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					The Protection and Advocacy for Individuals
   with Traumatic Brain Injury Program


         Report of Activities for 2004




 National Association of Protection & Advocacy Systems
   The Protection and Advocacy for Individuals with
       Traumatic Brain Injury (PATBI) Program

Background

The Traumatic Brain Injury (TBI) Act was authorized as part of the Children’s Health Act of 2000
(P.L.106-310). As part of the TBI Act, Congress created a Protection and Advocacy program for
individuals with brain injuries similar to the Protection and Advocacy programs serving other
individuals with disabilities. This program provides addition funding to the existing P&A system to
serve this growing vulnerable population.

Congress appropriated $1.5 million for FY 2003 which required a competition among P&As to begin
this effort. Grants were made to 33 states for $50,000. Funding in FY 2004 and FY 2005 increased
to $3 million, which triggered statutory language that created a formula grant program at $2.7
million. While 29 of the states, DC and Puerto Rico receive the minimum allotment of $50,000, and
the four territories and the Native American program receive the territorial minimum of $20,000, the
remaining 21 states receive more based on a formula with California receiving the largest allotment
of $117,000. A $5 million appropriation would trigger a formula that would increase both minimum
allotments and the larger states and would help ensure that each state can provide a significant
program of brain injury protection and advocacy, with an appropriate level of staff time and
expertise.

The President’s FY 2006 budget recommends NO funding for this important program. If this is
allowed to stand children and adults with TBI throughout the country will lose access to critical
advocacy services. This program should be continued to ensure that each state has the resources
necessary to maintain critical protection and advocacy services for the estimated 5.3 million people
who live with disabilities resulting from brain injury. According to data gathered from the P&A
network for FY 2004

              1,363 individuals were directly provided advocacy services;

              12,323 individuals received Information or Referrals; and

              36,700 individuals were trained on TBI-related issues.

          Each year in our nation 1.4 million individuals sustain a TBI and approximately 475,000
          TBIs occur among children ages 0-14.
          Incidence is generally higher among males, Native Americans, and children less than five.
          From January 2003 to this January, 437 cases of TBI were diagnosed among wounded
          soldiers at the Walter Reed Hospital. Slightly more than half had permanent brain
          damage.
          TBI screenings were held beginning in August 2004 at the National Naval Medical Center.
          The results showed 83% - or 97 wounded Marines and sailors - with temporary or
          permanent brain damage. Forty-seven cases of moderate to severe TBI had been
          identified earlier in the year.
People with traumatic brain injury have an array of advocacy needs including assistance with
returning to work, finding a place to live, accessing needed supports and services such as attendant
care and assistive technology, and obtaining appropriate mental health, substance abuse, and
rehabilitation services. Often these individuals remain in extremely expensive institutional settings
far longer than necessary because of their inability to find needed supports and services in the
community.

Effective advocacy for people with traumatic brain injury can lead both to reduced government
expenditures and increased productivity, independence and community integration. However, the
advocate must possess specialized skills and the work is often time-intensive.

With limited funds, P&A advocates across the country have been able to make a major impact on the
lives of individuals with traumatic brain injury. The list below is illustrative of the work carried out in
sampling of states.

       The Missouri P&A assisted a recently discharged veteran after an accident caused a
       traumatic brain injury. He sought the P&As assistance in achieving his goals of a new career
       and independent living. Following his discharge, he enrolled in Missouri Valley College in
       Sedalia. The P&A helped him identify affordable housing and get accommodations from the
       school, veterans’ services, and vocational rehabilitation. He now has a system of friends,
       family and other supports that enable him to navigate school and life responsibilities.

       The California P&A represented veterans with TBI and other disabilities after it learned that
       a large Veterans Administration Medical Center was not allowing residents with conservators
       to register to vote, regardless of their competence. As a result of the P&A intervention,
       advocates for people with disabilities were allowed to conduct voter registration and
       education activities at the Medical Center.

       The Ohio P&A developed a set of three “Housing Guides” to help individuals with TBI find
       decent, safe, affordable, and accessible housing in the community. The guides identified the
       housing problems faced by people with TBI; provided information on available housing
       resources; and information on how to advocate for additional housing in the community.

       The New York P&A represented a veteran in a disability claim on a referral from the Clinton
       County Veteran Services office. Among other things, the veteran had some cognitive
       problems caused by a build-up of fluid on his brain while he was stationed in Guam. A shunt
       had been placed in his brain to drain fluid but he still had some residual problems from this,
       as well as other medical issues. After the P&A intervened, his disability claim was allowed.

       The Utah P&A helped an individual with TBI obtain a small business license to start her own
       sewing business. Self-employment is a core component of the President’s New Freedom
       Initiative and employment in rural areas of Utah is a tremendous barrier for people with
       disabilities. The Utah P&A advocated for the woman with the Division of Rehabilitation
       Services, which previously had denied her request for educational and materials support
       needed to start her business. The woman is now successfully operating a small disabled
       clothing design business, paying taxes, and living independently – just as before her injury.

