AGENCY ANNUAL PROGRAM PERFORMANCE REPORT FOR PATBI

REPORTING PERIOD FROM 10/1/2016 TO 9/30/2017

STATE: Michigan

AGENCY NAME: Michigan Protection & Advocacy Service, Inc.

DATE SUBMITTED: 12/15/17

mmull@mpas.org

AGENCY INFORMATION

Agency Name: Michigan Protection & Advocacy Service, Inc.

Address of Agency:

a. Main Office:

4095 Legacy Parkway, Suite 500, Lansing, Ml 48911

b. Satellite Office(s) (if applicable):

129 W. Baraga Ave., Suite A Marquette, Ml 49855-4644 906-228-5910

c. Contract Office(s) (if applicable):

N/A

Agency Telephone Number: 517-487-1755

Agency Toll-Free Telephone Number: 1-800-288-5923

Agency TTY Number: 517-374-4687

Agency Toll-Free TTY Number: N/A

Agency Fax Number: 517-487-0827

Agency E-Mail Address:

Agency Web Address: www.mpas.org

Executive Director Name: Elmer L. Cerano

Executive Director Email: ecerano@mpas.org

Staff Preparing Report Name:

Staff Preparing Report Email: mmull@mpas.org

Staff Preparing Report Office Location: Main office

Michelle Mull

Total Individuals Receiving l&R ServicesTotal Number of l&R requests during the Fiscal Year

144185

Number of Trainings Presented by StaffNumber of Individuals Who Attended These Trainings

234

PART I: NON-CASE SERVICES

A. INFORMATION AND REFERRAL SERVICES (l&R)

8. TRAINING ACTIVITIES

3. Describe at least two (2) trainings presented by the staff. Be sure to include information about the topics covered, the purpose of the training, and a description of the attendees.

Supported in part with PATBI funds, staff provided training to 17 nurses at a Sexual Assault Nurse Examiner (SANE) conference. MPAS has been invited to present at this conference for several years in an effort to educate nurses and first responders who work in a variety of settings - emergency rooms, schools, nursing homes, etc. - about MPAS and our federal authority to investigate allegations of abuse and neglect in addition to other advocacy services. Information provided included an overview of MPAS history, the priority-setting process, types of MPAS advocacy, investigations and information & referral services.

Staff also provided this training to 17 masters-level forensic nursing program students at Oakland University.

4. Agency OutreachDescribe the agency's outreach efforts to previously unserved or underserved individuals including minority communities.

Supported in part by PATBI funds, MPAS continued involvement in events aimed at providing individuals who are homeless or at risk of homelessness with information about community resources and advocacy services. This fiscal year, MPAS staffed informational booths at nine Homeless Connect events throughout Michigan. Some events had a specific focus towards children and veterans who are homeless or living in poverty. Overall, MPAS provided information to 815 individuals. Advocacy staff took these opportunities to reach individuals who are homeless and to network with other organizations providing services and supports to this population.

MPAS staffed an information table at the annual Brain Injury Association of Michigan (BIAMI) conference. This year BIAMI chose to invite non-profit organizations to exhibit at no cost for three hours prior to a dinner activity. Attendees were given a "passport" which required them to visit each booth and

obtain a "stamp" which would then make them eligible for a $25 Meijer gift card drawing upon completion. Other exhibitors included the Disability Network, Michigan Department of Natural Resources, Department of Veterans Affairs, and a state Department of Health and Human Services representative explaining how individuals who receive food stamp benefits can get double the value of the food stamps when they are used to purchase fruits and vegetables from a farmer's market. This was a much more productive way to engage one-on-one with attendees at the annual conference and this feedback was provided to SIAMI administration. MPAS staff spoke directly with 60 individuals to answer their questions and discuss MPAS advocacy services.

