MDLC envisions a world where people with disabilities are fully included in the workplace, neighborhoods and all aspects of community life.  To move us toward this vision, we focus our advocacy toward:

• Freedom from abuse and neglect
• Freedom from unnecessary institutionalization
• Access to education, housing, transportation, and health care
• Technical assistance and legal information to promote self-advocacy
• Increasing public awareness about people with disabilities and the issues that matter to them

Our Statement of Priorities (full text below) contains these sub-headings:

• Children’s Mental Health
• Adult Mental Health
• Developmental Disabilities
• Education
• Access to Community-based Services for People in Nursing Facilities
• Access to Community-based Services for People with Traumatic Brain Injury
• Protection of civil Rights Public Programs
• Advocacy on Behalf of Beneficiaries of Social Security
• Voting Rights
• Medicaid
• Public Policy

Statement of Priorities – 2006 - 2007

In determining annual priorities for its advocacy work, MDLC solicits the ideas and opinions of people with disabilities, advocates, family members, MDLC staff and board members, and other members of the disability community about those matters that a legal organization with limited resources can best address. 

The following is a list of issues that will take precedence in the allocation of MDLC’s resources.  The decision to accept an individual case for representation would be informed by these priorities, but also by MDLC’s commitment to affecting broad-based, systemic change and our resource limitations.  

CHILDREN’S MENTAL HEALTH

All children diagnosed with a psychiatric disorder must have access to an array of high quality community-based mental health services. The legal rights of those children who must be confined in psychiatric residential treatment centers and hospitals must be safeguarded.

Priority Activities

·   Expand access to community-based services covered by the Maryland Medical Assistance Program for children diagnosed with a psychiatric disorder through outreach and education regarding the available services, representation of recipients in Medicaid Fair Hearings, the continuation of a pro bono attorney training and referral program for Medicaid fair hearings, and systemic advocacy regarding service barriers, such as inadequate reimbursement rates.

·   Advocate for government agencies to implement report recommendations to reduce the incidence of families being forced to relinquish custody of their children with mental illness in order to obtain services.

·   Advocate to ensure compliance by psychiatric residential treatment centers (RTCs) with the rights of residents by outreach to and education of residents and the filing of complaints with the Office of Health Care Quality.

·   Advocate for coverage of evidence-based mental health practices by the Maryland Medical Assistance Program.

·   Advocate for residential treatment centers to provide services and environments that are sensitive and responsive to histories of trauma so that individuals receive the necessary support for long-term recovery in the community.

·   Advocate for the elimination of restraint and seclusion through participation in a state-incentive grant and the development of education and training materials, including producing a film on the harmful effects of these interventions for presentation at state and national conferences and for training staff at state facilities.

ADULT MENTAL HEALTH

Persons diagnosed with a psychiatric disorder must have access to safe, affordable housing and high-quality community-based services that are recovery oriented and self-directed.  Psychiatric hospitals must provide acute care, if community alternatives are not available, in a safe, trauma sensitive environment free from harm, coercion and force.

Priority Activities

·   Advocate for state-operated or funded psychiatric hospitals and community programs to provide services and environments that are sensitive and responsive to histories of trauma so that individuals receive the necessary support for long-term recovery in the community.

·   Advocate for the elimination of restraint and seclusion through participation in a state-incentive grant and the development of education and training materials, including producing a film on the harmful effects of these interventions for presentation at state and national conferences and for training staff at state facilities.

·   Protect individuals in state-operated or funded psychiatric institutions and community residential programs from abuse and neglect by investigating individual cases and monitoring state facilities.

·   Advocate for the diversion from emergency departments, if possible, to community crisis supports and services, and that those receiving psychiatric care or being evaluated in emergency departments are free from practices that may cause or exacerbate a crisis, leading to unnecessary admissions.

·   Advocate to enforce the rights of persons diagnosed with a psychiatric disorder to live in the community and progress through the service systems toward independence and recovery, as set forth by the U.S. Supreme Court in Olmstead v. L.C.

·   Defend the right of persons with psychiatric disabilities to be free from involuntary medication and treatment, and to make voluntary treatment decisions.

DEVELOPMENTAL DISABILITIES

All individuals with developmental disabilities must have access to high quality services in the community.  Whether living in the community or institutions, all individuals with developmental disabilities must be free from abuse and neglect, with appropriate safeguards to ensure their legal and civil rights.

Priority Activities

·   Protect the right to receive quality services and be free from abuse and neglect, by monitoring and investigating targeted complaints about care for individuals with developmental disabilities in state funded and operated programs, and addressing the findings with providers and oversight agencies.

·   Advocate for improvements to the state's quality assurance infrastructure for services for individuals with developmental disabilities, including commenting on regulations to prioritize investigations and monitoring compliance with laws that require reporting on trends and patterns for serious incidents.

