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News from LRS - December 2011
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:
- PLEAS case dismissed after successful resolution
- LRS and People First support self-advocates
- Settlement establishes accessible parking policy
- LRS files employment disability discrimination complaint
- Action and results: Case summaries
- Winter heating season reconnect program
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PLEAS case dismissed after successful resolution
On December 15, 2011, the plaintiffs and defendants agreed to dismiss the federal court case, Parents' League for Effective Autism Services (PLEAS) v. Jones-Kelley, et al. The case was settled in September, ensuring continuation of behavioral health services for children with autism who receive Medicaid coverage. Although the terms of the settlement have been completed and the case dismissed, LRS will continue monitoring a newly created prior authorization process to ensure that Medicaid recipients receive the medically necessary services to which they are entitled. Prior authorization is an extra step providers must take in order to get approval for payment of some Medicaid services. If you or someone you know is having problems with getting approval through the new prior authorization process, please contact the LRS Intake department at 1-800-282-9181 or TTY 1-800-858-3542.
Case background
This federal lawsuit began in May 2008 when LRS filed suit on behalf of the PLEAS association and other individual children who received Applied Behavioral Analysis (ABA) services that were billed under the Ohio Department of Mental Health's (ODMH) Community Psychiatric Supportive Treatment (CPST) rules. At that time, the Ohio Department of Job and Family Services (ODJFS) and ODMH were prepared to rescind rules and file new rules that would have placed limits on the provision of CPST to Medicaid recipients. LRS alleged that the proposed rules would violate the right of children with disabilities to maintain, without interruption, needed medical services, and that without the needed services, the Plaintiff children risked suffering loss of skills, increases in unwanted, often dangerous behaviors, and placement in a segregated special education classrooms or institutional care.
LRS reached a settlement in the case in September 2011 under the following terms:
- The Court lifted the injunction;
- ODMH maintained the CPST rule that does not restrict services based on cognitive ability or recovery of lost skills;
- ODJFS filed a new rule that implements a prior authorization process for more than 104 hours of CPST services per year;
- 123 PLEAS member children and settlement beneficiaries were exempted from the prior authorization process for CPST services until those children reach age 21; and
- Defendants reimbursed plaintiffs' attorneys' fees.
Prior to dismissing the case, LRS wrote a letter to ODJFS expressing concern that Health Care Excel, the prior authorization vendor, was applying an incorrect standard to its determinations that children who are not covered under the PLEAS case are not entitled to more than 104 hours of CPST services. LRS pointed out that some of the rationale for denials included concepts that were in the rules that were enjoined by the court in the PLEAS case. In response to LRS' letter, Health Care Excel revised its notices to exclude the presence of developmental disabilities as a basis for denial of CPST services.
More information about the case is available in LRS' Legal Library: Parents League for Effective Autism Services (PLEAS) v Jones-Kelley
LRS and People First support self-advocates
LRS staff have been working closely with People First of Ohio to support their work to empower people with disabilities. In 2011, People First and LRS sponsored employment forums in an effort to generate ideas for expanding employment options in Ohio. The forums provided an opportunity for self-advocates to express their views. People First and LRS are working together to come up with an action plan based on the forums.
LRS supports People First because it is an organization run by people with disabilities for people with disabilities. The following article demonstrates how People First empowers people with disabilities to become self-advocates and to live self-determined lives.
Deanna's story
Deanna Hasty lives her own life. She has her own home in a community where she has many neighbors and friends. She works at a job she enjoys, is actively involved with self-advocacy organizations and stars in productions with a local theatre group. But it wasn't always this way. Deanna lived in an institution for most of her childhood, but with the assistance of People First of Ohio, she was able to transition into supported living and has become the person she is today - someone who makes her own choices and lives a life based on self-determination. Deanna recently shared her experiences with LRS.
What would you like people to know about you?
I would like to tell you about my life and how I have survived and become an active community citizen and a family member. The road has been hard at times but if you are trying to get out into the community I have found that you just need people who believe in you. I want to tell you about me now and then tell you about the hard times I have had. I like good things to come first in my story!
Deanna poses before going on-stage for the theatre production of Cinderella.
Where do you live and what do you do in the community?
I live in a cute house in a neighborhood where I do lots of activities with friends and neighbors. At work I see people all day who talk to me and ask me questions and I try to help them find what they are looking for. I also love acting and have been in many shows like Cinderella, Wizard of Oz and Charlotte's Web and am also on the board of directors of a local theatre group. There are many people in my life who support me. I still have to have help with some things, like taking care of my money which my friend Kelly helps me with. Joellen is an advocate who helps me be strong to tell people what I want. I have two best friends Kathy and Lynette, and I can't forget my boyfriend David!