MPAS was invited to provide information to military families who have children with disabilities. The event, arranged by the Michigan National Guard and open to all branches of the military, was the first of several planned throughout the state. Although attendance was low (11 families), staff were impressed by the breadth of exhibitors and speakers available to provide information and resources to attendees and anticipate greater attendance as the event develops. Other exhibitors included Peckham Industries, WIC, Michigan Dept. of Health and Human Services Family Center, Mich. Alliance for Families, Tri-County Office on Aging, Kids in Motion, Epilepsy Foundation, Special Olympics, Western Michigan University Music Therapy Program, Jacks Place, Early On, Easter Seals, National Alliance of the Mentally Ill, Ann Arbor Hands On Museum, Capital Area Down Syndrome, and Boy Scouts of America.

MPAS provides information to individuals who request brochures or other information such as the agency's newsletter, the Exchange. Upon request and during monitoring visits, MPAS posters and brochures are provided to nursing homes, group homes, state psychiatric hospitals and other settings where individuals with TBI may reside. Information and technical assistance materials are also made available to those who visit the MPAS website.

C. INFORMATION DISSEMINATED TO THE PUBLIC

1. Radio and TV Appearances by Agency Staff 02. Newspaper/Magazine/Journal Articles Prepared by Agency Staff 03. PSAsNideos Aired by the Agency 04. Website Hits

*Note this is the number of uniaue visitors to an AII-Aqencv website *26,4775. Publications/Booklets/Brochures Disseminated by the Agency

*1 % of MPAS' general agency brochure is funded using PA TB/ dollars*2% of MPAS' Exchange newsletter is funded using PA TB/ dollars

*33,813

PART II: CASE-SERVICES

6. OtherNumber Description (use separate sheets if necessary)1,872 Agency Facebook page (total Likes)

7 ExternaI Med'1a Coverage of A1gency ACfIVI'f1es

Radio/TV Coverage Newspaper/ Magazines/Journal PSAsNideos Publications/

Booklets/Brochures0 0 0 0

A. INDIVIDUALS SERVED1. Individualsa. Individuals Served Receiving Advocacy at Start of Fiscal Year (carryover from prior) 6b. Additional Individuals Served During Fiscal Year (new for fiscal year) 9c. Total Number of Individuals Served During Fiscal Year (a + b) 15d. Total Number of Individuals with Cases that Were Closed During Fiscal Year 5e. Total Individuals Still Being Served at the End of the Fiscal Year 10

2. Servicesa. Number of Cases/Service Requests Open at Start of Fiscal Year (carryover from prior) 6b. Additional Cases/Service Requests Opened During Fiscal Year (new for fiscal year) 10c. Total Number of Cases/Service Requests During Fiscal Year (a + b) 16d. Total Number of Cases/Service Requests that Were Closed During Fiscal Year 6e. Total Number of Cases/Service Requests Open at the End of the Fiscal Year 10

B. PROBLEM AREAS/COMPLAINTS OF INDIVIDUALS SERVEDComplaint1. Abuse (total) 2

a. Inappropriate Use of Restraint & Seclusion 1b. Involuntary Treatment 0c. Physical, Verbal, & Sexual Assault 0d. Other 0

2. Access to Records 03. Advance Directives 04. Architectural Accessibility 05. Assistive Technology (total) 0

a. Augmentative Comm. Devices 0b. Durable Medical Equipment 0c. Vehicle Modification/Transportation 0

0d. Other

6. Civil Commitment 07. Custody/Parental Rights 08. Education (total) 0

a. FAPE: IEP/IFSP Planning/Development/Implementation 0b. FAPE: Discipline/Procedural Safeguards 0c. FAPE: Eligibility 0d. FAPE: Least Restrictive Environ. 0e. FAPE: Multi-disciplinary Evaluation/Assessments 0f. FAPE: Transition Services 0g. Other 0

9. Employment Discrimination (total) 0a. Benefits 0b. Hiring/Termination 0c. Reasonable Accommodations 0d. Service Provider Issues 0e. Supported Employment 0f. Wage and Hour Issues 0g. Other 0

