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Team Updates

Abuse, Neglect, & Discharge Team

Monitor and Investigate

Death Report Review Results in Investigations and Corrective Action Plans

The AND Team reviewed 79 death reports and submitted comments 24 cases to the Mortality Review Committee (MRC). The MRC reviewed all cases and comments, and found enough evidence to issue Tier II letters, informing the provider that the actions or refusal to act may have indirectly contributed to the individual’s death, and demanding a corrective action plan. IDR also noted a pattern of deaths at one location. While no concerns were identified, the MRC instructed the provider to complete a root cause analysis to determine if there are other issues within the home that need to be addressed. (P&O 1.1)

Advocate

Investigation Leads to Plan of Correction

IDR investigated “Ammon’s” allegation of physical and emotional abuse by his supported group living house supervisor. IDR found that staff failed to report the allegation of abuse to BDS within the required timeframe, failed to thoroughly investigate the allegation of abuse, failed to adhere to their investigation policies, and failed to provide the required training for staff. IDR filed a complaint with IDOH, which found numerous failures that required a plan of correction.  IDR reported these failures to BDS and the provider and requested the concerns be addressed, for the benefit of all residents. (P&O 1.1, 2.1)

Educate

Presentations Reach 201 SAMHSA Staff Around the U.S.

In October, Tina Frayer presented to Substance Abuse and Mental Health Services Administration (SAMHSA), “A Photo Tour of Indiana’s Residential Facilities.” There were 45 people in attendance from across the United States and Territories. In December, Executive Director Melissa Keyes presented at the SAMHSA All Hands meeting to 156 SAMHSA staff. Officials praised IDR’s our work for truly implementing the spirit of the PAIMI program. (P&O 1.1, 2.1, 2.5)

Success Story

IDR Acts on Behalf of Youth in Immediate Jeopardy

“Aleksa” is a youth living in a group home. IDR found that the group home was calling the police to manage behaviors. An Immediate Jeopardy finding was issued to the group home due to lack of appropriate care and treatment of Aleksa. Thanks to IDR’s advocacy, DCS removed Aleksa from the provider, found her a new provider, and Aleksa is doing well. (P&O 1.1)

Monitoring Team

Monitor and Investigate

IDR Conducted 30 monitoring visits at ten facilities this quarter. (P&O 1.1)

Success Story

Monitoring Leads to Reports Filed with Overseeing Entities

The AND team’s investigations and monitoring of facilities resulted in four reports sent to IDOH, DCS and CPS for possible abuse, neglect and exploitation of residents in a PRTF, a supported group living facility and a long-term care facility. Monitoring allows IDR to protect the health and safety of residents. (P&O 1.1, 2.1)

Rep Payee Team

Monitor and Investigate

IDR started 15 new cases, had 21 cases in progress, and completed 10 cases this quarter. (P&O 1.1)

Advocate

IDR completed 77 appointments, i.e, payee appointments, beneficiary appointments, legal guardian appointments and/or third-party appointments. (P&O 2.1)

Success Story

AND and Rep Payee Teams Collaborate on State Hospital Fiduciary Reviews

Representative payees (rep payees) are slated for fiduciary review every three years. This includes state psychiatric hospitals who serve as representative payee to committed individuals. During this review period, IDR was assigned a review at Evansville State Hospital and Richmond State Hospital.

In a collaborative effort, IDR’s Social Security Rep Payee Coordinator, who also serves as the Monitoring Coordinator, enlisted the help of IDR monitors to conduct the rep payee reviews. IDR Monitors interviewed the beneficiary sample and conducted a monitoring visit of the areas those individuals frequent. The Monitor then provided the Rep Payee Reviewer all necessary information in a format compliant with Social Security requirements.

Thanks to the strong relationship between Monitors and the facility and its’ beneficiaries, the review was completed efficiently and accurately. Thanks to these two teams for all their hard work. This work fulfills IDR’s priority to investigate and monitor facilities for rights violations, including abuse, neglect, or exploitation. Additionally, it furthers the work assigned to the Protection and Advocacy system via the Strengthening Protections for Social Security Beneficiaries Act of 2018 whose purpose is to improve and strengthen the representative payment program. (P&O 1.1)

