|Name||Georgia Advocacy Office Inc.|
|Address||One West Court Square|
|Address Line 2||Suite 625|
|Name of P&A Executive Director||Ruby K. Moore|
|Name of PAIR Director/Coordinator||Julie Kegley|
|Person to contact regarding report||Julie Kegley|
|Contact Person phone||404-885-1234|
Multiple responses are not permitted.
|1. Individuals receiving I&R within PAIR priority areas||211|
|2. Individuals receiving I&R outside PAIR priority areas||181|
|3. Total individuals receiving I&R (lines A1 + A2)||392|
|1. Number of trainings presented by PAIR staff||28|
|2. Number of individuals who attended training (approximate)||2,246|
The P & A worked with a diverse coalition of stakeholders looking to advance competitive integrated employment for people with significant disabilities, to design and co-sponsor a national conference in Georgia -called the Evolutions Conference—focused on transforming segregated programs and helping people with disabilities to get real jobs. The P & A Executive Director Ruby Moore was a featured presenter at the conference along with other local and national leaders. Over four hundred (400) people with disabilities, family members, providers, advocates, and state officials attended.
The P & A presented two half-day workshops, one in Decatur and one in Macon, to people with disabilities and their supporters called "A Path to Employment." The P & A shared with the audience a brief overview of employment, how and when to make a request for a reasonable accommodation, and employment circles of support. A WIPA Benefits Navigator shared with the audience how work can affect their benefits. People with disabilities received information on the use of employment to achieve a meaningful day, how to self-advocate for employment, and how to work and still receive benefits. Eight (8) people with disabilities and their supporters attended the Decatur workshop and thirty (30) people with disabilities, their supporters, and Board and staff from the Center for Independent Living attended the Macon workshop. As a result of both workshops, the P & A provided one-on-one technical assistance and direct advocacy assistance to attendees who requested help locating competitive integrated employment.
The P & A presented at the Institute Designed for Educating All Students (IDEAS) Conference on June 8, 2017. Thirty (30) people attended the P & A’s presentation, “Employment, A Pathway to Independence and a Future for Today’s Students,” which was geared to give the audience information how to support students with disabilities to pursue competitive integrated employment opportunities. The presentation gave examples of how to do this by seeking creative ways to increase a student’s interest and knowledge of employment, such as incorporating informal meetings to job sites, including parents, sharing more stories of others who have been successful, and facilitating understanding of how Ticket to Work can affect benefits. Two thirds of the audience was Georgia Vocational Rehabilitation Agency (GVRA) counselors and the others were parents, education professionals and direct support professionals. Additionally, this presentation reached over 100,000 people, as it was posted on the IDEAS conference website. The P & A also hosted an exhibit table that contained information about the P & A and its programs along with voter applications and information. While there, the P & A also supported two young women with developmental disabilities that have developed a greeting card business to sell their cards and to talk about their work with a diverse audience of educators, advocates, people with disabilities, and family members. The IDEAS conference is sponsored by the Georgia Department of Education, Tools for Life and the Georgia Council for Exceptional Children.
The P & A presented at the Southeast Regional Institute on Deafness (SERID) conference. This is a conference that provides workshops and trainings on deaf/deaf-blind issues, designed to educate and promote information about communication, accessibility, education and employment. This conference also addressed accommodations and discrimination in the workplace, how to recognize, address and remedy discrimination for people who are deaf/deaf-blind. The P & A conducted a presentation titled, “Encouraging Employees with Disabilities to Use Self-Advocacy as a Tool to Address Real and Perceived Workplace Discrimination” and discussed self-advocacy in employment. The audience consisted of approximately fifty (50) people with disabilities, as well as Vocational Rehabilitation (VR) counselors, teachers, service providers, regional directors and other stakeholders who provide supports and services for individuals who are deaf/deaf-blind. As a result of this conference, 100,000 people were impacted either by attending, sharing information, or accessing this conference and the information via technology.
The P & A participated in the Northwest Georgia Transition Fair, which provides opportunities for students with disabilities who will be transitioning out of high school to learn about options available as they move into adulthood. The P & A educated one hundred and eight five (185) students about the P & A and the supports and services provided to people with disabilities; specifically, to support people with disabilities to engage in competitive integrated employment. The fair was held at a rural northwest Georgia town and students came from multiple surrounding areas to access information regarding transitioning out of high school.
The P & A supported a Long Road Home event in Fitzgerald, located in remote southern Georgia. The purpose of Long Road Home is to raise awareness about the U.S. Supreme Court Olmstead decision and provide education as to why Olmstead is so important for people with disabilities. Not only is Olmstead about receiving services in the most integrated setting, it is about de-institutionalization and making a difference in the lives of people with disabilities. Long Road Home events feature a freedom story about a person with a disability who has broken free of institutionalization and is living in the community. Long Road Home events also highlight the importance of voting and educating people with disabilities to understand that voting is key to changing the system. One hundred (100) people attended the five-hour Long Road Home event in Fitzgerald, which consisted of a resource fair, lunch and a rally.
The P & A presented to thirty (30) residents of the Cheshire Bridge High Rise who are people with disabilities who have been historically underserved in their local community. The P & A provided information and materials, and educated residents about assistive technology, voting rights, independent living, self-advocacy, and employment. The P & A also provided information about its mission, vision, and values.
Spread the Vote's Executive Director contacted the P & A to present at their Georgia Leadership Training. Spread the Vote is a non-profit working to register people of all political affiliations to vote, and to assist people who have been suppressed from registering to vote, including people with disabilities. The P & A educated thirty (30) Georgia chapter leaders of Spread the Vote about the issues that people with disabilities face in Georgia, including issues with obtaining a form of identification that is acceptable to register to vote.
The P & A supported and provided technical assistance to the Atlanta Chapter of the Autistic Self Advocacy Network (ASAN). The P & A hosted the monthly ASAN meetings in which twelve (12) young advocates with disabilities regularly attend. The P & A provided technical support and mentoring to the Atlanta ASAN chapter members by helping them to think through how to do self-advocacy projects and by connecting them with other self-advocates and other self-advocacy groups. The P & A provided information, materials, and technical assistance to ASAN members during monthly meetings.
The P & A is an active member of the Georgia Inclusive Postsecondary Education Consortium (GAIPSEC), which seeks to create opportunities for students who have historically not had access to post-secondary educational (PSE) opportunities. This year, GAIPSEC invited the P & A to present on supported decision- making and how it relates to transition and IPSE. The meeting participants included twenty (20) IPSE professionals from colleges around the state who have IPSE programs (or who are thinking about starting an IPSE program), the Center for Leadership in Disability, and Vocational Rehabilitation. The P & A presented on alternatives to guardianship, such as supported decision-making, and educated the audience regarding other state’s supported decision-making statutes (e.g. Texas) and the supported decision-making forms that can be used.
The P & A provided training to one hundred and ninety-nine (199) people with psychiatric disabilities in four Georgia cities that are studying to become Certified Peer Specialists (CPS). The P & A educated the CPS trainees on the importance of supporting self-advocates and employing a “do with,” not “for” approach to give guidance and support to individuals with disabilities to meet their goals.
The P & A educated three hundred and seventy-five (375) individuals at two Community Service Boards how to take action on the steps necessary in making a plan to reach their goals of self-determination, and also educated the individuals on the Americans with Disabilities Act, employment, voting, and talking to your doctor.
The P & A presented to a class of twenty (20) individuals with psychiatric disabilities at the DeKalb Community Service Board (CSB). The purpose of the presentation was to educate individuals with psychiatric disabilities about pursuing real jobs in the community and to present them with information to make an informed choice about employment, self-advocacy and accommodations. As a result of this presentation, individuals with disabilities received information on employment options that can lead to obtaining a job. Following the presentation, the P & A collaborated with the supported employment staff at the CSB to conduct follow up meetings with individuals who expressed interest in employment during the presentation. The P& A provided participants with an additional opportunity to make an informed choice about various employment opportunities.
The P & A participated in Mental Health Day at the Capitol, attended by four-hundred (400) people and sponsored by the Behavioral Health Services Coalition. The P & A hosted a table at the event where P & A information and materials were distributed.
The P & A orchestrated a meeting at West Central Georgia Hospital to share with their Therapeutic Work Program staff evidence-based practices in an effort to help them expand the work program at the state hospital. Currently, this work program only caters to in-house segregated employment with marginal hours. The P & A collaborated with a national employment expert, Rich Toscano, to share examples of how to expand employment opportunities by conducting vocational profiles and advocating for release from the premises for work purposes when an individual can be determined “safe.” The meeting concluded with an agreement to follow up with training on a much larger scale, which would include medical professionals, clinical staff, and direct support professionals from the individual’s treatment team.
