THE P&A SYSTEM
AT WORK FOR OVER 50 YEARS
HISTORY
ThenationwideProtection&Advocacysystemwascreatedinthe1970sinresponseto anexposérevealingabuse,neglect,andthelackofservicesandsupportsinstate-run facilitiesattheWillowbrookStateSchoolinStatenIsland,NewYork.Willowbrookwasa stateinstitutionforpeoplewithintellectualanddevelopmentaldisabilities.
Congressheldhearingsandconcludedthatthestateswerenotcapableofoverseeing theservicedeliverysystemandestablishedanindependentoversightsystem.In1975, throughtheDevelopmentalDisabilitiesAssistanceandBillofRights(DD)Act,thefirst ProtectionandAdvocacyprogram,PADD,wasborn(ProtectionandAdvocacyforPeople withDevelopmentalDisabilities).
CongressauthorizedtheProtection&Advocacysystemtoinvestigateallegationsof abuse&neglectandtoadvocateforthecivil&legalrightsofpeoplewithdisabilities.
TheProtection&AdvocacySystem
Wewerecreated through Congressional authority
Weare independent, nonpartisan agencies
Wearelocated ineveryState andTerritoryin theUS
Werepresent peoplewith disabilities
Wecombine investigative oversightwith directadvocacy
Congresshas expandedtheP&A systemoverthelast 50years
FRAUD WASTE&ABUSE
Ourinvestigationsuncoverwasteinourstate systemsandouradvocacyremediesthesefailures.
Wefocusonthesegoalswithbothindividual andsystemicapproaches.
Wetargetthemosteffectivesolutionsforthe peopleweareserving.
CONGRESSIONAL MANDATES
CongresscreatedtheProtectionandAdvocacySystem toinvestigateallegationsofabuseandneglect, educatethepublic,andadvocateforthecivilandlegal rightsofpeoplewithdisabilities.
ABUSE
Weinvestigateanduncover negligentandabusiveactsthat mayleadtoseriousharmand deathandadvocatetoprevent futureharm.
Directcareabuse&neglect
SocialSecuritybenefitmisuse
Unlawfulseclusion
Improperphysical&chemicalrestraint
Unnecessaryinstitutionalization
Financialabuse
Financialfraudisoneofthefastest growingformsofabusetargeting olderAmericansandpeoplewith disabilities.Manyaresusceptible tofraudstersbecausetheylacka meaningfulunderstandingoftheir rightsorhowtoreportabuse.
Weconductover200financial reviewsperyearandproactively deliverKnowYourRightstrainings toraiseawarenessforthoseatthe highestriskofexploitation.
WASTE
Peoplewithdisabilitiesareoftenunnecessarily institutionalizedatgreatercosttotaxpayers.
Thecostofinstitutionalcarefarexceedsthecostofservicesinthe community.Whenpeopleareunnecessarilyinstitutionalized, taxpayersbeartheburdenofthiswaste.Wehavehelpedhundredsof peoplewhowerestuckinhospitals,nursinghomes,andother institutionswhowanttoreturntotheircommunities.
Taxpayerssaveanaveragecostof$7,400perpersonpermonthfor thosedischargedfromnursingfacilities,andanaveragesavingsof $19,000perpersonpermonthforthosedischargedfromhospitals,or intermediatecarefacilitiestocommunity-basedservices.
Inthelastsixyears,ouradvocacyhassavedthetaxpayers $1,210,602amonth.
CLIENT ASSISTANCE PROGRAM
OVER 40 YEARS
OF HELPING PEOPLE GO TO WORK
CONGRESSIONAL MANDATES
ThenationwideClientAssistanceProgram(CAP)wascreatedin
1984tohelpindividualswithdisabilitiesunderstandandaccess vocationalrehabilitationemploymentservices.
CAPfunctionsasawatchdogofprogramsfundedunderthe RehabilitationActof1973,includingVocationalRehabilitation(VR) andIndependentLivingCenters(ILC).
CongressauthorizestheCAPtoeducate,advocatefor,andsupport individualswithdisabilitiesinaccessingvocationalrehabilitation services.Withhighratesofunderemploymentamongpeoplewith disabilities,CAPplaysacriticalroleinhelpingpeoplefindandmaintain employment.
