THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL 

ILLNESS (PAIMI) PROGRAM ACTIVITIES REPORT FOR

FISCAL YEARS 2015 AND 2016

3/1/2018
ii

Table of Contents

INTRODUCTION..................................................................................................................... 1

HISTORICAL OVERVIEW........................................................................................................ 1

FUNDING................................................................................................................................ 2

PAIMI PROGRAM ACTIVITIES................................................................................................ 3

A. Demographic Information................................................................................................... 3

Age in Years...................................................................................................................... 3

Gender.............................................................................................................................. 4

Ethnicity............................................................................................................................ 4

Race ................................................................................................................................. 4

Living Arrangement Type.................................................................................................... 4

B. Services for Individuals...................................................................................................... 5

Abuse ............................................................................................................................... 5

Neglect ............................................................................................................................. 6

Rights Violations................................................................................................................ 7

C. Class Action Litigation......................................................................................................15

D. Interventions on Behalf of Groups of PAIMI-eligible Individuals.............................................15

E. Public Education, Training, and Awareness Activities............................................................16

F. Accomplishments, Impediments, and Unmet Advocacy Needs..................................................17

GOVERNANCE ......................................................................................................................18

1. The Governing Authority .................................................................................................18

2. The PAIMI Advisory Council............................................................................................19

TRAINING AND TECHNICAL ASSISTANCE...........................................................................20

CONCLUSION........................................................................................................................23

DATA TABLES FOR FISCAL YEARS 2015 & 2016 ...................................................................24

Table 1: State PAIMI Appropriations......................................................................................25

Table 2: Age and Gender.......................................................................................................29

Table 3: Ethnicity and Race ...................................................................................................35

Table 4: Living Arrangements................................................................................................41

Table 5: Complaints Involving Abuse......................................................................................46

Table 6a – 6b: Complaints Involving Neglect............................................................................52
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Table 6a: Complaints Involving Neglect ..................................................................................55

Table 6b: Complaints Involving Neglect..................................................................................57

Table 7a – 7b – 7c: Complaints Involving Rights Violations.......................................................59

Table 7a: Complaints Involving Rights Violations.....................................................................62

Table 7b: Complaints Involving Rights Violations.....................................................................65

Table 7c: Death Investigations................................................................................................68

Table 8a – Analysis of Alleged Abuse......................................................................................74

Table 8b: Analysis of Alleged Neglect.....................................................................................80

Table 8c – Analysis of Alleged Rights Violations.......................................................................86

Table 9: Intervention Strategies..............................................................................................92

Table 10: Non-case Directed Services......................................................................................98

Table 11: Information and Referral/PublicEducation/Awareness & Training Activities.................104

ACRONYMS.........................................................................................................................111
1

INTRODUCTION

This report summarizes the annual activities for Fiscal Years (FY) 2015 and 2016 of the 

Protection and Advocacy for Individuals with Mental Illness (PAIMI) grantees, funded and 

administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), 

Center for Mental Health Services (CMHS). Each PAIMI grantee is required to transmit an 

annual report to the Secretary of the Department of Health and Human Services (HHS), that 

describes its program activities, accomplishments, and expenditures during the most recently 

completed FY.1 SAMHSA summarizes the grantee activity information and prepares a report, 

which includes aggregate data for the Secretary.

2 

HISTORICAL OVERVIEW

The Developmental Disabilities Assistance and Bill of Rights Act of 1975, commonly known as 

the DD Act, established systems in each state, the District of Columbia, and five territories to 

protect the legal and human rights of individuals with developmental disabilities. 3 These 

entities, the state Protection & Advocacy (P&A) systems, were governor-designated and 

approved by the Administration on Intellectual and Developmental Disabilities (AIDD), within 

the Administration of Community Living (ACL). The DD Act authorized formula grants to each 

eligible state P&A system to support activities on behalf of individuals with intellectual and 

developmental disabilities through the Protection and Advocacy for Developmental Disabilities 

(PADD) Program administered by AIDD/ACL. AIDD/ACL, is the lead federal agency on 

matters pertaining to designation or re-designation of a P&A system. 

The PAIMI Act of 19864 extended the DD Act protections to individuals with significant 

(serious) mental illness (adults) and significant (severe) emotional impairments (children/youth) 

at risk for, or in danger of abuse, neglect, and rights violations, while residing in public or private 

residential treatment facilities. The same AIDD-approved, governor-designated state P&A 

systems were authorized to administer the PAIMI Program. 

The PAIMI Act5 mandated state P&A systems to: 

1) Protect and advocate for the rights of residents with significant (serious) mental illness 

(adults) and significant (severe) emotional impairments (children and youth),6 residing in 

public and private care and treatment facilities who are at risk for, or in danger of abuse, 

neglect, and rights violations by using administrative, legal, systemic or other appropriate 

remedies on their behalf; 

2) Investigate reports of abuse, particularly incidents involving serious injuries and deaths,

related to the inappropriate use of seclusion and restraint; and

1 42 U.S.C. 10805(a)(7)

2 PAIMI Act at 42 U.S.C. 10824

3 42 U.S.C. 6041

4 42 U.S.C. 10801 et seq. 5 42 U.S.C. 10801(b)

6 Adults with significant mental illness denotes adults with serious mental illness. Children with significant

emotional impairments denotes children with severe emotional impairments.
2

3) Ensure enforcement of the United States Constitution, federal laws and regulations, and 

state statutes. 

In 1986, there were 56 P&A systems located in each state, the District of Columbia, and five 

territories (American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the 

Commonwealth of Puerto Rico, and the U.S. Virgin Islands). At that time, 45 P&A systems 

operated as private, non-profit organizations (as designated by the respective state governors). 

The remaining 11 P&A systems were state- or territory-operated (Alabama, American Samoa, 

Connecticut, Indiana, Kentucky, New York, North Carolina, North Dakota, Ohio, the 

Commonwealths of Puerto Rico, and Virginia) and independent of any state agency that 

provided treatment or services, other than advocacy services, to individuals with mental illness.7

As of September 30, 2016, there remained seven state-operated P&A systems in Alabama, 

American Samoa, Connecticut, Indiana, Kentucky, North Dakota, and the Commonwealth of 

Puerto Rico. In 2000, the PAIMI Act was amended by the Children’s Health Act (CHA) of 

2000.8 The CHA established a 57th P&A system for Native Americans, the American Indian 

Consortium (AIC). The AIC is composed of the Navajo Nation and Hopi tribal councils in the 

Four Corners region of the Southwest (Utah, Arizona, Colorado, and New Mexico). 

The CHA9 requires “public or private general hospital, nursing facility, intermediate care 

facility, or other health care facility that receives support in any form from any program 

supported in whole or in part with funds appropriated to any federal department or agency shall 

protect and promote the rights of each resident of the facility. This includes the right to be free 

from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions 

imposed for purposes of discipline or convenience.”10 Each facility covered under the PAIMI 

Act shall notify the appropriate agency, as determined by the Secretary, of each death that occurs 

at each such facility, while a patient is restrained or in seclusion of each death occurring within 

24-hours after the patient has been removed from restraints and seclusion, or where it is 

reasonable to assume that a patient's death is a result of such seclusion or restraint. A 

notification under this section shall include the name of the resident and shall be provided no 

later than seven days after the date of the death of the individual involved.11 This Act clarified 

that the state P&A systems had the authority to investigate incidents of restraint and seclusion in 

these types of facilities. CHA also allowed state P&A systems to serve PAIMI-eligible 

individuals who lived in the community, including their own homes; however, individuals 

residing in care and treatment facilities must have priority for program services. 

FUNDING

Each P&A system must submit an annual application or update its annual program priorities,

proposed budget/expenditures, the PAIMI Program assurances, and any other information 

requested by SAMHSA.12 The annual PAIMI Program awards, subject to availability of 

7 42 U.S.C. 10801(b)

8 42 U.S.C. 290 et seq. 9 42 U.S.C. 290ii

10 42 U.S.C. 290ii (a) 11 op. cit. at 42 U.S.C. 290ii - 1 12 42 U.S.C. 10821
3

appropriations, are based on a formula prescribed by the statute.

13 The PAIMI formula is based 

equally on the population of each state in which there is an eligible system and on the population

of each state weighted by its relative per capita income.14 Relative per capita income is the 

quotient of the per capita income of the United States and the per capita income of the state. 

Relative per capita income is not used forAmerican Samoa, Guam, the Commonwealth of the 

Northern Mariana Islands, and the U.S. Virgin Islands. Their quotient shall be considered as

one. 15 The Secretary shall use no more than two percent of the amount appropriated, commonly 

known as the set-aside under the PAIMI Act, to provide technical assistance to eligible 

systems.16

The following table reflects the total annual PAIMI Program grant appropriations, the technical 

assistance (TA) set-aside, and the minimum and maximum grant allotments awarded to the states 

and territories in FY 2015 and 2016. In FY 2015, California, the largest state P&A system, 

received the maximum state award of $3,156,787 for FY 2015 and $3,133,536 for FY 2016. The 

minimum state allotment for P&A system grants were $428,000 for both fiscal years. Each of 

the five territories, American Indian Consortium, American Samoa, Guam, the Commonwealth 

of the Northern Mariana Islands, and the U.S. Virgin Islands, each received $229,900 for both 

fiscal years.

FY 2015 FY 2016

To State P&A Systems $ 35,314,703 $ 35,318,517

Technical Assistance Set-aside $ 831,297 $ 827,483

Total Annual PAIMI Appropriation $ 36,146,000 $ 36,146,000

FY 2015 FY 2016

Minimum State Award $ 428,000 $ 428,000

Maximum State Award $ 3,156,787 $ 3,133,536

Minimum Territory Award $ 229,300 $ 229,300

 [See, Appendix - Table 1]

PAIMI PROGRAM ACTIVITIES 

 A. Demographic Information

1. Age and Gender 

The following tables summarize the number of PAIMI-eligible individuals or clients served in 

each FY by age and gender. 

Age in Years FY 2015 FY 2016

0-4 20 20

5-12 810 760

13-18 1,746 1,706

13 42 U.S.C. 10822 14 42 U.S.C. 10822 (a) (1) (A) (i) and (ii) 15 42 U.S.C. 10822 (a) (1) (B) 16 42 U.S.C. 10825
4

19-25 1,059 888

26-64 8,310 7,121

65+ 742 690

Total Served 12,687 11,185

Gender FY 2015 FY 2016

Male 7,168 6,413

Female 5,519 4,772

Total Served 12,687 11,185

 [See, Appendix - Table 2] 

2. Ethnicity and Race

PAIMI clients served by the P&A systems self-identified their ethnicity and race. The following 

tables provide the ethnicity and racial identities reported by individuals served by the P&A 

systems. The information was self-reported by clients and individuals/clients served, were 

permitted to select one or more races. The totals may exceed the number of PAIMI-eligible 

individuals served.

Ethnicity FY 2015 FY 2016

Hispanic/Latino 1,192 1,048

Race FY 2015 FY 2016

Native American/Alaskan Native 360 244

Asian 160 152

Black/African American 2,727 2,420

Native Hawaiian/Pacific Islander 114 103

White/Caucasian 7,842 6,808

Multiple Race 417 418

Non-Hispanic/Latino 11,141 9,010

 [See, Appendix - Table 3]

3. Living Arrangements

P&A systems served individuals who reside in various settings. Examples of these living 

arrangements included: 

Living Arrangement Type FY 2015 FY 2016

Independently in the community 3,818 3,215

Adult Community residential home 449 345

Psychiatric wards 1,000 928

Public and private institutional living 2,255 1,907

Legal Detention/Jail 829 904

Homeless/shelter 286 267
5

 [See, Appendix - Table 4]

B. Services for Individuals

Under the PAIMI Act, state P&A systems are mandated to protect and advocate for the rights of 

individuals with mental illness and authorized to investigate complaints of abuse, neglect, and 

rights violations. 17 The following table shows the total number of individual PAIMI abuse, 

neglect, and rights violation cases opened, investigated, and closed. 

1. Abuse 

Number and types of closed individual abuse complaints include: 

Abuse Complaints, Investigated and Closed

By Complaint Type

FY 2015 FY 2016

Inappropriate/excessive use of restraints 273 182

Inappropriate/excessive medication 166 173

Involuntary electroconvulsive therapy 4 1

Failure to provide mental health treatment 716 704

Physical assaults resulting in serious injuries 80 59

Sexual assaults 100 92

Staff threats/retaliation/assaults 162 118

Total 2,203 2,066

 [See, Appendix - Tables 5] 

Case Example from FY 2016

Arkansas

The P&A learned during a routine monitoring visit that a youth with mental illness, in custody at 

a juvenile correctional facility, suffered a broken collarbone during an incident in which a staff 

member attempted to restrain him. The P&A opened an investigation, and after reviewing 

documents and video of the incident, and interviewing staff and youth, determined the restraint 

used was excessive and did not follow any recognized or accepted methods of restraint. 

Additionally, the P&A determined the facility did not conduct a timely assessment or provide the 

youth with medical treatment following his injury, and the facility placed the youth in isolation 

as punishment following the incident. Furthermore, the P&A determined staff did not follow 

policy when reporting or documenting the incident, and staff misrepresented the incident in ways 

that minimized the staff's responsibility and the youth's injury. The P&A outlined in its findings 

and proposed recommendations in a letter to the facility and to Arkansas’ Division of Youth 

services.

2. Neglect 

Number and types of individual neglect complaints closed per FY included: 

17 42 U.S.C. 10805(a)(1)
6

Neglect FY 2015 FY 2016

Complaints Investigated & Closed 2,295 2,081

Discharge planning 963 881

Personal care 316 214

Mental health diagnoses 246 237

Medical diagnoses 202 229

Environmental safety 97 62

Personal safety 138 121

No written treatment plans 73 97

 [See, Appendix - Tables 6a & 6b] 

Case Examples from FY 2015

California

The P&A successfully advocated for more timely dental services to residents at all California 

state psychiatric hospitals. The case began when a number of residents at a State Hospital asked 

the P&A to investigate long delays in their receiving full and partial dentures. Several residents 

complained they lost most of their teeth, could not chew their food and were embarrassed by 

their appearance all of which made their recovery more difficult. Yet, their requests for dentures 

were denied or they were told there was a waiting list of five years to get dentures. Because of 

P&A advocacy, the Director of State Hospitals agreed to hire additional dental staff to clear the 

backlog; revamp the statewide dental program.

District of Columbia

The P&A advocated for an adult with mental illness who aged out of the child serving system 

and became homeless. The P&A filed a complaint with the Department of Behavioral Health

(DBH) because the client’s mental health provider failed to timely submit his application for

permanent supportive housing, in contravention of District regulations. As a result, DBH agreed 

to backdate the application to the date it should have been submitted. DBH further shared it is 

working to prevent this issue in the future by implementing a data management system that will 

allow mental health providers add individuals directly onto the housing waitlist. The P&A also 

advocated for immediate access to supported transitional housing. Because of P&A advocacy, 

the client entered a DBH transition-age group home then transitioned to independent housing, 

where he was able to reunite and live with his young child.

Oklahoma

A family member of an individual with serious mental illness, incarcerated in a rural county jail, 

contacted the P&A. His family member told the P&A her son was taking medications for his 

mental illness when he was arrested and placed in jail. At the time she contacted the P&A, he 

had been without medications for over a week. His mother reported, the jail told her that her son 

would have to tell the jail what medication he was on, the dosage and how often he took the 

medication before they would give him any medication. The P&A contacted the county sheriff 
7

and explained the seriousness of the client’s mental health condition and the substantial harm to 

the client, for the jail’s failure to provide appropriate mental health medications. The P&A 

provided the jail with the clients treating medical provider’s information so the jail could verify 

what medications the client was supposed to receive and the dosage amounts. Because of P&A 

intervention, the individual in jail began receiving appropriate mental health care.

Case Examples from FY 2016

Colorado

The P&A was contacted regarding a nursing home resident waiting approximately two years to

be transitioned from a nursing home to the community. The transition coordinator refused to 

hold, transition meetings until the nursing home agreed to provide an accommodation for the 

resident, who is hearing impaired. The P&A agreed to provide any needed accommodation and 

attend transition meetings. When the transition coordinator still did not schedule the initial 

meeting, the P&A contacted the state agency responsible for administering this transition 

program and demanded the transition coordinator be forced to schedule the meeting. The state 

agreed and the transition coordinator was made to schedule the initial meeting and subsequent 

meetings in a timely fashion. Because of the P&A’s intervention, this resident lives

independently in the community.

Wisconsin

The parents of a teenage boy residing at one of the state's juvenile correctionsfacilities contacted 

the P&A because they were concerned he was not receiving treatment for his mental illness. 

They were experiencing difficulty receiving information about their son because they only spoke

Spanish and the facility refused to provide an interpreter, except for meetings such as court dates 

and formal reviews. They were also told letters could no longer be in Spanish. A P&A advocate 

worked with the facility to connect it with translation services available for phone calls. The 

facility did inform all supervisors of this information and started using the system for all phone 

calls with the family. They also allowed the parents to send their son letters in Spanish again. 

The P&A met with the teen at the facility and reviewed his mental health records and 

programming. After several meetings with treatment staff, additional mental health services 

were provided. In a matter of months, the teen was discharged back to his home community.

2. Rights Violations

Number and types of individual rights complaints closed per FY included: 

Rights Violations FY 2015 FY 2016

Cases Investigated and Closed 5,818 5,196

Guardianship/conservator problems 396 298

Problem with advanced directives 77 114

Failure to provide confidentiality 61 69

 [See, Appendix - Tables 7a and 7b]
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Case Examples from FY 2015

California

The P&A assisted an elderly Vietnamese-speaking woman with a significant mental health 

disability who requires extensive In-home Supportive Services (IHSS) including protective 

supervision to live safely in the community. Because of her disability, the client wanders, 

becomes lost, and on one occasion was found by the police hours later. A home visit by county 

staff resulted in a significant reduction in the approved hours because the client answered and 

opened the door and the county concluded she did not require protective supervision. With the 

California P&A’s assistance, the client’s daughter was able to provide sufficient documentation 

to support the need for IHSS services including protective supervision. The service hours were 

restored retroactively to the original reduction date along with approval of 10 months of back 

pay. The client continues to live safely at home with the support and supervision of her 

daughter.

Massachusetts

The P&A assisted a woman who was terminated from employment after requesting an additional 

three months of medical leave following FMLA leave. The client was not ready to return to 

work because of the continuous depression that proved to be resistant to treatment. The 

employer failed to engage in the interactive process in good faith and instead, terminated her 

without further explanations. Following failed negotiations in an attempt to settle the matter 

prior to litigation, the P&A filed a Charge of Discrimination with the Massachusetts Commission 

Against Discrimination, alleging disability discrimination and failure to provide reasonable 

accommodation. Because of P&A advocacy, the case was settled with the client receiving 

compensation. The client is seeking other employment with an employer that will be willing to 

accommodate her disability.

Ohio

A service provider contacted the P&A regarding an individual who wanted to move into the 

community and needed assistance. The P&A, upon investigation, learned the individual was 

under guardianship, however, did not have a guardian. The P&A contacted the county probate 

court to inform the court about the matter, and the court appointed a new guardian for the 

individual who was supportive of his desire to move into the community. The P&A met with the 

client, representatives from the Ohio Department of Mental Health and Addiction Services, the 

long-term care ombudsman, a HOME Choice representative and the new guardian to plan the 

individual’s transition to the community. He moved into an apartment and has a job with fair 

wages in competitive employment. For the first time in several years, the individual has returned 

to living in the community and is thriving.

Tennessee

The P&A was contacted by an adult with a mental illness who reported she was denied access to 
9

a local business with her service animal. The P&A contacted the business owner who 

acknowledged after this complaint was made he retrained all his employees in all of his coffee 

shops about service animal access. Through this training and a commitment to monitoring, the 

business owner planned to ensure all customers and their service animals will have access to his 

buildings. The P&A was able to confirm with the client that a subsequent visit to this shop

occurred with no incidents. Because of P&A intervention, this local business owner and his 

employees are aware of service animal related laws.

