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News from LRS - April 2012
News from LRS is the monthly newsletter from the Ohio Legal Rights Services (LRS) providing information and updates about case work and activities of LRS, and other disability-related news.
In this issue:
- Introducing Disability Rights Ohio
- News from the LRS Commission
- Use of fiscal tool puts people at risk of losing services
- LRS assists in obtaining speech generating devices
- Action and results: Case summaries
- LRS releases its 2011 Annual Report
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Disability Rights Ohio is a non-profit corporation with a mission to advocate for the human, civil, and legal rights of people with disabilities in Ohio. Disability Rights Ohio will replace Ohio Legal Rights Service (LRS) as Ohio's Protection and Advocacy (P&A) system and Client Assistance Program (CAP) by October 1, 2012. This will allow us to conduct business as a non-profit corporation instead of an independent state agency.
The official name of the corporation is Ohio Disability Rights Law and Policy Center, doing business as Disability Rights Ohio. The Internal Revenue Service approved the corporation's non-profit 501(c)(3) status in March 2012. The governor will designate Disability Rights Ohio as the operator of the P&A and CAP programs in Ohio by no later than September 30, 2012.
Our name will change, but what we do best will not!
Disability Rights Ohio will provide the same services as LRS and continue to advocate for the rights of people with disabilities. Leaving state government and becoming a non-profit corporation will give us more freedom to make decisions about how we do our work. And that will allow us to improve our services for Ohioans with disabilities.
Board of Directors
An active and experienced board of eight founding members is currently focused on developing fiscal controls, corporate governance, committee structure and employee compensation schedules and policies. The founding board is also the screening and nominating committee for additional board members, with a goal of 15 members by October 1, 2012. The majority of the board members will be people with disabilities or their family members. The nominating committee will also seek geographic and cultural diversity. To provide continuity, members of the LRS Commission, LRS' current governing authority, have agreed to serve on the board beginning October 1, 2012.
Visit the Disability Rights Ohio website at www.disabilityrightsohio.org to learn more about the transition.
Two new Commission members appointed
William Crum of Columbus and Elena Lidrbauch of Cleveland were recently appointed to the LRS Commission. Crum, a Columbus business leader who rose through the ranks at Nationwide Insurance, was appointed by House of Representatives Speaker William Batchelder. This is the second time he has served as an LRS Commissioner, previously serving a partial term plus two full terms from 2001 to 2008 as Chair of the LRS Commission. He has also served as a board member for several organizations including the Ohio State Research Foundation, Ohio ADA Board, Ohio Head Injury Programs (Chair), Governing Council of the Ohio Statewide Independent Living Council and Governor's Council for People with Disabilities. "I learned early on the LRS team provides the means to make the dreams of many a reality," said Crum. "I look forward to rejoining the dedicated individuals comprising LRS."
Lidrbauch, an attorney for Hickman & Lowder who focuses on issues affecting people with disabilities and elderly individuals, was appointed by Senate President Thomas Niehaus. She also holds a Master of Education in Rehabilitation Counseling from Kent State University, spending 12 years working in the mental health field before returning to school to earn her Juris Doctor from the University of Akron School of Law. Commenting on her appointment she said, "I am very excited and honored to have been appointed to the Commission. I appreciate the advocacy work of the LRS staff and how important it is to the lives of persons with disabilities. I look forward to being part of this organization."
Crum and Lidrbauch join current Commission members Kalpana Yalamanchili (Chair) of Hilliard, Patrick Risser of Ashland, Kim Wisecup of Hilliard, and Joseph Witalec of New Albany. The Commission is LRS' governing authority.
LRS Commissioner Judge Peter Sikora dies
The LRS Commission and staff mourn the loss of Judge Peter M. Sikora who died April 18, 2012. He was appointed to the LRS Commission in 2009, a position he held until his death.
Sikora was deputy legal counsel to former Governor Richard Celeste, and deputy director and later general counsel for the department now known as the Ohio Department of Developmental Disabilities. For the past 19 years he served with distinction the people of Cuyahoga County as a Judge of Common Pleas Court, Juvenile Division. He was also involved on many civic boards, and belonged to numerous professional groups.
Sikora's engagement, wit, and intelligence set him apart from others in his field. His valuable contributions to the LRS Commission will be profoundly missed.
by Kerstin Sjoberg-Witt, LRS Legal Director
Receiving enough home and community based services is critical for many individuals who require assistance in order to live independently in their own home in the community. When agencies providing services assess a person's needs, the assessment should be based on the individual's own unique circumstances and individual functional needs.
LRS has been receiving requests for assistance from several individuals whose services have been reduced. These people are receiving home and community based services under a Medicaid waiver administered by CareStar, a contract agency of the Ohio Department of Job and Family Services. LRS found that CareStar has begun using as an assessment tool fiscal guidelines called "Colorado Norms" which were developed in Colorado to give home health agencies guidance on the average time needed to complete common care tasks. For example, the Colorado Norms assigns 15 minutes for assisting a person with walking to and using the toilet. But in reality, more than 15 minutes may be needed depending on the individual and their unique situation. A person's needs should be based on the unpredictability of daily living and cannot be neatly scheduled into discrete time blocks as described in the Colorado Norms.
Colorado Norms is neither mandated nor even mentioned by Ohio law that applies to Medicaid waiver services. However, CareStar is using the fiscal guidelines' timeframes to reduce the recommended amount of hours an individual needs, without considering that individual's unique needs that may require more time than the averages in the guidelines. The following are examples of how LRS has helped individuals faced with losing critical waiver services due to the use of the Colorado Norms.
