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

Indiana (INDIANA P and A SERVICES) - H240A160015 - FY2016

General Information

Designated Agency Identification

NameIndiana Protection and Advocacy Services
Address4701 N. Keystone Ave.
Address Line 2Suite 222
Zip Code46205
Website Address
TTY 317-722-5563
Toll-free Phone800-622-4845
Toll-free TTY800-838-1131
Name of P&A Executive DirectorDawn Adams
Name of PAIR Director/CoordinatorDawn Adams
Person to contact regarding reportDawn Adams
Contact Person phone317-722-5555

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 areas24
2. Individuals receiving I&R outside PAIR priority areas833
3. Total individuals receiving I&R (lines A1 + A2)857

B. Training Activities

1. Number of trainings presented by PAIR staff0
2. Number of individuals who attended training (approximate)0


C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff4
2. Newspaper/magazine/journal articles2
3. PSAs/videos aired6
4. Hits on the PAIR/P&A website18,315
5. Publications/booklets/brochures disseminated0
6. Other (specify separately)11


This year the P&A revamped the organization, recalled publications, and are in the process of updating publications and making them electronically accessible. The "other" designation includes presentations to groups as to the overall work of the P&A, including PAIR and the other 7 programs.

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)31
2. Additional individuals served during the year10
3. Total individuals served (lines A1 + A2)41
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)0

B. Individuals served as of September 30

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

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility2
2. Employment9
3. Program access0
4. Housing5
5. Government benefits/services9
6. Transportation1
7. Education6
8. Assistive technology0
9. Voting0
10. Health care1
11. Insurance0
12. Non-government services0
13. Privacy rights0
14. Access to records0
15. Abuse1
16. Neglect4
17. Other4

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor29
2. Other representation found0
3. Individual withdrew complaint3
4. Appeals unsuccessful0
5. PAIR Services not needed due to individual's death, relocation etc.2
6. PAIR withdrew from case2
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit5
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-advocacy5
2. Short-term assistance31
3. Investigation/monitoring2
4. Negotiation0
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)2
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 - 2210
3. 23 - 5918
4. 60 - 6411
5. 65 and over2

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females24
2. Males17

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race1
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American8
5. Native Hawaiian or Other Pacific Islander0
6. White32
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent24
2. Parental or other family home12
3. Community residential home0
4. Foster care0
5. Nursing home1
6. Public institutional living arrangement0
7. Private institutional living arrangement0
8. Jail/prison/detention center4
9. Homeless0
10. Other living arrangements0
11. Living arrangements not known0

E. Primary Disability of Individuals Served

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

1. Blind/visual impairment7
2. Deaf/hard of hearing9
3. Deaf-blind0
4. Orthopedic impairment12
5. Mental illness1
6. Substance abuse0
7. Mental retardation0
8. Learning disability0
9. Neurological impairment7
10. Respiratory impairment0
11. Heart/other circulatory impairment5
12. Muscular/skeletal impairment0
13. Speech impairment0
15. Traumatic brain injury0
16. Other disability0

Part IV. Systemic Activities and Litigation

A. Systemic Activities

1. Number of policies/practices changed as a result of non-litigation systemic activities0

2. Number of individuals potentially impacted by policy changes0

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.


B. Litigation/Class Actions

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

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

The P&A has 2 open litigation cases that have not closed. Those will be reported on in the next fiscal year, provided they are closed at that time.

