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

Michigan (MICHIGAN PROTECTION AND ADVOCACY SERVICES, INC. -- CLIENT ASSISTANCE PROGRAM) - H240A160023 - FY2016

General Information

Designated Agency Identification

NameMichigan Protection and Advocacy Service Inc.
Address4095 Legacy Parkway
Address Line 2Suite 500
CityLansing
StateMichigan
Zip Code48911
E-mail Addressecerano@mpas.org
Website Addresshttp://www.mpas.org
Phone517-487-1755
TTY 517-374-4687
Toll-free Phone800-288-5923
Toll-free TTY
Fax517-487-0827
Name of P&A Executive DirectorElmer L. Cerano
Name of PAIR Director/CoordinatorMark A. Cody
Person to contact regarding reportMark A. Cody
Contact Person phone517-487-1755
Ext.628

Part I. Non-Case Services

A. Individual Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Individuals receiving I&R within PAIR priority areas320
2. Individuals receiving I&R outside PAIR priority areas1,559
3. Total individuals receiving I&R (lines A1 + A2)1,879

B. Training Activities

1. Number of trainings presented by PAIR staff4
2. Number of individuals who attended training (approximate)119

Training - Access & Disability Issues - Flint - 4/19/2016 63 Training - Allegiance Health Forensic Nursing (SANE) Training - Jackson - 1/20/2016 23 Training - Forensic Nursing (SANE) Conference - 11/18/2015 19 Training - Oakland University Nursing Program - 11/10/2015 14

C. Information Disseminated to the Public

1. Radio and TV appearances by PAIR staff4
2. Newspaper/magazine/journal articles0
3. PSAs/videos aired0
4. Hits on the PAIR/P&A website39,495
5. Publications/booklets/brochures disseminated1,410
6. Other (specify separately)0

Narrative

6. Other (specify separately) Other activities funded by PAIR, as well as other MPAS funding sources, include: In addition, MPAS has 1,635 Facebook likes, including 263 new likes this fiscal year. MPAS also provided advance directive information upon request to 194 individuals.

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)25
2. Additional individuals served during the year20
3. Total individuals served (lines A1 + A2)45
4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)1

B. Individuals served as of September 30

Carryover to next FY may not exceed total on line II. A.3 above 20

C. Problem Areas/Complaints of Individuals Served

1. Architectural accessibility2
2. Employment2
3. Program access2
4. Housing3
5. Government benefits/services0
6. Transportation0
7. Education0
8. Assistive technology2
9. Voting0
10. Health care5
11. Insurance0
12. Non-government services1
13. Privacy rights0
14. Access to records0
15. Abuse4
16. Neglect24
17. Other0

D. Reasons for Closing Individual Case Files

1. Issues resolved partially or completely in individual favor13
2. Other representation found0
3. Individual withdrew complaint1
4. Appeals unsuccessful5
5. PAIR Services not needed due to individual's death, relocation etc.1
6. PAIR withdrew from case1
7. PAIR unable to take case because of lack of resources0
8. Individual case lacks legal merit2
9. Other3

Please explain

These service requests were initially opened as PAIR eligible, but closed and reopened to a different funding source upon receipt of additional information.

E. Intervention Strategies Used in Serving Individuals

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

1. Technical assistance in self-advocacy0
2. Short-term assistance2
3. Investigation/monitoring13
4. Negotiation1
5. Mediation/alternative dispute resolution0
6. Administrative hearings0
7. Litigation (including class actions)10
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 - 220
3. 23 - 5912
4. 60 - 646
5. 65 and over27

B. Gender of Individuals Served

Multiple responses not permitted.

1. Females21
2. Males24

C. Race/Ethnicity of Individuals Served

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race0
2. American Indian or Alaskan Native0
3. Asian1
4. Black or African American15
5. Native Hawaiian or Other Pacific Islander0
6. White29
7. Two or more races0
8. Race/ethnicity unknown0

D. Living Arrangements of Individuals Served

Multiple responses not permitted.