       The Washington P&A helped a veteran who received physical and mental health services
       from the Veterans Administration. He wanted to be able to choose his mental health provider
however, he was told that if he changed providers he would lose his health care services.
The P&A provided him with self-advocacy strategies about how to request his preferred
service: how to navigate the chain of command: and how to utilize his supporters. The next
month he was allowed to change his mental health provider without threatening his other
health care services.

The Wisconsin P&A represented a 42 year old man with a TBI who was neglected and
abused in a nursing home. His wife and children desperately wanted him to live in the
community. Although he was eligible the state and his county refused to provide funding
under the TBI waiver. Due to his brain injury, he was confused and made many attempts to
leave the nursing home. He had poor balance and difficulty walking and fell repeatedly while
wandering the hallways without supervision. Tragically, he fell down the stairs and broke his
neck. While in the hospital receiving treatment for his neck, he got an antibiotic-resistant
staph infection which the nursing home failed to treat properly, thus delaying his
recuperation. The P&A helped the client and his family make a complaint against the nursing
home and encouraged the family to pursue a personal injury claim with a private attorney the
family retained. The P&A also advocated with the state and county and secured funding so
that the man could move to the community, where he currently lives.

The Native American P&A helped a Navajo man with TBI who was inappropriately placed
in a residential center that could not provide him with proper care and treatment. The P&A
discovered that he had been denied appropriate services and an appropriate behavior
intervention plan.     The P&A advocated for his transfer to a state-certified setting with
appropriate services. Although this setting is not on the Navajo reservation, he lives with
another Navajo individual and the funding agency is training the staff to prepare Navajo food,
as well as take this man to Native American activities in the area.

The Arizona P&A co-sponsored a day long conference on TBI in collaboration with the
Governor’s Council on Spinal Cord and Head Injuries that was attended by 200 consumers
and family members. The P&A also held a workshop to train individuals with TBI on topics
such as eligibility for health care services, obtaining necessary assistive technology, vocational
rehabilitation services, their rights under the Americans with Disabilities Act, and available TBI
resources. The P&A revised all of its self-advocacy materials to meet the needs of people with
TBI.

The South Carolina P&A worked with 51 year old man with a traumatic brain injury who
was living at a nursing home operated by Department of Mental Health since November
2000. The P&A began working with him in May of 2002 to help him reach his goal of moving
into his own apartment. The P&A advocated for community placement by contacting and
meeting with Head and Spinal Cord Injury administrators, service coordinators, and treating
professionals at the nursing home. Eventually, a space opened up in the only community
training home for individuals with a TBI in the state. The man visited the residence and liked
it much better than the nursing home. He moved into his new home in February of 2004 and
is happy to be there.

The Alabama P&A helped a man with TBI who resides in a nursing home. His physical
therapist contacted the P&A on the man’s behalf regarding several issues. The main issue
was the concern that his guardian/conservator was not spending his money appropriately and
he needed better services -- which he would have been able to afford. The P&A met with the
nursing staff and with his guardian/conservator to develop a plan to improve his level of care
and services. He is currently receiving quality care and more appropriate services.

The Colorado P&A appealed two cases in which individuals were being removed from the
HCBS-TBI waiver for another Medicaid waiver program. The P&A was successful in keeping
the individuals on the TBI waiver. The P&A also intervened when the state Medicaid agency
was refusing to permit a woman in a nursing home to transfer to an out-of-state program
that specialized in working with people with TBI. The state changed its position and allowed
the transfer. The CO P&A also had a client who acquired a head injury in Iraq and was being
threatened with court martial. The P&A intervened and contacted the National Veteran
Service & Advocacy Program in an attempt to provide training on TBI at Ft. Carson, Colorado.

The New Jersey P&A intervened on behalf of a twenty-seven-year-old man with TBI
residing in a group home in Sussex County. A new residential program offering services
targeted to his specific needs was found for him. However, before the transfer could take
place, the existing residential provider wanted to discharge this individual to a nursing home
without his or his parents’ consent. An order to show cause was filed in the Superior Court of
New Jersey to prevent a transfer to the nursing home or any other inappropriate residence.
Temporary restraints preventing the move were granted by the court, pending a full hearing.
During the hearing, the residential provider agreed to a consent order not to transfer the man
until his new appropriate placement became available. Without any further disruption, he
later moved to his new residence.

The Georgia P&A helped a man with TBI who was residing in a nursing home in
metropolitan Atlanta. A Medicaid waiver program became available for individuals residing
outside the nursing home and he did not know what to do. The P&A advocate helped him
apply for Medicaid waiver benefits and made certain that the process continued. The man
has been released from the nursing home and is living in the community.

