New Jersey Protection and Advocacy, Inc. New Jersey's designated protection and advocacy system for people with disabilities

Information and Referral

In Fiscal Year 2006, NJP&A provided information and referral to 1,800 individuals. This number reflects the number of requests for assistance that are received and are not opened as new cases. Most of these requests are made and responded to by telephone. Intake staff are able to either answer a specific question, send out material from our resource collection, or refer the individual to another appropriate agency or program.

Case Highlights

INSTITUTIONAL MONITORING TEAM

• MEDICATION

NJP&A staff intervened on behalf of MB, a thirty-eight-year-old Atlantic County resident, diagnosed with schizophrenia. MB contacted NJP&A to complaint that the staff at Ancora Psychiatric Hospital was forcing her to take medication she did not want. She reported that at the time of her admission the psychiatrist told her, “You either take [the medication] or you will receive an injection.” MB told the psychiatrist that she was not violent nor suicidal and was against taking medication. While on the unit, the nurse at the medication window told MB, “You have to take it or we will give it to you anyway.” She said she took the medication only because she did not want to be forcibly medicated. NJP&A staff met with MB and reviewed her records. The records suggested that the procedures required before someone can be medicated involuntarily were not followed. NJP&A staff reported their concerns to hospital staff. MB subsequently contacted NJP&A staff to report she was removed from refusing status and no longer subject to involuntary medication.

• DEATH INVESTIGATION

NJP&A staff reviewed the records regarding the death of CB, a nineteen-year-old resident of the North Jersey Developmental Center, who died of pneumonia, sepsis, and acidosis. Following its own investigation, the facility initiated the following measures: (1) Procedures were implemented for vital signs for all respiratory compromised residents to be taken every shift and pulse oximetry is to be taken on a regular basis to apprise medical staff of sub-clinical indications of a problem. (2) The Center purchased a vest airway clearance system that addresses serious respiratory issues such as secretion retention. (3) The Center hired a part-time respiratory therapist to join the full-time therapist on staff to provide respiratory therapy services on the evening shift. (4) The center is seeking to hire a consultant pulmonologist to provide services on a weekly basis. (5) A new physician was hired to assume full assignment for all clients in the medical unit, specifically the individuals with respiratory problems. (6) The Center is attempting to ensure a more controlled living environment by monitoring temperature, air quality, and humidity. Because of the significant number of deaths of residents of institutions from respiratory causes, NJP&A staff is surveying the other developmental centers and the state-operated psychiatric hospitals to determine if they have instituted similar procedures.

COMMUNITY INTEGRATION TEAM

• MEDICAID WAIVER SERVICES

NJP&A intervened on behalf of RL, a thirty-two year resident of Middlesex County who as was severely injured in a dirt bike accident in 2000 and now has quadriplegia. RL requires total care in all areas of daily living and physical therapy three times each week. RL also requires assistance with daily wound care for the three decubitus ulcers, daily skin integrity checks, catheterizations, and related care. RL’s family contacted NJP&A for assistance when the local nursing agency terminated all his home care services without notice. RL was receiving services through the Community Care Program for the Elderly and Disabled (CCPED) Medicaid waiver, which provided RL home health aide, skilled nursing, and physical therapy services. RL’s brother and principal caretaker was shot and killed on the steps of the family home in April 2003. The nursing service decided to terminate services to RL, claiming the residence and neighborhood was unreasonably unsafe. Although the family and the local police department disputed the agency’s claims, the nursing agency stopped services without the approval of the State and without a required notice and opportunity for a hearing. When neither the State nor the agency responded to NJP&A’s demand that the services be restored, NJP&A, filed a complaint with the Chancery Division of the New Jersey Superior Court requesting an Order to Show Cause with Temporary Restraints. NP&A was successful in obtaining an order requiring the State and the nursing agency to restore home care services to RL until further order of the court. NJP&A’s complaint includes allegations against the nursing agency for nursing malpractice for abandoning their patient and racial discrimination for stereotyping the family home as dangerous.

• COMMUNITY RESIDENTIAL SERVICES

NJP&A staff intervened on behalf of KM, a thirty-one-year-old female Monmouth County resident diagnosed with cerebral palsy and mental retardation. When NJP&A was first contacted, KM was residing in a group home temporarily, but was advised by the Division of Developmental Disabilities that she would be leave because the resident whose space she occupied was returning. The Division intended to transfer KM to a nursing facility as another temporary placement. NJP&A staff determined the nursing home was an inappropriate placement for KM because the nursing facility could not provide KM contact with any peers and would not be able to provide physical therapy or meaningful skills and employment training. NJP&A informed the Division that the nursing home was inappropriate, even as temporary placement. In response, DDD agreed to place KM in a group home and to provide her with day workshops to help with socialization. After visiting the group home and meeting with the group home staff and residents, KM’s mother (and legal guardian) was happy with the new placement.

INDIVIDUAL RIGHTS (DISCRIMINATION) TEAM

• HELP AMERICA VOTE ACT OF 2002 (HAVA)

Following the enactment of the Help America Vote Act of 2002, NJP&A was invited by the Attorney General of New Jersey to sit on the HAVA State Planning Committee as one of only two representatives from the disability community. NJP&A staff attended weekly meetings of the committee from May through July. NJP&A authored several memos and papers about the issues facing voters with disabilities in New Jersey and was instrumental in convincing the State of New Jersey to commit to significant improvements in the voting experience for persons with disabilities and to 100% polling place accessibility. NJP&A provided written comments to each section of the draft plan which were incorporated in the preliminary State Plan submitted to the federal government. NJP&A staff also attended public hearings on the draft State Plan throughout the State and encouraged disability advocates to testify at the hearings. Additionally, NJP&A staff was asked by the Division of Elections and the Attorney General’s Office to assist the State in drafting its application for $350,000 in HAVA accessibility grant funds. Participation in these HAVA activities has resulted in increased awareness of disability issues and NJP&A by the Division of Elections, the Attorney General’s Office, and county election officials.