1. Independent9
2. Parental or other family home0
3. Community residential home2
4. Foster care0
5. Nursing home31
6. Public institutional living arrangement1
7. Private institutional living arrangement0
8. Jail/prison/detention center2
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 impairment2
2. Deaf/hard of hearing2
3. Deaf-blind0
4. Orthopedic impairment7
5. Mental illness1
6. Substance abuse0
7. Mental retardation0
8. Learning disability1
9. Neurological impairment20
10. Respiratory impairment5
11. Heart/other circulatory impairment5
12. Muscular/skeletal impairment0
13. Speech impairment0
14. AIDS/HIV2
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 activities2

2. Number of individuals potentially impacted by policy changes39,447

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

According to the Kaiser Family Foundation, at the end of Fiscal Year 2014, there were 39,447 residents in Michigan's 434 certified nursing facilities. Each one of these residents is a beneficiary of the work of MPAS. 1. Statewide Nursing Home Investigations: Statewide Nursing Home Investigations: Funded in part by PAIR, as well as other P&A funding, MPAS has assigned specific staff to review reports of the licensing and survey agency of the State of Michigan. If, upon review, it appears there is probable cause to believe a resident has been subjected to abuse and/or neglect, MPAS obtains relevant records, by either using our access authority or with the consent of the resident or his/her authorized representative. In addition to the records provided by the facility, MPAS staff also obtain records from other sources. These could include the county medical examiner, law enforcement, hospitals, etc. These records are reviewed and, if MPAS believes abuse/neglect has occurred, a complaint is filed with state agencies such as the Bureau of Professional Licensing and the Bureau of Community and Health Systems. Once a complaint is filed, MPAS staff track the complaint to determine whether the state agency has found that abuse/neglect has occurred and, if so, whether appropriate disciplinary action has been ordered. Typically, if there are sanctions, they are imposed on the nursing facility staff. These sanctions can include the imposition fines, mandatory continuing education, probation and a temporary or permanent ban on working in a nursing facility. In total, in FY 2016, 195 surveys were reviewed. Eleven service requests were opened and 30 projects were opened for investigation. Interestingly, the average number of deficiencies cited by Michigan nursing facility state survey teams decreased from 11.9 per facility in calendar year 2011 to 9.7 per facility in 2014. However, the rate of which complaints are received by MPAS has remained steady, forcing us to re-evaluate our strategies for FY17. As an example of the impact of this project, an 80 year old woman in a nursing facility was injured and ultimately died due to those injuries when her staff failed to follow her care plan. The care plan detailed the proper use of a mechanical lift. The aide was found to have neglected the woman and the aide is no longer allowed to work in facilities that accept Medicare or Medicaid. In FY2016, to obtain records needed for nursing facility investigations, MPAS lawyers filed suit against four nursing facilities and one hospital. These suits were filed only after MPAS clearly put the facilities on notice as to our records access authority. In each case, the facility provided the requested records shortly after filing of the litigation.

B. Litigation/Class Actions

1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts20,150
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.

This lawsuit was brought on behalf of a woman who is blind and dependent on government benefits. The state requires beneficiaries to regularly report income and other information. The forms provided to beneficiaries are in standard format. The client needed them to be in Braille, but the state refused. Suit was filed and the state agreed to change its policies and now provides required state forms to beneficiaries in Braille. The National Federation of the Blind estimates the prevalence rate of blindness in adults to be 2.3%. The Michigan Department of Health and Human Services provides food stamps to 876,000 recipients each month. Therefore, the estimated number of individuals who will benefit from this change in policy is 20,150.

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.