The Minnesota P&A helped a 53 year-old woman who was living in a nursing home. She
had a stroke several years ago and continued to suffer from aphasia. She was moved to a
nursing home when it became apparent that she could not take care of her own finances and
was living in an abusive relationship. For several years, she had asked her guardian and
conservator to assist her in moving into a more independent living her search for a new
home. As a result of the P&As help, the woman moved into her own apartment within an
assisted living facility.

The New Hampshire P&A investigated a private facility that houses children and adults
with disabilities and provides clinical treatment and behavior management for individuals with
TBI and other severe behaviors. The investigation concerned the facility’s inappropriate use
of restraints, discovered by the P&A while representing a client. The facility agreed to review
and modify its policies to address the P&As concerns. Changes in facility policies will improve
the 80 residents’ quality of life.

The Michigan P&A helped a man with TBI who was homeless and being denied services
from the local Community Mental Health agency. Through an outreach project, a local
housing agency suspected that this man also had a mental illness, although he had not been
assessed. Without a diagnosed mental illness, the housing agency was unable to assist him
with housing. The individual wanted assistance with mental health and housing issues so the
      housing agency contacted the MI P&A which was able to get the housing agency to pay for a
      psychiatric assessment. As a result, the individual was found to have a serious mental illness;
      was able to get the appropriate mental health treatment from the Community Mental Health
      agency; and was assisted in securing housing and applying for public benefits.

      The Pennsylvania P&A collaborated with the Community Skills Program to present regional
      trainings called “Seven Simple Steps to Success”. This was developed as a guide for people
      who currently lead a support group for people with brain injury or who might be interested in
      starting a new support group. Two regional trainings were held. Prior to and during its use,
      this document was reviewed by people with TBI, The Department of Health TBI Advisory
      Board, P&A staff from NV and PR, the Brain Injury Association of Florida, as well as the
      TBITAC Review Committee. It is important to note that “Seven Simple Steps to Success” was
      written as a simpler language document that would be easy to follow by a person with
      cognitive difficulties.

      The Tennessee P&A responded to a call from the father of an eleventh grader at a rural
      high school. His son has a TBI, quadriplegia, and uses a wheelchair. The father was
      concerned the school was not implementing his son’s Individual Education Plan because it
      would not allow the use of a Dynavox 3100 (an communication device) that the father had
      purchased. The school also would not send school personnel to free trainings on how to use
      the equipment. With the help of the TN P&A, the young man’s Dynavox is now being used in
      the school and trainings have been completed. He also received assistive technology,
      occupational, speech, behavioral and cognitive evaluations. The student began the 2004-
      2005 school year with all supports and services in place, and he was displaying increased
      independence.

      The Delaware P&A worked to create a Brain Injury Committee within an existing state cross
      disability council. The P&A serves as Vice-Chair of this Brain Injury Committee, which has
      worked to obtain passage of an impressive array of state laws and regulations in the areas of
      TBI prevention, TBI assessment, and service expansion. A few examples include: 1) an
      Airbag Safety law to stop repair shops from installing fake or non-functioning replacement air
      bags in vehicles; 2) limits on the number of passengers in cars driven by individuals with
      learning permits; 3) helmet requirements when using recreational motor scooters; and 4)
      removing financial disincentives to classify TBI students and instead encouraging the public
      school system to properly assess and identify students with TBI needing special education
      services.


The PATBI program currently receives training and technical assistance from the
Technical Assistance Center (TASC) of the National Association of Protection & Advocacy
Systems and the Traumatic Brain Injury Technical Assistance Center (TBI-TAC) of the
National Association of State Head Injury Administrators.

For more information contact NAPAS 202-408-9514

February 2005
                                         PATBI Problem Areas

                                                                  Advance Directives
                                                       Access to records           Architectural Accessibility
                                                   Abuse
                                Voting   Other                                     Assistive Technology
                 Unnecessary                                                       Civil Commitment
               Institutionalization
                                                                                       Custody/ Parental Rights
               Transportation
           Suspicious Death                                                             Education

  Rehabilitation Services
        Privacy Rights
Non-Medical Insurance
      Post-Secondary
        Education
                                                                                               Employment
                                                                                              Discrimination

                   Neglect
                                                                                            Employment Preparation

                  Immigration                                                            Financial Benefits

                            Housing                                                 Forensic Commitment

                                                                             Gov. Benefits/ Services

                                          Healthcare              Guardianship/
                                                                 Conservatorship
           Living Arrangements of Individuals Served by PATBI
                     VA Hospital   Unknown/ Not Provided        Community Residential
                         0%                1%                        Home
           Public Housing                                              5%
                 0%                  Other
                                      1%                   Foster Care
Public (State Operated)                                        1%
  Institution Setting                                          Homeless/ Shelter
           5%                                                        2%
     Private Institution Setting                                   Legal Detention/ Jail/
                3%                                                        Prison
                                                                            6%