Are you involved with any self-advocacy or other organizations?
People First has been my only family for many years. At People First I have held the positions in my local chapter as secretary and treasurer. I'm also on the People First Conference Planning Committee and have been a speaker. Before People First I was president of the Consumer Choice Club. I'm also in the Aktion Club where we do community service and lots of fun activities, like ball games and other events. I am also on a clown team and my name is "Pinky Dee."
You said that the road has been hard for you. What happened?
When I was five years old I lived in Missouri with my mom and brothers and sisters when a tornado ripped through our home. One of my brothers and I were the only ones to live. I was in a hospital for a long time and then my aunt took me and my brother to live with her and her ten kids. The state came in and said my father had to come get me, so when I was 11 years old I moved to Ohio to live with my father and stepmother. My father was a truck driver and was gone a lot. My stepmother took me to the Gruter Foundation and never returned to get me.
What was it like living at the Gruter Foundation?
It was a place where lots of people lived together. I was lonely and wanted someone to love me but there were people who did show me kindness. It was hard to forget where I came from because I had seizures and some other problems due to the injuries caused from the tornado. But as time went on I did not remember how I got there. It was just my life.
How did you get out of Gruter?
When I was in my 20s, Gruter closed and I was moved into many group homes with many people in and out of my life for several years. I then got into supported living and that's when I met Sadie who works at People First and we are still friends to this day. When we first met Sadie asked me if I had a dream what would I want to have. I told her I wanted to find my family.
Were you able to find your family?
The first Christmas after I met Sadie I went home with her to Nashville and that is where my dream to find my family began. Sadie's brother gave me a book on how to find your family and we read it and started to look for my family. We did a lot of research and Sadie found a phone number that belonged to my grandmother. When Sadie called her, she asked why she had not contacted me in all these years. She said that she called the place where they put me and that the place said I was so disabled that they could not enhance my life or me enhance theirs. Then Sadie put me on the phone and I talked with my real grandmother - I got a piece of my dream! Sadie and I went to visit my grandmother and I also met my uncle, aunts and cousins. Then we went to meet my brother and the rest of my family at a family reunion. Sadie helped raise money for the trip and she and I flew for the first time on a plane. Oh my what a wonderful day filled with so many faces that looked like me! I did not have part of a dream - I had the whole dream! Sadie arranged for me to stay a week after the reunion so I could get to know my family. I knew I would not be lonely again. I go back to the family reunions and visit my mom's family during the holidays. Now I even fly by myself!
What advice would you give to others?
At the beginning of my story is the good stuff and it is who I am today. The road has been hard at times but if you are trying to get out into the community you just need people who believe in you. I would like to tell other people to take the time with people with disabilities because you can change someone's life. People First has a saying, "We want what you got." I have my People First family but now I have my real family too! I have written a book about my life called "The Lonely Princess," and it does have a great ending because I am not lonely anymore.
Editor's note: Deanna would like to publish her book, "The Lonely Princess." If you know how she can make this happen please e-mail Sadie Hunter at shunter@columbus.rr.com.
Settlement establishes accessible parking policy
LRS reached a settlement on behalf of a college student with a disability who requires the use of an accessible parking space to safely enter and exit his van. The college has agreed to write and post a policy with regard to vehicles illegally parked in spaces reserved for vehicles with disability placards, provide the student with a van accessible parking space and pay him $5,000 in compensatory damages.
The complaint was originally filed in the U.S. District Court Southern District of Ohio Western Division and involved the college's failure to provide the client with a reasonable accommodation that would enable him to attend classes on the college's campus, thus violating his rights to be free from discrimination and to equal access to the college's facilities and participation in its program under Section 504 of the Rehabilitation Act and Title II of the Americans with Disabilities Act. The client drives a van that is modified for his wheelchair. The consistent lack of accessible parking spaces caused him to miss many classes. In addition, he received a physical injury when he was not able to safely enter his van because a car parked next to him and blocked his entrance to the van.
