disability-based discrimination in housing and the reduction of barriers to independent living.

OBJECTIVES:

0300 A. In collaboration with CLASI’s fair housing program, provide advocacy services to constituents aggrieved by significant violations of fair housing laws.

0301 B. Collaborate with the SCPD to promote the availability of independent living supports (e.g. attendant services; home health services; private duty nursing services; home modifications; caregiver services, and public financial incentives).

OUTCOME INDICATORS:

A. As a result of DLP intervention, 10 persons with disabilities will secure equal access to or maintain housing or independent living supports.

B. As a result of DLP intervention, 10 laws, regulations, or policies will be changed or other barriers to housing eliminated or reduced.

RATIONALE: This priority addresses both enforcement of fair housing laws and promotion of the availability of community-based housing options. For example, the DLP envisions addressing both individual housing discrimination complaints and, in conjunction with the SCPD, systemic barriers to independent living. For example, the DLP anticipates collaboration with the SCPD to facilitate implementation of recently enacted legislation (S.B. No. 179) barring discrimination in housing based on source of income. The DLP, in collaboration with CLASI’s fair housing program, typically protects client rights to reasonable accommodations by landlords and freedom from discrimination in the housing application context. Clients in institutions (e.g. DHCI) also benefit from advocacy support to facilitate discharge to community-based settings. The DLP envisions continued support of DHSS efforts to offer community-based options to residents of long-term care facilities. Lack of access to community-based housing results in homelessness, resort to substandard living arrangements, and over-institutionalization. The DLP anticipates preparation of an analysis of a reintroduced State Homeless Individuals Bill of Rights Act. The DLP contemplates advocacy to deter adoption of restrictive zoning laws and practices by local governments. The DLP envisions continued participation in the SCPD’s Housing Committee. In concert with the SCPD, the DLP anticipates continuing advocacy to preserve procedural safeguards for residents of long-term care facilities facing involuntary discharge, including supplemental analysis of draft DLTCRP legislation revising the procedural safeguards. In conjunction with the SCPD and Delaware Guardianship Commission, the DLP will assess options to reduce a prevalent bias towards institutional placement of wards and promote the availability of alternatives to guardianship. The DLP anticipates supporting implementation of the ABLE Act (H.B. No. 60). The DLP anticipates continued advocacy to ensure that State-funded home modifications include warranty or other consumer protections. Finally, the DLP plans to continue participation in Delaware Nursing Home Residents Quality Assurance Commission meetings which address both nursing home regulation and civil rights of residents.

IV. AUTONOMY

GOAL: The PAIR program will promote constituent autonomy and self-assurance through training, information dissemination, and assistance with supported decision-making agreements and substitute or advance consent documents.

OBJECTIVES:

0400 A. Offer individual technical assistance and information and referral services on substantive disability law (e.g. employment, housing, public benefits) and enforcement options.

0401 B. Offer group training on substantive disability law, enforcement options, and self- advocacy.

0402 C. If not readily available through other agencies, assist with preparation of a limited number of routine advance directives, powers of attorney, supported decision-making agreements authorized by recently enacted S.B. No. 230, and similar authorizing documents.

OUTCOME INDICATORS:

A. The DLP will provide information and referral services to 100 individuals and agencies.

B. The DLP will provide training to 10,000 individuals through articles, seminars, training events, and dissemination of training materials.

C. The DLP will prepare a minimum of 12 powers of attorney, advance directives, supported decision-making agreements, and similar authorizing documents.

RATIONALE: This priority encompasses the provision of individual technical assistance as well as group training activities. For example, the DLP anticipates presentation of seminars, drafting articles, enhancing its Website, and other information dissemination activities to promote informed constituent decision-making and empowerment. An informed constituency is confident, self-reliant, and enabled to engage in proactive advocacy. The DLP leverages resources through wide dissemination of information and advice to consumers.

GENERAL STANDARDS FOR DETERMINATION OF LEVEL AND TYPE OF SERVICES

Recognizing that the demand for assistance has historically outstripped available resources, the following factors will be considered in determining the level and type of services to be offered to an eligible applicant:

(1) potential impact on client;

(2) merits of case (both factually and legally);

(3) realistic alternate sources for referral and assistance;

(4) applicant’s ability to self advocate; and

(5) potential impact on other constituents or systems.

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 - October, 2015 - September, 2016

Source of funding

Amount Received

Amount Spent

Federal (section 509)

$171,598- FY 2016 funds

$ 29,789 - FY 2015 funds

$ 171,598 - FY 2016 funds

State

Program Income

Private

All other funds

$ 11,690 - unrestricted funds

Total (from all sources)

$171,598

$213,077

B. Budget for FY 16 & Projection for FY 17

Category

Prior Fiscal Year Actual Spent 10/01/15-9/30/16

Current Fiscal Year Budget

Wages/salaries

$ 121,045

$ 99,249

Fringe benefits (medical, dental ,FICA,

unemployment, etc.