TheClientAssistanceProgram
CAPwascreated through Congressional authority
CAPcombines oversightwith directadvocacy
Congresshas supportedtheCAP systemforover40 years
CLIENTASSISTANCE PROGRAM
Advocacy and Representation
Information and Guidance
CAPprovidesadvocacyandrepresentationtoensuretherights ofindividualswithdisabilitiesareprotectedintheirinteractions withVocationalRehabilitationagencies,IndependentLiving Centers,andotherprojects,programs,oractivitiesfunded undertheRehabilitationAct.
CAPprovidesinformationandguidanceonVRservices,ILCs, rehabilitationservices,andfederalanti-discriminationlaws
Assistance withAppeals andDue Process
Technical Assistance andSystemic
Advocacy
CAPassistsindividualsinpursuingappealsandother remediestoensuretheirrightsundertheRehabilitationAct areprotected,includingduringmediationsessionsorimpartial dueprocesshearings.
CAPprovidestechnicalassistanceandsystemicadvocacyto improvethedeliveryofservicesandaddresssystemic problemsthatmakeitdifficultforindividualswithdisabilitiesto accessservices
SelfAdvocacy Training
CAPprovidestrainingandresourcestohelpindividualswith disabilitieslearnhowtoadvocateforthemselvesand understandtheirrights
FRAUD,WASTE&ABUSE
Weprovidetrainingandresourcestohelpindividuals withdisabilitiesunderstandtheirrightstocombatabuse inemployment.
Weuncoverwasteinourstate’sVRsystemandadvocate toeliminateit.
Wefocusonthesegoalswithbothindividualand systemicapproaches.
Wetargetthemosteffectivesolutionsforthepeople weserve.
FRAUD
CAPprovides independentoversight offederallyfundedVR andILCprogramsand playsacrucialrolein combatingfraudwithin programsfunded underthe RehabilitationAct.
CAPfraudpreventionincludes: InformationandAdvice
CAPprovidesinformationand advicetoindividualsabout theirrightsandresponsibilities, helpingthemunderstandthe servicestheyareentitledtoand howtonavigatethesystem. Thisknowledgeempowers individualstoreportpotential fraud.
ProblemResolution
CAPresolvesdisputesand concernsrelatedtoservices, includingissueslike disagreementsaboutjob goals,assessments,or employmentplacements.This proactiveapproachcanhelp preventfraudfromoccurring orbeingperpetuated.
ABUSE
TheClientAssistanceProgram educatesindividualsabouttheir rightsandemployersabouttheir responsibilitiestocombat employmentabuse.
Advocacyand Representation
CAPadvocatesonbehalfof individualswhoencounter problemswithservices,helpingto resolvedisputesandensuretheir rightsareprotected.Thisincludes addressingissueslikedenialof services,delays,orlackof communicationfromVR agencies.
Ouradvocacyempowers individualstoreportpotential abuse.
In2024,working-agepeoplewithoutdisabilitieswerenearlytwiceas likelytobeemployed(75%)comparedtopeoplewithdisabilities (38%).Taxpayersoftenbeartheburdenofthiswasteofworkforce participation.Wehelppeopletoobtainandmaintainemployment therebyreducingrelianceonotherfederallyfundedprograms.
FOR INDIVIDUALS WITH MENTAL ILLNESS PROTECTION & ADVOCACY
HISTORY
ThenationwideProtectionandAdvocacyforIndividualswithMental Illness(PAIMI)programwasestablishedbyCongressin1986.
Congressactedindirectresponsetoitsfindingsofwidespread abuse,neglect,andexploitationofindividualsresidinginstate psychiatricinstitutions.
Reportsofinhumaneconditionsandalackof accountabilityinthesefacilitiesexposedthecritical needforanindependentsystemtoconductoversight andsafeguardtherightsofresidents.
In2000,inresponsetoabuse,neglect,andrights violationsoutsideofinstitutionalsettings,Congress expandedthePAIMIActtoothercommunitysettings, likeschools,supportedhousing,andhomelessshelters.
CONGRESSIONAL MANDATES
CongresscreatedthePAIMIprogramtoinvestigate reportsofabuseandneglectinfacilitiesthatcaredfor ortreatedadultswithseriousmentalillness(SMI)and childrenwithsignificantemotionaldisturbance(SED) andprovidedirectadvocacytoremedytheharm.
Advocacy and Representation
PAIMIprovidesadvocacyand representationtoprotecttherightsof adultswithSMIandchildrenwithSED, includingadvocatingforthoselivingin institutions.