More information about the case is available in LRS' Legal Library: Ashland v Cincinnati State Technical and Community College
LRS files employment disability discrimination complaint
LRS filed a complaint in the U.S. District Court Southern District of Ohio Western Division alleging that the employer retaliated against LRS' client after she asserted her rights under the Americans with Disabilities Act. The retaliation took the form of treating her more harshly than others similarly situated, refusing to continue to provide her with a reasonable accommodation and terminating her employment. The complaint and demand for a jury trial seeks a remedy for the employer's retaliation; denial of and failure to provide reasonable accommodations to the client to allow her to perform her essential job functions; and the termination of the client's employment on the basis of her disability.
Read the complaint: Leah Marzougui v. Cincinnati Children's Hospital Medical Center, Dawn Denno (PDF file)
Action and results: Case summaries
LRS assists student to avoid placement in residential facility
A 15-year-old student with autism was at risk of being placed out of his school district and into a facility after a behavioral incident happened at school. The district, citing safety reasons, notified the student's family that it would no longer provide services for the student and proposed other options, including residential facilities that would have removed the child from his family home and community. After the family refused the proposed options, the school district filed criminal charges against the student.
LRS advocated on behalf of the child and his family for an appropriate out-of-district placement, but the school district refused to pay for the placement. LRS sent a demand letter to the district stating that the family would request a due process hearing. The district responded by agreeing to the placement. The charges against the student were dismissed when the placement was finalized.
LRS also filed a complaint with the Office of Civil Rights of the U.S. Department of Education regarding the efforts by the school district that led to the student's criminal indictment. The complaint alleges that the district interfered with the student's due process rights by misusing the criminal justice system to intimidate the student's family into agreeing to an out-of-district placement.
Client reimbursed for excessive payment of guardianship fees
LRS assisted a client who was being forced to make payments for guardianship fees above the amount his guardian receives through the county Probate Court's indigent guardianship fund. LRS investigated and found that the guardian, who is a local attorney, had made several requests to the Probate Court to withdraw nearly $4,000 from the client's account. The guardian stated that this was necessary because the client was over his resource limit and at risk of losing Social Security benefits. LRS' investigation concluded that this was not true. The client's representative payee reimbursed him for the amount withdrawn and informed the guardian that the client was financially unable to pay any future fees.
LRS negotiates on behalf of clients to receive BVR services
A client contacted LRS after receiving a letter from her Ohio Rehabilitation Services Commission (RSC) Bureau of Vocational Rehabilitation (BVR) counselor stating that she was placed on a waiting list as having a "significant disability." She felt that the determination was incorrect because BVR had not reviewed an outstanding report about her disability which would place her in the "most significant disability" category. LRS negotiated with BVR on the client's behalf, the disability classification was changed and she is now working toward reaching her vocational goal.
In another case, LRS assisted a client who was on RSC's Order of Selection waiting list but was told his case was being closed because he did not show up for an appointment. The client had not received a notice about the appointment and BVR assumed this meant he no longer wanted BVR's assistance. LRS negotiated with BVR to rescind the case closure notice and the client is now working with a BVR counselor.
LRS ensures student's access to school's programming and services
A student's Individualized Education Program (IEP) included the provision of closed captioning technology to aid in course instruction, but his school district had stopped providing this service during the school year. The student's parent contacted LRS when she was asked to sign a revised IEP that removed the language to provide closed captioning. LRS negotiated with the school district which agreed to purchase and provide closed captioning materials for necessary course instruction to the student.
Winter heating season reconnect program
Heating assistance is available to residential electric and natural gas customers through the Public Utilities Commission of Ohio (PUCO) Reconnect Program. The program allows customers who have had their home heating service disconnected or have received a disconnection notice an opportunity to pay to have their home heating service restored or maintained.
Customers must pay $175 or the amount owed, whichever is less, plus a reconnection fee of no more than $36 to restore or maintain service with their regulated natural gas or electric company. The winter reconnect order may be used one time during the winter heating season. The winter reconnect program also applies to customers seeking to establish new service. The program ends April 13, 2012.
There is no income eligibility requirement to participate, but the plan requires customers to sign up for a payment plan to pay any remaining past-due balance on their utility bill. Eligible customers may apply payments from the Emergency Home Energy Assistance Program toward the $175 amount. If a utility's reconnection fee is greater than $36, the utility may bill the balance of the reconnection charge to the customer the following month.
There are several other state and federal programs available to assist those who qualify, such as Percentage of Income Payment Plan Plus (PIPP Plus), the Home Energy Assistance Program (HEAP), the Winter Crisis Program and the Home Weatherization Assistance Program. More information about these programs and additional ways to save on home heating bills this winter is available at Ohio's Winter Heating Resource website.