Community Integration (CI) Team

PRIORITY 1:  People with disabilities will receive the services and supports they need to live in the homes of their choice.

RATIONALE: People with disabilities continually encounter various forms of discrimination, including intentional exclusion. In its 1999 opinion in the Olmstead case, the U. S. Supreme Court recognized that the Americans with Disabilities Act (ADA) places an integration mandate on the states as they provide care and treatment services. In January and July of 2000, the U. S. Department of Health and Human Services sent letters to state governors and Medicaid directors mandating that each state set forth a plan detailing how they would comply with the integration mandate. Rather than a plan, a only a report was produced in South Carolina in 2001. Not having an adequate plan has resulted in continued unnecessary  institutionalization of people with disabilties. This is compounded by way SC  state agencies administer the Medicaid Waiver processes. Further, existing Medicaid Waiver eligibility requirements are too narrow, thus limiting the number of people who qualify for waivers. These actions by state agencies clearly violate the integration mandate by preventing people with disabilities from receiving the services and supports they are entitled to and that would allow them their home of choice. Further obstructing community integration, people with disabilities continually encounter various forms of discrimination in trying to find accessible and affordable housing in the community. The ADA, the Fair Housing Act and other federal laws both prohibit discrimination in housing and require accessible housing for people with disabilities. However, in many situations public housing authorities and operators of government-subsidized housing have not complied with these laws.                           

OUTCOMES:

1. 80% of South Carolinians with disabilities represented will receive the services and supports they need to live in the homes of their choice. (50% PAIDD; 15% PAIR; 10%  PAIMI; 20%  PATBI; 5% PAAT) 

2. As a result of P&A intervention, DDSN’s policies/practices regarding eligibility determinations and receipt of services for the HASCI and MR/RD Medicaid waivers will be modified to ensure that eligibility is determined within 90 days from the date of application and that services are provided within a reasonable period of time after eligibility is determined. (40% PAIDD; 40%  PATBI; 20%  PAIR)

3. 80% of South Carolinians with disabilities represented will have available, accessible and affordable housing so that they may live in the homes of their choice. (50% PAIDD, 30% PAIR, 5% PAIMI, 10% PATBI; 5% PAAT)

PRIORITY 2:  People with developmental disabilities or traumatic brain injuries who wish to work in competitive employment rather than a sheltered workshop will receive the services and supports they need to realize their employment goals.

RATIONALE: People with developmental disabilities and traumatic brain injuries continually encounter various forms of discrimination in trying to access competitive employment. Both the ADA and the Rehabilitation Act of 1973 prohibit discrimination in employment. Additionally, in the Olmstead case, the U. S. Supreme Court acknowledged the integration mandate of the ADA. State entities providing services to people with developmental disabilities and traumatic brain injuries have failed to uphold this decision by ensuring that those who wish to leave sheltered workshops for competitive employment have access to appropropriate services, such as job coaches. When a person lives in a local board-operated home, they are often required to be involved in the local sheltered workshops. The impetus for this priority is the denial of services supporting competitive employment under the vocational rehabiliation and the disabilities and special needs systems.

OUTCOMES:

1. 80% of South Carolinians with developmental disabilities or traumatic brain injuries represented will receive the services and supports they need to work in competitive employment rather than a sheltered workshop and P&A will use these cases to identify any pattern of denial of opportunity for competitive employment or denial of the services necessary to prepare for/obtain competitive employment by local boards or DDSN and use this information to advocate for systemic changes in the policies and/or practices of the agency. (70% PAIDD, 20% PATBI, 10% PABSS) 

PRIORITY 3:  People with mental illness will receive mental health services and supports in their community to avoid unnecessary inpatient treatment.

RATIONALE:  Many people with mental illness in South Carolina do not have adequate community mental health services, including crisis services. Therefore, they often seek services in emergency rooms of general hospitals when they are in crisis.  The lack of community mental health programs also results in repeated  inpatient treatment as well as delays in discharge from state institutions such as Bryan Hospital and Tucker nursing facility.  The impetus for this priority is the concern over the number of people with mental illness who are forced into emergency rooms at local hospitals when they are in crisis and the "revolving door" between community and centralized in patient mental health facilities.  In order to address this problem, systemic changes must be made.

OUTCOMES:

1.   80% of South Carolinians with mental illnesses represented will receive the services and supports they need to live in the homes of their choice and avoid unnecessary inpatient treatment. (80% PAIMI, 20% PATBI)

PRIORITY 1: People with disabilities who reside in facilities will be protected from abuse and neglect.

