NEWS LETTER November Disability Rights of West Virginia 2022 Suicide Prevention Article by Megan Elliott, Family Services Navigator - NAMI (National Alliance on Mental Illness) Suicide is one the most preventable deaths, yet it remains a leading cause of death worldwide year after year. Unfortunately, the COVID-19 pandemic has taken more lives for reasons beyond the virus itself. Two major contributing risk factors for suicide are isolation and hopelessness, feelings which have been exacerbated through quarantine and social distancing. As of 2019, there were 47,511 deaths by suicide in The United States alone. West Virginia has a rate of 18.8/100,000 or 3,445 deaths by suicide which puts the state among the top 10 in the U.S. for lives lost. Risk Factors Knowing the risk factors attributed to suicide is a vital piece of prevention efforts. Some of these risk factors include: Previous Suicide Attempt Substance Misuse Depression and other Mental Illness Serious Illness and/or Disability Bullying Adverse Childhood Events Witness to or experience of violence Lack of access to healthcare History of suicide in family/loved ones Discrimination Financial Hardship Stigma around mental illness Protective Factors Another important aspect of suicide prevention is the implementation of protective factors. Much like any other illness, there are steps we can take to ensure the health and safety of ourselves and those around us. It is within the ability of each of us to practice these actions. Some examples of protective factors include: Support from loved ones Access to healthcare, including mental health Cultural Connections Religious Beliefs Involvement in school, community, or social organizations Reduced access to lethal means Effective coping skills Connections to others Access to Lethal Means Restricting access to lethal means can be one of the biggest protective factors we have against death by suicide. Lethal means are anything which can be used to complete suicide. This includes but is not limited to firearms, medications, and sharp objects such as knives. Proper storage of these everyday items can go a long in keeping our communities safe from suicide. This can be done through the implementation of firearm locks, gun safes, and lock boxes to name just a few methods. Taking the time to safely store these potential dangers even when suicide is not believed to be a concern is worth more than a life lost. IS PATH WARM IS PATH WARM is an easy to memorize acronym that anyone can use in assessing risk for suicide. This handy tool looks like this: I solation – Increase in time spent alone S ubstance Abuse – Improper or excessive use of substances such as drugs or alcohol P urposelessness – Saying things like “I feel useless” or “I don’t have a purpose in life” A nxiety – Increased nervousness or worry T rapped – Can be expressed as a lack of motivation. Saying things like “I feel stuck” H opelessness – Lack of hope for the future W ithdrawal – Withdrawing from family, friends, or loved ones A nger – Uncharacteristic or increased anger R ecklessness – Uncharacteristic or increased risk-taking behavior M ood Changes – Unusual or dramatic changes in mood or behavior Resources If you are concerned for yourself or a loved one, please reach out to any of the resources below for help. You Are Not Alone! 988 suicide and crisis lifeline, call or text preventsuicidewv.com namiwheeling.org 844.MY.LOST1 BrotherUpFoundation.org help4wv.com sprc.org Sources for statistics: https://www.cdc.gov/suicide/factors/index.html https://preventsuicidewv.com/get-the-facts/ Client Comments Why we do what we do "I am very happy with the outcome of my complaint. WELL DONE JOB!" "Thank you!"

