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Advocacy Director’s Report

June 21, 2014 Report

This report represents a summary of the work Disability Rights California (DRC) advocacy programs and projects reported through March 31, 2014; some activities on the legislative and press front may be more current. I would like to thank those who provided the material to make this report possible.

 

COMMUNICATIONS


Highlights of DRC Coverage in Mainstream Press

Press reports mainly covered:
-    Three DRC sponsored bills (SB 468, SB 555, and SB 651) signed by the governor. Coverage occurred October - November 2013, in Ventura County Reporter, NPR, LATimes, ABC News, and Press Enterprise.
-    Pay for home care workers—at issue for DRC is the new federal regulations, which require overtime and has resulted in a proposal to cap hours at 40 per week per worker. So the typical in-home supportive services (IHSS) recipient using a family member to provide assistance in the intimate areas of bathing, feeding and dressing would have to bring an unfamiliar worker into the home for needs exceeding the cap. Coverage quoting Legislative Advocate Deborah Doctor occurred January 2014, in Truth.dig and LATimes.
-    DRC participation in a presidential report on voting access for people with disabilities. Coverage occurred January 2014, in Disability Scoop.
-    A delay in placing hundreds of thousands of people with disabilities into managed care in seven counties was urgently requested by DRC and other advocacy organizations because a test of the process in Los Angeles County revealed problems in the notices and other signs of unreadiness. Coverage occurred February 2014, in Healthline and LA Daily News.

Also featured during this period:
-    An in-depth television investigation by Oakland’s KTVU in February 2014, questioned if selection processes for heart transplants at leading California hospitals discriminate against people with disabilities. Quoted was DRC Attorney Candis Bowles about the lack of transparency in how selections are made, and referenced DRC reports.
-    Pam Romano, public member of DRC mental health advisory board, and Leslie Morrison, director of investigations, co-authored an op-ed about implementation of Laura's Law for the Orange County Register, published in early May 2014. There is renewed activity about Laura's Law in northern and southern counties, and we are working to get our views out through newspapers and radio. (All of these stories can be found online: www.disabilityrightsca.org/news/press.htm)

See here for press reports: http://www.disabilityrightsca.org/news/press.htm

Communications Goal(s): Goal 2
DRC Staff: Scott Barron, Candis Bowles, Deborah Doctor; Barbara Duncan, Christina Hager, Leslie Morrison
Grant/Funding Source(s): Equal Access, Trust Fund

 

Press Releases

After multiple releases in October 2013, to explain the new laws resulting from our bills, we issued three additional press releases:
1) December 2013, promoting the new law requiring parity in provision of health and mental health services, noting our friend of the court brief to challenge the provider's narrow interpretation of parity (see Rea v. Blue Cross:  http://www.disabilityrightsca.org/CalMHSA/Materials/ReaConformedAmicusBrief101513.pdf and press release here: http://www.disabilityrightsca.org/news/2013_newsaboutus/20131204CalMHSAParity.htm);
2) January 2014, analyzing the impact of the Governor's budget on Californians with disabilities, emphasizing that more than 20% of this population lives in poverty and are still awaiting reinstatement of critical services cut back in leaner years (see http://www.disabilityrightsca.org/news/2014NewsAboutUs/20140115GovernorsBudgetProposal.htm); and
3) January 2014, clarifying our settlement with the Inland Regional Center that will result in easier to read and more timely notices about services for more than 27,000 people with developmental disabilities (see http://www.disabilityrightsca.org/news/2014NewsAboutUs/20140131PressRelease.htm).

Communications Goal(s): Goal 2
DRC Staff: Evelyn Abouhassan, Deborah Doctor, Barbara Duncan, Maria Iriarte, Laura Reich
Grant/Funding Source(s): Equal Access, Trust Fund, PADD, CalMHSA

 

Website, Social Media and Publications

Website:  We had 326,054 total visits to our website for this period; 63.50% stay on our pages 2 minutes or longer. Our top five visited pages were: homepage, about us, publications, connect with us, and special educations rights and responsibilities publication.  Our top non-English page was Spanish publications.

