State of Connecticut Department of Social Services discriminating against and taking advantage of Brain Injury Survivors on the ABI medicaid waiver

My personal experience of how Victor Estay and his supervisor Kenneth R. Smith from the state of Connecticut Department of Social Services 888 Washington Boulevard Stamford, CT 06901 are taking advantage of Disabled traumatic brain injury survivors , If this is happening to you or someone you know first contact the office of protection and advocacy for persons with disabilities and a caregiver parent. Give them all this information and ask them to help you, be sure to contact your state Commission on Human Rights and Opportunities. I did it’s called Discrimination Gen. Stat. Section 46a-58 64(a) (1) & 46a-82
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My letter on 9 / 28 / 09

To: U.S Congressman Jim Himes CT, 211
State Street 2nd Floor Bridgeport, Ct 06604
www.himes.house.gov

(Please Help me.)
My name is Craig Sears I am a traumatic brain injury survivor I spoke to you in your office in Bpt, CT. About 3 or 4 months ago about the Sarah Jane brain foundation National PABI plan. Today I'm writing about my own problems that I'm having with the State of Connecticut Department of Social Services concerning my ABI non-medical waiver plan that has been helping me to live in the community outside of nursing homes and institutions.

(I am writing this because this is a known fact of how the state of Connecticut (Discriminates) against me as a traumatic brain injury survivor as of 9/2/09 everything I have worked on in the past six years I've lost. And now I could feel myself slipping away because the help I need to be able to function in community outside of nursing homes and institutions is being refused by the state of Connecticut Department of Social Services! ) (No matter how they put it they have refused to help me! or what they say there doing about it! (Been there done that.)

I don't know what tomorrow's going to bring for me. I do know all too well as a brain injury survivor what life is like with no help. U.S Congressman Jim Himes I do not want to go back to that cruel and unusual life on the streets or locked in an insane asylum or a prison cell. This is why I'm asking you for help I'm also sending a letter/copy to the White House I've had excellent response from president Barack Obama about the number one leading cause of death and disability for children and young adults in this country.

To President Barack Obama and our leaders and lawmakers, I plead with
You to put the Sarah Jane Brain Project's national PABI plan in place so others don’t have to go through what I am/have. This is cruel and unusual punishment because I/they have a disability called PABI/PTBI.

For the past six years I've been working with either DMHAS the head of the ABI waiver servers for the state or/and the Connecticut Department of Social Services. In the 1990s I became a spokesman for the Connecticut Brain Injury Association for Connecticut's Acquired Brain Injury Medicaid Waiver implemented in 1999. This waiver allows the state to permit organizations to provide non-medical services to people with TBI enabling them to live in the community outside of nursing homes and institutions.

I became a member of that class action lawsuit back in the 90s because (of /this is exactly what the state of Connecticut was doing to me then) the only difference now is I have been working my/ this/ a Program.

That has been set up by my team members to assists me because
Of my special needs due to my disability. Because I have been working my program the way it was set up for my needs. And I am very happy with the services I get. Look at my history. Look how well I've been working with my program and how well that program is working for me and the difference it is mocking in my life. That’s what it was made for. That's why I became an advocate for the class action lawsuit back in the 90s. In other words it's working for me. Why all of a sudden because a program provider not only misled/lied to me and the state of Connecticut why do I need an evaluation it's a known fact I'm disabled and my program is helping me.

And then the state of Connecticut DSS has decided not to give me the services that I have a legal right to get. Another proven fact in the copies below, Plus I have copies of all my service plans and my non-medical ABI waiver plan I also have all the copies of all the conversations and e-mails going back and forth between team members and my DSS worker Stamford Connecticut office Victor Estay and his supervisor Kenneth R Smith, same office. And Dr. Annemarie Murphy PhD...
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From: Jessica
To: kenneth.smith@ct.gov; Victor Estay
Subject: C.S. appeal


Good morning gentlemen,
Having received no reply from DSS to my previous e-mails, I have advised Mr. Sears to move forward with the appeal process. I have attached the relevant documents to this e-mail for your review.