                                                                              Nursing Facility
                                                                                   11%




         Independent
             37%




                                                                 Parental/ Guardian or
                                                                  Other Family Home
                                                                         28%
    Ethnicity/Race of Individuals Served by PATBI
                                              Arab American
                                                   0%
          Other        American Indian/ Alaskan
           0%                  Native
                                 2%                       Asian
Unknown/ Not Provided                                       2%
         2%
                                                        Black/ African American
  Multiracial/ Multiethnic
                                                                   8%
            1%



                                                                        Hispanic/ Latino
                                                                              6%


                                                                             Native Hawaiian/ Other
                                                                                 Pacific Islander
                                                                                       0%




         White/ Caucasian
               79%
                      Geographic Location of Individuals Served                       Gender of Individuals Served




                                                                            Female
         Rural
                                                                             36%
         39%




                                                               Urban/
                                                              Suburban                                                 Male
                                                                61%                                                    64%




                                                          Age of Individuals Served

                     1000
                      900
                      800
                      700
                      600
                      500
                      400
                      300




Individuals Served
                      200
                      100
                        0
                                0 to 12            13 to 18            19 to 25         26 to 64         65 and over
                                                                     Age ( Years)
                              Highest Intervention Strategy

                                     Legal Remedy/ Litigation
                 Admin. Hearing               2%
                      3%
                                                                Class Action Suits
                                                                       0%
  Mediation/ Alternative
   Dispute Resolution
           3%




         Negotiation
           20%




                                                                               Short Term Assistance
Investigation/ Monitoring                                                               62%
           7%


    Systemic/ Policy Activities
               3%
                                    Reasons for Closing Case Files
                                                            Issue not Resolved in
                                    Not Within Priorities
                Lack of Resources                               Client's Favor
                                            4%
                        1%                                           2%
Agency Withdrew From                                                         Other
       Case                                                                   2%
        0%
           Conflict of Interest
                   0%
    Case Lacked Legal Merit
               7%
    Individual Not
 Responsive to Agency
          5%                                                                         All Issues Resolved in
                                                                                          Client’s Favor
    Services Not Needed                                                                        43%
       Due to Death,
       Relocation, etc
             2%

   Individual Withdrew
        Complaint
           5%

         Other Representation
               Obtained
                 6%


                          Some Issues Resolved in
                              Client’s Favor
                                   23%
                NATIONAL PATBI PROGRAM STATISTICS (FY04)

PART I: NON-CASE SERVICES

A. INFORMATION AND REFERRAL SERVICES (I&R)

1. Total Individuals Receiving I&R Services                                                           12323
2. Total Number of I&R requests during the Fiscal Year                                                14802


B. TRAINING ACTIVITIES

1. Number of Trainings Presented by Staff                                                               1024
2. Number of Individuals Who Attended These Trainings                                                   36700

C. INFORMATION DISSEMINATED TO THE PUBLIC

1. Radio and TV Appearances by Agency Staff                                                             5480
2. Newspaper/Magazine/Journal Articles Prepared by Agency Staff                                         5115
3. PSAs/Videos Aired by the Agency                                                                      3821
4. Website Hits                                                                                       3142046
5. Publications/Booklets/Brochures Disseminated by the Agency                                         498405

6. External Media Coverage of Agency Activities
                               Newspaper/                                             Publications/
  Radio/TV Coverage                                        PSAs/Videos
                            Magazines/Journal                                      Booklets/Brochures
           23                         103                       2                          14

PART II: CASE-SERVICES

 A. INDIVIDUALS SERVED
1. Individuals
a. Individuals Served Receiving Advocacy at Start of Fiscal Year (carryover from prior)               288
b. Additional Individuals Served During Fiscal Year (new for fiscal year)                             1076
c. Total Number of Individuals Served During Fiscal Year (a + b)                                      1363
d. Total Number of Individuals with Cases that Were Closed During Fiscal Year                         818
e. Total Individuals Still Being Served at the End of the Fiscal Year                                 548

