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News from LRS - September 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:
- LRS reaches settlement to ensure medically necessary services
- Deadline to register to vote is a week away!
- LRS expands outreach to veterans with TBI
- LRS joins self-advocates at People First Forums
- Action and results: Case summaries
- Register now to attend the "Keys to Housing Options" conference
- October is National Disability Employment Awareness Month
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LRS reaches settlement to ensure medically necessary services
LRS reached a settlement in the federal class action lawsuit Parents' League for Effective Autism Services (PLEAS) v. Helen Jones-Kelley, et al., ensuring continuation of behavioral health services for children with autism who receive Medicaid coverage. LRS filed suit on behalf of the PLEAS association and other individual children who received Applied Behavioral Analysis (ABA) services at Step by Step Academy that were billed under the Ohio Department of Mental Health's (ODMH) Community Psychiatric Supportive Treatment (CPST) rules.
In 2008, the Ohio Department of Job and Family Services (ODJFS) and ODMH were prepared to rescind current rules and file new rules that would place limits on the provision of CPST to Medicaid recipients. The proposed rules would have limited CPST to individuals who lost skills and needed services to regain those skills. Also, a determination of cognitive ability to benefit from services would have been required. After a one-day hearing, the Court granted the plaintiffs' request for a preliminary injunction to maintain the current rules until trial on the merits. Defendants appealed the decision to the 6th Circuit Court of Appeals which upheld the lower Court's decision.
The parties entered into settlement discussions and reached an agreement that:
- Asks the Court to lift the injunction;
- Requires maintaining ODMH's CPST rule that does not restrict services based on cognitive ability or recovery of lost skills;
- Authorizes ODJFS to file a new rule that implements a prior authorization process for more than 104 hours of CPST services per year;
- Exempts 123 PLEAS member children and settlement beneficiaries from the prior authorization process for CPST services until those children reach age 21; and
- Reimburses plaintiffs' attorneys' fees.
Once all actions are completed, the case will be dismissed. LRS will monitor the new prior authorization process to ensure that Medicaid recipients receive the medically necessary services to which they are entitled.
LRS Chief Legal Counsel Sue Tobin, when reflecting on the broader application of the case said, "The Court's precedent-setting decision in this case has been used in federal cases in other states, as well as in administrative appeals in this state, to support the provision of ABA through private health insurance and Medicaid." Tobin added that LRS has received requests for consultation from attorneys who are advocating for services in other states and has provided them with information and support.
Public hearing scheduled on proposed rules related to settlement
ODMH recently gave notice of its intent to rescind the CPST Service rule. In place of that rule and in accordance with the settlement agreement, ODMH is filing a 'new' CPST rule. The 'new' rule is the same CPST rule that was in effect in 2008 and was used to bill for behavioral health services provided to the plaintiff and other children with autism. Copies of the rules are available at: Ohio Department of Mental Health Rules (follow the link under the "Pending Rules" heading)
A public hearing on the proposed rules will be held on Wednesday, November 2, 2011 beginning at 10:00 a.m. in room 806 on the 8th floor of the Rhodes State Office Tower at 30 East Broad Street, Columbus, Ohio, 43215. Individuals may also submit written testimony by email, fax or mail:
Email: Janel.Pequignot@mh.ohio.gov
Fax: 614-752-9453
Mail: Janel Pequignot, Chief, Standards Development and Administrative Rules, 30 East Broad Street, 8th Floor, Columbus, Ohio, 43215-3430
For more information about the PLEAS case: Parents League for Effective Autism Services (PLEAS) v Jones-Kelley
Deadline to register to vote is a week away!
Are you registered to vote? If not, you have until Tuesday, October 11 to register if you want to vote during the November General Election. In Ohio, you are eligible to vote if you:
- Are a U.S. citizen;
- Are 18 years old or older, including if you will be 18 by election day;
- Live in Ohio for at least 30 days before the election;
- Are not currently in jail for conviction of a felony; and
- Have not been found incompetent to vote through a specific finding and order of a probate judge regarding voting. (A general finding of incompetency and guardianship does not take away the right to vote. An order must state that a person is not competent to vote. If it does not, the person can vote.)