RATIONALE: For people confined in residential facilities, physical safety is a fundamental right under our federal and state constitutions. In Youngberg v. Romeo, 457 US 307 (1982), the United States Supreme Court recognized the right of individuals in facilities to adequate treatment and   physical safety. The original goal of both PAIDD and PAIMI federal laws is to ensure that the right of safety for people with disablities living in facilities is protected. P&A intends to increase the safety of individuals from any form of abuse and or neglect, specifically children and adults in facilities who are victims of physical and sexual assaults, unlawful restraints or suicides due to inadequate treatment. Constituent calls and the priorities of advisory council members support the need for advocacy on behalf of people with disabilities alleging serious abuse or neglect in facilities. Therefore P&A involvement includes not only individual case representation, but monitoring juvenile justice facilities, community residential care facilities, facilities operated and/or funded by DMH and DDSN, and any other facility where a South Carolinian with a disability may be at a serious health and safety risk.

OUTCOMES:

1. P&A will protect or vindicate the rights of individuals in 80% of abuse and neglect cases selected for individual representation.  (60% PAIMI, 40% PAIDD)

2. P&A will successfully complete the following initiative involving restraint for at least one targeted facility: Changes in policies, procedures or training for any facility targeted for reform to reduce the use of restraints and eliminate excessive or inappropriate restraint. (50% PAIMI, 50% PAIDD)

3. P&A will successfully complete the following initiatives involving health and safety: Enforce compliance by facilities and the Medicaid oversight agency for reporting abuse and implementing standards for seclusion and restraint  (75% PAIMI, 25% PAIDD); and Improve safety of people with disabilities in detention centers by enforcing compliance with laws and standards for identifying, protecting, treating and, if appropriate, transferring detainees (50% PAIMI, 50% PAIDD).

4. P&A will inspect 100% of the CRCFs designated under the Department of Mental Health contract; P&A will report all legal violations to regulatory entities for appropriate corrective action. (85% TEAM, 15% PAIMI) 

PRIORITY 2: People with disabilities who are in the custody of the South Carolina Department of Corrections will receive legally adequate care, including adequate mental health care.

RATIONALE: As mental health systems have deinstitutionalized patients without implementing adequate community-based services, prisons have become the "new mental health facilities" in our nation. The NDRN case docket is full of cases seeking systemic reform for seriously inadequate mental health care in state and federal prisons. In recognition of this costly and dangerous problem, Nelson Mullins a large regional law firm, filed a state court action against SCDC on behalf of P&A and certain individual inmates. The action seeks adquate care for inmates suffering from serious mental illness. P&A also receives many calls and letters from inmates and their families seeking appropriate care for inmates with mental, physical, and developmental disabilities. If a case involves serious injury due to SCDC's failure to provide care relating to an inmate's disability, and the lack of care constitutes cruel and unusual punishment, P&A will consider individual representation.

OUTCOMES:

1. P&A will obtain adequate mental health care for inmates at SCDC. (100% PAIMI)

2. P&A will protect or vindicate rights of inmates with any type of disability in at least 80% of the cases selected for individual representation.  (50% PAIMI, 40% PAIR, 10% PAIDD)

PRIORITY 1: People with disabilities will overcome barriers to work.

RATIONALE: People with disabilities are often unaware of the rights and the remedies that are available to them when they have been a victim of employment discrimination.  Those who do know their rights and seek legal help are often not able to find it.  Private attorneys often do not take disability discrimination cases due to the impact of adverse federal court rulings and the limited likelihood of significant damage awards or fees.   The Equal Employment Opportunity Commission (EEOC) and the South Carolina Human Affairs Commission (SCHAC) accept only a limited number of cases for direct representation.    Thus, neither state and federal administrative agencies nor the private bar fully and effectively address this pervasive problem.  Accepting employment discrimination cases allows us to provide an additional option for representation from the unique perspective of a disability rights organization.  Further, people with disabilities often face barriers to work from a variety of sources--employers, Vocational Rehabilitation (VR), Employment Networks (EN), Work Incentives Planning and Assistance (WIPA) offices, Commission for the Blind, schools, colleges, universities, and others. Federal funding is available under the Ticket to Work legislation to help beneficiaries of SSDI and SSI who are facing such barriers.