We have rotated out older photos and messages in the 12 website banners (slide show) at the top of our homepage, and have added new ones drawing on achievements in 2013. We will continue to update the banners on an ongoing basis.

Facebook: We use this social media platform to promote DRC positions, policies, and publications and illustrate our support for a wide array of issues and activities to advance disability rights. For example, in recent weeks we posted links to our new YouTube video featuring workers with disabilities in California businesses, our fact sheets about mental health stigma, staff participation in a seminar on managed care, our sponsorship of a forum for candidates for Secretary of State as well as staff recommended trainings, videos and books. See https://www.facebook.com/DisabilityRightsCalifornia

We have 2,150 likes; top rated items for views and comments concern DRC publications, reports of abuse or discrimination, announcements of webinars and advocacy events, and media portrayals of people with disabilities.

Twitter: DRC’s Twitter account is doing well and has been active for year as of April 25, 2014. We currently have 2,664 followers and have tweeted a total of 1,575 times in multiple languages. See https://twitter.com/DisabilityCA

YouTube: DRC’s YouTube channel now features multiple videos with more on the way. A total of seven videos are posted on our channel including: Our main “About DRC” video, two CalMHSA videos on “People First Language in Mental Health,” Theatre in the Now’s performance of “Your Rights, Your Voice, Your Vote,” and our three part “Integrated Competitive Employment” video series. Our videos have a total of 2,908 views. We are currently working on a new mental health stigma and discrimination video based on real people’s stories. See https://www.youtube.com/user/DisabilityRightsCA?feature=watch

Publications: Our top five downloaded publications this period were: “Special Education Rights and Responsibilities,” “Rights Under the Lanterman Act,” “In-Home Supportive Services Nuts & Bolts,” “Confidentiality of Mental Health Records/Information,” and “How to Obtain an Independent Educational Evaluation at Public Expense.”

Communications Goal(s): Goal 3, Objectives A, B, C, and D
DRC Staff:  Adam Borovkoff, Diana Duffy, Barbara Duncan
Grant/Funding Source(s): Equal Access, Trust Fund


LEGISLATIVE ACTIVITIES

NOTE: Legislative activities are current at the time this report was prepared, however, the legislature moves quickly and things can change overnight. For the most current information about legislative activities reported here, check our home page and legislative website: http://www.disabilityrightsca.org/ and http://www.disabilityrightsca.org/legislature/index.htm

 

Sponsored Bills

SB 1093 (Liu): This bill builds on legislative initiatives enacted over the last several years to address racial and ethnic disparities in the regional center system and ensure equal access to services.  First, it requires regional centers to develop objectives as part of their performance contract with the goal of increasing the use of regional center services among impacted diverse populations. Amendments also ensure that in the development of regional center performance objectives, regional centers consider feedback from key stakeholder groups. Second, it amends current law to clarify that Independent Living Skills (ILS) services are available to regional center consumers whether an individual chooses to live in the family home or chooses to move out. Many individuals with disabilities from underserved and diverse ethnic and cultural backgrounds often choose to live at home with their families as part of their cultural norm. However, some regional centers require individuals to plan to move out on their own before providing ILS services. This provision ensures that an individual receives ILS services, if needed, without being required to move out of their family home. Third, it requires regional center stakeholder meetings be held at times and locations that result in a high turnout by the public and undeserved communities. Finally, the law is being amended so that prior and current year purchase of service data reports are maintained on regional center websites for analysis and comparison purposes. DRC staff met with the author’s office, drafted amendments, and testified in committee in support of the bill. The measure passed the Senate Human Services Committee and the Senate Appropriations Committee. It is now on its way to the Senate Floor.