Civil Rights Team

Advocate

IDR Asks Governor for Clemency

Attorneys Sam Adams and Melissa Keyes sent a letter on December 6, 2024, to Governor Eric Holcomb, seeking clemency for death row inmate Joseph Corcoran. Mr. Corcoran, a person with serious mental illness, was sentenced to death in 1999 after admittedly killing four people. Although multiple psychiatrists and legal advocates expressed that Corcoran was unlikely competent to stand trial and noted that Corcoran’s mental illness influenced his decision not to use procedures that could delay or prevent his death, both state and federal appeal courts declined to intervene. Unfortunately, Mr. Corcoran was executed on December 18. Read the full letter. (P&O 2.1)

Educate

IDR Presents on Disability Discrimination at National Lawyers Guild

Attorney Sam Adams presented at the Law4ThePeople Convention on the topic of disability discrimination in housing and government services in October 2024. (P&O 3.1)

Success Story

IDR Clarifies Rights Regarding Assistance Animals

IDR recently released new fact sheets about Service Animals and Emotional Support Animals. This quarter, two assistance animal cases were tackled by the Civil Rights Team. Thanks to IDR’s advocacy, “Andre” was permitted to keep an emotional support animal at his home, and “Athena” was permitted to be accompanied by her service animal while donating blood. (P&O 2.1)

Litigation

Current cases pending. No updates this quarter.

Education Team

Advocate

Education Team Supports Dozens of Students

Forty students have been supported this quarter by the Education Team. Staff advised families on programs, services, and accommodations to support students’ academic success. Advocates helped families understand the IEP process and interpret reports and evaluations. IDR staff attended Case Conference meetings to help parents and students communicate their concerns and advocate for their rights to a free appropriate public education. (P&O 2.1, 2.5, 3.1)

Success Story

Bullying Based on Disability Addressed in the IEP

“Austin” and his family needed IDR’s help to advocate for updates to his IEP to address bullying Austin was experiencing. With IDR’s help, the school agreed, and added accommodations and services, including speech language therapy and social skills instruction, as it was believed that the bullying was related in significant part to Austin’s language deficits and social skills deficits. If a child with an IEP is being bullied, harassed, or teased due to their disability, parents can request it be addressed by the Case Conference Committee. (P&O 2.1)

Employment Team

Monitor and Investigate

DRS Employment Systems Transformation Plan Needs to Inform Sheltered Workers about CIE

IDR, CPR, and DRS continued meeting regularly to discuss implementation of DRS’s Employment Systems Transformation Plan. The teams clarified VR’s process for informing sheltered workers about competitive integrated employment options, the new Career Exploration service through the CIH and FS Waivers, and the potential changes due to the transition to a new gubernatorial administration. (P&O 2.2)

Advocate

IDR and Long-Term Care Advocacy Coalition Fight to Expand Self-Directed Waiver Services

IDR Policy Director Emily Munson continued actively participating in the LTCAC and DRS leadership to expand self-directed waiver services, without jeopardizing those that currently exist for limited participants. (P&O 2.3)

Educate

College Students Learn Their Rights

In October, Emily Munson and Ashim Singh, from ICRC, participated in a National Disability Employment Awareness Month webinar sponsored by Ivy Tech. Students, faculty, and staff learned what constitutes employment discrimination based on disability, how to request a reasonable accommodation in the workplace, and where to get help if they experience employment discrimination. (P&O 2.1, 3.1)

Success story

Post-Secondary Education Through VR Possible Even with Learning Disability

“Angel” receives employment services from VR and wanted to pursue post-secondary education. VR refused post-secondary education citing Angel’s learning disability as the reason. Thanks to IDR’s legal representation, Angel’s case was appealed and settled, with VR agreeing to amend her Individualized Plan for Employment (IPE) and provide Angel with education services to complete a college degree. (P&O 2.1, 2.2)

Health Care

Monitor and Investigate

IDR Serves on the Mortality Review Committee (MRC)

The Healthcare Team participates in the Bureau of Disabilities Services (BDS) Mortality Review Committee, which meets monthly to review reports of recent deaths of individuals receiving BDS services. (P&O 1.1)

Success Story

IDR Fights Involuntary Discharge

IDR represented “Adrian,” who lived in an assisted living community, when the facility recommended that he be placed in inpatient mental health treatment, due to alleged behavior concerns. When Adrian’s guardian declined placement, the facility issued a thirty-day notice of involuntary discharge. IDR appealed and witnesses and exhibits were prepared. Shortly before the hearing, the facility withdrew the involuntary discharge notice, allowing Adrian to remain in her home. (P&O 2.1, 2.3)

