Protection and Advocacy for Individuals with Mental Illness (PAIMI)

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) program is a federally-funded service for individuals with a diagnosis of mental illness who reside in some type of residential program, or who have recently been discharged from a residential program. In New York State, the Commission on Quality of Care is the designated protection and advocacy system. The Commission contracts with regional legal service providers to assist with the program mandate: to investigate allegations of abuse and neglect of individuals with mental illness and to assist individuals with mental illness by providing both legal and non-legal advocacy assistance. The priorities of the PAIMI program are: protection of individual rights; access to appropriate care and treatment; and access to health care, insurance, and rights under managed care. Each of these priorities contains several more specific objectives for case work.

These priorities and their related objectives have been developed to include ALL individuals, both children and adults, who meet the eligibility requirements for the federal Protection and Advocacy for Individuals with Mental Illness Act. Specifically defined "underserved populations," such as members of minority groups, residents of specific facilities, and individuals of certain age groups may receive preference based upon regional need, to be determined by PAIMI regional offices which are under contract with the NYS Commission on Quality of Care. PAIMI regional offices will consult with current and former recipients of mental health services, their family members, service providers, other advocates, and knowledgeable members of local communities when deciding to give preference to such "underserved populations."

These priorities and objectives may be achieved through individual case advocacy, group advocacy, litigation, legislative or other systemic advocacy, technical assistance, and/or constituency training - or any combination thereof. The priorities and objectives are not listed in any order which assigns more importance to any particular issue.

Objective 1: To protect PAIMI-eligible individuals from harm through the investigation of and advocacy regarding complaints of abuse and neglect.

Objective 2: To protect PAIMI-eligible individuals from financial exploitation.

Objective 3: To protect PAIMI-eligible individuals from illegal evictions, discriminatory housing practices, and abuse, neglect, and rights violations in residential programs.

Objective 4: To assist PAIMI-eligible individuals in asserting and enforcing their rights under the New York and United States Constitutions as well as their rights under all state and federal laws.

Objective 5: To assist PAIMI-eligible individuals in obtaining all entitlement benefits for which they are eligible.

Objective 6: To assist PAIMI-eligible individuals to assert and protect their rights as parents.

Objective 7: To assist PAIMI-eligible individuals to identify and challenge discriminatory practices which affect them as persons with psychiatric or other disabilities.

Objective 8: To assist PAIMI-eligible individuals in asserting and enforcing their right to a free and appropriate education, as well as their rights to rehabilitation and/or vocational programming.

Objective 9: To assist PAIMI-eligible individuals in asserting, enforcing, and defending their rights in guardianship, conservatorship, and committeeship proceedings as well as to ensure that individuals who are subject to civil commitment procedures meet the criteria established under Mental Hygiene Law and that these individuals have meaningful opportunities to challenge their hospitalizations.

Objective 1: To assist PAIMI-eligible individuals in obtaining access to the care and treatment services which they seek. To assure that these individuals are aware of their right to make informed decisions regarding their care and treatment.

Objective 2: To assure that PAIMI-eligible individuals are provided with evaluation and treatment modalities in a language or communication form which is understandable to them as well as to assure that PAIMI-eligible individuals receive treatment which is culturally competent and respectful of each person’s values and experiences.

Objective 3: To assure that PAIMI-eligible individuals’ rights are respected with regard to choice of treatment modalities and support services, and that they have participated in and agreed to the plan of treatment as well as the choice of an appropriate and specific discharge plan, with each plan being developed according to the needs and values of the individual being treated or discharged. In the case of minors (individuals 21 years of age or under) the plan must also be relevaant to the educational needs of the individual.

Objective 4: To assure that PAIMI-eligible individuals are provided with treatment in the least restrictive environment available, and relatedly to ensure that individuals who reside in inpatient settings have access to fresh air and exercise on a regular basis.

Objective 1: To assist PAIMI-eligible individuals in obtaining adequate and appropriate health insurance and health care and to have a choice of services, if applicable.

Objective 2: To provide assistance to PAIMI-eligible individuals who are experiencing difficulties in obtaining services or eligible benefits from a managed care organization, a special needs plan, or from an insurer.

Objective 3: To provide assistance to PAIMI-eligible individuals who are experiencing discriminatory practices in obtaining insurance coverage.

Objective 1: In the case of an individual who contacts the PAIMI system demonstrating an extreme need and who does not fall within the above defined priorities and objectives, that individual may obtain service from the PAIMI system provided s/he is eligible under federal law. In the rare event services are provided under this priority and objective, the agency will notify the Commission on Quality of Care in the next monthly report.

Each year, staff from the Commission, PAIMI regional offices, and members of the PAIMI Advisory Council review the program’s priorities and objectives and each year a report is developed assessing how well the program met its defined priorities and objectives. The report for the last federal fiscal year will be published in the summer of 2000. In order to better evaluate the services provided by the PAIMI program, feedback from constituency groups and stakeholders is sought. This year, Commission and PAIMI staff, with members of the program’s Advisory Council, hope to meet with several groups of knowledgeable individuals in order to invite this feedback.

Constituency groups include former and current recipients of mental health services, family members, advocates, and providers of mental health services. We hope that you will attend a meeting at your convenience to offer your opinions and speak about your needs. We are especially interested in your comments on the PAIMI priorities and objectives and the related case summaries of last year’s work, but we want to hear whatever you want to tell us.

If you would like to receive a copy of the published report on the PAIMI priorities and objectives prior to attending the public comment meeting, please contact Sylvia Wheeless by calling 518-381-7098 (collect calls are accepted) or by e-mail to sylviaw@cqc.state.ny.us.