Part V. PAIR'S Priorities and Objectives A. Priorities and Objectives for the Fiscal Year Covered by this Report For each of your PAIR program priorities for the fiscal year covered by this report, please: 1. Identify and describe priority. 2. Identify the need, issue or barrier addressed by this priority. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. 5. Provide the number of cases handled under the priority. Indicate how many of these, if any, were class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. A. Priority: Eliminate Abuse and Neglect 1. Describe the priority. Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities that are virtually unregulated. Abuse/neglect is especially prevalent in nursing facilities. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. If abuse and/or neglect is confirmed, whether appropriate corrective measures are taken to prevent future incidents. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS works collaboratively with the Office of Recipient Rights of the Michigan Department of Health and Human Services, the State Long Term Care Ombudsman, and licensing and certification agencies. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Thirty cases, no class actions. Note: PAIR funding is used to support much of this project. Individual cases are funded by the relevant funding source. 6. Provide at least one case summary that demonstrates the impact of the priority. MPAS investigated the treatment of a resident in a nursing facility. After investigation, a complaint was filed with the Bureau of Professional Licensing. The complaint alleged that nursing staff failed to properly and timely assess the resident's health and to report changes to the facility physician. These failures lead to the death of the resident. While MPAS promptly filed its complaint against the two LPNs who should have reported a change in the resident's condition, it took BPL approximately one year to finalize its investigation. BPL found both LPNs to have been negligent, placed both on probation, imposed a fine on both, and required both to take continuing education. However, the delay between filing of the complaint and the final action means the two LPNs could continue to work in nursing facilities for a year without oversight. At the close of the fiscal year, MPAS was actively reviewing records of five individuals to determine whether there was enough evidence to support a professional licensing complaint. The Bureau of Professional Licensing was investigating complaints that had been filed against six providers and the Michigan Attorney General was investigating complaints that had been filed against a nurse. A. Priority: Increase the Protection of Individual Rights, Independence and Self-Determination 1. Describe the priority. Advocate for effective systems and proceedings to safeguard the personal and service rights of consumers. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities frequently have their civil rights compromised by ineffective rights protection systems and overreaching guardians. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client received effective assistance from rights protection systems and/or whether the client was protected from a loss of personal rights as a result of a guardianship. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. No collaboration. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. No cases. 6. Provide at least one case summary that demonstrates the impact of the priority. N/A A. Priority: Eliminate Employment Barriers and Protect Rights 1. Describe the priority. To ensure that consumers have access to competitive employment and their rights under state and federal law are protected. 2. Identify the need, issue, or barrier addressed by this priority. Nationwide, the data indicate persons with disabilities continue to be underemployed and unemployed compared to persons without an identified disability. Although legal protections exist to address this issue, individuals with disabilities are most likely to receive assistance and representation from the private bar when they have been discharged from employment. For these individuals, legal assistance that is most effective focuses on negotiating reasonable accommodations with an employer prior to discharge. Unfortunately, many individuals with significant disabilities are unable to secure legal representation for any employment related issue. Finally, many individuals with disabilities are employed in settings that allow for deviated wages based on level of productivity and, as a result, they are not compensated as fully as is required by law for individuals in other settings. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to secure or maintain competitive employment. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. None. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. One case, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. MPAS represented a client who had disclosed to his employer that he is HIV+. Within days of the disclosure, he was discharged from employment. Because his employer had fewer than 15 employees, the Americans with Disabilities Act was not available to him. As the county in which he was working in is both small and conservative, MPAS initially filed a complaint with the Michigan Department of Civil Rights. MDCR proved to be of little assistance and suit was filed in state court. After much effort, we were able to negotiate a favorable settlement for the client. A. Priority: Improve Access to Services 1. Describe the priority. Advocacy for services to maintain consumers in the community and for obtaining accommodations in accessing critical services. 2. Identify the need, issue, or barrier addressed by this priority. Particularly in a time of severe funding shortages, the availability of services and supports for consumers is being compromised. In addition, many providers of critical services, such as hospitals, units of local government, etc. are not making needed physical and/or programmatic accommodations. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to gain or maintain needed services. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS worked with the State Long Term Care Ombudsman on cases involving termination of services provided through the Home and Community Based Services Nursing Facility Waiver. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. Thirteen cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. Our client, a woman with a seizure disorder, moved into a domestic violence shelter. Unfortunately, the shelter had a policy that prohibited residents from having a service animal on the premises. This client needed her service animal, as it assisted her in recognizing when she was about to experience a seizure and helped steady her. An MPAS attorney was able to convince the shelter to change its policy to comply with the ADA. In another case, our client had been providing what are referred to as Home Help Services to her adult son. However, the state agency that administers this program determined that, as she is seriously visually impaired, she could not perform the tasks required of someone in that position. This determination was made, even though she had been providing assistance to her son for years. When the state refused to budge, suit was filed in federal court, asserting violations of the ADA. MPAS retained a vocational expert who opined that the client was fully capable of performing the essential tasks. Shortly thereafter, the state agreed to a monetary settlement and a return to work for our client. A. Priority: Ensure the Right to a High Quality Education 1. Describe the priority. Advocacy to ensure students with disabilities receive the highest and best education possible and they will be fully prepared for entry into the competitive workforce. 2. Identify the need, issue, or barrier addressed by this priority. Students with disabilities are too often placed in segregated learning environments, are suspended, or expelled for disability-related conduct, or are not adequately prepared for work. 3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority. Whether the client was able to gain or retain access to general education or is prepared to enter the workforce. 4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration. MPAS works closely with the Pediatric Advocacy Clinic at the University of Michigan Law School. We work with them to develop litigation strategies. 5. Provide the number of cases handled under this priority. Indicate how many of these, if any, were class actions. No cases, no class actions. 6. Provide at least one case summary that demonstrates the impact of the priority. N/A

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.