Self-Determination

Advocate

IDR Staff Joins “Brain Injury and Domestic Violence” Subcommittee

Justin Schrock was selected to serve on the Indiana Traumatic Brain Injury Advisory Board and Stakeholder subcommittee focused on “brain injury and domestic violence.” (P&O 3.2)

Educate

IDR Educates Special Education Professionals on Supported Decision-Making

IDR staff presented to IIDC’s Southwest Indiana Transition Cadre, a multi-disciplinary group of special education professionals focused on transition-aged youth, regarding decision-making supports for young adults and various reasons why educators should be hesitant to recommend that families seek guardianship over students. This presentation will be repeated for the East Indiana Transition Cadre in early 2025. (P&O 3.1)

Technical Assistance

• Staff provided technical assistance to nine community stakeholders, schools and state agencies regarding guardianship and supported decision-making. (P&O 2.4)
• Staff educated the Indiana State Public Defender’s Office regarding options available under the Indiana Probate Code that may help them advocate for clients with limited decision-making capacity who wish to seek post-conviction relief. (P&O 2.4)

Press

Staff Attorney Interviewed by Fox59 Regarding Alleged Assault

Fox 59 interviewed Justin Schrock regarding a story of a man whose former home health aide allegedly assaulted and attempted to rob him in his home. Justin provided recommendations as to the limited steps Indiana consumers and families can take to try to avoid similar incidents. (P&O 1.1)

Success Stories

Retaining Rights When Loved One Dies Intestate

Due to IDR’s involvement, “Amy” retained her legal rights and avoided being taken advantage of after the passing of her mother. Amy’s case manager contacted IDR after her mother died without a will. Amy had no surviving immediate family and a neighbor appeared to be attempting to “groom” her into consenting to a legal guardianship. IDR counseled Amy and her waiver support team regarding her available options and the neighbor ceased efforts to become her legal guardian. Afterward, a creditor initiated an action regarding the mother’s estate. IDR successfully negotiated with the creditor to have a Special Administrator appointed to protect Amy’s interest in the estate proceeding. The Special Administrator will assist Amy in establishing a special needs trust funded by her share of the proceeds of her mother’s estate. (P&O 2.1, 2.4)

Rights Restoration After Identity Theft Led to Guardianship

Because of IDR’s assistance, “Avery” had his legal rights restored after being the victim of identity theft. Avery had his personal financial information stolen by so-called friends, who made fraudulent purchases with Avery’s money. Avery and his parents were incorrectly advised that the only way to address the situation was to become Avery’s legal guardians. After two years, Avery and his parents recognized guardianship to be unnecessary and overly burdensome. With assistance from IDR, Avery and his parents cooperatively ended the guardianship, and Avery established decision-making support instruments permitting his parents to continue assisting him with managing his finances and healthcare. (P&O 2.4)

Policy & Special Projects Team

Public Comments

Assisted Living Facilities that Fail to Provide HCBS are Institutional

In October 2024, IDR submitted public comments regarding the heightened scrutiny review of two assisted living facilities in Indiana. The heightened scrutiny review process, created through the federal HCBS Settings Rule, requires states to examine whether certain settings that receive payment for providing HCBS services to clients genuinely facilitate clients’ community integration or, instead, are mostly institutional. IDR’s comments explained its reasons for finding that neither facility overcame the presumption that it has significant institutional qualities. (P&O 2.3)

Clarity Needed for Proposed Investigation Process

In December 2024, IDR submitted comments in response to proposed regulations about the mental health referral program. More specifically, IDR: (1) expressed concern that councils’ ability to amend program guidelines at any time fails to promote transparency and clarity; (2) suggested that the proposed 30-day timeframe between identification and the scheduling of an assessment is too lengthy; and (3) recommended that FSSA consider adding more clarity, transparency, and structure to proposed investigation practices. (P&O 2.1, 3.2)

IDR Urges Division of Aging to Include Service Recipients in Provider Accountability Process

In December 2024, IDR submitted comments to the Division of Aging in response to a proposed rule regarding the Division’s provider fine practices. While IDR supports oversight agencies holding providers accountable for noncompliance, it shared several concerns about the proposed rule. Perhaps most importantly, details about fine levels and their intended application is absent. Additionally, IDR raised concerns that several proposed factors for fine mitigation are overbroad. IDR also asked for more information about how service recipients will be engaged in the fine determination process, as well as suggested that revenue generated from paid fines should be used for the ultimate benefit of service recipients rather than go to the General Fund. (P&O 2.3)