SB 1109 (Hueso): This bill would have required that anyone contracting with the state to provide services, pays their workers with disabilities at least minimum wage, for services provided under the contract. It would have created goals for persons with disabilities business enterprises, as defined in the bill, to participate in contracts awarded by a state agency for services. The legislation would have aligned with a recent federal executive order that raised the minimum wage to $10.10 per hour, applied to new federal contracts and replacement contracts beginning January 1, 2015, and covered individuals with disabilities working under service or concessions contracts; it grants these workers with disabilities minimum wage protections. Staff met with the author’s office, met with stakeholders who opposed the legislation, drafted amendments to address concerns, worked with other organizations to gather support, and testified in committee in support of the bill. The measure did not have the votes to pass the Senate Governmental Organizations Committee and died.

AB 1847 (Chesbro): This bill will replace offensive and outdated terms in California statutes concerning people with psychiatric disabilities. Some terminology still used today in California law reflects false beliefs about people with mental health life experiences. These include crazy, lunatic, insane, feeble-minded, mentally defective, and abnormal. This kind of terminology increases stigma by making assumptions about the characteristics of people with psychiatric disabilities. It can promote discrimination by promoting action based on these preconceived notions. Language in California codes has not kept up with the more contemporary mindset and terminology surrounding mental health issues. This bill will modernize terminology, using “people first” language, thereby promoting respect and dignity of people with mental health disabilities. We worked on the initial language of the bill and drafted several amendments to address stakeholder concerns about unintended consequences, and wrote a letter in support of the bill. It has passed through the Assembly and awaiting assignment to a Senate Policy Committee.

Public Policy Goal(s): Goal 1
DRC Staff: Evelyn Abouhassan, Brandon Tartaglia
Grant/Funding Source(s): Equal Access, Trust Fund

 

Update: Bills the Board Legislative Committee Approved Positions On

AB 1960 (Perea): This bill would require the attorney general to provide state summary criminal history information to the director of a state hospital for any patient committed to that facility for treatment. The bill would require the state hospital to only use the information for the purpose of treatment or the determination of security required for that patient and to remove the information from the patient’s file and destroy it within 30 days of the patient being discharged. This bill would also authorize a law enforcement officer at a state hospital who has access to the California Law Enforcement Telecommunication System to provide state summary criminal history information to the director of a state hospital. DRC is concerned that the bill is too broad, since it applies to patients who have not been found a “danger to others” by the court.  There is no limit on how far back into the criminal history for these patients the state hospital can go. There appears to be unlimited access to the records by anyone employed at the state hospital and few safeguards for protecting the information.  Assuming there is any value to reviewing the records: records are kept until the patient is discharged; once they are reviewed it is unclear why the records must be kept. For these reasons the DRC Board opposed the bill.  The bill passed through the Assembly and has been assigned to the Senate Health and Public Safety Committee.

 

Other Legislation

SB 577(Pavley):  This bill increases opportunities for individuals with developmental disabilities to gain integrated, competitive, community employment and career advancement by expanding the services offered to individuals with developmental disabilities to include a new “Community Based Vocational Development Service,” a service that will support individuals in achieving their vocational goals by increasing the opportunities for individualized job development and skills training.  The new service is conditioned a category of service which is conditioned upon qualifying for federal matching funds. We met with the sponsors, submitted a letter in support and will be testifying in committee.  We support SB 577 as it will provide the link for individuals to gain the skills necessary to transition into competitive or supported employment.

AB 1340 (Achadjian): This bill creates enhanced treatment programs (ETP).  Under current law the Department of State Hospitals (DSH) is authorized to develop ETPs.  In fact they have enhanced programs at Coalinga and Atascadero State Hospitals.  These programs are locked units of between 10 and 20 patients.  The patients on these units do not mingle with other state hospital patients, because they are locked into these units.  The individual rooms lock from the inside and no one can enter patient rooms without a key—patients can leave their rooms but not the unit.  Under current law, DSH is authorized to lock patients into rooms so they cannot leave as long as they comply with laws related to seclusion and restraint.  The primary purpose of this bill is to allow DSH to place patients in locked rooms, similar to prison cells, and exempt this practice from seclusion and restraint laws.  The other primary purpose of this bill is to allow patients to be locked in rooms through a simple referral by a psychiatrist or psychologist without due process prior to locking the patient up.  Once the patient is in the unit, treatment teams would make decisions about the length of time the patient would need to stay locked up in a room, again without due process.  A patient could stay locked in a room for years as the bill is currently structured. We are opposed to this bill because it exempts ETPs from seclusion and restraint provisions, does not provide adequate due process rights including a right to challenge the decision to be placed in an ETP, have a hearing before an independent decision maker, and a right to appointed counsel; and many provisions in the bill are vague and overbroad.  We have written letters, talked to legislators and their staff, met with stakeholders, met with DSH and worked to amend the bill.  The bill passed the Assembly and is currently in the Senate Health Committee.