You can register to vote in person at any of these places:
- Agencies that provide public assistance or disability programs;
- County board of elections;
- County treasurers' offices;
- Deputy registrars of the Ohio Bureau of Motor Vehicles;
- Office of the Ohio Secretary of State;
- Public libraries; or
- Public high schools or vocational schools.
You can also register by mail. Your registration must be postmarked at least 30 days before the election. You can print a voter registration application from the Ohio Secretary of State's website.
For more information on registering to vote, see LRS' Register to Vote - Frequently Asked Questions. Additional voter resources are available in the Voting section of the LRS website.
LRS expands outreach to veterans with TBI
One of LRS' goals through its federally funded Protection and Advocacy for Individuals with Traumatic Brain Injury (PATBI) program is to identify outreach opportunities, investigate the role of self-advocacy in veterans' services, and encourage referrals from service organizations for service members and veterans with traumatic brain injury (TBI). To increase its outreach capacity to veterans and others with TBI, LRS and the Brain Injury Association of Ohio (BIAOH) are working together to achieve these mutual outreach goals.
BIAOH director Suzanne Minnich and LRS Supervising Attorney Kristin Hildebrant at the joint meeting between BIAOH and LRS.
In September, staff from LRS and BIAOH met to explore possibilities for greater information exchange and collaboration to increase community integration for individuals with TBI, and to increase outreach and support to returning service members and veterans with TBI. LRS shared its community integration initiatives for individuals residing in nursing homes with behavioral health needs and asked for input from BIAOH on whether individuals with TBI might have similar service needs that could be met through this ongoing work. BIAOH shared its experiences with outreach efforts to service members, veterans and families. Future meetings will be held to continue discussions.
Staff from LRS and BIAOH discuss ways to work together to achieve mutual outreach goals.
BIAOH director Suzanne Minnich was also instrumental in connecting LRS with the TBI Workgroup of OhioCares, a collaboration of state and local agencies supporting the behavioral health of returning Operations Enduring Freedom and Iraqi Freedom veterans and their families. LRS' participation on the workgroup led to a project with the Chillicothe Veterans Affairs (VA) Medical Center to create a brochure on how LRS can assist veterans with disabilities. The VA will provide feedback on the brochure, including its review by veterans, and will assist in its dissemination.
Most recently, LRS took part in a "Stand Down" at the Chillicothe VA Medical Center, an all-day event focused on providing services to veterans who are homeless. According to LRS supervising attorney Kristin Hildebrant, "The event was an outreach success. Gaining access to the veterans' community and making connections with veterans service providers can be difficult for civilians. LRS' participation in the Stand Down helped us reach out to and connect personally with over 100 veterans who are homeless and in need of advocacy."
Throughout the year LRS has participated in national meetings and collaborated with other state's organizations to share best practices and identify opportunities to increase veteran outreach efforts. LRS also provides information and resources for veterans on its website in the Veterans with Disabilities section.
LRS joins self-advocates at People First Forums
People First of Ohio is holding "Employment Call-to-Action Forums" throughout the state in October and November. The purpose of the forums is to bring advocates together to work on an action plan to create more employment opportunities, better wages and benefits for people with disabilities.
Self-advocates will lead the discussions at the forums. An employment specialist from LRS will attend each forum to provide information and answer questions about employment rights. Representatives from the Ohio Department of Developmental Disabilities and the Ohio Rehabilitation Services Commission will also be present.
The first forum, held in St. Louisville on September 13, was a great success. People First of Ohio received valuable ideas from advocates for the action plan. The remaining forums are scheduled for:
October 17, 2011, 6:30 - 8:30 p.m.
Athens Community Center
701 E. State Street
Athens, OH 45701
October 20, 2011, 7:00 - 8:30 p.m.
Ability Center of Greater Toledo
5604 Monroe Street
Sylvania, OH 43560
November 3, 2011, 6:30 - 8:30 p.m.