4. P&A Involvement Related to Co-occurring Mental Illness and Intellectual and 

Developmental Disabilities

Case Examples – FY 2015

North Dakota

A 27-year-old client diagnosed with Intellectual Disabilities, Mental Illness, Borderline 

Personality Disorder, Depressive Disorder, Post-traumatic Stress Disorder due to sexual abuse as 

a child, and self-injurious behavior. The client was living in an apartment in a small community, 

receiving case management through the Regional Human Services Center and a community 

service provider was assisting with residential services. She had one-on-one staff and supportive 

day programming. The client became agitated, locked herself in her bathroom, and engaged in 

self-injurious behavior involving broken glass. The police were called and determined she was a 

danger to herself and met criteria for a mental health emergency commitment. She was 

transported to the local jail pending transfer to the ND State Hospital. The P&A was notified 

because the client's community service provider issued a 30-day discharge notice and indicated 

they would not accept the client back once released from the state hospital, as they could no 

longer assist her. The ND State Hospital discharge plan was to transfer the client to the state 

residential institution for individuals with intellectual disabilities. The P&A worked with the 

client’s guardian to access community-based services in another larger community that would 

have the resources available to provide needed supports and psychiatric care and follow-up. 

While in her previous placement, the state was not willing to fund the needed, 24-hour services 

in the client's apartment. The P&A worked with the guardian to find a community-based service 

provider willing to serve the client and who was able to negotiate funding for the level of service 

needed. As a result of the P&A’s efforts, the client was able to access residential and vocational 

services and move to an independent apartment setting with 24-hour care and supports. At case 

closure, the client had moved to the new community and was settling into her apartment very 

well.

Nevada

A 28-year-old client with a mental illness, borderline personality disorder and an intellectual 

disability was held in solitary confinement at a Nevada men’s prison for a period in excess of 13 

months. With the assistance of another prisoner, the client filed a lawsuit in federal court 

alleging the conditions of her confinement violated her Eighth Amendment right to be free from 

cruel and unusual punishment. Because of the seriousness of the allegations contained in the 

complaint, at the request of the United States District Court of Nevada Magistrate, the P&A was 
10

contacted for assistance by staff of the Unites States Court of Appeal for the Ninth Circuit and 

was subsequently appointed counsel for plaintiff for the purposes of early settlement. Upon 

notice of the P&A appointment, client was immediately transferred from the men’s prison back 

to the women’s prison. A Nevada licensed psychiatrist was also appointed guardian ad litem to 

assist the P&A with the settlement. A settlement conference was held at the Las Vegas women’s 

prison and the case was settled, the award was placed in a special needs trust for the client.

Because of client’s severe self-harming behaviors, some of the settlement funds were set-aside to 

pay for an expert in Dialectical Behavioral Therapy (DBT). In addition, as part of the settlement 

agreement, the Nevada Department of Corrections agreed to work in good faith with state mental 

health staff to ensure the client was safely discharged from prison. The client was safely 

discharged from prison to the state mental health facility where she has been receiving intensive 

DBT from an expert in the field at the University of Nevada.

Case Examples – FY 2016

Arkansas 

In FY 2016, the P&A investigated allegations of abuse, neglect, and exploitation at Support 

Solutions, a provider of home- and community-based waiver services, serving clients with both 

mental illness and developmental disabilities. Although in a community setting, the clients were 

not provided adequate access to community activities or treatment options. The P&A 

substantiated allegations of abuse, neglect, and exploitation and met with various state agencies 

to address these issues and ensure client safety. The P&A advocated for the revocation of the 

provider's license due to its inability to ensure clients would not be subjected to abuse, neglect, 

and exploitation. As a result of the P&A’s advocacy, the provider's license was revoked and 

clients were transitioned to more appropriate, safer settings where they would be able to receive 

adequate services and treatment options, and be afforded opportunities to engage in community 

activities.

Hawaii

A 51-year-old client with bi-polar disorder and spina bifida who attends a Mental Health 

Clubhouse day program and resides in a developmental disabilities adult foster home. The client 

wanted to formulate an Advanced Health Care Directive (AHCD). The P&A explained that the 

client could not appoint his care home operator as his agent as this would be a conflict of 

interest. It took the client a few months to decide who would be his agent as his biological father 

recently passed away; his mother resides on the Mainland and his sister on an outer island. Once 

the client determined to choose his sister and mother as agents, the P&A met with him at his 

home to discuss the document and review his choices. To client’s satisfaction, the P&A typed up 

AHCD accordingly and returned to client's home to finalize and notarize it with the agency 

Paralegal/Notary. The P&A mailed copies to each of the appointed agents and doctors. An 

original is saved in the P&A’s electronic scan files. 

5. P&A Involvement Related to Right to Refuse Medication

Case Examples FY 2016
11

California 

The P&A conducted a monitoring visit of a county jail and found inadequate mental health care. 

Several inmates with acute mental illness were restricted to their cells continuously - with no 

time out of their cells. For most of these clients, their only treatment was medication 

management. The P&A determined that jail’s behavioral health staff routinely medicated 

inmates with mental health disabilities, involuntarily. The state law requires a court order to 

administer psychiatric medication to inmates who lacked capacity to consent. Furthermore, the 

jail was administering long-acting antipsychotic medication without the inmates’ consent, who 

the court ruled had the capacity to consent. The P&A confronted the jail staff with its findings, 

but the jail maintained that the practices were legal. The P&A issued a public report regarding 

conditions at the jail, including an extensive analysis of the illegal medication practices. 

Consequently, the jail amended both medication policies to conform to the law. Since the report, 

the jail has not filed a petition to the court for determination of capacity in the subsequent six 

months. Instead, they work with inmates to encourage voluntary medication compliance.

Vermont

The P&A worked with a client who was involuntarily committed at the Brattleboro Retreat, 

Tyler 4 unit, with a court order to take medications. The client understood that although she was 

under an involuntary order she had the right to have a support person present when medications 

were administered. The client requested the presence of a staff member whom she had a good 

rapport with, from another unit and it was not honored. The client was traumatized when the 

charge nurse brought the medications and threatened her with a “level change” which would 

result in the loss of outside privileges if she did not take them without use of force. According to 

client, the nurse said, "If you don't take your meds I'll consider this unsafe behavior and you'll 

lose your level." The client ended up taking the medications without use of force so as not to 

lose her level of privileges. The client approached the P&A with concerns about the inability to 

have a support person present when medications are administered and the alleged coercion in 

part by the nurse. The P&A investigated and assisted the client by bringing her concerns to the 

attention of the Clinical Manager. The P&A referred the client to her team and a plan was 

developed for future medication administrations that would not require use of “hands-on.”

6. P&A Involvement Related to Facility, Institution, and Hospital Closures

Case Examples – FY 2015

Nevada

The P&A was advised that an old building of the state psychiatric hospital was being utilized as 

a patient intake/crisis unit. The P&A conducted two unannounced visits and identified several 

safety concerns. For example, the building being used as the intake/crisis unit had exposed pipes 

and fire sprinkler system on the ceiling throughout the dayroom; the beds in all of the patient 

rooms had exposed metal box springs; and bulletin boards were attached to the wall with nails 

and screws. The P&A sent a letter to the state psychiatric hospital Administrator outlining its 
12

concerns and as a result, the building used as a patient intake/crisis unit was closed and the 

patients were transferred to a newer and safer unit. 

Wisconsin

As part of the Wisconsin Department of Health Services closing team, the P&A staff engaged in 

a year-long process to relocate over 75 PAIMI-eligible individuals from Milwaukee County's 

public nursing home to other residential settings. The facility had come under scrutiny in recent 

years for a number of abuse and neglect allegations and lack of mental health treatment for its 

residents. Of the approximately 75 residents with mental illness, about half had health 

conditions that required another skilled nursing facility. The other half did not require nursing 

care, raising questions as to how they had passed the qualification criteria to reside there. 

Community placement plans had to be developed for each of these individuals. Often the county 

attempted to rush the process along to keep the closing on schedule, even though the proposed 

placement was not appropriate or what the resident wanted. The P&A’s role was to attend these 

meetings and advocate for the plan that assured the least restrictive setting and sufficient support 

services to make the placement successful. As the process came to a conclusion, this often 

meant insisting that the move be halted until permanent placement could be developed, instead 

of a hasty move to a temporary placement, which can lead to a poor outcome due to relocation 

trauma.

7. P&A Involvement Related to Facility, Institution, and Hospital Closures

Case Examples – FY 2015

Nevada

The P&A was advised that an old building of the state psychiatric hospital was being utilized as 

a patient intake/crisis unit. The P&A conducted two unannounced visits and identified several 

safety concerns. For example, the building being used as the intake/crisis unit had exposed pipes 

and fire sprinkler system on the ceiling throughout the dayroom; the beds in all of the patient 

rooms had exposed metal box springs; and bulletin boards were attached to the wall with nails 

and screws. The P&A sent a letter to the state psychiatric hospital Administrator outlining its 

concerns and as a result, the building used as a patient intake/crisis unit was closed and the 

patients were transferred to a newer and safer unit. 

Wisconsin

As part of the Wisconsin Department of Health Services closing team, the P&A staff engaged in 

a year-long process to relocate over 75 PAIMI-eligible individuals from Milwaukee County's 

public nursing home to other residential settings. The facility had come under scrutiny in recent 

years for a number of abuse and neglect allegations and lack of mental health treatment for its 

residents. Of the approximately 75 residents with mental illness, about half had health 

conditions that required another skilled nursing facility. The other half did not require nursing 

care, raising questions as to how they had passed the qualification criteria to reside there. 

Community placement plans had to be developed for each of these individuals. Often the county 
13

attempted to rush the process along to keep the closing on schedule, even though the proposed 

placement was not appropriate or what the resident wanted. The P&A’s role was to attend these 

meetings and advocate for the plan that assured the least restrictive setting and sufficientsupport 

services to make the placement successful. As the process came to a conclusion, this often 

meant insisting that the move be halted until permanent placement could be developed, instead 

of a hasty move to a temporary placement, which can lead to a poor outcome due to relocation 

trauma.

8. Death Investigations

The PAIMI Act authorized state P&A systems to investigate incidents of abuse, neglect, and 

deaths that occur in public and private care and treatment facilities on behalf of eligible 

individuals. 18 Most states had no mandatory reporting statutes, central registries or other 

statewide systems to capture incidents of restraint, seclusion, serious injuries, or fatalities. 

Despite state, data collection limitations, the state P&A systems monitored and investigated the 

use of restraint and seclusion in residential care and treatment facilities, especially incidents 

involving serious injury or death. States with mandatory reporting requirements and central 

registries often send all state death reports to the P&A system whose staff must then review the 

information to determine those incidents that require an investigation. Deaths reported by states 

and the CMS and investigated by state P&A systems and other sources as follows:

Deaths Reported by FY 2015 FY 2016

States 937 1,025

Centers for Medicare & Medicaid Services (CMS) 1 1

Other 106 167

Deaths Reported Total 1,251 1,193

Deaths Investigated, by incident type FY 2015 FY 2016

Seclusion (S) 9 4

Restraints (R) 10 5

Non S or R related 184 424

Deaths Investigated Total 203 433

 [See, Appendix - Table 7c]

18 at 42 U.S.C. 10802 (1), (3), (4), and (5)
14

9. Complaints Favorably Resolved for Clients

The case examples in section 2, 3, and 4 provide information on the types of favorable outcomes 

achieved on behalf of individual P&A system clients. The following table shows the total 

number of individual PAIMI complaints investigated, closed, and resolved. 

Complaints Investigated and Closed, by type FY 2015 FY 2016

Abuse 2,260 2,035

Neglect 2,331 2,046

Rights violations 5,753 5,058

Total 10,344 9,139

 [See, Appendix - Table 8a, 8b, 8c]

10. Intervention Strategies

The P&A systems are authorized by the PAIMI Act19 to pursue administrative, legal, and other 

remedies to ensure protection for individuals with mental illness. An individual’s initial 

complaint may involve multiple issues and P&A systems often use several strategies to resolve 

them. The total strategies used often exceeded the number of complaints investigated and closed 

in a FY, as clients’ initial complaints frequently include multiple issues and various strategies 

used to resolve them.

Intervention Strategies, by Type FY 2015 FY 2016

Short-term assistance 5,205 4,568

Abuse & neglect investigations 1,524 1,458

Technical assistance 2,378 1,642

Administrative remedies 304 358

Negotiation/Investigation 1,087 1,343

Legal remedies 336 345

Total Intervention Strategies 10,834 9,714

 [See, Appendix - Table 9] 

Case Example from FY 2016

Tennessee

Because of negotiations between the P&A and a local hospital, people who use service animals, 

including people with mental illness, will be able to bring their service animal with them to the 

hospital and receive the same range of services other patients and visitors receive. This outcome 

was the result of the P&A’s assistance of a 63-year-old client with a mental illness, when a 

hospital refused to perform an intake assessment due to the presence of her psychiatric service 

animal. The client went to this hospital because she was experiencing a mental health crisis and 

was seeking partial inpatient hospitalization. The hospital adopted a new service animal policy 

19 at 42 U.S.C. 10805 (a) (1) (C)
15

and entered a settlement agreement with the client that requires the hospital to train staff on the 

new policy and post signage at all main entrances welcoming service animal users. 

C. Class Action Litigation

To ensure compliance with federal or state laws and regulations and when immediate action is 

needed to protect a group of individuals, state P&A systems may use class litigation. 20 This type 

of litigation is the strategy of last resort. This complex strategy often takes years to resolve the 

presenting problem, and requires special staff expertise, resources, and time. These types of 

cases generally involve a range of issues that affect the lives of individuals or groups of 

individuals with mental illness and other disabilities, and their families. Class action activities 

reported by the P&A systems on behalf of PAIMI-eligible individuals included:

Class Actions FY 2015 FY 2016

Number of Events 50 60

Individuals Impacted 2,201,218 1,372,888

 [See, Appendix, Table 10]

Case Example from FY 2016

Washington

The P&A settled a class action lawsuit brought on behalf of six current and former PAIMIeligible patients against the Department of Social and Health Services (DSHS) to ameliorate the 

unconstitutional care and treatment of patients adjudicated, not guilty by reason of insanity, at 

State Hospitals. The trouble began when a series of new state laws and policies restricted access 

to therapy and superseded the opinions of patients’ treating clinicians. In response, the P&A 

filed a class action lawsuit in federal court. The settlement provides for a more streamlined 

treatment and discharge process to allow a more clinical judgment and less administrative delay. 

Patients will be allowed supervised access to the hospital grounds without a court order. While 

unsupervised access and trips to the community will still require a court order, DSHS agreed to 

facilitate and speed up this process. Settlement provisions also addressed appropriate use of 

personal restraint devices, patients’ personal property, strip search policies, and retaliation.

D. Interventions on Behalf of Groups of PAIMI-eligible Individuals

The majority of P&A systems advocated on behalf of groups of PAIMI-eligible individuals. 

These types of activities were not directed toward individuals, but for the resolution of a range of 

systemic issues affecting specific groups or larger populations throughout a state. Some 

systemic advocacy activities included legal actions to protect the rights, health and safety of 

vulnerable facility residents (See, C. Class Action). Sometimes individual complaints resulted

in-group advocacy. Generally, P&A non-case directed advocacy activities focused on 

implementing changes in administrative policy, procedures, or practices in state agencies, 

residential treatment facilities, and other service providers. Activities reported under the 

Legislative and Regulatory Advocacy section are limited to providing technical assistance, 

20 42 U.S.C. 10805 (a)(1)(B)
16

education, and awareness about current statutes and regulations regarding the rights and 

protection of individuals with SMI or SED and do not include, strictly prohibited activities such 

as the inappropriate use of federal dollars to influence legislation or any actions by federal or 

state governments described in Section 503 of Title V, in Division H of the Consolidated 

Appropriations Act and specific prohibitions against lobbying in the PAIMI regulations. 21

Non-Litigation Advocacy FY 2015 FY 2016

Number of events 387 435

Total number of individuals impacted 7,375,456 16,713,386

Legislative & Regulatory Advocacy FY 2015 FY 2016

Number of events 193 210

Total Number of Individuals Impacted 10,171,854 10,520,180

 [See, Appendix Table 10]

E. Public Education, Training, and Awareness Activities

Each state P&A system received requests for information and referral services from its 

constituents via telephone, e-mail, letter, face-to-face, and walk-in visits. The systems also 

provided information by conducting public education, training, and activities. Many state 

PAIMI Programs met with and provided civil rights informational training to consumers, 

stakeholders, and advocacy groups. Other P&A systems conducted mental health law classes for 

attorneys, graduate students, current and former recipients of mental health services, and mental 

health service professionals. The P&A system provided information to the public by various 

means including the media, newspapers, radio/television public service announcements, agency 

newsletters, websites, publications, investigative reports, and listservs. Some P&A systems 

within sparsely populated states or with large rural populations used technology to provide 

information through webcams, videoconferences, teleconferences, webinars, Facebook, and 

Skype. PAIMI Program public education, training, and awareness activities included:

Educational or Training Activities FY 2015 FY 2016

Information and Referral Requests 38,171 40,252

Public Awareness Events 2,319 1,778

Number of individuals receiving public 

awareness information 1,677,619 3,968,476

Number of education/training activities 

undertaken 2,048 1,813

Total number of individuals trained 82,008 58,189

 [See, Appendix, Table 11]

21 42 CFR Part 51. Subpart 
17

F. Accomplishments, Impediments, and Unmet Advocacy Needs

1. Accomplishments 

P&A system intervention improved the quality of life for individuals with mental illness and 

resulted in systemic changes. Examples of these accomplishments included:

MAJOR ACCOMPLISHMENTS 

Case Example from FY 2015

Vermont

The P&A used PAIMI funds to secure significant improvements in and reductions of the use of 

seclusion and restraint against people with mental illness in facilities and unnecessary uses of 

force in the community. These improvements include, continuing efforts to facilitate 

conversations between police, mental health professionals and peer advocates. Work on the Act 

80, Law Enforcement and People with Mental Illness Training Advisory Committee, the 

Criminal Justice Core Team and the Tri-Branch Task Force on Mental Health and Law 

Enforcement. Help redraft the Woodside Detention Facility policies on use of force and helping 

private and state facilities implement the Six Core Strategies. P&A staff greatly increased the 

profile of this important issue and obtained real and positive changes in many areas. 

Case Example from FY 2016

North Carolina

The P&A came to a resolution of a longstanding effort to obtain access to appropriate services 

for children with complex mental health needs. After lengthy negotiations with the state, the 

P&A reached agreement for the provision of diagnostic and screening services and appropriate 

treatment services for a class of approximately 550 such children with mental illness.

3. Impediments & Unmet Needs

Case Examples from FY 2015

Alaska

One of the impediments the P&A experiences when trying to provide services to individuals with 

mental illness who are incarcerated, is the difficulty and length of time it takes to obtain records. 

For example, when the P&A conducts an abuse and neglect investigation involving someone 

with mental illness, the P&A requests a copy of the facility’s own internal investigation into the 

alleged incident. The P&A is categorically denied any internal investigations, with a response 

that those reports are protected “in anticipation of litigation,” regardless of whether or not 

litigation following an incident ever occurs. In addition, when requesting other records (such as 
18

medical records) from the Department of Corrections, it often takes months before they are 

actually provided.

New York

Only a small number of entities covered by the requirements regarding reports of death and 

serious injuries provide such reports to the P&A.

Wisconsin

The P&A continues to experience difficulties getting from CMS, information and reports on 

abuse, neglect and deaths that are routinely received by state, local and private facilities. 

Because state regulators do investigations of both state and federal complaints of abuse and 

neglect in licensed facilities, they maintain a shared federal/state database, which often makes 

them hesitant to release information that overlaps both state and federal investigations. 

Additionally, the P&A rarely receives notice in cases where a death is related to restraint, 

seclusion or psychotropic medication.

Case Examples from FY 2016

American Samoa

An issue that arises when conducting investigations against abuse and neglect within the 

correctional facility is private access to clients for an interview. This mostly occurs when 

different or new correctional staff is encountered when PAIMI visits.

Colorado

Employees of facilities serving individuals with disabilities, impede PAIMI work by refusing to 

answer questions. Administrative subpoena power, with access to federal courts for enforcement 

would solve this problem. 

Florida

Despite having a current Data Use Agreement with CMS, we have not received any reports of

restraint or seclusion related deaths in over a decade from the Atlanta regional office. 