The P & A conducted six (6) one day introduction workshops to Social Role Valorization (SRV) and some of its main elements called “Power of Roles.” SRV is a theory that contains certain positive assumptions, principles, and practices that have proven to be important as a framework for supporting persons who are at risk of being devalued by society. In particular, it is designed to help participants understand the devaluation process that society and even human service providers perpetuate upon people using services. The one-day workshop assisted participants to understand the power of valued social roles, such as employment, in an effort to counteract some of the effects of devaluation and the importance of assisting people who have been marginalized to have a full, inclusive life. The P & A conducted Power of Roles workshops in six cities within Georgia, with three hundred (300) people in attendance. Participants left with a plan to assist at least one person each to acquire or deepen a valued social role to fully experience being connected, belonging, and having real relationships, all leading to the good things in life.
The 2017 Employment Advocacy Day at the Capitol was for people with disabilities to educate their policy-makers that employment is the key to an independent and integrated life in the community and encourage them to support changes in policy in funding. Ninety-seven (97) people with disabilities and their supporters participated and reached out to nineteen (19) state legislators. In 2015, 19,000 Georgians with intellectual and developmental disabilities were in day and employment programs, as compared with the 2,300 Georgians with intellectual and developmental disabilities who were working in integrated employment settings. By educating legislators as to these facts, people with disabilities hoped to change this practice so that more people with disabilities are in competitive integrated employment settings. People with disabilities and their supporters urged their legislators to commit to significantly increase the percentage of Georgians with disabilities working in competitive integrated settings. They also urged their legislators to join the other thirty-two (32) Employment First states by establishing in law the policy that employment in an integrated setting paying at or above minimum wage is the first and preferred option for people with disabilities. The P & A supported People First of Fitzgerald during Employment Advocacy Day. The P & A also supported a mother and her son to meet with a Senator’s Chief of Staff in his office. The mother and son shared their experiences of the school system not treating the son as able to do things, such as go to work. The Employment Advocacy Day was sponsored by the Georgia Council on Developmental Disabilities and the Arc of Georgia.
IPSE provides opportunities for students with intellectual disabilities to access higher education. This prepares them to live increasingly independent lives and pursue careers of their choice.
With legislative support, the number of Georgia IPSE programs has grown from one (1) to seven (7), with four (4) more to open in the next two (2) years. Students who attend IPSE programs have far better employment outcomes than their peers who do not. Specifically, students who attend IPSE make 73% higher weekly incomes than those who only go through vocational rehabilitation. But IPSE students cannot access many of the resources available to typical college students. For Fiscal Year 2018, the IPSE ask was for (1) $300,000 of new funding; specifically, to support the sustainability of IPSE programs in Georgia and increase student access to these programs. The P & A supported forty-one (41) students from several IPSE programs in the state to speak with their local representative, as well as with representatives on the Human Resources subcommittee, regarding the ask for increased IPSE funding. The IPSE Advocacy Day was sponsored by the Georgia Council on Developmental Disabilities and the Arc of Georgia.
The P & A supported individuals with disabilities to participate in Home and Community Day at the Capitol. The P & A’s objective was to assist people with disabilities in using self-advocacy skills to advocate for or against legislation in the Georgia House and Senate that impacts the services and supports that people receive. Self-advocates were educated on issues regarding the “Elder and Disabled Abuse” Registry; the Offensive Language Act—specifically, to remove the word "mental retardation" from Georgia's criminal law statutes and to replace it with "intellectual disability;” transportation issues faced by people with disabilities in Georgia; and the Family Leave Act which gives mandatory paid leave for family members to care for family members with disabilities. Following this particular self-advocacy day, a bill to remove the word "Mental Retardation" from Georgia criminal law statutes was passed in both chambers, and has been forwarded to the Governor's desk for signature.
|1. Radio and TV appearances by PAIR staff||0|
|2. Newspaper/magazine/journal articles||9|
|3. PSAs/videos aired||0|
|4. Hits on the PAIR/P&A website||102,522|
|5. Publications/booklets/brochures disseminated||800|
|6. Other (specify separately)||1,976|
The “Other” information disseminated to the public in 6 above is 1976 likes on the P & A’s Facebook page.
The P & A is featured on websites and blogs as a legal advocacy resource. In addition, hundreds of websites feature events involving the P & A.
The P & A, the Children’s Freedom Initiative, and the Parent Leadership Support Project maintain current Facebook pages and websites. Also, some of the Citizen Advocacy offices funded by the P & A maintain websites and Facebook pages.
The Fall 2016 edition of the Georgia Council on Developmental Disabilities (GCDD) publication, Making a Difference Magazine, references GAO’s involvement in the DD network and joint efforts to further the Children’s Freedom Initiative, the statewide campaign to move children out of facilities and into real homes.
The same edition of the magazine features an editorial by P&A Counsel, Alison Barkoff, in which she explains the importance of using and furthering current regulatory structure to realize the vision of integrated employment for everyone. Ms. Barkoff discusses her experience serving with P&A Executive Director Ruby Moore on a federal advisory committee created to provide recommendations on increasing employment opportunities for people with disabilities, and how that committee brought instructions to Congress on how to enact “Employment First” policies and regulations.
On December 22, 2016 the Huffington Post ran an article titled “Disability Rights Advocates Champion Tom Perez For DNC Chair” quoting P&A Counsel, Alison Barkoff. Ms. Barkoff states that “Tom [Perez] really committed the resources of the Department of Labor to make that a success,” when he insisted that President Obama’s executive order raising the minimum wage for workers under federal contracts extend to workers with disabilities.
GAO Executive Director Ruby Moore was featured in GCDD’s winter newsletter in a piece titled “Georgia Evolution Conference Reimagines Opportunities for People with Disabilities.” Ms. Moore was a leadership panel speaker at the conference, aimed at giving providers the tools they need to support all people with disabilities in careers and in the community, including follow-up technical assistance, educating and empowering families and individuals with disabilities and engaging them as active partners in this time of change, and building critical partnerships and collaboration between all players in Georgia’s disability community.
The February 16, 2017 Journal of Vocational Rehabilitation included an extensive research article authored by GAO Executive Director, Ruby Moore. The article, The role of informed choice in advancing competitive integrated employment, reviews current regulation, case law, and policies regarding integrated employment. The piece examines the Workforce Innovation and Opportunity Act (WIOA), the Home- and Community-Based Services (HCBS) Settings Final Rule, two landmark Department of Justice (DOJ) court cases (Oregon and Rhode Island) regarding sheltered workshops, the Olmstead decision by the Supreme Court, and recent interpretations of the Americans with Disabilities Act to better understand the affirmative legal mandate and additional affirmative steps needed to fully secure the right to informed choice regarding employment services and to promote competitive integrated employment.
On March 21, 2017, The Atlantic ran an article titled “The Separate, Unequal Education of Students With Special Needs: Georgia’s system to teach children with disabilities falls vastly short of its promise.” The article quotes P&A Counsel, Leslie Lipson. Ms. Lipson, speaking on children placed in GNETS system, states that “because of their disabilities … these kids need potent, individualized instruction, but instead they’re receiving one-size-fits-all—or what I call ‘one-size-fits-none’—computerized instruction and coercive behavior controls, or warehousing."
On July 28, 2017, in their piece “Disability Advocates Relieved by Failure of Health Bill,” Disability Scoop quotes P&A Counsel Alison Barkoff as saying “We know that the threats to Medicaid and health care are not over…We will continue our fight to protect health care, Medicaid and disability rights.”
On July 28, 2017, Family Voices of California shared an editorial penned by P&A Counsel, Alison Barkoff, in which she opines on the importance of the disability community in banding together and the role that group played in protecting Medicaid in 2017.
On September 4, 2017, the Marietta Daily Journal paraphrased GAO Executive Director. “Children are entitled to receive care so that their medical condition does not deteriorate, notes Ruby Moore, director of the Georgia Advocacy Office, a nonprofit organization based in Decatur that advocates for the developmentally disabled in Georgia.”
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 year||73|
|3. Total individuals served (lines A1 + A2)||104|
|4. Individuals w. more than 1 case opened/closed during the FY. (Do not add this number to total on line A3 above.)||24|
Carryover to next FY may not exceed total on line II. A.3 above 34
|1. Architectural accessibility||1|
|3. Program access||7|
|5. Government benefits/services||37|
|8. Assistive technology||1|
|10. Health care||25|
|12. Non-government services||2|
|13. Privacy rights||3|
|14. Access to records||0|
|1. Issues resolved partially or completely in individual favor||88|
|2. Other representation found||1|
|3. Individual withdrew complaint||8|
|4. Appeals unsuccessful||1|
|5. PAIR Services not needed due to individual's death, relocation etc.||2|
|6. PAIR withdrew from case||0|
|7. PAIR unable to take case because of lack of resources||0|
|8. Individual case lacks legal merit||0|
List the highest level of intervention used by PAIR prior to closing each case file.
|1. Technical assistance in self-advocacy||34|
|2. Short-term assistance||28|
|5. Mediation/alternative dispute resolution||0|
|6. Administrative hearings||1|
|7. Litigation (including class actions)||1|
|8. Systemic/policy activities||0|
|1. 0 - 4||1|
|2. 5 - 22||3|
|3. 23 - 59||71|
|4. 60 - 64||10|
|5. 65 and over||19|
Multiple responses not permitted.
|1. Hispanic/Latino of any race||3|
|2. American Indian or Alaskan Native||2|
|4. Black or African American||61|
|5. Native Hawaiian or Other Pacific Islander||0|
|7. Two or more races||2|
|8. Race/ethnicity unknown||0|
Multiple responses not permitted.
|2. Parental or other family home||8|
|3. Community residential home||4|
|4. Foster care||0|
|5. Nursing home||43|
|6. Public institutional living arrangement||1|
|7. Private institutional living arrangement||2|
|8. Jail/prison/detention center||4|
|10. Other living arrangements||0|
|11. Living arrangements not known||0|
Identify the individual's primary disability, namely the one directly related to the issues/complaints
|1. Blind/visual impairment||14|
|2. Deaf/hard of hearing||14|
|4. Orthopedic impairment||23|
|5. Mental illness||5|
|6. Substance abuse||1|
|7. Mental retardation||2|
|8. Learning disability||0|
|9. Neurological impairment||25|
|10. Respiratory impairment||4|
|11. Heart/other circulatory impairment||6|
|12. Muscular/skeletal impairment||8|
|13. Speech impairment||0|
|15. Traumatic brain injury||1|
|16. Other disability||0|
|1. Number of policies/practices changed as a result of non-litigation systemic activities||13|
|2. Number of individuals potentially impacted by policy changes||632,084|
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.