LRS represents clients at state hearings to avoid service reductions
In one case, CareStar attempted to reduce personal care aide hours for a person who lives alone. She requires assistance with all basic living skills such as bathing, using the toilet, eating and moving around her apartment. She receives 16 hours per day of personal care aide services, but in a recent home visit her CareStar case manager challenged this level of need and, applying the Colorado Norms, determined that she only needed 12 hours per day. This, if implemented, would have prevented her from continuing to live independently in the community. LRS was successful in reversing CareStar's decision at a state hearing and her hours were not reduced.
In another case, a person was receiving 16 personal care aide hours per day with the remaining 8 hours per day funded through other sources. However, his CareStar case manager stated his hours would be reduced by three hours per day based on the Colorado Norms. LRS represented the client at a state hearing, arguing that even if the total amount of time to complete each discrete task was actually 13 hours, his need for services could not be predicted in a way that could be covered during a pre-determined 13-hour period. In addition, he still needed services during the 3-hour period they were proposing to eliminate. The hearing officer agreed and the client's amount of services remained the same.
If you or someone you know is experiencing a potential loss in care hours because of Colorado Norms or any other reason, contact the LRS Intake Department at 1-800-282-9181 or TTY 1-800-858-3542.
Assistive technology (AT) is any item, piece of equipment, or system commonly used to increase, maintain, or improve functional capabilities of people with disabilities. An AT device often is the key to helping someone lead a more independent life. However, many experience barriers in obtaining approval for AT, such as restrictive requirements, mountains of paperwork and required documentation, and a long waiting process that often leads to a denial of the request. LRS assists people with disabilities in acquiring necessary AT devices and services by providing information about the right to AT and types of AT available, as well as negotiating with service providers for the provision of AT devices and services.
Speech Generating Devices
One type of AT that people often need is a speech generating device (SGD). These devices provide people with severe speech difficulties the ability to meet their functional speaking needs. LRS has been successful in representing many clients in receiving SGDs. The following are a couple examples.
In one case, a person's request for a new SGD was denied multiple times over a two-year period. His current device was over 10 years old and unusable because of his progressive mobility difficulties. He needed a new device that better met his current communication needs. Medicaid denied the claim stating that the device was not medically necessary, although he had no way of communicating without the device. He appealed Medicaid's decision and contacted LRS for assistance with the state hearing. LRS negotiated with Medicaid and the device was approved just prior to the hearing. The client has since received the SGD and can once again communicate with his family and caregivers.
In another case, a child who is non-verbal had an older SGD that was no longer meeting her needs. Her parent had requested a new SGD and accessories to access the device from Medicaid, but prior authorization to purchase the device was denied several times. It was at that point that the parent contacted LRS. An LRS attorney assisted the client by working with Medicaid and the child's speech-language pathologist to submit additional information Medicaid needed to approve the device. The device was approved; however, some of the necessary accessories were not. LRS represented the client at a state hearing to appeal the decision. The appeal was denied so LRS then advocated for the device vendor to provide the equipment and pursue the provider appeal process. The client now has the SGD and accessories and can again communicate at school and with her family.
LRS negotiates for accessible entrance to apartment building
An apartment tenant who uses a wheelchair was not able to easily or safely enter his apartment building because the doors to the main entrance were not accessible. He contacted LRS because, in spite of multiple requests to the building manager, nothing was done to improve the conditions of the entryway which was too narrow for a wheelchair and didn't have power doors.
An LRS attorney negotiated with the property manager and the owner to make the necessary modifications to the building entrance. The client and other residents who use wheelchairs can now easily access their apartment building.
LRS assists veterans with service animal issues
A veteran was denied access to a Veterans Affairs (VA) facility because he had his dog with him and the dog wasn't certified as a service animal. The veteran receives treatment for anxiety and Post Traumatic Stress Disorder (PTSD) and the dog performs specific tasks to support him, such as providing assistance to prevent him from having anxiety issues in public places. The veteran contacted LRS for information on how to get his dog certified. An LRS attorney assisted him in getting the documentation required to meet the criteria of a service animal. His dog became certified and the veteran is thrilled that he can now participate more often in the community because of the support provided by his service dog.
In another case, a veteran was advised by his physician to get a service animal to assist him with mobility and PTSD. The veteran already had a dog and was interested in having his own dog trained and certified. He contacted LRS and an LRS attorney provided resources and also assisted him with finding someone who could train and certify his dog as a service animal. The veteran's dog is currently in the process of being trained.
For additional information about service animals, see LRS' publication: Service Animals: Rights and Responsibilities for People with Disabilities
Individual avoids institutionalization with LRS assistance
Thanks to a concerned guardian and an LRS attorney, a woman who was told she would have to remain in an Intermediate Care Facility (ICF/MR) was able to move back into the community. She had been moved to the facility after her mother, who was also her guardian and with whom she lived with, passed away. Her new guardian was told that the woman would not qualify for an Individual Options (IO) waiver and would have to remain in an ICR/MR. The guardian contacted LRS for assistance and an LRS attorney successfully negotiated with the county board of developmental disabilities to secure an emergency IO waiver. The client received the waiver and is now living in the community with appropriate services to meet her daily living needs.
LRS' Annual Report for federal fiscal year 2010-2011 is now available. The report features several successful case outcomes where LRS attorneys and advocates assisted people with disabilities to resolve complaints of rights violations, such as lack of reasonable accommodations, employment discrimination, denial of services to provide for community integration, and abuse and neglect. Selected litigation filed by LRS is highlighted, and a brief overview of the agency, summary demographic data about LRS' clients and a fiscal review of general expenses and income is included.
Read the report: LRS Annual Report 2011