10. Employment Preparation 011. Financial Benefits (total) 0

a. SSDI Work Incentives 0b. SSI Eligibility 0c. SSI Work Incentives 0d. Social Security Benefits Cessation 0e. Welfare Reform 0f. Work Related Overpayments 0g. Other Financial Entitlements 0

12. Forensic Commitment 013. Government Benefits/Services 014. Guardianship/Conservatorship 015. Healthcare (total) 3

a. General Healthcare 1b. Medicaid 2c. Medicare 0d. Private Medical Insurance 0e. Other 0

16. Housing (total)a. Accommodationsb. Architectural Barriersc. Landlord/Tenant

0000

d. Modifications 0e. Rental Denial/Termination 0f. Sales/Contracts/Ownership 0g. Subsidized Housing/Section 8 0h. Zoning/Restrictive Covenants 0i. Other 0

17. Immigration 018. Neglect (total) 11

a. Failure to Provide Necessary or Appropriate Medical Treatment 6b. Failure to Provide Necessary or Appropriate Mental Health Treatment 0c. Failure to Provide Necessary or Appropriate Personal Care & Safety 5d. Other 0

19. Post-Secondary Education 020. Non-Medical Insurance 021. Privacy Rights 022. Rehabilitation Services (total) 0

a. Communications Problems (Individuals/Counselor) 0b. Conflict About Services To Be Provided 0c. Individual Requests Information 0d. Non-Rehabilitation Act 0e. Private Providers 0f. Related to Application/Eligibility Process 0g. Related to IWRP Development/Implementation 0h. Related to Title I of ADA 0i. Other Rehabilitation Act-related problems 0

23 Suspicious Death 124. Transportation (total) 0

a. Air Carrier 0b. Paratransit 0c. Public Transportation 0d. Other 0

1 Reason for Closmg Case F'1Ies

25. Unnecessary Institutionalization 026. Voting (total) 0

a. Accessible Polling Place / Equipment 0b. Registration 0C. Other 0

27. Other* 0

*For any cases listed under "27. Other," describe the specific problem area or complaint and the number of cases covered under each problem area or complaint listed. Use separate sheets if necessary.N/A

C. REASONS FOR CLOSING CASE FILES

Reason

a. All Issues Resolved in Client's Favor 2b. Some Issues Resolved in Client's Favor 3c. Other Representation Obtained 0d. Individual Withdrew Complaint

e. Services Not Needed Due to Death, Relocation, etc.

f. Individual Not Responsive to Agency

g. Case Lacked Legal Merit

0000

h. Conflict of Interest

i. Agency Withdrew from Case00

j. Lack of Resources 001

k. Not Within PrioritiesI. Issue Not Resolved in Client's Favor

m. Other* 0n. Total 6

*For any cases listed under "Other," describe the reason for closing the case and the number of cases covered under each reason listed. Use separate sheets if necessary.

N/A

D. HIGHEST INTERVENTION STRATEGY

Interventions

1. Short Term Assistance 0

2. Systemic/Policy Activities 03. Investigation/Monitoring 34. Negotiation 05. Mediation/Alternative Dispute Resolution 06. Administrative Hearing 17. Legal Remedy/Litigation 28. Class Action Suits 0

PART Ill: STATISTICAL INFORMATION FOR INDIVIDUALS SERVED

A AGE OF INDIVIDUALS SERVED

B. GENDER OF INDIVIDUALS SERVEDMale 8

Female 7

Total 15

C. RACE/ETHNICITY OF INDIVIDUALS SERVEDRace/Ethnicity1. American Indian/Alaskan Native 02. Arab American 03. Asian 04. Black/African American 55. Hispanic/ Latino 06. Native Hawaiian/Other Pacific Islander 07. White/Caucasian 88. Multiracial/Multiethnic 09. Race/Ethnicity Unknown 110. Other Than Above* 111. Total 15

*For any individuals listed under "Other Than Above," describe the race/ethnicity of the individual and the number of cases covered under each description listed. Use separate sheets if necessary.