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. 1. Priority 1: Reduce or eliminate abuse and neglect of individuals with disabilities. A. 2. The issue addressed the abuse and neglect of people with disabilities. A. 3. Successful outcomes are the identification of abuse/neglect and ensuring changes for the victim so that abuse/neglect is eliminated from the person's life. A. 4. Yes, the P&A collaborates with other investigative agencies including, but not limited to, the state health department, the family and social services administration, Medicaid fraud licensing agency, attorney general, department of justice, and federal bureau of investigation. A. 5. 5 abuse/neglect cases were handled. None were class actions. A. 6. A nursing aid assigned to conduct routine patient checks found patient lying on the floor naked. The resident in question was allegedly on top of her (also naked) sodomizing her with his hand. The patient, who has MS, was unable to fight off or scream for help because she is in a catatonic state and is paralyzed on the entire left side. She also has clearly visible open wounds on her buttocks and other areas due to ongoing neglect she has been subjected to. The administrator stated that initially there was no investigation conducted as it was not an allegation of abuse. Upon being notified of an investigation by the Indiana State Department of Health, the facility conducted an investigation, and the reporter was suspended and eventually terminated for not reporting an allegation of abuse according to facility policy. No other staff involved were suspended or terminated. P&A conducted an investigation into the incident and reported this incident to the Indiana State Department of Health (ISDH) upon receipt of the allegation. ISDH conducted an investigation and issued an immediate jeopardy regarding supervision. The complaint survey was conducted and an Immediate Jeopardy was issued by ISDH the following day. The facility was notified of the Immediate Jeopardy at 7:05 pm on that day. The immediate Jeopardy was issued for tag F0323, Free of Accident Hazards/Supervision/Devices. The Immediate Jeopardy was released when the alleged perpetrator was discharged from the facility. The facility remained out of compliance but did not meet the level of Immediate Jeopardy. The facility disputed the Immediate Jeopardy as they did not feel that the alleged perpetrator was a danger to anyone else as he did not target other people. A follow up survey was conducted 2 months later and the facility remained out of compliance. ISDH provided notice to the facility that “based on the deficiencies cited during this survey, the Division is giving notice of imposition of the following remedy, as authorized by the Centers for Medicare and Medicaid Services (“CMS): Mandatory Denial of Payment for New Admissions previously imposed continues.” Other recommended remedies, “Because the facility was not in substantial compliance, the follow remedies will be recommended to CMS and/or the Office of Medicaid Policy and Planning (“OMPP”) for imposition:-Civil Money Penalty previously recommended in the amount of three thousand nine hundred and fifty ($3,950) dollars for one day, continuing at a rate of two hundred and fifty ($250) dollars per day until the facility achieves substantial compliance continues.” Further, “Mandatory Remedy for Continued Noncompliance-The Division will recommend to CMS and/or OMPP that the facility’s provider agreement be terminated if substantial compliance is not achieved by that date.” ISDH accepted the Corrective Action Plan submitted. In a later survey report the complaints were listed as corrected. It should be noted that the annual survey was conducted 2 months later. There were several violations found, but did not include the F0323 tag cited in this investigation. The Medicaid Fraud Control Unit (MFCU) was also contacted and conducted an investigation. At last report they were going to attempt to remove the professional licenses from the administrator, director of nursing and possibly a registered nurse based on the poor investigation practices that were conducted following an allegation of abuse. B. 1. Priority 2: Reduce or eliminate discrimination or the denial of rights due to disability. B. 2. The issue addressed is rights discrimination of people with disabilities. B. 3. Successful outcomes are indicated when the client has received the services requested by the client from the agency/party that has been violating the person's rights. B. 4. Yes, the P&A collaborates with other organizations in the community including, but not limited to, Indiana Fair Housing Alliance of Central Indiana and IN*Source (education advocacy organization for parents). B. 5. 36 cases were handled and none of them were class actions. B. 6. Client contacted P&A for legal advocacy after being told by a government entity that they would not provide an ASL interpreter for the vocational training sessions offered by the entity. Employee of entity told her she would have to bring her own interpreter. P&A advocated on behalf of the client and entity agreed to provide an ASL interpreter for any training session client selected. C. 1. Priority 3: Increase awareness and effective self-advocacy by providing education and training about disability rights and the exercise of these rights. C. 2. The issue addressed was the general lack of awareness of the P&A and a need to ensure people with disabilities have effective self-advocacy tools. C. 3. Measurable indicators have not been identified to date. C. 4. Yes, the P&A collaborates with the DD network partners and the Self Advocates of Indiana. C. 5. N/A - this is not a case-based priority C. 6. N/A - this is not a case-based priority