Monitoring and Investigation
PAIMImonitorsandinvestigatesreportsof abuseandneglectinpublicandprivate facilities,includinghospitals,nursingfacilities, supportedhousing,andschools.
Thisisacrucialsafeguardforthewell-being ofadultswithSMIandchildrenwithSED receivingmentalhealthservices,especially thosewhoresideininstitutionalsettingsata higherriskofabuseandexploitation.
System Advocacy
PAIMIengagesinsystemadvocacyto changestate&localpoliciesandpractices thatharmadultswithSMIandchildren withSED.
PROTECTION&ADVOCACY
ThePAIMIprogramisa criticalpartofthestate-level protectionandadvocacy systemforadultswithSMI andchildrenwithSED.
PAMIensuresthattheirrights areprotectedandthatthey haveequalaccessto opportunities.
ThePAIMIprogrampreventsfraud,waste,andabuseby empoweringadultswithSMIandchildrenwithSED,by investigatingpotentialissuesandadvocatingfortheir rights.
PAIMIensuresthatfederallyfundedresourcesareused effectivelytosupportthosewhoneedthemmost.
FRAUD,WASTE&ABUSE PREVENTION
ProtectingAdultswithSMIandChildrenwithSED
PAIMIprotectsthosewhoaremoresusceptibletoabuseorneglect, suchasindividualsinfacilities,orthosewithlimitedaccessto resources.
EnsuringProperUseofFunds
PAIMIensuresthatfederalfundingforadultswithSMIandchildrenwith SEDisusedappropriatelybymonitoringserviceproviders.
PromotingSystemicChange
PAIMIreducesfraud,waste,andabusethroughlegalaction,advocacy, andeducationalinitiatives.Asaresult,theintegrityofmentalhealth servicesisimproved.
ThePAIMIprogramplaysauniqueroleinpreventingfraud, waste,andabuserelatedtoadultswithSMIandchildren withSEDandtheprogramsthatservethem.
FRAUD,WASTE&ABUSE PREVENTION
1in20adultsand1in10childrenlivewithSMIorSED.Morethan 50%ofadultsand80%ofchildrenfaceseriousbarriersin accessingmentalhealthservices.
Taxpayersbearthefinancialandlong-termcostsfromdelayedor ineffectivementalhealthtreatment.
Overthepast5years,PAIMIdirectlyassisted3,347 peoplewithSMIandSED, withanadditional 2,458,606peoplebenefitingfromsystemic advocacy.
DirectPAIMI advocacyreduceswasteresultingin costsavingsandimprovedoutcomes
PROTECTION & ADVOCACY FOR INDIVIDUAL RIGHTS
HISTORY
ThenationwideProtection&AdvocacyforIndividual Rights(PAIR)Programwascreatedin1993asan independentoversightsystemtoensurethatallpeople withdisabilities,nomatterthediagnosis,areprotected fromabuse,neglect,andrightsviolations.
WiththecreationofPAIR,Congressremedieda significantgapintheProtectionandAdvocacy(P&A) system.
Fordecades,onlypeoplewithdevelopmentaldisabilities orseriousmentalillnesswereentitledtoP&Aservices.
Therightsofpeoplewithphysical,sensorial,orother disabilitieswereleftunprotected.
CONGRESSIONAL MANDATES
CongressauthorizedPAIRtoinvestigate allegationsofabuse&neglectandtoadvocatefor thecivil&legalrightsofpeoplewithdisabilities.
PAIRservesindividualsnotprotectedbyother previouslycreatedP&Aprograms.
Advocacy and Representation
PAIRensurescommunityintegrationandfull participationinsocietybyeliminating barrierstoeducation,employment, transportation,housing,andpublic accommodations.
Monitoring and Investigation
PAIRinvestigatessuspectedabuseorneglect andseeksjusticeforvictims.Thisiscrucialfor safeguardingtherightsandwell-beingof individualswithdisabilities,especiallythosein institutionalsettingsorreceivingcommunitybasedservices.
System
Advocacy
PAIRchangespoliciesandpracticesthat discriminateagainstpeoplewithdisabilities throughsystemadvocacy.
PROTECTINGINDIVIDUALS FROMABUSE
ThePAIRprogramplaysa uniqueroleinpreventing fraud,waste,andabuse relatedtoindividualswith disabilitiesandthe programsthatservethem.
Protection
PAIRprotectsthosemoresusceptibletoabuseorneglect,suchas individualswithdisabilitiesinfacilitiesorthosewithlimitedaccess toresources.