2. Services
a. Number of Cases/Service Requests Open at Start of Fiscal Year (carryover from prior)                307
b. Additional Cases/Service Requests Opened During Fiscal Year (new for fiscal year)                  1121
c. Total Number of Cases/Service Requests During Fiscal Year (a + b)                                  1428
d. Total Number of Cases/Service Requests that Were Closed During Fiscal Year                          879
e. Total Number of Cases/Service Requests Open at the End of the Fiscal Year                          549
B. PROBLEM AREAS/COMPLAINTS OF INDIVIDUALS SERVED
Complaint
1. Abuse (total)                                          63
   a. Inappropriate Use of Restraint & Seclusion          7
  b. Involuntary Treatment                                 4
  c. Physical, Verbal, & Sexual Assault                    8
  d. Other                                                44
2. Access to Records                                      5
3. Advance Directives                                      5
4. Architectural Accessibility                            15
5. Assistive Technology (total)                           18
  a. Augmentative Comm. Devices                            4
  b. Durable Medical Equipment                             4
  c. Vehicle Modification/Transportation                   1
  d. Other                                                9
6. Civil Commitment                                        6
7. Custody/Parental Rights                                12
8. Education (total)                                      188
  a. FAPE: IEP/IFSP Planning/Development/Implementation   73
  b. FAPE: Discipline/Procedural Safeguards               19
  c. FAPE: Eligibility                                    12
  d. FAPE: Least Restrictive Environ.                     19
  e. FAPE: Multi-disciplinary Evaluation/Assessments       8
  f. FAPE: Transition Services                            14
  g. Other                                                43
9. Employment Discrimination (total)                      96
  a. Benefits                                             6
  b. Hiring/Termination                                   26
  c. Reasonable Accommodations                            17
  d. Service Provider Issues                               0
  e. Supported Employment                                 4
  f. Wage and Hour Issues                                  0
  g. Other                                                43
10. Employment Preparation                                 6
11. Financial Benefits (total)                            92
  a. SSDI Work Incentives                                  3
  b. SSI Eligibility                                      38
  c. SSI Work Incentives                                                    2
  d. Social Security Benefits Cessation                                     3
  e. Welfare Reform                                                         0
  f. Work Related Overpayments                                              5
  g. Other Financial Entitlements                                          41
12. Forensic Commitment                                                     7
13. Government Benefits/Services                                           105
14. Guardianship/Conservatorship                                           47
15. Healthcare (total)                                                     157
  a. General Healthcare                                                    42
  b. Medicaid                                                              70
  c. Medicare                                                               4
  d. Private Medical Insurance                                              9
  e. Other                                                                 32
16. Housing (total)                                                        104
  a. Accommodations                                                        12
  b. Architectural Barriers                                                 3
  c. Landlord/Tenant                                                       15
  d. Modifications                                                          3
  e. Rental Denial/Termination                                             14
  f. Sales/Contracts/Ownership                                              3
  g. Subsidized Housing/Section 8                                          10
  h. Zoning/Restrictive Covenants                                           0
  i. Other                                                                 44
17. Immigration                                                             0
18. Neglect (total)                                                        120
  a. Failure to Provide Necessary or Appropriate Medical Treatment         31
  b. Failure to Provide Necessary or Appropriate Mental Health Treatment   42
  c. Failure to Provide Necessary or Appropriate Personal Care & Safety    12
  d. Other                                                                 35
19. Post-Secondary Education                                                9
20. Non-Medical Insurance                                                   6
21. Privacy Rights                                                          6
22. Rehabilitation Services (total)                                        101
  a. Communications Problems (Individuals/Counselor)                       10
  b. Conflict About Services To Be Provided                                40
  c. Individual Requests Information                      8
  d. Non-Rehabilitation Act                               0
  e. Private Providers                                    1
  f. Related to Application/Eligibility Process          12
  g. Related to IWRP Development/Implementation           3
  h. Related to Title I of ADA                            0
  i. Other Rehabilitation Act-related problems           27

23 Suspicious Death                                       2

24. Transportation (total)                               25
  a. Air Carrier                                          1
  b. Paratransit                                          7
  c. Public Transportation                                8
  d. Other                                                9
25. Unnecessary Institutionalization                     45
26. Voting (total)                                        0
  a. Accessible Polling Place / Equipment                 0
  b. Registration                                         0
  c. Other                                                0
27. Other                                                140

C. REASONS FOR CLOSING CASE FILES

 Reason
 a. All Issues Resolved in Client’s Favor                343
 b. Some Issues Resolved in Client’s Favor               181
 c. Other Representation Obtained                        49
 d. Individual Withdrew Complaint                        41
 e. Services Not Needed Due to Death, Relocation, etc.   20
 f. Individual Not Responsive to Agency                  41
 g. Case Lacked Legal Merit                              59
 h. Conflict of Interest                                  2
 i. Agency Withdrew from Case                             2
 j. Lack of Resources                                    11
 k. Not Within Priorities                                34
 l. Issue Not Resolved in Client’s Favor                 14
 m. Other                                                14
 n. Total                                                811
D. HIGHEST INTERVENTION STRATEGY
 Interventions
 1. Short Term Assistance                              579
 2. Systemic/Policy Activities                         31
 3. Investigation/Monitoring                           69
 4. Negotiation                                        188
 5. Mediation/Alternative Dispute Resolution           25
 6. Administrative Hearing                             31
 7. Legal Remedy/Litigation                            17
 8. Class Action Suits                                     1