Two or more (1 ).

AgeOto 12 1

013 to 1819 to 25 126 to 64 665 and over 7Total 15

D. LIVING ARRANGEMENTS OF INDIVIDUALS SERVED

Arranaement1. Community Residential Home 02. Foster Care 03. Homeless/Shelter 04. Legal Detention/Jail/Prison 05. Nursing Facility 126. Parental/Guardian or Other Family Home 37. Independent 08. Private Institutional Setting 09. Public (State Operated) Institutional Setting 010. Public Housing 011. VA Hospital 012. Other* 013. Unknown/Not Provided 0

*For any cases listed under "Other," describe the living arrangement of the individual and the number of cases covered under each description listed.

N/A

E. GEOGRAPHIC LOCATIONGeographic Location1. Urban/Suburban 72. Rural 83. Total 15

A. SYSTEMIC ACTIVITIES

1. Number of Policies/Practices Changed as a Result of Non-Liti ation S stemic Activities0

PART IV: SYSTEMIC ACTIVITIES AND LITIGATION

2. Describe the agency's systemic activities. Be sure to include information about the policies that were changed and how these changes benefit individuals with disabilities. If possible, estimate the number of individuals potentially impacted by such policy changes. Also include at least three case examples of how the agency's systemic activities impacted individuals served.

MPAS wrote an amicus brief supporting Coalition Protecting Auto No-Fault's (CPAN) claim that records of the Michigan Catastrophic Claims Association (MCCA) should be subject to the Freedom of Information Act (FOIA). The MCCA is an organization providing support for individuals with disabilities who have been injured in an auto accident and works with the insurance commission to set rates and fees. The Michigan Supreme Court denied the Leave to Appeal, leaving a negative decision in place shielding records of the MCCA from disclosure under FOIA.

B. LITIGATION/CLASS ACTIONS

1. Total Number of Non-Class Action Lawsuits Filed 0a. Number of Non-Class Action Lawsuits Filed During Fiscal Year

(new for fiscal year)0

b. Number of Non-Class Action Lawsuits Filed at Start of Fiscal Year (carryover from prior fiscal year)

0

2. Total Number of Class Action Lawsuits Filed 0a. Number of Class Action Lawsuits Filed During Fiscal Year

(new for fiscal year)0

b. Number of Class Action Lawsuits Filed at Start of Fiscal Year(carryover from prior fiscal year)

0

3. Describe the agency's litigation/class action activities. Explain how individuals with disabilities benefited from such litigation. If possible, estimate the number of individuals potentially impacted by changes resulting from the litigation. Be sure to include at least three case examples that demonstrate the impact of the agency's litigation.

MPAS did not file litigation using PATBI funds during FY17.

C. MONITORINGDescribe any monitoring conducted by the agency by providing the major areas of non-litigation-related monitoring activities and the groups likely to be affected.Address the major outcomes of the monitoring activities during the fiscal year. Be sure to include at least three case examples that demonstrate the impact of the agency's monitoring activities.

MPAS continues to regularly monitor state psychiatric institutions, adult foster care homes, group homes, child caring institutions and select nursing homes where individuals with TBI reside or receive services. Monitoring efforts are important because individuals in these settings might not otherwise have access to or be aware of MPAS services. MPAS' presence also reduces the likelihood residents will be subjected to abuse or neglect.

Monitoring visits are generally unannounced and unaccompanied by facility staff in order to allow unimpeded access to residents and areas of the facility. Residents in these settings are diagnosed with disabilities including TBI, mental illness, autism, Alzheimer's disease, and cerebral palsy, among others. Individuals are from geographic locations throughout the state and include people from a variety of cultural backgrounds, races and ethnicities.

During fiscal year 2017, MPAS conducted more than 41 visits to facilities where people with disabilities, including TBI, live.