GOVERNANCE 

1. The Governing Authority

The DD Act of 1975,22 which created the state P&A systems, and the PAIMI Act, 23 mandated 

that private, non-profit entities have a multimember governing authority (the Board) to oversee 

22 42 U.S.C. 15043 (a), amended in 2000 23 42 U.S.C. 10805(c)
19

the system. 24 Each Board is responsible for the planning, designing, implementing, and 

functioning of its system.25 The Board must work jointly with its PAIMI Advisory Council 

(PAC)26 and establish policies and procedures for the selection of its members.27 The DD Act 

included provisions for Board terms of appointment, size, and composition. The DD Act 

required that: 

• Board members be selected according to policies and procedures of the system; 

• The Board include individuals who broadly represent or are knowledgeable of the needs 

of individuals served by the system; 

• The Board must make continuing efforts to ensure that its members represent racial and 

ethnic minorities.28 

• The majority of Board members include individuals with disabilities who are current or 

former recipients of disability services, their family members, guardians, authorized 

representatives and advocates; 

• The system set term limits to ensure rotating membership on the board; and 

• Board vacancies be filled within 60-days.29 

As of September 30, 2014, there were 50 private, non-profit P&A systems. Unlike private, nonprofit P&A systems, state-operated P&A systems may have a governing authority, but are not 

required to do so. 

The PAIMI Act and Rules also require the PAC Chair, who must be a current or former recipient 

of mental health services or a family member, sit on the governing Board of private, non-profit 

P&A systems. 

2. The PAIMI Advisory Council 

Each state P&A system is mandated to establish a PAC30 to advise the system on policies and 

priorities to be carried out in protecting and advocating for the rights of individuals with mental 

illness.31 The composition of the PAC is also mandated.32 The PAC Chair must be a current or 

former mental health recipient or a family member.33 

Each PAC is required to provide independent advice and recommendations to its state P&A 

system, to work jointly with the governing authority in the development of policies and 

priorities, and submit a section of the system’s annual report. 34 Council terms of appointment 

must be staggered and of reasonable duration. The size of the PAC varies by state, but at least 

60 percent of Council members must be current or former recipients of mental health services or 

24 42 U.S.C. 15044 25 42 U.S.C. 10805(c) (2) (A) 26 42 U.S.C. 10805(c) (2) (B) 27 42 U.S.C. 10805(c) (1) (B) 28 respectively at, 42 U.S.C. 10805(a) (6) (C) and 42 CFR 51.22(b) and (c) 29 respectively, at 42 U.S.C. 15044 (a) (1) (A), (B) (i), (ii) and (C) (3) and (4) 30 PAIMI Act at 42 U.S.C. 10805(a) (6) (C) 31 at 42 U.S.C. 10805 (a) (6) (A) 32 PAIMI Act at 42 U.S.C. 10805(a) (6) (B) 33 42 U.S.C. 10805(a) (6) (C) and the PAIMI Rules at 42 CFR at 51.23(b) (2) 34 PAIMI Rules at 42 CFR 51.23 (a) (1) -(3)
20

their family members. The Council must meet at least three times each calendar year, include 

ethnic and racial minorities, and receive information related to its corresponding P&A system’s 

budget, staff, current program policies, priorities and performance outcomes.35

The PAC is mandated to provide the governing board with advice and recommendations on the 

annual PAIMI programmatic activities and priorities to be funded in a FY. The PAIMI Act 

requires the PAC Chair sit on the governing board of private, non-profit state P&A systems;36

however, any PAC member may serve on the governing board.37

By January 1 of each year, each P&A system is required to submit an annual PPR to the HHS

Secretary.38 The PAC is also required to submit a section of that annual PPR as mandated by the 

PAIMI Act39 and the PAIMI Rules. 40

The Council’s report must:

• Describe its membership and its PAIMI Program activities;

• Explain its relationship to the P&A governing board of the previous calendar year;

• Independently assess the P&A system’s PAIMI Program; and

• Include whether the program accomplished its priorities, goals, and objectives for the 

previous FY. 

In addition to attending meetings, PAC members participated in numerous activities sponsored 

or endorsed by the PAIMI Program (e.g., attending in- and out-of-state trainings, serving on 

P&A governing board committees, engaging in systemic advocacy; and participating in special 

projects). 

TRAINING AND TECHNICAL ASSISTANCE

SAMHSA provided training and technical assistance (T/TA) to the state P&A systems through 

an interagency agreement (IAA) administered by the AIDD. AIDD, which oversees the PADD 

Program, is the first federal protection and advocacy program, and is the lead on the federal P&A 

system for issues pertaining to designation, re-designation, regulations, etc. SAMHSA supports 

the IAA with funds specifically set-aside for T/TA and limited to a maximum of two percent of 

the annual PAIMI Program appropriation. The Rehabilitation Services Administration (RSA), 

within the Office of Special Education and Rehabilitation Services, U.S. Department of 

Education, administers the Protection and Advocacy for Individual Rights Program, the Client 

Assistance Program, and the Protection and Advocacy for Assistive Technology Program. RSA 

has a separate IAA with AIDD. This consolidation of federal P&A program set-aside funds 

maximizes each agency’s limited resource and contributes to a federal partnership among the 

three agencies that fosters cooperation, information sharing, strategic planning, coordination, and 

integration of P&A system activities. 

35 PAIMI Rules at 42 CFR 51.23(b) (2), (3) and (c) 36 42 U.S.C. 10805 (a) (6) (A), 42 CFR at 51.22 (b) (3) 37 42 CFR at 51.22(d) 38 42 U.S.C. 10805 (a) (7) 39 42 U.S.C. 10824 40 42 CFR 51.8
21
22

The Training Advocacy and Support Center (TASC) of the National Disability Rights Network 

was the contractor selected by the AIDD to serve the P&A systems. Under the contract, TASC 

is responsible for T/TA various tasks including both, general and agency specific tasks (e.g., the 

annual PAC training). TASC activities under FYs 2015 and 2016 contract included the 

following topics: 

• Investigation protocols for incidents of abuse and neglect cases involving deaths; 

• Seclusion and restraint; 

• Community integration (Olmstead); 

• Medicaid funding; 

• Consumer self-advocacy; 

• Role of PACs; 

• Access to jails, prisons, and juvenile detention facilities; 

• Housing; and 

• Outreach strategies for unserved and underserved populations including members of 

ethnic and racial minorities, and individuals in urban or ruralsettings, prisons, jails, or

detention centers. 

TASC also assisted P&A systems prepare legal briefs when their PAIMI Act investigative and 

access authority were challenged. 

Under the IAA, TASC prepared three publications: the TASC Update (monthly), LegalEase

(monthly), and the P&A News (quarterly). Each publication was reviewed and edited by the 

federal P&A TA partners (SAMHSA, AIDD, and RSA) before AIDD approved their distribution 

to the state P&A systems. 

Under the IAA, TASC staff:

• Maintained a website accessible to the public and a webpage accessible only to the 

federal partners and the state P&A systems; 

• Developed model guidelines, training manuals, and legal advocacy materials, including

LegalEASE (monthly) and Case Dockets;

• Analyzed public policy;

• Established relationships with state P&A system staff;

• Served as liaison to the state P&A system staff;

• Facilitated information exchanges and requests for assistance from the P&A system staff; 

• Subcontracted with national legal organizations, including the Bazelon Center for Mental 

Health Law, the Center for Public Representation, and other legal experts for P&A 

system consultation services; 

• Promoted the use of the Protection and Advocacy Standards, which were developed in 

2009;

• Identified and disseminated samples of model P&A system policies and procedures;

• Developed P&A system self-assessment procedures, a project started in 2009; and 
23

• Planned and conducted training on current disability, legal, and advocacy issues 

including the Annual Conference, the P&A executive director, and fiscal management 

training. 

Through the IAA SAMHSA assist, P&A’s to improve performance (e.g., legal advocacy services 

to include individual and systems advocacy), operations, and outcomes; maintaining statutory 

compliance, support P&A’s as leaders and catalysts of systems change, capacity building and 

advocacy at the national, state/territory, and local levels.

CONCLUSION

This report offers examples of successful implementation of statutorily mandated activities 

related to the PAIMI program. PAIMI grantees worked tirelessly to protect and advocate for the 

rights of individuals with significant (serious) mental illness (adults) and significant (severe) 

emotional impairments (children and youth), residing in public and private care and treatment 

facilities who are at risk for, or in danger of abuse, neglect, and rights violations by using 

administrative, legal, systemic or other appropriate remedies on their behalf. PAIMI grantees 

successfully investigated reports of abuse, particularly incidents involving serious injuries and 

deaths related to the inappropriate use of seclusion and restraint; and ensure enforcement of the 

United States Constitution, federal laws and regulations, and state statutes. 

Through the PAIMI program, systemic changes were implemented in a variety of settings, which 

ultimately improved treatment, support and services for those with SMI and SED. The PAIMI 

grantees assisted states/territories in making systemic changes, change or improve practices, and 

help implement best practices. Through these and other efforts, PAIMI program assisted 

individuals and families with better treatment, decrease in abuse or neglect, protected rights of 

individuals, expanded employment and educational opportunities, and promote access to 

