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Establishing a Place of Abode: A Person-Centered Approach to Meet the Challenge of the Establishing a Place of Abode: A Person-Centered Approach to Meet the Challenge of the

Establishing a Place of Abode: A Person-Centered Approach to Meet the Challenge of the - PowerPoint Presentation

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Establishing a Place of Abode: A Person-Centered Approach to Meet the Challenge of the - PPT Presentation

NGA Conference 2013 Terry W Hammond Esq Orit Simhoni PhD 1 Sun Oct 13 2013 345500 pm Breakout Session We will describe nonadversarial and litigious strategies for personcentered discharge from facility to community We review a classaction suit in which a person under guar ID: 750732

uls person services code person uls code services legal ethics rule guardianship amp environment 2013 http assistance www centered

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Slide1

Establishing a Place of Abode: A Person-Centered Approach to Meet the Challenge of the NGA Code of Ethics Rule #3

NGA Conference 2013Terry W. Hammond, EsqOrit Simhoni, PhD

1Slide2

Sun. Oct 13, 2013 (3:45-5:00 pm) Breakout Session

We will describe non-adversarial and litigious strategies for person-centered discharge from facility to community. We review a class-action suit in which a person under guardianship is a plaintiff, asserting his right under ADA to live in the most appropriate integrated setting.2Slide3

Session Handouts

Casantro, Simon & Roman (1988). A Model Code of Ethics for Guardians Rule 3-Custody of the Person; Establishing a Place of Abode. NGN (2011).

Third National Guardianship Summit Standards of Excellence-Guardian Standards and Recommendations for Action.

Wood, E. &

Simhoni

, O. (2013).

Still a Best-Kept Secret in Adult Guardianship: Using the Skills of Occupational Therapists.

Third Amended Complaint, Thorpe v. D.C., Case No. 1:10cv02250, Docket No. 98 (filed March 27, 2013).   Center for Public Representation (2013). Intellectual Disabilities. Evans v Gray.DC LTC Ombudsman for the District of Columbia (2012). Testimony Submitted to the Committee on Health, DM

3Slide4

1 hr 15 minutes: up to 15 min for discussion, questions; 2 min average per slide; 60 min= 30 slides OK?

Icon for Terry slides, Orit slides… legal scale , ruby slippers.  ?4Slide5

The Back Story

5Slide6

Key Concepts

Person-Centered Approach in Guardianship CasesNGA Code of Ethics Rule #3 Custody of the Person; Establishing a Place of AbodeADA Integration MandateInclusionLeast Restrictive Environment

6Slide7

The Person-Centered Approach in Guardianship Cases

Defined in standards (new) terry sent themThe Person-Centered Approach is based on the theory of Dr Carl Rogers. It is a non-directive approach to being with another (BAPCA, 2011 @ http://www.bapca.org.uk/)

Application for guardians: The individual makes his or her own choices —regardless of the guardian’s beliefs, values, and ideas

7Slide8

Code of Ethics http://www.guardianship.org/documents/Code_of_Ethics.pdf

8Slide9

Code of Ethics Rule 3

3.1 – 3.39Slide10

Code of Ethics Rule 3

3.3-3.810Slide11

Americans with Disabilities Act

http://www.ada.gov/ada_intro.htm11Slide12

Integration Mandate

http://www.ada.gov/olmstead/q&a_olmstead.htm12Slide13

Inclusion

Inclusion is a philosophy that states all individuals, regardless of ability, should participate within the same environment with necessary support and individualized attention.  Inclusion is more than simply placing individuals together, it’s a belief that all individuals belong and are valued (Kasser & Lytle, 2005).Kasser, S.L., & Lytle, R.K. (2005).

Inclusive physical activity: A

liftetime

of

opportunities.

Champaign, IL: Human Kinetics.

13Slide14

Least Restrictive Environment

The doctrine of least restrictive environment provides that restrictions on liberty should be limited to the minimum necessary to accomplish the asserted government purpose. This is a key concept to support placements in smaller, more home-like facilities. Such placements are aimed at improving the residents’ quality of life and increasing their chance of maximizing their independence. (Zuckerman, Deborah and March Charmatz,

Mental Disability Law

, Fourth Edition 1991.)

14Slide15

15Slide16

16Slide17

Fundamental Placement Challenges

Housing optionsHome Service deliveryProfessional assessmentsEnvironmental modificationDurable Medical EquipmentInteragency Communication BarriersLack of facility staff education and training

17Slide18

Challenges…

Financial issuesRegulationsAdd MORE CHALLENGES (endless…)18Slide19

Added challenge; ULS assists again, sept 2013

ULS is happy to assist Community Connections with obtaining the medication information the CRT needs.  Regarding the issues you noted related to Mr. X’s mobility and administration of medication, it is inappropriate to place Mr. X’s application on hold for the reasons cited.  

Under D.C.

Mun

.

Regs

. tit. 22B § 3827.2, a person may not be disqualified from placement in a CRF because they: (1) are not ambulatory, (2) need assistance with medication administration, including injections, (3) need limited or intermittent nursing care, among other reasons.  As Ms. S noted, Mr. X is a Medicaid beneficiary who receives PCA services from a home health aide.  Standby assistance must be available in contract CRFs because  persons in CRFs are entitled to receive their PCA services in a CRF.  Mr. X spends most of his days at a day program, and his home health aide can provide any standby assistance that is necessary when he is in the CRF.     

Regarding PRN narcotics, Mr. X’s ACT treatment team can create a plan to accommodate Mr. X to administer these medications, if needed.  Medication administration should not be a barrier to CRF placement. Please advise on how the CRT intends to proceed. 

19Slide20

Ensuring the Least Restrictive Environment Available

Factors to be considered (3.2, 3.3, 3.6)Non-Adversarial Methods (3.1, 3.4, 3.5. 3.7)Litigious Methods: Retaining legal counsel to assist if necessary (Rule 3.8)

20Slide21

Non-Litigious Solutions

Case ManagementCase ConferenceIndependent Service Plan (ISP)Meeting with facility staff and administratorOmbudsmanLetter to key decision-makerComplaints (e.g., state, Department of Professional Regulations, mayor’s office, DMH)

21Slide22

More Non-Litigous Solutions

MediationFamily TherapyMore…..22Slide23

BATNA: Litigation

Bar complaintJudicial complaint23Slide24

University Legal Services

http://www.uls-dc.org/24Slide25

ULS language: OK with Dari

University Legal Services is a private, non-profit organization that serves as the District of Columbia's federally mandated protection and advocacy system for the human, legal and service rights of people with disabilities.Services provided by ULS under the protection and advocacy grants include information and referral; education and training; investigation of reported or suspected instances of abuse or neglect; legal counsel; technical assistance, and litigation services; and technical assistance regarding legislative and policy concerns. All services are offered free of charge to eligible individuals in accordance with ULS' available resources and policies.

ULS' staff includes professional advocates and attorneys

25Slide26

Orit to connect call to terry, uls

Review of handouts: terry will call dari re: ULS26Slide27

Acknowledgments

Dari Pogach, Esq.University Legal Services220 I St NE Suite 130Washington, DC 20002Draft slide thank you for contribution to presentation

27Slide28

Last Slide

Yeah! We finished! Great job. Any questions? Let’s go to the beach28