·   Promote integration and inclusion by assisting residents of State Residential Centers (SRC) to rejoin the community.

·   Collaborate with the developmental disability advocacy community to identify obstacles to deinstitutionalization and seek solutions, including monitoring the state's implementation of Individualized Habilitation Planning for residents of SRCs and the right to be informed of less restrictive more integrated community settings.

·   Promote self-determination and inclusion by advocating for transparency in Maryland’s procedures to access state funded services for individuals with developmental disabilities.

·   Advocate to improve the Developmental Disabilities Administration process for determining eligibility for services and to create a process for application for the Medicaid Waiver.

·   Expand access to community-based services covered by the Maryland Medical Assistance Program for children with developmental disabilities through outreach and education regarding the available services, representation of recipients in Medicaid Fair Hearings, continuation of a pro bono attorney training and referral program for Medicaid Fair Hearings, and systemic advocacy regarding service barriers including inadequate reimbursement rates and the failure to consistently send written denial letters when services are denied.

EDUCATION

All children and youth with disabilities must receive a free and appropriate public education in compliance with state and federal special education laws.  All families of children and youth with disabilities must have access to knowledge and resources to exercise their rights under these laws.  Implementation of these priorities is guided by MDLC’s focus on family empowerment, systemic change through individual case handling, class representation, and legal and policy activities.

Priority Activities

·   Monitor implementation of federal court consent decrees in Vaughn G. v. Mayor and City Council of Baltimore, et al., targeting the reform of special education services in Baltimore City Public School System (BCPSS).  Specifically, monitor the 15 measurable outcomes adopted by the Court in 2000, which require BCPSS to:  facilitate the delivery of services to students with disabilities in inclusive settings; increase school completion and graduation rates; eliminate interruptions in the delivery services; comply with timelines; and comply with laws related to the suspension and expulsion of students with disabilities.  MDLC will provide individual representation to a limited number of individual students whose cases relate to the specific areas addressed by the outcomes.

·    Provide training and disseminate information (including bilingual and accessible formats) on special education rights and advocacy skills to families, advocates and professionals so that they can better advocate for appropriate special education and related services, including information about the reauthorized federal law, the Individuals with Disabilities Education Improvement Act.

·   Monitor Maryland State Department of Education’s exercise of its general supervisory authority to ensure that public agencies comply with state and federal special education laws.

·   Advocate on behalf of children with disabilities who need to secure appropriate assistive technology (AT) services and devices in order to receive a free and appropriate public education or appropriate early intervention services.

·   Provide services to students who are inappropriately disciplined from school, including suspension, expulsion, restraint and seclusion.  Work will include provision of information and training, direct representation in a select number of cases, pro bono referrals, and systemic advocacy.

·   Advocate to break down the systemic barriers that prevent more students from being educated appropriately in their neighborhood schools.   

·   Advocate for students with disabilities involved in the juvenile justice system to ensure that they receive appropriate special education and related services.

·   Expand MDLC’s pro bono referral program for indigent families needing access to free representation by trained attorneys in special education cases. 

ACCESS TO COMMUNITY-BASED SERVICES FOR PEOPLE IN NURSING FACILITIES

Nursing facility residents must be provided sufficient information about their options for living in the community.  They must have access to appropriate Medicaid waivers and other programs designed to facilitate their movement to high quality community-based services.

Priority Activities

·   Advocate to enforce the right of persons living in nursing facilities on Medicaid to live in the community with adequate supports, as set forth by the U.S. Supreme Court in Olmstead v. L.C.

·   Monitor implementation of the Medicaid Home and Community-Based waivers administered by the Department of Health and Mental Hygiene.

·   Advocate for policies to expand community options, and ensure access, for nursing facility residents.

·   Collaborate with staff and volunteers of independent living centers and other advocates to facilitate integration of nursing facility residents into community life.

ACCESS TO COMMUNITY-BASED SERVICES FOR PEOPLE WITH TRAUMATIC BRAIN INJURY

All individuals with traumatic brain injury should have access to community-based, high quality services to avoid unnecessary and harmful institutionalization.

Priority Activities

·   Advocate for people with traumatic brain injury to be diverted from state psychiatric facilities, nursing facilities and jails through outreach, training and individual case representation.

·   Participate on the Maryland Traumatic Brain Injury Board to expand community options for individuals with traumatic brain injury.

PROTECTION OF CIVIL RIGHTS PUBLIC PROGRAMS

Discrimination that impedes the opportunities of persons with disabilities to be included in our communities must be challenged, especially when the source of the discrimination is a state or local entity.  Access to affordable and accessible housing, to public transportation, and to participation in school athletic programs identified as significant civil rights issues.

