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
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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
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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
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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
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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
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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
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Code of Ethics http://www.guardianship.org/documents/Code_of_Ethics.pdf
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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.
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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.)
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Fundamental Placement Challenges
Housing optionsHome Service deliveryProfessional assessmentsEnvironmental modificationDurable Medical EquipmentInteragency Communication BarriersLack of facility staff education and training
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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.
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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)
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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)
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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
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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
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Last Slide
Yeah! We finished! Great job. Any questions? Let’s go to the beach28