2022 NEWS LETTER January Disability Rights of West Virginia Successful Client Resolutions 2021 As Disability Rights of West Virginia (DRWV) closes out fiscal/program year 2021, I thought it would be nice to provide data and successful outcome stories for the people with disabilities we served this year. While the pandemic continued to rage on, the DRWV staff didn’t miss a beat. We have been working every day to help ensure the human and civil rights of our most vulnerable citizens are protected. In FY 2021, 973 Federally funded Service Requests were created for 694 clients. In addition to individual advocacy, DRWV conducted a total of 268 monitoring visits, using a combination of in-person and virtual visits for 126 different sites. These sites included, state and private operated psychiatric facilities, prisons, jails, state and private operated nursing homes, intermediate care facilities (ICF), Specialized Family Care homes, assisted living facilities and children’s residential facilities. DRWV also conducted polling place accessibility studies for 316 sites in 12 counties. In addition to our federally funded programs, DRWV serves over 300 individuals with developmental disabilities through the Medley/Hartley Advocacy Program, which is a state funded grant. Following is a collection of successful outcomes that we were able to deliver for our clients in FY 21. DRWV received a report that a client with a serious mental illness harmed herself while in a seclusion room at a state psychiatric hospital. DRWV conducted an investigation. As a result of the incident and DRWV's involvement, the facility modified policies related to seclusion/restraint which should provide for a safer environment. Also, as result of the investigation, DRWV was able to clarify our access to "Peer Review" documents from state operated psychiatric hospitals. DRWV opened an investigation to address the death of a client who had been served under the Medley/Hartley Advocacy Program, our state grant. DRWV completed interviews and a document review for the investigation. Our investigation determined policy violations with the Specialized Family Care (SFC) program. A complaint was filed with the WV Nursing Board and Medicaid Fraud Unit. Findings letters were also sent. Findings were also reviewed with SFC program supervisors. A client’s legal guardian sought assistance with potential financial exploitation by the previous representative payee. The guardian alleged that several of the client’s personal belongings were missing after the client was moved. DRWV requested and reviewed records, interviewed the client, guardian, and staff, then communicated with the service provider to address issues identified related to the client's belongings. DRWV arranged for a mediation with the guardian and service provider, drafted a settlement agreement, and followed up to ensure that the settlement agreement was executed by all parties. As a result, DRWV confirmed that the client was reimbursed for lost personal items. Abuse/Neglect/Financial Exploitation Accessibility DRWV conducted accessibility studies when requested throughout the fiscal year and sent findings to the sites. The sites included: a Unites States Post Office; a children’s museum; medical providers; potential office sites for our satellite office; and outdoor recreation areas including a state forest. These letters included the ADA or ABA violations, suggestions for remedying them, and resources that may be of assistance. We were also contacted by the West Virginia Coalition to End Homelessness about the need to conduct studies at several homeless shelters in WV in the coming year. A client with a mobility impairment requested assistance regarding accessible parking at a public recreational area. DRWV completed a site visit then communicated with the owner of the marina regarding the need to properly designate and stripe the accessible parking. Due to intervention by DRWV, the marina owner agreed to pave the parking area in the Spring, before they re-open for the season. They assured DRWV that the accessible parking spots will be appropriately marked and striped and will be in compliance with ADA guidelines. Access to Services A client requested assistance with her Medicaid Title XIX Aged & Disabled Waiver (ADW) Provider's refusal to add staffing hours after the client was approved for more hours. DRWV contacted KEPRO and learned that the client was approved to receive approximately 124 hours of personal attendant services per month. DRWV communicated with the ADW provider and found that they were only providing her with 10 hours a week (40-50 hours per month) of personal attendant services based on their independent assessment of the client's needs. The client also informed DRWV that her assigned personal care attendant abused/neglected/financially exploited her in the following manner: asked the client to say she worked when she did not, or she refused to work when at the client's home; add her to the client's cell phone plan; give her some of the client's prescription medication; and used the client's food stamps. DRWV filed a complaint against the ADW provider due to their refusal to provide the client with staffing at the level she was assessed and to address the alleged abuse/neglect/exploitation. This complaint was sent to the ADW provider as well as Adult Protective Services (APS), Medicaid Fraud Control Unit, Bureau for Medical Services and Bureau of Senior Services. DRWV educated the client on other ADW Provider Agencies as well as Personal Options, the self-directed option for the ADW program. Due to advocacy provided by DRWV, the client's allegations are being investigated by APS. The personal attendant is no longer on the client's cell phone plan and the client was reimbursed for the costs incurred. The client chose to self-direct her ADW services, hiring her own staff, and has chosen a different provider agency. A client who was in state prison needed nursing home level of care upon discharge but was experiencing barriers. The state-operated nursing home that accepted him later denied him just prior to his discharge date. DRWV communicated with the nursing home and WVDHHR, advocating