S&H Products
435 S. Stolle Avenue
Sidney, OH 45365
There is no cost to attend, but please RSVP to Carrie Swingle at 740-397-6100 or carrie@peoplefirstohio.org.
Action and results: Case summaries
Client wins appeal to receive in-home aide through Level 1 waiver
A client with escalating behavioral issues was denied a request to receive waiver services from his county board of developmental disabilities. The parents, concerned for their son's safety, contacted LRS for assistance. LRS represented the client at a state hearing and the hearing officer ordered the county board to grant emergency status for a waiver. The client is now receiving services from an in-home aide through the Level 1 waiver and other home health services through the Medicaid state plan.
Accommodations ensure health and safety of clients
LRS represents clients who have been denied a request for an accommodation. Denying such requests has the potential to cause harm to an individual and often the request is simple to implement and will not cause substantial additional costs. The following are examples of cases where LRS represented clients who were denied reasonable accommodation requests.
A client who visits a treatment clinic to receive medication was unable to make her weekly appointments after she was in an accident that caused her to use a wheelchair. Since the clinic would not provide home delivery of the medication, a friend of the client offered to take her to the clinic. However, the clinic did not have accessible parking spaces or entrances to the facility. LRS, on behalf of the client, negotiated with the clinic and the client now has the use of an accessible parking space behind the clinic and is able to receive her medications.
In another case, a client who uses a wheelchair contacted his landlord to ask for accommodations to allow him to safely access the walkway to his apartment. He was told that they would "make a note of it." The client contacted LRS and negotiations by LRS with the apartment owner resulted in a plan to have a curb altered for wheelchair access and to implement a process of timely snow and ice removal of the walkway during the winter.
LRS assists client in successful appeal to preserve nursing services
LRS represented a client at a Medicaid state hearing to appeal a decision to reduce the client's night nursing hours from eight hours to one. CareStar, the case management company contracted through the Ohio Department of Job and Family Services, had proposed to reduce the child's nursing services provided through the Transitions Waiver. The client's parents, with assistance from an LRS attorney, appealed the decision and presented evidence of their child's medical needs at the hearing. The hearing officer found that the weight of the evidence showed that the client's medical condition necessitated the need for eight hours of nursing per night and directed CareStar to rescind the reduction in hours.
Register now to attend the "Keys to Housing Options" conference
LRS is a co-sponsor of the upcoming "Keys to Housing Options" conference, an event to provide information, resources and supports for Ohioans with disabilities who want a home of their own in the community. The conference will be held November 8-9, 2011 at the Hyatt Regency Hotel in Columbus. Space is limited so register now!
At the conference, you will learn new and important information about living in a home of your choice, including how to advocate for more safe, affordable, accessible housing in your community. Workshops will cover many topics, such as learning about support programs, preparing for emergencies, connecting with the community, understanding rights and responsibilities and more. Featured speakers are Al Condeluci, Derrick Dufresne, Eleanor Smith and panels of people with disabilities. See the conference brochure for a complete list of workshops and details about the speakers.
The event is organized and sponsored by the Ohio Developmental Disabilities Council, the Ohio Olmstead Task Force and Ohio HomeChoice with financial support from LRS. For more information and to register: Keys to Housing Conference
October is National Disability Employment Awareness Month
Congress designated each October as National Disability Employment Awareness Month. During the month, events and activities are being held throughout the United States to increase public awareness of the contributions and skills of American workers with disabilities and to highlight employment barriers that still exist for people with disabilities. The national theme for this year is "Profit by Investing in Workers with Disabilities."
According to the Library of Congress, this public education effort began in 1945 when Congress enacted a law declaring the first week in October each year "National Employ the Physically Handicapped Week." In 1962, the word "physically" was removed to acknowledge the employment needs and contributions of individuals with all types of disabilities. In 1988, Congress expanded the week to a month and changed the name to "National Disability Employment Awareness Month."
The Fall edition of the DD Quarterly newsletter, published by LRS for the Ohio Developmental Disabilities Council, will focus on employment initiatives and issues affecting people with disabilities in Ohio. The newsletter will be available later this month on the LRS website in the DD Quarterly section.