PART III: STATISTICAL INFORMATION FOR INDIVIDUALS SERVED

A. AGE OF INDIVIDUALS SERVED
0 to 12                      72
13 to 18                                133
19 to 25                                142
26 to 64                                888
65 and over                                 28
Total                                   1263

B. GENDER OF INDIVIDUALS SERVED
Male        803
Female             460

Total             1263


C. RACE/ETHNICITY OF INDIVIDUALS SERVED
1. American Indian/Alaskan Native                               30
2. Arab American                                                0
3. Asian                                                        21
4. Black/African American                                      103
5. Hispanic/ Latino                                             73
6. Native Hawaiian/Other Pacific Islander                       6
7. White/Caucasian                                             984
8. Multiracial/Multiethnic                                      15
9. Race/Ethnicity Unknown                                       25
10. Other Than Above                                            6
11. Total                                                      1263
D. LIVING ARRANGEMENTS OF INDIVIDUALS SERVED
Arrangement
1. Community Residential Home                                                       63
2. Foster Care                                                                      14
3. Homeless/Shelter                                                                 20
4. Legal Detention/Jail/Prison                                                      78
5. Nursing Facility                                                                134
6. Parental/Guardian or Other Family Home                                          353
7. Independent                                                                     475
8. Private Institutional Setting                                                    39
9. Public (State Operated) Institutional Setting                                    69
10. Public Housing                                                                   2
11. VA Hospital                                                                      0
12. Other*                                                                          14
13. Unknown/Not Provided                                                            10

E. GEOGRAPHIC LOCATION
Geographic Location
1. Urban/Suburban                                        717
2. Rural                                                 461
3. Total                                                 1178

PART IV: SYSTEMIC ACTIVITIES AND LITIGATION

A. SYSTEMIC ACTIVITIES
1. Number of Policies/Practices Changed as a Result of Non-Litigation Systemic Activities       82

B.   LITIGATION/CLASS ACTIONS
1.   Total Number of Non-Class Action Lawsuits Filed                                            17
a.   Number of Non-Class Action Lawsuits Filed During Fiscal Year (new for fiscal year)         10
b.   Number of Non-Class Action Lawsuits Filed at Start of Fiscal Year
                                                                                                7
      (carryover from prior fiscal year)

2. Total Number of Class Action Lawsuits Filed                                                  5
a. Number of Class Action Lawsuits Filed During Fiscal Year (new for fiscal year)               1
b. Number of Class Action Lawsuits Filed at Start of Fiscal Year
                                                                                                4
    (carryover from prior fiscal year)

C. DEATH INVESTIGATIONS
 1. Number of Formal Death Reports Received                                                 0
 2. Number of Informal/External Death Reports Received                                      4
 3. Number of Death Investigations                                                          1
           FY 2005 PATBI Program Allotments
STATE                  ALLOTMENT   STATE               ALLOTMENT
ALABAMA                $50,000     NEW HAMPSHIRE       $50,000
ALASKA                 $50,000     NEW JERSEY          $58,335
ARIZONA                $50,734     NEW MEXICO          $50,000
ARKANSAS               $50,000     NEW YORK            $82,785
CALIFORNIA             $117,266    NORTH CAROLINA      $57,490
COLORADO               $50,000     NORTH DAKOTA        $50,000
CONNECTICUT            $50,000     OHIO                $65,138
DELAWARE               $50,000     OKLAHOMA            $50,000
DISTRICT OF COLUMBIA   $50,000     OREGON              $50,000
FLORIDA                $75,855     PENNSYLVANIA        $67,286
GEORGIA                $57,808     PUERTO RICO         $50,000
HAWAII                 $50,000     RHODE ISLAND        $50,000
IDAHO                  $50,000     SOUTH CAROLINA      $50,000
ILLINOIS               $67,606     SOUTH DAKOTA        $50,000
INDIANA                $52,933     TENNESSEE           $52,027
IOWA                   $50,000     TEXAS               $87,127
KANSAS                 $50,000     UTAH                $50,000
KENTUCKY               $50,000     VERMONT             $50,000
LOUISIANA              $50,000     VIRGINIA            $55,243
MAINE                  $50,000     WASHINGTON          $52,501
MARYLAND               $51,118     WEST VIRGINIA       $50,000
MASSACHUSETTS          $53,555     WISCONSIN           $51,273
MICHIGAN               $61,864     WYOMING             $50,000
MINNESOTA              $50,245     NATIVE AMERICAN     $20,000
MISSISSIPPI            $50,000     AMERICAN SAMOA      $20,000
MISSOURI               $51,809     GUAM                $20,000
MONTANA                $50,000     NORTHERN MARIANAS   $20,000
NEBRASKA               $50,000     VIRGIN ISLAND       $20,000
NEVADA                 $50,000     TOTAL               $2,969,998
                                                   List of P&As/CAPs