On July 19, 2017, the P & A Executive Director, Ms. Ruby Moore, testified at a Congressional Hearing and Policy Briefing on Advancing Employment of People with Disabilities and meeting the goals of the Americans with Disabilities Act (ADA) including economic self-sufficiency.
The United States Department of Labor, Office of Disability Employment Policy (ODEP) asked Ms. Moore to write a peer reviewed journal article on Informed Choice. Ms. Moore submitted this to the Journal of Vocational Rehabilitation, an international publication with a readership of over 7500. The article, “The role of informed choice in advancing competitive integrated employment,” was accepted immediately and was fast-tracked to be published. It was included in the February 16, 2017 edition. The piece reviews current regulation, case law, and policies regarding integrated employment. It examines the Workforce Innovation and Opportunity Act (WIOA), the Home- and Community-Based Services (HCBS) Settings Final Rule, two landmark Department of Justice (DOJ) court cases (Oregon and Rhode Island) regarding sheltered workshops, the Olmstead decision by the Supreme Court, and recent interpretations of the Americans with Disabilities Act (ADA) to better understand the affirmative legal mandate and additional action steps needed to fully secure the right to informed choice regarding employment services and to promote competitive integrated employment.
Ms. Moore also contributed to a policy analysis for ODEP on effective practices in the public mental health system for advancing employment for people with significant psychiatric disabilities.
Employment First Georgia (EFG):
The P & A hosts Employment First Georgia (EFG). EFG advocates for the State of Georgia to offer employment as the first and preferred option in day services for people with disabilities. EFG’s objectives include the following: increase the number of people interested and knowledgeable about customized employment in Georgia; work with state agencies towards systems change and capacity development for employment; provide training and technical assistance to individuals, families, providers, and employers on employment-related issues as requested; and create a new EFG website with relevant content. This year, the P & A continued to work with the Georgia Vocational Rehabilitation Agency (GVRA) on their outreach to youth who have been transitioned from school to a sheltered workshop, in violation of Section 511 of (WIOA). The P & A also engaged experts in customized employment to help deflect placements in segregated day programs and to help people with disabilities get out of sheltered workshops and to obtain assistive technology they needed to be successful on the job. The P & A’s goal is to ensure that people with disabilities are afforded the opportunity to engage in, and maintain, competitive integrated employment.
Georgia Vocational Rehabilitation Agency (GVRA) Collaborations:
The P & A requested a meeting with the new GVRA Chief Client Management Officer and his leadership team, which was very productive. As a result of this meeting, the P & A is in frequent contact with GVRA regarding GVRA’s delivery of services to clients and GVRA’s implementation of Section 511 of the Workforce Innovation and Opportunity Act (WIOA) regulations. The P & A engages in ongoing collaborative efforts with GVRA to introduce more people with disabilities to Discovery and Customized Employment, and to move more people with disabilities out of segregated day services. Specifically, the P & A maintains regular contact with GVRA’s Director of WIOA Compliance to let GVRA know which sheltered workshops have not yet been visited by GVRA, and that the people whom the P & A meets in the sheltered workshops have not been supported by GVRA to make an informed choice about competitive integrated employment. As a result of this robust communication with GVRA, the P & A continues to advocate for people with disabilities experiencing barriers to obtaining GVRA services, such as a lack of response from their GVRA counselor, or, in some instances, having their GVRA case being closed without obtaining a job. As a result of P & A intervention, these people now have frequent contacts with their GVRA counselor and had their GVRA case re-opened without being subjected to an appeals process or a waiting period.
The P & A also provided technical assistance to GVRA regarding several items to be included in the Memorandums of Understanding (MOU) that GVRA is developing with both the Georgia Department of Education (DOE) and the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD). The P & A encouraged GVRA to consider providing values-based training for GVRA staff, and for GVRA to provide alternatives to guardianship for parents of youth with disabilities who have been encouraged by the State to pursue guardianship over their child.
Georgia Vocational Rehabilitation Agency Board (GVRA) Meetings:
The P & A attended the Georgia Vocational Rehabilitation Agency (GVRA) Board Meetings in order to continue its systemic advocacy for people with disabilities across the state of Georgia in employment preparation, services, and supports. The P & A continues to advocate for competitive integrated employment so that people with disabilities can earn living wages in employment positions that are aligned with their interests and skills. Two problematic policies and practices were addressed during one of the Board meetings. The first was the long-standing practice of people with disabilities being paid subminimum wage at sheltered workshops. Increased WIOA (Workforce Innovation and Opportunity Act) compliance efforts under Section 511 of WIOA assure that Section 14(c) holders, which allows employers to pay sub-minimum wage, adhere to certain conditions. However, there was concern by the Board that these conditions do not go far enough. Secondly, the Board noted there is a focus on students who are at the high school program transition age of 22, rather than focusing efforts on students who are still in high school (ages 18-21) in order to provide the necessary services and supports for students to plan for education and a career after high school. Both of these policies and practices have a negative impact on people with disabilities. Moving forward, the Board urged GVRA to place more emphasis on WIOA compliance to assure that employers are following its policies and procedures and to place more emphasis on students with disabilities at transition age (18-21), rather than beginning to work with a student immediately before they graduate from high school. The P&A's goal is to assure that GVRA is indeed addressing these problematic policies and will continue to monitor GVRA’s efforts in these areas.
State Rehabilitation Council (SRC):
The P & A attends the Georgia State Rehabilitation Council (SRC) meetings to learn about Georgia Vocational Rehabilitation Agency (GVRA) activities and to monitor how GVRA is implementing Workforce and Innovation Opportunity Act (WIOA). The P & A made public comment at these meetings based upon meeting agenda topics and asked questions as part of our monitoring Georgia’s implementation of WIOA. SRC is a federally mandated council composed of Georgia citizens from across the state appointed by the Governor to represent a broad range of individuals with disabilities and stakeholders. The SRC collaborates with GVRA to develop plans for services and make recommendations to assist individuals with disabilities achieve employment and independence.
Monitoring Sheltered Workshops:
Through its monitoring of sheltered workshops, the P & A has met many people who have been in “pre-vocational” status for years, some as long as nineteen years, with no supported employment goals. The P & A has met with these individuals and with sheltered workshop staff to address its goal to have advocacy plans for each individual to receive more support from the individual’s waiver by bringing the support coordinators on board and to engage the Georgia Vocational Rehabilitation Agency (GVRA) to open cases and provide services to each individual so that they can access competitive, integrated employment.
In addition, the P & A has met staff in day programs and sheltered workshops that do not realize a person with a disability’s full potential for employment. This year, the P & A’s goal was to provide technical assistance to the staff at the day programs and sheltered workshops by sharing strategies on how to be effective with increasing the capacity for individuals with disabilities to have real employment. As a result of the P & A’s conversations, one day program sent its staff to a six (6) day training to learn about customized employment. The staff also learned about the benefits of Discovery Profiles, which is a process that helps supporters working with people with disabilities to uncover a wealth of information about the person that may have remained unknown if not for the profile. The day program staff reported to the P & A that they have been able to observe and participate in areas of profile development and implementation, such as data collection and person centered planning meetings. Overall, the process of creating profiles has been beneficial to supporting individuals with disabilities to access job sampling, job carving, and ultimately, competitive integrated employment.