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 priority; 2. the need addressed by each priority; and; 3. a description of the activities to be carried out under each priority. B. Priority: Eliminate Abuse and Neglect 1. Describe the priority. Prevent consumers from being subjected to restraint and/or seclusion or otherwise abused and/or neglected. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities too often are subjected to abuse and/or neglect. This can occur in facilities or in the community. When abuse/neglect occurs in a nursing facility and is investigated by the state agencies, there are frequently long delays between the time when a complaint is filed and sanctions are imposed. Those delays mean that staff ultimately found to have committed abuse and/or neglect are allowed to continue working in a nursing facility with residents who are vulnerable individuals. In addition, the use of restraint and/or seclusion is an ongoing problem, particularly in schools and some types of facilities where regulations are ineffective in curtailing these practices. 3. Description of the activities to be carried out. Educate policymakers in an effort to establish better measures to protect consumers and to eliminate the use of restraint and/or seclusion; investigate suspected abuse/neglect cases and follow-up as needed; and file appropriate litigation. B. Priority: Increase the Protection of Individual Rights, Independence, and Self-Determination. 1. Describe the priority. Advocate for effective systems and proceedings to safeguard the rights of consumers. 2. Identify the need, issue, or barrier addressed by this priority. People with disabilities frequently have their civil rights compromised by overreaching guardians and representative payees. In Michigan, as of calendar year 2015, there are approximately 33,000 adults under a guardianship order. This does not include individuals with a developmental disability. There is little to no oversight of these guardians, many of whom have 100 or more individuals for whom they have been appointed. As an example of the extent of the authority granted to these guardians, Michigan law was amended three years ago to allow guardians to execute do-not-resucitate orders for their wards. All that the guardian must do is to confer with a physician, meet with their ward, and determine whether the ward is capable of meaningful communication (an undefined term.) The guardian may then sign the order. All this occurs with no court oversight. 3. Description of the activities to be carried out. Advocacy in individual cases involving allegations of interference with the exercise of the right to vote, denial of marriage, or the loss of other civil rights by a guardian. Advocacy to challenge the refusal by a court to recognize the validity of an alternative to guardianship. Advocacy in cases where there are allegations of abuse, neglect, significant financial exploitation, or forced treatment by a guardian or rep payee. Training of consumers, advocates, and family members on alternatives to guardianship, such as supported decision-making. Provide information and forms that will enable consumers to create advance directives for both health care and mental health cares. Provide information and training on voting rights. B. Priority: Eliminate Employment Barriers and Protect Rights 1. Describe the priority. Ensure that consumers have access to competitive employment and their rights under state and federal law are protected. 2. Identify the need, issue, or barrier addressed by this priority. The enactment of Workforce Innovation and Opportunity Act (WIOA) is an important recognition of the right of persons with disabilities to employment in the competitive market. Decades of indifference to this right has left structural impediments to the full inclusion of persons with disabilities in the workplace. Consumers expect that MPAS will be a forceful advocate for their employment rights. 3. Description of the activities to be carried out. Provide technical assistance to clients to assist them in securing needed accommodations prior to termination from employment or as applicants for employment. Advocate for full implementation of WIOA; challenge the use of sheltered workshops, particularly those that rely on 14c waivers; and advocate for supported employment. Representation in individual or systemic litigation to challenge placement in segregated work settings Advocate for elimination of the sub-minimum wage. B. Priority: Improve Access to Services 1. Describe the priority. Advocate for services to maintain consumers in the community, for accommodations needed to access critical services, and for discharge planning including access to services in facilities (e.g. nursing homes). 2. Identify the need, issue, or barrier addressed by this priority. There are approximately 11,000 individuals who receive services through the MiChoice Program, Michigan's Home and Community Based Waiver for individuals who would otherwise be confined to nursing facilities. The main service provided through the MiChoice program is community living supports (CLS.) CLS staff assist consumers in their homes and in the community. Access to competent CLS staff is critical to the success of the MiChoice program and to the safety and full inclusion of its participants. However, it is becoming apparent that the MiChoice program will soon be unable to meet the demand for staffing, as the stagnant wages paid to CLS staff have not kept pace with other sectors of the slowly improving economy. Without drastic measures, consumers will experience either a refusal by the MiChoice Program to serve them or a sharp reduction in staffing. In addition, the State of Michigan will likely begin funding all long term care services and supports through a managed care system. This could have a substantial impact on consumers and will require close monitoring by MPAS and advocacy, as needed. 3. Description of the activities to be carried out. Representation in individual and systemic cases involving denial, reduction or termination of critical services needed to avoid institutionalization or to secure discharge to the community. Advocate for full implementation of the Home and Community Based Waiver rules issued by CMS that will result in more integrated living for individuals with disabilities. Advocate for accommodations needed for access to critical services. B. Priority: Ensure the Right to a High Quality Education 1. Describe the priority. Advocate to ensure students with disability-related behavior remain in school and students will receive appropriate transition services to be fully prepared for entry into the integrated and competitive workforce. 2. Identify the need, issue, or barrier addressed by this priority. Students with challenging disability related behavior are too often placed in segregated learning environments, suspended, or expelled for disability-related conduct, or are not adequately prepared for work. 3. Description of the activities to be carried out. Advocacy in systemic and individual cases and policy advocacy with a focus on effective transition services; elimination of disability-related removals; and effective child find practices.