STATE OF CONNECTICUT

OFFICE OF PROTECTION AND ADVOCACY FOR PERSONS WITH DISABILITIES
60B Weston Street, Hartford, CT 06120-1551
1-800-842-7303 (toll-free CT only) (V/TTY)
(860) 297-4300 (V) - (860) 297-4380 (TTY)
(860) 566-8714 (facsimile)
www.ct.gov/opapd

Department of Social Services
Office of Legal Counsel
Regulations and Administrative Hearings
25 Sigourney St.
Hartford, CT 06106


Re: Craig Sears


To Whom It May Concern:

I am currently representing Mr. Sears, a client of the Department of Social Services ABI Medicaid Waiver Program. I have attached a release form signed by Mr. Sears. On behalf of Mr. Sears I am requesting a hearing to address an informal suspension of his services.

Please schedule a fair hearing for Mr. Sears and send written notification to both Mr. Sears and I. I can be reached at (860), or through the above address.

Sincerely,

Jessica,
Human Services Advocate
Protection and Advocacy for Individuals with Traumatic Brain Injury/
Protection and Advocacy for Individuals with Mental Illness


cc: Victor Estay
Craig Sears


State of Connecticut
Office of Protection and Advocacy for Persons with Disabilities


From: Jessica
Subject: Fwd: C.S. appeal

Good morning Craig,
Below is a copy of the e-mail I issued to Victor Estay and Kenneth Smith at DSS, along with the relevant attachments. A complete set of the necessary documents was faxed to DSS' Office of Legal Counsel. Please let me know if you have any questions, or receive any response.
Thank you,


Jessica
Human Services Advocate PAIMI/PATBI
Office of Protection and Advocacy for Persons with Disabilities
60 B Weston Street
Hartford, CT 06120
1.800.842.7303 (V and TDD)
TDD 860.297.4380
Fax 860-566-8714


Good morning gentlemen,
Having received no reply from DSS to my previous e-mails, I have advised Mr. Sears to move forward with the appeal process. I have attached the relevant documents to this e-mail for your review.

Jessica


Human Services Advocate PAIMI/PATBI
Office of Protection and Advocacy for Persons with Disabilities
60 B Weston Street
Hartford, CT 06120
1.800.842.7303 (V and TDD)
TDD 860.297.4380
Fax 860-566-8714


STATE OF CONNECTICUT

OFFICE OF PROTECTION AND ADVOCACY FOR PERSONS WITH DISABILITIES
60B Weston Street, Hartford, CT 06120-1551
1-800-842-7303 (toll-free CT only) (V/TTY)
(860) 297-4300 (V) - (860) 297-4380 (TTY)
(860) 566-8714 (facsimile)
www.ct.gov/opapd


Department of Social Services
Office of Legal Counsel
Regulations and Administrative Hearings
25 Sigourney St.
Hartford, CT 06106


Re: Craig Sears


To Whom It May Concern:

I am currently representing Mr. Sears, a client of the Department of Social Services ABI Medicaid Waiver Program. I have attached a release form signed by Mr. Sears. On behalf of Mr. Sears I am requesting a hearing to address an informal suspension of his services.

Please schedule a fair hearing for Mr. Sears and send written notification to both Mr. Sears and I. I can be reached at (860) or through the above address.

Sincerely,

Jessica,
Human Services Advocate
Protection and Advocacy for Individuals with Traumatic Brain Injury/
Protection and Advocacy for Individuals with Mental Illness


cc: Victor Estay
Craig Sears


Mr. Sears requests the immediate re-instatement of his ABI Waiver plan, as written. By withholding both the authorization to provide services and payment, to an authorized provider, the Department has placed Mr. Sears at risk of re-institutionalization, has halted his means of financial self-support, has left him without the ability to meet his own basic needs, and has neglected to support him in the least restricted environment available.