During and after visits, MPAS staff follow up on concerns raised by residents and staff or issues observed directly by advocacy staff. Cases are routinely accepted by MPAS for investigation as a direct result of monitoring visits, and information and referral is provided to both residents and facility staff alike.

During a monitoring visit, MPAS staff assess: What are the residents doing? What are staff doing - are they interacting with the residents? If so, are they interacting respectfully? Are residents dressed, clean, alert, lying on the floor, crying, etc.? Are there any visible or reported injuries? Is anyone in restraint or seclusion - and if so, why, for how long, have they been given an opportunity to stretch, eat, use the restroom, and do they know what the criteria is for being released from restraint or seclusion? Is the facility in good repair? Do school age residents have access to educational services?

The results of monitoring are multifaceted and include increased safety for residents, increased identification and access to appropriate services, opportunities for self-advocacy, and assistance with discharge planning.

D. LITIGATION-RELATED MONITORINGDescribe any monitoring conducted by the agency related to court orders or case settlements by providing the major areas of monitoring and the groups likely to be affected. Address the major outcomes of the litigation-related monitoring during the fiscal year. Be sure to include at least three case examples that demonstrate the impact of the agency's litigation-related monitoring.

NIA

E. FULL OR PRELIMINARY INVESTIGATIONSDescribe any full investigations conducted by the agency by providing the major areas of investigation and the groups likely to be affected. Address the major outcomes of the investigations during the fiscal year. Be sure to include at least three case examples that demonstrate the impact of the agency's investigations. Use separate sheets if necessary.

See case examples in Part V. Priorities and Objectives below.

F. DEATH INVESTIGATIONS

1. Number of Formal Death Reports Received 0

2. Number of Informal/External Death Reports Received 2

3. Number of Death Investigations 2

4. Describe any death investigations conducted by the agency during the fiscal year and any subsequent activities resulting from these investigations. Also include the major outcomes of the death investigations. Use separate sheets if necessary.

Case example #1 :MPAS received a complaint alleging neglect of a PATBl-eligible resident which resulted in death. The resident, of a nursing facility, who required assistance for all activities of daily living, developed pressure ulcers on the ear and coccyx which allegedly worsened. Additionally, the complaint alleged the resident was not given seizure medication as ordered. An advocate requested and reviewed records from the nursing facility including medication orders, treatment orders, wound notes and medical consultations. The advocate also obtained documents from the medical examiner. Medical records provided indicated the pressure ulcers developed prior to admission to the nursing facility and were showing improvement as a result of receiving weekly wound care. All wound care and medication was documented as being provided as ordered and there was no evidence provided to support the allegation of neglect by facility staff.

Case example #2:MPAS received a complaint regarding a PATBl-eligible resident's death at a nursing facility. The complaint alleged aides were performing routine care when

Outcome:Met Partial! Met/ContinuinX Not MetTotal Number of Cases Handled 3

the resident "slipped" out of bed. The aides allegedly did not have all the supplies they needed when preparing to change the resident's brief. The resident fell from the bed when staff weren't paying close attention. Following the fall, the resident complained of right hip pain and was transported via ambulance to the hospital. At the hospital, the resident was diagnosed with a hip fracture. The resident passed away less than one month later and "right hip fracture" was listed as a cause of death on the death certificate. From experience, MPAS staff have learned filing complaints with the state against the certificates of aides has proven to be futile in most instances and determined this was not a viable option in this case. There was consideration of referring the case to an outside law firm for private action, but after contacting probate court, staff determined a personal representative had not been appointed for this client. As no other complaint options were available, the investigation was closed.

PART V: PRIORITIES AND OBJECTIVES

A. CURRENT PRIORITIES AND OBJECTIVESUse the format below to describe the program priorities and objectives toward which the prior fiscal year's activities were targeted.

Priority #1: Eliminate abuse and neglect.Objective 1A: Individuals with disabilities will not be subjected to restraint or seclusion.Objective 1C: Individuals with disabilities will not be subjected to abuse or neglect, including inappropriate or coercive treatments.