                      ALABAMA                                                         GEORGIA
           Division of Rehabilitation Services                         Georgia Client Assistance Program (CAP)
      and Children's Rehabilitation Services (CAP)                       Website: www.theOmbudsman.com
                Website: www.sacap.org
                                                                         Georgia Advocacy Office, Inc. (P&A)
     Alabama Disabilities Advocacy Program (P&A)                              Website: www.thegao.org
               Website: www.adap.net
                                                                                      GUAM
                        ALASKA                                             Parent-Agencies Network, CAP
                  ASIST, Inc. (CAP)                                        (no website at the present time)
        Website: http://home.gci.net/~alaskacap/
                                                                             Guam Legal Services (P&A)
         Disability Law Center of Alaska (P&A)                              (no website at the present time)
                Website: www.dlcak.org
                                                                                     HAWAII
                  AMERICA SAMOA                                    Hawaii Disability Rights Center (P& A & CAP)
 Client Assistance Program and Protection and Advocacy                    www.hawaiidisabilityrights.org
                 (no website at this time)
                                                                                     IDAHO
                      ARIZONA                                               Co-Ad, Inc. (P&A & CAP)
    Arizona Center for Disability Law (P&A & CAP)                      Website: www.users.moscow.com/co-ad
               Website: www.acdl.com
                                                                                       ILLINOIS
                      ARKANSAS                                         Illinois Client Assistance Program (CAP)
       Disability Rights Center, Inc (P&A & CAP)                              www.dhs.state.Il.us/ors/cap/
          Website: www.arkdisabilityrights.org
                                                                          Equip for Equality, Inc. (P&A)
                   CALIFORNIA                                            Website: www.equipforequality.org
          Department of Rehabilitation (CAP)
           Website: www.rehab.cahwnet.gov                                             INDIANA
                                                               Indiana Protection and Advocacy Services (P&A & CAP)
          Protection & Advocacy , Inc. (P&A)                                  Website: www.IN.gov/ipas
               Website: www.pai-ca.org
                                                                                       IOWA
                    COLORADO                                          Division on Persons w/Disabilities (CAP)
            The Legal Center (P&A & CAP)                      Website:www.state.ia.us/government/dhr/pd/client_assist_p
            Website www.thelegalcenter.org                                       rogram/index.htm

                   CONNECTICUT                                             Iowa P&A Services, Inc. (P&A)
Office of P&A for Persons with Disabilities (P&A & CAP)                       Website: www.ipna.org
            Website: www.state.ct.us/opapd/
                                                                                      KANSAS
                    DELAWARE                                      Disability Rights Center of Kansas (P&A & CAP)
           United Cerebral Palsy, Inc. (CAP)                                     www.drckansas.org
            (no website at the present time)
                                                                                   KENTUCKY
       Community Legal Aid Society, Inc. (P&A)                             Client Assistant Program (CAP)
                 www.declasi.org                                            Website: http://kycap.ky.gov

            DISTRICT OF COLUMBIA                                       Kentucky Protection and Advocacy (P&A)
        University Legal Services (P&A & CAP)                                  Website: www.kypa.net
             Website: www.dcpanda.org
                                                                                    LOUISIANA
                      FLORIDA                                              Advocacy Center (P&A & CAP)
 Advocacy Ctr. for Persons w/Disabilities (P&A & CAP)                       Website: www.advocacyla.org
          Website: www.advocacycenter.org
                      MAINE                                                    NEVADA
               CARES, Inc. (CAP)                                  Client Assistance Program (CAP)
             Website: www.caresinc.org                     Website: http://detr.state.nv.us/rehab/reh_cap.htm

           Disability Rights Center (P&A)                    Nevada Advocacy & Law Center, Inc (P& A)
              Website: www.drcme.org                                 Website: www.ndalc.org

                   MARYLAND                                             NEW HAMPSHIRE
       Maryland State Department of Education                Governor's Commission on Disability (CAP)
Division of Rehabilitation Services/MD Rehabilitation    Website: www.state.nh.us/disability/caphomepage.html
                    Center (CAP)
           Website: www.dors.state.md.us                           Disabilities Rights Center (P&A)
                                                                      Website: www.drcnh.org
       Maryland Disability Law Center (P&A)
           Website: www.mdlcbalto.org                                     NEW JERSEY
                                                                 New Jersey P&A, Inc. (P&A & CAP)
              MASSACHUSETTS                                         Website: www.njpanda.org
           MA Office on Disability (CAP)
  Website: www.state.ma.us/mod/MSCAPBRO.html                               NEW MEXICO
                                                              Protection & Advocacy, Inc (P&A & CAP)
         Disability Law Center, Inc. (P&A)                            Website: www.nmpanda.org
            Website: www.dlc-ma.org/
                                                                            NEW YORK
                  MICHIGAN                                       NYS Commission on Quality of Care
       Michigan P&A Services (P&A & CAP)                       for the Mentally Disabled (P&A & CAP)
             Website: www.mpas.org                                   Website: www.cqc.state.ny.us