$ 63,676

$ 50,160

Materials/supplies

$ 1,200

$ 1,009

Postage

$ 459

$ 487

Telephone

$ 1,662$ 1,853

Occupancy (Rent, Utilities, Bldg & Grounds Maintenance)

$ 11,503$ 7,780

Travel/Training

$ 3,181$ 2,561

Membership dues

$ 227$ 461

Bonding/Insurance

$ 1,374$ 974

Equipment

(rental/purchase)

$ 1,120$ 1,072

Litigation Costs

$ 556$ 500

Contractual (Payroll, Audit, Law Library on-line)

$ 6,510$ 5,242

Miscellaneous

$ 564$ 250

Total Budget

$ 213,077

$171,598

C. Description of PAIR staff - October 2015 - September 2016

Type of Position

FTE

% of year filled

Person-years

Professional
Full-time

1.72

100%1.72
Part-time

Vacant

Clerical

Full-time

0 .17

100%

0.17

Part-time

Vacant

The PAIR positions for Fiscal Year 2016, October 2015 - September 2016, included the Sr. Project Director, 8 attorneys, 7 paralegals, 4 administrative, and 4 support staff required to provide PAIR services in each of Delaware’s three counties. The staff positions:

Professional Staff FTE

Disabilities Law Program Sr. Project Director 0.08

Executive Director 0.01

C.F.O 0.04

Accountant 0.04

Attorneys

New Castle County 1 Senior Attorney 0.32

New Castle County 3 Attorneys 0.17

Kent County 2 Attorneys 0.07

Sussex County 2 Senior Attorneys 0.16

Paralegal

New Castle County 4 Paralegals 0.31

Kent County 2 Paralegals 0.01

Sussex County 1 Paralegal 0.31

Administrative Assistant 0.20

Clerical Staff

Legal Secretary FTE

New Castle County 1 Office Manager/Legal Secretary 0.04

Intake Receptionist 1 0.04

Kent Count 1 Office Manager/Legal Secretary 0.04

Sussex County 1 Office Manager/Legal Secretary 0.04

The Executive Director, Chief Financial Officer, Accountant, Administrative Assistant, and Legal Secretary positions are representative of the administrative and clerical positions that provided support to the legal staff. In addition to these positions, the intake receptionists and additional secretaries worked with the program in each county.

D. Involvement with Advisory Board

The DLP maintains a separate PAIR Advisory Council. The Council meets three times a year. In FY 16 the Council met on November 4, 2015; February 3, 2016; and July 13, 2016. The membership includes both consumer and agency representatives, including the following: CAP Director, Division of Services for Aging & Adults with Physical Disabilities representative, Division of Vocational Rehabilitation Administrator, Delaware Assistive Technology Initiative director, and State Council for Persons with Disabilities Administrator. The Council reviews and approves priorities and the annual report. At each meeting, DLP staff provided a written and oral statistical update, advocacy update, and Project Director's report. The Council provides input and advice on current issues affecting persons with disabilities.

E. Grievances Filed

There were no grievances filed during the fiscal year.

F. Coordinating with the CAP & Long-term Care Ombudsman

The DLP maintains a positive relationship with both the CAP and Long-term Care Ombudsman. The CAP Director serves on the DLP's PAIR Advisory Council and the DLP supplements CAP advocacy in the vocational rehabilitation context as follows:

1. DLP staff member serves as the Chair of the Dept. of Labor’s Division of Vocational Rehabilitation [“DVR”] advisory council;

2. DLP staff serve on the DVR Client Services Policy Committee, Membership Committee, Government Relations Committee, State Plan Committee, and Annual Report Committee;

3. DLP Director and CAP representative serve together on the State’s special education council, the Governor’s Advisory Council for Exceptional Citizens;

4. DLP Project Director and CAP Director serve together on the State Council for Persons with Disabilities Policy & Law Committee which acts on the DLP’s monthly critiques of legislative, regulatory, and policy initiatives;

5. DLP staff responds to CAP requests for technical information on matters within the DLP’s particular expertise;

6. DLP staff screens CAP referrals on matters outside the CAP’s mandate; and

7. DLP staff offers independent or collaborative training on the vocational rehabilitation system on request.

A representative of the state agency administering the Ombudsman program serves on the DLP’s PAIR advisory council and the DLP supports and supplements Ombudsman advocacy as follows:

1) DLP responds to Ombudsman requests for technical assistance;

2) DLP staff offers independent and collaborative training on abuse, neglect, and rights of constituents.

3) DLP staff and the Ombudsman serve together on the State Nursing Home Residents Quality Assurance Commission.

4) DLP Project Director and Ombudsman representative serve together on State Council for Persons with Disabilities Policy & Law Committee.

Certification

Signed?Yes
Signed ByBrian Hartman
TitleSenior Project Director
Signed Date12/14/2016