for the client's need for services. As a direct result of our involvement, the client was approved then transferred to the state-operated nursing home upon discharge from prison. A client whose primary language was Spanish had been denied interpreter services by his primary care physician (PCP). DRWV communicated with the hospital where the physician's office was located regarding interpreter access. DRWV provided the PCP's office with information on how to access the hospital's existing translation service. Due to advocacy provided by DRWV, translation services were arranged for the client's appointment. DRWV also educated the client and the staff at the facility where he resided of the proper way to request translation services for upcoming appointments. A client's legal guardian requested DRWV's representation for a Medicaid fair hearing related to an insufficient I/DD Waiver budget amount for the client. The client was in need of more nursing services than were approved. DRWV communicated with the case manager and reviewed records. DRWV attended the pre-hearing conference call to advocate for the client's needs. As a result of the pre-hearing, it was agreed that the client will get the services she needs in order to remain in her home. In late FY 2020 the legal guardian of a client with a TBI who was on the I/DD Waiver, along with the client’s Service Coordinator, requested DRWV's assistance. The client’s residential service provider did not have appropriate positive behavior supports nor sufficiently trained staff which resulted in staff filing multiple criminal charges against the client. DRWV attended multiple meetings and provided feedback on the draft positive behavior support plan. Due to the advocacy provided by DRWV, the team developed a new positive behavior support plan in FY 2021 which included information on traumatic brain injuries. The service provided retrained all of the client's staff. Education The father of a student with a disability requested assistance regarding the scheduled placement for the 2021-22 academic year. DRWV communicated with the school and the Local Education Agency (LEA) and reviewed Individualized Education Programs (IEPs). The LEA confirmed that services will remain in place, but in a more integrated classroom. The student will continue to receive necessary specialized educational services in the home county. Employment A client requested assistance regarding his employer's inability or reluctance to use the assistive technology (AT) device that DRWV negotiated for him to use at work through a previous service request. DRWV worked with the client and the employer to compromise with communication since the AT device was not working inside the building. The employer provided the client and the shift manager with cell phones to use for effective communication while the client is at work. As a result of DRWV’s collaboration with the WV Developmental Disabilities Council (DDC), House Bill 2290 was passed, and the WV Employment First Taskforce was created in July 2021. DRWV is a required member of this Taskforce, and our Executive Director participates in meetings as well as the Strengths and Weaknesses sub-committee. The Taskforce is charged with developing and implementing a statewide Employment First Plan. Housing A client requested DRWV's assistance with issues she was having with her landlord. She was at risk of being evicted. DRWV communicated with the Comprehensive Behavioral Health Center who served the client as well as the landlord regarding the client's concerns. DRWV found that the client hears voices which distract her causing her to leave faucets run, which previously flooded her apartment, and a neighboring apartment. DRWV assisted the client and her case manager with completing a housing modification request form. Due to advocacy provided by DRWV, the client's leaky faucets were repaired then automatic shut-off faucets were installed. The mother of a child with a disability requested assistance to fight an eviction that she was facing because of alleged noises that her son was accused of making. DRWV negotiated a settlement of this eviction case, communicated with the attorney for the housing provider to inform him that if the client and her family were evicted, she would have a claim for disability discrimination under the Fair Housing Act. In exchange for the client's agreement to waive her claim under the Fair Housing Act, the housing provider purchased her interest in the apartment for $10,000. The client and her remained in the apartment for several more months without paying rent or maintenance fees. Litigation The Hartley lawsuit is systemic litigation grounded in W.Va. Code 27-5-9, which provides rights to persons involuntarily committed to mental health facilities. DRWV’s position as a party in the Hartley case provides leverage to DRWV’s systemic advocacy efforts. The lawsuit was closed in February 2021. The dismissal order obligates the WV Department of Health and Human Resources (WVDHHR) to continue to fund community-based mental health services, as well as independent patient advocates in WV’s two state psychiatric hospitals. The WVDHHR is also obligated to implement the Therapeutic Activities Group (TAG) Program as the 2 state psychiatric hospitals. In addition, the WVDHHR will create a new Office of the Mental Health Ombudsman to transition from judicial oversight to a departmental administrative process. DRWV along with A Better Childhood (a national nonprofit) and a local WV law firm filed a federal class action lawsuit against the WV Department of Health and Human Resources (WVDHHR) and several state officials at the end of FY 2019. The suit alleges that the WV Foster Care system is failing to protect children and failing to provide needed services. During FY 2021, the federal district court granted the defendants’ Motion to Dismiss. In reply, plaintiffs filed a notice of appeal with the Fourth Circuit challenging that decision. During FY 2022, the appeal will be fully litigated complete with a detailed brief by plaintiffs supported by amici including ChildUSA and the disAbility Law Center of Virginia, Virginia’s P&A. Plaintiffs are asserting the