community living. 
24

DATA TABLES FOR FISCAL YEARS 2015 & 2016

Table 1 – State PAIMI Appropriations

Table 2 – Age and Gender

Table 3 – Ethnicity and Race

Table 4 – Living Arrangements

Table 5 – Complaints Involving Abuse

Table 6a – Complaints Involving Neglect

Table 6b – Complaints Involving Neglect

Table 7a – Complaints Involving Rights Violations

Table 7b – Complaints Involving Rights Violations

Table 7c – Death Investigations

Table 8a – Analysis of Alleged Abuse

Table 8b – Analysis of Alleged Neglect

Table 8c – Analysis of Alleged Rights Violations

Table 9 – Intervention Strategies

Table 10 – Non-Case Directed Services

Table 11 – Information and Referral/Public Education/Awareness & Training

Activities
25

Table 1: State PAIMI Appropriations

FY 2015

States FY 2015

FinalAppropriations

Alabama $456,090 

Alaska $428,000 

Arizona $616,908 

Arkansas $428,000 

California $3,156,787 

Colorado $433,624 

Connecticut $428,000 

Delaware $428,000 

District of Columbia $428,000 

Florida $1,704,717 

Georgia $917,657 

Hawaii $428,000 

Idaho $428,000 

Illinois $1,075,584 

Indiana $599,111 

Iowa $428,000 

Kansas $428,000 

Kentucky $428,000 

Louisiana $428,000 

Maine $428,000 

Maryland $456,617 

Massachusetts $506,963 

Michigan $903,618 

Minnesota $444,348 

Mississippi $428,000 

Missouri $544,367 

Montana $428,000 

Nebraska $428,000 

Nevada $428,000 

New Hampshire $428,000 

New Jersey $681,414 

New Mexico $428,000 

New York $1,525,779 

North Carolina $896,314 

North Dakota $428,000 

Ohio $1,031,064 

Oklahoma $428,000 

Oregon $428,000 
26

Table 1: State PAIMI Appropriations

FY 2015 Continued

States

FY 2015

Final

Appropriations

Pennsylvania $1,074,746

Rhode Island $428,000

South Carolina $452,783 

South Dakota $428,000 

Tennessee $586,600 

Texas $2,255,157 

Utah $428,000 

Vermont $428,000 

Virginia $666,587 

Washington $574,891 

West Virginia $428,000 

Wisconsin $498,588 

Wyoming $428,000 

American Indian Consortium $229,300 

American Samoa $229,300 

Guam $229,300 

Northern Marianas $229,300 

Puerto Rico $551,889 

Virgin Islands $229,300 

To State P&A Systems $35,314,703 

Technical Assistance Set-aside $831,297

Total Annual PAIMI Appropriations $36,146,000
27

Table 1: State PAIMI Appropriations

FY 2016

States FY 2016

FinalAppropriations

Alabama $456,202 

Alaska $428,000 

Arizona $620,810 

Arkansas $428,000 

California $3,133,536 

Colorado $437,326 

Connecticut $428,000 

Delaware $428,000 

District of Columbia $428,000 

Florida $1,724,396 

Georgia $924,616 

Hawaii $428,000 

Idaho $428,000 

Illinois $1,068,437 

Indiana $601,509 

Iowa $428,000 

Kansas $428,000 

Kentucky $428,000 

Louisiana $428,000 

Maine $428,000 

Maryland $461,758 

Massachusetts $507,383 

Michigan $900,554 

Minnesota $447,204 

Mississippi $428,000 

Missouri $538,623 

Montana $428,000 

Nebraska $428,000 

Nevada $428,000 

New Hampshire $428,000 

Jersey $684,418 

New Mexico $428,000 

New York $1,522,543 

North Carolina $900,754 

North Dakota $428,000 

Ohio $1,026,130 

Oklahoma $428,000 

Oregon $428,000 
28

Table 1: State PAIMI Appropriations

FY 2016 Continued

States FY 2016

FinalAppropriations

Pennsylvania $1,068,002

Rhode Island $428,000

South Carolina $455,079 

South Dakota $428,000 

Tennessee $587,219 

Texas $2,268,331 

Utah $428,000 

Vermont $428,000 

Virginia $672,622 

Washington $573,924 

West Virginia $428,000 

Wisconsin $496,018 

Wyoming $428,000 

American Indian Consortium $229,300 

American Samoa $229,300 

Guam $229,300 

Northern Marianas $229,300 

Puerto Rico $538,623 

Virgin Islands $229,300 

To State P&A Systems $35,318,517 

Technical Assistance Set-aside $827,483

Total Annual PAIMI Appropriations $36,146,000
29

Table 2: Age and Gender

FY 2015

States Clients 

Served

Age

Served Total

Gender

0-4 5-12 13-18 19-25 26-64 65+ Male Female

AK 98 0 2 6 8 77 5 98 53 45 

AL 309 0 35 88 15 153 18 309 232 77 

AR 115 0 21 38 14 40 2 115 80 35 

AS 28 0 0 3 2 23 0 28 21 7 

AZ 266 0 1 6 21 228 10 266 124 142 

CA 968 0 17 53 66 736 96 968 465 503 

CO 93 0 0 4 32 55 2 93 70 23 

CT 136 0 13 15 14 87 7 136 89 47 

DC 123 0 0 7 9 89 18 123 56 67 

DE 168 0 9 12 10 131 6 168 88 80 

FL 243 0 6 16 21 185 15 243 163 80 

GA 125 0 3 11 12 93 6 125 75 50 

GU 33 0 3 6 2 21 1 33 21 12 

HI 244 0 57 68 6 104 9 244 151 93 

IA 90 0 9 10 19 46 6 90 36 54 

ID 96 0 8 5 8 70 5 96 37 59 

IL 345 1 62 53 18 195 16 345 180 165 

IN 166 0 12 24 7 115 8 166 103 63 

KS 532 2 37 48 26 394 25 532 254 278 

KY 210 0 13 41 16 121 19 210 142 68 

LA 120 0 16 32 6 56 10 120 81 39 

MA 147 0 0 11 15 111 10 147 79 68 

MD 130 0 2 10 8 106 4 130 72 58 

ME 272 1 38 49 11 160 13 272 151 121 

MI 90 0 2 19 5 50 14 90 46 44 

MN 189 0 16 29 15 120 9 189 107 82 
30

Table 2: Age and Gender

FY 2015 Continued

States Clients 

Served

Age Served TotalGender

0-4 5-12 13-18 19-25 26-64 65+

Male Female

MO 214 0 2 6 11 181 14 214 135 79 

MP 16 0 2 5 0 8 1 16 9 7 

MS 117 1 23 68 6 17 2 117 81 36 

MT 301 0 17 71 25 176 12 301 229 72 

NA 72 0 11 19 5 36 1 72 49 23 

NC 232 0 16 39 31 136 10 232 169 63 

ND 188 0 36 47 19 76 10 188 118 70 

NE 45 0 0 0 6 34 5 45 18 27 

NH 395 0 16 40 37 288 14 395 180 215 

NJ 289 0 6 32 25 203 23 289 166 123 

NM 113 0 3 6 10 83 11 113 69 44 

NV 42 0 0 3 6 31 2 42 18 24 

NY 364 0 18 28 29 276 13 364 224 140 

OH 650 4 25 59 59 463 40 650 343 307 

OK 761 4 67 60 46 552 32 761 360 401 

OR 87 0 4 6 11 59 7 87 34 53 

PA 656 0 44 87 74 417 34 656 400 256 

PR 160 1 15 22 13 101 8 160 88 72 

RI 221 3 13 15 31 135 24 221 110 111 

SC 205 0 13 145 9 29 9 205 112 93 

SD 145 0 21 33 15 71 5 145 91 54 

TN 128 0 14 34 12 65 3 128 83 45 

TX 930 3 50 191 103 555 28 930 555 375 

UT 209 0 0 12 22 164 11 209 118 91 

VA 132 0 0 15 16 86 15 132 76 56 

VI 21 0 1 3 1 16 0 21 6 15 
31

Table 2: Age and Gender

FY 2015 Continued

States Clients 

Served

Age Served TotalGender

0-4 5-12 13-18 19-25 26-64 65+

Male Female

VT 88 0 0 5 4 70 9 88 53 35 

WA 356 0 1 8 24 265 58 356 209 147 

WI 117 0 7 17 13 79 1 117 37 80 

WV 55 0 3 4 7 38 3 55 35 20 

WY 42 0 0 2 3 34 3 42 17 25 

Total 12,687 20 810 1,746 1,059 8,310 742 12,687 7,168 5,519 

Percentages 100% 0.2% 6% 14% 8% 66% 6% 100% 56% 44%
32

Table 2: Age and Gender

FY 2016

States Clients 

Served

Age

Served Total

Gender

0-4 5-12 13-18 19-25 26-64 65+ Male Female

AK 74 0 0 3 10 54 7 74 42 32

AL 287 0 33 66 14 155 19 287 218 69

AR 128 0 38 36 8 41 5 128 91 37

AS 34 0 0 1 3 30 0 34 21 13

AZ 231 1 1 7 15 195 12 231 91 140

CA 959 1 46 55 62 714 81 959 503 456

CO 76 0 0 6 4 61 5 76 60 16

CT 138 0 5 15 22 90 6 138 96 42

DC 117 0 1 5 7 87 17 117 67 50

DE 194 0 6 10 17 153 8 194 95 99

FL 198 0 3 9 8 165 13 198 142 56

GA 124 0 1 12 10 90 11 124 67 57

GU 24 0 1 9 0 14 0 24 13 11

HI 260 1 53 66 5 127 8 260 169 91

IA 68 0 10 17 4 34 3 68 30 38

ID 197 0 6 8 25 147 11 197 101 96

IL 359 0 35 93 25 187 19 359 209 150

IN 82 0 2 33 12 33 2 82 53 29

KS 422 0 33 36 24 309 20 422 191 231

KY 167 0 14 30 16 95 12 167 110 57

LA 130 0 24 29 10 57 10 130 96 34

MA 101 0 1 2 12 77 9 101 51 50

MD 146 0 1 15 12 111 7 146 81 65

ME 237 1 31 73 15 106 11 237 119 118

MI 90 0 5 18 9 44 14 90 52 38
33

Table 2: Age and Gender

FY 2016 Continued

States Clients 

Served

Age

Served Total

Gender

0-4 5-12 13-18 19-25 26-64 65+ Male Female

MN 209 0 17 34 18 131 9 209 105 104

MO 228 0 1 4 15 185 23 228 144 84

MP 16 0 1 2 1 11 1 16 9 7

MS 103 1 21 61 6 12 2 103 70 33

MT 284 1 23 62 30 148 20 284 196 88

NA 33 0 8 15 1 9 0 33 26 7

NC 189 2 10 31 23 119 4 189 140 49

ND 223 0 40 59 14 96 14 223 82 141

NE 39 0 0 0 5 30 4 39 16 23

NH 379 0 17 34 36 273 19 379 185 194

NJ 301 0 11 29 15 233 13 301 173 128

NM 102 0 3 7 8 77 7 102 57 45

NV 46 0 0 2 6 38 0 46 29 17

NY 417 0 17 38 30 305 27 417 242 175

OH 678 4 38 72 47 473 44 678 343 335

OK 82 0 19 15 8 39 1 82 48 34

OR 56 0 3 4 8 37 4 56 17 39

PA 345 0 30 72 31 202 10 345 207 138

PR 141 1 17 16 9 84 14 141 79 62

RI 249 3 16 20 32 151 27 249 120 129

SC 206 0 10 153 6 28 9 206 117 89

SD 127 0 21 34 13 54 5 127 85 42

TN 89 0 5 21 7 52 4 89 53 36

TX 977 4 59 195 107 575 37 977 595 382

UT 96 0 2 7 14 70 3 96 53 43

VA 106 0 1 17 10 57 21 106 55 51
34

Table 2: Age and Gender

FY 2016 Continued

States Clients 

Served

Age

Served Total

Gender

0-4 5-12 13-18 19-25 26-64 65+ Male Female

VI 20 0 0 3 0 17 0 20 14 6

VT 98 0 0 3 10 74 11 98 57 41

WA 302 0 4 4 14 243 37 302 186 116

WI 120 0 10 31 9 67 3 120 81 39

WV 52 0 6 6 4 30 6 52 40 12

WY 29 0 0 1 2 25 1 29 21 8

Total 11,185 20 760 1,706 888 7,121 690 11,185 6,413 4,772

Percentages 100% 0.2% 6.8% 15% 7.9% 64% 6.2% 100% 57% 43%
35

Table 3: Ethnicity and Race

FY 2015

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native Hawaiian 

Pacific Islander

Ethnicity 

Total

Hispanic/

Latino

Not 

Hispanic/

Latino

AK 97 3 8 61 8 17 0 98 1 97 

AL 309 1 151 156 1 0 0 309 2 307 

AR 115 0 43 66 5 1 0 115 0 115 

AS 28 0 0 1 0 0 27 0 0 0 

AZ 231 3 20 194 7 7 0 266 35 231 

CA 812 29 164 578 17 15 9 987 175 812 

CO 93 0 39 53 0 1 0 93 32 61 

CT 115 2 23 90 0 0 0 136 21 115 

DC 123 1 96 20 5 1 0 123 7 116 

DE 160 1 64 94 1 0 0 168 8 160 

FL 225 2 78 137 5 2 1 244 18 226 

GA 125 3 56 65 1 0 0 125 6 119 

GU 33 7 0 3 0 0 23 33 0 33 

HI 244 41 10 77 85 0 31 244 10 234 

IA 90 1 6 75 6 1 1 90 2 88 

ID 83 1 2 74 2 3 1 96 13 83 

IL 345 8 122 176 29 10 0 374 50 324 

IN 166 0 31 131 3 1 0 166 0 166 

KS 488 3 56 410 6 12 1 532 30 502 

KY 210 0 43 161 5 0 1 5 5 0 

LA 120 0 58 60 2 0 0 120 3 117 

MA 127 4 21 101 0 0 1 147 20 127 

MD 130 1 71 48 10 0 0 130 7 123 

ME 253 1 6 233 4 9 0 272 0 272 

MI 90 1 24 65 0 0 0 90 1 89 
36

Table 3: Ethnicity and Race

FY 2015 Continued

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native Hawaiian 

Pacific Islander

Ethnicity 

Total

Hispanic/

Latino

Not 

Hispanic/

Latino

MN 179 2 35 126 4 12 0 189 10 179 

MO 214 0 60 152 0 2 0 214 1 213 

MP 17 0 1 1 4 0 11 16 0 16 

MS 115 2 69 42 1 1 0 117 2 115 

MT 286 0 2 241 0 43 0 301 10 291 

NA 72 0 0 1 0 71 0 72 0 72 

NC 232 1 95 125 11 0 0 234 14 220 

ND 200 0 9 141 6 43 1 188 5 183 

NE 43 0 7 34 2 0 0 45 0 45 

NH 386 6 3 363 8 6 0 395 9 386 

NJ 289 3 75 208 3 0 0 289 34 255 

NM 113 0 4 105 0 4 0 113 42 71 

NV 36 1 10 24 0 1 0 42 6 36 

NY 312 1 108 185 17 0 1 364 46 318 

OH 643 3 212 410 16 2 0 651 8 643 

OK 733 7 126 490 59 50 1 761 28 733 

OR 51 2 4 41 1 2 1 87 8 79 

PA 621 1 191 421 7 1 0 656 35 621 

PR 0 0 0 0 0 0 0 160 160 0

RI 205 2 11 181 9 2 0 221 13 208 

SC 202 0 91 102 8 1 0 205 3 202 

SD 132 0 7 97 8 20 0 145 13 132 

TN 128 0 43 82 2 1 0 128 2 126 

TX 691 4 229 445 6 7 0 930 239 691 

UT 191 0 7 179 1 2 2 209 13 196 

VA 129 2 51 71 4 1 0 3 3 0 
37

Table 3: Ethnicity and Race

FY 2015 Continued

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native Hawaiian 

Pacific Islander

Ethnicity 

Total

Hispanic/

Latino

Not 

Hispanic/

Latino

VI 20 0 19 0 1 0 0 20 2 18 

VT 85 0 2 80 3 0 0 88 3 85 

WA 273 7 35 198 25 7 1 352 25 327 

WI 117 2 22 87 6 0 0 117 8 109 

WV 54 0 6 45 3 0 0 55 1 54 

WY 39 1 1 36 0 1 0 3 3 0 

Total 11,620 160 2,727 7,842 417 360 114 12,333 1,192 11,141 

Percentages 100% 1.4% 23% 67% 3.6% 3.1% 1% 100% 10% 96%
38

Table 3: Ethnicity and Race

FY 2016

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native 

Hawaiian 

Pacific 

Islander

Ethnicity Total Hispanic/

Latino

Not Hispanic/

Latino

AK 72 1 7 48 3 13 0 74 2 72

AL 287 1 133 151 2 0 0 287 3 284

AR 125 1 41 77 4 1 1 128 3 125

AS 31 1 0 0 1 0 29 0 0 0

AZ 195 2 20 162 6 4 1 231 36 195

CA 766 33 138 536 40 10 9 859 135 724

CO 76 1 24 50 0 1 0 76 10 66

CT 117 3 28 86 0 0 0 138 21 117

DC 113 0 92 17 3 1 0 117 9 108

DE 183 2 68 112 1 0 0 194 11 183

FL 182 2 65 108 5 2 0 98 12 86

GA 124 1 51 67 3 2 0 124 5 119

GU 24 4 0 6 0 1 13 24 0 24

HI 260 39 9 74 108 1 29 260 11 249

IA 64 0 9 50 4 1 0 68 4 64

ID 184 2 1 167 9 3 2 197 13 184

IL 319 11 103 189 13 3 0 359 52 307

IN 80 0 15 62 3 0 0 82 0 82

KS 397 0 46 341 7 3 0 422 20 402

KY 167 0 48 115 4 0 0 167 3 164

LA 126 0 62 58 5 1 0 130 4 126

MA 92 2 13 77 0 0 0 101 9 92

MD 176 0 112 61 3 0 0 146 3 143

ME 182 1 4 168 2 6 1 237 1 236
39

Table 3: Ethnicity and Race

FY 2016 Continued

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native 

Hawaiian 

Pacific 

Islander

Ethnicity Total Hispanic/

Latino

Not Hispanic/

Latino

MI 90 4 22 60 2 2 0 90 5 85

MN 203 2 44 135 11 11 0 209 6 203

MO 228 0 63 162 0 3 0 228 0 228

MP 27 7 1 1 5 0 13 16 0 16

MS 103 0 57 46 0 0 0 103 4 99

MT 281 0 2 245 1 33 0 284 3 281

NA 33 0 0 0 0 33 0 0 0 0

NC 189 1 81 97 7 3 0 189 5 184

ND 220 3 6 159 5 46 1 223 13 210

NE 37 1 5 27 3 1 0 39 2 37

NH 369 1 6 345 11 6 0 379 10 369

NJ 301 3 68 222 8 0 0 301 38 263

NM 63 1 2 56 0 4 0 102 39 63

NV 41 0 17 19 3 2 0 46 5 41

NY 388 3 116 234 35 0 0 417 49 368

OH 665 2 203 446 12 2 0 9 9 0

OK 75 0 11 52 8 4 0 82 7 75

OR 56 1 4 49 0 2 0 6 6 0

PA 287 0 80 201 3 2 1 345 16 329

PR 0 0 0 0 0 0 0 141 141 0

RI 234 2 13 209 9 1 0 249 11 238

SC 206 0 99 93 12 1 1 206 5 201

SD 116 0 2 94 2 18 0 127 11 116

TN 89 0 31 55 2 0 1 89 1 88

TX 726 4 256 446 15 5 0 977 248 729
40

Table 3: Ethnicity and Race

FY 2016 Continued

States Clients Served Asian

Black/

African 

American

White/

Caucasian

Multiple 

Races

Native 

American/

Alaska 

Native

Native 

Hawaiian 

Pacific 

Islander

Ethnicity Total Hispanic/

Latino

Not Hispanic/

Latino

UT 88 1 4 78 4 1 0 96 8 88

VI 19 0 19 0 0 0 0 20 1 19

VT 94 0 2 85 7 0 0 98 4 94

WA 279 5 58 196 13 7 0 302 23 279

WI 115 2 19 82 10 1 1 5 5 0

WV 52 0 7 42 2 1 0 53 0 53

WY 27 1 0 24 0 2 0 2 2 0

Total 10,145 152 2,420 6,808 418 244 103 10,058 1,048 9,010

Percentages 100% 1.5% 24% 67% 4.1% 2.4% 1% 100% 10% 90%
41

Table 4: Living Arrangements

FY 2015

States

Clients ServedIndependent LivingParental or Family HomeCommunity Residential Home for Children/Youth 0-18 yrs.Adult Community Residential HomeNon-medical Community-based for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown Other

AK 98 46 9 1 12 1 0 0 0 0 0 7 1 1 12 0 8 0 0

AL 309 14 84 2 26 0 17 6 0 1 0 1 70 38 49 0 1 0 0

AR 115 16 33 1 1 0 0 0 0 1 0 5 8 21 28 1 0 0 0

AS 9 0 9 0 0 0 0 0 0 0 0 0 0 0 4 12 3 0 0

AZ 266 184 21 5 2 0 0 2 0 1 0 3 17 1 4 18 7 1 0

CA 968 495 169 4 38 2 5 11 3 11 0 18 105 5 39 15 46 2 0

CO 93 6 2 5 1 0 0 8 0 1 1 1 10 3 15 30 4 6 0

CT 136 34 34 0 14 0 1 6 0 19 0 0 4 0 21 0 3 0 0

DC 123 31 9 0 3 0 1 4 0 0 0 10 30 16 2 0 16 1 0

DE 168 62 32 0 17 0 0 3 0 0 0 0 45 6 0 2 1 0 0

FL 243 69 35 3 5 0 0 2 4 0 4 0 40 9 63 0 9 0 0

GA 125 14 25 11 6 0 1 6 0 0 3 0 46 6 3 0 4 0 0

GU 33 6 25 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0

HI 244 60 137 0 11 0 7 0 0 0 0 23 0 0 0 0 6 0 0

IA 90 36 14 0 7 2 0 2 0 1 0 3 1 12 9 3 0 0 0

ID 96 47 21 0 3 0 0 1 1 0 0 0 12 3 0 0 8 0 0

IL 345 100 120 2 11 0 0 45 3 3 2 7 41 2 1 1 5 2 0

IN 166 24 19 6 1 4 0 0 1 0 0 4 51 22 2 29 3 0 0

KS 532 306 108 2 12 0 0 37 3 1 5 18 25 2 3 0 8 2 0
42

Table 4: Living Arrangements

FY 2015 Continued

States

Clients ServedIndependent Living Parental or Family HomeCommunity Residential Home for Children/Youth 0-18 yrs.Adult Community Residential HomeNon-medical Community-based for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown Other

KY 210 32 25 21

30490039 24 619 10000

LA 120 15 48

110060201 283 120300

MA 147 35 14

050020100 79600410

MD 130 47

5230010005 52620700

ME 272 70 65 24 33

002031 11 37 1620710

MI 90 10 13

7 1200 120105 111 108000

MN 189 49 56

0 180 1308029 12746410

MO 214 44 16

1 2020 271006 7216 15210

MP 16

290000000010030100

MS 117

3 62850100000 33041000

MT 301 27 24

310211000 43 71 49 74410

NA 72

8 483104000002030300

NC 232 15 36

25010000 17 34 383 79110

ND 188 33 85

171040002 25788700

NE 45

830100210 152 13000000

NH 395 168 100

24205032 6416 12 14 1200

NJ 289 31 47

13013130 10 179730000

NM 113 14

640001000 510 3700000

NV 42 14

2020000001 11534000

NY 364 176 47

4 27008040 12016 72610
43

Table 4: Living Arrangements (FY 2015 Continued)

States

Clients ServedIndependent Living Parental or Family HomeCommunity Residential Home for Children/Youth 0-18 yrs.Adult Community Residential HomeNon-medical Community-based for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown Other

OH 650 201 86 5 25 0 0 56 1 10 2 147 82 2 23 1 9 0 0

OK 761 432 202 0 15 0 3 13 0 20 0 4 7 3 30 13 18 1 0

OR 87 7 6 1 6 1 0 1 0 20 0 1 25 2 6 10 1 0 0

PA 656 173 112 42 11 21 1 7 0 4 6 71 56 9 68 65 9 1 0

PR 160 69 59 4 10 0 0 0 0 1 1 7 0 3 1 1 4 0 0

RI 221 64 69 2 11 0 0 16 0 5 2 31 6 4 3 0 8 0 0

SC 205 6 29 1 0 2 4 0 0 1 0 1 23 12 120 5 0 1 0

SD 145 23 51 0 1 0 1 0 0 0 0 5 57 4 0 0 3 0 0

TN 128 24 44 2 9 2 1 1 0 0 0 4 15 1 13 8 4 0 0

TX 930 152 119 11 13 11 93 14 0 13 2 386 29 7 66 8 6 0 0

UT 209 98 22 2 6 1 0 5 0 1 1 4 22 6 31 1 9 0 0

VA 132 9 6 0 5 1 0 1 0 1 0 4 93 8 4 0 0 0 0

VI 21 9 4 2 0 0 0 0 0 0 0 0 0 1 2 0 3 0 0

VT 88 27 1 4 7 0 0 1 0 0 0 16 3 4 1 20 2 2 0

WA 356 144 18 9 0 0 0 1 0 2 1 2 116 2 48 0 13 0 0

WI 117 17 22 1 7 0 0 5 0 0 1 10 6 4 19 23 2 0 0

WV 55 8 9 0 2 0 0 0 0 0 0 0 22 6 0 7 1 0 0

WY 42 4 2 1 0 0 0 2 0 0 0 1 32 0 0 0 0 0 0

Total 12,668 3,818 2,478 213 449 53 161 339 28 134 54 1,000 1,756 499 829 564 286 26 0

Percentages 100% 30% 20% 1.7% 3.5% 0.4% 1.3% 2.7% 0.2% 1.1% 0.4% 7.9% 14% 3.9% 6.5% 4.5% 2.3% 2.3% 0%
44

Table 4: Living Arrangements

FY 2016

States

Clients ServedIndependent Living Parental or Family HomeCommunity Residential Home for Children/Youth 0-18 yrsAdult CommunityResidential HomeNon-medical Communitybased for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown/Other

AK 74 37 7 1 5 1 0 0 0 0 0 4 1 0 11 1 6 0 0

AL 287 17 62 0 19 0 41 3 0 0 0 0 92 13 12 26 2 0 0

AR 128 15 60 0 3 0 1 1 0 2 0 6 9 15 14 2 0 0 0

AS 34 3 8 0 1 0 0 0 0 0 0 0 13 0 7 0 2 0 0

AZ 231 170 20 8 1 0 0 1 0 0 0 2 14 3 3 1 8 0 0

CA 959 482 148 4 24 2 1 7 2 6 3 19 108 3 78 14 57 1 0

CO 76 6 1 0 1 0 0 14 0 4 0 0 1 0 27 14 2 6 0

CT 138 37 29 0 4 0 0 3 0 31 0 0 1 0 30 0 3 0 0

DC 117 31 9 0 1 0 0 4 0 4 0 12 25 13 2 0 13 3 0

DE 194 72 32 0 15 0 0 4 0 0 0 0 59 4 6 0 2 0 0

FL 198 23 12 2 9 0 0 2 0 1 0 9 66 7 33 29 4 1 0

GA 124 22 16 10 0 0 1 5 0 0 3 4 52 7 2 0 2 0 0

GU 24 8 6 2 0 0 2 0 0 0 0 0 5 1 0 0 0 0 0

HI 260 47 137 30 0 0 6 0 0 0 0 36 0 0 1 0 3 0 0

IA 68 23 17 1 4 1 0 2 0 0 2 1 4 3 6 3 1 0 0

ID 197 81 42 0 12 0 0 3 3 0 0 1 26 10 3 0 16 0 0

IL 359 84 136 0 8 0 1 46 4 2 2 27 38 1 2 3 5 0 0

IN 82 13 32 3 6 1 0 3 0 0 0 18 0 1 1 2 1 1 0

KS 422 234 85 0 12 0 0 29 0 2 6 19 21 4 4 0 6 0 0

KY 167 21 27 18 0 0 5 7 0 0 0 5 21 28 20 14 1 0 0

LA 130 18 54 1 1 0 0 5 0 1 0 6 26 3 11 1 3 0 0
45

Table 4: Living Arrangements

FY 2016 Continued

States

Clients ServedIndependent Living Parental or Family HomeCommunity Residential Home for Children/Youth Adult CommunityR id ti l HNon-medical Communitybased for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown/Other

MA 101 33 17 5 0 0 0 0 0 0 0 0 35 3 0 1 6 1 0

MD 146 61 7 3 7 1 1 2 1 0 0 0 41 11 3 0 8 0 0

ME 237 57 56 37 32 0 0 4 0 0 0 10 9 10 11 1 9 1 0

MI 90 7 22 3 13 1 0 10 0 1 0 5 16 0 5 6 1 0 0

MN 209 52 54 0 21 0 11 0 11 1 0 5 31 6 7 5 5 0 0

MO 228 56 14 0 11 0 0 44 2 0 0 2 70 1 6 21 1 0 0

MP 16 5 4 0 0 0 0 0 0 0 0 1 0 0 4 0 2 0 0

MS 103 4 69 0 1 0 0 1 0 0 1 0 21 1 3 1 1 0 0

MT 284 52 20 2 2 0 0 1 0 0 2 3 44 64 60 33 1 0 0

NA 33 2 23 2 1 0 2 0 0 0 0 0 1 0 2 0 0 0 0

NC 189 16 33 7 0 0 0 1 0 0 0 16 24 28 1 61 0 2 0

ND 223 52 103 1 6 1 0 5 0 1 0 3 22 4 8 7 10 0 0

NE 39 6 0 0 0 0 0 2 1 0 0 0 15 15 0 0 0 0 0

NH 379

17

7 87 1 5 1 1 3 0 7 1 62 0 5 7 14 8 0 0

NJ 301 38 60 3 2 0 0 4 0 4 0 11 168 5 6 0 0 0 0

NM 102 11 6 1 1 0 0 1 0 0 0 4 77 0 1 0 0 0 0

NV 46 16 3 2 0 0 0 0 0 0 0 0 14 2 3 4 2 0 0

NY 417

19

8 60 5 30 0 0 16 0 2 0 8 2 4 9 71 11 1 0

OH 678

24

1 110 11 13 5 1 44 1 3 2

13

0 64 1 34 8 10 0 0

OK 82 17 32 0 0 0 0 0 0 0 0 8 0 5 15 4 1 0 0

OR 56 3 3 1 1 2 2 0 0 6 0 0 13 3 15 7 0 0 0

Table 4: Living Arrangements
46

FY 2016, cont.