AB 1455 (Campos): This bill will authorize a school district to refer a victim of, or other pupil impacted by an act of bullying, to related supports. These may include meeting with the school counselor, school psychologist, social worker, child welfare attendance personnel, school nurse, or other school support service personnel for case management, counseling, or participation in a restorative justice program. Children with disabilities are disproportionately discriminated against, harassed, intimidated, and bullied in schools, on the basis of their disabilities or on some perceived characteristic of having a disability. This bill will help them receive services to cope with instances of bullying, making it easier to remain in school with their non-disabled peers. We are supporting this bill through support letters and testimony at hearings. The bill has passed through the Assembly and is in the Senate Education Committee.

AB 1725 (Maienschein): This bill would have authorized the court, after a hearing, to recommend a conservatorship to the officer providing conservatorship investigation when the court, in a conservatorship established under the Probate Code, determines that a person, for whom a conservatorship has been established under the Probate Code, may be gravely disabled as a result of a mental disorder or impairment by chronic alcoholism or substance abuse and is unwilling to accept, or incapable of accepting treatment voluntarily. This bill would have provided a procedure for a family member or interested person who believes a conservatorship is necessary to petition the probate court to establish a conservatorship. We opposed this bill because a petition for conservatorship could have been filed when the conservatorship investigator did not recommend conservatorship. We were troubled by provisions that allowed a family member to petition for LPS conservatorship. Too often we have seen situations where people have been committed by their families when other less restrictive alternatives work better and encourage recovery. The expansion of grave disability to individuals with substance use disorders was not necessary because those individuals are already subject to probate conservatorship when they can’t meet their basic needs for food, clothing or shelter. We worked with the author, committee staff and stakeholders to remove the provisions described above and develop amendments that allow the probate court to recommend a conservatorship to the conservatorship investigator, if the probate judge, following a hearing, finds probable cause that the proposed conservatee is gravely disabled and is unable or unwilling to accept treatment voluntarily. These amendments were taken and we now have a neutral position on the bill.  The bill was held in the Assembly Appropriations Committee on suspense.

AB 1816 (Yamada): This bill will require the California Department of Public Health (CDPH) to complete investigations of complaints of abuse and neglect in long-term care facilities within 40 working days of their receipt. The period may be extended up to an additional 30 days if the department has diligently attempted, but has not been able to obtain, necessary evidence related to the investigation. The bill requires the department, if it extends an investigation, to notify the complainant in writing, of the basis for the extension.

There have been significant delays by CDPH in issuing citations involving the most grave and dangerous practices at developmental centers, state psychiatric hospitals, and other long term care facilities. Too often, years have elapsed before CDPH issues a citation, imposes a fine and requires a facility to take appropriate corrective action. This leaves other residents at risk for similar incidents during the intervening time period. By requiring CDPH to complete its investigations in a timely manner, evidence is more likely to be preserved, witnesses’ memories will be fresher, and perpetrators will more likely to be prosecuted. We support this bill and have sent letters and testified at committee hearings. It passed the Assembly Appropriations Committee and is headed to the Assembly Floor.

AB 1848 (Allen) and 1885 (Bigelow): These bills would have required notice before a person with a disability could file an action against a business for violating the laws related to architectural access for people with disabilities. This bill treats people with disabilities as second class citizens by targeting them for additional procedural and legal barriers to enforce their rights. The bills single out people with disabilities, alone among all groups with civil rights protections, to jump through legal hoops before being able to have their civil rights violations addressed. Further legislation was passed just last year to address issues raised by businesses related to complying with access laws.  There has been insufficient time to determine whether the changes as a result of that bill have had time to improve the situation. We opposed the bills.  We wrote letters, made legislative visits and testified at hearings.  Both bills failed in the Assembly Judiciary Committee.