Description of Need, Issue, or Barrier Addressed:

Individuals with disabilities are often subjected to abuse and/or neglect by use of restraint/seclusion or by the direct result of a caregiver's action or lack thereof. This priority is aimed at eliminating the occurrence of abuse and neglect.

Illustrative Cases (at least one specific case description showing the success)

Case example:MPAS received a complaint alleging neglect of a resident with a TBI at a nursing facility. After several unsuccessful attempts to obtain a release of information from the resident's sister/guardian an advocate requested records from the nursing facility and medical hospital using MPAS access authority. When the nursing facility failed to respond to MPAS' request for records, legal team staff intervened successfully. After reviewing the records, the advocate determined the resident had not received insulin for 10 days, had not received pericare as

Outcome:Met Partial! Met/Continuin Not Met XTotal Number of Cases Handled 0

ordered, and had developed pressure ulcers while at the facility. The advocate proceeded by filing complaints against the professional licenses of the director of nursing/registered nurse and the nursing home administrator. Unfortunately, neither complaint was authorized for investigation by the respective boards. Since there is no mechanism available to appeal these decisions the investigation had to be closed.

Priority #2: Increase the protection of individual rights, independence and self-determination

Objective: Individuals with disabilities will not be deprived of their rights including those related to guardianship, advance directives, funeral representatives and voting.

Description of Need, Issue, or Barrier Addressed:Often, individuals ordered to have a guardian, representative payee or other legal representative have difficulty asserting their civil rights. This can be discouraging to individuals who may in turn choose not to work through these systems or speak up when their rights have been violated or restricted in some way.

Illustrative Cases (at least one specific case description showing the success)

No case-level work was done under this priority during FY17.

Priority #3: Eliminate employment barriers and protect rightsObjective 3A: Improve access and rights to services within vocational rehabilitation and centers for independent living.Objective 38: Individuals with disabilities will have employment options in the competitive and integrated workforce.Objective JC: Individuals with disabilities will have access to Social Security work incentives.

Description of Need, Issue, or Barrier Addressed:Individuals with disabilities often have difficulty accessing vocational rehabilitation services as well as other services to assist them in securing and maintaining employment. This priority targets barriers to accessing these important services as well as asserting the client's employment rights under the Americans with Disabilities Act. Individuals too often find themselves managing work-related overpayments which can also be a barrier to employment. MPAS works to assist individuals in eliminating erroneous work-related overpayments or negotiating repayment in a manageable way when the overpayment has been verified.

Outcome:Met Partial! Met/Continuin Not Met XTotal Number of Cases Handled0

Outcome:Met Partial! Met/ContinuinX Not MetTotal Number of Cases Handled3

Illustrative Cases (at least one specific case description showing the success)

No case-level work was done under this priority during FY17.

Priority #4: Improve access to servicesObjective 4A: Individuals with disabilities will be assured services, including housing, transportation and assistive technology, identified to support them in the community and prevent institutionalization or segregation.Objective 48: Governmental entities and providers of critical services will be accessible and provide needed accommodations.Objective 4C: Individuals with disabilities will have access to services, including assistive technology, which supports them in institutional/facility/service provider settings in order to promote discharge and community inclusion.

Description of Need, Issue, or Barrier Addressed:Individuals with disabilities have difficulty accessing services needed in order to remain in their community, gain access to housing and critical services, and stay out of more restrictive, institutional, or congregate placements. They may also have difficulty obtaining the services needed in these restrictive settings, resulting in delayed recovery and discharge back to their communities. This priority specifically targets the lack of services for people with disabilities.