decision was based on outdated legal precedent. DRWV has continued our partnership with the Arc, the Arc of Three Rivers, the Judge David L Bazelon Center for Mental Health Law, Mountain State Justice, and Latham and Watkins, LLP to examine the placement of students with disability-related behaviors. The federal district court certified the class in this matter and the defendants have filed for a permissive appeal with the Fourth Circuit challenging that decision. While the appeal is pending, the parties are engaging in mediation to see if they can resolve the matter without further litigation. Should mediation be unsuccessful, a trial will ensue. With the COVID-19 pandemic still having adverse effects on long-term care residents, Advocates were able to monitor changing policies regarding residents’ rights such as visitation, dining, activities, and medical treatment to ensure residents weren’t having their rights violated. One specific issue that Advocates assisted with directly related to changing policies was communication with visitors. DRWV advocated for appropriate screen time with visitors who couldn’t come to the facilities in person. In addition, DRWV requested and received a proclamation from the governor declaring October 2020 Residents Rights Month. A client requested assistance with transition services from an ICF/IID that serves youth to a Specialized Family Care placement. He also wanted to ensure that the ICF/IID did not unnecessarily file a guardianship petition. DRWV filed a complaint with the Foster Care Ombudsman in order to get the WVDHHR to release the client's original birth certificate and Social Security card so that an identification card could be obtained. DRWV found that the ICF/IID had a medical provider blanketly recommend guardianship for each of their clients when they turn 18. DRWV attended the discharge meeting and educated facility staff on supported decision making. DRWV brought this to the attention of Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS). Due to advocacy provided by DRWV, the client was re-evaluated to see if he required a guardian. It was found that he did not require a guardian. The client was discharged from the ICF/IID to live in a Specialized Family Care home where he receives I/DD Waiver services Rights Restrictions/Violations Voting As a result of the collaboration between DRWV and the WV Secretary of State's Office on the option for and promotion of electronic absentee ballots in 2020, 271 people with disabilities voted in this manner in the November 2021 election, up from just 20 people when it was first offered. DRWV conducted polling site accessibility studies at 316 sites in 12 counties in WV in FY 2021 to ensure access for people with disabilities. Reports were sent to the County Clerk of each county detailing the findings and providing information about the applicable accessibility standards. I hope this newsletter conveys the commitment that DRWV has to citizens with disabilities in West Virginia. If you know of anyone in need of our services, please have them call 800-950-5250. Susan Given Executive Director

KNOW YOUR RIGHTS: DISPUTE RESOLUTION Parents are encouraged to work with their school districts to resolve disagreements regarding the need for special education or related services. These informal discussions include eligibility committee meetings, Individualized Education Program (IEP) meetings, 504 plan meetings, discussions with the school principal, and discussions with the special education coordinator or superintendent of your district. Parents should be willing to compromise, but feel empowered to make their child’s needs known and speak up when they disagree. Parents are wise to put their wishes and disagreements in writing and send a copy to the school district. Also, parents of students with disabilities need to familiarize themselves with the law, policies and procedures regarding special education and the processes available to protect those rights. Below are methods available under Federal and State law to help resolve matters regarding special education or related services: State Complaint (Investigation) – This is a formal complaint process that can trigger an investigation conducted by the Office of Special Programs (OSP) where there are issues regarding the identification, evaluation, placement, the provision of appropriate services, or a general complaint with school policy. This is a great self-advocacy tool for parents because once a sufficient complaint is filed, a third-party investigator will look into the alleged violations. Within 60 days of filing a complaint (excluding unusual circumstances), the investigator will generate a report detailing their findings and submit a corrective action plan if violations are found. Mediation – Mediation is a voluntary process that encourages parents and district to come together with the help of a neutral third party to reach an agreement. Opportunities to mediate can arise as part of a state complaint investigation or due process hearing procedure, but parents may also request a standalone mediation session. Mediation is arranged and paid for by the WV Department of Education at no cost to the parents or district. You do not have to come to an agreement at the end of mediation session. Due Process Complaint – This is the most formal of the dispute resolution procedures and is very similar to a court proceeding. The school district will have an attorney to represent them in front of an Administrative Law Judge. Parents may represent themselves or have an attorney present. This dispute resolution process is complex, but a necessary step when other avenues of resolving disputes prove futile or they feel that their child is in danger. In some circumstances, a parent may request and be granted an expedited hearing. Additionally, parents and districts will have the opportunity to participate in a dispute resolution session, which is much like mediation, after a due process complaint is filed. The funding for this publication is provided, at taxpayer expense, by the U.S. Department of Health and Human Services, Administration for Community Living. Published by Disability Rights of West Virginia (DRWV). Content is solely the responsibility of DRWV and does not reflect the official views of the funding agency. Know Your Rights: Dispute Resolution (PDF)