Part VI. Narrative

At a minimum, you must include all of the information requested. You may include any other information, not otherwise collected on this reporting form that would be helpful in describing the extent of PAIR activities during the prior fiscal year. Please limit the narrative portion of this report, including attachments, to 20 pages or less.

The narrative should contain the following information. The instructions for this form outline the information that should be contained in each section.

  1. Sources of funds received and expended
  2. Budget for the fiscal year covered by this report
  3. Description of PAIR staff (duties and person-years)
  4. Involvement with advisory boards (if any)
  5. Grievances filed under the grievance procedure
  6. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency

A. Sources of funds received and expended: U.S. Department of Education (FY 2014-2015) ($23,007) U.S. Department of Education (FY 2015-2016) $454,929 MPAS Program Income $2,280 Total Available for FY 2016 $480,216 Total expended for FY 2016 $411,463 B. Budget 2016 Actual 2017 Projected Admin $41,763 $ 47,304 Services $359,370 $403,946 Other $ 10,330 $ 11,000 Total $441,463 $462,250 C. Description of PAIR staff (duties and person-years) 1. Duties PAIR funding supports attorneys, advocates, support staff, information technology staff, public policy, and finance and administration staff. Advocates provide information and referral services, monitoring, investigations, and direct representation of clients. The legal team supports the work of the advocates on issues that have come to their attention through calls to the agency or from monitoring. For example, when advocates have been unable to secure records from a facility, the legal team intervenes and, if needed, files litigation to enforce the records access provisions of federal law. The work of the legal team includes the filing of class action litigation, filing of amicus briefs, etc.. 2. Person-Years PAIR had 4.83 FTEs of direct advocacy staff during FY 2016. PAIR pays a federally approved indirect cost rate of 11.4%, which funds administration, finance, human resources, and information systems. D. Involvement with advisory boards (if any) MPAS staff was actively involved with the Statewide Independent Living Council, the Michigan Disability Housing Workgroup, the Michigan Disability Rights Coalition, the Community Housing Network, and the Olmstead Coalition. In addition, the MPAS CAP Director serves as the Chair of the Michigan Rehabilitation Council, the mandated advisory group to Michigan Rehabilitation Services. E. Grievances filed under the grievance procedure MPAS received no grievances from PAIR-eligible consumers. F. Coordination with the Client Assistance Program (CAP) and the State long-term care program, if these programs are not part of the P&A agency. The CAP is part of MPAS. MPAS works in cooperation with the State Long Term Care Ombudsman. The State Long Term Care Ombudsman program has been hampered in its work as, through the end of FY 2016, it was housed in state government. However, beginning in FY 2017, it will be housed with the Michigan Advocacy Project and will be independent of state government. Hopefully this will allow it to more aggressively advocate for the rights of nursing facility residents.

Certification

Signed?Yes
Signed ByElmer L. Cerano
TitleMPAS Executive Director
Signed Date12/15/2016