Transition Age Students Pipeline to Sheltered Workshops:
The P & A’s goal was to monitor several Section 14c certificate holder sheltered workshops around the state. During the monitoring visits, the P & A noticed a common trend whereby the sheltered workshops reported they had not been contacted by, or received a visit from, GVRA. The P & A notified GVRA that it was not fulfilling its obligation under Section 511 of WIOA to conduct affirmative outreach to the sheltered workshops to provide career counseling to people with disabilities making subminimum wage, so they can be informed of opportunities to obtain real jobs in the community. GVRA recognized its shortcomings in this area and asked the P & A to notify GVRA which sheltered workshops had not been visited by GVRA and also asked the P & A to encourage the sheltered workshops to contact GVRA directly, which the P & A did. We continue to work with GVRA to make sure that youth are not entering sheltered workshops and that they are supported to make experientially-based informed choice regarding employment. In addition, the P & A was invited to educate twenty-five (25) students with disabilities ages 18-22 at a sheltered workshop on "four steps to self-advocacy" for students to follow while engaging in the self-advocacy process. The P & A's objective was to ensure the students are aware of, and can implement, self-advocacy skills and supported decision making in every aspect of their lives, including employment, education, and health care.
Collaborations with Work Incentives Planning and Assistance (WIPA):
The P & A continued to meet with Georgia Work Incentives Planning and Assistance (WIPA) staff to discuss collaborative efforts to support people who want to work but need benefits navigation and assistance. This meeting resulted in increased referrals between offices, as well the P & A’s invitation to WIPA’s Benefits Navigators to speak at a half-day workshop to people with disabilities and their supporters in Decatur and in Macon called "A Path to Employment." The P & A shared with the audience a brief overview of employment, how and when to make a request for a reasonable accommodation, and employment circles of support. A Benefits Navigator shared with the audience how work can affect their benefits. The objective of the workshop was to encourage people with disabilities to think about work as an avenue to pursue a meaningful day and to let them know that it is possible to work and still receive their benefits. Thirty people with disabilities received information on the use of employment to achieve a meaningful day, how to self-advocate for employment, and how to work and still receive benefits.
Georgia Microboard Association (GMA)
The P & A’s goal in continuing to support the Georgia Microboard Association (GMA) to develop microboards and microenterprises is that people with disabilities can guide and direct their own services and supports and do not always want to be served by traditional providers. We directly support several people’s microenterprises and small businesses and provide support to the GMA as it grows the capacity to serve more people.
Nursing Facility Transition/Money Follows the Person (MFP):
The P & A continues its assertive advocacy supporting persons with disabilities who are confined to nursing facilities to transition into the community and to obtain the appropriate services and supports they will need to live successfully and safely in the community. As a person transitions, the P & A works closely with Money Follows the Person (MFP) to ensure that MFP fully considers all the services and support that a person will need in the community. The P & A continues to role model, train and support MFP, nursing facility administrators, and social workers on best practices to assist people with disabilities to obtain the most appropriate services and supports as they transition from the facility into the community.
Other Monitoring Activities:
The P & A routinely monitors state hospitals, nursing facilities, and private residential treatment facilities where people with disabilities are housed. Among the things the P & A monitors include the following: the person’s quality of life; the facility conditions; whether the person is experiencing a meaningful day; and whether the facility adheres to the new nursing facility regulations and the Patient’s Bill of Rights. Through routine monitoring, the P & A has documented and responded to situations involving abuse, neglect, and rights violations. This information has been reported to the appropriate oversight agencies (such as Georgia’s Healthcare Facility Regulations Division - HFRD - and the Centers for Medicare and Medicaid Services - CMS) for use in their investigations. Additionally, throughout the course of routine monitoring, the P & A advocates met people with disabilities who expressed an interest in moving into the community, and in response, assisted many individuals to move into homes in the community and to gain access to supports such as waiver services, employment, assistive technology, and transportation.
Statewide Independent Living Council of Georgia, Inc. (SILC):
The Statewide Independent Living Council of Georgia, Inc. (SILC) is a private nonprofit corporation governed by people with all types of disabilities from all across the state. The role of the SILC is to identify societal barriers to independent living and to collaborate with Centers for Independent Living, Rehabilitation Services and other related entities to remove those barriers, including barriers to assistive technology, and to increase the supports and services needed to create independent living opportunities. This year, the P & A worked with the SILC to educate legislators on the impact of proposed cuts and caps to Medicaid. The P & A worked with the SILC and other stakeholders to give input to the Department of Community Health’s development of their Transition Plan, which is required by the Centers for Medicare and Medicaid Services (CMS) to rebalance services and structure funding to divest from segregating and isolating settings for people with disabilities served by the State, and to bring the State to a higher level of compliance with Olmstead and the ADA. The P & A’s goal in collaborating with the SILC is to identify and advocate on behalf of individuals in nursing facilities and in the community who want to more fully participate in independent living and to engage in competitive integrated employment.
Georgia Accessible Transportation Coalition:
The P & A provided support and technical assistance to the Georgia Accessible Transportation Coalition to remove barriers in accessible transportation. Specifically, the P & A supported self-advocates in an urban county to advocate for accessibility in ride share services (also known as vehicles for hire), accessible sidewalks, and accessible pathways in the community. As a result of the P & A’s support to self-advocates, two sidewalks were repaired and two new crosswalks were implemented. These sidewalks and crosswalks are located in predominantly pedestrian areas of the county and affords people with disabilities the opportunity to participate fully in their communities.
Unnecessary and Restrictive Guardianships:
The P & A recognizes that guardianship over a person with a disability is often unnecessary, can be very restrictive and in some cases, can result in abuse and/or neglect or unnecessary rights restrictions of the person under guardianship. The P & A has successfully represented numerous individuals throughout the state to have their guardian and conservator removed. As a result of gaining their own independence, people with whom we have advocated are now able to live in their own homes in the community and make their own decisions- large and small. The P & A has continued its relationship with the Public Guardianship Office (PGO) of the Georgia Division of Aging to collaborate on cases where the person is under state guardianship and wants a more independent life. PGO will refer individuals to us whom they believe may no longer need a guardian. PGO is also working with us to enrich the lives of people under state guardianship, by ensuring that they have the right and the ability to receive appropriate services and supports and live in the community.
Georgia’s Network for Educational and Therapeutic Supports (“GNETS”):
In 2016, the United States Department of Justice (DOJ) filed suit against the State of Georgia, alleging the State violated Title II of the Americans with Disabilities Act, which prohibits discrimination against people with disabilities by public entities. The suit alleged that Georgia has sent thousands of students with behavior-related disabilities to separate, segregated, and unequal settings, called the Georgia Network for Educational and Therapeutic Support (GNETS). The P & A has led the advocacy effort to hold the DOJ and the State accountable. The P & A and other partners are convening and leading a number of stakeholders in a strategic process to facilitate the negotiations or enforcement actions necessary to end segregation by GNETS called the Georgia Coalition for Equity in Education (GCEE). The coalition includes groups with expertise in education, mental health, child welfare, juvenile justice, and developmental disabilities, as well as civil rights, parent, self-advocacy, and youth groups. We have a robust media strategy resulting in numerous stories raising consciousness about not only the existence of the GNETS and the DOJ Letter of Finding, but also the harm created by the GNETS. This year, The Atlantic published “The Separate Unequal Education of Students with Special Needs” describing the GNETS programs for students with disabilities in Georgia and how it violates the Americans with Disabilities Act. We worked extensively with the reporter for over a year during the development of this article. http://theatln.tc/2n9f9St. GCEE has hosted multiple litigation and advocacy strategy meetings and built a coalition website to bring information to stakeholders, families, and students with a vision of quality behavioral supports in education. The P & A has recruited very strong legal allies to work with us on the case and to finance it: DLA Piper, Center for Public Representation, Bazelon Center for Mental Health, Atlanta Legal Aid, the ARC/US, and two local private attorneys. The P & A has worked on recruiting individual plaintiffs to complement our status as an organizational plaintiff, and our work in this case continues.
Collaboration with the Georgia State ADA Coordinator’s office:
The P & A continues to have a strong relationship with the Georgia State ADA Coordinator’s office. The P & A and the State ADA Coordinator communicated regularly regarding individual and systemic advocacy efforts, such as a lack of accommodations provided by a state licensing board and lack of effective communication at certain doctors’ offices. As the State ADA Coordinator’s office is limited to providing information and education to people with disabilities, the State ADA Coordinator refers individuals with disabilities who needed direct advocacy assistance to the P & A.
Tools for Life (TFL) Advisory Council:
The P & A is a member of Georgia's Tech Act agency, Tools for Life’s Advisory Council. Other members of this council include representatives from the Georgia Vocational Rehabilitation Agency, Friends of Disabled Adults and Children, the Department of Education, and others. The goal and purpose of the P & A's participation on the Tools for Life Advisory Council is to serve in an advisory capacity in assisting Tools for Life (TFL), Georgia’s Tech-Act Project, in accomplishing its goal and mission with measurable outcomes, which includes ensuring people with disabilities have access to assistive technology while obtaining and maintaining employment. The P & A serves as a statewide resource of information to the TFL project, reviews and gives input on programs & services, and assists the Council in being a statewide voice for public awareness and advocacy on increased access to Assistive Technology, including in the workplace.