Priority Activities

·   Monitor the implementation of the federal court consent decree in Bailey et al. v. Housing Authority of Baltimore City, et al.  The lawsuit alleged that the housing authority discriminated against people with disabilities by refusing to allow them to live in certain housing, refusing to make public housing accessible, and refusing to provide reasonable accommodations.  Court ordered remedies include creating 1,850 new housing opportunities for persons with disabilities; creating nearly 800 units of public housing that are accessible for persons with mobility impairments; providing a process to respond to persons needing immediate modifications or accommodations for their disabilities; distributing a million dollar victim fund; providing special resources and assistance to help persons with disabilities use a voucher to obtain subsidized housing.

·   Monitor the implementation of the federal court settlement agreement in Smith, et al. v. Flanagan, et al., a class action lawsuit alleging that the State discriminated against people with disabilities by operating an inferior public transit (paratransit) service.  The lawsuit alleged the discrimination resulted in people regularly missing appointments for dialysis and other medical treatment, being stranded for hours in dangerous weather or locations, missing work and school, and being unable to rely on public transportation for daily activities of life.  The court sanctioned remedies include increasing on time performance, reducing missed trips and no-shows, enhancing the telephone reservation and communications systems, hiring more staff, purchasing more vehicles, and continuing a court sponsored negotiation process using an independent expert and a group of class representatives to focus on continued service improvement.

·   Achieve resolution of McFadden v. Howard County Board of Education, a lawsuit alleging that the Howard County Board of Education was discriminating against a high school student who uses a wheelchair by refusing to allow her to participate in athletic activities available to students without disabilities and by denying her educational opportunities available to other students. The federal court granted injunctive relief to require the school system to include the student in  their  track  meets  and  to  allow  her  to  race on the track along side her peers and teammates.  The  Maryland State 

Department of Education has agreed to review their policies to promote inclusion of students with disabilities in athletic programs and to remove barriers to their participation.

ADVOCACY ON BEHALF OF BENEFICIARIES OF SOCIAL SECURITY

All recipients of benefits through the Social Security Administration (SSA) must be aware of work incentives available to them under current law, in particular, expanded benefits available under the Ticket to Work and Work Incentives Improvement Act of 1999.   SSA beneficiaries should have access to appropriate services and assistance including access to reliable public transportation, transition planning from school to work, and continuing Medicaid/Medicare services to facilitate them in meeting employment goals.

Priority Activities

·   Provide individual consultation and legal representation to a limited number of beneficiaries related to SSA benefits and return to work issues, within the restrictions of SSA grant funding.

·   Monitor the implementation of Maryland’s Medicaid Buy-in program in conjunction with the Work Incentives Improvement Coalition, and provide representation to a limited number of beneficiaries denied enrollment in the Buy-in program.

·   Respond to paratransit issues affecting SSA beneficiaries’ ability to engage in work-related activities as a part of MDLC’s public transportation advocacy work.

·   Develop written self-advocacy material regarding work incentives and overpayments for SSI and SSDI beneficiaries.

·   Participate in coalition-based outreach and education to SSI and SSDI beneficiaries related to work incentives, including Maryland's Medicaid Buy-in.

VOTING RIGHTS

All individuals with disabilities who are of voting age must have the ability to participate fully in the electoral process, including being able to vote privately and independently.      

Priority Activities

·   Provide voter education and advocacy to encourage the full participation of individuals with disabilities in the electoral process.

·   Advocate to increase access of persons with disabilities to their polling places and to the electoral process.

·   Increase the number of individuals with disabilities who are registered to vote.

MEDICAID

Maryland’s Medical Assistance (MA) program must be structured to enable people with disabilities to live in the most integrated, least restrictive setting.  MDLC will advocate against cost caps and service restrictions that interfere with this goal.  People with disabilities and their chosen advocates must have meaningful participation in and access to a client-centered, equitable MA program designed to enable people with disabilities to live productive, fulfilling lives.

Priority Activities

·   Advocate for a Medicaid system that mandates involvement of true stakeholders and their advocates prior to submission of any changes to the State Plan Amendments and applications for Medicaid waivers.

·   Advocate with the Department of Health and Mental Hygiene and other Administration officials to seek funding opportunities leading to self-determination, community integration and independence for people with disabilities.

·   Participate in the Medicaid Matters! Maryland coalition.

PUBLIC POLICY

To the extent permitted under federal law and non-federal funding sources, MDLC engages in public policy advocacy primarily at the state and local levels on issues affecting people with disabilities.  These issues include expanded public financial support for programs serving people with disabilities, initiatives to expand community-based services and to facilitate the movement of people with disabilities out of institutional settings, and support for state-wide advocacy on a cross-disability basis, as well as other issues as described in these priorities.

                                     MDLC Staff