INFORMATION SHEETS 2022 Special Education Fact Sheet EMS Communication Board Traumatic Brain Injury (TBI) Self Advocacy Handout Durable Medical Equipment (D.M.E.) or Medical Supplies from Medicaid - Tips HELP! The school and I don't agree on my child's IEP. Know your rights: Dispute Resolution Representation of Protected and Incapacitated Persons Temporary Accessibility Solutions for Election Day

Understand the importance of a transition plan. 2023 NEWS LETTER May Disability Rights of West Virginia Transition Services for Students and Youth with Disabilities Article by Sherill Hoffman, DRWV Advocate Transitioning into adulthood can be an exciting and stressful time for all students. Plans for post-secondary education, living arrangements, and career planning are on the minds of students, parents, and educational professionals throughout a student's high school career. For students with disabilities, there can be an additional layer of planning that can become overwhelming. Understanding a student's rights and the process of proper transition planning can help ease minds and help prepare individuals with disabilities for a successful transition into adult life. Transition Plan The Individuals with Disabilities Education Act (IDEA) and the Rehabilitation Act of 1973 require transition services be available to students and youth with disabilities (OSERS, 2020). Transition services are coordinated and collaborative activities with a person-centered, outcome-driven process that depends on student and family involvement, the local vocational rehabilitation agency, and the school. A transition plan is to be included in a student's individualized education program (IEP) by the time they turn sixteen and can begin earlier if deemed appropriate by the IEP Team. The plan should include post-secondary goals based upon assessments related to training, education, employment, and, if needed, independent living skills such as self-advocacy and finance management. Additionally, a list of services, including courses of study, will assist the individual with a disability in obtaining post-secondary goals (OSERS, 2020). The student should be at the center of transition planning. The team should consider interests, strengths, needs, and preferences throughout the transition process. Students should attend IEP meetings. If a student cannot participate, efforts should be made to ensure the student is at the center of the conversation. Understanding what a person hopes to achieve after high school is essential, increasing chances for success. Questions to think about when Creating a Transition Plan Does the student want to attend college or a vocational program? Which career path does the student want to take? How can the team ensure integrated work (including supported employment)? What are the student’s goals for independent living, and which services and supports may be needed? What additional support and services will be required to create a successful transition plan? Agencies that offer Transition Services In West Virginia, the Division of Rehabilitation Services (WVDRS) is the vocational rehabilitation agency for individuals with disabilities who want to work. Each school in West Virginia has assigned counselor(s) to assist in identifying students who would benefit from transition services. It is also vital for the IEP team to invite WVDRS to the conversation as WVDRS can provide a wide range of services, such as: Vocational and educational planning Career counseling and guidance Work-related training and education Workplace assessments and accommodations Job coaching Supported employment Assistive technology assessments and equipment WVDRS is also able to provide pre-employment transition services (pre-ETS). Pre- ETS are collaborative efforts between the school and WVDRS. These services are available for ages 14 to 21 and include job exploration and counseling, which helps students learn about potential careers and the necessary training. Participating in work-based learning experiences helps transition youth to learn about a workplace, including job shadowing and mentoring opportunities. Pre-ETS include counseling on programs that assist a student in planning post-secondary education and training. This can include workplace readiness which helps to develop independent living, social, and self-advocacy skills, which allow a person with a disability to learn how to represent themselves (WVDRS, 2023). Pre-ETS can help create the framework for a successful transition plan. Disability Rights of West Virginia (DRWV) is West Virginia's federally mandated protection and advocacy system for people with disabilities. DRWV advocates for transition services and employment for individuals with disabilities. The Client Assistance Program (CAP) advocates for individuals who receive or need services from the WVDRS. Examples of CAP advocacy include assistance with applying for vocational rehabilitation services, issues related to a counselor and client relationship, and working to ensure a person receives appropriate support and services from WVDRS to help them achieve their goals for employment. To learn more about DRWV please visit our website at www.drofwv.org or request additional information or support regarding transition services, call us for an intake at 304-346-0847 or 1-800-642-8207. Resources A Transition Guide to Postsecondary Education and Employment for Students and Youth with Disabilities United States Department of Education - Office of Special Education and Rehabilitative Services https://sites.ed.gov/idea/files/postsecondary-transition-guide-august-2020.pdf West Virginia Division of Rehabilitation Services (WVDRS) Pre-Employment Transition Services https://wvdrs.org/index.cfm?fuseaction=home.displaystory&groupID=89&itemid=78 Client Comments Why we do what we do "When our advocate comes to the home to visit my non-verbal son, she is very friendly to him. She also always keeps in touch with us. She is very in tune to his needs. " "My advocate is always friendly and polite."