The P & A hosts People First of Atlanta (PFA) and People First of Georgia (PFG) and works with the PFA and PFG leadership towards the goal of building their leadership skills and strengthening local chapters statewide. We also supported People First members to attend national board meetings in Regional Representative roles with the Self Advocates Becoming Empowered (SABE) national advocacy organization. The P & A conducted advocacy training this year for People First members on Medicaid issues, relationship building, assistive technology, the legislative process, the death penalty in Georgia, and voter access. The P & A supported People First members to attend the Advocacy Days at the Capitol sponsored by the Georgia Council on Developmental Disabilities (GCDD).
Self-Advocates Becoming Empowered Voter Project:
As part of SABE's (Self Advocates Becoming Empowered) efforts to encourage collaboration between state self-advocacy organizations and state P & As, the Voter Project was formed. SABE selected the P & A and People First of Georgia as one of four P & As and self-advocacy organizations to participate in a training program where participants gained the skills necessary to present on voting rights for people with disabilities across their state. Both organizations attended a series of webinars, prepared a presentation, and held an event at the P & A for self-advocates where that presentation was delivered. The objective of the project was to provide information and materials on voting to people with disabilities in Georgia and encourage people with disabilities to become involved in the electoral process. The purpose of the training was to learn about the following to include in presentations and informational materials: how to register to vote; how to go to the polls; where to vote; issues that voters with disabilities may experience at the polls; and how to build connections across local and state agencies, self-advocates, family members, elected officials and legislators to increase voting participation of people with disabilities. Using the skills obtained from the training, People First of Georgia and the P & A will continue to develop their presentations to ensure full participation in the electoral process for people with disabilities in Georgia, including people in rural areas of the state who are often overlooked in voter outreach efforts.
Rev-Up Georgia collaboration:
The P & A collaborated with the Centers for Independent Living, the Shepherd Center, Georgia Council on Developmental Disabilities (GCDD), ARC, Georgia Secretary of State’s Office, and the Department of Justice, Civil Rights Division through Rev-Up Georgia, a statewide non-partisan network of individuals and groups dedicated to increasing participation in the electoral process by people with disabilities. This includes, but is not limited to, helping people navigate the registration and voting process, assuring that they have the ability to cast their vote, engaging them to participate in all forms of the political process, and educating the public and candidates about disability related issues. The P & A served in an administrative role in the group and was responsible for educating the group about any legal changes nationally and statewide that could impact voting rights.
Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults:
The P & A participates as an active member of the Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults, which serves as a comprehensive clearinghouse between local advocacy groups serving individuals with disabilities and older adults, and Georgia agencies responsible for emergency preparedness under the Georgia Emergency Operations Plan. In addition, the Coalition provides subject matter expertise to emergency response planners to ensure that all emergency plans incorporate the needs of people with disabilities and older adults and organizations throughout Georgia that serve and advocate for people with disabilities and older adults enabling them to share disaster preparedness and response information with their constituencies. Specifically, during Hurricane Irma, a Category 5 Hurricane that impacted Georgia, the P & A ensured that an emergency response plan was in place and safeguards were being implemented at the state and local levels so that people with disabilities were being assisted to evacuate or seek shelter as directed by emergency personnel. As an active participant in the daily Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults phone calls with Federal Emergency Management Agency (FEMA), the P & A confirmed the following: the state psychiatric hospital in Savannah had evacuated approximately 100 patients and approximately 70-80 staff, and nursing facilities were evacuated as needed. The P & A also communicated with the Department of Developmental and Behavioral Disabilities (DBHDD) and learned that the DBHDD regional office had contacted all providers within the evacuation zone to determine preparedness and confirm that people were evacuated and they knew where people were going. Through this effort, the P & A worked to safeguard the experience of the hurricane for people with disabilities in Georgia as well as communicating with state and federal emergency response agencies to share information about current emergent issues and other concerns.
Children and Youth Subcommittee of the Statewide Traumatic Brain Injury (TBI) Advisory Panel:
The P & A is a member of the Child Youth Brain Injury Subcommittee of the Brain and Spinal Injury Trust Fund. The P & A participates in monthly meetings to provide updates to the committee members (including representatives from the Brain and Spinal Injury Trust Fund, the Shepherd Center and Children’s Healthcare of Atlanta) regarding the number of youth with brain and spinal cord injuries residing in skilled nursing facilities, as well as resources related to Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT) and Medicaid waiver programs to ensure youth with brain and spinal cord injuries have access to home and community based services and avoid risk of institutionalization.
Children’s Freedom Initiative (CFI):
The P & A works collaboratively on the Children’s Freedom Initiative (CFI) with our federal partners, the Institute on Human Development and Disability (IHDD), the Center for Leadership in Disability (CLD), and the Georgia Council on Developmental Disabilities (GCDD). CFI’s goal and mission is to prevent children with disabilities from going into institutions or segregated facilities and to ensure that children currently living in congregate facilities are given the chance for permanent, loving homes, and obtain the assistive technology they need. CFI monitors the admissions and discharges of youth under age 22 into skilled nursing facilities (SNF) or Intermediate Care Facilities for people with an intellectual and/or developmental disability (ICF-IDD). This year, CFI brought twelve children out of facilities into loving homes and deflected institutionalization for another eleven children. Remedies being considered to address the inappropriate admission of youth to SNFs and ICFs/IDD include changes to state policy to eliminate the payment of Medicaid dollars to facilities when the SNF lacks proof that PASRR 1 and 2 screens were conducted and all available avenues to community living have been exhausted. Additionally, CFI is considering proposing legislation to the Georgia General Assembly that would reduce Medicaid payments to those facilities accepting admission of a youth under age 22.
Health Improvement Project by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD):
Georgia’s Department of Behavioral Health and Developmental Disabilities initiated a statewide Health Improvement Project that aims to improve health outcomes and reduce adverse conditions for people with developmental disabilities. In the course of implementation, the leaders of this project identified a provider that was considering opening a segregated day program. The P & A intervened and provided technical assistance on customized employment, standards and best practices in disability employment, and the requirements of WIOA and the CMS Final Settings Rule. We are continuing to work with this provider to deflect unnecessary segregation of working age adults.
Georgia Inclusive Postsecondary Education Consortium (GAIPSEC):
The P & A is an active member of the Georgia Inclusive Postsecondary Education Consortium (GAIPSEC), which seeks to create opportunities for students who have historically not had access to post-secondary educational (PSE) opportunities. Housed in the Center for Leadership in Disability at Georgia State University, one of the P & A’s federal partners, the GAIPSEC is a group of people dedicated to ensuring that every Georgia student has access to learning after high school, regardless of intellectual or developmental disability. Consortium members include colleges and universities, community support agencies, families, and K-12 educators. Together, GAIPSEC is ensuring that every Georgia student with an intellectual or developmental disability has the opportunity to realize his or her full potential, and to obtain competitive integrated employment. This year, GAIPSEC invited the P & A to present on supported decision- making and how it relates to transition and IPSE. The meeting participants included twenty IPSE professionals from colleges around the state who have IPSE programs (or who are thinking about starting an IPSE program), the Center for Leadership in Disability, and Vocational Rehabilitation. The P & A presented on alternatives to guardianship, such as supported decision-making, and educated the audience regarding other state’s supported decision-making statutes (e.g. Texas) and the supported decision-making forms that can be used.
State Advisory Panel for Special Education (SAP):
The State Advisory Panel for Special Education (SAP) advises the Georgia Department of Education (GA DOE) Divisions for Special Education Services and Supports on the provisions of special education and related services for students with disabilities. The SAP is comprised of parents, persons with disabilities, educators and administrators, as well as representatives from public and private agencies. The P & A reguarly attends SAP meetings to hear reports and to provide comment as needed. The SAP is a critical partner in the development of Georgia’s State Performance Plan (SPP) and Annual Performance Report (APR). The Panel also advises the Divisions on the improvement activities that need to be developed and implemented in order to improve outcomes for students with disabilities. Each year, members review data on the improvement activities included in the SPP and APR and make suggestions for updates to the activities and targets. The SAP advises the GA DOE in developing corrective action plans to address findings identified in federal monitoring reports under IDEA and advises the GA DOE in developing and implementing policies relating to the coordination of services for children with disabilities. The SAP participates in the Continuous Improvement Monitoring Process by recommending target areas for upcoming focused monitoring activities.
Education to the Georgia chapter of the American Civil Liberties Union (ACLU):
The P & A reached out to the American Civil Liberties Union (ACLU) chapter in Georgia in response to the confusion over the President's Executive Order on Immigration. Some incoming legal residents and valid United States visa holders and refugees were being denied entry to the United States and being detained at airports around the country. As Atlanta Hartsfield-Jackson Airport is a major international hub for airlines, the ACLU Georgia chapter worked at the airport to try to resolve immigration issues and assist these travelers. The P & A educated the ACLU Georgia chapter of our role as the protection and advocacy system for people with disabilities in Georgia, including any travelers with disabilities who may be detained.
|1. Number of individuals potentially impacted by changes as a result of PAIR litigation/class action efforts||750|
|2. Number of individuals named in class actions||0|
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.