OUTCOMES:

1. 80% of employment discrimination cases accepted will result in a successful resolution for the client. (PABSS 10%, PAIR 50%, PAIMI 10%, PAIDD 30%)           

2. 80% of cases accepted involving work-related adverse actions by SSA will result in a successful resolution for the client. (100% PABSS)

3. 80% of cases accepted that involve barriers to work created by Vocational Rehabilitation, Commission for the Blind, Employment Networks, Work Incentives Planning and Assistance Offices (WIPA), public schools,  and others will result in a successful resolution for the client. (PABSS 50%, PAIR 10%, PAIMI 10%, PAIDD 30%)      

PRIORITY 2: People with disabilities will be able to fully participate in the voting process.

RATIONALE: People with disabilities face discrimination in the voting process. Our work in previous years under the PAVA grant has indicated problems with inaccessible polling places in many parts of the state. Mental health consumers have identified discrimination in the registration process as another major problem. People who are deaf have indicated that lack of effective communication is a barrier to their participation in the voting process. Federal funding is available under the Help America Vote Act (HAVA) to address this problem.

OUTCOMES: (All PAVA)

1. 80% of individual cases and short term assistance cases that are accepted will result in successful resolution through non-litigation strategies.                      

2. Increase awareness of the voting rights of people with disabilities.

3. Increase the numbers of people with disabilities who are registered to vote.

4. Improve the State and County Election Commissions’ compliance with the Help America Vote Act and other laws that protect the rights of people with disabilities in the voting process.

PRIORITY 3: People who are deaf will be provided qualified interpreters or equivalent services to allow for effective communication in South Carolina courts.

RATIONALE: The failure of South Carolina Courts to provide interpreters needed for effective communication for people who are deaf has been a problem for years. It has been raised by numerous individual callers requesting assistance. Contacts with the Department of Outreach Services at the South Carolina School for the Deaf and Blind, the South Carolina Department of Mental Health--Deaf Services Division, and the South Carolina Association of the Deaf have all identified this as a problem and have requested P&A assistance to resolve it. The PAIR Advisory Council has identified this as an important issue needing P&A's attention. The South Carolina Supreme Court has recently issued Rule 511 addressing Rules of Professional Conduct for Court Interpreters. This rule is directed to interpreters and not to the courts. It also does not address the legal obligations of the Courts under Title II of the ADA and other laws to provide effective communication to people with disabilities.

OUTCOMES:

1. Increase the lower courts’ and deaf community’s knowledge regarding effective communication rights.  Effective instructions will be issued by the Court Administration. (70 % PAIR, 10% PAIMI, 20% PAIDD)

2. 80% of clients will receive effective communication from the courts or a full and fair resolution of their complaint of the denial of effective communication. (70% PAIR, 10% PAIMI, 20% PAIDD)

PRIORITY 4: People with disabilities will have legal representation in order to enforce their legal rights so that they may access goods, services, employment and places in the community.

RATIONALE: Few resources are available to provide legal representation to people with disabilities when their rights are violated under civil rights laws such as the Americans with Disabilities Act, the Rehabilitation Act of 1973, the Fair Housing Act Amendments of 1988, and the South Carolina “Bill of Rights” for people with disabilities.  Callers regularly request our help in a wide variety of issues--employment discrimination, housing discrimination, architectural barriers, denial of needed reasonable accommodations, denial of effective communication (including, but not limited to, denial of effective communication by health care providers), and discrimination based on the use of service animals. An important function of a P&A is to provide a source of legal representation for these callers. Rather than attempting to identify beforehand the specific types of calls that will come in we can better serve the disability community by carefully screening calls using our case selection criteria and providing legal representation in a variety of important individual cases.

OUTCOMES:

1.   80% of the clients represented under this priority will receive a successful resolution of their complaint. (70 % PAIR, 10% PAIMI, 20% PAIDD)

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PRIORITY 1:  Students with disabilities in the public school system will receive appropriate Assistive Technology (AT) evaluations, devices and supportive services.

RATIONALE: Students with disabilities often need AT in order to benefit from the educational services provided by the public schools.  The Individuals with Disabilities Education Improvement Act (IDEA 2004) requires public schools that receive funding under the IDEA to provide necessary AT evaluations, AT devices, and AT services to students with disabilities at no cost to their parents.  This priority addresses school districts’ failure to provide appropriate AT evaluations, devices, and supportive services.  Previous case representation and intakes continue to indicate this is a serious problem in South Carolina. 