Illustrative Cases (at least one specific case description showing the success)

Case example #1:MPAS was contacted in May 2017 regarding a 21-year-old individual with a brain injury who had been receiving 118 hours per week of in-home staffing support which allowed the client to live independently for the past two years. In January, the support hours were reduced to approximately 60 hours per week and the public mental health agency tried to convince the mother/guardian to place the client in an adult foster care (AFC) home. Initially the mom had appealed the reduction, but then agreed to defer the hearing while some AFC homes were considered. During this time, the client had to move back in with her mom because there were not enough staffing hours to ensure her safety in her apartment. In May the client received another notice indicating the support hours were going to be reduced to 42 hours per week. The mom/guardian no longer wanted to consider moving the client into an AFC home and wanted her to continue living independently with adequate staffing. A MPAS advocate advised the mother to request a Medicaid Fair Hearing and to request that service hours

remain intact pending the outcome of the hearing. The advocate requested records from the public mental health agency to review and determine whether or not MPAS would provide representation at the hearing. After determining representation would not be provided by MPAS, technical assistance was provided to the mother/guardian in preparation for the hearing. Fortunately, at a pre-hearing meeting, the public mental health agency reversed their decision and agreed to provide 96 service hours per week. The mother rescinded the hearing request and the case was closed.

Case example #2:MPAS was contacted by a parent after a therapy service provider terminated services to the client. The client, an 8-year-old with brain injury, would periodically get up and walk out of therapy sessions for a few moments and then return to the session. During the last session, however, the client walked out and didn't return. After some time passed and the client didn't return, the mom and therapist began looking for the client, but couldn't locate him. The police were contacted and the client was found nearly three miles away at his grandfather's house. This is what prompted the provider to terminate services. At the time MPAS was contacted the mom had already submitted a request for a Medicaid Fair Hearing and had requested services remain in place pending the outcome of the hearing. Despite her request, therapy services did not continue because services were provided by an entity not covered by this rule. The public mental health agency, who is the service authorization entity, had not changed the authorization and offered other providers for the parent to choose from. An advocate advised the parent that therapy was still authorized as a service, but it would need to be received from a different clinic since the former provider has the right to determine whether they serve someone or not. The parent went forward with the hearing despite MPAS explaining there was not a hearable issue. The appeal was dismissed after the administrative law judge determined there had not been a termination of a Medicaid-covered service and therapy was still authorized. MPAS encouraged the parent to work with the public mental health agency to establish a therapeutic relationship with a new provider and the case was closed.

Priority #5: Ensure the right to a high quality educationObjective SA: Students with disability-related behavior will be identified and evaluated for special education.Objective 58: Eligible students at risk of discipline or push-out due to disability-related behavior will remain in school.Objective SC: Transition needs from post education to community living will be identified and addressed.

Outcome:Met Partial! Met/Continuin Not Met XTotal Number of Cases Handled0

Description of Need, Issue, or Barrier Addressed:Students with disabilities are often not identified and given proper educational supports to be successful. Students find themselves in disciplinary proceedings when behavioral concerns increase and are often suspended or expelled as a result. This priority specifically targets the lack of identification of students for special education and works to ensure students receive the educational supports necessary to learn and graduate.

Illustrative Cases (at least one specific case description showing the success)

No case-level work was done under this priority during FY17.

B. AGENCY ACCOMPLISHMENTSDescribe the most significant accomplishments of the agency during the fiscal year.

Information about MPAS advocacy and services was provided to 815 individuals at nine Homeless Connect events throughout the state.

MPAS advocates provided information, referral, short-term assistance, or technical assistance to 144 individuals. 62% of the time this assistance was provided to callers whose issue fell within MPAS priorities although did not require case-level assistance to resolve it.