United States v. Georgia:
The P & A represents ourselves, as well as being a member of the amici, which the Bazelon Center for Mental Health Law is representing in this case. The P & A had significant involvement this year in negotiating the two-year extension on the Settlement Agreement. The Court approved the Extension Agreement. In it, the State committed to take additional steps to address the areas in which the Department of Justice and Independent Reviewer found the State had not complied with the terms of the 2010 Settlement Agreement. The P & A is particularly concerned about several provisions in the Developmental Disabilities side of the Agreement, including the rollout of Intensive Support Coordination, the people who are on the high risk list, the use of the Integrated Clinical Support teams, crisis services, and the findings letter that the Centers for Medicare and Medicaid Services (CMS) issued to the Georgia Department of Community Health (DCH), requiring a Corrective Action Plan of the Comprehensive Supports Waiver Program (COMP) waiver. There are still about 200 people institutionalized at East Central Regional Hospital - Gracewood, six of whom the P & A is involved with in individual advocacy to support their transitions into the community. We also worked on a project with the Independent Reviewer to assess the supports provided by a particular provider, where there have significant concerns related to the health and safety of residents. The P & A will determine what actions the provider has made to improve outcomes and what has changed after several people died in their care over the years of the Settlement. The P & A is also monitoring the transition of several individuals as they move into new homes and begin services with new providers due to the closure of their current provider. The P & A is conducting deeper investigations into the deaths of people with developmental disabilities that have occurred in the last year, and we are working with the media to more accurately portray the issues the state is developing regarding safeguards and systems of accountability.
Georgia Advocacy Office v. Reese:
The P & A filed suit in federal court against the Georgia Department of Community Health (DCH) for violations of our P & A access authority. DCH failed to provide us access to records we were seeking as part of two investigations. The court denied DCH’s motion to dismiss and directed the parties to reach an agreement. The P & A filed a motion for summary judgment and injunctive relief, the state filed a reply, and the P & A then filed a response with a Proposed Order for the Judge to adopt. The Judge adopted the P & A’s Proposed Order, which confirmed the P & A’s access authority. This will have a positive impact for P & As nationally. The P & A filed a fee petition in November 2016 and was awarded $42,630.00 in fees.
J.B. v. Georgia Department of Community Health (DCH):
J.B. is a 55-year-old man who uses a wheelchair and is confined to a nursing facility. J.B. wants to transition out of the nursing facility and into independent housing near his family in the community. J.B. applied for community services and supports through the Georgia Department of Community Health (DCH)’s Independent Care Waiver Program (ICWP). However, DCH denied his application for waiver services, stating that because he did not have a family member or a friend to sign a “Circle of Support” form, he was ineligible for the waiver. The P & A represented J.B. to appeal DCH’s denial to the Office of State Administrative Hearings (OSAH). After a hearing, and reviewing closing briefs from each party, the Judge reversed DCH's decision to deny ICWP services to J.B. and remanded the issue for DCH and J.B. to work together to determine who can serve as a natural support once J.B. transitions to the community. DCH appealed the Judge’s decision to the DCH Commissioner and briefings will follow.
C.C. v. Georgia Department of Community Health (DCH) and Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD):
CC is an 8-year-old girl with several significant medical issues. Her nursing hours were cut as a result of a new formulary being utilized by DBHDD and DCH, thereby placing C.C. at risk of institutionalization. The P & A filed an appeal of this cut and had an all-day hearing with multiple witnesses. The parties have fully briefed the matter and we are awaiting the Judge’s decision.
A.M. v. Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD):
A.M., a young woman with complex developmental disabilities, had been on a Developmental Disabilities Waiver for almost a year. However, during the time she had been receiving services through the waiver, she had not been able to go out into the community and live a meaningful life due to inadequate staffing. Thus, A.M. requested 6-7 hours per week of community access individual (CAI) support services and 28 hours a week of community living support services (CLS) through the waiver. DBHDD denied her request. The P & A, in collaboration with Atlanta Legal Aid, filed a request for an administrative appeal with the Office of State Administrative Hearings (OSAH) on A.M.’s behalf regarding DBHDD's denial. After a series of negotiations with DBHDD, and prior to the hearing, DBHDD agreed to provide the CAI and CLS hours requested.
D.A. v. Georgia Department of Community Health (DCH):
D.A. is a 60-year-old woman who entered a nursing facility for “rehab” last fall. She did not want to be in the nursing facility anymore and wanted to return to the community. She applied for community services and supports through the Georgia Department of Community Health (DCH)’s Independent Care Waiver Program (ICWP). However, DCH denied her application for waiver services, stating that because she did not have a family member or a friend to sign a “Circle of Support” form, she was ineligible for the waiver. The P & A represented D.A. to appeal the waiver denial, and a hearing was set. The week of the hearing, D.A. produced two friends who signed the “Circle of Support” form. DCH then withdrew its adverse action, and no hearing was held. D.A. moved back into the community, with services from ICWP and Money Follows the Person.
In Re: Estate of N.M.S., Sr.:
N.M.S. is a 48-year-old man who experienced a traumatic brain injury as a result of a gunshot wound to the head a few years ago. The state Public Guardianship Office (PGO) was appointed as his guardian. However, N.M.S. has made great strides in his recovery and no longer believes he needs a guardian. N.M.S. requested that the P & A represent him in Probate Court to remove PGO as his guardian. His treating physician and his PGO case manager were supportive of the guardianship removal. The P & A filed a petition for restoration of rights on behalf of N.M.S., and a hearing was held. N.M.S. testified that he could make and communicate significant responsible decisions regarding his health and safety. The PGO Director also testified as to the same. The Judge promptly restored N.M.S.’s rights and he is now free of guardianship!
GAO v. Assurance Consulting:
After receiving reports relating to two deaths in two separate homes run by Assurance Consulting, the P & A opened an investigation into the deaths and attempted to acquire records. Assurance failed to respond to multiple calls and letters from the P & A. The P & A filed suit in the Southern District of Georgia to defend our access authority. The suit was served on Assurance. After the Court ordered a hearing on the matter, Assurance provided the P & A with the requested documents and refunded the costs of litigation.
For each of your PAIR program priorities for the fiscal year covered by this report, please:
1. Identify and describe priority
The first priority is to protect individuals with disabilities in Georgia from abuse and neglect. The P & A will investigate and address allegations of abuse or neglect, including the suspicious or unexplained deaths of persons with disabilities.
2. Identify the need, issue or barrier addressed by this priority.
Georgians with disabilities are at risk of institutionalization due to the lack of appropriate community-based services and supports. People with disabilities who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Community-based supports are needed to end the institutional bias in Georgia.
3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
The P & A investigates and positively addresses instance of abuse and neglect of persons with disabilities. The P & A intervenes to protect any persons with disabilities from circumstances of abuse and neglect, and to assist in their transfer to community settings, in which abuse and neglect is less likely to occur.
4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
The P & A receives Type I Critical Incident Reports from the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)’s Director of Incident Management and Investigations based upon reports received from state institutional staff. The P & A makes case-by-case determinations as to which reports warrant further investigation by the P & A and/or other entities.
The P & A monitors the discharge of individuals leaving state hospitals, with particular emphasis on compliance with the United States v. Georgia settlement agreement, and the “fit” between what people with disabilities need and what they are actually receiving in terms of supports and services and real choices. The P & A reports findings to the United States Department of Justice (DOJ) and the Court Monitor as part of its investigation into the State hospital system.
The P & A has participated in facility transition meetings and individual service plan (ISP) meetings. The P & A has helped to identify barriers to discharge and advocates for services within the ISP that will bring more self-determination and full inclusion to people’s lives. During the P & A’s visits, the P & A has discussed current census and inquired as to any developments regarding transition planning specifically to certain individuals and to the population as a whole. The P & A also attended planning sessions for family members to provide information about community resources upon discharge from the hospital.
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.
D.A. is a 60 year old woman who experiences multiple sclerosis who entered a nursing facility for “rehab.” She did not want to be in the nursing facility and wanted to return to the community. D.A. applied for community services and supports through Georgia's Medicaid agency, the Department of Community Health (DCH)’s Independent Care Waiver Program (ICWP). However, DCH denied D.A.’s application for waiver services, stating that because she did not have a family member or a friend to sign a “Circle of Support” form, she was ineligible for the waiver. The P & A entered an appearance on behalf of D.A. to appeal the adverse action denying her the ICWP waiver. The week before the hearing, D.A. identified two women who were willing to sign the Circle of Support form. The P & A negotiated with DCH for them to withdraw their adverse action and find D.A. eligible for the ICWP waiver. The Judge agreed and dismissed D.A.'s case in her favor. The P & A is working with D.A. to ensure a successful transition to the community with the support of ICWP, as well as Money Follows the Person.