NEWS LETTER December Disability Rights of West Virginia The Medley Hartley Advocacy Program 2021 Article by Stephanie Thorn, DRWV Medley Program Director Disability Rights of West Virginia (DRWV) offers advocacy services to people in West Virginia through federal and state programs. The Medley Hartley Advocacy Program (MHAP) is a state funded program that provides advocacy services to people in West Virginia who are eligible. The Medley Program emerged as part of a class action lawsuit (Medley v. Ginsberg, 1981) and the Medley Consent Decree. It mandated that people with developmental disabilities would be served in the least restrictive environment and receive individualized services based on their individual needs. It formed an advocacy system for all Medley Class Members. It also changed the conditions of the state’s institutions, which resulted in several of them closing. Hartley was established due to a different class action lawsuit (E.H. v. Matin, 1983) and provided major improvements to the state’s behavioral health system. It mandated that people with mental illness, substance abuse, traumatic brain injury or developmental disabilities get services in the least restrictive environment. The MHAP grant narrows those eligible for Hartley services through this program. Those individuals that meet the broader definition may be served through one of DRWV’s federal programs DRWV provides advocacy services to more than 300 Medley Class Members. We have seven different regions with an Advocate assigned to each. Advocates attend treatment team meetings, complete home and day activity visits, and advocate for the needs and wishes of Medley Class Members . We visit homes, hospitals, group homes, nursing facilities, and other locations where the Medley members live. We advocate for people to live in their desired community, to work or participate in the day activities that they want, and most importantly to ensure that their needs are met. We report abuse, neglect, and exploitation to the WV Department of Health and Human Resources and to law enforcement when it is needed. We strive for Medley Class Members to live in the most independent way that they can, with individualized supports and services in place to help them do so. Advocates focus on the members wishes and interests and attempt to assist individuals fully achieve them. Who is Eligible to become a Medley Class Member? To become a Medley Class Member an individual must: live in West Virginia; have a diagnosis of an intellectual or developmental disability; been hospitalized prior to age 23 in a West Virginia institution such as Weston State Hospital, William R Sharpe Jr. Hospital, Huntington State Hospital (now Mildred Mitchell-Bateman Hospital), Colin-Anderson Center, Greenbrier Center, Spencer State Hospital, Lakin Hospital or Hopemont Hospital for at least 30 days; and, have been born on or after April 1, 1956. Once a person becomes a Medley Class Member, they receive advocacy services for their lifetime. Through Hartley, DRWV works to find individuals who may be eligible to become Medley Class Members. Please contact DRWV for more information or if you know someone who may qualify to become a Medley Class Member. DRWV believes that people with disabilities can have lives that are enjoyable, dignified, valuable, and productive. Our job is to make sure that the needed supports and services are in place so they can live an integrated life in the least restrictive environment; that they are safe from abuse, neglect, and exploitation; and, that their wishes are expressed and acknowledged. . Client Comments Why we do what we do Thank you for keeping me in my home! Very pleased with all, eased my mind.

2022 DRWV NEWSLETTERS January 2022: 2021 Successful Client Resolutions February 2022: Assistive Technology for People with Disabilities March 2022: Programs and Supports for Individuals with Traumatic Brain Injury (TBI) April 2022: Threat Assessment: Looking at Angry Words in the Social Media Age May 2022: Foster Care and Special Education June 2022: Post Traumatic Stress Disorder (PTSD) July 2022: Fragile X Syndrome August 2022: Reentry: A Lifeline for the Formerly Incarcerated September 2022: DRWV Accessibility Studies October 2022: Down Syndrome November 2022: Suicide Prevention December 2022: Guardianship and/or Conservatorship

2020 DRWV NEWSLETTERS March 2020: Improvements in Voting Accessibility April 2020: Cameras in the Classroom May 2020: Monitoring Nursing Homes and Assisted Living Facilities June 2020: Attention Parents! It's Time to Grade your Child July 2020: Trauma-Informed Care August 2020: Caroline's Cart - A Shopping Cart for People with Disabilities September 2020: Why the Disability Community Matters when Counting the Census October 2020: Voting: A Fundamental Right of Each and Every American Citizen November 2020: Solitary Confinement: Is it Torture or a Necessity? December 2020: Healthy Relationships: Important for Everyone

Accessing and Using our Accessibility Toolbar Since DRWV believes in accessibility for all, we’ve added an accessibility and language toolbar called Recite Me to our website to make it accessible and inclusive for as many people as possible. It helps one in four people in the US who have a disability, including those with common conditions like sight loss and dyslexia, access our website in the way that suits them best. It also meets the needs of the 67.8 million people in the US who speak a language other than English at home, by translating our web content into over 100 different languages. With a unique range of functions, the accessibility toolbar allows visitors to customize content based on personal preferences . How do I access the Accessibility Toolbar? You can open our Accessibility Toolbar by clicking on the “Accessibility Tools” button in the top right corner of the page. This button now appears in the