AB 1873 (Gonzalez) and AB 2028 (Mullin): These bills dealt with all mail elections.  Both bills proposed to allow all mail elections for all special elections regardless of the size of the community.  We opposed these bills because vote by mail, while useful for some people with disabilities, is inaccessible to numbers of voters with disabilities, such as those who are blind, have manual dexterity disabilities or learning disabilities. Paper ballots are not accessible to people with certain disabilities because they cannot read or mark the ballot unassisted, which means they cannot vote privately or independently as required by the federal Help America Vote Act. No attempt was made in the bills to provide alternatives for people with disabilities to vote privately and independently when paper ballots are not accessible to them, such as accessible voting locations with accessible voting systems. Through our advocacy efforts, AB 2028 was amended and is now a pilot program for San Mateo and includes access provisions.  AB 2028 passed out of the Assembly Elections Committee and is now on the Assembly floor. We wrote letters and testified against AB 1873.  It passed out of the Assembly Election Committee and is on Assembly Floor.

AB 2041(Jones): This bill seeks to make training and education requirements for Behavior Management Assistants and Behavior Management Consultants who provide behavioral health treatment to individuals with pervasive developmental disorders and autism spectrum disorders consistent with the definition of behavioral health treatment services that are covered under health care service plans and policies. The proposed change allows other behavioral health practitioners to be vendors of regional centers and be included in a health care service plan network to offer behavioral health services consistent with current law. The definition for "behavioral health treatment" provided for in statute for purposes of the health insurance coverage mandate includes certain evidence-based, behavior intervention programs that are not categorized as applied behavior analysis (ABA). Not all health insurance plans are adhering to the mandate to cover behavioral health treatment provided by some programs because the regulations specify that professionals need education and experience in ABA. AB 2041 allows vendorization of alternative evidence based modalities and allows practitioners to make treatment decisions based on the unique needs of the child rather than using a "one size fits all" approach to therapy. Consistent with our principles, we advocated for the legislation and wrote letters in support.  The bill passed the Assembly and is currently in the Senate Committees on Health, Human Services and Appropriations.

AB 2186 (Lowenthal): This bill proposed to make changes to how psychotropic medication is administered involuntarily to people who are incompetent to stand trial (IST). We opposed this bill because psychotropic medication and their side effects are always a serious concern; emphasis should be placed on providing treatment that is agreed to by the patient, including non-medication based treatment. Involuntary medication is not always the best option for a patient, working with a person so they voluntarily agree to treatment, including treatment other than medication, produces better outcomes. The bill did not contain adequate due process in order to protect substantive rights (liberty interest). The proposal favored court calendaring and administrative interests over the liberty interests of the individual. We worked with the author on amendments to correct our concerns and now have a neutral position on the bill.  The bill has passed through the Assembly and is now in the Senate Public Safety Committee.

AJR 36 (Gonzalez): This resolution aims to establish fair wages and equal treatment for all workers by calling on the federal government to end the use of Special Minimum Wage Certificates for workers with disabilities.  These certificates, allowed by Section 14(c) of the 1938 Fair Labor Standards Act, allow employers to pay workers with disabilities less than minimum wage.  Subminimum wages are determined by time studies, which compares the “productivity” of a worker with a disability as determined by the speed of task to that of a worker without a disability. DRC staff drafted a letter of support and testified in support of the measure when the bill was in the Assembly Labor and Employment Committee. The resolution was passed by the Assembly and Senate, enrolled by the Secretary of State and chaptered.