Jessica
Human Services Advocate PAIMI/PATBI
Office of Protection and Advocacy for Persons with Disabilities
60 B Weston Street
Hartford, CT 06120
1.800.842.7303 (V and TDD)
TDD 860.297.4380
Fax 860-566-8714
________________________________________

Fair Hearing Statement for Craig Sears
Prepared by Jessica, Human Services Advocate


Craig Sears is an independent ## year old man with a brain injury. He has been an active and effective advocate for the brain injury survivor community and a participant in the Acquired Brain Injury (ABI) Waiver Program for several years. Prior to obtaining waiver services, and as a result of a lack of community based supports, Mr. Sears was imprisoned and institutionalized. It is Mr. Sears’ goal to continue to strive for independence with appropriate supports, and to continue his advocacy efforts for other survivors. With these goals in mind Mr. Sears’ ABI Waiver Service plan was developed in a truly person-centered cooperative team approach. His specific needs and goals were addressed through the design of a unique employment support program, and structured services that address his needs.

After an annual review, Mr. Sears’ current ABI Waiver service plan was approved, dated to commence May of 2009, and was signed by two Department of Social Services (herein referred to as the Department) social workers, Carolyn Wright, Mr. Sears’ former social worker, and Victor Estay, Mr. Sears’ current social worker, and social work supervisor, Gary Vertula. Mr. Sears recently issued to the Department a complaint about an approved ABI Waiver provider that was not meeting his needs. Mr. Sears and the provider agreed to part ways, leaving Mr. Sears without services. This service lapse should have been temporary; however, through time delays and a refusal to authorize both service provision and payment to an approved provider selected by Mr. Sears, the Department has essentially suspended all of Mr. Sears’ ABI Waiver services without a formal notice, and without good cause. Despite having a current service plan that was approved by the Department, Mr. Sears’ has been without any services since August 29, 2009.

Sec. 17b-260a-1I, Individuals who are eligible for ABI services shall be given free choice of all qualified providers of each service included in his or her plan of care. When Mr. Sears exercised this right to choice, DSS refused to authorize service provision and payment to an alternate DSS/ Allied approved provider of his choice, resulting in a complete absence of services for Mr. Sears. Sec. 17b-260a-1J7 states that it is the responsibility of the Department to pay for approved ABI waiver services delivered by qualified providers through its fiduciary agent on behalf of the individual.

While the Department may argue that a review of Mr. Sears’ service plan is necessary, additional evaluations are requested, etc., it cannot hold his services in suspense while these decisions are made by his team. Mr. Sears’ has a current Department approved ABI Waiver service plan. The Department has a responsibility and an obligation to provide Mr. Sears with these services until such time as any changes are made to his plan. Sec. 17b-260a-1J2c Responsibilities of the Department, The Department shall assign social work staff to execute the following ABI responsibilities: implement the approved service plan and coordinate services provided to the individual under the waiver. Furthermore, the Department has overstepped its authority; it is the interdisciplinary team that makes determinations about the service plan. This was done without an ABI Waiver team meeting, and in absence of Mr. Sears, his appointed advocate, and a neurophysiologist familiar with Mr. Sears. Sec. 17b-260a-1G4 The service plan shall be developed by an interdisciplinary team that includes the individual, his or her conservator, if any, the Department social worker assigned to coordinate the individual’s service plan, a neurophysiologist who is familiar with the individual, other clinical staff as needed, and any other person(s) of the individual’s choice.

Mr. Sears requests the immediate re-instatement of his ABI Waiver plan, as written. By withholding both the authorization to provide services and payment, to an authorized provider, the Department has placed Mr. Sears at risk of re-institutionalization, has halted his means of financial self-support, has left him without the ability to meet his own basic needs, and has neglected to support him in the least restricted environment available. stricted environment available.