Advocate

IDR Staff Joins Governing Board of National Consumer Voice

Emily Munson interviewed to join the Policy Committee of the Governing Board of the National Consumer Voice. After the interview, she was then invited to join the Governing Board, which has more decision-making authority. Emily was thrilled to accept the important role to push advocacy for quality long-term care to a new level. (P&O 3.2)

Voting

Monitor and Investigate

Determining Whether County Websites Were Accurate and Accessible for Voters

Attorney Tash Crespo led a project to determine whether Indiana’s counties offered voters accessible and accurate information about early voting through their respective websites ahead of the November 2024 General Election. IDR staff and volunteers evaluated all 92 counties. Results from the survey will be shared with election officials. (P&O 2.6)

Tash also presented to election administrators from the Certification in Election Administration, Technology, and Security (CEATS) program at Ball State in December on ensuring elections are accessible (P&O 2.1, 2.6)

Advocate

IDR Asked Candidates Non-Partisan Disability Policy Questions

In September 2024, IDR’s Policy Team asked candidates for statewide and federal office to answer a brief, nonpartisan questionnaire about disability policies. IDR posted these responses to the Hoosiers Vote website. IDR hopes to expand this project in future elections, including through the solicitation of topics from Hoosier voters with disabilities. (P&O 3.2)

Final Gubernatorial Debate Offered Live ASL Interpretation

IDR arranged for Indiana’s final televised gubernatorial debate to offer live American Sign Language (ASL) interpretation. To provide the Deaf community with the most accurate interpretation, a Certified Deaf Interpreter (CDI) worked on-screen in tandem with two off-screen ASL interpreters. WFYI staff expressed interest in incorporating ASL interpretation in future debates. (P&O 2.6, 3.2)

Success Story

Self-Advocate Votes in Person for the First Time

“Ava,” a resident of a long-term care facility, told IDR staff at the SAI Picnic in September that she wanted to vote in person. An IDR advocate spoke with her staff, and Ava was taken to the polling location to cast her vote in person for the first time. (P&O 2.1)

Education & Outreach

Educate

IDR Staff Educate 567 Individuals on Rights Issues

IDR staff provided 12 presentations to 567 attendees, on topics including advanced directives, supported decision-making, overview of IDR services, ADA Title I, ADA Title II, the Know Your Rights coloring book, and election accessibility. (P&O 3.2)

Staff Interact with 400 Attendees at NAMI Indiana Conference

Tash Crespo and Michelle Wickham hosted an information table at the NAMI Indiana Conference in October. They interacted with over 400 people and handed out 150 print resources. See image at right. (P&O 3.1)

Outreach

Staff Create Relationships to Support Advocacy

Carmen Ledezma and John Heinz attended the U.S. District Court Southern District of Indiana’s celebration of Hispanic Heritage Month, where they introduced IDR’s mission and services to several organizations serving the Latino population. This connection will help foster relationships that will help the agency better serve Latino clients. (P&O 3.2)

PSP Team members Carmen Ledezma and Michelle Wickham attended the November meeting of the Indiana Migrant Seasonal Farmworker Coalition and later met with leaders from Purdue’s MESA program and the Great Lakes ADA Center to share IDR resources, in English and Spanish. IDR was able to fulfill an immediate need for a Spanish-language reasonable accommodation resource for the Great Lakes ADA Center. (P&O 3.1, 3.2)

Press

IDR Attorneys Educate the Public Through Media Interactions

IDR attorneys spoke to members of the press 7 times, resulting in 8 published articles to educate the public about voting rights, caregiver abuse, Medicaid  questions, and severe mental illness and the death penalty. (P&O 3.1)

Supplemental Information

IDR Staff

Here is a current staff list.

Current Grant Programs

• CAP – Client Assistance Program
• PAAT – Protection & Advocacy for Obtaining Assistive Technology
• PABSS – Protection & Advocacy for Beneficiaries of Social Security
• PADD – Protection & Advocacy for Persons with Developmental Disabilities
• PAIMI – Protection & Advocacy for Individuals with Mental Illness
• PAIR - Protection & Advocacy for Individual Rights
• PATBI - Protection & Advocacy for Persons with Traumatic Brain Injury
• PAVA - Protection & Advocacy for Voting Access

State Hospitals

• LCH – Larue Carter Hospital
• LSH – Logansport State Hospital
• EPCC – Evansville Psychiatric Children’s Center
• ESH – Evansville State Hospital
• MSH – Madison State Hospital
• RSH – Richmond State Hospital