Public Policy Goal(s): Goal 1
DRC Staff: Evelyn Abouhassan, Dan Brzovic, Margaret Johnson, Leslie Morrison, Brandon Tartaglia
Grant/Funding Source(s): Equal Access, Trust Fund

 

Budget

IHSS: When the Governor’s Budget Proposal was released in January, we promptly analyzed it and sent a press release (http://www.disabilityrightsca.org/news/2014NewsAboutUs/20140115GovernorsBudgetProposal.htm) concerning missed opportunities and a harmful proposal to limit the hours worked by caregivers in the IHSS program. Since January, and collaborating with other organizations, DRC staff have spoken out about these issues in legislative hearings, in the press and in trainings and outreaches.

Outreach, Public Education and Training Goal(s): Goal 1
Public Policy Goal(s): Goals 1 and 2
DRC Staff: Deborah Doctor
Grant/Funding Source(s): Equal Access

Department of State Hospitals: The budget proposes a $1.5 million General Fund to design and plan for specialized short-term enhanced treatment programs (ETPs) at most state hospitals, totaling approximately 44 new beds. DSH plans to lock patients into individual rooms, similar to prison cells, when it is “clinically indicated.”  They further propose to exempt these rooms from licensing requirements related to seclusion and restraint and place patients in them without adequate due process, such as a hearing before a judge or hearing officer. DRC is opposed to specialized short-term enhanced treatment programs unless the ETPs comply with current federal and state licensing requirements (Health & Safety Code § 1180 et seq.), including requirements related to seclusion and restraint and include adequate due process before patients are placed in them. Secluding patients in locked rooms deprives a patient of their personal liberty, which violates numerous federal and state laws, including the United States Constitution. Prior to placing a patient in a restrictive placement, adequate due process must be provided in the form of a hearing before an impartial judge or hearing officer with an independent attorney or advocate to represent the patient. The budget proposal is premature, since underlying policy changes, including those related to exempting locked rooms from licensing laws, have not passed through the legislature and been signed by the governor. See AB 1340 discussed above. DRC has sent letters, visited legislative offices and budget committee staff and testified at budget hearings.

Public Policy Goal(s): Goal 1
DRC Staff: Margaret Johnson
Grant/Funding Source(s): Equal Access, Trust Fund

 

Coordinated Care Initiative

The 2012 budget authorized the Coordinated Care Initiative (CCI), by which persons eligible for both Medicare and Medi-Cal (dual eligibles) will receive medical, behavioral, long-term supports and services including home- and community-based services, through a managed care health plan in eight demonstration counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara).

CCI contains three key components: 1) Cal MediConnect—individuals who receive Medi-Cal and Medicare (dual eligible) and who elect to receive both Medi-Cal and Medicare through a managed care plan; 2) mandatory enrollment of dual eligibles (including those who opt out of Medi-Connect for their Medicare services) into Medi-Cal managed care for their Medi-Cal services including long term services and supports; and 3) movement of long-term supports and services into managed care for duals and for seniors and persons with disabilities (who are already in managed care for their Medi-Cal). The original statute named certain conditions, which if not met would kill the CCI and links these components together so that each component could not go forward exclusive of the other. The 2013 legislature amended the CCI statute to allow any component to go forward without the others, and pushed the start date to no earlier than April 1, 2014. Because of problems in some of the managed care organizations, deadlines have changed many times and roll-out in some counties will start in late 2014 or in 2015.

For three years, DRC staff, in joint advocacy with other organizations pushed to improve the possible outcomes for individuals with disabilities in the following areas: 1) the role of independent ombudsman; 2) increasing transparency; 3) ensuring appropriate Long Term Care Services and Supports and; 4) improving state plan readiness, scope, and speed of the roll-out. We advocated in the legislature, with CMS, with members of congress and with the state administration. The state did create an independent ombudsman function and changed some of the policies and documents, in response to pressure from advocates.

Now enrollment has begun; consumers and advocates report significant problems, most of which we and others warned about, including:
1) Confusion from enrollment notices and materials that are misleading and not understandable—and were never tested with beneficiaries;
2) Bad information from the enrollment broker;
3) Populations receiving notices when they are exempt; and
4) Widespread disability inaccessibility of offices and information.