R.C., a young man who is a college graduate, experienced a traumatic brain injury as a result of a fall while playing basketball. The brain injury left R.C. with significant issues in cognitive processing and limited communication skills. R.C. is able to walk without difficulty but needs assistance with his daily activities, requiring supervision and prompting to complete most tasks. Unfortunately, R.C. was hospitalized at West Central Georgia Regional Hospital, even though he did not have a diagnosis of mental illness. R.C.'s parents were his legal guardians and they asked the P & A for assistance in ensuring appropriate support for R.C. in the community. For over two years, the state hospital, West Central, made little progress in discharging R.C. into the community. During that time, the hospital attempted to discharge R.C. to a group home, but did not create or implement a specific discharge plan that ensured appropriate support from trained staff and R.C. spent less than a day at the group home before returning to the state hospital. In addition, R.C. applied for services under the Independent Care Waiver Program (ICWP), a Georgia Medicaid program that provides services and supports to people with TBI in the community. However, R.C. was twice denied for this program by Medicaid on the basis that he 'had a primary diagnosis of a mental disorder, his estimated cost of care exceeded budgetary restraints, and he could not safely move into a community setting.' When R.C. applied for the ICWP waiver a third time, he received a letter from the state withdrawing his application unilaterally. Hospital staff informed the P & A that R.C. could live in the community with appropriate services and supports and recognized that the hospital was not an appropriate place for him to live. The P & A requested a meeting with the Commissioner of the Georgia Department of Community Health and the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities to notify them that the P & A had identified a provider willing to support R.C. to have a good life in the community. The P & A negotiated with the state to provide sufficient funding for housing and one-on-one behavioral support for R.C. in the community. The hospital and the provider then came together to develop a comprehensive transition and discharge plan that included visits to the home where R.C. would live, and staff training. The P & A actively participated in R.C.'s transition planning meetings. R.C. was finally successfully discharged to a home in the community where he has a roommate and one-on-one supports.
When the P & A first met L.H. at a nursing facility, L.H. was frustrated but determined to create a better life. L.H. had missed his son’s parent-teacher meetings and sporting events due to his confinement in the nursing facility. L.H. aspired to obtain his GED but was refused access to a computer by the facility. Instead of working towards a meaningful life, L.H.’s days were spent within the confines of four walls. Immediately after their initial meeting, L.H. and P & A worked with the facility staff, educating them on the Medicare Patient Bill of Rights, and eventually restoring L.H.’s ability to come and go from the facility without restriction. Once L.H. again had the freedom to visit his family, attend doctor visits, and go to the store by himself, L.H. and the P & A created a plan for L.H. to move into his own home near his family and to obtain the daily supports he needed to live a healthy and full life. After much teamwork, L.H. was approved for the Money Follows the Person (MFP) Program, a Medicaid program designed to help individuals who are institutionalized move out of a facility and into a home in the community with supports. After L.H. learned he would finally have the opportunity to move out of the facility and into a home of his own, the P & A supported L.H. to identify possible apartments and services. Four days after his thirty-third birthday, L.H. moved into a beautiful furnished apartment and is living successfully in the community!
1. Identify and describe the priority
The second priority is to respond to allegations of discrimination and legal rights violations of persons with disabilities. The P & A will advocate for appropriate home and community-based supports and services, including healthcare and educational, for people with disabilities at risk of institutionalization. The P & A will also advocate for people with disabilities subject to legal rights violations and discrimination in any of the following areas: fiduciary relationships, local and state government, healthcare, housing, transportation, and employment.
2. Identify the need, issue, or barrier addressed by this priority.
This priority addresses the need of individuals with disabilities to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services and public places. Persons with disabilities are subject to discrimination in essential services and domains of life, particularly with respect to healthcare, housing, transportation, and employment. Public and private accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. People with disabilities are more likely to have their rights restricted based upon the perception that they are not able to make decisions regarding their own lives.
3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
The indicators of success for this priority are as follows: to investigate and reverse the effects of reliable reports of overt deprivation of fundamental rights for individuals; to avert discrimination against persons with disabilities by achieving equal opportunities from employers, housing providers, healthcare providers, transportation providers, public entities, and public accommodations through reasonable accommodations and removal of policy barriers.
4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
The P & A works closely with the Money Follows the Person (MFP), a program designed to transition persons with disabilities from facilities into the community and provides funding for one year following the transition, for items such as environmental modifications to the home, coverage of the first month’s rent and utilities, peer support, and transportation. The P & A has successfully facilitated scores of transitions of individuals from nursing facilities into the community, in part because of our current relationships with the long-term care ombudsman’s office, MFP, and Medicaid waiver staff. The P & A actively participated in the quarterly MFP stakeholder meetings held throughout the state. The P & A heard reports from the state Division of Aging and the Department of Behavioral Health and Developmental Disabilities regarding information about its nursing facility transitions for the previous quarter.
Through the P & A’s collaboration with the Public Guardianship Office (PGO) of the Georgia Division of Aging on cases where the person is under state guardianship and wants a more independent life, PGO refers individuals to the P & A whom they believe may no longer need a guardian. PGO is also working with the P & A to enrich the lives of persons under state guardianship, by ensuring that they have the right and the ability to receive appropriate services and supports and live in the community.
The P & A works closely with the Statewide Independent Living Council (SILC) and each of the nine (9) Center for Independent Living (CIL) offices. The P & A contributed to the discussions surrounding ensuring that persons with disabilities have access to, among others, accessible housing, transportation, living alternatives, and assistive technology.
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.
I.C., a 62 year old man with physical disabilities, is someone that the P & A previously assisted in transitioning from a nursing facility to the community. I.C. was approved for a Medicaid waiver, the Independent Care Waiver Program (ICWP), which would provide him with services and supports to remain in the community. However, once I.C. entered the community, he was notified that his services through ICWP would not begin as there was an unresolved Medicaid issue. The P & A negotiated on I.C.’s behalf with Medicaid to identify and resolve the issue. As a result of P & A intervention, I.C.’s Medicaid issue was resolved and he is now receiving ICWP services and living successfully in the community!
A.P. is a 63-year-old man who experiences low vision. He is responsible for one-fifth of his medical costs. He resided in HUD-assisted housing, and the rent for his apartment required over half of his income. Between his medical and housing costs, A.P. was at risk of becoming homeless or being forced into a nursing facility. A.P. requested the P & A’s assistance with locating more affordable, income-based housing. Some of the housing forms A.P. needed to complete did not come in large print, which made applying for housing even more difficult. The P & A negotiated with the thirteen apartment complexes to which A.P. wanted to apply to ensure that A.P. received the assistance he needed to be able to apply for housing. A.P. is now on each apartment’s waiting list. Once an apartment is available, A.P. will reduce his risk of homelessness and institutionalization, as his rent will only be one-third of his income as opposed to half of his income.
1. Identify and describe the priority.
The third priority is to promote the integration and self-determination of persons with disabilities in the community. The P & A seeks to empower people with disabilities, family members, and concerned citizens to advocate for competitive employment, educational, healthcare, and other services that are appropriate to the person’s needs.
2. Identify the need, issue, or barrier addressed by this priority.
This priority addresses the need of people to live fully integrated lives in their communities. Persons with disabilities have been continually isolated and segregated from the community. Starting when they are young, they are placed in classes separate from everyone else. It continues when opportunities to be in the community are limited because of inaccessibility. Most significantly, too many persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for persons with disabilities is to be involved and connected with their communities and to develop and practice self-advocacy skills.
3. Identify and describe indicators PAIR used to determine successful outcome of activities pursued under this priority.
The indicators of success for this priority are as follows: to support individuals and concerned citizens to obtain equal opportunities from employers, housing providers, healthcare providers, transportation providers, and to support individuals and concerned citizens to obtain home and community-based supports for individuals to live and fully participate in their communities.
4. Explain whether pursuing this priority involved collaborative efforts by other entities. If so, describe this collaboration.
The P & A provides ongoing support to People First of Atlanta and People First of Georgia. The P & A also hosts their monthly meetings as well as serving as their fiscal agent. The P & A sends a supporter to monthly meetings and also provides support to the chapter and the Board in the planning and execution of the annual Long Road Home event and the annual People First of Georgia conference that all People First chapters attend.
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.
M.B., a twenty-five year old young man who is hard of hearing, contacted the P & A because he wanted help seeking employment. The traditional employment opportunities did not seem to meet M.B.'s needs or build on his gifts and talents. M.B. had experience with outdoor work in the past, but he found people did not have the patience with him. After much discussion with the P & A, M.B. decided he would like to explore providing computer and phone services for people who needed assistance setting up new technology devices. M.B. felt there was an unmet need for people who did not grow up with the technology that is now basic in most homes. M.B. prepared flyers about his business, distributed them in his community, and began working with his church to get the word out (and do a little work there as well). M.B. recognized the importance of using social media and posted information about his new business enterprise on his Facebook page. As a result, M.B. has customers that are using his services to set up their computers and phones.
T.E. is a 44 year old man who experiences neurological, physical, and speech disabilities. T.E. requested assistance from the P & A, due to fears he would lose his job based upon his disability. Specifically, T.E.’s job required him to pass a certification test. However, due to his disability, he was not able to pass the test. The P & A provided technical assistance in self-advocacy to T.E. by suggesting that he ask his employer if he could take the test verbally as a reasonable accommodation. The P & A also provided assistance to T.E. to craft a path to employment to reach his future employment goals. As a result of P & A intervention, T.E. has improved his current employment situation and no longer feels he will lose his job, and he has a path to reach his future employment goals.