EnsuringProperUseofFunds
PAIRensuresthatfederalfundingallocatedtosupportpeoplewith disabilitiesisusedappropriatelybyadvocatingfortheirrightsand monitoringserviceproviders.
PromotingSystemicChange
PAIRreducesfraud,waste,andabusethroughlegalaction, advocacy,andeducationalinitiatives.Asaresult,theintegrityof publicservicesforpeoplewithdisabilitiesisimproved.
ThePAIRprogrampreventsfraud,waste,andabusebyempowering peoplewithdisabilities,investigatingpotentialissuesandadvocatingfor theirrights.PAIRensuresthatfederallyfundedresourcesareused effectivelytosupportthosewhoneedthemmost.
Whenpeopleareunnecessarilyinstitutionalized,taxpayersbearthe burdenofthiswaste.WithPAIRfunding,wehavehelpedindividuals whoarestuckinhospitalsandnursingfacilitiesreturntotheir communities.
PeoplewithDisabilitiesareoftenunnecessarily institutionalizedatgreatercosttotaxpayers. Over $4,829,616ayear
PROTECTION & ADVOCACY
FOR VOTING ACCESS
HISTORY
CongressestablishedtheProtection&Advocacyfor VotingAccess(PAVA)programinthe2002HelpAmerica VoteAct(HAVA),toensureolderadultsandpeoplewith disabilitieshaveequalaccesstoparticipateinthe electoralprocess.
Voter Education
Accessibility
Informingvoterswithdisabilitiesabouttheir rightsandhowtoregisterandvote.
Workingtoensurepollingplacesareaccessible andthatvotingequipmentisusablebypeople withdisabilities.
Advocatingforindividualswhofaceunique disabilityrelatedobstaclestovoting.
Educatingpollworkersandelectionofficialson howtoassistvoterswithdisabilities.
PAVAisakeycomponentofthenationwideProtection &AdvocacySystem(P&A),focusingspecificallyon addressingandremovingbarriersthatolderadults andpeoplewithdisabilitiesfaceintheelectoral process.
Congressrecognizedtheuniqueobstaclesolder adultsandpeoplewithdisabilitiesfacewhentryingto exercisetheirrighttovoteindependentlyand privately.
VOTERACCESS
Accessibilityinvotingsystemsisacrucialaspect ofensuringthatallcitizenswithdisabilitiescan exercisetheirrighttovoteprivatelyand independently.
ADDRESSINGBARRIERS TOVOTING
PAVAexiststoensurethatthefundamental righttovoteisaccessibletoall,regardlessof disability.
PAVATARGETS:
voteroutreach&education
pollingplaceaccessibility
votingequipmentaccessibility
trainingforelectionofficials&poll workers
Providingtrainingforpollworkerstobetterunderstand theneedsofoldervotersandvoterswithdisabilities.
Examiningpollingplacesforaccessibilityandidentifying necessarymodifications.
Disseminatingaccessibleresources.
Maintainingvotinghotlinesforvoterswithdisabilities.
Educatingvotersabouttheirrightsandregistration procedures.
Publishingreportsofpollingplacesinaccessibility.
Assistingindividualswithdisabilitiesinaccessing pollingplacesonElectionDay.
FRAUD,WASTE&ABUSE PREVENTION
ProtectingVoterAccess
PAVAfocusesonprotectingthosewhomightbemoresusceptibleto disenfranchisementduetotheirdisability.
EnsuringProperUseofFunds
Byadvocatingforthevotingrightsofcitizensandmonitoringthe electoralprocess,PAVAensuresthatfederalHAVAfundingforvoting systemsisusedappropriatelyandnotwasted.
PromotingSystemicChange
Throughadvocacy,non-partisanmonitoring,andeducational initiatives,PAVAmakessystemicchangesthatreducesfraud,waste, andabuse.
ThePAVAprogramplaysauniqueroleinpreventingfraud,waste& abuseintheelectoralprocessbyimprovingvotingaccessibility, efficiency,andintegrity.
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DRNY is supported at taxpayer expense by the U.S. Department of Health & Human Services, The Administration for Community Living; Center for Mental Health Services, Substance Abuse & Mental Health Services Administration; U.S. Department of Education, Rehabilitation Services Administration; and, the Social Security Administration. This publication does not represent the views, positions or policies of, or the endorsements by, any of these federal agencies.