top right corner on every page of our website. After you click on the “Accessibility Tools” button, the toolbar opens and displays a range of different options for customizing the way the website looks and ways you can interact with the content. How does the Accessibility Toolbar help me access this website? Recite Me helps people access our website and customize the content in a way that works best for them. The Recite Me toolbar has a unique range of functions. You can use it to: Read website text aloud (including PDFs) Download the text as an MP3 file to play it where and when it suits you Change font sizes and colors Customise background-colors Translate text into more than 100 different languages Access a fully integrated dictionary and thesaurus Overview of Tools Previous Play Next Decrease Font Size Select Font Incease Font Size Color Theme Ruler Screen Mask Dictionary Change Language Magnifying Glass Plain Text Mode Download Audio Settings Reset User Guide Accessibility Toolbar User Guide Play Audio Previous Rewind to the previous paragraph of text . Play Click the Play button to read the te xt aloud . Next Skip forward to the next paragraph of text . Text Options Decrease Font Size This will decrease the text size . Select Font You can change the font that displays on the page . Incease Font Size This will increase the text size . Color, Ruler and Mask Color Theme Ruler Screen Mask Change the background, text, and link colors . Click to enable the reading ruler . Will create a letterbox for focused viewing of a section of the pag e . Dictionary, Translation and Magnifier Dictionary Highlight and click on this to view the definition of the word. Change Language Translate text into a different language . Magnifying Glass Click and drag the magnifying glass to magnify text on the screen . Plain Text Mode and Download Audio Text Mode Remove images to view content in plain text mode . Download Audio Highlight the text then click the button to download the text as an audio file . Settings Settings Adjust your Recite Me toolbar settings Reset This will restore the default settings . User Guide This will give you an overview of the Toolbar Features

# Psychiatric Advance Directives - Information for Providers Disability Rights of West Virginia Protection and Advocacy for Individuals with Mental Illness Advisory Council This information was developed to raise awareness of Psychiatric Advance Directives. It is not intended to provide legal or medical advice. ## Providers Psychiatric Advance Directives Used to document an individual’s specific instructions or preferences regarding mental health treatment, in preparation for the possibility that the person may lose capacity to give or withhold informed consent to treatment during a crisis ## Options Three options for developing a Psychiatric Advance Directive: *Living Will *Medical Power of Attorney *Combination of Living Will and Medical Power of Attorney ## Typically under state laws... *Accept or refuse treatment *Have an advance directive and / or healthcare agent *Most states you can have a single or separate plan for physical and psychiatric care ## West Virginia Healthcare Decisions Act *Addresses End of Life Care *Includes psychiatric care under the definition for health care decisions under the definition of healthcare facilities ## Right to Create a Psychiatric Advance Directive State Rule 64-74-5 Advance Psychiatric Directive Right *A consumer has a right to an advance psychiatric directive prepared at a time when the individual has not been adjudged to be incompetent ## Consumer Rights *A consumer has the right to refuse to create an advance psychiatric directive *A consumer with an advance psychiatric directive has the right to have it entered into his or her clinical record at the behavioral health service at which he or she is receiving or may receive care or treatment ## Role as a Provider *Inform consumers of their right to create a psychiatric advance directive ## State Medicaid Agency Obligations *Must develop a written description of the state’s Advance Directive law to be distributed by Medicaid providers and health plans *Any revisions to state law must be incorporated into information no later than 60 days of effective date of law *When contracting with managed care plans, state Medicaid agencies must require the plan to comply with requirements of federal law in regard to written policies and procedures *Plan must meet the requirements of the Patient Self Determination Act ## Federal Role Department of Health and Human Services is required to: *Conduct public education campaign *Conduct Provider technical assistance to states *Oversee compliance *Mail Advance Directive information to Social Security recipients *In partial fulfillment of these requirements Federal DHHS has developed a brochure describing advance directives* ## Community Education The same written materials do not have to be provided in all settings, however all must: *Define a advance directive *Emphasize that it is designed for consumers to exercise self-direction over healthcare *Describe applicable state law in regard to advance directives *All information distributed must be current *Must include state law revisions within 90 days of effective date of the revision *Providers may contract with other entities to provide the information; however, the provider is legally responsible for ensuring education occurs ## When Information on AD Policies Must Be Provided *At time of admission *Upon enrollment in a healthcare plan *Before receiving care *When initially receiving care ## Family receipt of Advance Directive Information Providers may give information regarding an advance directive when: *The consumer is incapacitated and unable to receive information due to a mental disorder or an incapacitating condition, or if the consumer is unable to articulate whether or not