States

Clients ServedIndependent Living Parental or Family HomeCommunity Residential Home for Children/Youth 0-18 yrs.Adult Community Residential HomeNon-medical Communitybased for Children 0-18Foster CareNursing FacilitiesIntermediate CarePublic and Private General HospitalOther Health FacilityPsychiatric WardsPublic Institutional LivingPrivate Institutional LivingLegal/Jail DetentionState PrisonHomelessFederal FacilityUnknown/Other

PA 345 88 89 18 5 15 0 2 0 2 3 25 28 0 23 45 2 0 0

PR 141 70 48 2 9 0 0 0 0 0 0 7 2 0 0 1 2 0 0

RI 249 74 79 1 11 0 0 17 0 6 4 30 7 5 6 1 7 1 0

SC 206 7 18 1 1 0 3 0 0 0 0 6 17 9 136 7 1 0 0

SD 127 19 50 2 3 0 0 0 0 0 0 3 36 8 6 0 0 0 0

TN 89 16 25 2 8 1 0 0 0 0 0 2 13 3 9 7 3 0 0

TX 977 159 77 11 22 14 139 12 0 12 4 382 23 3 105 0 13 1 0

UT 96 65 6 1 1 0 0 3 0 0 0 4 6 2 8 0 0 0 0

VA 106 2 4 2 2 0 0 1 0 0 0 1 81 5 6 0 2 0 0

VI 20 11 2 1 0 0 0 0 0 0 0 0 0 1 1 0 4 0 0

VT 98 22 1 1 5 0 0 2 0 3 0 21 6 7 4 22 2 2 0

WA 302 101 8 7 0 0 0 0 1 0 5 1 60 2 103 0 14 0 0

WI 120 25 40 0 5 0 0 2 0 0 0 9 0 0 22 15 2 0 0

WV 52 5 13 1 0 0 0 1 0 1 0 0 17 10 1 2 1 0 0

WY 29 3 0 0 1 0 0 0 0 0 0 0 22 1 1 0 1 0 0

Total 11,185

3,21

5 2,183 214 345 46 218 317 26 102 38 928 1,567

34

0 904 454 267 21 0 

Percentag

es 100% 29% 20%

1.9

%

3.1

% 0.4%

1.9

% 2.8%

0.2

%

0.9

% 0.3%

8.3

% 14%

3

%

8.1

%

4.1

%

2.4

%

0.2

%

0.0

%

Table 5: Complaints Involving Abuse

FY 2015
47

State

Number of Abuse Complaints Closed

Inappropriate/Excessive Involuntary

Failure to provide 

Mental 

Health 

Treatment

Complaints Concerning

MedicationPhysical RestraintChemical 

Restraint

Mechanical 

Restraint

SeclusionMedicationInvoluntary Electroconvulsive

Therapy

Aversive 

Behavioral 

TherapySterilizationFailure to provide Medical TreatmentPhysical 

Assaults Resulting 

in Serious InjuryPhysical Assault -Non-serious injuries Sexual assaultStaff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

AK 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1

AL 48 1 9 0 1 1 1 0 0 0 18 2 3 4 1 5 0 0 1 1

AR 27 0 11 1 1 1 0 0 0 0 6 1 1 1 3 0 0 0 1 0

AS 4 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 0

AZ 13 0 2 0 0 0 0 0 0 0 5 2 0 2 2 0 0 0 0 0

CA 95 9 11 0 2 2 3 0 0 0 13 3 1 13 6 3 11 6 12 0

CO 11 1 1 0 1 1 0 0 0 0 0 1 1 3 0 0 0 0 2 0

CT 44 4 1 1 0 0 20 0 0 0 10 1 3 0 0 3 1 0 0 0

DC 35 6 7 3 0 0 0 0 0 0 4 1 3 3 2 1 0 5 0 0

DE 12 0 3 0 0 0 0 0 0 0 2 1 0 2 0 0 0 3 1 0

FL 94 13 10 0 1 8 0 0 0 0 8 14 2 11 6 4 2 7 7 1

GA 36 1 0 0 0 0 1 0 0 0 8 1 0 5 0 1 0 3 16 0

GU 2 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0

HI 5 0 0 0 0 0 0 0 0 0 2 0 1 0 1 0 0 1 0 0

IA 20 1 3 0 0 1 1 0 0 0 5 2 0 0 0 2 0 3 1 1

ID 4 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 1 0 0

IL 27 5 3 1 0 1 1 0 0 0 3 6 0 1 0 1 0 5 0 0

IN 65 1 12 1 1 1 0 0 0 0 13 11 2 5 5 6 0 4 3 0

KS 30 3 0 1 1 0 0 0 0 0 10 4 1 1 3 0 2 4 0 0

KY 29 0 11 0 7 1 0 0 0 0 2 1 3 2 0 0 0 0 2 0

LA 8 0 0 0 0 0 0 0 0 0 4 1 1 0 0 1 0 1 0 0

Table 5: Complaints Involving Abuse

FY 2015, cont.
48

State

Number of Abuse Complaints Closed

Inappropriate/Excessive Involuntary

Failure to provide 

Mental 

Health 

Treatment

Complaints Concerning

MedicationPhysical RestraintChemical 

Restraint

Mechanical 

Restraint

SeclusionMedicationInvoluntary Electroconvulsive

Therapy

Aversive 

Behavioral 

TherapySterilizationFailure to provide Medical TreatmentPhysical Assaults Resulting in Serious Injury Physical Assault –Non-serious Injuries Sexual 

Assault

Staff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

MA 29 1 2 1 0 1 0 0 0 0 16 1 1 3 0 0 0 3 0 0

MD 37 1 0 2 1 0 1 0 0 0 5 0 0 1 20 1 3 0 2 0

ME 75 2 16 0 3 6 3 0 0 0 34 2 0 0 2 2 1 4 0 0

MI 12 1 2 2 0 0 0 0 0 0 2 0 1 2 0 1 0 1 0 0

MN 23 0 0 0 0 0 0 1 0 0 17 4 0 1 0 0 0 0 0 0

MO 57 12 2 0 0 0 2 3 0 0 27 9 0 0 0 1 0 0 1 0

MP 2 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0

MS 11 1 0 0 0 0 0 0 0 0 4 0 0 0 0 4 2 0 0 0

MT 102 2 4 2 0 0 1 0 0 0 70 6 0 2 6 1 0 0 1 7

NA 2 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0

NC 41 1 1 1 0 6 0 0 0 0 19 4 0 1 4 4 0 0 0 0

ND 47 0 4 0 0 1 7 0 0 0 15 0 0 5 0 0 0 11 4 0

NE 8 0 0 0 1 0 0 0 0 0 3 0 1 0 2 0 0 0 1 0

NH 64 6 1 1 0 1 7 0 0 0 27 13 0 2 0 4 0 2 0 0

NJ 101 24 3 0 3 0 5 0 0 0 3 13 3 22 2 10 0 2 11 0

NM 21 1 1 0 0 0 0 0 0 0 4 0 0 3 2 10 0 0 0 0

NV 8 1 0 0 0 2 0 0 0 0 3 2 0 0 0 0 0 0 0 0

NY 71 2 0 0 0 3 1 0 0 0 50 4 1 6 0 3 0 0 1 0

OH 142 20 13 4 0 1 4 0 0 0 35 21 5 16 6 14 0 2 0 1

OK 30 1 2 0 0 0 0 0 0 0 10 13 0 2 0 2 0 0 0 0

OR 7 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 3 0

Table 5: Complaints Involving Abuse

FY 2015, cont.
49

State

Number of Abuse

Complaints 

Closed

Inappropriate/Excessive Involuntary

Failure to provide 

Mental health 

Treatment

Complaints Concerning

MedicationPhysical RestraintChemical 

Restraint

Mechanical 

Restraint

SeclusionMedicationInvoluntary Electroconvulsive 

Therapy

Aversive 

Behavioral 

TherapySterilizationFailure to provide Medical TreatmentPhysical Assaults Resulting in Serious Injury Physical Assault -Non-serious Injuries Sexual 

Assault

Staff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

PA 132 1 16 0 0 0 1 0 0 0 2 4 38 7 6 47 4 6 0 0

PR 6 0 0 0 0 0 0 0 0 0 5 0 0 0 0 1 0 0 0 0

RI 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

SC 114 0 0 11 0 0 0 0 0 0 97 1 0 2 1 0 0 1 0 1

SD 9 1 1 0 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 0

TN 33 8 1 0 0 0 0 0 0 0 13 2 0 4 0 3 0 2 0 0

TX 106 13 10 4 10 4 19 0 0 0 4 4 5 12 6 6 4 5 0 0

UT 53 3 4 0 0 5 0 0 0 0 30 3 1 0 1 5 0 0 1 0

VA 51 3 9 0 4 1 1 0 0 0 9 9 2 2 3 0 8 0 0 0

VI 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0

VT 45 3 8 3 0 1 0 0 0 0 20 3 0 3 1 2 0 0 0 1

WA 96 7 2 0 2 2 2 0 0 0 38 18 0 7 6 11 0 1 0 0

WI 18 0 3 0 0 0 0 0 0 0 12 1 0 0 1 0 0 0 1 0

WV 14 2 2 0 0 0 1 0 0 0 2 4 0 0 1 1 0 1 0 0

WY 23 0 2 0 0 1 1 0 0 0 13 4 0 1 0 1 0 0 0 0

Total 2,203 166 195 39 39 52 84 4 0 0 716 199 80 158 100 162 38 85 72 14

Percentages 100% 7.5% 8.9% 1.8% 1.8% 2.4% 3.8% 0.2% 0% 0% 33% 9% 3.6% 7.2% 4.5% 7.4% 1.7% 3.9% 3.3% 0.6%

Table 5: Complaints Involving Abuse

FY 2016
50

States

Number of Abuse 

Complaints 

Closed

Inappropriate/Excessive Involuntary

Failure to provide 

Mental 

Health 

Treatment

Complaints Concerning

MedicationPhysical RestraintChemical restraintMechanical restraintSeclusionMedicationInvoluntary Electroconvulsive 

Therapy

Aversive 

Behavioral 

TherapySterilizationFailure to provide Mental TreatmentPhysical Assaults Resulting in Serious Injury Physical Assault -Non-serious Injuries Sexual 

Assault

Staff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

AK 14 3 0 0 0 0 0 0 0 0 7 0 0 0 3 0 0 0 0 1

AL 49 0 6 0 1 0 0 0 0 0 8 4 12 6 0 8 0 3 1 0

AR 17 0 3 0 0 0 1 0 0 0 8 0 1 2 1 1 0 0 0 0

AS 7 1 0 0 0 0 0 0 0 0 3 0 0 0 1 2 0 0 0 0

AZ 15 1 3 0 0 0 2 0 0 0 5 0 0 1 1 2 0 0 0 0

CA 105 3 0 7 0 7 1 1 0 0 10 2 2 10 8 6 7 3 38 0

CO 14 1 2 0 0 2 0 0 0 0 4 1 0 2 1 0 0 0 1 0

CT 60 1 1 0 1 0 32 0 0 0 21 0 1 0 0 3 0 0 0 0

DC 22 2 3 1 1 0 1 0 0 0 6 0 0 2 1 0 0 4 1 0

DE 11 0 1 0 0 0 1 0 0 0 2 3 0 0 0 0 0 4 0 0

FL 51 4 4 0 0 0 1 0 0 0 4 6 2 13 4 4 0 4 5 0

GA 39 6 0 1 0 0 3 0 0 0 5 2 0 3 3 2 0 0 14 0

GU 4 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0

HI 5 0 1 0 0 0 0 0 0 0 2 0 1 0 0 0 0 1 0 0

IA 18 0 6 0 0 2 0 0 0 0 6 0 1 0 0 0 0 2 0 1

ID 27 4 6 3 0 1 6 0 0 0 0 0 0 3 1 0 0 2 1 0

IL 38 5 3 0 0 2 3 0 0 0 9 7 0 1 0 2 0 6 0 0

IN 43 0 6 0 0 0 0 0 0 0 15 2 0 14 3 2 0 1 0 0

KS 30 5 1 0 0 0 1 0 0 0 7 3 0 3 2 2 0 6 0 0

KY 13 1 2 0 0 0 0 0 0 0 2 1 0 1 0 0 0 0 6 0

LA 9 0 0 0 0 0 1 0 0 0 6 2 0 0 0 0 0 0 0 0

Table 5: Complaints Involving Abuse

FY 2016, cont.
51

States

Number of Abuse 

Complaints 

Closed

Inappropriate/Excessive Involuntary

Failure to provide Mental Health Treatment

Complaints Concerning

MedicationPhysical RestraintChemical restraintMechanical restraintSeclusionMedicationInvoluntary Electroconvulsive TherapyAversive 

Behavioral 

TherapySterilizationFailure to provide Mental TreatmentPhysical Assaults Resulting in Serious Injury Physical Assault -Non-serious Injuries Sexual 

Assault

Staff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

MA 19 1 0 0 0 0 0 0 0 0 12 2 0 0 0 2 0 2 0 0

MD 33 2 4 0 0 0 1 0 0 0 2 0 2 6 12 2 0 0 2 0

ME 66 1 7 2 1 11 0 0 0 0 38 5 0 0 1 0 0 0 0 0

MI 11 0 3 0 0 0 0 0 0 0 1 0 0 2 1 2 0 0 2 0

MN 29 1 0 0 1 1 1 0 0 0 15 7 0 0 0 0 2 1 0 0

MO 65 9 4 0 0 0 5 0 0 0 18 22 1 0 0 6 0 0 0 0

MP 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0

MS 11 0 0 0 0 0 0 0 0 0 3 0 0 1 0 5 1 0 1 0

MT 99 0 4 0 0 1 0 0 0 0 51 11 0 6 8 4 0 1 0 13

NA 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0

NC 57 0 2 0 0 0 1 0 1 0 44 2 3 1 1 1 1 0 0 0

ND 68 0 10 1 1 0 10 0 0 0 12 1 0 1 3 8 3 18 0 0

NE 21 2 1 0 3 0 0 0 0 0 2 1 0 5 4 0 0 2 1 0

NH 67 9 3 0 0 2 5 0 0 0 31 8 0 3 0 4 1 0 0 1

NJ 88 23 1 0 2 0 4 0 0 0 8 7 1 24 2 5 0 0 11 0

NM 37 5 2 1 0 2 2 0 0 0 1 1 0 12 8 2 0 1 0 0

NV 5 0 0 0 0 1 0 0 0 0 2 2 0 0 0 0 0 0 0 0

NY 79 1 2 0 0 2 4 0 0 0 47 4 1 8 4 5 0 1 0 0

OH 144 28 10 0 1 3 1 0 0 0 40 21 2 15 3 13 1 5 0 1

OK 10 0 1 0 0 1 0 0 0 0 3 1 0 0 3 0 1 0 0 0

OR 3 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0

Table 5: Complaints Involving Abuse

FY 2016, cont.
52

States

Number of Abuse 

Complaints 

Closed

Inappropriate/Excessive Involuntary

Failure to provide appropriate Mental Health Treatment

Complaints Concerning

MedicationPhysical RestraintChemical restraintMechanical restraintSeclusionMedicationInvoluntary Electroconvulsive TherapyAversive 

Behavioral 

Therapy

SterilizationFailure to provide Mental TreatmentPhysical Assaults Resulting in Serious Injury Physical Assault -Non-serious Injuries Sexual 

Assault

Staff Threats/Retaliation/AssaultsCoercionFinancial 

Exploitation

Suspicious 

Death

Other

PA 57 1 3 2 0 2 0 0 0 0 4 0 14 15 3 8 0 5 0 0

PR 10 3 0 0 0 0 0 0 0 0 2 0 0 1 0 3 1 0 0 0

RI 5 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0

SC 142 1 1 0 0 1 0 0 0 0 127 5 1 2 0 1 1 1 1 0

SD 10 4 1 0 0 0 0 0 0 0 4 0 0 0 0 1 0 0 0 0

TN 40 13 1 0 0 0 1 0 0 0 13 3 0 5 2 0 0 2 0 0

TX 79 15 10 1 2 6 15 0 0 0 6 2 9 4 4 3 0 2 0 0

UT 2 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0

VA 42 2 0 7 4 1 2 0 0 0 4 0 1 2 1 1 2 0 15 0

VI 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0

VT 46 2 4 4 6 3 0 0 0 0 16 1 3 0 0 3 2 0 1 1

WA 91 6 2 1 2 3 4 0 0 0 51 10 0 3 1 3 1 4 0 0

WI 11 0 0 0 0 5 1 0 0 0 5 0 0 0 0 0 0 0 0 0

WV 6 0 0 0 0 1 1 0 0 0 0 0 0 1 0 2 0 1 0 0

WY 16 2 1 0 0 0 0 0 0 0 6 5 0 0 1 0 0 0 1 0

Total 2,066 173 125 31 26 60 111 1 1 0 704 154 59 180 92 118 24 85 104 18

Percentages 100% 8.4% 6.1% 1.5% 1.3% 2.9% 5.4% 0.0% 0.0% 0.0% 34% 7.5% 2.9% 8.7% 4.5% 5.7% 1.2% 4.1% 5% 0.9%