Public Policy Goal(s): Goals 1 and 2
DRC Staff: Dan Brzovic, Deborah Doctor, Ron Elsberry, Elissa Gershon
Grant/Funding Source(s): Equal Access

 

Outreach and Education

Disability Capitol Action Day: This year is the 11th anniversary of our annual Disability Capitol Action Day. The event will be held on May 21, 2014. We are currently working on the logistical planning with our advocacy partners, including The Arc, the California Association of Public Authorities, and the California Foundation for Independent Living Centers. We are working on a legislative platform covering several bills and budget items of major importance to the disability community. We will work with our advocacy partners to ensure we have a comprehensive document that the community can agree on. The platform will be distributed at the event to inform the public and the legislature about the concerns of people with disabilities. It will be used to train attendees so they can be better informed when making legislative visits on the day of the event.

Public Policy Goal(s): Goal 2
DRC Staff: Brandon Tartaglia
Grant/Funding Source(s): Equal Access

 

IU Staff Testify at Informational Hearing about Delays in Licensing Investigations

In late January, Leslie Morrison, Director of the Investigations Unit at Disability Rights California, testified at a joint oversight hearing of the Assembly Committees on Aging and Long-Term Care; and Health.  The committees were focusing on the responsiveness of the Department of Public Health (Department) to consumer complaints about long-term care facilities and professionals certified by the Department. 

For years, the IU has noted significant delays in the Department completing investigations and issuing findings (i.e., “citations”) in cases involving grave and/or dangerous practices that have resulted in resident injury and death.  Often years lapse before the Department requires that the facility take appropriate corrective action.  Such lengthy delays leave other vulnerable residents at risk for similar incidents of abuse or neglect during the intervening time period.

At the hearing, Ms. Morrison described several examples:

-    On July 20, 2010, a 30 year old skilled nursing facility resident with paraplegia died from uncontrolled bleeding from pressure ulcers at his groin.  Over two years later, the Department issued a citation, citing the facility for failure to monitor the use of blood thinning drugs with this resident.

-    In November 2007, two witnesses saw care staff at a psychiatric nursing facility smearing feces on a patient’s face and putting it in his mouth.  An investigation by the facility confirmed the incident. Nearly four years later, in August 2011, the department issued a Class B citation for $1,000, citing the facility for failing to treat patients with dignity and respect and ensuring they are not subjected to physical and mental abuse by staff.

-    In March 2008, a 36 year old resident with cerebral palsy and spastic quadriplegia was assaulted by a CNA employed at his six-bed ICF.  The CNA was arrested and charged with dependent adult abuse.  Four years later, L&C issued a Class B citation for $1,000, finding the facility failed to protect the resident from physical abuse. 

Ms. Morrison described cases, “often languishing in a bureaucratic quagmire, awaiting review and approval by upper level management, medical experts, and attorneys.”  She and other advocates called for the legislature to set minimum timelines by which the Department complete investigations.  Ms. Morrison recommended these timeframes be structured so that the most egregious incidents, those resulting in death or posing an imminent risk of serious harm, receive the most prompt attention.  Disability Rights California has drafted legislation to set deadlines and is currently looking for a legislator to author the bill.  Ms. Morrison is due to testify at an oversight hearing by the Senate Committees on Health and Business, Professions and Economic Development regarding similar issues in mid- February.

Public Policy Goal(s): Goal 1
DRC Staff: Leslie Morrison
Grant/Funding Source(s): Trust Fund

 

PEER SELF-ADVOCACY

 

Peer Self Advocacy Group Successes

Advocating for Rights as a Tenant: After a training using DRC materials “Tenants with Mental Health Disabilities: The Right to Reasonable Modifications in Housing,” a self-advocacy group member of El Progreso worked with her social worker to ask her landlord for a reasonable modification to have her emotional support animal live with her in her apartment.  As a result, the landlord waived a no-pets rule to allow her to keep her emotional support animal, which helps her maintain her wellness and recovery.