B. Priorities and Objectives for the Current Fiscal Year

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

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

Priority 1: Reduce or eliminate abuse and neglect of individuals with disabilities. NEED: Abuse and neglect of people with disabilities. ACTIVITIES: Investigations. Priority 2: Reduce or eliminate discrimination or the denial of rights due to disability. NEED: People with disabilities experience discrimination at work, school, and in the community. ACTIVITIES: Legal advocacy on behalf of the individual. Priority 3: Increase awareness and effective self-advocacy by providing education and training about disability rights and the exercise of these rights. NEED: Increase awareness of the P&A services and support the self-advocacy movement. ACTIVITIES: Continued research and development of electronic resources.

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. Source of Funding Amount Received Amount Spent Federal (section 509) $309,839 $248,233 State $0 $0 Program income $0 $0 Private $0 $0 All other funds (2014 Carryover) $86,182 $86,182 Total (from all sources) $396,021 $334,415 B. Category Prior Fiscal Year Current Fiscal Year Wages/salaries $186,348 $187,000 Fringe benefits (FICA, unemployment, etc.) $92,112 $93,000 Materials/supplies $531 $2,000 Postage $297 $1,000 Telephone Telecommunications $6,512 $7,000 Rent $12,142 $13,000 Travel $6,595 $8,000 Copying & Printing $988 $1,000 Bonding/insurance $801 $1,000 Equipment (rental/purchase) $0 $0 Legal services $0 $0 Indirect costs $0 $0 Miscellaneous $28,089 $29,000 Total Budget $334,415 $342,000 C. Description of PAIR staff During the 2016 federal fiscal year, Indiana Protection and Advocacy Services (IPAS) employed 25 staff members. IPAS administers eight federally funded advocacy programs: Client Assistance Program (CAP), Protection & Advocacy: Assistive Technology (PAAT), Protection & Advocacy for Beneficiaries of Social Security (PABSS), Protection & Advocacy: Developmental Disabilities (PADD), Protection & Advocacy for Individuals with Mental Illness (PAIMI), Protection & Advocacy of Individual Rights (PAIR), Protection & Advocacy: Traumatic Brain Injury (PATBI), Protection & Advocacy: Voting Access (PAVA). All staff members work under all eight programs as needed. The time reporting system utilized by IPAS requires staff to closely track and report their work activities under each program. Biweekly, each staff member accounts for the amount of time worked in each program. This accounting is used to determine the portion of each staff member’s salary and benefits paid by each of the federal programs for that biweekly period. This cost allocation approach ensures that each funding source supports only those activities and expenses which are authorized under that source’s legislation and regulations. The number and type of positions are listed here: 1 Executive Director; 1 Chief Financial Officer; 1 Legal Services Director; 1 Director of Communication & Outreach; 1 Managing Attorney; 4 Staff Attorneys; 1 Advocate Supervisor; 1 Investigation Coordinator; 2 Intake Advocates; 6 Advocacy Specialists; 1 Communications Specialist; 1 Technology Clerk; 1 Administrative Assistant; 2 Accountants; 1 part-time Project Specialist. D. Involvement with advisory boards (if any) IPAS staff participated in six committees, continuing this year its participation on the ADA Indiana Steering Committee; the Back Home in Indiana Alliance Steering Committee; Indiana Task Force on Disability and Health; the Adult Guardianship Task Force; the Elder Justice Convening; and the Fair Housing Center of Central Indiana Board of Directors. E. Grievances filed under the grievance procedure IPAS had 2 grievances filed during FY2016, concerning the denial of the agency to not open cases for the individuals. Upon appeal, it was confirmed that the cases did not have merit. F. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency The Client Assistance Program (CAP) administered by IPAS. The Indiana Family and Social Services Administration, Division of Aging administers the State long-term care program. IPAS has an on-going arrangement with the administering agency based on a prior written agreement, which defined coordination and referrals between all IPAS programs and the State long-term care ombudsman program


Signed ByDawn Adams
TitleExecutive Director
Signed Date12/21/2016