Table 6a – 6b: Complaints Involving Neglect

FY 2015
53

States

Number of Neglect Complaints Closed

Failure to Provide for Appropriate

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnosis

Medical 

Diagnostic

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

AK 1 0 0 0 0 0 0 0 0 0 0 1

AL 93 7 0 43 5 3 18 1 9 1 0 6

AR 17 0 0 10 0 5 0 1 0 0 0 1

AS 13 1 3 1 1 1 2 2 2 0 0 0

AZ 28 1 0 2 15 4 5 0 0 1 0 0

CA 30 5 0 6 3 9 6 0 1 0 0 0

CO 3 0 0 2 0 0 0 1 0 0 0 0

CT 19 1 0 8 0 0 2 1 2 5 0 0

DC 48 1 0 16 1 1 16 0 0 10 3 0

DE 22 1 0 15 0 0 3 0 2 1 0 0

FL 54 8 1 18 1 4 12 2 7 0 1 0

GA 57 0 0 38 2 3 2 0 0 0 12 0

GU 7 4 0 1 0 0 0 0 0 2 0 0

HI 5 0 0 2 1 1 1 0 0 0 0 0

IA 5 0 1 2 0 0 2 0 0 0 0 0

ID 22 2 0 16 0 1 2 1 0 0 0 0

IL 68 8 0 34 6 4 7 2 3 2 2 0

IN 25 0 0 4 1 0 2 3 14 1 0 0

KS 53 2 2 19 4 7 7 4 6 0 2 0

KY 12 0 0 2 4 2 2 1 0 1 0 0

LA 17 2 0 12 0 2 0 0 0 0 1 0

Table 6a – 6b: Complaints Involving Neglect

FY 2015, cont.
54

States

Number of Neglect Complaints Closed

Failure to Provide for Appropriate

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnosis

Medical 

Diagnostic

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

MA 35 2 0 27 1 0 2 0 1 2 0 0

MD 17 1 0 12 1 1 0 0 0 0 0 2

ME 42 7 0 29 0 3 1 0 2 0 0 0

MI 24 0 0 3 0 6 15 0 0 0 0 0

MN 32 2 1 11 0 0 10 0 3 5 0 0

MO 52 3 1 10 3 9 10 3 3 10 0 0

MP 0 0 0 0 0 0 0 0 0 0 0 0

MS 17 1 0 4 2 0 7 0 1 0 2 0

MT 109 3 0 9 13 5 1 51 22 0 0 5

NA 4 1 0 0 0 0 2 1 0 0 0 0

NC 106 12 3 47 23 12 6 1 2 0 0 0

ND 46 0 0 15 0 4 15 1 4 7 0 0

NE 1 0 0 0 0 1 0 0 0 0 0 0

NH 73 24 3 25 7 4 3 0 2 3 1 1

NJ 40 1 0 31 0 1 4 2 1 0 0 0

NM 76 3 1 26 0 0 30 0 4 0 12 0

NV 5 0 0 5 0 0 0 0 0 0 0 0

NY 42 6 2 13 5 3 5 2 4 0 2 0

OH 177 8 2 102 7 12 26 1 11 5 2 1

OK 7 2 0 5 0 0 0 0 0 0 0 0

OR 13 0 0 9 1 3 0 0 0 0 0 0

Table 6a – 6b: Complaints Involving Neglect

FY 2015, cont.
55

States

Number of Neglect Complaints Closed

Failure to Provide for Appropriate

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnosis

Medical 

Diagnostic

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

PA 58 1 2 15 11 5 11 3 5 1 4 0

PR 13 10 0 1 0 0 2 0 0 0 0 0

RI 13 0 0 9 0 1 0 0 2 0 0 1

SC 11 2 0 8 0 0 0 0 0 1 0 0

SD 56 2 0 53 0 0 1 0 0 0 0 0

TN 15 0 0 3 0 4 4 1 2 1 0 0

TX 347 5 0 105 105 64 49 1 10 1 2 5

UT 16 1 0 5 0 0 0 3 4 3 0 0

VA 65 1 0 48 0 2 4 2 3 2 3 0

VI 0 0 0 0 0 0 0 0 0 0 0 0

VT 20 4 0 11 0 2 1 1 0 1 0 0

WA 95 11 1 40 10 6 8 3 5 6 1 4

WI 29 0 0 13 11 4 0 0 0 0 1 0

WV 26 0 1 15 2 3 3 0 1 1 0 0

WY 14 2 0 3 0 0 7 2 0 0 0 0

Total 2,295 158 24 963 246 202 316 97 138 73 51 27

Percentages 100% 6.9% 1% 42% 11% 8.8% 14% 4.2% 6% 3.2% 2.2% 1.2%

Table 6a: Complaints Involving Neglect

FY 2016
56

States

Number of Neglect Complaints Closed

Failure to Provide for Appropriate

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnostic

Medical 

Diagnosis

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

AK 1 0 0 1 0 0 0 0 0 0 0 0

AL 82 3 4 37 3 8 3 1 9 1 0 13

AR 20 2 0 12 2 3 0 1 0 0 0 0

AS 13 3 3 0 0 3 2 1 0 1 0 0

AZ 11 3 2 3 1 0 1 0 0 0 0 1

CA 49 5 1 5 19 10 8 0 1 0 0 0

CO 6 0 0 2 1 1 1 0 1 0 0 0

CT 23 2 0 12 1 1 2 0 1 3 1 0

DC 42 1 0 15 0 2 16 0 1 6 1 0

DE 9 0 0 6 0 1 1 0 0 0 0 1

FL 40 5 0 16 2 6 8 1 1 0 1 0

GA 70 1 0 40 2 6 2 0 0 0 19 0

GU 7 4 0 0 0 0 0 1 1 1 0 0

HI 3 0 0 1 0 2 0 0 0 0 0 0

IA 3 0 0 0 0 1 1 0 0 0 0 1

ID 82 6 0 62 1 10 0 0 1 1 0 1

IL 64 6 0 39 2 4 4 1 3 1 4 0

IN 10 0 0 3 0 0 2 3 1 0 1 0

KS 43 1 0 19 0 9 11 1 1 1 0 0

KY 13 0 0 3 0 0 1 0 0 9 0 0

LA 13 0 1 6 1 2 2 0 0 1 0 0

Table 6a: Complaints Involving Neglect

FY 2016, cont.
57

States

Number of Neglect Complaints Closed

Failure to Provide for Appropriate

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnostic

Medical 

Diagnosis

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

MA 26 5 0 21 0 0 0 0 0 0 0 0

MD 25 1 0 19 0 3 1 0 0 0 1 0

ME 37 4 0 29 0 0 0 0 4 0 0 0

MI 13 0 0 3 1 2 2 0 2 2 1 0

MN 33 2 1 14 0 0 11 0 1 4 0 0

MO 104 0 0 25 7 10 16 1 5 40 0 0

MP 0 0 0 0 0 0 0 0 0 0 0 0

MS 7 0 0 2 1 1 0 0 2 0 1 0

MT 81 4 0 4 7 10 6 34 11 3 0 2

Subtotal 930 58 12 399 51 95 101 45 46 74 30 19

Table 6b: Complaints Involving Neglect

FY 2016

States N

umber

Failure to Provide for Appropriate
58

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnostic

Medical 

Diagnosis

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

NA 1 0 0 0 0 0 1 0 0 0 0 0

NC 52 3 0 40 2 3 0 1 0 3 0 0

ND 43 3 0 17 2 4 9 0 1 6 0 1

NE 8 0 0 4 0 0 2 1 1 0 0 0

NH 68 22 1 21 4 1 4 0 4 2 7 2

NJ 41 0 0 31 0 1 6 1 2 0 0 0

NM 65 3 0 25 1 14 11 0 9 0 2 0

NV 9 1 0 5 0 0 0 0 0 2 0 1

NY 28 2 1 13 2 3 3 0 4 0 0 0

OH 142 11 2 53 7 16 35 0 14 1 1 2

OK 3 0 0 3 0 0 0 0 0 0 0 0

OR 2 0 0 2 0 0 0 0 0 0 0 0

PA 32 4 0 11 5 6 3 0 2 1 0 0

PR 24 10 3 4 2 1 1 0 0 0 3 0

RI 23 0 0 9 1 7 2 0 2 0 0 2

SC 15 1 0 6 1 0 0 2 1 1 0 3

SD 49 2 0 43 1 3 0 0 0 0 0 0

TN 8 0 0 4 0 1 2 0 1 0 0 0

TX 356 5 0 102 138 55 25 0 25 1 3 2

UT 5 1 0 0 0 0 0 1 2 1 0 0

VA 40 0 0 29 1 1 1 3 3 0 2 0

Table 6b: Complaints Involving Neglect

FY 2016, cont.

States

Number of Neglect

Failure to Provide for Appropriate
59

Admission to 

Residential

Care or 

Treatment Facility

Transportation to/from Treatment FacilityDischarge PlanningMental 

Health 

Diagnosis

Medical 

Diagnostic

Personal 

Care 

Environmental SafetyPersonal SafetyNo Written 

Treatment Plans

Rehabilitation/

Vocational

ProgrammingOther

VI 0 0 0 0 0 0 0 0 0 0 0 0

VT 31 3 1 12 1 5 1 5 1 1 1 0

WA 48 5 0 19 9 5 3 1 3 0 1 2

WI 25 0 0 7 8 5 0 1 0 4 0 0

WV 17 0 0 14 0 2 1 0 0 0 0 0

WY 9 0 0 6 0 0 2 1 0 0 0 0

Subtotal 6b 1,144 76 8 480 185 133 112 17 75 23 20 15

Subtotal 6a 937 58 12 401 52 96 102 45 46 74 32 19

Total 6a &6b 2,081 134 20 881 237 229 214 62 121 97 52 34

Table 7a – 7b – 7c: Complaints Involving Rights Violations

FY 2015
60

States

Number of Rights Complaints Closed

Discrimination in: Denial of: Failure to Provide:

Problem with Advance

Directives

Denial of Parental/Family 

Rights

DiscriminationEmploymentReimbursement andOther 

Entitlement

Guardianship/

Conservator 

ProblemsRights Protec Legal AssistancePrivacyRecreational Opportunities VisitorsAccess to RecordsConfidentialityInformed ConsentEducation 

AK 29 3 1 20 1 0 0 0 0 0 0 0 2 0 0 2

AL 70 1 1 3 5 2 1 5 0 1 1 2 38 0 1 9

AR 27 6 1 0 4 2 2 0 0 1 0 0 2 0 0 9

AS 23 1 2 4 1 1 4 0 3 0 0 0 4 1 2 0

AZ 41 2 0 3 0 15 3 2 0 7 3 0 6 0 0 0

CA 796 175 67 238 20 96 4 3 1 5 5 1 39 1 5 136

CO 9 3 1 0 0 1 4 0 0 0 0 0 0 0 0 0

CT 41 3 2 0 1 3 1 1 0 0 0 0 18 0 1 11

DC 22 3 0 4 7 1 0 1 0 0 2 2 0 2 0 0

DE 49 5 1 24 3 1 0 0 0 1 0 0 8 0 2 4

FL 75 4 1 5 1 35 1 4 2 3 2 6 5 1 0 5

GA 19 4 0 1 4 5 0 0 0 0 0 0 2 0 3 0

GU 24 1 1 3 4 4 1 1 0 1 0 0 6 2 0 0

HI 191 2 0 19 17 0 0 4 0 0 0 0 102 32 0 15

IA 49 4 3 2 8 12 2 4 0 0 0 0 12 0 0 2

ID 57 1 0 37 3 7 4 0 0 1 1 1 0 0 1 1

IL 248 7 50 4 19 0 4 10 0 3 0 0 113 0 0 38

IN 42 0 0 6 0 5 1 13 1 0 0 2 14 0 0 0

Table 7a – 7b – 7c: Complaints Involving Rights Violations

FY 2015, cont.

States

Number of Right

Discrimination in:

Denial of: Failure to Provide:

Problem with Denial of ParenOther 
61

DiscriminationEmploymentReimbursement andEntitlementGuardianship/

Conservator 

ProblemsRights Protec Legal AssistancePrivacyRecreational Opportunities VisitorsAccess to RecordsConfidentialityInformed ConsentEducation 

KS 439 85 38 58 33 7 20 3 1 3 13 31 54 1 8 84

KY 38 4 2 4 3 3 0 8 3 0 0 0 5 0 2 4

LA 33 2 1 1 2 2 0 2 0 2 0 1 20 0 0 0

MA 64 10 25 2 4 12 1 2 0 0 0 0 2 0 2 4

MD 48 40 0 0 0 0 0 0 0 0 1 2 0 0 1 4

ME 101 29 9 4 8 2 1 2 0 1 0 1 44 0 0 0

MI 21 2 0 2 2 5 5 0 0 0 0 1 4 0 0 0

MN 68 8 1 5 8 2 2 8 0 0 1 0 22 0 1 10

MO 104 6 2 17 44 3 8 6 2 9 0 1 1 2 3 0

MP 5 0 1 1 0 0 0 1 0 0 0 0 2 0 0 0

MS 49 1 0 5 0 3 2 1 0 0 1 0 36 0 0 0

MT 63 2 4 0 3 3 7 0 0 1 0 1 10 0 2 30

NA 42 4 0 24 0 2 0 0 0 0 0 1 10 0 0 1

NC 45 6 3 7 13 12 0 2 0 0 0 0 0 1 0 1

ND 62 0 3 5 7 1 0 0 0 0 0 0 46 0 0 0

NE 6 0 0 0 5 0 0 0 0 0 0 0 0 0 0 1

NH 214 48 28 48 34 4 3 8 1 3 3 0 22 0 5 7

NJ 62 3 4 7 0 2 2 3 0 1 1 0 28 1 1 9

NM 25 0 0 0 2 14 4 0 0 1 1 2 0 0 1 0

NV 22 0 0 1 0 7 0 0 0 1 0 0 0 0 0 13

Table 7a – 7b – 7c: Complaints Involving Rights Violations

FY 2015, cont.
62

States

Number of Rights Complaints Closed

Discrimination in: Denial of: Failure to Provide:

Problem with Advance

Directives

Denial of Parental/Family 

Rights

DiscriminationEmploymentReimbursement andEntitlementGuardianship/Other 

Conservator

ProblemsRights Protec Legal AssistancePrivacyRecreational OpportunitiesVisitorsAccess to RecordsConfidentialityInformed ConsentEducation

NY 201 57 41 13 5 4 2 5 0 4 1 3 32 0 0 34

OH 372 47 48 30 48 23 19 30 6 10 3 39 67 0 2 0

OK 380 43 16 125 8 58 1 1 1 5 1 2 102 0 15 2

OR 43 1 0 0 5 2 0 0 3 1 0 0 2 2 1 26

PA 427 63 17 61 20 181 4 0 3 9 1 2 40 4 22 0

PR 69 3 7 5 0 27 0 1 0 1 0 0 25 0 0 0

RI 70 24 0 2 4 3 0 0 0 0 0 0 19 0 0 18

SC 38 10 0 1 2 0 0 0 1 1 0 0 17 0 0 6

SD 59 0 1 15 0 0 1 0 0 0 0 0 38 0 0 4

TN 68 4 2 3 0 16 1 1 0 1 0 0 40 0 0 0

TX 299 11 12 13 19 12 20 50 0 8 12 11 93 1 6 31

UT 110 0 8 19 6 68 2 0 0 0 0 0 1 1 5 0

VA 22 0 0 0 2 0 0 2 0 2 0 0 4 12 0 0

VI 5 1 0 0 1 1 1 0 0 0 0 0 1 0 0 0

VT 21 2 0 0 0 0 2 0 0 0 0 0 0 12 0 5

WA 243 45 42 65 6 40 5 6 3 4 6 1 1 1 9 9

WI 35 4 3 4 1 8 0 0 1 0 1 1 12 0 0 0

WV 22 2 0 0 1 4 3 2 0 1 0 0 5 0 1 3

WY 11 1 0 1 2 4 0 1 0 0 1 1 0 0 0 0

Total 5,818 793 449 921 396 725 148 193 32 92 61 115 1,176 77 102 538

Percentages 100% 14% 7.7% 16% 6.8% 12% 2.5% 3.3% 0.6% 1.6% 1% 2% 20% 1.3% 1.8% 9.2%

Table 7a: Complaints Involving Rights Violations

FY 2016

States

Number of Rig

Discrimination in: Denial of:
63

HousingEmploymentReimbursement and EntitlementGuardianship/Conservator problemsRights Protec Legal AssistancePrivacyRecreational

Opportunities 

AK 14 2 0 10 0 0 0 0

AL 50 6 1 2 5 0 1 1

AR 76 1 3 2 1 1 0 0

AS 15 1 2 1 0 4 2 0

AZ 14 0 1 0 2 2 0 1

CA 703 170 59 99 4 10 2 3

CO 10 5 0 0 0 2 2 0

CT 32 4 1 1 0 1 0 0

DC 28 2 1 3 5 0 0 1

DE 44 8 4 20 2 0 0 0

FL 59 1 2 7 0 33 1 3

GA 20 2 3 0 8 1 0 0

GU 13 0 6 1 0 1 0 0

HI 219 2 0 18 15 0 0 0

IA 31 3 4 2 6 0 0 0

ID 123 8 0 62 6 15 3 9

IL 283 4 25 4 30 0 7 4

IN 42 6 2 2 0 0 0 5

KS 331 65 26 14 17 11 3 0

KY 49 3 0 2 0 11 0 17

LA 48 5 1 6 3 2 2 0

Table 7a: Complaints Involving Rights Violations

FY 2016, cont.

States

Number of Righ

Discrimination in: Denial of:
64

HousingEmploymentReimbursement and EntitlementGuardianship/Conservator problemsRights Protec Legal AssistancePrivacyRecreational

Opportunities 

MA 62 22 23 1 1 4 1 2

MD 87 62 0 1 1 3 1 2

ME 101 22 11 2 8 4 4 6

MI 19 3 0 1 0 1 3 1

MN 84 14 1 8 2 0 1 11

MO 108 3 0 41 32 5 9 8

MP 8 1 0 3 0 0 0 0

MS 33 1 0 0 0 0 2 1

MT 69 0 8 6 3 3 0 0

NA 20 1 0 3 0 0 0 0

NC 59 1 1 8 8 32 2 1

ND 87 3 3 7 10 9 0 0

NE 5 0 0 1 3 0 0 1

NH 215 58 20 44 25 4 2 4

NJ 79 6 12 8 0 1 2 5

NM 42 0 1 2 6 18 2 0

NV 27 0 0 0 0 4 2 1

NY 245 70 39 18 6 8 1 2

OH 397 64 57 18 42 49 12 17

OK 34 2 0 5 0 1 0 0

Table 7a: Complaints Involving Rights Violations

FY 2016, cont.

States

Number of Rig

Discrimination in: Denial of:
65

HousingEmploymentReimbursement and EntitlementGuardianship/Conservator problemsRights Protec Legal AssistancePrivacyRecreational

Opportunities 

OR 33 2 0 0 5 0 0 0

PA 230 19 26 24 2 95 1 2

PR 54 5 7 8 0 19 0 0

RI 90 30 2 4 2 2 0 0

SC 23 4 1 1 0 0 0 0

SD 51 0 0 6 0 0 0 1

TN 44 8 0 0 1 9 0 3

TX 251 9 13 13 19 28 31 35

UT 80 0 19 13 7 35 0 0

VA 15 1 0 0 2 4 1 0

VI 9 2 0 3 4 0 0 0

VT 33 1 2 2 0 3 5 3

WA 212 20 21 37 4 13 10 7

WI 55 8 13 1 0 11 0 0

WV 27 4 0 4 0 0 2 3

WY 4 0 0 0 1 1 1 0

Total 5,196 744 421 549 298 460 118 160

Percentages 100% 14% 8.1% 11% 5.7% 8.9% 2.3% 3.1%

Table 7b: Complaints Involving Rights Violations

FY 2016

States

Number of Rig

Discrimination in: Failure to Provide:

Problem witDenial of ParentaOther 
66

VisitorsAccess to RecordsConfidentialityInformed ConsentEducation 

AK 14 0 0 0 0 1 1 0 0

AL 50 0 0 3 0 26 2 1 2

AR 76 0 1 0 0 49 0 1 17

AS 15 2 0 0 1 1 2 0 0

AZ 14 1 1 4 0 0 0 2 0

CA 703 2 10 10 5 40 0 3 286

CO 10 1 0 0 0 0 0 0 0

CT 32 1 0 0 0 12 0 0 12

DC 28 0 1 2 3 1 4 1 4

DE 44 0 0 0 0 4 3 0 3

FL 59 0 4 0 2 6 0 0 0

GA 20 0 0 0 4 2 0 0 0

GU 13 0 0 0 0 3 2 0 0

HI 219 0 1 0 0 101 74 0 8

IA 31 1 1 0 0 9 0 0 5

ID 123 0 3 0 1 7 0 3 6

IL 283 0 2 2 1 169 2 0 33

IN 42 4 1 0 1 18 0 0 3

KS 331 1 1 6 2 44 0 10 131

KY 49 6 0 0 0 6 2 2 0

LA 48 0 0 0 3 25 0 1 0

Table 7b: Complaints Involving Rights Violations

FY 2016, cont.

States N

umbe

Discrimination in: Failure to Provide:

Problem Denial of PaOther 
67

VisitorsAccess to RecordsConfidentialityInformed ConsentEducation 

MA 62 0 0 1 0 0 0 1 6

MD 87 0 1 0 1 0 0 1 14

ME 101 1 0 0 0 37 0 0 6

MI 19 0 0 0 1 7 0 0 2

MN 84 1 1 1 0 33 1 1 9

MO 108 1 4 0 3 1 1 0 0

MP 8 0 0 0 0 2 0 0 2

MS 33 0 0 0 0 28 0 1 0

MT 69 0 1 0 2 17 0 3 26

NA 20 0 0 0 1 14 0 0 1

NC 59 0 4 0 0 1 1 0 0

ND 87 0 0 0 0 55 0 0 0

NE 5 0 0 0 0 0 0 0 0

NH 215 1 1 4 0 34 1 8 9

NJ 79 1 0 1 0 36 1 0 6

NM 42 0 1 8 0 3 1 0 0

NV 27 0 0 1 0 0 0 0 19

NY 245 0 3 0 0 40 0 2 56

OH 397 4 7 10 37 74 0 6 0

OK 34 0 0 1 0 25 0 0 0

OR 33 0 0 0 0 4 0 0 22

Table 7b: Complaints Involving Rights Violations

FY 2016, cont.