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. The first goal is to protect individuals with disabilities in Georgia from abuse and neglect. The first priority of this goal is to investigate and address allegations of abuse or neglect, including the suspicious or unexplained deaths of persons with disabilities. The second priority of this goal is to advocate for appropriate home and community-based supports and services for persons with disabilities residing in facilities, with a focus on monitoring the State’s compliance with US v GA, the ADA and Olmstead.
2. Needs: Georgians with disabilities are at risk of institutionalization due to the lack of community-based services and supports. People who reside in congregate facilities are at heightened risk of abuse, neglect, and even death. Children are at the greatest risk due to their heightened vulnerability. Community-based supports are needed to end the institutional bias in Georgia.
3. Activities: The P & A monitors state hospitals, nursing facilities, and private residential treatment facilities. The P & A responds to calls involving community-based services including community living arrangements, sheltered workshops, and other day services. Children and other individuals residing in facilities will be considered more vulnerable than those living in community settings and will receive priority response from the P & A. The P & A will investigate deaths and cases of severe abuse and neglect against people with disabilities. The P & A will seek the full range of remedies for individuals through protection and advocacy from abuse and neglect.
1. A statement of each priority. The second goal is to respond to allegations of discrimination and legal rights violations of persons with disabilities. The first priority of the second goal is to advocate for appropriate home and community-based supports and services, including healthcare and education, for people with disabilities at risk of institutionalization. The second priority of the second goal is to advocate for people with disabilities residing in the community who are subject to legal rights violations and discrimination in any of the following areas: fiduciary relationships (such as unnecessary and restrictive guardianships), local and state government, healthcare, housing, transportation, and employment.
2. Needs: People with disabilities often face discrimination in areas such as healthcare, transportation, housing, and employment. People need to be free from overt discrimination or the failure to provide requested reasonable accommodations in government services and public accommodations. Public accommodations need to be accessible and free from discriminatory policies and practices in order for people with disabilities to have an opportunity to participate fully in their communities. Additionally, persons with disabilities can be subjected to financial exploitation by family members or acquaintances or by other persons upon whom they are dependent.
3. Activities: The P & A will seek the full range of remedies for individuals who have been subjected to discrimination and rights violations. The P & A will address discrimination in healthcare, transportation, housing, and employment by negotiation, mediation, and litigation. The P & A collaborates with a wide range of agencies, such as the State ADA Coordinator’s office, the Centers for Independent Living, Atlanta Legal Aid Society, Georgia Legal Services, and private attorneys to assist people whose rights are being violated and who are being subjected to fiduciary relationships.
1. The third goal is to promote self-advocacy and self-determination of persons with disabilities in the community. The first priority of the third goal is to empower people with disabilities, family members, and concerned citizens to advocate for competitive employment, educational, healthcare, and other services that are appropriate to the person’s needs.
2. Needs: Persons with disabilities have been continually isolated and segregated from the community. Opportunities to be in the community continue to be limited because of inaccessibility. Most significantly, persons with disabilities are isolated in nursing facilities or other congregate settings away from life in the community. The best safeguard for persons with disabilities is to be involved and connected with their communities.
3. Activities: The P & A supports persons to be involved in their community by teaching self-advocacy skills and mentoring persons with disabilities on their individual self-advocacy plans. The P & A provides information to individuals with disabilities about their human and legal rights to ensure that individuals secure the accommodations and services they are entitled to under the law. The P & A also provides technical assistance in self-advocacy by assisting individuals and their families in applying for community-based supports and also refers individuals and families to local independent living centers for information and peer support about transitioning into community life.
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.
A. Source of Funds expended and received: Federal (section 509): Amount Received = 465,051 Federal (section 509): Amount Spent = 488,893 State: Amount Received = 0 State: Amount Spent = 0 Program income: Amount Received = 42,630 Program income: Amount Spent = 23,841 Private: Amount Received = 0 Private: Amount Spent = 0 All other funds: Amount Received = 0 All other funds: Amount Spent = 0 Total (from all sources): Amount Received = 507,681 Total (from all sources): Amount Spent = 488,051 B. Budget for the fiscal year covered by this report Wages/salaries: Prior Fiscal Year = 285,000 Wages/salaries: Current Fiscal Year = 288,966 Fringe benefits (FICA, unemployment, etc): Prior Fiscal Year = 70,000 Fringe benefits (FICA, unemployment, etc): Current F/Y= 80,514 Materials/supplies: Prior Fiscal Year = 5,000 Materials/supplies: Current Fiscal Year = 3,450 Postage: Prior Fiscal Year = 1,000 Postage: Current Fiscal Year = 950 Telephone: Prior Fiscal Year = 4,850 Telephone: Current Fiscal Year = 4,364 Rent: Prior Fiscal Year = 37,000 Rent: Current Fiscal Year = 39,742 Travel: Prior Fiscal Year = 15,973 Travel: Current Fiscal Year = 18,566 Copying: Prior Fiscal Year = 2,700 Copying: Current Fiscal Year = 1,971 Bonding/insurance: Prior Fiscal Year = 2,600 Bonding/insurance: Current Fiscal Year = 2,357 Equipment (rent/purchase): Prior Fiscal Year = 10,875 Equipment (rent/purchase): Current Fiscal Year = 8,756 Legal Services: Prior Fiscal Year = 10,000 Legal Services: Current Fiscal Year = $10,000 Indirect costs: Prior Fiscal Year = 0 Indirect costs: Current Fiscal Year = 0 Miscellaneous: Prior Fiscal Year = 18,536 Miscellaneous: Current Fiscal Year = 29,257 Total Budget: Prior Fiscal Year = 463,534 Total Budget: Current Fiscal Year = 488,893 C. Description of PAIR Staff Professional position: 14 FTE filled 100% of year Professional full-time positions: 12 FTE, 12 person-years Professional part-time positions: 2 FTE, 1 person-year Professional vacant positions: 2 FTE, 1 person-year Clerical position: 5 FTE filled 100% of year Clerical full-time positions: 5 FTE, 5 person-years Clerical part-time positions: 0 FTE, 0 person-years Clerical vacant positions: 0 FTE, 0 person-years Description of PAIR staff Julie Kegley is the PAIR program director and an attorney with sixteen years of experience working with P & A systems. Ms. Kegley supervises the PAIR caseload, provides individual advocacy in PAIR cases, (such as defending the P & A’s access authority, representing people with disabilities in nursing facilities to receive a Medicaid waiver so they can live successfully in the community, and representing people with disabilities to have their guardian/conservator removed), participates on stakeholders’ committees, conducts presentations, and provides information and referrals. Denise Quigley is the Director of the Resource Advocacy unit and an attorney who has been with the P & A for over twenty (20) years. Cheri Mitchell is an advocate who has been with the P & A for over ten (10) years. Ms. Mitchell’s primary focus is advocating for the transition of people with disabilities from nursing facilities into the community, supporting self-advocacy, advocating for affordable and accessible housing, and assistive technology. Stacey Gardenhire is an advocate who has been with the P & A for thirteen (13) years. Ms. Gardenhire advocates on behalf of individuals transitioning into the community from facilities, as well as on behalf of individuals experiencing employment discrimination. Ilias Savakis has been with the P & A for two years and he provides direct advocacy, outreach, training, self-advocacy support, and information and referral to PAIR-eligible clients. The Executive Director, Litigation Director, Chief Operating Officer, Comptroller, Accountant, and all members of the Administrative Support team have contributed to, and participated in support of, the PAIR program. D. Involvement with Advisory Boards The P & A serves on the following boards and committees: Advisory Committee on Increasing Competitive Integrated Employment for Individuals with Disabilities; Georgia’s Assistive Technology Act Program, Tools For Life; Training and Technical Assistance Committee of Georgia Emergency Preparedness Coalition for Individuals with Disabilities and Older Adults; Georgia’s Council on Developmental Disabilities; State Traumatic Brain and Spinal Cord Injury Steering Committee; Unlock the Waiting List Steering Committee; TASH Employment Committee; and the Money Follows the Person stakeholders committee. The P & A is an advisor to People First of Georgia. The P & A serves on several Boards and Committees at the local, state, and national levels related to employment representing the protection and advocacy system. E. Grievances filed under the grievance procedure. The P & A did not receive any grievances filed under the grievance procedure this year. F. Coordination with the Client Assistance Program and the State long-term care program, if these programs are not part of the P & A agency. The P & A and the Client Assistance Program (CAP), which is not housed within the P & A, communicated with each other about the best way to support persons with disabilities in employment through its shared participation on the SRC and the GVRA Policy Revision Committee. The P & A and CAP recognize that it is essential to work together to support people with disabilities who seek services from GVRA in a way that promotes strong advocacy and employment opportunities. The State long-term care program is not housed within the P & A. However, the P & A continues to receive referrals from the Long Term Care Ombudsman regarding individuals residing in nursing facility who have experienced abuse and/or neglect in the facility and/or who want to transition from the facility into the community.
|Signed By||Julie C. Kegley|
|Title||Program Director and Senior Staff Attorney|