ADA and Employment: El Progreso self-advocacy group members have been learning about their rights under the ADA when they apply for jobs. Using the information gained about pre-employment questions and assertiveness skills, one group member advocated to keep the information from an employer requested medical examination in a separate medical file rather than in his personnel folder. He successfully asserted his right to keep his personal medical information confidential. He also learned that testing for illegal use of drugs in not considered part of a “medical examination,” but that the employer could request that he be tested prior to making an offer of employment.  He felt more confident and informed knowing his employment rights.

Reaching out to the Asian/Pacific Islander (API) Community: We presented a training on reducing stigma and discrimination for members of the Asian Coalition at the Department of Mental Health in Los Angeles.  Participants were receptive to the information and provided input and insight into the issues they face as members of this community, such as the belief that physical health symptoms are more readily recognized and accepted than mental health symptoms. The training provided some strategies that participants could use to overcome stigma and discrimination and help people in their community get the mental health services they need.

Board and Care Residents Assert their Rights: Many self-advocacy group members of the San Francisco OSHPSA group live in board and care facilities and were not aware of their rights as residents. As a result, they started asking questions about their rights to their money, and learned who to talk to if they had rights violations to report.  One of the group members had questions about how he was being paid at his job.  He found out that he was being paid below minimum wage because his employment contract was for “piece work.” With this new information, he understood how he was being paid and could decide whether he wanted to continue working there under those circumstances.

Self-Advocacy Group Members Return to their Communities: Several members of PSA self-advocacy groups have been discharged from facilities and returned to their communities. Two people left Crestwood Redding and four people were discharged from Napa State Hospital. Some of the topics that the groups had focused on included, discharge planning as well as “How to Get Out and Stay Out,” based on our publication of the same name.

Corner Clubhouse Group Members’ Successes: A recent topic that the members of the Corner Clubhouse self-advocacy group in San Diego have discussed is advanced directives. Group members followed along, step-by-step, and one person completed theirs, had it signed by a witness and gave it to her psychiatrist. Group members have learned how advance directives are an important way to assert their rights and make their own decisions about their future healthcare. Learning about Section 8 housing, a group member decided he wanted to be on the waiting list, and has begun to plan who he will ask to help him with the process. Another individual spoke to his doctor and got a medication change after learning self-advocacy skills from PSA materials such as, “How to Talk with Your Doctor.”

Peer-Self-Advocacy Goal(s): Goal 1, Objective A (Self-Advocacy Groups) and B (Workshops)
DRC Staff:  Leonard Alfaro, Debi Davis, Robyn Gantsweg, Lisa Hurley, Senobia Pichardo
Grant/Funding Source(s):  PAIMI

 

Stigma and Discrimination Reduction Activities

Under our CalMHSA project funding, we have conducted several presentations, at professional conferences (i.e., Tools for Change and CASRA) and in the community. Some of the presentation topics included employment discrimination, parity in mental health services, stigma and discrimination reduction among law enforcement officers, and the right to service and emotional support animals. We presented additional CalMHSA trainings at the Esperanza conference in Alhambra, the Patients’ Rights Advocacy Training conference in Sacramento, the Latino Conference in Los Angeles (our presentation was in Spanish) and a training on reducing stigma and discrimination in employment for Lake County staff. We have been successful in our outreach efforts, including meeting with Behavioral Health Directors of both Orange and San Diego Counties and the mental health director at the Union of Pan Asian Communities (UPAC) to discuss our work and ways to reach traditionally underserved communities. We have several trainings already planned for the coming year, including two trainings in Santa Barbara County in June and two trainings at the National Alliance on Mental Illness conference in Newport Beach. PSA staff have worked in collaboration with DRC legal staff on a policy paper on hospital diversion and recovery aftercare that will help facilitate change in our mental health services on a broader, systemic level. Additionally, we collaborated with other DRC staff to develop a YouTube video that involved interviews with mental health consumers about their own experiences with stigma and discrimination, which is in the process of being completed.

Peer-Self-Advocacy Goal(s): Goal 1, Objective B (Workshops)
DRC Staff:  Leonard Alfaro, Rob Chittenden, Monica Gallegos, Robyn Gantsweg, Lisa Hurley, Senobia Pichardo, David Solis
Grant/Funding Source(s):  CalMHSA