States

Number of Rig

Discrimination in: Failure to Provide:

Problem witDenial of ParentaOther 
68

VisitorsAccess to RecordsConfidentialityInformed ConsentEducation 

PA 230 0 1 4 1 43 3 9 0

PR 54 0 0 0 0 14 0 0 1

RI 90 0 0 0 2 22 0 0 26

SC 23 0 1 0 0 10 0 0 6

SD 51 0 0 0 1 42 0 0 1

TN 44 0 0 0 0 23 0 0 0

TX 251 3 14 8 16 31 1 3 27

UT 80 0 1 0 0 4 0 1 0

VA 15 0 1 0 2 2 1 1 0

VI 9 0 0 0 0 0 0 0 0

VT 33 0 2 1 2 1 10 0 1

WA 212 1 3 2 3 1 1 6 83

WI 55 0 0 0 0 22 0 0 0

WV 27 1 2 0 0 9 0 0 2

WY 4 0 1 0 0 0 0 0 0

Total 5,196 33 75 69 95 1,159 114 67 835

Percentages 100% 0.6% 1.4% 1.3% 1.8% 22% 2.2% 1.3% 16%

Table 7c: Death Investigations

FY 2015
69

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Non-Seclusion/Restraint

AK 4 0 0 4 0 0 0 0

AL 2 0 0 2 2 0 0 2

AR 0 0 0 0 1 0 0 1

AS 1 0 0 1 1 0 0 1

AZ 1 0 0 1 1 0 0 1

CA 34 33 0 1 8 0 1 7

CO 1 0 0 1 1 0 0 1

CT 5 5 0 0 5 0 0 5

DC 4 3 0 1 2 0 0 2

DE 12 11 0 1 12 0 0 12

FL 7 2 0 5 7 0 0 7

GA 17 0 0 17 17 0 0 17

GU 1 1 0 0 1 0 0 1

HI 0 0 0 0 0 0 0 0

IA 8 4 0 4 8 0 0 8

ID 1 0 0 1 1 0 0 1

IL 20 18 0 2 16 0 0 16

IN 8 0 1 7 2 0 0 2

KS 0 0 0 0 0 0 0 0

KY 15 9 0 6 15 3 1 11

LA 0 0 0 0 0 0 0 0

MA 295 295 0 0 1 0 0 1

MD 6 6 0 0 6 0 0 6

ME 1 0 0 1 0 0 0 0

MI 17 9 0 8 17 0 0 17

Table 7c: Death Investigations

FY 2015, cont.
70

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Non-Seclusion/Restraint

MN 1 0 0 1 1 0 0 1

MO 442 439 0 3 10 0 0 10

MP 0 0 0 0 0 0 0 0

MS 1 0 0 1 1 0 0 1

MT 1 1 0 0 1 1 0 0

NA 0 0 0 0 0 0 0 0

NC 13 10 0 3 2 1 1 0

ND 7 0 0 7 5 0 1 4

NE 1 0 0 1 1 0 0 1

NH 0 0 0 0 0 0 0 0

NJ 19 18 0 1 19 1 1 17

NM 0 0 0 0 1 0 0 1

NV 2 0 0 2 2 0 1 1

NY 8 0 0 8 8 0 0 8

OH 157 155 0 2 157 0 1 156

MN 0 0 0 0 0 0 0 0

OK 0 0 0 0 0 0 0 n/a

OR 5 5 0 0 5 0 0 5

PA 34 34 0 0 0 0 0 0

PR 0 0 0 0 0 0 0 0

RI 0 0 0 0 0 0 0 0

SC 1 0 0 0 1 0 0 1

SD 0 0 0 0 0 0 0 0

TN 0 0 0 0 0 0 0 0

Table 7c: Death Investigations

FY 2015, cont.
71

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Non-Seclusion/Restraint

TX 9 0 0 9 9 0 4 5

UT 13 12 0 1 1 1 0 0

VA 55 54 0 1 7 0 0 7

VI 0 0 0 0 0 0 0 0

VT 4 0 0 4 4 2 0 2

WA 6 0 0 6 6 0 0 6

WI 11 6 0 5 11 0 1 10

WV 0 0 0 0 0 0 0 0

WY 1 1 0 0 1 0 0 1

Total 1,251 937 1 106 203 9 10 184

Table 7c: Death Investigations

FY 2016
72

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Non-Seclusion Restraint

AK 7 0 0 7 7 0 0 7

AL 2 0 0 2 2 0 0 2

AR 1 0 0 1 1 0 0 1

AS 0 0 0 0 0 0 0 0

AZ 0 0 0 0 1 0 0 1

CA 39 39 0 0 44 0 0 44

CO 2 0 0 2 2 0 1 1

CT 6 6 0 0 0 0 0 0

DC 6 5 0 1 2 0 0 2

DE 20 19 0 1 20 0 1 19

FL 5 1 0 4 5 0 0 5

GA 14 0 0 14 14 0 0 14

GU 1 1 0 0 1 0 0 1

HI 0 0 0 0 0 0 0 0

IA 7 0 0 7 7 0 0 7

ID 1 0 0 1 1 0 0 1

IL 17 15 0 2 15 0 0 15

IN 1 0 0 1 1 0 0 1

KS 0 0 0 0 0 0 0 0

KY 6 3 0 3 6 3 0 3

LA 0 0 0 0 0 0 0 0

MA 247 245 0 2 4 1 0 3

MD 64 8 0 56 2 0 0 2

ME 1 0 0 1 1 0 0 1

Table 7c: Death Investigations

FY 2016, cont.
73

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Not Seclusion Restraint

MI 7 1 0 6 7 0 1 6

MN 2 0 0 2 2 0 0 2

MO 364 361 0 3 5 0 0 5

MP 0 0 0 0 0 0 0 0

MS 1 0 0 1 1 0 0 1

MT 6 0 0 6 6 0 0 6

NA 0 0 0 0 0 0 0 0

NC 21 21 0 0 1 0 0 1

ND 4 0 0 4 4 0 0 4

NE 0 0 0 0 0 0 0 0

NH 0 0 0 0 0 0 0 0

NJ 19 18 0 1 19 0 0 19

NM 0 0 0 0 0 0 0 0

NV 1 0 0 1 1 0 0 1

NY 13 0 0 13 13 0 0 13

OH 187 186 0 1 187 0 1 186

OK 0 0 0 0 0 0 0 0

OR 3 2 0 1 3 0 0 3

PA 41 41 0 0 0 0 0 0

PR 2 0 0 2 2 0 0 2

RI 0 0 0 0 0 0 0 0

SC 0 0 0 0 1 0 0 1

SD 0 0 0 0 0 0 0 0

TN 0 0 0 0 0 0 0 0

TX 9 0 0 9 9 0 0 9

Table 7c: Death Investigations

FY 2016, cont.
74

States

Deaths Reported by Death Investigations Conducted

Total Number of 

Deaths Reported States Number of Deaths Medicaid Other Total Number of Death Investigations

Number of 

Deaths Seclusion

Number of 

Deaths Restraint

Number of Deaths 

Not Seclusion Restraint

UT 0 0 0 0 0 0 0 0

VA 42 42 0 0 11 0 0 11

VI 0 0 0 0 0 0 0 0

VT 8 2 0 6 8 0 0 8

WA 1 0 1 0 2 0 0 2

WI 13 7 0 6 13 0 1 12

WV 0 0 0 0 0 0 0 0

WY 2 2 0 0 2 0 0 2

Total 1,193 1,025 1 167 433 4 5 424

Percentages 100% 86% 0.1% 14% 36% 0.3% 0.4% 36%

Table 8a – Analysis of Alleged Abuse

FY 2015
75

States Total Complaints Closed Total Abuse Complaints Abuse complaints 

withdrawn, no merit, etc.

Favorably

Resolved

Not Favorably 

Resolved

Percentage Favorably

Resolved

AK 32 2 1 1 0 100%

AL 211 48 17 27 4 87%

AR 71 27 20 6 1 86%

AS 40 4 1 2 1 67%

AZ 82 13 5 5 3 63%

CA 921 95 6 89 0 100%

CO 23 11 1 10 0 100%

CT 104 44 4 34 6 85%

DC 105 35 13 19 3 86%

DE 83 12 1 11 0 100%

FL 223 94 42 43 9 83%

GA 112 36 1 35 0 100%

GU 33 2 1 1 0 100%

HI 201 5 4 1 0 100%

IA 74 20 9 10 1 91%

ID 83 4 2 1 1 50%

IL 289 25 2 15 8 65%

IN 133 65 46 9 10 47%

KA 520 28 13 13 2 87%

KY 84 30 1 29 0 100%

LA 59 8 1 7 0 100%

MA 128 29 3 26 0 100%

MD 104 37 5 30 2 94%

ME 234 72 24 33 15 69%

MI 57 12 3 8 1 89%

Table 8a – Analysis of Alleged Abuse

FY 2015, cont.
76

States Total Complaints Closed Total Abuse Complaints Abuse complaints 

withdrawn, no merit, etc.

Favorably

Resolved

Not Favorably 

Resolved

Percentage Favorably

Resolved

MN 123 23 6 15 2 88%

MO 334 107 7 98 2 98%

MP 7 2 1 1 0 100%

MS 79 13 2 10 1 91%

MT 278 104 69 27 8 77%

NA 46 2 0 1 1 50%

NC 192 42 4 38 0 100%

ND 109 37 4 32 1 97%

NE 33 25 17 4 4 50%

NH 353 64 1 56 7 89%

NJ 203 101 26 71 4 95%

NM 122 21 2 15 4 79%

NV 35 8 2 6 0 100%

NY 315 72 24 44 4 92%

OH 691 142 33 107 2 98%

MN 123 23 6 15 2 88%

OK 417 30 0 30 0 100%

OR 63 7 5 2 0 100%

PA 617 132 63 52 17 75%

PR 88 6 2 2 2 50%

RI 45 1 1 0 0 NA

SC 163 114 7 99 8 93%

SD 124 9 2 6 1 86%

TN 116 33 21 12 0 100%

TX 752 106 37 62 7 90%

Table 8a – Analysis of Alleged Abuse

FY 2015, cont.
77

States Total Complaints Closed Total Abuse Complaints Abuse complaints 

withdrawn, no merit, etc.

Favorably

Resolved

Not Favorably 

Resolved

Percentage Favorably

Resolved

UT 178 53 28 22 3 88%

VA 138 51 13 38 0 100%

VI 6 1 0 0 1 0%

VT 86 45 19 19 7 73%

WA 433 96 0 96 0 100%

WI 82 18 4 13 1 93%

WV 62 14 2 10 2 83%

WY 48 23 0 23 0 100%

Total 10,344 2,260 628 1,476 156 90%

Table 8a: Analysis of Alleged Abuse

FY 2016
78

States Total Complaints 

Closed Total Abuse Complaints Abuse complaints withdrawn, no merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

AK 29 14 12 2 0 100%

AL 181 49 29 11 9 55%

AR 113 17 9 7 1 88%

AS 43 3 1 2 0 100%

AZ 40 15 2 10 3 77%

CA 857 105 9 93 3 97%

CO 30 14 10 4 0 100%

CT 115 60 11 42 7 86%

DC 92 22 9 11 2 85%

DE 64 11 0 11 0 100%

FL 149 51 31 20 0 100%

GA 129 39 8 30 1 97%

GU 24 4 0 4 0 100%

HI 202 5 4 1 0 100%

IA 52 18 10 8 0 100%

ID 232 27 13 14 0 100%

IL 330 37 9 16 12 57%

IN 82 28 0 28 0 100%

KS 404 30 15 13 2 87%

KY 75 13 5 7 1 88%

LA 70 9 2 7 0 100%

MA 107 19 0 19 0 100%

MD 143 31 14 17 0 100%

ME 206 67 26 38 3 93%

MI 43 11 2 6 3 67%

Table 8a: Analysis of Alleged Abuse

FY 2016, cont.
79

States Total Complaints 

Closed Total Abuse Complaints Abuse complaints withdrawn, no merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

MN 144 29 8 16 5 76%

MO 303 76 5 70 1 99%

MP 10 2 1 1 0 100%

MS 52 11 1 1 9 10%

MT 249 99 32 44 23 66%

NA 23 2 0 2 0 100%

NC 168 57 8 49 0 100%

ND 125 47 3 43 1 98%

NE 34 21 17 3 1 75%

NH 350 67 8 58 1 98%

NJ 208 88 22 57 9 86%

NM 144 37 2 32 3 91%

NV 41 5 2 2 1 67%

NY 353 80 27 52 1 98%

OH 682 144 16 120 8 94%

OK 46 10 0 10 0 100%

OR 38 3 0 3 0 100%

PA 319 57 17 37 3 93%

PR 88 10 6 4 0 100%

RI 73 5 1 4 0 100%

SC 180 142 8 129 5 96%

SD 110 10 3 6 1 86%

TN 92 40 24 16 0 100%

TX 683 79 42 24 13 65%

UT 87 2 0 2 0 100%

Table 8a: Analysis of Alleged Abuse

FY 2016, cont.
80

States Total Complaints 

Closed Total Abuse Complaints Abuse complaints withdrawn, no merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

VA 97 42 9 32 1 97%

VI 8 1 0 1 0 100%

VT 111 46 23 18 5 78%

WA 351 91 1 90 0 100%

WI 91 11 1 7 3 70%

WV 50 6 2 4 0 100%

WY 29 16 0 16 0 100%

Total 9,151 2,035 520 1,374 141 90%

Table 8b: Analysis of Alleged Neglect

FY 2015
81

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

AK 32 1 0 1 0 100%

AL 211 93 20 71 2 97%

AR 71 17 7 6 4 60%

AS 40 13 3 8 2 80%

AZ 82 28 7 20 1 95%

CA 921 30 1 28 1 97%

CO 23 3 0 3 0 100%

CT 104 19 3 16 0 100%

DC 105 48 9 36 3 92%

DE 83 22 1 21 0 100%

FL 223 54 13 38 3 93%

GA 112 57 4 51 2 96%

GU 33 7 2 5 0 100%

HI 201 5 4 1 0 100%

IA 74 5 2 3 0 100%

ID 83 22 7 11 4 73%

IL 289 61 10 33 18 65%

IN 133 25 16 4 5 44%

KA 520 53 15 35 3 92%

KY 84 12 1 9 2 82%

LA 59 17 3 14 0 100%

MA 128 35 3 32 0 100%

MD 104 17 3 13 1 93%

ME 234 41 7 24 10 71%

Table 8b – Analysis of Alleged Neglect

FY 2015, cont.
82

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

MI 57 24 1 21 2 91%

MN 123 32 4 28 0 100%

MO 334 113 6 104 3 97%

MP 7 0 0 0 0 n/a

MS 79 17 2 12 3 80%

MT 278 110 30 73 7 91%

NA 46 3 0 3 0 100%

NC 192 105 8 97 0 100%

ND 109 30 0 30 0 100%

NE 33 1 0 1 0 100%

NH 353 75 1 71 3 96%

NJ 203 40 12 26 2 93%

NM 122 76 3 67 6 92%

NV 35 5 5 0 0 n/a

NY 315 42 13 27 2 93%

OH 691 177 17 156 4 98%

OK 417 7 0 7 0 100%

OR 63 13 3 6 4 60%

PA 617 58 10 44 4 92%

PR 88 13 1 11 1 92%

RI 45 11 3 7 1 88%

SC 163 11 0 11 0 100%

SD 124 56 3 52 1 98%

TN 116 15 7 8 0 100%

Table 8b – Analysis of Alleged Neglect

FY 2015, cont.
83

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

TX 752 347 147 174 26 87%

UT 178 16 2 13 1 93%

VA 138 65 1 64 0 100%

VI 6 0 0 0 0 0%

VT 86 20 8 8 4 67%

WA 433 95 0 95 0 100%

WI 82 29 8 21 0 100%

WV 62 26 3 18 5 78%

WY 48 14 0 14 0 100%

Total 10,344 2,331 439 1,752 140 89%

Table 8b: Analysis of Alleged Neglect

FY 2016
84

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

AK 29 1 1 0 0 NA

AL 181 82 19 51 12 81%

AR 113 20 11 8 1 89%

AS 43 13 0 13 0 100%

AZ 40 11 0 10 1 91%

CA 857 49 3 46 0 100%

CO 30 6 3 2 1 67%

CT 115 23 3 20 0 100%

DC 92 42 10 27 5 84%

DE 64 9 1 8 0 100%

FL 149 39 17 21 1 95%

GA 129 70 10 58 2 97%

GU 24 7 0 7 0 100%

HI 202 3 2 1 0 100%

IA 52 3 1 2 0 100%

ID 232 82 16 64 2 97%

IL 330 59 15 25 19 57%

IN 82 10 0 10 0 100%

KS 404 43 20 21 2 91%

KY 75 13 3 10 0 100%

LA 70 13 2 10 1 91%

MA 107 26 1 25 0 100%

MD 143 25 5 20 0 100%

ME 206 38 8 27 3 90%

Table 8b: Analysis of Alleged Neglect

FY 2016, cont.
85

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

MI 43 13 3 8 2 80%

MN 144 31 3 23 5 82%

MO 303 100 8 92 0 100%

MP 10 0 0 0 0 n/a

MS 52 8 0 7 1 88%

MT 249 81 34 42 5 89%

NA 23 1 0 1 0 100%

NC 168 52 4 48 0 100%

ND 125 29 0 28 1 97%

NE 34 8 2 6 0 100%

NH 350 68 2 62 4 94%

NJ 208 41 4 37 0 100%

NM 144 65 0 55 10 85%

NV 41 9 2 6 1 86%

NY 353 28 13 14 1 93%

OH 682 141 17 118 6 95%

OK 46 3 0 3 0 100%

OR 38 2 0 2 0 100%

PA 319 32 5 24 3 89%

PR 88 24 3 19 2 90%

RI 73 23 4 2 17 11%

SC 180 15 2 13 0 100%

SD 110 49 1 47 1 98%

TN 92 8 4 4 0 100%

Table 8b: Analysis of Alleged Neglect

FY 2016, cont.
86

States Total Complaints Closed Total Neglect Complaints

Neglect complaints 

withdrawn, no merit, 

etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

TX 683 353 169 126 58 68%

UT 87 5 0 5 0 100%

VA 97 40 3 37 0 100%

VI 8 0 0 0 0 n/a

VT 111 31 9 18 4 82%

WA 351 48 0 48 0 100%

WI 91 25 7 15 3 83%

WV 50 17 5 10 2 83%

WY 29 9 0 9 0 100%

Total 9,151 2,046 455 1,415 176 89%

Table 8c – Analysis of Alleged Rights Violations

FY 2015
87

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

AK 32 29 18 11 0 100%

AL 211 70 0 69 1 99%

AR 71 27 14 10 3 77%

AS 40 23 3 20 0 100%

AZ 82 41 6 26 9 74%

CA 921 796 50 727 19 97%

CO 23 9 0 8 1 89%

CT 104 41 8 33 0 100%

DC 105 22 6 13 3 81%

DE 83 49 4 45 0 100%

FL 223 75 13 53 9 85%

GA 112 19 1 18 0 100%

GU 33 24 2 21 1 95%

HI 201 191 37 149 5 97%

IA 74 49 12 37 0 100%

ID 83 57 5 50 2 96%

IL 289 203 27 106 70 60%

IN 133 43 22 18 3 86%

KS 520 439 153 224 62 78%

KY 84 42 11 26 5 84%

LA 59 34 7 23 4 85%

MA 128 64 13 51 0 100%

MD 104 50 5 44 1 98%

ME 234 121 39 72 10 88%

MI 57 21 4 14 3 82%

Table 8c – Analysis of Alleged Rights Violations

FY 2015, cont.
88

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

MN 123 68 7 60 1 98%

MO 334 114 17 90 7 93%

MP 7 5 1 3 1 75%

MS 79 49 3 43 3 93%

MT 278 64 13 38 13 75%

NA 46 41 13 16 12 57%

NC 192 45 0 43 2 96%

ND 109 42 4 38 0 100%

NE 33 7 1 6 0 100%

NH 353 214 1 200 13 94%

NJ 203 62 15 46 1 98%

NM 122 25 3 18 4 82%

NV 35 22 8 12 2 86%

NY 315 201 106 92 3 97%

OH 691 372 39 326 7 98%

OK 417 380 3 376 1 100%

OR 63 43 11 21 11 66%

PA 617 427 67 356 4 99%

PR 88 69 5 56 8 88%

RI 45 33 15 18 0 100%

SC 163 38 9 27 2 93%

SD 124 59 23 34 2 94%

TN 116 68 33 35 0 100%

TX 752 299 86 179 34 84%

UT 178 109 14 91 4 96%

Table 8c – Analysis of Alleged Rights Violations

FY 2015, cont.
89

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

VA 138 22 2 20 0 100%

VI 6 5 2 1 2 33%

VT 86 21 4 16 1 94%

WA 433 242 1 241 0 100%

WI 82 35 5 29 1 97%

WV 62 22 3 18 1 95%

WY 48 11 0 11 0 100%

Total 10,344 5,753 974 4,428 351 93%

Table 8c: Analysis of Alleged Rights Violations

FY 2016
90

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

AK 29 14 4 8 2 80%

AL 181 50 19 24 7 77%

AR 113 76 18 56 2 97%

AS 43 15 1 1 0 100%

AZ 40 14 1 13 0 100%

CA 857 703 56 633 14 98%

CO 30 10 5 5 0 100%

CT 115 32 7 23 2 92%

DC 92 28 10 18 0 100%

DE 64 44 2 42 0 100%

FL 149 59 19 40 0 100%

GA 129 20 0 20 0 100%

GU 24 13 1 12 0 100%

HI 202 194 51 133 10 93%

IA 52 31 12 18 1 95%

ID 232 123 14 108 1 99%

IL 330 234 25 134 75 64%

IN 82 44 10 34 0 100%

KS 404 331 148 160 23 87%

KY 75 49 7 36 6 86%

LA 70 48 13 34 1 97%

MA 107 62 14 48 0 100%

MD 143 87 12 73 2 97%

ME 206 101 43 54 4 93%

MI 43 19 6 10 3 77%

Table 8c: Analysis of Alleged Rights Violations

FY 2016, cont.
91

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

MN 144 84 15 64 5 93%

MO 303 127 26 91 10 90%

MP 10 8 2 4 2 67%

MS 52 33 3 30 0 100%

MT 249 69 8 34 27 56%

NA 23 20 3 14 3 82%

NC 168 59 4 55 0 100%

ND 125 49 2 47 0 100%

NE 34 5 2 1 2 33%

NH 350 215 15 193 7 97%

NJ 208 79 34 45 0 100%

NM 144 42 0 37 5 88%

NV 41 27 9 14 4 78%

NY 353 245 143 92 10 90%

OH 682 397 44 344 9 97%

OK 46 33 0 32 1 97%

OR 38 33 5 28 0 100%

PA 319 230 40 184 6 97%

PR 88 54 15 33 6 85%

RI 73 45 22 2 21 9%

SC 180 23 0 20 3 87%

SD 110 51 12 35 4 90%

TN 92 44 18 26 0 100%

TX 683 251 103 119 29 80%

UT 87 80 15 63 2 97%

Table 8c: Analysis of Alleged Rights Violations

FY 2016, cont.
92

Sates Total Complaints 

Closed

Total Rights 

Complaints Closed

Rights complaints 

withdrawn, no 

merit, etc.