• EMPLOYMENT

NJP&A intervened on behalf of MK, a sixty-one-year-old resident of Hunterdon County with pulmonary hypertension. MK was an employee of the United States Postal Service for nearly eighteen years as a rural mail carrier. MK requires the use of a portable oxygen tank, which he uses every two to three hours. In 1999, when MK returned from a four month medical leave, the Postal Service refused to allow him to drive his mail delivery truck with his portable oxygen tank. MK was reassigned to work in the postal facility. In 2001, a new postmaster was assigned to MK’s facility, and MK was prohibited from entering the building with the portable oxygen tank. As a result, MK was placed on unpaid leave. NJP&A staff assisted MK with filing a complaint with the Equal Employment Opportunities Commission, arguing that the Postal Services’ refusal to permit MK to have access to portable oxygen while working was unreasonable. At a court-ordered mediation, MK entered into a settlement agreement awarding him $65,000 in compensatory damages and returning him to work immediately with full benefits.

• HOUSING

NJP&A staff intervened on behalf of GC, a thirty-nine-year-old resident of Burlington County with significant orthopedic impairments. GC contacted NJP&A when the management of his condominium association did not respond for more than six months to his request to install a short sidewalk from his unit to his parking lot. NJP&A staff contacted the association and urged them to address the issue at the next meeting. Shortly thereafter, GC was advised that the sidewalk would be installed.

INDIVIDUAL RIGHTS (SPECIAL EDUCATION) TEAM

NJP&A staff intervened on behalf of ML, a fourteen-year-old student from Burlington County with learning disabilities, dysgraphia, and attention deficit disorder. ML had a 504 plan permitting accommodations such as extended test time, use of a calculator, and reduced requirement for handwritten materials. The school district subsequently informed the family that ML was no longer eligible for any accommodations, and the district was unwilling to allow the use of any assistive technology devices. NJP&A assisted the family to request evaluations, and later independent evaluations, to determine whether ML was eligible for special education or a 504 plan. Following the evaluations, NJP&A assisted the family during several meetings with the school district to develop an appropriate 504 plan that would allow ML to use a laptop computer or hand-held device in class. NJP&A also assisted the family to file a complaint investigation with the federal Department of Education regarding the delay in developing the 504 Plan.

NJP&A filed a complaint investigation against a Mercer County school district regarding the change in placement of a sixteen year old student with learning disabilities. The student’s Individualized Education Program (IEP) provided for him to attend a half-day vocational program. When he arrived at school on the first day, he was told that that because of an administrative mistake he was no longer in the vocational program. When he inquired why his program was changed without notice, he was suspended for being disruptive. The student never received home instruction during his suspension, and the IEP for vocational training was never implemented. NJP&A filed a complaint investigation with the state Department of Education alleging that the district violated N.J.A.C. 6A:14-4.8 for failing to provide home instruction and N.J.A.C. 6A:14-2.3 and 3.7 for unilaterally changing this student’s placement. The State found the district to be out of compliance with the law and ordered compensatory services for this student and a revision of school policy with respect to IEP changes.

NJP&A filed a complaint investigation against an Ocean County school district regarding the improper suspension of a six year old boy with attention deficit disorder who had just started first grade. Following one behavioral incident, the school district removed the student from school and sent him to an out-of-district placement. NJP&A filed a complaint investigation with the state Department of Education alleging that the district violated N.J.A.C. 6A:14-2.8(b) when it failed to develop a behavior intervention plan or convene an IEP meeting prior to changing the student’s placement. Additionally, NJP&A alleged that the district violated the least restrictive placement mandate when it automatically sent the student to a private placement. The State ordered the school district to provide compensatory services and revise its policies related to discipline.

WORK & VOCATIONAL REHABILITATION TEAM

• CLIENT ASSISTANCE PROGRAM

NJP&A’s Client Assistance Program assisted PB, a forty-nine-year-old Ocean County resident with genitourinary impairments. PB contacted CAP for assistance receiving services from the Division of Vocational Rehabilitation Services. PB stated that she attempted to apply to DVRS in 2000 for funding for training to become an registered nurse, but, before eligibility was determined, she was told verbally that she would not be able to receive assistance. PB has since completed the necessary courses to become an RN and is now seeking financial assistance to pay for the tests and State Board Examination to become licensed. CAP staff referred her to DVRS to complete an application. CAP staff spoke with DVRS staff, who reported that he is working with PB. DVRS staff has discussed PB’s needs and vocational goals with her and is confident that DVRS will be able to provide her with the necessary services. CAP staff spoke with PB, who reported that the DVRS process was running smoothly.

ASSISTIVE TECHNOLOGY TEAM

NJP&A intervened on behalf of DJ, an eighty-year-old resident of a long-term care facility in Essex County. DJ had a stroke a few years ago, and, as a result, she was paralyzed on one side of her body and substantially limited in her ability to speak. Following a successful trial period during which DJ was able to communicate with family and staff, DJ attempted to obtain Medicaid funding for an augmentative communication device from Medicaid. Medicaid denied the request, claiming it was not cost-effective. NJP&A represented DJ at an administrative fair hearing appealing Medicaid’s denial. The Administrative Law Judge issued a fully favorable initial decision requiring Medicaid to purchase the augmentative communication device.

 

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