they have an advance directive *The information must be given to the consumer once they are no longer incapacitated ## Providers *A consumer has the right to be informed by a behavioral health service of the availability and applicability of an advance psychiatric directive and to receive education and assistance from the behavioral health service in preparing such a document ## Role as a Provider *Entities must provide education to their staff and their community on advance directives either directly or with other providers *Education must include education regarding: *Rights under state law to participate in decisions regarding their medical care *The facilities policies regarding advance directives Tips * Don’t wait until a crisis to introduce the idea of creating an Advance Directive *Include in treatment plan *Collaborate with other providers to do community education *Distribute information to consumers at intake, and periodically thereafter ## Providers should consider... *Advance directives can describe treatment(s) a consumer wants in the event of a crisis *An Advance directive can be rejected, even verbally, at any time by the consumer ("Ulysses effect") *Involuntary treatment may be requested -- or imposed (mental hygiene process) in an emergency - even when there is an advance directive ## When providers can refuse to implement an Advance Directive *The provider does not have the resources to provide the treatment *A provider believes that the directive would endanger the consumer’s life or be dangerous to others *If a provider does not honor a psychiatric advance directive, they must tell the consumer the reason for not honoring their advance psychiatric directive Tips: *Be specific *Do it in writing ## Complaints *State Medicaid agencies are responsible for reviewing and responding to complaints regarding advance directives *Penalties can include fines and / or removal as Medicaid / Medicare approved provider ## What to do if directives are not being followed *Complaints can be filed with the agency that surveys and certifies Medicare and Medicaid providers *Providers and healthcare plans must inform consumers they have this right, and how to file a complaint ## Benefits *Promotes self-direction of care *May enable crisis intervention early *Enhances communication between healthcare providers and the consumer *Self-directed services may be provided even if involuntarily hospitalized *Can be included in Treatment Plans *Allows the consumer to describe their own crisis and behaviors to identify behaviors and preferences regarding interventions *Helps providers engage the consumer in their own treatment *Could assist in avoiding involuntary treatment ## The Role of Education *Locate or develop and distribute printed materials describing Psychiatric Advance Directives *Inform staff of the provider’s role *Ask individuals if they want to include Psychiatric Advance Directives in their treatment plan ## Resources West Virginia Advocates (800) 950-5250 WV Bureau of Senior Services (877) 987-3646 Caring Connections (800) 658-8898 Advance Self-Advocacy Plan (ASAP) National Resource Center on Psychiatric Advance Directives

Disability Rights of West Virginia PAIMI Advisory Council Application Biographical Data Sheet Date Name Home Address Home Address Line 2 City Region/State/Province Postal / Zip code County Business Address Business Address Line 2 City Region/State/Province Postal / Zip code County Home Phone Mobile Phone Business Phone Facsimile Phone Email How do you prefer to receive mail? At Home At Work How do you prefer to receive calls? At Home At Work Occupation/Employer Education/Training Volunteer Experience Primary Interest Developmental Disabilities Mental Illness Other Please list the disabilities with which you have the most knowledge and/or experience If you have other experience or interest besides the areas indicated above, please explain. For Federal grant documentation and report purposes, please check all that apply: Gender Male Female Ethnicity Caucasian African American Hispanic Native American Asian Native Hawaiian or other Pacific Islander Other Are you a person with a disability? Yes No If so, what is/are your disability(ies)? (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you a guardian of a person with a disability? Yes No If so, what is/are their disability(ies)? (Please check all that apply) Developmental Disability Mental Illness Other Disability If the person for who you are a guardian is eligible for services, what age is that person who is eligible? Check all that apply Preschool Elementary School Age Secondary School Age Adult Senior Citizen (over 55) Do you have a family member who has a disability? Yes No If so, what is/are the family member's disability(ies)? (Please check all that apply) Developmental Disability Mental Illness Other Disability If your family member is eligible for services, what age is that person who is eligible? (Check all that apply) Preschool Elementary School Age Secondary School Age Adult Senior Citizen (over 55) Are you a professional in the field of… (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you a service provider for persons with… (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you an advocate for persons with… (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you an Attorney? Yes No Are you an individual from the public knowledgeable about… (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you a person who broadly represents or is broadly knowledgeable about the needs of people with… (Please check all that apply) Developmental Disability Mental Illness Other Disability Are you a Board Member or Advisory Council Member for a provider of services to Individuals with Disabilities? Yes No Submit Application Thank you for applying! We'll get back to you soon.

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