Favorably

Resolved

Favorably Not 

Resolved

Percentage 

Favorably

Resolved

VA 97 15 6 9 0 100%

VI 8 7 4 2 1 67%

VT 111 34 10 22 2 92%

WA 351 212 0 212 0 100%

WI 91 55 8 40 7 85%

WV 50 27 4 21 2 91%

WY 29 4 0 4 0 100%

Total 9,151 5,058 1,070 3,654 321 89%

Table 9: Intervention Strategies

FY 2015
93

States Total Intervention

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigation Technical Assistance Administrative Remedies Negotiation/ Investigations Legal Remedies

AK 32 24 1 0 5 2 0

AL 211 124 50 12 3 8 14

AR 95 74 6 13 0 1 1

AS 46 12 13 2 0 18 1

AZ 82 63 1 11 4 3 0

CA 952 907 14 6 12 9 4

CO 23 5 9 5 3 1 0

CT 104 27 26 15 15 17 4

DC 105 48 34 5 8 10 0

DE 83 33 13 12 15 10 0

FL 223 96 39 45 15 27 1

GA 112 13 35 3 1 58 2

GU 33 9 6 1 1 6 10

HI 201 117 10 21 18 34 1

IA 74 33 16 7 4 9 5

ID 107 43 9 55 0 0 0

IL 396 181 8 110 9 72 16

IN 132 55 60 11 2 1 3

KS 726 283 3 429 1 0 10

KY 145 25 49 24 2 33 12

LA 58 33 9 0 4 9 3

MA 130 78 8 2 0 38 4

MD 104 24 36 28 5 6 5

ME 240 106 10 8 19 85 12

MI 64 11 36 3 4 2 8

Table 9: Intervention Strategies

FY 2015, cont.
94

States Total Intervention

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigation Technical Assistance Administrative Remedies Negotiation/ Investigations Legal Remedies

MN 123 41 5 44 7 19 7

MO 214 13 4 69 9 92 27

MP 6 0 2 0 4 0 0

MS 92 28 16 6 6 26 10

MT 284 127 142 3 5 1 6

NA 47 7 3 18 11 4 4

NC 186 155 0 17 2 10 2

ND 155 47 56 0 0 50 2

NE 15 0 11 0 0 0 4

NH 353 40 0 306 2 3 2

NJ 203 31 111 30 5 20 6

NM 123 66 37 3 9 5 3

NV 36 16 1 18 0 0 1

NY 315 197 12 72 7 26 1

OH 691 570 79 24 6 12 0

OK 417 364 9 2 0 40 2

OR 132 33 9 5 1 17 67

PA 617 223 11 377 1 2 3

PR 67 1 11 1 5 46 3

RI 88 32 6 32 2 14 2

SC 164 11 108 13 1 29 2

SD 124 91 1 3 10 18 1

TN 116 38 38 10 0 30 0

TX 752 327 211 36 38 89 51

UT 172 133 36 0 0 2 1

Table 9: Intervention Strategies

FY 2015, cont.
95

States Total Intervention

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigations Technical Assistance Administrative Remedies Negotiation/ Investigations Legal Remedies

VA 138 61 26 4 10 33 4

VI 11 6 1 2 2 0 0

VT 86 33 35 6 6 1 5

WA 433 1 2 430 0 0 0

WI 86 34 12 6 5 25 4

WV 62 38 0 13 0 11 0

WY 48 17 28 0 0 3 0

Total 10,834 5,205 1,524 2,378 304 1,087 336

Percentages 100% 48% 14% 22% 2.8% 10% 3.1%

Table 9: Intervention Strategies

FY 2016
96

States

Total 

Intervention 

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigation

Technical 

Assistance

Administrative

Remedies

Negotiation/ 

Investigations Legal Remedies

AK 44 14 26 0 0 4 0

AL 181 58 52 41 0 27 3

AR 106 68 6 23 6 0 3

AS 31 3 11 6 0 11 0

AZ 40 31 3 3 1 1 1

CA 1149 817 8 5 11 187 121

CO 60 0 56 0 0 0 4

CT 115 51 15 15 22 12 0

DC 91 35 11 17 1 25 2

DE 64 31 4 12 12 5 0

FL 149 42 33 36 5 31 2

GA 129 26 45 10 0 46 2

GU 24 9 7 0 0 4 4

HI 223 165 8 14 14 22 0

IA 52 17 14 5 1 9 6

ID 223 71 12 132 5 1 2

IL 424 212 1 84 16 91 20

IN 53 35 18 0 0 0 0

KS 404 55 3 310 24 1 11

KY 119 22 34 17 1 34 11

LA 70 34 13 0 2 19 2

MA 107 50 0 0 0 57 0

MD 70 11 48 7 2 0 2

ME 212 77 2 18 16 95 4

MI 46 9 19 4 7 0 7

Table 9: Intervention Strategies

FY 2016, cont.
97

States

Total 

Intervention 

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigation

Technical 

Assistance

Administrative

Remedies

Negotiation/ 

Investigations Legal Remedies

MN 227 61 10 54 6 80 16

MO 282 19 2 93 26 118 24

MP 10 3 4 0 3 0 0

MS 92 23 21 7 10 19 12

MT 261 189 50 2 6 8 6

NA 25 1 2 5 2 14 1

NC 168 145 4 0 1 18 0

ND 201 69 83 0 0 49 0

NE 35 2 32 0 0 1 0

NH 350 37 5 301 0 4 3

NJ 208 56 87 29 7 24 5

NM 190 120 44 1 5 18 2

NV 40 22 1 17 0 0 0

NY 353 197 10 102 11 30 3

OH 633 508 80 15 7 22 1

OK 46 15 2 0 0 29 0

OR 38 26 5 1 3 3 0

PA 324 156 15 124 2 6 21

PR 88 9 27 6 12 25 9

RI 73 20 7 35 1 4 6

SC 180 14 141 7 0 18 0

SD 110 54 4 5 7 37 3

TN 92 21 41 7 2 21 0

TX 682 255 231 33 84 62 17

UT 78 64 5 1 2 4 2

Table 9: Intervention Strategies

FY 2016, cont.
98

States

Total 

Intervention 

Strategies

Short-term 

Assistance

Abuse & Neglect 

Investigation

Technical 

Assistance

Administrative

Remedies

Negotiation/ 

Investigations Legal Remedies

VA 97 29 46 2 6 12 2

VI 18 8 1 5 0 4 0

VT 111 75 29 1 4 0 2

WA 351 346 1 4 0 0 0

WI 86 39 3 16 3 22 3

WV 50 34 0 10 1 5 0

WY 29 8 16 0 1 4 0

Total 9,714 4,568 1,458 1,642 358 1,343 345

Percentages 100% 47% 15% 17% 3.7% 14% 3.6%

Table 10: Non-case Directed Services

FY 2015
99

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of events Total Number of Individuals Impacted 

Number of 

events

Total Number of 

Individuals Impacted 

AK 2 1,000 1 0 0 0 

AL 5 196,107 1 10,000 10 610,721 

AR 13 1,000,000 0 0 6 856,410 

AS 3 300 0 0 0 0 

AZ 1 48 1 11,000 1 2,400 

CA 4 14,100 2 13,000 0 0 

CO 1 1,800 1 150 1 250 

CT 48 11,039 0 0 13 240,663 

DC 13 10,000 1 200 4 10,000 

DE 25 1,200 0 0 1 120 

FL 0 0 3 13,300 16 877,600 

GA 3 1,451,812 2 1,464,012 2 1,456,812 

GU 0 0 0 0 0 0 

HI 1 1,000 1 1,400 1 500 

IA 26 1,134,765 0 0 2 500,000 

ID 2 55 0 0 1 0 

IL 1 701,000 3 52,026 0 0 

IN 14 12,786 1 5,900 1 3,000 

KS 1 464,842 0 0 0 0 

KY 4 874,000 0 0 4 874,000 

LA 11 53,393 2 207,675 8 274,755 

MA 4 1,000 0 0 0 0 

MD 1 4,000 1 1,000 2 250,000 

Table 10: Non-case Directed Services

FY 2015, cont.
100

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of Events Total Number of Individuals Impacted 

Number of 

Events

Total Number of 

Individuals Impacted 

ME 11 16,730 1 0 0 0 

MI 1 39,805 0 0 1 578,015 

MN 4 15,611 0 0 4 43,525 

MO 7 425 1 3,000 0 0 

MP 0 0 0 0 0 0 

MS 2 1,000 2 15,000 0 0 

MT 1 530 1 1,450 1 52,000 

NA 3 22,650 0 0 1 540 

NC 1 6,000 0 0 0 0 

ND 0 0 0 0 0 0 

NE 5 54 0 0 1 45,850 

NH 0 0 1 10,000 3 10,000 

NJ 2 20,000 1 250 0 0 

NM 7 25,420 1 25,420 9 30,000 

NV 1 5,000 0 0 1 10,000 

NY 8 22,650 4 16,995 0 0 

OH 26 297,541 6 260,200 57 609,861 

OK 10 17,280 0 0 2 5,000 

OR 2 7,200 0 0 1 800,000 

PA 1 91,852 1 1,090 0 0 

PR 94 0 0 0 0

RI 8 32,420 0 0 0 0 

SC 3 170,663 1 2,400 1 23,000 

SD 1 11 0 0 0 0 

Table 10: Non-case Directed Services

FY 2015, cont.
101

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of Events Total Number of Individuals Impacted 

Number of 

Events

Total Number of 

Individuals Impacted 

TN 52 555,855 0 0 19 1,202,000 

TX 16 12,000 0 0 4 150,000 

UT 6 10,000 1 50 5 110,000 

VA 1 517 0 0 0 0 

VI 0 0 0 0 0 0 

VT 4 2,700 0 0 1 3,100 

WA 10 13,281 7 4,700 7 41,732 

WI 3 20,000 0 0 2 500,000 

WV 3 33,750 2 81,000 0 0 

WY 5 170 0 0 0 0 

Total 387 7,375,456 50 2,201,218 193 10,171,854 

Table 10: Non-case Directed Services

FY 2016
102

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of events Total Number of Individuals Impacted 

Number of 

events

Total Number of 

Individuals Impacted 

AK 2 3,500 1 68 0 0

AL 31 1,565,181 1 13,000 11 499,344

AR 15 775,900 0 5,000 6 146,634

AS 2 25,000 0 0 0 0

AZ 1 111 1 11,270 1 2,789

CA 3 10,300 1 201 0 0

CO 1 1,800 1 40,000 1 3,000

CT 6 248,000 1 178,000 1 70,055

DC 5 19,000 1 200 4 19,000

DE 1 875 0 0 0 0

FL 0 0 2 13,300 9 561,500

GA 17 7,816,687 1 5,000 5 2,265,658

GU 0 0 0 0 0 0

HI 0 0 1 1,400 1 500

IA 31 1,482,076 0 0 1 57,000

ID 4 18,255 0 0 7 75,000

IL 1 701,000 3 52,026 0 0

IN 1 500 1 647 0 0

KS 1 422,549 0 0 0 0

KY 6 874,000 1 874,000 9 874,000

LA 15 4,312 5 1,250 17 26,975

MA 5 1,500 0 0 0 0

MD 1 3,250 1 1,000 2 250,000

ME 9 20,000 1 5,000 0 0

Table 10: Non-case Directed Services

FY 2016, cont.
103

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of Events Total Number of Individuals Impacted

Number of 

Events

Total Number of 

Individuals Impacted

MI 7 228,138 1 7 11 897,152

MN 3 11,900 1 500 5 54,190

MO 6 520 1 3,000 0 0

MP 0 0 0 0 0 0

MS 3 1,150 2 150 1 10,000

MT 2 5,000 0 0 2 52,000

NA 1 22,500 1 9,000 2 25,000

NC 1 6,000 0 0 0 0

ND 0 0 0 0 0 0

NE 54 0 0 0 3 43,792

NH 0 0 1 0 2 0

NJ 2 320,000 0 0 0 0

NM 4 150,982 0 0 2 1,500

NV 1 1,000 0 0 1 1,000

NY 33 259,747 7 15,070 0 0

OH 45 565,177 2 15,000 47 1,781,054

OK 4 3,351 0 0 2 5,000

OR 1 7,860 0 0 1 145,000

PA 9 88,978 2 1,890 4 800

PR 1 2,893 0 0 1 337

RI 4 8,800 0 0 1 8,800

SC 3 170,550 1 2,400 0 0

SD 1 822 0 0 0 0

TN 45 607,380 0 0 21 2,285,045

Table 10: Non-case Directed Services

FY 2016, cont.
104

States

Non-Litigation Advocacy Class Action Litigation Legislative & Regulatory Advocacy

Number of Events Total Number of 

Individuals Impacted Number of Events Total Number of Individuals Impacted

Number of 

Events

Total Number of 

Individuals Impacted

TX 14 10,000 1 0 6 200,000

UT 3 32 3 540 5 35

VA 1 1,460 1 75 0 0

VI 1 20,600 0 0 0 0

VT 4 2,700 0 0 1 350

WA 10 102,906 11 40,894 9 39,669

WI 8 119,000 0 0 6 118,000

WV 2 0 2 83,000 2 1

WY 4 144 0 0 0 0

Total 435 16,713,386 60 1,372,888 210 10,520,180

Table 11: Information andReferral/Public Education/Awareness & Training Activities

FY 2015
105

States

Number 

of Information and 

Referral Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Total Number of 

Individuals Trained

Number of Individuals

Receiving Public Awareness 

Information

AK 487 4 1 12 204

AL 547 6 36 1489 110

AR 238 11 15 331 3626

AS 24 4 3 860 860

AZ 88 13 15 731 1840

CA 72 238 104 2,444 14,255

CO 488 1 19 900 75

CT 203 3 16 975 200

DC 21 50 56 1157 2112

DE 84 10 27 657 1824

FL 1,840 53 10 635 54,169

GA 443 7 57 3,275 5,300

GU 37 29 19 1,634 1,841

HI 658 202 49 5,169 4,592

IA 195 29 29 1078 1380

ID 115 14 28 700 658

IL 806 77 228 13683 10103

IN 651 79 31 257 10795

KS 56 90 26 1,660 1,893

KY 877 6 29 973 2,541

LA 603 30 12 349 4,189

MA 55 4 8 457 6880

MD 278 3 50 1,304 500

ME 592 73 283 4322 1758

MI 2,411 12 27 743 1,125

Table 11: Information andReferral/Public Education/Awareness & Training Activities

FY 2015, cont.
106

States

Number 

of Information and 

Referral Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Total Number of 

Individuals Trained

Number of Individuals

Receiving Public Awareness

Information

MN 191 14 47 2,298 2,745

MO 752 30 9 239 8426

MP 226 193 4 263 3135

MS 161 19 74 1945 4575

MT 200 7 2 55 665

NA 19 1 7 553 50

NC 4006 17 10 318 300

ND 283 29 7 350 2646

NE 214 100 12 521 1585

NH 400 23 13 537 100000

NJ 844 42 28 1001 12271

NM 454 48 52 682 589

NV 648 15 10 147 1717

NY 621 11 21 669 657

OH 529 38 49 1,737 1,460

OK 496 26 18 912 5,234

OR 443 11 6 192 378

PA 198 15 25 735 1,275

PR 1,309 120 60 1,245 4,652

RI 227 5 9 529 4,365

SC 630 18 24 732 2,940

SD 483 153 19 807 2,869

TN 656 221 23 1,128 1,354,334

TX 1,205 22 179 14,465 1,780

UT 415 12 10 394 6,705

Table 11: Information andReferral/Public Education/Awareness & Training Activities

FY 2015, cont.
107

States

Number 

of Information and 

Referral Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Total Number of 

Individuals Trained

Number of Individuals

Receiving Public Awareness 

Information

VA 1078 12 58 1243 1243

VI 5 12 4 120 766

VT 824 5 46 662 350

WA 7,963 3 28 1,442 1,163

WI 562 2 5 100 450

WV 161 27 9 165 1538

WY 99 20 2 27 13,926

Total 38,171 2,319 2,048 82,008 1,677,619

Table 11: Information and Referral/Public Education/Awareness & Training Activities

FY 2016
108

States

Number 

of Information and Referral

Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Number of 

Individuals Trained

Number of Individuals

Receiving Public Awareness 

Information

AK 328 2 2 20 100

AL 566 3 24 994 160

AR 286 24 10 353 1,750

AS 68 3 5 1500 4,500

AZ 124 21 28 666 2,517

CA 53 150 87 87 22,396

CO 700 2 5 144 1,000

CT 326 17 8 226 4,212

DC 258 34 91 1,577 2,810

DE 100 9 35 840 4,439

FL 2,191 89 22 1,475 13,801

GA 490 4 44 2,325 3,690

GU 42 54 17 1,459 2,351

HI 859 173 46 615 1,951

IA 332 8 26 780 388

ID 256 11 14 532 745

IL 645 47 88 4,013 5,810

IN 532 74 7 180 3,085

KS 27 45 23 707 2,430

KY 851 8 95 1,248 3,359

LA 464 34 9 152 3,305

MA 65 8 11 877 6,000

MD 303 1 1 110 500

ME 757 124 160 3,920 4,014

MI 2,318 15 22 434 1,013

MN 410 15 35 1,152 4,760

Table 11: Information and Referral/Public Education/Awareness & Training Activities

FY 2016, cont.
109

States

Number 

of Information and Referral 

Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Number of 

Individual Trained

Number of Individuals

Receiving Public Awareness 

Information

MO 775 20 9 395 6,800

MP 298 60 60 4,197 4,197

MS 144 16 49 1,138 3,000

MT 197 10 5 297 2,313

NA 17 3 1 200 2,000

NC 2,061 1 10 525 30

ND 356 13 19 354 2,750

NE 242 41 19 745 2,318

NH 345 0 21 538 0

NJ 749 39 34 1,204 11,514

NM 428 15 52 1,400 525

NV 480 14 5 95 918

NY 623 8 34 2,014 1,337

OH 505 51 38 1,668 4,023

OK 280 10 38 2,242 1,735

OR 711 0 4 231 0

PA 431 11 21 816 1,032

PR 1,435 23 88 1,779 1,114

RI 257 9 5 138 8,526

SC 683 17 26 749 4,190

SD 328 86 25 659 2,444

TN 462 188 16 1,041 1,611,042

TX 1,234 22 150 6,820 1,838

UT 545 10 11 521 257

VA 251 37 11 499 499

VI 9 21 6 39 2,128,534

Table 11: Information and Referral/Public Education/Awareness & Training Activities

FY 2016, cont.
110

States

Number 

of Information and Referral 

Requests

Number of 

Public Awareness 

Events

Number of 

Education/Training 

Activities 

Undertaken

Number of 

Individuals Trained

Number of Individuals

Receiving Public Awareness

Information

VT 856 13 54 491 400

WA 11,310 4 49 1,675 51,089

WI 543 26 14 460 2,141

WV 220 22 21 223 10,597

WY 126 13 3 0 227

Total 40,252 1,778 1,813 58,189 3,968,476
111

ACRONYMS

ACF Administration for Children and Families

ADD Administration on Developmental Disabilities

AIDD Administration on Intellectual and Developmental Disabilities

CAU Crisis and Admissions Unit

CHA Children’s Health Act 

CMHS Center for Mental Health Services

CYFD Children, Youth & Families Department

DD Act Developmental Disabilities Assistance and Bill of Rights Act 

DMHA Department of Mental Health and Addictions

DOC Department of Corrections

DOL Department of Licensing

FY Fiscal Year

HHS Department of Health and Human Services

IAA Interagency agreement

ICU Intensive care unit

IMD Institution for mental disease

LCH Larue D. Carter Hospital

MOU Memorandum of Understanding

MSH Minnesota Security Hospital

NDSH North Dakota State Hospital

OIG Office of Inspector General

P&A Protection and Advocacy systems

PAC PAIMI Advisory Council

PADD Protection and Advocacy for Developmental Disabilities Program 

PAIMI Protection and Advocacy for Individuals with Mental Illness

PIW Psychiatric Institute of Washington

PPR Program Performance Report

RSA Rehabilitation Services Administration

RTC Residential treatment center

SAMHSA Substance Abuse and Mental Health Services Administration

TASC Training Advocacy and Support Center

T/TA Training and technical assistance

UNMPC University of New Mexico Psychiatric Center

VOCAL Virginia Organization of Consumers Asserting Leadership

WORK Working Opportunities Reward Kansas

WSH Wyoming State Hospital