                  MINNESOTA                                            NORTH CAROLINA
   Minnesota Disability Law Center (P&A & CAP)                  North Carolina Department of Health &
             Website: www.mndlc.org                                    Human Services (CAP)
                                                                    Website: http://cap.state.nc.us
                  MISSISSIPPI
            Easter Seal Society (CAP)                              Governor's Advocacy Council for
         Website: www.mississippicap.com                           Persons with Disabilities (P&A)
                                                                     Website: www.Gacpd.com
    Mississippi P&A System for DD, Inc. (P&A)
           Website: www.mspas.com-ms                                    NORTH DAKOTA
                                                            North Dakota Client Assistance Program (CAP)
                   MISSOURI                                        Website: www.state.nd.us/cap/
       Missouri P&A Services (P&A & CAP)
          Website: www.moadvocacy.org                     North Dakota Protection & Advocacy Project (P&A)
                                                                     Website: www.ndpanda.org
                  MONTANA
     Montana Advocacy Program (P&A & CAP)                            N. MARIANAS ISLANDS
             Website: www.mtadv.org                     Northern Marianas Protection and Advocacy System, Inc.
                                                                            (P&A & CAP)
              NATIVE AMERICAN                                       Website: www.NMPASI.com
Native American Protection & Advocacy Project (P&A)
         Website: www.nativelegalnet.org                                       OHIO
                                                               Ohio Legal Rights Service (P&A & CAP)
                   NEBRASKA                                         Website: www.state.oh.us/olrs/
          Client Assistance Program (CAP)
           Website: www.cap.state.ne.us                                    OKLAHOMA
                                                           Oklahoma Office of Handicapped Concerns (CAP)
     Nebraska Advocacy Services, Inc (P&A)                     Website: www.state.ok.us/~ohc/cap.htm
    Website: www.nebraskaadvocacyservices.org
                                                             Oklahoma Disability Law Center, Inc (P&A)
                                                              Website: www.oklahomadisabilitylaw.org
                   OREGON                                                     UTAH
      Oregon Advocacy Center (P&A & CAP)                       Disability Law Center (P&A & CAP)
          Website: www.oradvocacy.org                          Website: www.disabilitylawcenter.org

                 PENNSYLVANIA                                            VERMONT
      Center for Disability Law & Policy (CAP)                Vermont Disability Law Project (CAP)
             www.equalemployment.org                              Website: www.vtlegalaid.org

           Pennsylvania P&A, Inc. (P&A)                    Vermont Protection & Advocacy, Inc. (P&A)
                 www.ppainc.org                                     Website: www.vtpa.org

                 PUERTO RICO                                           VIRGIN ISLANDS
              Office of the Governor                       Virgin Islands Advocacy, Inc. (P&A & CAP)
     Ombudsman for the Disabled (P&A & CAP)                       Website: www.viadvocacy.org
       Website: http:// www.oppi.gobierno.pr
                                                                             VIRGINIA
                 RHODE ISLAND                         Virginia Office for Protection & Advocacy (P&A & CAP)
Rhode Island Disability Law Center Inc. (P&A & CAP)                Website: www.vopa.state.va.us
              Website: www.ridlc.org
                                                                         WASHINGTON
               SOUTH CAROLINA                                    Client Assistance Program (CAP)
  Division of Ombudsman & Citizen Services (CAP)                   Website: www.capseattle.org
       Website: www.govoepp.state.sc.us/cap/
                                                                 Washington P&A System (P&A)
       Protection & Advocacy for People with                     Website: www.wpas-rights.org
               Disabilities, Inc. (P&A)
        www.protectionandadvocacy-sc.org                               WEST VIRGINIA
                                                           West Virginia Advocates, Inc. (P&A & CAP)
                SOUTH DAKOTA                                     Website: www.wvadvocates.org
   South Dakota Advocacy Services (CAP & P&A)
          Website: www.sdadvocacy.com                                    WISCONSIN
                                                                    Department of Agriculture
                  TENNESSEE                                    Trade & Consumer Protection (CAP)
         Tennessee P&A Inc. (P&A & CAP)                              (no website at this time)
             Website: www.tpainc.org
                                                             Wisconsin Coalition for Advocacy (P&A)
                    TEXAS                                           Website: www.w-c-a.org
          Advocacy, Inc. (P&A & CAP)
          Website: www.advocacyinc.org                                  WYOMING
                                                              Wyoming P&A System (P&A & CAP)
                                                               Website: www.wypanda.vcn.com

				
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