      OUTCOME:

1. 80% of students with disabilities in the public school system who are represented based on case selection criteria will receive appropriate AT evaluations, devices and/or support services. (100% PAAT)

PRIORITY 2:  Students with disabilities in the public school system will be placed in the least restrictive environment (LRE). ^[6]

RATIONALE:  The Individuals with Disabilities Education Improvement Act (IDEA 2004) and Section 504 of the Rehabilitation Act of 1973 (Section 504) both require school districts who receive federal funding to educate students with disabilities to the maximum extent appropriate with their non-disabled peers.  The Americans with Disabilities Act (ADA) requires school districts to provide reasonable accommodations to students with disabilities.  The ADA also requires that public schools integrate students with disabilities with their non-disabled peers.  This priority addresses the failure of school districts to place students with disabilities enrolled in the public school system in the least restrictive environment.  Previous case representation, surveys, and intakes continue to indicate that this is a significant issue in South Carolina.

OUTCOME:

1. 80% of students with disabilities in the public school system who are represented based on case selection criteria will be placed in the least restrictive environment. (40% PAIDD, 30% PAIMI, 25% STATE, 5% TBI)

PRIORITY 3:  Students with disabilities in the public school system who have health care needs will receive the health related services, accommodations or assistance they require due to their disability.

RATIONALE:  The Individuals with Disabilities Education Improvement Act (IDEA 2004), Section 504 of the Rehabilitation Act of 1973, as well as US Supreme Court decisions, require public schools to provide health services, accommodations and assistance to students with disabilities.  State law also requires school districts to provide individual health care plans to students with special health care needs. This priority addresses the failure of school districts to provide health related services, accommodations and/or assistance in the public school system.  Previous case representation, surveys, and intakes indicate there continues to be a failure to provide adequate health-related services, accommodations and assistance in the public schools in South Carolina. 

OUTCOME:

1. 80% of students with disabilities in the public school system who are represented based on case selection criteria will receive the health related services, accommodations or assistance they require due to their disability. (50% PAIDD, 50% State)

PRIORITY 1:  P&A will provide quality outreach, information and referral services. 

RATIONALE: Within P&A’s mission statement, commitment to self-advocacy is the primary goal. P&A’s function is to ensure that people with disabilities have access to resources so that they can serve as effective self-advocates. An on-going goal of OIR is to inform people with disabilities of their rights and information how to access goods and services. In addition to outreach, accurate and timely information and referral services are crucial for effective self-advocacy. For many years, people with disabilities have been targets of discrimination. UNDERSERVED^[7] individuals with disabilities have additional barriers to overcome. OIR targets outreach to UNDERSERVED individuals with disabilities because according to the U.S. Census, approximately 1/3 of all South Carolina residents are African American, 1/3 are age 50+ and 1/3 reside in rural locations. South Carolina also has a strong link to the U.S. military^[8].

OUTCOMES:

1. People with disabilities, including those who reside in rural counties; whose native language is other than English; of minority ethnicity; and 50+ years old will be informed of P&A’s programs, services, and effective self-advocacy tools. (40% State, 30% PAIMI, 30% PAIDD)

2. Military[9] personnel with disabilities and their family members with disabilities will be informed of P&A’s programs, services, and effective self-advocacy tools. (10% PAIDD, 40% PAIMI, 30% PATBI, 10% PAIR, 10% STATE)

PRIORITY 2: P&A, as part of the SC DD Network, will work with people with disabilities, state agencies, disability rights organizations and local and state Emergency Management Division personnel to ensure that South Carolina emergency preparedness procedures and policies are inclusive of people with disabilities. These will include, but not be limited to, accessible transportation, accessible shelters, medication, and accessible communication including interpreters for people whose primary language is other than English including ASL and Spanish. (PAIDD, STATE)

RATIONALE: South Carolina has potential for a variety of emergencies and/or disasters including hurricanes and tropical storms; tornadoes; floods; earthquakes; fires; hazardous materials; dam failure; severe winter weather; transportation disruption; pandemic flu; terrorism; and nuclear power plants (5 facilities). Historically, individuals with disabilities have not been involved in planning.  Additionally in 2004, the U.S. President issued an Executive Order^[10] that recognized the importance of including people with disabilities in emergency preparedness.

OUTCOME:

1.   South Carolinians with disabilities will be aware of and involved in developing resources available for state, local and individual emergency preparation.

P&A will consider individual case representation issues that are legally compelling and are not identified under other priorities.

RATIONALE:  P&A resources are primarily dedicated to our planned case priorities.  However, other compelling issues may arise within a given year.  Cases will be taken under this priority only if resources are available and if there is strong legal merit.

OUTCOME: 

1.  80% of cases taken under this priority will be resolved successfully. (PAIDD, PAIMI, PAIR, PATBI, PABSS, PAVA, PAAT)