Client Satisfaction Card Results for FYl 7 (responses from 690 cards from all MPAS funding sources - includes both PAIMI Cases and I&Rs): 1. I am a: 398 Person with a disability 291 Family Member 84 Professional

2. I needed help with (check one):170 Special Education 128 Benefits 113 Abuse/Neglect in facility113 Housing 135 Community Mental Health54 Guardianship 65 Vocational Rehabilitation55 Employment Discrimination29 Juvenile Justice

3. Did we (check all that apply):587 Listened267 Agreed to do something455 Gave advice you understood

4. Did the information help?

391 Knew/Found answers 528 Treated with respect238 Referred out to someone who helped

499 Yes 185 No

I PATBI grievances filed against the agency during the fiscal year 1

5. Were written materials helpful?

6. Would you use our services again?

279 Yes

574 (87%) Yes

141 No

85 (13%) No

7. Satisfied: 510 (77%) Not Satisfied: 154 (23%)

8. Would you like an application to vote? 86 Yes 567 No

9. Would you like information on advance directives? 236 Yes 395 No

C. IMPLEMENTATION PROBLEMSDescribe any external or internal implementation problems for priorities marked "not met" or "partially met."

MPAS priorities and objectives are not disability-specific which allows for flexibility and a client-centered focus when providing advocacy to clients with brain injury and other disabilities. At a minimum, MPAS staff provide information and referral to anyone who contacts the agency for assistance.

PART VI: AGENCY ADMINISTRATION

A. GRIEVANCES FILED

B. COLLABORATIVE EFFORTS

1. NETWORK COLLABORATIONIdentify issues selected for network collaboration.

Throughout FY17, MPAS committed resources to learn more about human trafficking. Michigan reportedly has the second highest rate of human trafficking due to the number of border crossings and high numbers of migrant farm workers. Aware of the vulnerability disabilities create and the high rates of trafficking victims who sustain a TBI resulting from victimization, staff participated in a variety of activities in an effort to determine how P&A advocacy can contribute to and complement efforts already underway to eradicate sex and labor trafficking. MPAS staff spoke with other protection & advocacy agencies throughout the network and staff from the National Disability Rights Network to determine how best to utilize the unique qualities of P&As. Staff attended two meetings and a conference sponsored by the Michigan Abolitionist Project to learn about various initiatives throughout the

state, attended a Human Trafficking Commission (created by the Michigan Attorney General) meeting, and a human trafficking forum at Michigan State University. Sadly, no one in attendance at any of these events mentioned the word "disability." While a lot of time and resources are being spent by people committed to this very important issue, they are missing existing opportunities for protection, services, supports and resources available to victims by failing to recognize the role disability has in human trafficking. MPAS signed on in support of legislation to remove the restriction under which a person may be eligible for deferral and dismissal of charges for prostitution-related offenses he or she committed as a victim of human trafficking. And finally, in collaboration with the National Disability Rights Network and Equip for Equality (Illinois P&A), MPAS staff began preparing a training on the intersection of disability and human trafficking for staff and volunteers at the National Human Trafficking Resource Center and hotline in Washington D.C. The training occurred in early FY18 and will be included in next year's PPR along with additional efforts in this area.

2. ALL OTHER COLLABORATIONDescribe any coordination with programs that are not part of the agency (e.g. state long term care programs, etc.). Use separate sheets if necessary.

MPAS' Director of Advocacy served for the fifth year on the planning committee for the Brain Injury Association of Michigan's annual Legal Conference. In collaboration with two private attorneys who work with individuals with brain injury, a robust conference was prepared for attendees. This year attorneys spoke to attendees about how to effectively submit claims for payment, how not to void policies, how to avoid submitting claims with errors which could be determined fraudulent, and when providers may still have an independent cause of action. The conference was attended by 203 individuals including case managers, nurses, individuals with brain injury and their family members.

Supported in part by PATBI funds, MPAS made efforts to reach traditionally unserved and underserved individuals. In partnership with other community organizations, MPAS provided information directly to 815 individuals at nine events for individuals who are homeless throughout the state of Michigan. Some events were also directed at specific groups of individuals who are homeless such as veterans and children. Advocacy staff took the opportunity to network with other organizations in attendance that provide services and supports to this population.

Elmer L. Cerano

DateExecutive Director

PART VII: END OF FORM

Name (printed) Title